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|| Year Gamma: London: Wednesday: July 18: 2018 ||
First Published: September 24: 2015
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Life-Elle Arkive Year Alpha: September 24: 2015-September 23: 2016

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New Research Initiative to Improve Surgical Outcomes Across the Globe



|| July 17: 2018: University of Birmingham News || ά. The University of Birmingham is leading on major health research projects in Asia, Africa and Latin America to help develop surgical research, that will have the potential to improve the quality of surgery. The National Institute for Health Research:NIHR Global Health Research Unit on Global Surgery is launching a number of initiatives to improve care for surgical patients in low-middle income countries.

Presently, the Unit is launching a range of health improvement initiatives, including, a clinical trial of interventions to prevent surgical wound infection:FALCON; a study to measure outcomes from cancer surgery and a study to evaluate access to healthcare for patients requiring surgery. Launched by Universities of Edinburgh and Warwick with partners from low and middle income countries, the Unit aims to establish independent and sustainable research ‘hubs’ and:or trial centres in partner countries.

The partner countries are Ghana, Rwanda, South Africa, Mexico, Pakistan, India, Nigeria, Philippines, Benin, where these centres will perform their own clinical research relevant to local populations, whilst serving global needs.

Speaking at a showcase event in Birmingham on July 12, to mark the Unit’s first anniversary, University of Birmingham Chancellor Lord Karan Bilimoria said, “The University of Birmingham’s research is world-changing and we’re focusing our efforts on tackling nine of the UN’s Global Goals, including, ‘Good Health and Well-being’ to produce practical solutions to some of the greatest challenges facing humankind.

We are proud to link with our partners at NIHR and the Universities of Edinburgh and Warwick in this amazing global health research initiative, that will have the potential to save many thousands of lives across Asia, Africa and Latin America.”

The Unit is based at the University of Birmingham and co-directed by Professor Dion Morton, Barling Chair of Surgery at the University’s Institute of Cancer and Genomic Sciences and Professor Peter Brocklehurst, Director of the Birmingham Clinical Trials Unit.

Professor Morton said, ‘’Each year, six million people die within 30 days of an operation. Surgical Site Infection:SSI is the most common complication from surgery and a health burden for both patients and health-care providers. 

Reducing SSI has huge benefits. Patients suffer less and save money, whilst being able to return to work or school faster. They are, also, subjected to fewer and shorter courses of antibiotics, contributing to a reduction in global antimicrobial resistance. Hospitals can reduce costs and discharge patients earlier, preventing re-admissions.

Partners in the Unit have, also, formed a Policy and Implementation Consortium to work with professional associations, NGOs and government organisations across the world, including, the World Health Organisation. This Consortium will use the results from the research generated by the Unit as a tool to inform changes in clinical practise and provide evidence to drive policy changes across the globe.

The University of Birmingham is ranked amongst the world’s top 100 institutions, its work brings people from across the world to Birmingham, including, researchers and teachers and more than 6,500 international students from over 150 countries.

NIHR Global Health Research Unit works with partner institutions in a range of Low and Middle Income countries, including, Ghana: University of Development Studies, Tamale; Nigeria: Obafemi Awolowo University Teaching Hospitals, Ile-Ife; Rwanda: University of Rwanda, University Teaching Hospital, Kigali; South Africa: Chris Hani Baragwanath Academic Hospital, Johannesburg; Mexico: Hospital Espanol, Veracruz; Pakistan: King Edward’s Medical University, Lahore; India: Christian Medical College and Hospital, Ludhiana; Benin: University of Abomey-Calavi, Cotonou and The Phillipines: Philippine General Hospital University, Manila.

Caption: From left, Professor David Adams; University of Birmingham Chancellor Lord Karan Bilimoria and Professor Dion Morton. :::ω.

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Teen-Age High-Intensity Exercise Could Ward Off Heart Disease



|| July 12: 2018: University of Exeter News || ά. New research published in Experimental Physiology has indicated potential differences in heart health benefits of differing levels of exercise intensity in teenagers. Teenage years form an important stage of life, with research suggesting it is a time during which heart diseases start to develop. These findings indicate that teenagers, who participate in high-intensity exercise have lower blood pressure.

