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  • June 29, 2016 10:13 AM | Ashley Monson (Administrator)

    Two candidates provided protection after just one dose; clinical trials planned for later this year


    TUESDAY, June 28, 2016 (HealthDay News) -- Experimental studies support the effectiveness of two vaccine candidates against the Zika virus, according to research published online June 28 in Nature.

    This "critical first step" is leading to trials in monkeys and humans, "and gives us early confidence that development of a protective Zika virus vaccine for humans is feasible," said researcher Col. Nelson Michael, M.D., Ph.D., of the Walter Reed Army Institute of Research (WRAIR) in Silver Spring, Md., and one member of a team involved in the search for a vaccine against the virus.

    One of the new vaccines was developed at Harvard Medical School in Boston and is partly based on a Zika strain isolated in Brazil. The other vaccine, using a strain isolated in Puerto Rico, has been developed by Michael's team at WRAIR. Both vaccines shielded mice against Zika infection with just a single dose required, the researchers said. The two vaccines are similar to others already in use against flaviviruses, which include dengue fever, West Nile, and others. Clinical trials in humans are scheduled to begin later in 2016.

    "We showed that vaccine-induced antibodies provided protection, similar to existing vaccines for other flaviviruses," senior author Dan Barouch, M.D., Ph.D., of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, said in a center news release. "The effectiveness of these vaccines, the clarity of the antibody protection, and the similarity to successful vaccines that have been developed for other flaviviruses provide substantial optimism for a clear path forward for the development of a safe and effective Zika virus vaccine for humans."

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  • June 29, 2016 10:08 AM | Ashley Monson (Administrator)

    THURSDAY, April 29 (HealthDay News) -- The daughters of women who suffered from a severe form of morning sickness are three times more likely to be plagued by it themselves, Norwegian researchers report.

    This form of morning sickness, called hyperemesis gravidarum, involves nausea and vomiting beginning before the 22nd week of gestation. In severe cases, it can lead to weight loss. The condition occurs in up to 2 percent of pregnancies and is a common cause of hospitalization for pregnant women. It is also linked with low birth weight and premature birth, the researchers said.

    The new study suggests "a strong influence of maternal genes" on the development of the condition, said lead researcher Ase Vikanes, a graduate student at the Norwegian Institute of Public Health in Oslo.

    "However, environmental influences along the maternal line, shared risk factors such as life styles reflected in BMI (body mass index) and smoking habits, infections and nutrition might also be contributing to the development of hyperemesis gravidarum," she added.

    The report is published in the April 30 online edition of the BMJ.

    According to Vikanes, hyperemesis gravidarum was once thought to be caused by psychological issues, "such as an unconscious rejection of the child or partner." But her team wanted to see if genetics was actually the culprit.

    For the study, Vikanes's team collected data on 2.3 million births from 1967 to 2006. They tracked the incidence of hyperemesis gravidarum in more than 500,000 mother-daughter pairs and almost 400,000 mother-son pairs.

    They found that if a mother had the condition, her daughter was three times more likely to develop it as well. However, there is no increased risk to the female partners of men whose mothers suffered through it.

    Vikanes hopes the finding adds new insight into this condition. Besides helping to illuminate possible causes, "our findings might help health care personnel who treat and counsel women with a family history of hyperemesis gravidarum," she said.

    Brad Imler, president of the American Pregnancy Association, said that "hyperemesis gravidarum is a serious condition that creates health risks for both the mother and the baby. "Research into the causes and treatments of this condition are essential for discovering ways to alleviate the condition along with the health risks related to it," he said.

    Imler cautioned that a three-fold increase in risk is not something that should cause fear among pregnant women. That "means going from 1 in 100 to 3 in 100 incidences," he noted.

    Genetics appears to have a relationship with the condition, Imler said. "However, it would be important to have further research that controlled for environmental factors, dietary intake, and lifestyle habits, which also tend to be carried on from one generation to the next," he added.

    Dr. Gene Burkett, a professor of obstetrics and gynecology at the University of Miami Miller School of Medicine, said that, "for a long time we have thought there is a familial component, and this gives us the first real information on which we can say, 'Yes, there seems to be something that we need to pursue.'"

    However, Burkett said that the results need to be replicated in different populations before one can be sure the link is genetic.

    More information

    For more information on morning sickness, visit the U.S. National Library of Medicine.


