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Old antibiotic compounds would be life-saving drugs

To combat  drug-resistant infections, scientists are scouring chemical compounds that were previously discarded to identify the ones that could be transformed into new antibiotics. In the mid-20th century, many different chemical compounds were examined to determine the ones that had antibacterial properties; however, only a small proportion of compounds was used for drug development.

In modern times, diseases have become highly resistant to existing drugs. At the University of Leeds, these old compounds are being re-examined by biologists and chemists by using advancements in science and technology. These compounds are being tested very precisely to determine if they could be developed into a drug in the near future.

Presently, more than 3,000 antibiotics have been discovered till date. Nevertheless, only a handful of compounds have been prescribed clinically till date. There may be several compounds with untapped potential.

Life-saving drugs may be produced by identifying compounds that have anti-bacterial properties; these compounds might have not been used in clinical practice earlier. With the mutation of bugs, scientists are clueless about tackling them with existing batches of antibiotics.

Potential new drug

According to latest research studies, a compound identified in 1940s was a realistic contender as a new antibiotic drug. Actinorhodins (ACT) constitute a family of compounds with some antibiotic properties; however, these compounds were not developed into life-saving drugs previously.

A promising new drug has been developed to combat bacterial infections.  Antibacterial activity was exhibited by two most important representatives of ESKAPE category of bacteria, which have the ability to ‘escape’ the action of existing drugs.

New drugs should be discovered and developed to tackle antibiotic resistance. Potentially useful drugs were identified from antibiotics, which were already to people.  The group of drugs belonging to ACT family showed weak antibiotic activity, so they could not be evaluated previously.

To discover new drugs, one needs to identify chemical compounds that were shelved out previously. New antibiotics have not been discovered in the past 25 years. Current strategy of considering chemical compounds that were shelved off previously is a nice way of combating the growing strain of drug-resistant bacteria.

 

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International Conference on Public Health in East Asia

Harrisco announces first international conference on past, present, and future of public health in east Asia. The role of public health is now very significant today as most people die today due to chronic ailments and accidents. In the past, most people died due to infectious diseases and nutritional ailments.

Date: February 22, 2018

Venue:  Ramada Plaza, Jeju Hotel, Jeju Island, South Korea

Website: http://www.ivnforum.org/

Public health implies a concept that aims at maintaining the well-being of a society, given the sophisticated segregation and morphology.  The community is the smallest unit of public health, and the fundamental unit of a community are local residents.

The purpose of public health is as follows:

  • Prevention of disease
  • Life-span extension
  • Improvement in the efficiency of physical and mental health

In East Asia, pandemic such as Severe Acute Respiratory Syndrome (SARS) in 2003 and Middle-Eastern Respiratory Syndrome Coronovirus (MERS-CoV) in 2015 could not be solved by a single country; therefore, our conference emphasizes on solving such problems.

The topics of the conference are as follows:

A. Hygiene History
B. Hygiene, sanitation
C. Health administration
D. Community health
E. Health Communication
F. Environmental Health
G. Health Education
H. Occupational Health
I. Medical Service
J. National Health Insurance
K. Health Literacy

In this international conference, papers will be presented on these topics. After a fair review, the selected papers would be published in Iranian Journal of Public Health, which is indexed (SSCI) journal.

Speakers from Konkuk University and Korea University are going to present research papers on public health at this conference.  The first session consists of lectures on public health and medicines in rural China, Japan, and Korea. Second session analyzes the impact of health following untold disasters in factories and industries. Academic papers presented would analyze following topics: Sewol Ferry Disaster, Cigarette smoking, MERS-CoV outbreak, Social Anxiety disorder, aging, obese and elderly population.

Third session would include papers on following topics: educational policies of martial arts and health, cultural and social aspects of drinking, oral health knowledge, and mental illness. Fourth session would include papers on following topics: daily sports participation, plyometric training of women, physical activity restriction of cancer patients, and TAS inflammatory factors and exercise.

 

 

 

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A new inclusive treatment guideline for stroke patients

American Heart Association/American Stroke Association has issued a new guideline for treating blood clots that cause strokes. As per this new treatment guideline, more patients would be eligible for receiving critical care and treatments.

The novel guideline was based on the most recent research study, and it was published in the journal Stroke. This novel guideline was presented at the International Stroke Conference 2018. This is an annual conference that invites globally renowned researchers and clinicians who are specialized in treating stroke.

According to this new recommendation, the window of time could be increased for selected patients provided blood clots can be mechanically removed from blood vessels that supply human brain. If blood clots block large blood vessels, then these clots can be removed mechanically.

