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Showing posts with label Prevention. Show all posts
Showing posts with label Prevention. Show all posts

Saturday, August 01, 2020

end of century world population

The global population

Global population projections to 2100. Credit: The Lancet. Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: a forecasting analysis for the Global Burden of Disease Study


Sunday, May 24, 2020

Preventing Alzheimer D.

Preventing Alzheimer's:  Our lifespan has outpaced our brain's healthspan. Harvard professor of neurology Rudolph Tanzi has been at the leading edge of neuroscience as co-director of the Center for Brain Health at Mass General Hospital.  His work  illuminates the key role of neuroinflammation in Alzheimer's disease and the potential to stop it before symptoms emerge.   Like cholesterol and heart disease, waiting for late-stage disease to initiate statin therapy is too late.  Leveraging primary prevention and early detection modalities (i.e. imaging, polygenenic risk scores, to blood tests & eye-tracking modalities) and an early response will be key.  In Dr. Tanzi's terrific talk at Exponential Medicine 2019, he explores the biology, new therapy approaches, including leveraging 3D brain organoid dish models, to developing an understanding and bring a future with personalized treatment, targeting the right pathology, with the right interventions at the right time. Dr. Tanzi closes with lessons on how to protect your brain, summarized by SHIELD (Sleep, Handling stress, Interaction with others, Exercise, Learning new things, and Diet).
 
 

Sunday, May 17, 2020

Edward Jenner



Edward Jenner, (born May 17, 1749, Berkeley, Gloucestershire, England—died January 26, 1823, Berkeley), English surgeon and discoverer of vaccination for smallpox.
Jenner was born at a time when the patterns of British medical practice and education were undergoing gradual change. Slowly the division between the Oxford- or Cambridge-trained physicians and the apothecaries or surgeons—who were much less educated and who acquired their medical knowledge through apprenticeship rather than through academic work—was becoming less sharp, and hospital work was becoming much more important.
Jenner was a country youth, the son of a clergyman. Because Edward was only five when his father died, he was brought up by an older brother, who was also a clergyman. Edward acquired a love of nature that remained with him all his life. He attended grammar school and at the age of 13 was apprenticed to a nearby surgeon. In the following eight years Jenner acquired a sound knowledge of medical and surgical practice. On completing his apprenticeship at the age of 21, he went to London and became the house pupil of John Hunter, who was on the staff of St. George’s Hospital and was one of the most prominent surgeons in London. Even more important, however, he was an anatomist, biologist, and experimentalist of the first rank; not only did he collect biological specimens, but he also concerned himself with problems of physiology and function.
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Vaccine Effectiveness

After Pasteur’s time, a widespread and intensive search for new vaccines was conducted, and vaccines against both bacteria and viruses were produced, as well as vaccines against venoms and other toxins. Through vaccination, smallpox was eradicated worldwide by 1980, and polio cases declined by 99 percent. Other examples of diseases for which vaccines have been developed include mumpsmeaslestyphoid fevercholeraplaguetuberculosistularemia, pneumococcal infection, tetanusinfluenzayellow fever, hepatitis A, hepatitis B, some types of encephalitis, and typhus—although some of those vaccines are less than 100 percent effective or are used only in populations at high risk. Vaccines against viruses provide especially important immune protection, since, unlike bacterial infections, viral infections do not respond to antibiotics.

Vaccine Types

The challenge in vaccine development consists in devising a vaccine strong enough to ward off infection without making the individual seriously ill. To that end, researchers have devised different types of vaccines. Weakened, or attenuated, vaccines consist of microorganisms that have lost the ability to cause serious illness but retain the ability to stimulate immunity. They may produce a mild or subclinical form of the disease. Attenuated vaccines include those for measles, mumps, polio (the Sabin vaccine), rubella, and tuberculosis. Inactivated vaccines are those that contain organisms that have been killed or inactivated with heat or chemicals. Inactivated vaccines elicit an immune response, but the response often is less complete than with attenuated vaccines. Because inactivated vaccines are not as effective at fighting infection as those made from attenuated microorganisms, greater quantities of inactivated vaccines are administered. Vaccines against rabies, polio (the Salk vaccine), some forms of influenza, and cholera are made from inactivated microorganisms. Another type of vaccine is a subunit vaccine, which is made from proteins found on the surface of infectious agents. Vaccines for influenza and hepatitis B are of that type. When toxins, the metabolic by-products of infectious organisms, are inactivated to form toxoids, they can be used to stimulate immunity against tetanusdiphtheria, and whooping cough (pertussis).

