ABC Examines Shortage Of Medical Workers To Provide HIV-Positive Children In Lesotho With Treatment

ABC’s “World News” on Monday examined how a physician shortage in Lesotho is hindering efforts to provide HIV-positive children in the country with treatment. There are six pediatricians in Lesotho to serve a population of 800,000 children, including an estimated 18,000 children who are living with HIV, “World News” reports. Most of the pediatricians are U.S. citizens working in Lesotho at a clinic operated by the Baylor College of Medicine in Texas. According to “World News,” the government of Lesotho pays for medical students to leave the country for training if they agree to return after graduation, but many students take jobs in South Africa or Europe and do not return.

Projects led by the Baylor clinic and the Clinton Foundation have helped increase the number of HIV-positive children in Lesotho with access to antiretroviral drugs from 600 a few years ago to more than 1,000 currently, but the shortage of medical workers has complicated efforts to administer the drugs. Pediatrician Lineo Thahane said, “We have the medications. They are distributed throughout the country. What we need are people who are comfortable administering those medications to children.”

Women typically stay with their children in the hospital to care for them and administer drugs because there are not enough medical workers, according to “World News.” Physicians with the Baylor clinic also are working to train more physicians and nurses to administer antiretrovirals (Snow, “World News” Web site, 9/3). Video of the segment and expanded ABC News coverage are available online.

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading

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Children With Severe Epilepsy Need Special Precautions At Home To Prevent Accidents

Children with severe epilepsy need special safety measures at home to lower their risk of having an accident, states a Seminar in this week’s issue of The Lancet.

Epilepsy is suspected when there is repetition of seizures. Scientists estimate that worldwide, 10.5 million children under 15 years have active epilepsy. In his Seminar Renzo Guerrini (University of Pisa, Italy) states that children with epilepsy are at increased risk of accidents, but only children with the most severe epilepsies have a high risk.

Professor Guerrini states: “The kitchen and bathroom are the most dangerous places: burning accidents should be prevented with shields for sources of heat and children should never be left alone when bathing. Beyond these precautions, the details of reasonable restrictions should be adapted to the individual child.”

Professor Renzo Guerrini, Department of Child Neurology and Psychiatry University of Pisa & IRGGS Fondazione Stella Maris, via dei Giacinti 2, 56018 Calambrone, Pisa, Italy.

Joe Santangelo
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Boston Scientific Begins International Launch And First Implants Of Next-Generation Devices To Treat Heart Failure And Sudden Cardiac Death

Boston Scientific Corporation (NYSE: BSX) today announced the launch and first implants of its ENERGEN™ and PUNCTUA™ cardiac resynchronization therapy defibrillators (CRT-Ds) and implantable cardioverter defibrillators (ICDs) in Europe and other international markets. They are the world’s smallest and thinnest high-energy devices to treat heart failure and sudden cardiac death and offer excellent longevity.

“These devices build on the technological advancements of COGNIS® and TELIGEN® by providing options to customize therapy for individual patients,” said Professor Joachim Winter, M.D., who performed one of the first implants of the ENERGEN ICD with Dong-In Shin, M.D., at the University Hospital Dusseldorf in Germany. “The small profile, coupled with the 4-SITE™ connector system, allowed for an easy implant with a less pronounced physical appearance for the patient.”

“Physicians and patients will truly appreciate the longevity of these devices since it may reduce the need for additional implant surgeries,” said Peter Lecher, M.D., who performed one of the first implants of the ENERGEN CRT-D with Gunther Prenner, M.D., at the Medical University in Graz, Austria. “Additionally, the new therapy options, combined with the LATITUDE® Patient Management system, increase the variety of diagnostic parameters to help treat heart failure patients.”

Most of the new ENERGEN and PUNCTUA devices offer the 4-SITE™ DF4 connector system option, designed to simplify the implant procedure and comply with international connector standards. Additionally, nearly all models are compatible with Boston Scientific’s LATITUDE® Patient Management system, which enables physicians to remotely monitor implantable cardiac device patients between on-site office visits.

“The ENERGEN and PUNCTUA devices are designed to improve the ability of physicians to deliver effective patient care,” said Hank Kucheman, Executive Vice President and Group President, Cardiology, Rhythm and Vascular for Boston Scientific. “This new portfolio of products, built on our tradition of innovation, continues our advantages in size, shape and longevity and provides multiple therapy options to match specific patient needs.”

