Kidney disease may be the price you pay in the quest for a fair skin

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Kidney disease may be the price you pay in the quest for a fair skin

Kerala researchers report fairness cream link to kidney diseases; blood and urine have elevated mercury

The quest for that perfect, aspirational fair skin can come with unforeseen dangers of kidney damage. Kerala researchers have reported in the journal Kidney International that of the 15 patients of a particular kind of kidney disease that they saw over a two year period, 13 had a history/were actively using fairness creams at the time of diagnosis.

Neural epidermal growth factor-like protein 1 (NELL-1) is an autoantigen associated with both primary and secondary membranous nephropathy (MN) – kidney disease – and is associated with malignancy, autoimmune diseases, lipoic acid, and traditional indigenous medicines. The doctors looked at all patients diagnosed to have NELL-1 MN between July 2021 and September 2023 at Aster MIMS Hospital, Kottakkal, India. Those with a history of fairness cream use underwent heavy metal screening in blood and/or urine.

“Among our NELL-1 MN cohort, 13 of 15 patients admitted using skin fairness creams before their symptom onset. Of the rest, one (aged 57 years, male) had history of use of traditional indigenous medicines, whereas the other (aged 75 years, female) had no identifiable trigger. All were negative for hepatitis B and C, autoimmune markers, and malignancy,” they reported. Most of the patients had complained of fatigue, mild edema and increased frothing of urine. Most patients tested showed elevated levels of mercury levels in blood or urine. The degree of elevation varied depending on whether or not the product was being actively used at the time of testing.

The doctors advocated better awareness initiatives to make the people particularly the young who often fall prey to the lure of fairness creams, more conscious of the associated risks. “The incriminated creams are unregulated, widely available, and hugely popular among the youth.S9 Given the societal obsession with fair skin, this could portend a widespread problem, potentially of epidemic proportions. Studies from Asia and Africa show that this practice extends beyond India, implying global public health significance.S10 Subtle clinical features at presentation coupled with lack of awareness among physicians regarding the link between fairness creams and nephrotic syndrome and failure to obtain a positive history of the same, may explain why this problem has not been identified on a larger scale. To curb further use, it is essential to educate the general public and sensitize physicians about the health hazards posed by contaminated skin creams and alert regulatory authorities to curtail their availability,” they wrote.

US hospital does first pig kidney transplant in woman with mechanical heart

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US hospital does first pig kidney transplant in woman with mechanical heart

The patient was not eligible for a heart and kidney dual transplant because of several chronic medical conditions

A hospital in the USA has become the first ever to do a combined mechanical heart pump and gene-edited pig kidney transplant surgery. The surgery was performed on a 54-year-old resident of New Jersey who could not undergo a double transplant because of several chronic medical conditions.

In a statement, the hospital, NYU Langone said that the doctors performed the feat in two stages: first surgically implanting the heart pump days before embarking on the landmark transplant, which included a gene-edited pig kidney and a pig’s thymus gland to aid against rejection.

Before the procedure, patient Lisa Pisano, faced heart failure and end-stage kidney disease that required routine dialysis.

“All I want is the opportunity to have a better life,” she said. “After I was ruled out for a human transplant, I learned I didn’t have a lot of time left. My doctors thought there may be a chance I could be approved to receive a gene-edited pig kidney, so I discussed it with my family and my husband. He has been by my side throughout this ordeal and wants me to be better.”

The hospital claimed that there is no documented instances of anyone with a mechanical heart pump receiving an organ transplant of any kind. It is only the second transplant of a gene-edited pig kidney into a living person, and the first with the thymus combined.

“It is incredible to consider the scientific achievements that have led to our ability to save Lisa’s life, and what we are endeavoring to do as a society for everyone in need of a lifesaving organ,” said Robert Montgomery, MD, DPhil, who led the transplant surgery and who is the H. Leon Pachter, MD, Professor of Surgery; chair of the Department of Surgery; and director of the NYU Langone Transplant Institute. “This could not have been done without the dedication and skill of the many talented physicians, researchers, nurses, health administrators, and perioperative care teams at NYU Langone Health, and the numerous pioneers who came before us.”

Poor cardiovascular health may be a risk factor for early cognitive decline

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Poor cardiovascular health may be a risk factor for early cognitive decline

Researchers from the  Chicago site of the Study of Women’s Health Across the Nation have reported these findings for black women

Poor cardiovascular health may be a risk for early signs of cognitive decline in mid-life at least in some populations. A new study has found that Black women with poor cardiovascular health may face an elevated risk of early signs of cognitive decline in midlife.

The study, which has been published in the Journal of the American Heart Association, included 363 Black and 402 white women who enrolled in the Chicago site of the Study of Women’s Health Across the Nation when they were 42-52 years old. Cognition (measured as processing speed and working memory) was assessed annually or biennially over a maximum of 20 years, with an average follow-up of 9.8 years. A composite index of cardiovascular health (Life’s Essential 8) was calculated based on blood pressure, body mass index, glucose, cholesterol, smoking, physical activity, diet, and sleep.