  • June 29, 2016 9:15 AM | Ashley Monson (Administrator)

    The U.S. Preventive Services Task Force seeks comments on a draft recommendation statement and draft evidence review on screening for gynecologic conditions with pelvic examination. After reviewing the evidence, the Task Force concluded that there is not enough evidence to determine the benefits or harms of performing screening pelvic exams in asymptomatic, nonpregnant adult women. The draft recommendation statement and draft evidence review are available for review and public comment from June 28 to July 25.

    Read more.

  • June 28, 2016 8:50 AM | Ashley Monson (Administrator)

    In the last week, 15 states reported new Zika virus cases to the CDC, bringing to total number of cases in the 50 states to more than 800. U.S. territories also experienced a spike in reported cases.

    Between June 17 and Wednesday, 64 new cases of Zika virus in the 50 states and the District of Columbia were reported to the CDC, bringing the total number of cases from 756 to 820. In the U.S. territories, 420 new cases were reported in the last week, bringing that total from 1,440 to 1,860. All together, there are 2,680 Zika cases in the U.S. as of Wednesday.

    There are still no reports of locally acquired Zika cases in the states, excluding the lab-acquired case in Pennsylvania, but of the 819 travel-associated cases in the states, 11 were sexually transmitted and four had Guillain-Barré syndrome. Of the 1,854 locally acquired cases in the territories, seven had Guillain-Barré syndrome.

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    To see where Zika cases have been reported in the U.S. from Jan. 1 to Wednesday, check out the map below.

    zikamap0624


  • June 28, 2016 8:49 AM | Ashley Monson (Administrator)

    New research points the way toward a potential vaccine against Zika, and may explain why the formerly mild virus exploded with such fury when it arrived in Brazil.

    A pair of studies published Thursday focus on Zika's complex relationship with a related virus called dengue, a common illness in Latin America and the Caribbean that causes flu-like symptoms. Dengue is spread by the same mosquito species as Zika, and the two viruses are so similar that blood tests sometimes can't tell the two apart.

    When people are infected with dengue, or any virus, the immune system releases key proteins called antibodies to neutralize the invaders. Authors of a study published Thursday in Nature found that two of the antibodies the body makes to fight dengue also prevent Zika infections.

    That finding could help scientists develop vaccines against Zika and dengue, said study coauthor Juthathip Mongkolsapaya, a researcher at Imperial College London. Scientists also might be able to use these antibodies to treat Zika, she said.

    Several groups are already working on Zika vaccines.

    Inovio Pharmaceuticals announced this week that it has received Food and Drug Administration permission for a small, early clinical trial of a Zika vaccine it's developing with GeneOne Life Science. The National Institute of Allergy and Infectious Diseases is pursuing four types of Zika vaccines; officials there say they expect to begin clinical trials in August.

    Yet the close relationship between dengue and Zika has a dark side.

    There are four varieties of dengue virus. While people infected with the virus one time may develop relatively mild symptoms, those are infected a second time, with a different variety of of dengue virus, can develop severe, life-threatening complications, said Amesh Adalja, a senior associate at the Center for Health Security at the University of Pittsburgh Medical Center.

    In a second paper, published in Nature Immunology, researchers found that the vast majority of dengue antibodies do nothing to stop Zika infection. In fact, a lab experiment showed that most dengue antibodies actually helped Zika viruses proliferate and invade cells. That suggests that people previously infected with dengue, whose antibodies against dengue remain in their blood, might have a more severe reaction to Zika, said Gavin Screaton, chair of medicine at Imperial College London.

    These results lend support to similar findings from Florida Gulf Coast University and the University of Pittsburgh Center for Vaccine Research.

    Mother Jusikelly da Silva holds her 7-month-old daughter

    Mother Jusikelly da Silva holds her 7-month-old daughter Luhandra, who was born with microcephaly, as she wears her new glasses while waiting for a bus on June 2, 2016 in Recife, Brazil. (Photo: Mario Tama, Getty Images)

    Not everyone is convinced that past dengue infections can make Zika cases more severe.

    While dengue antibodies may exacerbate Zika infections in the lab, there's no evidence that this happens in the real world, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

    Scientists first discovered Zika in 1947, but it was never known to cause birth defects until Brazil experienced an alarming increase last year in microcephaly, a condition in which babies are born with abnormally small heads and incomplete brain development.