The Company received CE Mark approval for its ENERGEN and PUNCTUA CRT-Ds and ICDs in October 2010. In the U.S., they are investigational devices, limited by applicable law to investigational use and not available for sale. The Company expects Food and Drug Administration approval for the devices in late 2011 or early 2012.

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Ability To Learn A Second Language In Adulthood Linked To Brain Anatomy

Think you haven’t got the aptitude to learn a foreign language? New research led by Northwestern University neuroscientists suggests that the problem, quite literally, could be in your head.

“Our study links brain anatomy to the ability to learn a second language in adulthood,” said neuroscientist Patrick Wong, assistant professor of communication sciences and disorders at Northwestern and lead author of a study appearing online in Cerebral Cortex.

Based on the size of Heschl’s Gyrus (HG), a brain structure that typically accounts for no more than 0.2 percent of entire brain volume, the researchers found they could predict — even before exposing study participants to an invented language — which participants would be more successful in learning 18 words in the “pseudo” language.

Wong and his colleagues measured the size of HG, a finger-shaped structure in both the right and left side of the brain, using a method developed by co-authors Virginia Penhune and Robert Zatorre (Montreal Neurological Institute). Zatorre and Penhune are well known for research on human speech and music processing and the brain.

“We found that the size of left HG, but not right HG, made the difference,” said Northwestern’s Catherine Warrier, a primary author of the article titled “Volume of Left Heschl’s Gyrus and Linguistic Pitch.” Anil K. Roy (Northwestern), Abdulmalek Sadehh (West Virginia University) and Todd Parish (Northwestern) also are co-authors.

The study is the first to consider the predictive value of a specific brain structure on linguistic learning even before training has begun. Specifically, the researchers measured the size of study participants’ right and left Heschl’s Gyrus on MRI brains scans, including calculations of the volume of gray and white matter.

Studies in the past have looked at the connection between brain structure and a participant’s ability to identify individual speech sounds in isolation rather than learning speech sounds in a linguistic context. Others have looked at the connection between existing language proficiency and brain structure.

“While our study demonstrates a link between biology and linguistics, we do not argue that biology is destiny when it comes to learning a second language,” Wong emphasized. Adults with smaller volumes of left HG gray matter need not despair that they can never learn another language.

“We are already testing different learning strategies for participants whom we predict will be less successful to see if altering the training paradigm results in more successful learning,” Wong added.

According to Warrier, Northwestern research professor of communication sciences and disorders, the researchers were surprised to find the HG important in second language learning. “The HG, which contains the primary region of the auditory cortex, is typically associated with handling the basic building blocks of sound — whether the pitch of a sound is going up or down, where sounds come from and how loud a sound is — and not associated with speech per se,” she said.

The 17 research participants aged 18 to 26 who had their brain scans taken prior to participating in the pseudo second-language training were previously participants in two related studies published by Wong and his research team.

The three studies have identified behavioral, neurophysiologic and, with the current study, neuroanatomic factors which, when combined, can better predict second- language learning success than can each single factor alone.

In a behavioral study, Wong’s group found that musical training started at an early age contributed to more successful spoken foreign-language learning. The study participants with musical experience also were found to be better at identifying pitch patterns before training.

In a neurophysiologic study — again with the same participants — Wong’s team used functional magnetic resonance imaging to observe brain areas that were activated when participants listened to different pitch tones. They found that the more successful second-language learners were those who showed activation in the auditory cortex (where HG resides).

The participants all were native American English speakers with no knowledge of tone languages. In tone languages (spoken by half the world’s population), the meaning of a word can change when delivered in a different pitch tone. In Mandarin, for example, the word “mi” in a level tone means “to squint,” in a rising tone means “to bewilder” and in a falling and then rising tone means “rice.”

For the study reported in “Cerebral Cortex,” Wong’s 17 participants entered a sound booth after having their brains scanned. There they were trained to learn six one-syllable sounds (pesh, dree, ner, vece, nuck and fute). The sounds were originally produced by a speaker of American English and then re-synthesized at three different pitch tones, resulting in 18 different “pseudo” words.

The participants were repeatedly shown the 18 “pseudo” words and a black and white picture representing each word’s meaning. Pesh, for example, at one pitch meant “glass,” at another pitch meant “pencil” and at a third meant “table.” Dree, depending upon pitch, meant “arm,” “cow” or “telephone.”

As a group — and sometimes in fewer than two or three sessions — the nine participants predicted on the basis of left HG size to be “more successful learners” achieved an average of 97 percent accuracy in identifying the pseudo words. The “less successful” participants averaged 63 percent accuracy and sometimes required as many as 18 training sessions to correctly identify the words.