The question of interest was to determine whether better cardiovascular health was related to less cognitive decline equally for both Black and white midlife women.

Processing speed, a leading indicator of early cognitive decline, appeared to decline in Black women with poorer cardiovascular health starting in midlife but not in white women. Working memory did not decline in the total study group, or in groups based on race or cardiovascular health.

“The results suggest that promotion of cardiovascular health, particularly management of blood pressure and smoking cessation, in midlife Black women may be important for the early prevention of cognitive decline and maintenance of independence through aging,” said corresponding author Imke Janssen, PhD, of Rush University Medical Center. “A clinical trial should determine whether optimizing heart health in midlife slows cognitive decline.”

Gujarat’s first genomics institute is being helmed by the Apollo Group

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Gujarat’s first genomics institute is being helmed by the Apollo Group

The Ahmedabad chapter of the Apollo Genomics Institute is the sixth for the chain after Mumbai, Delhi, Chennai, Hyderabad, and Kolkata

Apollo, the world’s largest vertically integrated healthcare provider, today announced the expansion of the Apollo Genomics Institute with the launch of Gujarat’s first facility in Ahmedabad. Doubling down on its investments in genomics, Apollo Genomics Institute was earlier launched in Mumbai, Delhi, Chennai, Hyderabad, and Kolkata.

India has made huge progress in terms of combating communicable diseases over the years. However, the increase in the number of genetic disorders in the recent past has been overlooked. With genomics, these diseases can be identified before they manifest; in turn, enabling early intervention and preventive care. The Apollo Genomics Institute aims to transform medical practice by bringing genomic services within the reach of every clinician & patient.

The Apollo Genomic Institute of Ahmedabad will host a range of genomic services including genetic evaluation, clinical diagnostics, obstetric genetics, cancer genomics, prenatal genetic screening capabilities and more, empowering patients with information to manage and prevent genetic disorders.

Dr. Preetha Reddy, Vice Chairperson, Apollo Hospitals, shared her enthusiasm, “Today marks a significant milestone in our journey towards pioneering healthcare. With the inauguration of the Genomic Institute at Apollo Hospitals Ahmedabad, we embark on a transformative path in medical science. This initiative reflects our unwavering commitment to harnessing the power of genomics to revolutionize patient care. We are optimistic that this endeavor will drive us towards new frontiers of innovation and ultimately, redefine the future of healthcare.”

The Apollo Genomic Institute of Ahmedabad will host a range of genomic services including genetic evaluation, clinical diagnostics, obstetric genetics, cancer genomics, prenatal genetic screening capabilities and more, empowering patients with information to manage and prevent genetic disorders.

Dr. Madhu Sasidhar, President & CEO Hospital Division, Apollo Hospitals Group said, “At Apollo, we believe that patients need to be brought to the forefront of the decision-making process with regard to their health journey. Constantly increasing availability of real-world data sources coupled with patient-centric analytics offer deeper insights into how they are diagnosed, treated and beyond. Genomics is one such area. On the back of increasing NCDs, the greater availability of patient-level data helps practitioners better understand the patient’s journey. This also enables personalization in medicine by leveraging genetic insights is immensely impacting decisions made regarding the prevention, diagnosis, and treatment of diseases. At Apollo Genomics Institute, our focus on preventive care and personalized medicine underscores our commitment to a more resilient and healthier society.”

Women make better doctors than men? Study suggests so based on treatment outcomes

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Women make better doctors than men? Study suggests so based on treatment outcomes

The study looked at two parameters – mortality at 30 days and readmission – in a total of 58108 female and 318819 male patients over a three year period

It is a battle of the sexes and men do not seem to be faring too well. A study that looked at relative treatment outcomes for male and female doctors suggests that patients tend to do better in the latter case.

Published in the journal Annals of Internal Medicine, the study looked at treatment outcomes for a 20% random sample of Medicare fee-for-service beneficiaries hospitalized with medical conditions during 2016 to 2019 and treated in the hospital. It looked at two outcomes primarily – mortality at a 30-day mark and whether or not the patients had to be readmitted. A total of 58108 female and 318819 male patients were examined.

It concluded: “The findings indicate that patients have lower mortality and readmission rates when treated by female physicians, and the benefit of receiving treatments from female physicians is larger for female patients than for male patients.” Of the patients, 31.1% had been treated by male doctors and 30.6% by female doctors.

An interesting observation was that female patients seemed to benefit more when treated by female doctors. “Both female and male patients had a lower patient mortality when treated by female physicians; however, the benefit of receiving care from female physicians was larger for female patients than for male patients,” the researchers from the University of Tokyo reported along with their co-authors. In fact for female patients the difference in outcomes when they were treated by doctors of the same sex were large and “clinically meaningful”, they reported.