This, may, lead to a lower risk of developing heart disease later in life but this requires confirmation with further research. This study, conducted by researchers at the Children’s Health and Exercise Research Centre at the University of Exeter, recruited healthy male teenagers, mostly 13-15 years old, who underwent testing on four separate occasions across three weeks. In the first visit, participants performed an exercise test to calculate the exercise intensities reflective of vigorous and moderate intensity exercise.

After this first visit, all participants completed three experimental conditions in a randomised order and on separate days: i: vigorous intensity exercise; ii: moderate intensity exercise and iii: no exercise, which served as a control. Blood pressure was monitored every heart beat before and up to one hour after the exercise.

The measurements, also, involved ultrasound images of the carotid arteries, the main blood vessels, that supply the head and neck, to determine the ‘stretch’ of the arteries and how this impacts the control of blood pressure following exercise.

In the hours following exercise, blood pressure decreases below resting values. This is known as post-exercise hypotension. These results suggest that in teenagers, eight one-minute bouts of running at a vigorous intensity, i.e, running close to the maximum heart rate, caused post-exercise hypotension lasting up to one-hour.

The same effect was not observed following running at moderate intensity, i.e, jogging, where blood pressure was restored just twenty minutes after exercise. The stretch of the carotid arteries and the brain’s control of the heartbeat, which are known to monitor and adjust blood pressure, were similar between the two exercise intensities at one-hour after the exercise. 

These findings indicate that exercise intensity alters other mechanisms of adjustments in blood pressure differently, one hour following the completion of the exercise in healthy teenagers. This study is, thus, the first to show that post-exercise hypotension is dependent on exercise intensity in healthy 13-15 year olds.

The fall in blood pressure of healthy teenagers, may, have a long-term clinical importance, if, translated to those with high blood pressure, as previously reported in adults. Similarly, the blood pressure reducing effects of the exercise could lead to better blood pressure control, particularly, when young people face stressful situations.

Although, these data are novel, the ethical implications of working with teenagers meant that all measurements were taken non-invasively, which, may, have reduced accuracy in comparison to more invasive drug-infusion methods.

Also, the research involved only boys, which does not allow extrapolation of the findings to girls. Furthermore, the observed reduction in blood pressure was only measured up to one hour after a single bout of exercise.

However, the authors aim to expand these initial findings to children, teenagers with hypertension and other conditions, that increase the risk of heart disease, such as, obesity and low levels of fitness. Similarly, the research team, also, wish to investigate whether the decrease in blood pressure results in lowered vessel reactivity to stressful situations.

Finally, the effects of exercise training on the control of blood pressure following exercise in teenagers remain to be seen. Mr Ricardo Oliveira, a Brazilian PhD student funded through the Science Without Borders PhD Scheme, who led the research, said, “The best part of the research was the involvement and dedication of the participants, who, we, always, find are better research participants than adults!

All were disappointed that the project came to an end and they reported to have enjoyed visiting the university facilities, participating in a scientific study and learning new information about their heart, blood vessels and how the cardiovascular system responds to exercise.” :::ω.

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New Research Finds: Babies Born of Mothers with Type One Diabetes Face Higher Risk of Heart Defects




|| July 08: 2018: Karolinska Institutet News || ά. Pregnant women with Type One Diabetes run a higher risk of having babies with heart defects, especially, women with high blood glucose levels during early pregnancy, a study from Karolinska Institutet and the Sahlgrenska Academy in Sweden, published in The BMJ, shows. It has long been known that patients with Type One Diabetes are at increased risk of complications.

The study demonstrates a clear correlation between elevated levels of blood glucose, HbA1c, in the mother and the risk of heart defects in her baby. However, even, those women, who followed the current guidelines, had a higher, albeit, still, small, risk of heart defects. The results show that 03.3 per cent of pregnant women with Type On Diabetes and blood glucose levels within the recommended span gave birth to a baby with a heart defect. The corresponding figure for women without Diabetes was 01.5 per cent.

‘’This confirms previous findings that there is a higher risk of birth defects, primarily, of the heart.” says Professor Jonas F. Ludvigsson at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet and Consultant at the Paediatric Clinic at Örebro University Hospital.

“The risk of birth defects is, especially, sensitive to factors during early pregnancy and, here, blood glucose plays a vital part.”

Pregnant women with Type One Diabetes, who had very high blood glucose levels, HbA1c reading of 09.1 per cent or higher, were at much greater risk.