“What’s important is that we are looking at the brain in a new way that may allow us to understand brain functions more comprehensively and that could help us more effectively teach foreign languages and possibly other skills,” said Wong.

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Wong’s research is supported by grants from the National Institutes of Health.

Source: Pat Vaughan Tremmel

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Childhood Sun Exposure May Influence Risk Of Developing Multiple Sclerosis

New research has suggested that people who spend more time in the sun as a child are less likely to develop multiple sclerosis (MS).

Scientists in California have released results of a study involving 70 pairs of identical twins in which one twin had MS while the other did not, which examined their history of sun exposure.

The twins were asked how much time they had spent outdoors on hot and cold days, how much time they had spent on getting a tan, going to the beach, and taking part in team sports. Sun exposure was gauged according to a sun exposure index (SI).

Scientists found a strong connection between a lack of sun exposure and development of MS and discovered that a twin spending more time in the sun as a child was up to 40 per cent less likely to be diagnosed with MS in later life.

Dr Laura Bell, research communications officer at the MS Society, said: “This interesting study highlights the role of sunlight in MS development and supports findings from previous similar studies.

“There are issues involved in accuracy of recall in studies based on self reporting from participants, however the authors do point out that their data was collected when sun exposure was not considered to be an important factor in MS development – meaning participants would be less likely to unintentionally bias their activities,” she said.

The causes of MS are unknown. However, research suggests that a combination of genetic and environmental factors play a role in its development.

If a twin has MS there is a one in three chance the other twin will have MS as its development is not due to genetic susceptibility alone.

It is thought exposure to sunlight could bring about protection against autoimmune disease such as MS by any number of several immunosuppressive mechanisms such as vitamin D production.

Laura added: “Further studies of the pathways by which sun exposure reduces MS risk would be beneficial in determining factors involved in MS development.”

Read more information about vitamins and minerals on the MS Society’s diet and nutrition pages.

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Australian Study Shows Link Between MS And Birth Month

An Australian study published today (Friday 30 April) has shed further light on the correlation between vitamin D and MS.

The study, published in the British Medical Journal, shows that people born after the vitamin D-scarce winter months are roughly 30% more likely to go on to develop MS later in life compared with those born after the summer months.

The work complements a Scottish study recently published which showed that people born in April (after the winter months) were around 50 per cent more likely to develop MS than people born in November (after the summer months).

Vitamin D deficiency has been a widely studied risk factor for MS and this work adds to the evidence linking deficiency to MS.

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BIOTRONIK Introduces New Unique Reliaty Pacing System Analyzer

BIOTRONIK SE & Co. KG, announced the European launch of the Reliaty pacing system analyzer after CE approval and successful pre-market evaluation. The pacing system analyzer (PSA) is used during an implantation of implantable pacemakers, implantable cardioverter-defibrillators (ICDs) and Cardiac Resynchronization Therapy (CRT) systems to ensure adequate lead placement, maintenance of basic cardiac functions, and to evaluate pacing parameters for customized device programming.

“Using the Reliaty allows me to be more flexible during implant procedures. It can be set up and moved very quickly from one location to another whenever necessary”, says Dr. Richard Derksen, Cardiologist in the Rijnstate Clinic Arnhem, The Netherlands. “Reliaty streamlines the workflow of procedures with a focused set of exactly the analytics that are required intraoperatively and for which I would otherwise have to use a programming device which is bulkier and less mobile, especially in the constrained space of the cath lab.”

BIOTRONIK is the only company manufacturing a hand-held PSA such as Reliaty. The new intuitive user interface and option for connecting to a larger external screen allows for quick and easy testing when time is of the essence, supporting safe and accurate measurements. Reliaty also now features an additional test channel that allows for testing of up three implanted cardiac leads to more easily accommodate CRT cases. It is battery powered to last for more than 12 hours of service daily, and additionally offers a universal stationary power cord that can be used worldwide. The measurement data can be exported from the PSA to a memory stick or printed via Bluetooth®.

“Reliaty is yet another example of BIOTRONIK’s focus on developing optimized solutions for advanced patient management”, states Marlou Janssen, Vice President, Global Marketing and Sales, Cardiac Rhythm Management, BIOTRONIK. “Reliaty is part of a completely new external device portfolio from BIOTRONIK. Together with the new external pacemaker Reocor and the upcoming new programmer Renamic, BIOTRONIK is setting new standards in offering the highest quality portfolio of external CRM devices.”

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