Day: May 22, 2024

Categories : Obstetrics & Gynaecology PaediatricsTags :

Health and Economic Benefits of Breastfeeding Quantified

On By ModernMedia

Among half a million Scottish infants, those exclusively breastfed were less likely to use healthcare services and incurred lower costs to the healthcare system

Photo by Wendy Wei

Breastmilk can promote equitable child health and save healthcare costs by reducing childhood illnesses and healthcare utilisation in the early years, according to a new study published this week in the open-access journal PLOS ONE by Tomi Ajetunmobi of the Glasgow Centre for Population Health, Scotland, and colleagues.

Breastfeeding has previously been found to promote development and prevent disease among infants. In Scotland – as well as other developed countries – low rates of breastfeeding in more economically deprived areas are thought to contribute to inequalities in early childhood health. However, government policies to promote child health have made little progress and more evidence on the effectiveness of interventions may be needed.

In the new study, researchers used administrative datasets on 502,948 babies born in Scotland between 1997 and 2009. Data were available on whether or not infants were breastfed during the first 6-8 weeks, the occurrence of ten common childhood conditions from birth to 27 months, and the details of hospital admissions, primary care consultations and prescriptions.

Among all infants included in the study, 27% were exclusively breastfed, 9% mixed fed and 64% formula fed during the first 6-8 weeks of life. The rates of exclusively breastfed infants ranged from 45% in the least deprived areas to 13% in the most deprived areas.

The researchers found that, within each quintile of deprivation, exclusively breastfed infants used fewer healthcare services and incurred lower costs compared to infants fed any formula milk. On average, breastfed infants had lower average costs of hospital care per admission (£42) compared to formula-fed infants (£79) in the first six months of life and fewer GP consultations (1.72, 95% CI: 1.66 – 1.79) than formula-fed infants (1.92 95% CI: 1.88 – 1.94). At least £10 million of healthcare costs could have been avoided if all formula-fed infants had instead been exclusively breastfed for the first 6-8 weeks of life, the researchers calculated.

The authors conclude that breastfeeding has a significant health and economic benefit and that increasing breastfeeding rates in the most deprived areas could contribute to the narrowing of inequalities in the early years.

Provided by PLOS

Categories : Genetics OphthalmologyTags :

CRISPR Treatment Improves Vision in Inherited Retinal Degeneration

On By ModernMedia
Photo by Jeffrey Riley on Unsplash

About 79% of clinical trial participants experienced measurable improvement after receiving experimental, CRISPR-based gene editing that is designed to fix a rare form of blindness, according to a paper published in the New England Journal of Medicine.

“This trial shows CRISPR gene editing has exciting potential to treat inherited retinal degeneration,” said corresponding author Mark Pennesi, MD, PhD. “There is nothing more rewarding to a physician than hearing a patient describe how their vision has improved after a treatment. One of our trial participants has shared several examples, including being able to find their phone after misplacing it and knowing that their coffee machine is working by seeing its small lights.

Pennesi is an ophthalmologist and Oregon Health & Science University’s lead scientist for the Phase 1/2 BRILLIANCE trial, which evaluated the safety and effectiveness of EDIT-101, an experimental CRISPR-based gene editing treatment developed by Editas Medicine. The experimental treatment was designed to edit a mutation in the CEP290 gene, which provides instructions to create a protein that is critical for sight.

People with this gene mutation have a rare condition that is commonly called Leber Congenital Amaurosis, or LCA, Type 10, for which there is currently no Food and Drug Administration-approved treatment. LCA’s various types occur in about 2 or 3 out of 100 000 newborns.

The OHSU Casey Eye Institute treated the trial’s first participant in early 2020. That procedure also marked the first time that CRISPR had been used to edit genes within the human body, called in vivo gene editing.

The new paper describes the study’s findings through February 2023 and details how the trial’s 14 participants – 12 adults and two children – responded to receiving EDIT-101 in one eye. Key results include:

  • 11 participants, about 79%, showed improvement in at least one of four measured outcomes.
  • 6 participants, about 43%, showed improvement in two or more outcomes.
  • 6 participants, about 43%, reported improved vision-related quality of life.
  • 4 participants, about 29%, had clinically meaningful improvement in visual acuity, or how well they could identify objects or letters on a chart.
  • There were no serious adverse events related to the treatment.
  • Most adverse events were mild or moderate, and all have since been resolved.