“Here, the risk of the baby having a heart defect was as much as 10.1 per cent or one in every ten babies.” says Professor Ludvigsson. “The reason why the risk of deformity can be linked to blood glucose levels in early pregnancy is that it is than that the foetus’ organs develop. Also, many women aren’t aware that they’re pregnant during the first few months.”

This, he stresses, is why women must know about the dangers before trying to have children. “There’s an opportunity here for women to influence the risk of their baby developing a heart defect by keeping their blood glucose levels low.

Yet, we as doctors, also, know that many pregnant women struggle valiantly to keep their blood glucose down, as it is no easy task. The potential benefit of intensified insulin treatment to reduce the risk of heart defects should, also, be weighed against possible risks with hypoglycaemia in the mother and foetus.” says Professor Ludvigsson.

The study was done by cross-referencing the National Diabetes Register with the National Patient Register and the Medical Birth Registry and comparing 2,458 living new-borns of mothers with Type One Diabetes with 1,159,865 babies of mothers without diabetes.

Since this is an observational study no definitive conclusions can be drawn regarding causality. The researchers are now planning to make further investigations in the field. 

The study was financed with grants from the Swedish Diabetes Association, the Strategic Research Area in Epidemiology at Karolinska Institutet, the Swedish Research Council and Stockholm County Council.

The Paper: Periconceptional glycemic control in type 1 diabetes and the risk of major birth defects: population based cohort study in Sweden: Jonas F. Ludvigsson, Martin Neovius, Jonas Söderling, Soffia Gudbjörnsdottir, Ann-Marie Svensson, Stefan Franzén, Olof Stephansson, Björn Pasternak: The BMJ: Online: July 05: 2018

Caption: Illustration by Marek Skupinski:::ω.

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The World’s Two Leading Organisations of Oncologists Call on All World Governments to Improve Cancer Services and Reduce Cancer Deaths


|| July 05: 2018 || ά. The European Society for Medical Oncology:ESMO and the American Society of Clinical Oncology:ASCO, the world’s two leading organisations for oncology professionals, today issued a joint statement, calling upon all governments to renew their political commitment to improve cancer services and reduce cancer deaths. The statement was issued on the occasion of the United Nations Civil Society Hearing on Non-Communicable Diseases NCDs in New York.

“As cancer doctors we work hard every day to ensure that patients receive the best possible care.” said Dr Alexandru Eniu, the Chair of the ESMO Global Policy Committee. “We are progressively increasing our knowledge about cancer and how to treat it. We can, even, cure some cancers, if, we intervene early enough. However, in many countries access to, even, the most inexpensive essential cancer medicines and priority medical devices is lacking.

We urgently need governments to work with us and ensure that we have enough oncology professionals and the necessary resources, to apply our knowledge and save lives.”

ESMO President, Dr Josep Tabernero said, “Recent UN and WHO reports note that unless countries significantly scale-up their actions and investments, they will not meet agreed targets to reduce deaths from non-communicable diseases. We are concerned that governments, may, find it easier to achieve their targets by reducing deaths from only some NCDs, leaving cancer patients behind.

We believe there are cost-effective ways to improve cancer care and stand ready to assist countries in doing this by providing our expertise in cancer management to support implementation of the 2017 World Health Assembly Cancer Resolution.

We urge Member States to consider our joint call and amendments to strengthen the Political Declaration to be approved during the UN High-Level Meeting on September 27 and, thus, change the future outlook for cancer patients worldwide

About the European Society for Medical Oncology:ESMO: ESMO is the leading professional organisation for medical oncology. With 18,000 members representing oncology professionals from over 150 countries worldwide, ESMO is the society of reference for oncology education and information. We are committed to supporting our members to develop and advance in a fast-evolving professional environment. :::ω.

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The World Global Progress on Reducing Child Deaths

|| November 19: 2016: London School of Hygiene and Tropical Medicine News || ά. Around 05.9 million children worldwide died before reaching the age of five, including 02.7 million newborns, according to 2015 estimates, published in The Lancet. Globally, more than four million fewer child deaths occurred in 2015 than in 2000, mainly thanks to reductions in deaths from pneumonia, diarrhoea, malaria, death during birth and measles. This image, let it be the window to show the world and world humanity that humanity always rises back up from the ashes and flies a phoenix. Nothing, can destroy this eternal phoenix that humanity is.

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