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DOH declares national dengue epidemic

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The Department of Health (DOH) on Tuesday, August 6, declared a national dengue epidemic; announcement came three weeks after the DOH issued a national dengue alert following a spike in reported cases of the mosquito-borne viral disease.

The Department of Health reports a total of 146,062 dengue cases from January to July 2019

Based on DOH data, Western Visayas had the highest number of cases, with 23,330 for the first 7 months of the year. This is followed by Calabarzon with 16,515, Zamboanga Peninsula with 12,317, Northern Mindanao with 11,455, and Soccsksargen with 11,083.

Two other regions have breached the epidemic threshold: Bicol region, which has had 3,470 cases in the last 3 weeks, and Eastern Visayas with 7,199 cases.

Health secretary Francisco Duque III said that declaring a national epidemic is important “to identify where a localized response is needed and to enable local government units to use their Quick Response Fund to address the epidemic situation.”

READ DOH Press Release

Two Men Might Be Second And Third To Be Cured Of HIV

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A second person has experienced sustained remission from HIV-1, according to a case study published Tuesday in the journal Nature. Some scientists believe that the “London patient” has been effectively cured of the viral infection, which affects close to 37 million people worldwide.

Another group of researchers said Wednesday that a third patient also may have cleared an HIV infection. Evidence of a “Düsseldorf patient” was presented at the Conference on Retroviruses and Opportunistic Infections in Seattle, alongside the report on the London patient. This third case study has not been published in a peer-reviewed journal.

The published case report of the London patient comes more than 10 years after the first case, known as the “Berlin patient.” Both patients were treated with stem cell transplants from donors who carried a rare genetic mutation, known as CCR5-delta 32, that made them resistant to HIV. The London patient has been in remission for 18 months since he stopped taking antiretroviral drugs.

“By achieving remission in a second patient using a similar approach, we have shown that the Berlin Patient was not an anomaly and that it really was the treatment approaches that eliminated HIV in these two people,” said Ravindra Gupta, lead author of the study and a professor in University College London’s Division of Infection and Immunity.

Gupta added that the method used is not appropriate for all patients but offers hope for new treatment strategies, including gene therapies. He and his colleagues will continue to monitor the man’s condition, as it is still too early to say that he has been cured of HIV.

Almost 1 million people die annually from HIV-related causes. Treatment for HIV involves medications that suppress the virus, known as antiretroviral therapy, which people with HIV need to take for their entire lives.

Another patient in remission

Gupta’s patient, a male resident of the UK who prefers to remain anonymous, was diagnosed with HIV infection in 2003 and began antiretroviral therapy in 2012. Later, he was diagnosed with advanced Hodgkin’s lymphoma. After chemotherapy, he underwent a stem cell transplant in 2016 and subsequently remained on antiretroviral therapy for 16 months.

To test whether he was truly in HIV-1 remission, the London patient disrupted his usual antiretroviral therapy. He has now been in remission for 18 months, and regular testing has confirmed that his HIV viral load remains undetectable.

Similarly, Timothy Ray Brown, the Berlin Patient, had been living with HIV and routinely using antiretroviral therapy when he was diagnosed with a different disease, acute myeloid leukemia. After two bone marrow transplants, Brown was considered cured of his HIV-1 infection. Traces of HIV were seen in Brown’s blood a few years after he stopped antiretroviral therapy. However, because HIV remained undetectable, he is still considered clinically cured of his infection, according to his doctors.

Despite various attempts by scientists using the same approach, Brown had remained the only person cured of HIV until the new London patient.

Dr. Gero Hütter, who treated the Berlin patient and is now medical director at Cellex Collection Center in Dresden, Germany, said in an email that the treatment used for the London patient is “comparable” to the one he pioneered.

“They used a reduced intense conditioning regimen but I think that had no influence on the outcome,” he said. A conditioning regimen, which may include chemotherapy and radiation to the entire body, prepares a patient to accept a stem cell treatment, such as a bone marrow transplant, by making room for the new stem cells.

The important point here is that it had been assumed that there might be something special about the Berlin patient, but now “we know it is reproducible,” said Hütter, who was not involved in the London patient’s treatment. He believes translation of the approach into gene therapy could work — though it has not yet been proven — and if so, it could become an option for a large number of HIV patients.