    Brazil has reported 1,660 cases of microcephaly, about 10 times more than usual, according to the World Health Organization. Microcephaly linked to Zika has been reported in 11 other countries or territories, including Puerto Rico, Panama, El Salvador, Colombia, Martinique, the Marshall Islands, French Polynesia and Cape Verde.

    These locations have different varieties of dengue viruses, Adalja said. It's possible that some varieties of the virus are more likely to be associated with Zika complications than others.

    Researchers have looked at a number of possible explanations for Zika's explosive growth, said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. It's possible Zika's spread has been aided by environmental factors, such as climate change, poverty and urbanization. It's also possible the virus has mutated.

    To really understand whether dengue antibodies exacerbate Zika infections, researchers will need to study pregnant women, said Ernesto Marques, scientific director of Cura Zika, an international alliance between the University of Pittsburgh and Brazil's Oswaldo Cruz Foundation, known as Fiocruz.

    The National Institutes of Health announced this week that it will partner with Fiocruz in a study of up to 10,000 pregnant women in areas with Zika outbreaks, beginning with Puerto Rico and expanding to Brazil and Colombia.

    Leaders of the new study will study whether a past dengue infection increases the risk of complications on pregnant women and their babies. Researchers also will compare the health of babies born to mothers infected with Zika virus and those who were not, recording rates of miscarriage, premature birth, microcephaly, malformations of the nervous system and other complications.

    Researchers will study whether these problems are more common in women who had symptoms of Zika compared to those with no symptoms. Only about 20% of Zika patients develop symptoms, which include rash, fever, joint pain and pink eye. Researchers also will study whether complications are more common in women infected early in pregnancy compared to those infected later. Doctors will follow women throughout pregnancy and for six weeks after delivery.


  • June 28, 2016 8:48 AM | Ashley Monson (Administrator)

    An international team of researchers has discovered a simple, accurate new way to predict which women with gestational diabetes will develop type 2 diabetes after delivery. The discovery would allow health care providers to identify women at greatest risk and help motivate women to make early lifestyle changes and follow other strategies that could prevent them from developing the disease later in life.

    Gestational diabetes is defined as glucose intolerance that is first identified during pregnancy. It occurs in three to 13 percent of all pregnant women, and increases a woman's risk of developing type 2 diabetes by 20 to 50 percent within five years after pregnancy.

    The joint efforts of the University of Toronto's Michael Wheeler, a professor in the Department of Physiology, and Erica Gunderson, Senior Research Scientist with the Kaiser Permanente Northern California Division of Research, led to development of a technique called targeted metabolomics to better predict the development of type 2 diabetes in women with recent gestational diabetes. Typically, diabetes is diagnosed by measuring blood sugar levels in the form of glucose, an important fuel used by cells in the body. The researchers identified several other metabolites that indicate early changes that signify future diabetes risk long before changes in glucose levels occur.

    The team tested fasting blood samples collected from women with gestational diabetes within two months after delivery -- predicting with 83 percent accuracy which women would develop the disease later on. These results were significantly better at predicting the development of type 2 diabetes than conventional methods, a fasting blood test followed by the time-consuming and inconvenient oral glucose tolerance test.

    "After delivering a baby, many women may find it very difficult to schedule two hours for another glucose test," says Wheeler, who is also a Senior Scientist at the Toronto General Research Institute. "What if we could create a much more effective test that could be given to women while they're still in the hospital? Once diabetes has developed, it's very difficult to reverse."

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    "Early prevention is the key to minimizing the devastating effects of diabetes on health outcomes," says Dr. Gunderson. "By identifying women soon after delivery, we can focus our resources on those at greatest risk who may benefit most from concerted early prevention efforts."

    The fasting blood samples used for this study were obtained from 1,035 women diagnosed with gestational diabetes and enrolled in the Kaiser Permanente's Study of Women, Infant Feeding and Type 2 Diabetes after GDM Pregnancy, also known as the SWIFT Study, which was funded by the U.S. National Institutes of Health (R01 HD050625). The SWIFT study screened women with oral glucose tolerance tests at 2 months after delivery and then annually thereafter to evaluate the impact of breastfeeding and other characteristics on the development of type 2 diabetes after a pregnancy complicated by gestational diabetes.