According to this guideline, mechanical thrombectomy can be safely performed on large vessel strokes if patients receive treatment within 16 hours after a stroke. With advanced brain imaging, mechanical thrombectomy can be performed on some stroke patients even after 24 hours. The previous time-limit was six hours.

Mechanical thrombectomy is a procedure in which a physician places a device within a catheter, which is a thin tube threaded within an artery. The clot is then grabbed and removed with the device. The procedure is more effective as the risk of disability is limited. In particular, it is very useful to treat blockages in larger vessels, which lead to human brain.

The risk of disability from stroke would be minimized in most patients as the time-window is expanded for mechanical thrombectomy in appropriate patients Many people would benefit from this new treatment guideline, and the purview of acute stroke treatment has changed completely. Hospitals have now upgraded their rigorous standards for performing mechanical endovascular thrombectomy.

Alteplase is a clot-busting IV drug, which works as a tissue plasminogen activator (tPA). It is the only drug that is approved by FDA for treating clots caused by ischemic stroke. In previous studies, clot-busting treatment was not performed on patients with mild strokes, but the new treatment guideline suggests that these patients could be included in this new line of treatment.

According to this guideline, the risk and benefits depend on individual patients because if this new treatment modality is administered promptly and correctly, disability caused by the drug can be decreased. The number of people receiving intravenous treatment for clot busting increases consequently.

Whenever a patient shows signs of a stroke, the most important measure in saving the person’s life would be a treatment modality with immediate action. The risk of disability can be minimized in stroke patients if they receive treatment as soon as possible.

Stroke is one of the leading causes of death all over the world. Moreover, it is also a leading cause of disability in patients. Acute ischemic stroke is the most common type of stroke as per new guidelines.

Such kind of stroke is caused whenever a blood clot blocks the artery that supplies blood to the brain, reducing blood flow. In the USA, a person suffers from stroke every 40 seconds and more than 133,000 people in the USA die of stroke each year. Of all the cases of stroke, more than 87% patients suffer from ischemic stroke.

The guideline was published after performing a systematic review of more than 400 research studies, which were published in peer-reviewed journals. A group of highly specialized experts in stroke treatment formulated these guidelines after carefully examining these studies. These are the most comprehensive guidelines for ischemic stroke treatment since 2013.

 

 

 

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A month long standoff ends between Elsevier and South Korean universities

ScienceDirect is a database of more than 3500 academic journals and books, which is published by world’s no.1 academic publisher Elsevier. The publisher Elsevier is headquartered in Amsterdam, Netherlands. For more than a month, South Korean universities were opposing a steep price rise proposed by Elsevier.

Initially, Elsevier had proposed a price hike of 4.5%, which was severely opposed by a consortium of top South Korean universities. On January 12, 2018, a settlement was finally achieved between South Korean universities and Elsevier.

South Korean universities have agreed to a price rise of about 3.5–3.9%.  In the initial proposal, Elsevier was compelling South Korean universities to compulsorily prescribe to its lesser known journals, as part of their ScienceDirect package deal. In future, South Korean universities would negotiate further for more concessions.

According to Lee Chang Won, secretary general of the Korea University & College Library Association, Elsevier currently provides a flat rate system. Therefore, universities have to pay for digital content of all journals, including the ones that are read least by viewers.

Lee Chang Won led the consortium of South Korean universities along with Korean Council for University Education (KCUE). Previously, South Korean universities accepted whatever rate increase was imposed by Elsevier, but they can no longer do the same due to budget cuts in library expenditure.

The consortium of 300 university and college libraries was formed in May 2017 by negotiating with 42 providers of databases. This group sought concessions on open-access journals and other less-read journals, which were included in the ScienceDirect package of Elsevier.

When Elsevier authorities refused to oblige, the consortium boycotted Elsevier and refused to renew contracts. During the period of negotiations, Elsevier provided access to all its products. Following negotiations, individual universities will now have to renew their one-year license at 3.9%; moreover, their three-year contract would be increased by 3.5%, 3.6%, and 3.7% above the baseline. These terms and conditions have been agreed by the consortium of universities in South Korea.

For 2019 contracts, negotiations would continue about pricing and other details between the consortium of South Korean universities and Elsevier, the publisher. According to Sogang’s Kim, the consortium is keen on signing a multi-year contract with Elsevier, wherein the annual increase of fees would be in the range 3.5–3.9%. This annual rate of increase in subscription fees is well above the international level of 2%. ScienceDirect journals are expensive but indispensable for academicians, rights from professors to post-doc scholars.