Since the Berlin patient, “cure” and not just treatment has become a topic in HIV research, said Hütter: “This new case supports the idea to seek an HIV cure.”

Dr. Björn Jensen of Düsseldorf University presented the case of the third patient, who remains HIV-free after stopping his medication for 3½ months.

Like the London patient, the Düsseldorf patient underwent mild cancer chemotherapy, no radiation and a single stem-cell transplant as part of blood cancer treatment and achieved remission from HIV.

The patient was investigated by internationally renowned researchers who used the most sensitive techniques available and detected only traces of HIV genetic material, according to a statement from IciStem, a collaborative project to investigate the potential for an HIV cure in patients requiring stem cell transplants for blood diseases. The researchers reported no rebound of HIV in the patient.

Evidence from both the London and the Düsseldorf patients, who are both part of a program at IciStem, suggests that the technique is more than an anomaly.

Additional patients are part of the IciStem program, which has identified more than 22,000 donors with the rare CCR5-delta 32 gene defect, so news of more patients achieving HIV remission may follow soon.

‘We have a lot more work to go’

Dr. Sharon Lewin, director of the Peter Doherty Institute for Infection and Immunity and a professor of medicine at the University of Melbourne, said the long remission seen in the London patient is “exciting.”

“Coming 10 years after the successful report of the Berlin Patient, this new case confirms that bone marrow transplantation from a CCR5-negative donor can eliminate residual virus and stop any traces of virus from rebounding,” said Lewin, who was not involved in the new case study. “Two factors are likely at play: The new bone marrow is resistant to HIV, and also, the new bone marrow is actively eliminating any HIV-infected cells.”

Graham Cooke, a professor of infectious diseases at Imperial College London, said in a statement to the Science Media Centre that the new study is “encouraging.”

“If we can understand better why the procedure works in some patients and not others, we will be closer to our ultimate goal of curing HIV,” said Cooke, who was not involved in the case study. “At the moment the procedure still carries too much risk to be used in patients who are otherwise well, as daily tablet treatment for HIV is able to usually able to maintain patient’s long-term health.”

Dr. Timothy Henrich, an associate professor of medicine and physician scientist at University of California, San Francisco’s Department of Medicine, also noted that the London patient’s treatment “is not a scalable, safe or economically viable strategy to induce HIV remission.” For now, its use is restricted to those who need the transplant for other reasons, not for HIV alone, said Henrich, who was not involved in the new case study.

“There are actually many strategies right now that are currently being pursued,” Henrich said. “Some of them are directly related to the Berlin patient and work with transplantation: for example, gene modification therapy.”

Scientists are also examining immune modifying therapies.

“I am an optimist because I’m a scientist and vice versa,” Henrich said. “I do have hope. I think that finding a scalable cure that is safe and can be applied to a vast majority of individuals living with HIV is definitely attainable, but we have a lot more work to go.”