Four specific outcomes were used to evaluate the experimental treatment’s effectiveness:

  • Visual acuity
  • How well participants did in a full-field test, which involves seeing coloured points of light while looking into a specialised device
  • How well participants navigated a research maze with physical objects and varying amounts of light
  • How much participants reported experiencing improved quality of life

Further research for a future treatment

In November 2022, trial sponsor Editas Medicine announced that it was pausing the trial’s enrolment and would seek another partner to continue the experimental therapy’s development. Pennesi and colleagues are exploring working with other commercial partners to conduct additional trials, in collaboration with Editas. The researchers hope future studies can examine ideal dosing, whether a treatment effect is more pronounced in certain age groups such as younger patients, and include refined endpoints to measure impacts on activities of daily living.

Source: Oregon Health & Science University

Categories : Ageing ExerciseTags :

New Insights into How Exercise Slows Age-related Cognitive Decline

On By ModernMedia
Photo by Ketut Subiyanto on Unsplash

New research published in Aging Cell provides insights into how exercise may help to prevent or slow cognitive decline during aging.

For the study, investigators assessed the expression of genes in individual cells in the brains of mice. The team found that exercise has a significant impact on gene expression in microglia, the immune cells of the central nervous system that support brain function. Specifically, the group found that exercise reverts the gene expression patterns of aged microglia to patterns seen in young microglia.

Treatments that depleted microglia revealed that these cells are required for the stimulatory effects of exercise on the formation of new neurons in the brain’s hippocampus, a region involved in memory, learning, and emotion.

The scientists also found that allowing mice access to a running wheel prevented and/or reduced the presence of T cells in the hippocampus during aging. These immune cells are not typically found in the brain during youth, but they increase with age.

“We were both surprised and excited about the extent to which physical activity rejuvenates and transforms the composition of immune cells within the brain, in particular the way in which it was able to reverse the negative impacts of aging,” said co–corresponding author Jana Vukovic, PhD, of The University of Queensland, in Australia. “It highlights the importance of normalising and facilitating access to tailored exercise programs. Our findings should help different industries to design interventions for elderly individuals who are looking to maintain or improve both their physical and mental capabilities.”

Source: Wiley

Categories : Ethics and Law IT in HealthcareTags :

Best Practice in POPIA Compliance in TeleHealth

On By ModernMedia

By Wayne Janneker, Executive for Mining Industrial and Health Management at BCX

In the intricate field of healthcare, where privacy and patient’s data security are of utmost importance the Protection of Personal Information Act (POPIA) emerges as a cornerstone legislation. Specifically crafted to safeguard individual privacy, POPIA carries profound implications for the healthcare sector, particularly in the protection of a patient’s medical data.

POPIA establishes a framework for healthcare professionals, mandating that they exert reasonable efforts to inform patients before obtaining personal information from alternative sources. The Act places significant emphasis on the secure and private management of patient’s medical records, instilling a sense of responsibility within the healthcare community.

Section 26 of the Act unequivocally prohibits the processing of personal health information, yet Section 32(1) introduces a caveat. This section extends exemptions to medical professionals and healthcare institutions, but only under the condition that such information is essential for providing proper treatment and care pathways. It’s a delicate balance, ensuring the patient’s well-being while respecting the boundaries of privacy.

A breach of POPIA transpires when personal information is acquired without explicit consent, accessed unlawfully, or when healthcare professionals fall short of taking reasonable steps to prevent unauthorised disclosure, potentially causing harm or distress to the patient. The consequences for non-compliance are severe, ranging from substantial monetary compensation to imprisonment.

For healthcare providers, especially those venturing into the realm of telehealth services, navigating POPIA compliance is of critical importance. Good clinical practices become the guiding principles in this journey of upholding patient confidentiality and privacy.

Let’s delve into the essentials of ensuring privacy in healthcare, where understanding the nuances of privacy laws becomes the bedrock for healthcare providers. It’s not merely about keeping up with regulations; it’s about aligning practices with the legal landscape, creating a solid foundation for what follows.

When we shift the focus to telehealth, selecting platforms tailored to meet POPIA requirements becomes even more crucial—it’s imperative. Envision these platforms as protectors of patient information, featuring end-to-end encryption and secure data storage, creating a fortress around sensitive data. But we can’t merely stop there; we need to be proactive. Regular risk assessments become the secret weapon, requiring healthcare providers to stay ahead of the game, constantly evolving, and nipping potential security threats in the bud.

Managing the human element—the healthcare team—becomes significant. Educating them about compliance, data security, and the significance of patient confidentiality adds another layer of protection. When everyone comprehends their role in maintaining compliance, it’s akin to having a team of protectors ensuring the safety of patient data.

