May
19

FDA Panel Recommends First Drug For HIV Prevention

 The US FDA has strongly backed approval of the first-ever drug for the prevention of sexually acquired HIV-1 infection. The panel recommended approval of a supplemental indication for Truvada (emtricitabine/tenofovir disoproxil fumarate) for preexposure prophylaxis (PrEP) in:

  • HIV-uninfected men who have sex with men,
  • HIV-uninfected partners in serodiscordant couples, and
  • Other individuals (such as sex workers) who are at risk of acquiring HIV through sexual activity.

However, there is concern that healthy people taking Truvada for HIV prevention will be harmed if they become infected with HIV and do not change from single-drug PrEP prophylaxis to a 3-drug combination antiretroviral treatment regimen, that continuing single-drug Truvada after HIV infection will lead to development of Truvada-resistant viral strains, and that taking the PrEP regimen increases the risk for adverse effects, particularly kidney damage.

Men who have sex with men (MSM) represent 2% of the population older than 13 years and account for from 56% to 61% of new HIV infections annually.

Data from the Preexposure Prophylaxis Initiative (iPrEx) trial found that MSM participants who took Truvada daily had a 44% reduction in HIV incidence over the course of 1.2 years of follow-up compared with placebo. Results of the iPrEx study were published online November 23, 2010, in the New England Journal of Medicine.

Truvada is already being seen as a “medical condom” (in the words of AIDS Healthcare Foundation’s Whitney Engeran-Cordova) and might be taken intermittently or as a “party drug,” leading to rapid development of Truvada-resistant HIV.

May
19

Sumatriptan-Naproxen Combo Effective For Adolescent Migraine

In a randomized, double-blind trial, more adolescents with acute migraine became pain-free within two hours if they received a combination of sumatriptan and naproxen sodium instead of placebo. The study, reported online May 14 in Pediatrics, “constitutes the first large-scale, placebo-controlled evidence for acute relief of adolescent migraine pain and associated symptoms with an oral medication,” the authors state. (Source: Medscape)

May
19

High FIO2 Harms Therapeutically Cooled Neonates

In neonates treated with therapeutic cooling for hypoxic ischemic encephalopathy, a higher fraction of inspired oxygen (FIO2) was significantly associated with adverse outcomes in a study from theUK. Dr. Hemmen Sabir, who led the study, told Reuters Health by email, “It has long been known that breathing a high proportion of oxygen is damaging to the newborn brain. Cooling is protective for term babies in poor condition at birth. We now found that breathing a high proportion of oxygen remains damaging to the newborn brain, despite being cooled.” “Our study underlines that you should keep the oxygen concentration as low as possible in cooled newborns,” he added. His report was published online April 18th in the Journal of Pediatrics. (Source: Medscape)

May
19

Child Mortality Rate Lowered By Early Prenatal Micronutrients

Early multiple micronutrient supplementation (MMS) along with early food supplementation for pregnant women improved infant survival compared with standard iron, folic acid, and food supplementation, according to a randomized controlled trial published in the May 16 issue of JAMA. Lars Ake Persson, MD, PhD, fromUppsalaUniversityinSweden, and colleagues conducted a randomized clinical trial involving 4436 pregnant women recruited between November 2001 and October 2003 and followed-up through June 23, 2009. The researchers randomly assigned the women to 1 of 6 groups: first to 2 treatment groups of early vs later food supplementation, then to 3 different levels of micronutrient supplementation (30 mg of iron and 400 μg of folic acid, 60 mg of iron and 400 μg of folic acid, and 15 micronutrients). The primary outcome measures were hemoglobin level at 30 weeks’ gestation, birth weight, and infant mortality. “Although the 2 treatment groups affected maternal hemoglobin level only marginally and did not affect birth weight, pregnant women who received multiple micronutrients combined with an early invitation to food supplementation substantially improved survival of their offspring,” the researchers write. (Source: Medscape)

May
18

Centre To Double Medical Seats By 2021

The Centre is planning to double the number of medical seats in undergraduate and postgraduate courses to achieve a target of 80,000 MBBS and 45,000 PG seats by 2021, health ministry officials said. The officials said the plan has been mooted to ensure a doctor-patient ratio of 1:1,000 against the current fraction of 1:2,000.The ministry of health and family welfare is targeting additional 38,431 seats in the MBBS and 22,806 seats in the PG streams by 2021, representing a rise of 92.45 per cent and 102.75 per cent respectively. The target is 80,000 MBBS seats and 45,000 PG seats by 2021, the officials said at the meeting of Parliamentary Consultative Committee on health chaired by health minister Ghulam Nabi Azad here on Monday. The meeting was called to discuss the scenario of medical infrastructure. At present, there are 41,569 MBBS seats in the 335 medical colleges acrossIndiaand 22,194 PG seats. However, most of these seats and medical colleges are concentrated in the southern and western states with the central Indian states of Madhya Pradesh and Chhattisgarh barely getting any share in medical infrastructure. Ministry’s latest data shows that 66 per cent of the 335 medical colleges and 69 per cent of the current MBBS seats are located at present in the Southern and Western states, including Kerala, Karnataka, Andhra Pradesh, Tamil Nadu, Maharashtra, Gujarat, Rajasthan andGoa. Eastern India, comprising Bihar andWest Bengal, which feature among the five most populous states, have 10 per cent just 9 per cent MBBS seats. (Source:DeccanChronicle, May 15, 2012)