The month-long standoff between South Korean universities and Elsevier is akin to similar dispute between the consortium of German universities and Elsevier in 2017. At that point of time, electronic journals of Elsevier were not accessible to more than 60 universities in Germany as Elsevier had temporarily suspended access; however, the publisher restored access few weeks later though negotiations are still going on between consortium of German universities and Elsevier. Meanwhile, more than 200 universities in Germany have ceased their contract with Elsevier.

 

 

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New methods approved by FDA for treating digestive tract cancers

The drug Lutathera (lutetium Lu 177 dotatate) was approved by US FDA for treating  neuroendocrine tumors that originate in the gastrointestinal tract and pancreas (GEP-NETs). This is an important breakthrough as it is the first radioactive drug to have been approved by the FDA. It is now a novel treatment for GEP-NETs.

Lutathera drug was found to be quite effective in treating adult patients with GEP-NETs. The treatment options for GEP-NETs were limited as it is a rare type of cancer and the conventional therapy was not successful in preventing the proliferation of this cancer. With US FDA approving the drug Lutathera, it is a ray of hope for patients diagnosed with these rare type of cancer.

It also establishes that US FDA is now open to considering data from alternative therapies, which can provide hope to patients with this rare type of cancer. GEP-NETs develop not only in the pancreas but also in different parts of the digestive system, such as stomach, colon, intestine, and rectum.

Statistical data suggests that the diagnosis of GEP-NETs has been low each year. Only one out of 27,000 people develop this cancer in the United States of America. Lutathera is a radiopharmaceutical drug. It exerts its therapeutic activity by clinging to the somatostatin receptor, which is a component of cell and is present in certain types of tumors.

After clinging to  the receptor, the drug gets into the cell and exudes radiation to damage cancerous activity. The drug Lutathera was approved by two research studies: a randomized clinical trial was conducted on 229 patients, who were diagnosed with a certain type of advanced GEP-NET. These patients elicited a positive response to the drug.

In this clinical trial, a combination of Lutathera and octreotide drug was administered to some patients, while the remaining patients only received   octreotide drug. After providing treatment to patients, researchers measured the period of time for which tumors did not show any signs of grow or development. This period was defined as progression-free survival of patients.

Patients who consumed a combination of Lutathera and octreotide drugs had a longer period of progression-free survival as compared to patients who only consumed the drug octreotide. Moreover, the possibility of the growth of tumors or death was lower in patients who received both the drugs: Lutathera and octreotide .

The second research study was performed on 1,214 patients in Netherlands. These patients were diagnosed with tumors showing positive response to somatostatins, including GEP-NETS. The drug Lutathera was administered at a single site in these patients.

In a clinical trial that included 360 patients with GEP-NETs, it was found that tumors  either shrunk completely or partially in about 16 percent of included patients . These patients also received the drug Lutathera initially, and their responses were monitored by the US FDA.

The drug Lutathera has following side-effects: the white blood cells decrease sharply in patients (lymphopenia); the levels of enzymes become high in certain organs (increased GGT, AST and/or ALT); some patients may develop nausea and vomiting; there could be a sudden spike in blood sugar levels (hyperglycemia), and the levels of potassium become low in the blood (hypokalemia).

The drug Lutathera has following serious side-effects: blood cells may decrease sharply in numbers (myelosuppression); certain types of blood or bone marrow cancers may develop in patients(secondary myelodysplastic syndrome and leukemia);  some patients may witness a serious damage to their kidneys (renal toxicity); some patients may suffer from permanent liver damage (hepatotoxicity); the hormonal levels may become abnormal in the human body (neuroendocrine hormonal crises), and infertility.

The drug Lutathera can harm the fetus developing in the womb of a pregnant mother; therefore, pregnant women are educated about the potential damage caused to the fetus by this drug . In general, radiation exposure is provided to patients before administering the drug.

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Guidelines to include feedback of patients in clinical trials

 

The impact of treatment on participants and their quality of life must be assessed more comprehensively, so it is imperative to make changes in international guidelines. The safety of participating patients and integrity of data collected depends on the protocols used for describing a clinical trial: objectives, design, methodology, statistical consideration, and organization.

Current protocols do not emphasize much on patient-reported outcomes (PROs). Most researchers have recommended that feedback must be collected from patients on how clinical trial affects overall quality of life.

According to a noted medical researcher at the University of Birmingham, feedback received from patients participating in a clinical trial can hold valuable information for following purposes: pharmaceutical labeling claims, clinical guidelines, health policy, shared-decision making.

Most clinical trials currently do not include information on quality of life and symptom data. This data must be collected to provide patient-centered care and to develop specific protocol guidelines.