In the late 20th century, advances in laboratory techniques allowed approaches to vaccine development to be refined. Medical researchers could identify the genes of a pathogen (disease-causing microorganism) that encode the protein or proteins that stimulate the immune response to that organism. That allowed the immunity-stimulating proteins (called antigens) to be mass-produced and used in vaccines. It also made it possible to alter pathogens genetically and produce weakened strains of viruses. In that way, harmful proteins from pathogens can be deleted or modified, thus providing a safer and more-effective method by which to manufacture attenuated vaccines.
Recombinant DNA technology has also proven useful in developing vaccines to viruses that cannot be grown successfully or that are inherently dangerous. Genetic material that codes for a desired antigen is inserted into the attenuated form of a large virus, such as the vaccinia virus, which carries the foreign genes “piggyback.” The altered virus is injected into an individual to stimulate antibody production to the foreign proteins and thus confer immunity. The approach potentially enables the vaccinia virus to function as a live vaccine against several diseases, once it has received genes derived from the relevant disease-causing microorganisms. A similar procedure can be followed using a modified bacterium, such as Salmonella typhimurium, as the carrier of a foreign gene.
Vaccines against human papillomavirus (HPV) are made from viruslike particles (VLPs), which are prepared via recombinant technology. The vaccines do not contain live HPV biological or genetic material and therefore are incapable of causing infection. Two types of HPV vaccines have been developed, including a bivalent HPV vaccine, made using VLPs of HPV types 16 and 18, and a tetravalent vaccine, made with VLPs of HPV types 6, 11, 16, and 18.

Another approach, called naked DNA therapy, involves injecting DNA that encodes a foreign protein into muscle cells. The cells produce the foreign antigen, which stimulates an immune response.

Table Of Vaccine-Preventable Diseases

diseaseyear
*Vaccine recommended for universal use in U.S. children. For smallpox, routine vaccination was ended in 1971.
**Vaccine developed (i.e., first published results of vaccine usage).
***Vaccine licensed for use in United States.
smallpox*1798**
rabies1885**
typhoid1896**
cholera1896**
plague1897**
diphtheria*1923**
pertussis*1926**
tetanus*1927**
tuberculosis1927**
influenza1945***
yellow fever1953***
poliomyelitis*1955***
measles*1963***
mumps*1967***
rubella*1969***
anthrax1970***
meningitis1975***
pneumonia1977***
adenovirus1980***
hepatitis B*1981***
Haemophilus influenzae type b*1985***
Japanese encephalitis1992***
hepatitis A1995***
varicella*1995***
Lyme disease1998***
rotavirus*1998***
human papillomavirus2006
dengue fever
Vaccine-preventable diseases in the United States, presented by year of vaccine development or licensure.
diseaseyear
*Vaccine recommended for universal use in U.S. children. For smallpox, routine vaccination was ended in 1971.
**Vaccine developed (i.e., first published results of vaccine usage).
***Vaccine licensed for use in United States.

Saturday, May 16, 2020

Contágio e Controle

Artigo que enviei para ZH e não foi publicado
CONTÁGIO E CONTROLE
Aloyzio Achutti. Médico

