Testing hair from Asian monkeys living close to people may provide early warnings of toxic threats to humans and wildlife, according to a study published online this week in the American Journal of Physical Anthropology.

In parts of South and Southeast Asia, macaques and people are synanthropic, which means they share the same ecological niche. They drink from identical water sources, breathe the same air, share food sources, and play on the same ground.

“Macaques are similar to humans anatomically, physiologically and behaviorally,” said the senior author on the study, Dr. Lisa Jones-Engel, a senior research scientist at the National Primate Research Center at the University of Washington in Seattle.

“They are also similar in their response to toxic exposures,” said lead author Dr. Gregory Engel, a physician at Swedish Cherry Hill Family Medicine in Seattle and a research scientist at the UW National Primate Research Center. When macaques live in environments polluted by motor vehicles, openly disposed garbage, and industrial waste, they can come into contact with toxic substances such as lead, just as their human neighbors might.

Lead toxicity, the authors noted, remains a significant public health problem around the world. Intense exposure to lead can damage the nervous, circulatory, and reproductive systems, as well as the kidneys and liver. Exposure during childhood, according to other studies, may cause more subtle effects, such as decreased intelligence.

According to Jones-Engel, the researchers hypothesized that young macaques, in particular, would be good sentinels for human exposure to lead exposure.

“Young macaques share a propensity for curiosity and have a penchant for picking up objects and inserting them into their mouths, just as young children do,” Jones-Engel noted. “A juvenile macaque has all the curiosity and energy of a toddler, and then some! Plus their parents aren’t well informed about environmental hazards.”

She and her team of primatologists, physicians, epidemiologists, veterinarians and toxicologists decided to test urban macaques as a potential early indicator that their human neighbors, especially the children, are being exposed to lead and other toxic metals. They took hair samples from three groups of free-ranging macaques at the Swoyambhu temple overlooking Kathmandu, Nepal. The macaques patrolling the site have abundant contact with people and with human-made environments. This World Heritage Site temple is located in a densely populated urban area with poor infrastructure that leaves point sources like discarded lead batteries, flaking leaded paint, and lead contaminated soil, a by-product of decades of leaded fuel, in the environment.

Hair lead levels differed among the three groups of macaques, and were much higher in younger macaques. The researchers’ data did not support the idea that these lead levels were from basic differences in the animals’ diet, and instead suggested that, in this population of macaques, behavioral or physiological factors among young macaques might play a significant role in determining exposure to lead and subsequent tissue concentration.

Animal sentinels of poisonous conditions for people have been used for a long time. From the 19th century and well into the 20th century coal miners sent canaries into mining shafts to check if the air was safe to breathe.

“While using animal sentinels is not a new phenomenon, we argue that not all animal species are relevant models for human toxicant exposures, but young macaques that share the same ecological niche with humans may be one of the best animal sentinels we have,” Engel said.

Scientists testing for environmental exposures also don’t want to hurt the animals they are monitoring. Collecting a few hairs is a gentle, non-invasive approach.

The researchers noted, “All of these factors contribute to making synanthropic macaques — those that share the environment with humans — potentially valuable as sentinels for toxic exposures and predictors of physiologic responses in humans.”

The research team concluded, “Chemical analysis of hair is a promising, non-invasive technique for determining exposure to toxic elements in free-ranging, non-human primates, and further multidisciplinary research is needed to establish whether it can be used to predict lead levels in humans who live in the same areas.”

In addition to Engel and Jones-Engel, other researchers on this study were Todd M. O’Hara and Tamara Cardona-Marek of the Institute of Arctic Biology at the University of Alaska, Fairbanks; John Heidrich of Quatros, LLC; Mukesh K. Chalise of the Central Department of Biology, Tribhuvan University; and Randall Kyes of the UW Department of Psychology and the UW National Primate Research Center.

The study was funded by grants from the Defense Advanced Research Projects Agency and the National Institutes of Health.

Source:
Leila Gray

University of Washington

There is now a new alternative to immunosuppressive treatment after kidney transplants which comes without the usual severe side effects. The Medical University was significantly involved in the clinical development of the active ingredient Belatacept and a suitable preparation has now been given EU-wide authorisation.