Europe sees surge in vaccine preventable diseases; ECDC sounds alarm

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Europe sees surge in vaccine preventable diseases; ECDC sounds alarm

Between March 2023 and February 2024, 5770 measles cases were reported, including 5 deaths. There is a 10-fold increase in Pertussis cases

Europe is seeing a surge in cases of vaccine-preventable diseases. In a statement issued on Monday the European Centre for Disease Prevention and Control (ECDC) has flagged the increase in the number of measles and pertussis cases in countries across the continent.

The number of measles cases began to rise in 2023, and this trend has continued in several EU Member States. Between March 2023 and the end of February 2024, at least 5770 measles cases have been reported, including at least 5 deaths.

The highest risk is amongst infants below one year of age, as they are too young to be vaccinated and should therefore be protected by community immunity. Measles spreads very easily, therefore, high vaccination coverage, of at least 95% of the population vaccinated with two doses of measles-containing vaccine, is essential to interrupt transmission.

An increase in pertussis cases has been reported since mid-2023 in several EU/EEA countries, with preliminary data indicating a more than 10-fold increase in cases in 2023 and 2024 compared to 2022 and 2021. Newborn babies and infants, who are too young to be fully vaccinated, are at an increased risk of severe disease and death. To best protect them, it is essential to ensure that all recommended pertussis-containing vaccines are given on time. Vaccination during pregnancy can also protect young infants.

“It is disheartening to see that despite decades of a well-documented safety and effectiveness track record of vaccines, countries in the EU/EEA and globally still face outbreaks of several vaccine-preventable diseases. Achieving and maintaining high vaccination uptake, disease surveillance and prompt response actions to control outbreaks remain the key actions against these diseases. Vaccines have protected many generations, and we should ensure that this continues to be the case”, Dr Andrea Simmons ECDC director said.

COVID19 disruptions caused modest development delays in children

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COVID19 disruptions caused modest development delays in children

 

The study by Johns Hopkins looked at data from more than 5000 paediatric practices all over the United States

 

The disruption in social systems and routine caused by COVID19 may have caused just modest developmental delays in children. Recently,  a study by Johns Hopkins School of medicine published in JAMA Pediatrics has reached this conclusion.

“We found, overall, that while there are some changes, the sky is not falling, and that is a really important and reassuring finding,” says Sara Johnson, Ph.D., M.P.H., corresponding author of the study, director of the Rales Center for the Integration of Health and Education at Johns Hopkins Children’s Center, and Blanket Fort Foundation professor of pediatrics at the Johns Hopkins University School of Medicine.

Investigators evaluated possible links between pandemic-related disruptions to everyday life and changes in developmental milestone screening scores. The data were from the Comprehensive Health and Decision Information System (CHADIS), a web-based screening platform caregivers use to complete surveys about their children’s development. It is used by more than 5,000 pediatric practices in 48 U.S. states.

 

 

What’s in a name? WHO unveils new terminology for airborne pathogens

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What’s in a name? WHO unveils new terminology for airborne pathogens

The new document will apply for COVID-19, influenza, measles, Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), and tuberculosis

It had taken much time and substantial debate to reach the conclusion that the SARS-CoV2 virus that triggered the COVID19 pandemic, is in fact, airborne. Couple of years on, the World Health Organisation has now come up with global technical consultation report introducing updated terminology for pathogens that transmit through the air. The pathogens covered include those that cause respiratory infections, e.g. COVID-19, influenza, measles, Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), and tuberculosis, among others.

The publication, entitled “Global technical consultation report on proposed terminology for pathogens that transmit through the air”, is the result of an extensive, multi-year, collaborative effort and reflects shared agreement on terminology between WHO, experts and four major public health agencies: Africa Centres for Disease Control and Prevention; Chinese Center for Disease Control and Prevention; European Centre for Disease Prevention and Control; and United States Centers for Disease Control and Prevention. This agreement underlines the collective commitment of public health agencies to move forward together on this matter.

“This global technical consultation process was a concerted effort of many influential and experienced experts,” said Dr Gagandeep Kang, Christian Medical College, Vellore, India who is a Co-Chair of the WHO Technical Working Group. “Reaching consensus on these terminologies bringing stakeholders in an unprecedented way was no small feat. Completing this consultation gives us a new opportunity and starting point to move forward with a better understanding and agreed principles for diseases that transmit through the air,” added Dr Yuguo Li from the University of Hong Kong, Hong Kong SAR (China), who also co-chaired the Technical Working Group.

This consultation was the first phase of global scientific discussions led by WHO. Next steps include further technical and multidisciplinary research and exploration of the wider implementation implications of the updated descriptors.