May
18

Guidance For Young People With Wolff-Parkinson-White Syndrome

Guidance For Young People With Wolff-Parkinson-White Syndrome

A “first-of-its-kind” consensus statement on the management of asymptomatic patients with Wolff-Parkinson-White (WPW) syndrome should help clarify which young people should undergo catheter ablation, authors of the document say. “While it is a small chance that an asymptomatic young person could end up having a life-threatening heart event, the number is not zero,” lead author on the statement, Dr Mitchell I Cohen (Phoenix Children’s Hospital, AZ), said in a press statement. “Yet, catheter ablation for every child who has ever had a WPW pattern is also not the answer.” Cohen and colleagues released the statement last Friday at the Heart Rhythm Society (HRS) 2012 Scientific Sessions. The guidance is explicitly directed at physicians treating young patients with WPW and defines young people as between eight and 21. At the crux of the document is the question of just when physicians should intervene — and when they shouldn’t — in young people found, on ECGs, to have the signature electrocardiographic WPW pattern. These are increasingly important questions, given increased emphasis on preparticipation screening for sports in young people. (Source: Medscape)

May
18

Weight-Control Diet For Mom Builds A Better Baby

A healthy, calorie-controlled diet to reduce excess weight gain during pregnancy is not only safe for mother and baby but also can improve pregnancy outcomes compared with exercise alone or a combination of the two, a meta-analysis showed. The analysis of randomized trials conducted among more than 7,000 women showed that a calorie-restricted healthy diet limited gestational weight gain by a mean difference of -3.84 kg, or about 8.4 lbs. (95% CI 11.5 lbs. to 5.4 lbs., P<0.001) compared with other interventions, and improved pregnancy outcomes for mother and baby, the researchers wrote online in BMJ. (Source: Medpage Today)

May
18

Hypothalamic Involvement Affects Childhood Craniopharyngioma

Regardless of how childhood craniopharyngioma is treated, initial hypothalamic involvement resulting from surgical lesions is the major risk factor for impaired prognosis and quality of life (QoL), according to a new study. Hermann Müller, MD, from the Klinikum Oldenburg, in Germany, and colleagues presented their findings here at the Joint 15th International Congress of Endocrinology and 14th European Congress of Endocrinology. According to the researchers, hypothalamic obesity has a major impact on prognosis and QoL in childhood craniopharyngioma; however, the effects of initial hypothalamic involvement, compared with treatment-related hypothalamic lesions, remain unclear. (Source: Medscape)

 

May
17

Love, Affection Of Distant Kin Good Enough For Donation Of Organs: HC

 In what could script new rules for organ donation between distant relatives, the Delhi High Court on Tuesday said that love and affection between the donor and recipient held top priority in such cases and a request could not be turned down simply because a family member had not stepped forward. Justice Vipin Sanghi made these observations while adjudicating a petition by Parveen Begum who was in dire need of a kidney. The Sir Ganga Ram Hospital’s authorisation committee had turned down her request to receive the organ from her niece. Her case was first reported by Newsline on April 24 when her family moved court against the hospital’s decision. Justice Sanghi said that a hospital’s authorisation committee, which examines cases of organ donation between distant relatives, could reject such a request only when there is ground to apprehend that the donation involved commercial transaction. “Merely because in a given case, a near relative may not be willing to donate his or her organ/tissue to the recipient, it is not ground to either raise suspicion of a commercial transaction, or to reject the case altogether. It is not the mandate of the authorisation committee to compel or drive the near relative of the recipient to donate their organ/tissue to the recipient,” he said.

Justice Sanghi opted to interpret the term “payment” under the Transplantation of Human Organ and Tissues Act and noted that this would not cover a monetary transaction between a donor and recipient in the past when such a transplant was not required. “It refers to a monetary payment made by a donor on his or her behalf to a recipient as consideration for the donation of an organ. It does not refer to a contribution, gift or monetary support made or granted gratuitously in the past, when even the need for organ transplant was not in existence. The test is, whether the said payment would not have been made but for the donor agreeing to donate his or her organ,” he said. Justice Sanghi noted that financial disparity between the donor and the recipient will also not come in the way of such donations unless the committee has something material on record indicating involvement of commercial elements. Going a step further, he said that a sense of love, affection and gratitude, once established, provided the impetus to donate one’s organ, and any financial help by the recipient’s family in future could not lead to a conclusion that a monetary deal was struck between them at the time of the donation.  (Source: The Indian Express, May 16 2012)

May
17

Third MMR Dose Well-Tolerated During Mumps Outbreak

Adverse event rates for third-dose measles, mumps, rubella (MMR) vaccines were similar or lower than comparable rates seen in previous second-dose MMR vaccine research, according to results from a study presented here at the National Foundation for Infectious Diseases 15th Annual Conference on Vaccine Research. “These findings suggest that a third dose of MMR vaccine administered in a school campaign as an outbreak intervention is safe, compared with first or second doses of MMR,” said lead investigator Glen Abedi, BS, an epidemiologist at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. The findings come from the first documented study to look specifically at adverse events related to a third dose of MMR vaccine, he added. (Source: Medscape)

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