“This could fundamentally revolutionise kidney transplantation and its treatment”, says Ferdinand MГјhlbacher, director of the University Department of Surgery and together with the immunologist Thomas Wekerle, head of the Viennese study centre. Instead of nine years, a transplanted kidney supported with Belatacept can last 13 years according to conservative estimations. MГјhlbacher is somewhat more optimistic. “I estimate 15 to 17 years.” Nine out of 22 patients are still involved in the Vienna scientist’s long-term study. They are being treated with the substance ten years after a transplant. “Their kidney functions are excellent”, says MГјhlbacher.

The advantage of the co-stimulation blocker Belatacept is easily explained as contrary to the usual immunosuppressants, the calcineurin inhibitors such as ciclosporin for example, Belatacept does not have any side effects. For almost 30 years calcineurin inhibitors have been used for the life-long suppression of the immune system’s undesired reactions following organ transplants. The possible side effects such as high blood pressure, diabetes or lipid metabolism disorders used to have to be considered. MГјhlbacher says, “However we now have a substance which is as effective, which is not toxic, which does not have any side effects, and which ensures better organ function.” With transplants there is still the fundamentally increased risk of cancer which according to MГјhlbacher is as high with the active ingredient Betalacept as with the calcineurin inhibitors.

Around 420 transplants are performed at the MedUni Vienna each year and 180 of these involve kidneys. “We shall of course not now change all of our patients to the new medicine, however we shall of course consider this for new patients”, says MГјhlbacher.

MedUni Vienna has had a great reputation in transplant medicine since 1990

The significant proportion of the clinical development of this active ingredient also underlines the Medical University of Vienna’s expertise in transplants which it has acquired over decades. “Our reputation in transplant medicine can be attributed to the astronomical numbers of donors in the 1990s”, says MГјhlbacher. “In 1990 only there were 260 kidney patients.” As a result of the successful transplants there was a positive “yo-yo effect” which led to increasing numbers of donors and also to an increased reputation and international regard. In 2013 the European Transplant Congress shall take place in Vienna, and Vienna was the venue of the 20th World Congress of the Transplantation Society in 2004.

Kidney and liver transplants are already commonplace these days, says MГјhlbacher, and the current trend is for lung transplants. The Medical University of Vienna is also a world leader in this field. Walter Klepetko, Chairman of the Department of Thoracic Surgery, leads the largest lung transplant centre in Europe, which is also the second largest in the world.

Sources: Medical University of Vienna, AlphaGalileo Foundation.

The House Veterans’ Affairs Health Subcommittee on Thursday approved by voice vote six bills related to health care services administered by the Department of Veterans Affairs, CQ HealthBeat reports.

One of the bills (HR 1527), sponsored by Rep. Jerry Morgan (R-Kan.), would allow “highly rural” veterans to receive health services through outside providers. The bill defines highly rural as veterans seeking primary care who live more than 60 miles from the nearest veterans’ facility; veterans seeking acute hospital care who live more than 120 miles from a facility; and those seeking tertiary care who live more than 240 miles from a facility. An amendment to the bill, which also was approved on Thursday, would establish a three-year pilot program to allow veterans enrolled in four of VA’s 21 health care networks to receive outside health services. The bill does not include funding for the pilot program.

The other five bills were improved en bloc by voice vote. The bills include a measure (HR 6439), sponsored by Rep. Phil Hare (D-Ill.), that would extend mental health benefits to family members of veterans who seek non-service related treatment (Johnson, CQ HealthBeat, 7/10). In addition, the panel approved a measure (HR 6445) sponsored by Rep. Don Cazayoux (D-La.) that would prohibit hospitals and nursing homes from requiring copayments from catastrophically disabled veterans, such as those who are paralyzed or have neurological disorders (CongressDaily, 7/10).

The bills are expected to be marked up by the full committee on July 16 (CQ HealthBeat, 7/10).

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.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The Global Fund To Fight AIDS, Tuberculosis and Malaria on Monday announced it has approved nearly $3 billion in Round 8 funding to improve access to HIV treatment and prevention and help reduce deaths from TB and malaria by 50% by 2015, AFP/Yahoo! News reports (AFP/Yahoo! News, 11/10). The Global Fund’s board approved 94 grants worth $2.75 billion, representing the group’s largest funding round to date (Global Fund release, 11/10).

