Stories about: Global health

What we’ve been reading: Week of May 18, 2015


From cancer to feet: the power of Twitter in healthcare (MedCity News)
Why does Twitter care about the healthcare industry? Craig Hashi, one of two Twitter engineers dedicated to healthcare, details the opportunities.

MIT’s implantable device could help docs determine best cancer medicine (Boston Business Journal)
Removing the trial and error associated with cancer drug treatments is high on oncologists’ wish lists. Heeding that call, MIT has developed an implantable device (about the size of a grain of rice) that can carry up to 30 different drug doses to a cancerous tumor, and then be removed to test responses.

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Early neglect and deprivation change the body’s stress response systems

Photo: Angela Catlin/Wikimedia Commons
Photo: Angela Catlin/Wikimedia Commons

Severe social and emotional deprivation in early life is written into our biochemical stress responses. That’s the latest learning from the long-running Bucharest Early Intervention Project (BEIP), which began in 2000 and has been tracking severely neglected Romanian children in orphanages. Some of these children were randomly picked to be placed with carefully screened foster care families, and they’ve been compared with those left behind ever since.

While studies in rodents have linked early-life adversity with hyper-reactivity of the sympathetic nervous system and the hypothalamicpituitaryadrenal (HPA) axis, the relationship has been harder to pin down in humans. BEIP’s study, involving almost 140 children around the age of 12, had children perform potentially stressful tasks, including delivering a speech before teachers, receiving social feedback from other children and playing a computer game that malfunctioned partway through.

Unlike the rodents, the institutionalized children had blunted responses in the sympathetic nervous system, which is associated with the “fight or flight” response, and in the HPA axis, which regulates production of the stress hormone cortisol. The researchers note that this dulled physiologic response has been linked to health problems, including chronic fatigue, pain syndrome and auto-immune conditions, as well as aggression and behavioral problems.

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What we’ve been reading: Week of March 30, 2015

shutterstock_175074977Bubble wrap used for cheap blood and bacteria tests (New Scientist)
Snap, crackle, pop are the familiar sounds of bubble wrap. According to George Whitesides at the Wyss Institute for Biologically Inspired Engineering at Harvard University, the cheap packing material may be popping up in the near future as a diagnostic tool, replacing costlier 96-well plates.

Nearly half of all pre-schoolers with ADHD are on medication (Washington Post)
The American Academy of Pediatrics calls for children under 6 with ADHD to engage in behavioral therapy before taking medication. Yet according to a national survey published in the Journal of Pediatrics, nearly half of preschool-aged children are on medication for the condition, and more than a fifth were receiving neither of the recommended therapies.

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What we’ve been reading: Week of March 23, 2015



Single-Dose Cures for Malaria, Other Diseases (MIT Technology Review)
Pills that deliver a full course of treatment in one swallow could, or “super pills,” could simplify the treatment of diseases such as malaria and potentially produce cost savings that stretch into the $100 billion a year range, according to Bob Langer, PhD, from the Massachusetts Institute of Technology.

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Six emerging trends in vaccine development

boy receiving vaccine-shutterstock

Vaccines to protect against infectious disease are the single most effective medical product, but developing new ones is a challenging and lengthy process, limiting their use in developing countries where they are most needed. Once a new vaccine is developed, it undergoes animal testing, which is time-consuming and does not necessarily reflect human immunity.

“It can take decades from the start of vaccine development to FDA approval at huge cost,” says Ofer Levy, MD, PhD, a physician and researcher in the Division of Infectious Diseases at Boston Children’s Hospital. “We are working on making the process faster and more affordable.”

A variety of new strategies are emerging to facilitate vaccine development and delivery:

1. Modular approaches to vaccine production

The Multiple Antigen Presenting System (MAPS) is one innovative modular method to more efficiently produce vaccines that provide robust immunity.

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Measles in America: Why vaccination matters

Maimuna (Maia) Majumder is an engineering systems PhD student at MIT and computational epidemiology research fellow at HealthMap.

The 2015 Disneyland measles outbreak in the United States, which started in late December and spread to more than 100 people in just 6 weeks, has recently become the subject of substantial media scrutiny.

Measles is extremely infectious, exhibiting a basic reproductive number between 12 and 18—one of the highest recorded in history. This means that for every 1 case who gets sick in a totally susceptible population, 12 to 18 other folks get sick, too. Thankfully, when uptake of the measles vaccine is high enough in a given community, it’s almost impossible for the disease to spread—thus halting a potential outbreak in its tracks.

But what happens when vaccine rates aren’t high enough?

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When HIV and TB coexist: Digging into the roots of IRIS

HIV (green dots) budding from a white blood cell. (CDC)
HIV (green dots) budding from a white blood cell. (CDC)

Millions of people worldwide suffer from co-infection with tuberculosis (TB) and HIV. While prompt antibiotic and antiretroviral treatment can be a recipe for survival, over the years, physicians have noticed something: two or three weeks after starting antiretrovirals, about 30 percent of co-infected patients get worse.

The reason: immune reconstitution inflammatory syndrome, or IRIS. Doctors think it represents a kind of immune rebound. As the antiretrovirals start to work, and the patient’s immune system begins to recover from HIV, it notices TB’s presence and overreacts.

“It’s as though the immune system was blanketed and then unleashed,” says Luke Jasenosky, PhD, a postdoctoral fellow with Anne Goldfeld, MD, of Boston Children’s Hospital’s Program in Cellular and Molecular Medicine. “It then says, ‘I can start to see things again, and there are a lot of bacteria in here.'”

Though potentially severe, even fatal, IRIS may actually be a good sign: there is evidence that patients who develop it tend to fare better in the long run. But why does it arise only in some patients?

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A link between cystic fibrosis and arsenic poisoning?

boys playing in arsenic-endemic area of Bangladesh

Since its causative gene was sequenced in the 1980s, cystic fibrosis (CF) has been the “textbook” genetic disease. Several thousand mutations have been identified in the CFTR protein, which regulates the flow of chloride in and out of cells. When CFTR is lost or abnormal, thick mucus builds up, impairing patients’ lungs, liver, pancreas, and digestive and reproductive systems, and making their lungs prone to opportunistic infections.

But new research could add a chapter to the textbook, pinpointing an unexpected environmental cause of CF-like illness. A study reported in the February 5 New England Journal of Medicine found that people with arsenic poisoning have high chloride levels in their sweat—the classic diagnostic sign of CF.

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Autism-like behaviors, impaired nerve tracts found in institutionalized children

Sad child-shutterstock_92102072 croppedThe sad experience of abandoned children in Romanian orphanages continues to provide stark lessons about the effects of neglect and deprivation of social and emotional interactions. The long-running Bucharest Early Intervention Project (BEIP) has been able to transfer some of these institutionalized children, selected at random, into quality foster care homes—and documented the benefits.

In a review article in the January 29 Lancet, BEIP investigator Charles A. Nelson, PhD, and medical student Anna Berens, MsC, both of Boston Children’s Hospital, make a strong case for global deinstitutionalization—as early in a child’s life as possible. Currently, it’s estimated that at least 8 million children worldwide are growing up in institutional settings.

The BEIP studies have documented a series of problems in institutionalized children, especially those who aren’t placed in foster care or are placed when they are older:

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Hope for the New Year: A dengue vaccine in 2015?

(Photo: CDC Public Health Image Library)

Katherine Broecker is an MPH student at Boston University and a data curator at HealthMap. In this post, which originally appeared on HealthMap’s Disease Daily, she explores the burden of dengue and hopes that a new vaccine will be licensed sometime this year.

What is Dengue?

A virus transmitted by Aedes aegypti and Aedes albopictus mosquitoes, dengue is a flu-like illness characterized by a high fever and severe joint pain, sometimes with hemorrhagic manifestations. There are four distinct serotypes of the virus (DEN-1, DEN-2, DEN-3, DEN-4). Recovery from one infection provides lifelong protection from a homologous (same-strain) infection and partial temporary protection from the other strains. However, subsequent heterologous (different-strain) infection increases the risk of severe dengue manifestations.

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