Recommended changes to current protocols of clinical trials were published in the Journal of American Medical Association. This information was a joint-collaboration across universities of Toronto, Sydney, and Birmingham. It is important to understand the impact clinical trials have on cancer patients.

With this information, patients can then decide which line of treatment is most suitable for them. The side-effects of cancer treatments are often long-lasting and most clinical trials do not include this line of information. A cancer patient receiving treatment may live for years but their quality of life is severely impacted with these side-effects.

Patient-related outcomes (PROs) are classified as primary or secondary in clinical trial protocols; these outcomes need to be included in the current checklist guidelines of clinical trial protocol.

The PRO specific issues are as follows: trial rationale, eligibility criteria, objective, intervention, assessment time-points, proxy completion, and strategies for minimizing missing data.

The guidance prescribed in PROs is not prescriptive, but it provides a pathway for implementing a careful planning of PRO components of trials. Thus, PRO trial design improves, and the rationale for assessing PRO is improved. Thus, high quality analysis is ensured and reported, thereby improving the evidence base of PRO on a global scale.

Clinicians can use PROs effectively to make right decisions, thereby improving the line of recovery and treatment. This is a more effective strategy for comprehensively reporting personal experiences of patients with serious illness.

More guidelines must be consistently presented to help both patients and clinicians and to improve the outcome of prognosis. By improving the reporting of PRO data, the outcomes of patients with chronic diseases can be improved tremendously.

 

 

 

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First clinical trial on lung stem cell transplantation in China

A significant breakthrough has been achieved by researchers working at China’s Tongji University. They have managed to develop an innovative technology for regenerating human lungs. In a successful clinical trial, an autologous transplantation of stem cells was carried out in the lungs. The main goal was to regenerate damaged lungs of patients.

This study was reported in the noted scientific journal named “Protein & Cell” . This journal is published by Springer Nature. The team of researchers headed by professor Zuo successfully identified p63+/Krt5+ adult stem cells in the lungs of experimental mice. These stem cells were later regenerated into bronchioles, alveoli, and other pulmonary structures.

Following this successful breakthrough, these researchers from Tongji University are now working together with a team of scientists at the Kiangnan Stem Cell Institute to apply the same discovery to human cells as the earlier clinical trial was successful on mice.

Human lungs are completely different from the lungs of mice, both in terms of anatomy and developmental processes. Therefore, chronic pulmonary disorders can be solved by directly investigating human lungs.

An SOX9+ marker was used to label the category of basal cells, which could be cloned into stem cells of the lung in human beings. Professor Ren Tao is a renowned physician who works at the Shanghai East Hospital.

The main goal was to produce lung stem cells from a small sample of basal cells. For this purpose, lung bronchoscopy was performed by a team of researchers headed by Professor Ren Tao.

Lung stem cells were obtained from about 0.2% of cells isolated from each brush. A scaled expansion was conducted in a well maintained fashion to ensure that the cells were genetically stable and to retain their distinct molecular phenotype.

To determine the ability with which lung stem cells could regenerate tissues of lungs in vivo, the researchers transplanted GFP-labeled, lung stem cells of humans into the damaged lungs of experimental mice.

The team of researchers then waited for three weeks after completing the transplantation. At this stage, a “human-mouse chimeric organ” was formed by integrating lung stem cells of humans into a large area of mice lungs.

By performing histological analysis, the transplanted stem cells were regenerated into structures resembling the bronchioles and alveoli of lungs in mice. Researchers observed a host of rising capillaries in the regenerated components of human lungs.

In other words, the team of researchers successfully regenerated respiratory units that were functional in nature. This was confirmed by gold-nanoparticle tracking. After performing stem cell transplantation successfully, new human alveoli were formed in place of fibrotic section of injured lungs.

Lung function in mice was significantly restored by conducting arterial blood gas test.The first clinical trial was performed successfully by a team of researchers from the following organizations: Southwest Hospital of China Army University and Regend Therapeutics.

An autologous transplantation of lung stem cells was performed on patients diagnosed with bronchiectasis. In this condition, the bronchial structure of the lungs is permanently damaged. Two patients were included in this study in March 2016 following strict supervision by ethical committees.

The generated lung stem cells were transplanted into patients’ lung by performing bronchoscopy. These patients were then monitored for one year continuously. Coughing, dyspnea, and other respiratory issues were alleviated in these patients, one year after transplantation.

The dilated structures showed almost complete recovery as per CT images. After the transplantation, it took three months for the patients to show a significant improvement in lung function. Thereafter, they showed further signs of recovery till one year.