    The American Diabetes Association recommends type 2 diabetes screening at six to 12 weeks after delivery in women with gestational diabetes, and every one to three years afterwards for life. The time-consuming nature of the two-hour oral glucose test is believed to be one reason for low compliance rates of less than 40 percent in some settings.

    The new method may also be able to predict individuals who may develop type 2 diabetes in the general population - a major advance at a time when more than 300 million people suffer from the preventable form of this disease. A next-generation blood test that's more simple and accurate than the current options could help to identify individuals who would benefit most from more timely and effective interventions to prevent type 2 diabetes.

    Wheeler and Gunderson are now hoping to conduct additional tests in women with gestational diabetes to evaluate racial and ethnic differences in prediction, and investigate high risk groups with prediabetes to learn if metabolomics will predict type 2 diabetes in the general population.

    Source:

    University of Toronto


  • June 27, 2016 9:02 AM | Ashley Monson (Administrator)

    July 31 is the deadline to submit your CME presentation and workshop proposals for AAPA 2017 in Las Vegas! Questions? Contact conferencecme@aapa.org.

  • June 22, 2016 9:29 AM | Ashley Monson (Administrator)

    The itchy, red welts that appear after being bitten by a mosquito may help any viruses the insect is carrying pass on to a new host. A mouse study published June 21 in Immunity suggests that the swelling and irritation that make mosquito bites so unpleasant may provide a mechanism by which viruses like Zika are able to replicate and spread. "Before we did this study, little was known about the events and processes that occur at mosquito bite sites," says Clive McKimmie, a Research Fellow at the University of Leeds and the paper's senior author. 

    "Our findings suggest that the inflammatory response at these sites helps viruses to replicate, enhancing their ability to cause disease." In the new research, the investigators used mouse models to study the bites of the Aedes aegypti mosquito, the species that spreads infections such as Zika, dengue, and chikungunya. When a mosquito bites, it injects saliva into the skin. The saliva triggers an immune response, in which white blood cells called neutrophils and myeloid cells rush to the site. In this study, the team injected mice with viruses into the skin with or without the presence of a mosquito bite at the injection site and compared the reaction. 

    They found that instead of helping, some of these immune cells get infected and inadvertently replicate virus. In the absence of mosquito bites and their accompanying inflammation, the viruses failed to replicate well. But the presence of mosquito bites at the infection site resulted in an order of magnitude higher levels of virus. Further studies showed that the influx of white blood cells was required for enhanced replication of the viruses. According to McKimmie, previous studies that have used in vivo models to study the course of mosquito­borne infections 6/22/2016 Inflammation from mosquito bites may enhance viral infection haven't looked at the bite as a necessary component. 

    "We think the bite itself is affecting the systemic course and clinical outcome of the infection," he says. "If you want an in vivo model that replicates the most relevant parts of infection, you should include this inflammatory aspect." "This was a big surprise we didn't expect," he adds. "These viruses are not known for infecting immune cells. And sure enough, when we stopped these immune cells from coming in, the bite did not enhance the infection anymore." Although this research is still early work done in mice, McKimmie says the finding suggests new approaches for combating viruses that lead to health problems in humans.

     "We're quite keen to see if using topical creams to suppress bite inflammation will enable you to stop a virus from making someone as sick as it otherwise would do," he says. He notes that if it's proven effective, this approach could work against future virus outbreaks that we don't know about yet. "Nobody expected Zika, and before that nobody expected chikungunya," he says.

     "There are estimated to be hundreds of other mosquito­borne viruses out there and it's hard to predict what's going to start the next outbreak." More information: Immunity, Pingen et al: "Host inflammatory response to mosquito bites enhances severity of arbovirus infection."

     http://www.cell.com/immunity/fulltext/S1074­7613(16)30205­9 , DOI: 10.1016/j.immuni.2016.06.002 Provided by Cell Press "Inflammation from mosquito bites may enhance viral infection" June 21, 2016 http://medicalxpress.com/news/2016­06­inflammation­mosquito­viralinfection.html

  • June 22, 2016 9:27 AM | Ashley Monson (Administrator)

    Written by Honor Whiteman

    Published: Tuesday 21 June 2016

    Researchers have identified an existing drug that they say has the potential to prevent or delay breast cancer for women at high risk of developing the disease.