Quit support for smokers as part of lung cancer screening prog can save lives

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Quit support for smokers as part of lung cancer screening prog can save lives

Of the 15% eligible people who turned up for screening, 323 reported not smoking for four weeks

Offering stop smoking support as part of the national lung cancer screening programme can be a life saver, claims a new study that advocates for dedicated funding for this.

The results of the study, published in the European Respiratory Journal, showed that offering stop smoking support at the same time and in the same place as lung screening, resulted in a high uptake of support across a range of demographic characteristics.

This has the potential to reduce smoking-related illness and death in a high-risk group of the population and experts are urging policy makers to consider dedicated funding for stop smoking support urgently.

The research was led by Professor Rachael Murray in the School of Medicine at the University of Nottingham and was carried out as part of the Yorkshire Lung Screening Trial, led by Professor Matthew Callister and delivered in partnership with Leeds Teaching Hospitals and the University of Leeds. The study was funded by Yorkshire Cancer Research.

Up to half of people who attend for lung cancer screening currently smoke and offering them support to quit at the time of attendance is an ideal opportunity to maximise the chance of successful quitting, the study hypothesised.

In this study, researchers offered 2,150 people who attended a lung cancer screening programme, and reported currently smoking, the opportunity to speak with a specialist stop smoking advisor.

89% accepted the offer, and 75% chose to accept ongoing weekly support. Men were less likely to engage with support, whereas those who were more dependent on nicotine were more motivated to stop smoking, and were more confident in their ability to stop smoking successfully, and were subsequently more likely to take up the offer of support.

Uptake of support was the same across other characteristics including age, ethnicity, deprivation or level of education.

Overall, 323 people reported not smoking at four weeks (15% of all those attending screening who were eligible to receive stop smoking support); 266 of these provided a breath sample that showed they had stopped smoking. Men were more likely to stop smoking, along with those who were more motivated to stop and had attempted to stop smoking in the past.  Those who smoked more cigarettes per day were less likely to successfully stop smoking.

Professor Murray said: “The high uptake of smoking cessation support and promising quit rates reported across a range of participant demographics indicates that adding stop smoking support as an integrated part of the national lung cancer screening programme has the potential to reduce all-cause smoking related morbidity and mortality.  Protected, dedicated funding must be considered by policy makers in order to ensure the national screening programme realises its’ full potential.”

Dr Stuart Griffiths, Director of Research at Yorkshire Cancer Research said: “The evidence is clear that lives can be saved by offering people the chance to quit smoking with specialist support while they are on a lung health check unit.

“This opportunistic moment to help people significantly improve their health and reduce their risk of cancer and other serious diseases should not be ignored. It is vital that funding is directed to provide this essential support.”

 

Artificial Intelligence can speed up search for Parkinson’s cure

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Artificial Intelligence can speed up search for Parkinson’s cure

Researchers from the University of Cambridge have used AI-based strategy to identify compounds that block the clumping of the protein that causes Parkinson’s Disease

Artificial Intelligence (AI) techniques can accelerate the search for Parkinson’s disease treatments.

Researchers from the University of Cambridge designed and used an AI-based strategy to identify compounds that block the clumping, or aggregation, of alpha-synuclein, the protein that characterises Parkinson’s.

The team used machine learning techniques to quickly screen a chemical library containing millions of entries, and identified five highly potent compounds for further investigation.

Parkinson’s affects more than six million people worldwide, with that number projected to triple by 2040. No disease-modifying treatments for the condition are currently available. The process of screening large chemical libraries for drug candidates – which needs to happen well before potential treatments can be tested on patients – is enormously time-consuming and expensive, and often unsuccessful.

Using machine learning, the researchers were able to speed up the initial screening process by ten-fold, and reduce the cost by a thousand-fold, which could mean that potential treatments for Parkinson’s reach patients much faster. The results are reported in the journal Nature Chemical Biology.

Parkinson’s is the fastest-growing neurological condition worldwide. In the UK, one in 37 people alive today will be diagnosed with Parkinson’s in their lifetime. In addition to motor symptoms, Parkinson’s can also affect the gastrointestinal system, nervous system, sleeping patterns, mood and cognition, and can contribute to a reduced quality of life and significant disability.

Proteins are responsible for important cell processes, but when people have Parkinson’s, these proteins go rogue and cause the death of nerve cells. When proteins misfold, they can form abnormal clusters called Lewy bodies, which build up within brain cells stopping them from functioning properly.

“One route to search for potential treatments for Parkinson’s requires the identification of small molecules that can inhibit the aggregation of alpha-synuclein, which is a protein closely associated with the disease,” said Professor Michele Vendruscolo from the Yusuf Hamied Department of Chemistry, who led the research. “But this is an extremely time-consuming process – just identifying a lead candidate for further testing can take months or even years.”

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