DOH reminds public to do the 4-S against Dengue

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The Department of Health (DOH) today reminded the public to practice the 4-S campaign against dengue. Dengue, now a year-round disease, is an acute viral infection that affects mostly young children and infants.
Based on the latest data released by the DOH Epidemiology Bureau, there are 36,664 dengue cases reported covering the period from January 1 to February 23, 2019. This is 14,703 or 67% higher compared to the same time period last year (21,961 cases).
Dengue is transmitted through a bite of dengue-infected Aedes aegypti and Aedes albopictus mosquitoes.  These mosquitoes can lay eggs in any space or container that holds clear and stagnant water like a bottle cap, dish dryer, plant axil, gutter, trash can, old rubber tire, etc. They usually bite between 2 hours after sunrise and 2 hours before sunset and can be found inside and outside the house.
“The first step to prevent dengue is within our homes, it is important to remove any space or container than can hold unnecessary stagnant water which may become breeding sites of mosquitoes,” Health Secretary Francisco T. Duque III emphasized.
The Enhanced 4-S implementation calls for everyone to become prime movers in controlling mosquito population and avoiding any possible dengue deaths within the community.
The Enhanced 4-S campaign stands for Search and destroy mosquito-breeding sites, secure Self-protection measures like wearing long pants and long sleeved shirts and daily use of mosquito repellent, Seek early consultation, and Support fogging/spraying only in hotspot areas where increase in cases is registered for two consecutive weeks to prevent an impending outbreak.
The period of the drop in bodily temperature between 3-6 days of infection marks the transition of the disease from mild to more serious categories. Symptoms of dengue include sudden onset of fever of 2 to 7 days, plus two of the following: headache, body weakness, joint and muscle pains, pain behind the eyes, loss of appetite, vomiting, diarrhea, and skin rashes.
It is important to seek early consultation between 1-3 days of fever to immediately recognize the disease, which may require the patient to increase fluid intake, especially Oral Rehydration Solution that is proven to be life-saving for dengue patients.
If the fever temperature drops to at least 1° C or to almost normal between 3-6 days, health care providers should watch out if the fever comes back and strictly monitor the possible occurrence of warning signs. These warning signs include abdominal pain or tenderness, persistent vomiting, edema, mucosal bleeding (i.e. mouth, nose, etc.), and lack of energy.
“For the families of dengue patients, if any of these warning signs occur when the fever comes back, it is necessary to give the patient the right amount of oral fluids, especially Oral Rehydration Solution before immediately referring to the nearest hospital for confinement so that proper clinical management can be provided and serious complications can be avoided,” the health chief concluded.

Newly Mapped Genes May Hold Keys to ADHD

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Researchers analyzed data from more than 55,000 individuals and identified 12 gene regions linked with ADHD. These regions probably affect the central nervous system, the study authors said. The discovery might help scientists develop new treatments for ADHD, which affects more than 9 percent of American children.

“We all carry genetic risk variants for ADHD,” explained researcher Anders Borglum, a professor of biomedicine at Aarhus University in Denmark. “The more we have, the greater our risk for developing ADHD.”

Those same genetic areas share a connection with 200 other diseases and traits, he said. The investigators also found that 44 gene variants implicated in ADHD are linked with depression, anorexia and insomnia.

“We now understand better why some individuals develop ADHD, and begin to get insights into the underlying biology, paving the way towards new and better treatment of ADHD,” Borglum added.

The genetic areas his team uncovered show that this is primarily a brain disorder, Borglum said.

The researchers also found genes that may be linked with ADHD have a role in how brain cells interact and also affect speech development, learning and regulation of dopamine (a chemical messenger that carries signals between brain cells).

Still, the vast majority of ADHD genetics is still undiscovered and will require larger studies, Borglum said.

Study author Stephen Faraone noted that the team “found 12 of the very many — we don’t know how many — probably thousands of genes related to ADHD.” Faraone is a professor of psychiatry and behavioral sciences at SUNY Upstate Medical University in Syracuse, N.Y.

The researchers don’t expect to discover just one, two or even 10 genes that each have a dramatic effect on causing ADHD and can be used to diagnose the disorder or quickly develop a treatment, he said. Most likely, a combination of genes and environmental factors trigger ADHD, the study authors said.

Environmental factors may include being born prematurely and underweight or suffering from developmental problems, such as fetal alcohol syndrome, Faraone said.

Interestingly, he added, even though medications work in treating ADHD, they don’t target the genes that the investigators found were linked to the condition. None of the genes affected by the drugs showed up in their analysis of genes tied to ADHD, Faraone said.

The report was published online Nov. 26 in the journal Nature Genetics.

Ronald Brown, dean of the School of Health Sciences at the University of Nevada in Las Vegas, said, “This is a promising investigation, as it provides further evidence that ADHD is likely an inherited disorder.” Brown was not involved with the study, but was familiar with the findings.

It’s been clear for years that ADHD runs in families, he said. These findings are also important because they suggest that certain therapies effective for one family member are likely to be effective for other family members who are diagnosed with ADHD, he added.

This study is also important because it shows that several psychological disorders are likely tied to these genes, though no cause-and-effect relationship was proven in the study. This information could help families with prevention and early intervention efforts, Brown said.

This health news article was originally published in WebMD.