    [Breast cancer cells]
    Researchers found the drug denosumab stopped the growth of cells that are a precursor to breast cancer in women with a BRCA1 gene mutation.

    In a study published the journal Nature Medicine, researchers reveal how the drug denosumab halted the growth of pre-cancerous cells in breast tissue of women with a faulty BRCA1 gene.

    Women with a BRCA1 gene mutation are at significantly greater risk for breast and ovarian cancers; around 55-65 percent of women with such a mutation will develop the disease by the age of 70, according to the National Cancer Institute, compared with 12 percent of those in the general population.

    At present, the only way for women with a BRCA1 mutation to significantly reduce their risk of breast and ovarian cancers is to opt for a mastectomy - the surgical removal of one or both breasts - or an oophorectomy - the removal of the ovaries.

    But in this latest study, Prof. Geoff Lindeman, of the Walter and Eliza Hall Institute of Medical Research (WEHI), Australia, and colleagues show promise for a non-surgical alternative.

    Uncovering the 'holy grail' of cancer research

    To reach their findings, the team analyzed a number of breast tissue samples from women with and without a BRCA1 mutation.

    Fast facts about breast cancer

    • This year, around 246,660 new cases of invasive breast cancerwill be diagnosed in the U.S.
    • Around 40,450 women will die from breast cancer in 2016
    • There are currently more than 2.8 million breast cancer survivors in the U.S.

    Learn more about breast cancer

    From this, they identified cells in the breast tissue from women with a BRCA1 mutation that act as a precursor to breast cancer.

    "These cells proliferated rapidly, and were susceptible to damage to their DNA - both factors that help them transition towards cancer," explains study co-author Prof. Emma Nolan, of the Department of Medical Biology at The University of Melbourne, Australia.

    What is more, the researchers found that a protein called RANK acted as a marker for these pre-cancerous cells - a finding that excited the team, given that there are already drugs in clinical use that target and block the RANK pathways.

    As such, the researchers decided to investigate how one of these drugs - known as RANK ligand inhibitors - would affect the progression of pre-cancerous breast cells.

    They focused on a medication called denosumab, which is currently used to treatosteoporosis and bone cancers, including breast cancers that have spread to the bone.

    On applying denosumab to BRCA1-mutated breast tissue, they found itdeactivated the growth activity of pre-cancerous cells. What is more, the drug halted breast cancer development in a BRCA1-deficient mouse model.

    Overall, the researchers say their findings indicate that targeting the RANK pathway may be an effective strategy to reduce breast cancer risk in women with a BRCA1 mutation.

    "By thoroughly dissecting how normal breast tissue develops, we have been able to pinpoint the precise cells that are the culprits in cancer formation.

    It is very exciting to think that we may be on the path to the 'holy grail' of cancer research, devising a way to prevent this type of breast cancer in women at high genetic risk."

    Study co-author Prof. Jane Visvader, WEHI

    The authors say that a clinical trial is already underway to further investigate the breast cancer-preventing potential of RANK-inhibiting drugs.

    Learn how even light alcohol consumption may increase breast cancer risk.

    Written by Honor Whiteman


  • June 22, 2016 9:20 AM | Ashley Monson (Administrator)

    The Centers for Disease Control and Prevention (CDC) has recently launched the U.S. Zika Pregnancy Registry to understand more about pregnancy and infant outcomes following Zika virus infection during pregnancy. The Wisconsin Department of Health Services (DHS) intends to collaborate with CDC on this registry. Health care providers are asked to identify any cases of pregnant women with laboratory evidence of Zika virus or any infants with suspected congenital Zika virus exposure. If you have identified a woman or infant meeting these criteria, please call DHS at 608-267-9003 or the CDC Zika Pregnancy Registry at 770-488-7100.

    Additional information regarding the U.S. Zika Pregnancy Registry can be found at http://www.cdc.gov/zika/hc-providers/registry.html. Registry fact sheets designed specifically for obstetric health care providers, pediatric health care providers, pregnant women, and parents can be accessed using the links below and are also available in Spanish.

    For the latest updates regarding Zika virus, please visit http://www.cdc.gov/zika/ and https://www.dhs.wisconsin.gov/arboviral/zika.htm

    Zika Pregnancy Registry Fact Sheet for obstetric providers (PDF)

    Pika Pregnancy Registry Fact Sheet for pregnant women (PDF)


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