Rajat Gupta, chair of the Global Fund’s board, said the grants represent “the highest amount of new financing approved by the Global Fund ever,” adding that 38% of the resources will be used for HIV/AIDS programs, 11% for TB programs and 51% for malaria programs. Gupta said that 90% of the approved grants will be distributed to low-income countries, 77% of which are in Africa and the Middle East. The remaining funds will be dispersed to countries in Asia, Central Asia, Eastern Europe, Western Pacific, the Caribbean and Latin America (AP/International Herald Tribune, 11/11). The funding brings the total amount of aid awarded by the Global Fund to $14.4 billion.

Michel Kazatchkine, executive director of the Global Fund, said the “increased demand” for funding “requires a renewed resource mobilization effort.” He added that the Global Fund has a “fantastic message to bring back to the rich nations of the world: programs to fight these three diseases save lives, reduce disease burdens and strengthen health systems” (Global Fund release, 11/10).

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.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

China will survey the smoking habits among key sectors, including doctors and teachers, in 31 provinces, autonomous regions and municipalities as it works towards establishing a national network of anti-smoking clinics.

The goal is to have at least one outpatient facility in each province, where smokers would be offered a combination of medical and psychological treatment depending on their nicotine dependence.

According to the Department of Maternal and Child Health Care, the survey, whose parameters were yet to be determined, would study whether people knew of the risks of smoking and how to stop.

China has 350 million smokers and 540 million people affected by passive smoking. These figures mean that two-thirds of the population are either smokers or are subjected to second-hand smoke, with the government estimating that second-hand smoke is responsible for 100,000 deaths each year.

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UroToday – Abnormalities in hormonal regulation may have a role in the etiology of cryptorchidism. The objective of this study by Soumi et al was to assess the hypothalamic-pituitary-testicular axis in cryptorchid boys during the postnatal hormonal surge. This was a prospective, longitudinal, population-based study performed at two primary obstetric centers. There were 388 Finnish and 433 Danish boys (88 and 34 with cryptorchidism, respectively). Clinical examinations were performed at 0 and 3 months. Blood samples were taken at 3 months. The main outcome measures were testis position and reproductive hormone levels.

The group found that the Finnish cryptorchid boys had significantly higher FSH and lower inhibin B levels than Finnish control boys. Danish cryptorchid boys had higher FSH levels than controls. Inhibin B levels in healthy Danish boys were lower than those in Finnish boys and were not reduced in Danish cryptorchid boys. Changes in hormone levels were strongest in boys with severe, persistent cryptorchidism, but were also detectable in mild cryptorchidism and retractile testes. Effects on Leydig cell function were subtle, with an increase in LH in Finnish (but not Danish) cryptorchid boys as compared to, but testosterone levels remained within the normal range.

The group concluded that their results support the hypothesis that cryptorchidism is associated with a primary testicular disorder. One can postulate that the cryptorchidism itself may end up playing a primary role since there was low inhibin B production in the Finnish cohort and high gonadotropin drive in both the Finnish and Danish cohorts. Further investigation is warranted to replicate these findings, as they are an important observation to further our knowledge of the undescended testis.

By Pasquale Casale, MD

Reference: A Suomi, KM Main, M Kaleva, IM Schmidt, M Chellakooty, HE Virtanen, KA Boisen, IN Damgaard, C Mau Kai, NE Skakkebжk, J Toppari.
The Journal of Clinical Endocrinology & Metabolism, 91(3): 953-958, March 2006
Link Here.

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UroToday – Prostate cancer gene 3 is a promising new prostate cancer (CaP) biomarker as it is over-expressed in CaP tissue compared to normal prostate tissue. As such, Dr. Donna P. Ankerst and colleagues hypothesized that its inclusion in the Prostate Cancer Prevention Trial (PCPT) risk calculator may augment its predictive capabilities. Their research report appears in the October 2008 issue of the Journal of Urology.

Specimens for the analysis were collected from 521 patients at four North American centers – along with data on PCA3, PSA, DRE, age, race, and history of prostate biopsy. In addition, a cohort from Europe comprised of 443 patients at high risk for CaP, was evaluated for external validation of posterior risks.

A noted difference between the 521 men in the PCA3 group and the 5,519 men in the PCPT placebo group used to derive the PCPT risk calculator is that the PCPT cohort was a screened population. Only 11.7% of the PCPT placebo group had undergone a prior biopsy compared to 49.5% of the PCA3 group. Only 21.2% of CaP was high grade in the group of PCPT men, compared to 42.7% in the PCA3 cohort. This demonstrates that the PCA3 cohort was at a much greater risk for CaP and high-grade disease.