Establishing clear policies and procedures around telehealth use, patient consent, and the secure handling of patient data is our compass for ethical and legal navigation. It’s not just about ticking boxes; it’s about creating a roadmap that ensures we’re on the right path.

Informed consent is the cornerstone of this journey. It’s about building trust with patients by transparently communicating through secure communication channels, encryption of patient data, stringent access controls, regular internal audits, and airtight data breach response plans, all of which forms part of a strategy, ensuring a state of readiness to tackle any challenges that come our way.

In this dynamic landscape, technology can’t be static. Regular updates to telehealth technology, software, and security measures are our way of staying in sync with evolving threats and regulations.

Healthcare providers aren’t necessarily experts on the Act or technology, which is why consulting with legal experts specialising in healthcare can provide accurate information on which to base decisions. It ensures that practices aren’t just compliant but resilient against any legal scrutiny that may come their way.

The final and most crucial element is the patient. Their feedback is like a map, guiding healthcare providers to areas of improvement. By monitoring and seeking insights from patients regarding their telehealth experiences, providers uncover ways to enhance their compliance measures.

In embracing these best practices and remaining vigilant to changes, healthcare practitioners and providers can navigate POPIA compliance successfully and deliver high-quality health and telehealth services. It’s a commitment to patient privacy, data security, and the evolving landscape of healthcare regulations that will propel the industry forward.

Categories : Diseases, Syndromes and ConditionsTags :

“Silent Disease” Outed at African Hepatitis Convention

On By ModernMedia

Many South Africans with hepatitis go undiagnosed

By Liezl Human for GroundUp

The African Viral Hepatitis Convention, held in Cape Town, has put a spotlight on the need to eliminate from the African continent hepatitis B and C, the “silent disease”.

The World Health Organisation(WHO) says Africa “accounts for 63% of new hepatitis B infections, and yet only 18% of newborns in the region receive the hepatitis B birth-dose vaccination”.

In South Africa, 2.8-million people are infected with hepatitis B and 240 000 have chronic hepatitis C. Of those with hepatitis B, only about 23% have been diagnosed.

The convention, hosted by The Gastroenterology and Hepatology Association of sub-Saharan Africa (GHASSA) in conjunction with the International Hepato-Pancreato Biliary Association (IHPBA), took place over several days.

On the last day, a declaration was adopted, demanding the “immediate prioritisation of national elimination plans”, allocation of resources domestically, and the political commitment to eliminate hepatitis.

“As a community of people living with viral hepatitis, advocates for those living with viral hepatitis, healthcare workers, academics and those who simply care, we say no more … All the tools to eliminate viral hepatitis are available and are uncomplicated interventions,” the declaration read.

Hepatitis B

– Liver infection caused by the Hepatitis B virus

– Usually transmitted from mother to child, as well as between children under the age of five, and via injection drug use and sex in adults

Source: Wikipedia

Hepatitis C

– Liver infection caused by the Hepatitis C virus

– Usually transmitted by injection drug use, poorly sterilised medical equipment, needlestick injuries, and transfusions

Source: Wikipedia

The convention follows a WHO 2024 global hepatitis report that says globally deaths are on the rise and that 1.3 million people died of viral hepatitis in 2022, with hepatitis B causing 83% and hepatitis C causing 17% of deaths.

In Africa, 300,000 people died from hepatitis B and C. This is despite having the “knowledge and tools to prevent, diagnose and treat viral hepatitis”.

There are vaccines available for hepatitis B, and hepatitis C can be cured with medication. Hepatitis B is spread through blood and bodily fluids.

Hepatitis-related liver cancer rates and deaths are also on the rise, according to the WHO report.

At the convention Mark Sonderup, a hepatologist at Groote Schuur Hospital, said, “Inaction now results in a bigger problem later.”

Danjuma Adda, former president of the World Hepatitis Alliance, spoke about stigma as barriers to receiving care.

“Because of high stigma we have low testing because people are not motivated to be tested … We need to change the narrative,” he said.

Anban Pillay, the deputy director-general of the National Department of Health, said that at a national level, guidelines around hepatitis education and treatment can be created, but there “has to be advocacy at a local level” too. He also stressed the importance that voices of patients on the challenges they face be heard at a national and provincial level.

Pillay said that the conference had highlighted “gaps in our programme” and that it will identify and implement interventions that have worked in other countries.

At the end of the last session of the hepatitis convention, the declaration was read and signed by those in attendance.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp