Cardiovascular diseases are still the leading global cause of mortality and invalidity, especially in industrialized countries. A great share of medical and scientific resources, in general, are focused on developing better diagnostic methods and better treatment strategies for these patients aiming to decrease the toll these illnesses take.
Dangerous arrhythmias caused by abnormal electrical waves in the heart tissue are the quite frequent cause of sudden death. Some patients suffer arrhythmias all from the start while others end up with electric activity left as a consequence of some other heart condition. All of these patients are at high risk of developing malignant arrhythmia and sudden cardiac arrest or sudden death.
So far, doctors have used various blood pumping measurements, invasive or not – invasive procedures, to determine the heart’s condition and predict its risk of developing dangerous, possibly fatal arrhythmias. When a patient is estimated to be at high risk of developing abnormal rhythm, current practice is to implant a small defibrillator into the heart muscle. A defibrillator is supposed to sense the onset of arrhythmia, fire preventive electric impulse and get the rhythm back to normal.
Defibrillators were the best solution we had so far, but they came with risk and possible complication, such as invasive access to the heart, battery changes, possible infections, device malfunctioning and similar.
Groundbreaking research at Johns Hopkins University, conducted by a team of scientists lead by Natalia Trayanova constructed a completely new approach that could outcome all strategies used so far.
The team has developed a non – invasive 3D virtual heart model tool, meant to determine precisely whether a particular patient is at risk of developing critical arrhythmia and needs to have the defibrillator installed or not. New technology was developed in coordination with cardiologists Katherine C. Wu using her magnetic resonance imaging records of patients who suffered a heart attack and ended up with tissue damaged enough to trigger fatal arrhythmias.
The technology enables doctors to use virtually shaped heart and computer technique that realistically represents a replica of patient’s heart and its electrical activity. Adjusting virtual heart according to all parameters of the particular patient, the virtual model shows whether there is or there is not a high risk of developing fatal arrhythmias in that particular case.
The effeteness of this alternative method was proved (in the study that involved 41 patients) risky, according to their previously measured ejection fraction which was less than 35. The team of scientists used their new technology to predict their risk of arrhythmias, and the patients were monitored for some time after releasing from the hospital. Some patients did develop arrhythmias; some did not. The predictions made be a virtual model of the heart were compared to real time statistics and showed to be four to five time more precise at predicting the risk of abnormal rhythm in these patients than the traditional method.
The approach was completely personalized and built patient – specific replica of the heart. Amazing results showed that this technology could be used in every day’s work of cardiologists to offer more accurate predictions of patients’ individual risk and indicate implantation of defibrillator only to those patients who would benefit from that procedure.
“They’ve been living on the mere edge of existence for months, they are exhausted, often hungry and some of them are sick, but on the top of all – they are all very frightened. More than 2000 of them are being put on a bus and exported out of the camp without any explanation. They are calm, but worried for their future.”
This is how Katy Athersuch from Doctors without Borders described the atmosphere in Idomeni camp in last few days.
The Greek government ordered the eviction of refugees settled in improvised refugee camp in village Indomeni on the border with Macedonia. The border with Macedonia has been one of the hot checkpoints on the migrants’ road through Balkan, closed few months ago.
Police officers, accompanied by people from International Rescue Committee helped people pack and get on the buses. More than two thousand of emigrants will be taken to state – run camps near Thessaloniki.
The camp in Indomeni is surrounded by riot police officers in the case of tension escalation or any troubles. Currently, as the reports state, everything is moving smoothly, the atmosphere is depressive, but under control. A police helicopter monitors the terrain, and no press or media is allowed to approach.
If everything goes as planned, the evacuation should be over by the end of the week. When the evacuation started, there was roughly 8 000 migrants, mostly Syrians, which is drastically less compared to 20 000 migrants living in the camp in March.
They lived in the camp for months waiting for approval to cross the borders and move towards Western Europe or Scandinavia. These borders are closed for some time, and the chances migrants will be allowed to move on are quite weak.
Considering all of that, so as the fact that Greece had been severely pressured by the enormous amount of migrants, plus country’s crisis and the economy struggling, the government has recently begun to urge refugees to leave the camp. This lead to significant decrease in a number of migrants still living there, so this currently happening evacuation is explained as an intensification of the evacuating process that has been going on for some time.
Running away from horrific war state in their countries, more than a million refugees headed toward Germany and Europe countries during last year. Greece is on their way to final aim, so over a million of them entered the Greece. Unfortunately, when the crucial borders towards Europe got closed recently, the majority of these people got stuck in Greece, living for months in improvised or state-run camps.
Aside several protest against organizing of these excepting centers and camps, Greeks were quite tolerant and willing to help. But the atmosphere is charged, people are devastated and escalations of anger, even violence happen often. Macedonian police fired tear gas recently when refugees aggressively tried to cross the border, and many were hurt.
Considering the current deals with Turkey and closing of the border to the majority of European countries, the further destiny of thousands of migrants is still uncertain.
The crucial aim right now is to keep these people safe, control the atmosphere and work intensively on finding an adequate solution for everyone.
Protest against labor reforms in France continues across the country spreading and intensifying each day. Thousands of protesters are marching on the streets of France confronting riot police in the violent clashes.
So far, over 20 people have been arrested; many are hurt, and protest caused severe demolition in several cities. It’s estimated that only in Paris roughly 20 000 people turn out on the streets, but national demonstrations involved many cities across the country, including Toulouse and Bordeaux.
Police reacted quite aggressively firing tear gas and fighting protesters directly, which caused a mass outcry and accusations of police violence and the use of brutal force. Officials claim legitimate defense strategy.
The country is currently halted in many ways. Striking workers continue to sabotage working process in most of the country’s refineries, and all but three nuclear power stations decided to block the work. Since nuclear stations provide 75% of country’s electricity, this is going to cause a severe collapse of the industry. Protesters have blocked main roads, and bridges, air, and train traffic is disrupted, and nearly all newspapers are prevented from printing.
Triggered by controversial government’s decision to push the recently established law, demonstrations across the country started two months ago. Protesters demand the law to be abandoned completely, not modified as announces, but due to government’s refusing to abandon reforms, the riots escalated. Members of the CGT union who organized demonstrations decided to block fuel supplies resulting in a third of petrol station either running low on fuel either ending up empty. Authorities are applying strategic fuel reserves, and drivers are stuck in long lines in front of petrol stations, but the supplies are dangerously limited.
The whole situation is complicated by the upcoming Euro 2016 football tournament, announced for June 10 when the country is supposed to host almost two million tourists. The members of the Union threatened to strike on the Paris Metro on the day of opening Euro 2016 if the government doesn’t change the decision in the meantime.
The French government and the President François Hollande came up with a plan to adopt and apply new labor reforms which citizens have found to be rather contentious. People found these proposed changes as companies – oriented and as an assault on worker’s rights. Almost 75% of French citizens are against this law and proposed reforms claiming that reforms will enable companies to hire and fire workers easily and use their free will to modify conditions of work as it fits their interest. The reforms were meant to decrease the critical rate of unemployment and public debt, but opposition contradicts this point of view.
Prime Minister Valls suggested to modify the law, make certain changes and improvements, but the member of Union refused, insisting the legislation to be abandoned fully. The government is determined not to give up the reforms at this point, but as the riots progress disrupting crucial industries and blocking country at critical areas, people hope that President will change the decision or at least make some drastic changes.
Press and media are overwhelmed these days with alarming headlines reporting about super-bug detected in the USA and the end of the antibiotics era as we know it.
The event that triggered these panic warnings did bring particular cause for concern, but the real picture is slightly less apocalyptic.
Namely, 49-years old woman from Pennsylvania was treated for urinary infection and her urine culture revealed E. coli strain resistant to Colistin. Colistin is an antibiotic of the last – resort. Further analysis of the microbe showed that bacteria carries CR – 1 gene that codes resistance to Colistin, and the gene is located on a plasmid. The plasmid is a circular DNA that can be transferred to other bacteria.
These findings were published in reputable scientific journal and public was instantly disturbed partially with justified reason, but partially due to bad reporting.
The majority of newspapers reported about the first case of this kind found – ever and about bacteria being resistant to the – last functional antibiotic we have in the pool. Both claims are distorted.
Scientists from China discovered a mcr-1 gene in bacteria of some of their patients over there during last year. Since China case, bacteria carrying mcr-1 gene was found on every continent so that Pennsylvania case might be the first in the USA, but it’s not the first ever. We’ve seen these strains before. What’s crucial now is to continue surveillance, figure out the true frequency of a mcr-1 gene in the US and estimate the risk.
The second statement also needs to be explained more precisely.
This is not the first bacteria resistant to last-resort antibiotic. The whole group of last-resort antibiotics contains several different types of drugs, and many bacteria resistant to some of them have been detected by now. Also, many reports mentioned the connection between colistin – resistant E. coli and so-called CRE, an abbreviation that stands for carbapenem – resistant Enterobacteriaceae. Scientists are concerned about steadily raising carbapenem resistance because these infections have a huge mortality rate. Spreading of bacteria resistant to both colistin and carbapenem is a big problem, but fortunately, the group of Enterobacteriaceae consists of many different bacteria, and not all of them are resistant to both groups of drugs. Beside, the strain isolated from Pennsylvania patient was not resistant to carbapenem antibiotics.
The only aspect of this reported case that raises concern a big time is resistance based on plasmid DNA. Namely, all bacteria detected so far resistant to last-resort medications carried colistin resistance genes located on bacterial chromosomes. Genes on chromosomes are not mobile and shareable. The problem with a plasmid carrying mcr-1 gene is that plasmid can easily be spread to other bacteria and in the worst scenario – transferred to those bacteria already resistant to some other groups of last-resort antibiotics.
This is all concerning, but not unexpected and certainly not catastrophic. Most of the bacteria are not multiresistant to last-resort antibiotics yet, and doctors can use combinations of these drugs strictly prescribed when needed to fight these tough infections.
Meanwhile, the medical community has to focus all attention and resources to antibiotic resistance crisis, apply strict rules about prescriptions and use of existing drugs and work on the development of the new, different and more potent medications.
After one failed attempt in China and one successfully completed the procedure in South Africa, Massachusetts General Hospital in Boston has performed the first penis transplantation in the USA, the third in the world.
The whole story is a big drama of common people.
Thomas Manning suffered a severe accident at work few years ago when some heavy machinery fell on him. He was hurt badly, including pelvic injuries. While treated in hospital, doctors noticed highly suspicious changes on his penis and the series of tests and diagnostic procedures revealed cancer. His penis was amputated.
There was a lot of bitter irony in this scenario. If there weren’t for his tough accident, he’d probably die as an oncology patient quite soon, but the amputation of the penis has handicapped his life in many ways. His urinary function was damaged, he couldn’t urinate while standing and the infections were frequent. His reproductive function was damaged too, but the amputation of penis sort of amputated his complete love life, since it led to tough psychological and emotional problem and low self-esteem.
Until three years later, he was offered by the same hospital to undergo the first penis transplantation.
On May 8, Dr. Cetrulo and his team of plastic and reconstructive surgeons performed 15 hours lasting cadaveric penis transplantation procedure.
Manning ended up in an operating room again two days later, due to one and so far the only complication – hemorrhaging. That went well, and he feels quite fine right now.
It’s not over yet, and in a way, it never will be since he has to take immunosuppressive therapy till the rest of his life and there is always a chance of organ rejection. But in a few weeks, his urinary function will be restore and few months from now his sexual function too. Considering that the only patient in the world who had penis transplanted successfully (in Africa in 2014) became a biological father in the meantime, there are reasons for high expectations.
Manning admits he was advised by his male friends not to mention the procedure, but he decided to speak freely hoping that his experience will encourage all those stigmatized and ashamed men out there to ask for this kind of help.
Currently, penis transplantation is experimental surgery in a research program in two hospitals in the USA, mainly focused on cancer and trauma patients. There is no predetermined number of planned procedures, but the candidates are patients with penis tumor, war veterans who suffered severe pelvic injuries and accident victims.
Military surgeons are particularly interested in this program since a huge number of very young soldiers ended up losing their penis partially or completely, usually due to explosive devices. If the procedure of transplantation becomes routine, that will give a chance to all these young men to restore their anatomy and have an intimate life again.
At this moment, penis transplantation is not available for transgender people, neither it is approved to those simply bothered by “the size”.
The team of doctors in Boston hospital is working to minimize the need for anti-rejection drugs after the surgery and to keep donations frequent enough to support the program.
Another patient is currently waiting for the matching donor, hoping to undergo the second successful penis transplantation in the USA.
Heavy rains that started several days ago have turned to deadly floods in Texas. Thunderstorms lead to the critical raising of water levels when at least one tornado hit the region. The floods have paralyzed the city, the roads, schools, and other institutions are closed, and people are being evacuated.
Dozens of first responders are searching hazardous terrain looking for anyone trapped, helping people to leave their damaged homes full of water and rescuing people from vehicles stuck in deep waters.
The situation is quite critical at the moment since more rain is expected over next few days.
Current reports claim two people died, and two are missing. The first dead person was found in flooded mobile house, and it is believed that cause of death is drowning. Another person, found in the vehicle stuck in deep water, probably died of heart attack.
At the flooded area between Austin and Houston a vehicle was swept away and the driver, allegedly 21-year-old man, is missing. According to his family’s statement, he was trapped in the car for hours. He called home to say he’s in trouble and posted scary Facebook post, a uploading picture of his car windows being half – flooded. Soon after this, he was gone, and the chase continues.
This is an estimate at the moment, but there are chances that the number of dead and missing is much higher.
In the meantime, some major roads are blocked causing students and children to spend nights at school and on the campus because the traffic is disrupted. The water threatens to sweep away vehicles and the buses stopped driving for some time.
Dozens of homes are demolished and filled with water, and people are climbing to the roofs and waiting for rescuing teams in a helicopter to spot them. Over fifty interventions have been conducted successfully by now, and nine boat teams are working on terrain and trying to reach people through the windows of flooded houses.
One person was rescued from the tree where he climbed when his car was swept away.
Brenham, the main city in the county, received a record 17 inches of rainfall and National Weather Service meteorologists are announcing more upcoming falls.
All emergency teams are using all their resources and preparing for the potential upcoming second phase of floods and authorities have ordered the further evacuation of people in endangered areas. All citizens who are not evacuated are advised to look for proper shelters because storm demolished many trees, roofs, and infrastructure elements, and there is a constant risk of getting hurt by broken objects falling or crashing down.
Tornadoes, thunderstorms, and floods began on Monday and predictions say that it’s not over yet. It’s too early for estimating the overall damage, but aside human victims which are the biggest tragedy, the material damage will be huge.
This is the second dramatic weather crisis in last two months hitting Southeast Texas. Recently, Houston area suffered similar catastrophe when storm and floods killed at least eight people. Also, in May 2015, 22 people died due to tornadoes followed by floods in Texas after record rainfall since April 1976.