Rodney Willoughby, MD, a pediatric infectious disease specialist at the Medical College of Wisconsin, can’t help thinking about the future—a future in which thousands of men and women develop precancerous or cancerous lesions that could have been prevented had they been vaccinated against the human papillomavirus (HPV) as 11- or 12-year-olds.
“The family practitioners and pediatricians do a really bad job in promoting HPV vaccination for a variety of reasons,” said Willoughby, a member of the Advisory Committee on Immunization Practices’ (ACIP) working group on the HPV vaccine and the American Academy of Pediatrics’ Committee on Infectious Diseases. “We recognize that we are falling down on the job. This is actually a real emergency.”
The incidence of type 1 diabetes has been progressively increasing during the past several decades, particularly among children younger than 5 years.1 At the same time, there has been substantial progress in understanding the pathogenesis of the disease and identifying those at risk of progressing to type 1 diabetes.2 In children at genetic risk, diabetes-related autoantibodies appear, followed by the evolution of metabolic abnormalities and the eventual clinical appearance of the disease.2 If individuals identified by genetic markers subsequently undergo seroconversion and develop 2 or more diabetes-related autoantibodies, their risk of progression to type 1 diabetes is 75% over 10 years and appears to be almost inevitable over 20 years.3 However, attempts at both primary prevention, ie, before seroconversion, and secondary prevention, ie, in those with diabetes-related autoantibodies, have not been successful.4 The interventions evaluated to date have been limited to those deemed extremely safe, because such interventions would be used in at-risk individuals who may or may not actually progress to type 1 diabetes.
The human body is soft, curvilinear, and continuously evolving; modern electronic devices are rigid, planar, and physically static. Recent research has yielded a complete set of advanced materials, manufacturing approaches, and design layouts that eliminates this profound mismatch in properties. The resulting devices can intimately integrate onto or into the human body for diagnostic, therapeutic, or surgical function with important unique capabilities in biomedical research and clinical medicine. These emerging technologies have strong potential to improve human health and to enhance the understanding of living systems. They fall into 3 categories—soft, injectable, and bioreabsorbable electronics—each demonstrated in extensive animal studies and several in initial human trials. The Figure presents images of bioelectronic devices.
Figure. Images of Biocompatible Electronic Devices A, Inflated balloon catheter equipped with arrays of sensors for pressure, flow, and contact along with actuators for ablation therapy and light-emitting diodes for optical characterization. B, Three-dimensional membrane wrapped around the entire surface of the heart for cardiac electrotherapy. C, Actively multiplexed sheet of electronics laminated onto the surface of the brain for high-resolution electrocorticography. D, Wireless electronics mounted on the skin for continuous, multimodal monitoring of physiological status. E, Injectable optoelectronic system threaded through the eye of a sewing needle and wrapped around its shaft to highlight the small dimensions and flexible mechanics. F, Bioresorbable electronic circuit, partially dissolving in a drop of water. All of the constituent materials dissolve at controlled rates into harmless end products when exposed to biofluids.
For over two decades, the quest to develop a working malaria vaccine has proven largely fruitless. According to the World Health Organisation (WHO), about 3.2 billion people worldwide are at risk of being diagnosed with malaria. Every year, nearly 198 million cases are identified. WHO says a significant number of the almost 200 million cases are from Africa. However in recent times not only is there a potential malaria vaccine in the pipeline, a new device which is capable of diagnosing Malaria in minutes has emerged.
John Lewandowski, co-founder and CEO of Disease Diagnostics Group, has invented a new way of diagnosing the deadly disease using two magnets and a laser pointer. He believes that this will eradicate malaria by strengthening the offensive against it, while curbing issues regarding delay in detection.
Clinical Question Are Echinacea products associated with a reduced incidence and a shorter duration of common colds compared with placebo?
Bottom Line Individual prophylaxis trials show no association with prevention of the common cold, but exploratory meta-analysis suggests that Echinacea products may be associated with a small reduction in cold incidence. In treatment trials, there was no association of Echinacea products with a shorter duration of colds.
Preparations of the plant Echinacea are widely used in North America and Europe for prevention and treatment of the common cold.1 This JAMA Clinical Evidence Synopsis summarizes the results of a Cochrane review2 regarding the association ofEchinacea products with prevention and treatment of colds.
Over the last 2 decades, adults around the world modestly increased their intake of healthy dietary items, but this trend was exceeded by increases in consumption of unhealthy items, according to an analysis of global dietary patterns (Imamura F et al.Lancet Glob Health. 2015;3:e132-e142).
Study finds global diet quality declined, despite increased consumption of healthy foods.
UCLA stakes an early claim to leadership in clinical genomic sequencing.
A. Eugene Washington, MD, MSc Vice Chancellor, UCLA Health Sciences Dean, David Geffen School of Medicine at UCLA Gerald S. Levey, MD, Endowed Chair
Yes, the future does often exist somewhere. In the case of genomic medicine, that place is UCLA. I witnessed it firsthand when I participated last July in the eye-opening weekly case conference of our Clinical Genomics Center (CGC). This collaboration among multiple departments in the David Geffen School of Medicine at UCLA and UCLA Health System has set the standard for the transformation of molecular medicine to the new era of genomic medicine.
Moving beyond traditional genetic testing of one or a few genes at a time, the CGC utilizes so-called “next-generation” or “massively parallel” DNA sequencing to obtain full DNA sequences of all the protein-coding regions in the human genome, about 30-million nucleotides of genetic code comprising about 20,000 genes.
At least 400 million people lack access to essential health services, the World Health Organization and World Bank said Friday in a new report that they described as a “wake-up call” about the challenges to achieving universal health coverage.
The report also said that at least 6 percent of people in 37 low-and-middle-income countries are living in poverty because of the money they must spend on health. That finding alone suggested that the poorest could be left further behind by rising global health costs.
“The world’s most disadvantaged people are missing out on even the most basic services,” Dr. Marie-Paule Kieny, assistant director-general for health systems and innovation at the W.H.O., said in a statement announcing the 98-page report, which was released online and at a news conference at United Nations headquarters in New York. Read more →
Within the last decade, the phrase “gut feelings” has taken on a whole new meaning. Traditionally, scientists have focused on the role of the central nervous system in regulating our moods and behaviors, but a paradigm shift is afoot, with new research revealing a unique role of our gut microbiota in influencing emotion.
A seminal study published in 2004 provided some of the first evidence of bidirectional interaction between gut bacteria and the brain, demonstrating that germ-free (GF) mice without commensal microorganisms have an exaggerated response to stress, accompanied by altered brain chemistry and elevated stress hormones, which could be normalized by administration of a single type of bacterium, Bifidobacterium infantis (Sudo N et al. J Physiol. 2004;558[pt 1]:263-275).
In November, with the Ebola outbreak in West Africa showing no signs of slowing, the list of people climbing aboard planes to Liberia and Sierra Leone was not terribly long. Deborah Theobald, the co-founder of Cambridge-based health care company Vecna Technologies, was one of them. Accompanying her were two new tools that, it was hoped, could aid health workers trying to care for stricken patients.One was a briefcase-sized electronic medical record system, a field-ready version of a product that Vecna Technologies designed to digitally store and share patient information.
The other was “telepresence” robot made by New Hampshire company VGo Communications — a camera and recording system on wheels that could be controlled from afar by an iPad app, meant to help nurses talk to each other across containment zones. Read more →