Nas últimas três décadas do século passado andei pela mídia envolvido com prevenção de doenças crônicas e não transmissíveis (não contagiosas). Até então os objetivos de saúde pública focavam quase que só doenças infecciosas e parasitárias, saúde materno-infantil e desnutrição. Os demais problemas passaram a ser valorizados em todo o mundo somente a partir da divulgação de dados populacionais mostrando que as outras doenças não eram somente “privilégio” de gente rica. Por aqui, começamos na década de 70 tentando controlar uma cardiopatia iniciada na idade escolar a partir de bactérias da garganta - portanto com início infectocontagioso, e evolução cardiológica, crônica e não transmissível - facilitando sua aceitação pelos sanitaristas da época. Seguiu-se com tentativa de controle do fumo, hipertensão, diabete, sedentarismo, câncer, etc...
Apesar do deslumbramento da descoberta dos germes e da vacina no século 19, e dos antibióticos no século passado, ficava o controle de doenças limitado àquelas nas quais um potencial culpado era identificado. A complexidade das outras doenças sem um agente causal conhecido, tornava difícil sua abordagem.
No clima da atual pandemia, e contemplando já de longe minha história, senti-me obrigado a retomar o assunto, reconhecendo também ter havido deslumbramento em nossas conquistas, não devendo menosprezar qualquer fator que ponha em risco a vida e sua qualidade.
A dimensão ecológica não pode ser ignorada: por dentro de nós mesmos (micro bioma), e por fora, mergulhados no meio ambiente, com todos os seres com que coabitamos, inclusive humanos. Ressurgem os germes e tomamos progressivamente consciência de um terceiro grupo de doenças, já comprometido com os dois anteriores: as doenças provocadas pelo próprio homem “man-made-diseases”.
Pode parecer lúgubre, falar nisso nessa hora, mas como conclui John Cairns (abordando saúde pública, biologia molecular, câncer e perspectivas para nossa espécie) em seu livro “Assuntos de Vida e Morte” (1997), isso não é mais preocupação para longo prazo, é o destino da geração de nossos netos. Sensação de perigo, perda de poder e frustrações desencadeiam reações de rebanho (contágio) e tribalismo (perda de solidariedade), e compromete-se a sobrevivência de nossa própria espécie. Ficam profundas marcas neuropsiquiátricas, com consequências para o resto do organismo e da população. Estresse, ansiedade, modificações do caráter, da sociabilidade, inveja, ódio, voracidade, agressividade, dependência, depressão, infelicidade, etc... Vacinas, antibióticos, outros remédios, respiradores, e intervenções cirúrgicas ou genômicas não resolvem. Nem quarentena adianta. Dependemos uns dos outros, de nosso próprio comportamento, de nossa sensibilidade, e do relacionamento mútuo

Tuesday, May 05, 2020

Malária

Thursday, March 26, 2020

copper’s antimicrobial properties

Copper Kills Coronavirus. Why Aren’t Our Surfaces Covered in It?

Civilizations have recognized copper’s antimicrobial properties for centuries. It’s time to bring the material back.

Fast Company
Fast Company
Mar 16 · 5 min readphoto: 
By Mark Wilson
In China, it was called “qi,” the symbol for health. In Egypt it was called “ankh,” the symbol for eternal life. For the Phoenicians, the reference was synonymous with Aphrodite — the goddess of love and beauty.
These ancient civilizations were referring to copper, a material that cultures across the globe have recognized as vital to our health for more than 5,000 years. When , bacteria like , superbugs like MRSA, or even coronaviruses land on most hard surfaces, they can live for up to four to five days. But when they land on copper, and copper alloys like brass, they die within minutes. “We’ve seen viruses just blow apart,” says Bill Keevil, professor of environmental healthcare at the University of Southampton. “They land on copper and it just degrades them.”
No wonder that in India, people have been drinking out of copper cups for millennia. Even here in the United States, a copper line brings in your drinking water. Copper is a natural, passive, antimicrobial material. It can self-sterilize its surface without the need for electricity or bleach.
Copper boomed  as a material for objects, fixtures, and buildings. Copper is still widely used in power networks — the copper market is, in fact, growing because the material is such an effective conductor. But the material has been pushed out of many building applications by a wave of new materials from the 20th century. Plastics, tempered glass, aluminum, and stainless steel are the materials of modernity — used for everything from architecture to Apple products. Brass door knobs and handrails went out of style as architects and designers opted for sleeker-looking (and often cheaper) materials.
Now Keevil believes it’s time to bring copper back in public spaces, and hospitals in particular. In the face of an  full of global pandemics, we should be using copper in healthcare, public transit, and even our homes. And while it’s too late to stop COVID-19, it’s not too early to think about our next pandemic.