A “likelihood ratio” (LR) which expresses how much more likely a given PCA3 value is for cases vs. controls was used. A LR >1 means the PCA3 value is more often seen in cases while an LR

A letter to U.S. Department of Agriculture Secretary Tom Vilsack from 75 Members of Congress asks that farmers be allowed to plant Roundup Ready alfalfa (RRA) in the fall 2010 planting season.

The June 21, 2010, decision by the U.S. Supreme Court lifted a nationwide ban on the cultivation of biotech alfalfa, but remanded the case back to the District Court. Depending on the District Court’s decision, USDA can then decide what interim measures can be implemented while the agency completes its Environmental Impact Statement (EIS).

The letter points out that the USDA’s draft EIS concluded that there is “no significant impact on the human environment due to granting non-regulated status to Roundup Ready alfalfa.” A partial deregulation would allow farmers to plant their inventoried RRA seed this fall while the USDA’s Animal and Plant Health Inspection Service (APHIS) completes its final environmental impact study.

The International Pediatric Transplant Association (IPTA) will welcome leaders in the field of pediatric transplantation to present at the 5th Congress of the IPTA, being held April 18 – 21, 2009 in Istanbul, Turkey. The Congress is a critical component in transplantation education, and the only event concentrating solely on the clinical and research aspects of pediatric solid organ, tissue, and bone marrow/stem cell transplantation.

Transplant professionals from around the world are expected to attend, looking to take advantage of the valuable information and networking opportunities presented at the meeting. The Congress will feature an outstanding line-up of plenary speakers addressing issues of common interest to the entire pediatric transplant community, including immunosuppression, ethical issues, facilitating clinical trials, treatment of long term post-transplant complications, and more.

A record number of abstracts have been submitted this year, and cutting edge scientific and clinical information will also be presented in the form of state-of-the-art presentations, interactive workshops, symposia, debates, and poster presentations.

Highlights of the Congress include a post-graduate course on quality of life and vaccines and viruses in transplant recipients; a symposium on how to improve the outcomes of pediatric transplantation; and plenary sessions on non-adherence, registry reports, organ allocation, chronic allograft dysfunction/prevalence/treatment/outcomes, and ethical issues. A complete schedule of the presentations can be accessed on the Congress Web site, iptaonline/5thcongress.

The International Pediatric Transplant Association (IPTA) is a professional organization of individuals in the field of pediatric transplantation. The purpose of the association is to advance the science and practice of pediatric transplantation worldwide in order to improve the health of all children who require such treatment. The association is dedicated to promoting technical and scientific advances in pediatric transplantation and advocating for the rights of all children who need transplantation.

For more information on IPTA and to register for the Congress, please visit iptaonline.

International Pediatric Transplant Association

No patient who is at least 65 years old should ever go to a hospital emergency room without his or her electronic medical record being present. This is the opinion of Dr. Matthew Narrett, chief medical officer for Erickson Health, the nation’s largest integrated wellness and health system for people in this age group.

Few hospitals in the United States have the technology that is required to receive and process electronic medical records. As a result, emergency room doctors lack patient information related to immunizations, advance directives, medications, X-rays, Cat-scans, MRIs, family histories, and recent medical visits.

This information is crucial, according to Dr. Narrett, who said that 80 percent of a successful diagnosis by a doctor comes from knowing the patient’s history. “Timely and comprehensive information about a patient – particularly in an emergency room — can mean the difference between an appropriate therapeutic intervention and an ineffective, potentially risky situation.”

Erickson Health has invested nearly $2 million to bring its medical records for the more than 21,000 people who live at Erickson campuses nationwide online. The health system has already seen improved efficiencies, better outcomes and cost savings as a result of its move to cyberspace medical histories.

“Without having access to electronic medical records, doctors in hospital emergency rooms must often make educated guesses about a diagnosis, based on lab work for a patient that is compiled in a compressed timeframe,” Dr. Narrett said. “There is no reason for this to have to be the case.

“A doctor is only as good as the information that he or she is given,” said Dr. Narrett. “Electronic medical records are the future, and the future is now.”

erickson