The benefits of copper, quantified

We should have seen it coming, and in reality, someone did.
In 1983, medical researcher Phyllis J. Kuhn  of the disappearance of copper she’d noticed in hospitals. During a training exercise on hygiene at Hamot Medical center in Pittsburgh, students swabbed various surfaces around the hospital, including toilets bowls and door knobs. She noticed the toilets were clean of microbes, while some of the fixtures were particularly dirty and grew dangerous bacteria when allowed to multiply on agar plates.
“Sleek and shining stainless steel doorknobs and push plates look reassuringly clean on a hospital door. By contrast, doorknobs and push plates of tarnished brass look dirty and contaminating,” she wrote at the time. “But even when tarnished, brass — an alloy typically of 67% copper and 33% zinc — [kills bacteria], while stainless steel — about 88% iron and 12% chromium — does little to impede bacterial growth.”
Ultimately, she wrapped her paper up with a simple enough conclusion for the entire healthcare system to follow. “If your hospital is being renovated, try to retain old brass hardware or have it repeated; if you have stainless steel hardware, make certain that it is disinfected daily, especially in critical-care areas.”
Decades later, and admittedly with funding from the  (a copper industry trade group), Keevil has pushed Kuhn’s research further. Working in his lab with some of the most feared pathogens in the world, he has demonstrated that not only does copper kill bacteria efficiently; it also kills viruses. (In 2015, he even  with a precursor to COVID-19, coronavirus 229E).
In Keevil’s work, he dips a plate of copper into alcohol to sterilize it. Then he dips it into acetone to get rid of any extraneous oils. Then he drops a bit of pathogen onto the surface. In moments it’s dry. The sample sits for anywhere from a few minutes to a few days. Then he shakes it in a box full of glass beads and a liquid. The beads scrape off bacteria and viruses into the liquid, and the liquid can be sampled to detect their presence. In other cases, he has developed microscopy methods which allow him to watch — and record — a pathogen being destroyed by copper the moment it hits the surface.
The effect looks like magic, he says, but at this point, the phenomena at play is well-understood science. When a virus or bacteria strikes the plate, it’s flooded with copper ions. Those ions penetrate cells and viruses like bullets. The copper doesn’t just kill these pathogens; it destroys them, right down to the nucleic acids, or reproductive blueprints, inside.
“There’s no chance of mutation [or evolution] because all the genes are being destroyed,” says Keevil. “That’s one of the real benefits of copper.” In other words, using copper doesn’t come with the risk of, say, over-prescribing antibiotics. It’s just a good idea.

In real-world testing, copper proves its worth

Outside of the lab, other researchers have tracked whether copper makes a difference when used in real-life medical contexts–which includes hospital door knobs for certain, but also places like hospital beds, guest-chair armrests, and even IV stands.
In 2015, researchers working on a Department of Defense grant compared infection rates at three hospitals, and found that when copper alloys were used in three hospitals, it . A similar study was done in 2016 inside a pediatric intensive care unit, which charted  in infection rate.
But what about expense? Copper is always more expensive than plastic or aluminum, and often a pricier alternative to steel. But given that hospital-borne infections are costing the healthcare system as much as  — not to mention killing as many as 90,000 people — the copper upgrade cost is negligible by comparison.
Keevil, who no longer receives funding from the copper industry, believes the responsibility falls to architects to choose copper in new building projects. Copper was the first (and so far it is the last) antimicrobial metal surface approved by the EPA. (Companies in the silver industry tried  to claim it was antimicrobial, which actually .) Copper industry groups have registered over 400 copper alloys with the EPA to date. “We’ve shown copper-nickel is just as good as brass at killing bacteria and viruses,” he says. And copper nickel doesn’t need to look like an old trumpet; it’s indistinguishable from stainless steel.
As for the rest of the world’s buildings that haven’t been updated to rip out the old copper fixtures, Keevil has a piece of advice: “Don’t remove them, whatever you do. These are the best things you’ve got.”

Fast Company

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