Prevention strategies the focus of first animal model for sexual transmission of HIV

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs
Article Date: 17 Aug 2013 - 0:00 PDT Current ratings for:
Prevention strategies the focus of first animal model for sexual transmission of HIV

Infection by human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS), a debilitating disorder in which progressive weakening of the immune system makes affected individuals more susceptible to potentially life-threatening infections and chronic diseases. Despite advances in the treatment and management of AIDS, there is no cure, and HIV infection remains a major global health problem. According to the WHO, there were an estimated 34 million infected individuals in 2011. Over the last three decades, a number of animal models have been developed to study aspects of HIV infection, pathogenesis and control. However, the currently available models do not recapitulate the physiological environment of the most common route of HIV transmission worldwide, vaginal intercourse. Now, Mary Jane Potash and colleagues from St. Luke's-Roosevelt Hospital Center and Columbia University Medical Center in New York, NY, have developed an approach for modelling heterosexual transmission of HIV in vivo. Their work was published recently in Disease Models & Mechanisms.

The work stems from an earlier collaboration between Potash and David J. Volsky (also from Columbia University); they established a chimeric HIV clone with a genetic modification that allows the virus to propagate in rodents instead of humans. Infection of mice with these viruses has been successfully applied to study aspects of HIV neuropathogenesis and to evaluate antiretroviral drugs and potential HIV vaccines. In their latest study, Potash and colleagues describe the efficient and reproducible transmission of chimeric HIV from infected male mice to uninfected females via mating, providing the first report of HIV transmission by coitus in an animal model. Treatment of females with antiretroviral drugs prior to mating prevented transmission of the virus, in line with observations in humans. Intriguingly, the efficiency of viral transmission declined during estrus in mice, providing evidence that the hormonal environment in the female reproductive tract can impact on host susceptibility to HIV infection. This finding has implications for HIV infection in humans, where it has been suggested that vulnerability to viral infection could vary during the menstrual cycle.

The model described here has several advantages compared with previous experimental approaches for investigating sexual transmission of HIV. For example, transmission occurs during mating, in contrast with earlier systems in which viral stocks need to be applied manually to the vaginal surface; thus, the system preserves features of the male and female reproductive tracts. This is important, as previous work has shown that host factors and cells in the seminal fluid activate cells in the female reproductive tract and enhance HIV infection, yet the underlying mechanisms remain poorly understood. Similarly, as indicated in this study, the local environment in the female reproductive tract can influence the rate and efficiency of HIV sexual transmission. By preserving the physiological features of coitus, the approach allows the dynamic aspects of viral sexual transmission to be investigated in vivo. Furthermore, the system can be used to investigate the efficacy of new interventive strategies aimed at preventing the most frequent route of HIV transmission.

"We developed this system to study HIV spread by mating in mice with the hope that it can be applied to promote practical approaches to prevent HIV sexual transmission to people at risk" explained Dr Potash, when asked about the goals of this research.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Employers can play a role in cancer prevention and treatment

Main Category: Cancer / Oncology
Also Included In: Preventive Medicine;  Public Health
Article Date: 15 Aug 2013 - 1:00 PDT Current ratings for:
Employers can play a role in cancer prevention and treatment

Employers can have a significant role in improving efforts to prevent and treat diseases such as cancer by introducing and supporting health promotion programs in the workplace. Together, companies can influence health care policies and reimbursement and industry practices to support the fight against cancer. Johnson & Johnson's active role in implementing the CEO Cancer Gold Standard program is described in an article in Population Health Management, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available on the Population Health Management website.

Rachel Henke, PhD and coauthors representing Truven Health Analytics (Cambridge, MA and Washington, DC), Emory University (Atlanta, GA), and Johnson & Johnson (Southwest Ranches, FL, Mansfield, MA, and New Brunswick, NJ), focus on how J&J has incorporated the industry-leading standards developed by the CEO Roundtable on Cancer into its existing Live for Life worksite health promotion program.

In the article "Employers' Role in Cancer Prevention and Treatment - Developing Success Metrics for Use by the CEO Roundtable on Cancer," the authors describe the "5 Pillars" of the CEO Cancer Gold Standard program, the framework J&J created to monitor the use and effectiveness of the cancer prevention and treatment enhancement efforts it introduced, and examples of the data collected by the company.

"This nationally prominent group of researchers has once again demonstrated that employers can bend the cost curve and improve outcomes, too," says Editor-in-Chief David B. Nash, MD, MBA, Dean and Dr. Raymond C. and Doris N. Grandon Professor, Jefferson School of Population Health, Philadelphia, PA.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cancer / oncology section for the latest news on this subject.

Employers' Role in Cancer Prevention and Treatment - Developing Success Metrics for Use by the CEO Roundtable on Cancer

Rachel Henke, Ron Z. Goetzel, Janice McHugh, Deborah Gorhan, Malinda Reynolds, Jaclyn Davenport, Kate Rasmussen, and Fikry Isaac. Population Health Management. -Not available-, ahead of print. doi:10.1089/pop.2012.0090. Online Ahead of Print: May 14, 2013

Mary Ann Liebert, Inc./Genetic Engineering News

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Researchers urge review of health system-wide pediatric injury training, triaging and prevention efforts

Main Category: Pediatrics / Children's Health
Also Included In: Health Insurance / Medical Insurance;  Public Health
Article Date: 31 Jul 2013 - 0:00 PDT Current ratings for:
Researchers urge review of health system-wide pediatric injury training, triaging and prevention efforts

New research from The Center for Injury Research and Prevention at The Children's Hospital of Philadelphia (CHOP), signals that emergency and outpatient healthcare providers may need to prepare for higher demand for treatment among younger patients with mild and moderate injuries. As federal and state policies encouraging people to be covered by health insurance go into effect, researchers estimate the potential for more than 730,000 additional medically attended injuries annually, or a 6.1 percent increase if all currently uninsured children and young adults (ages 0-26) become insured. The estimates are based on 2008 injury data from the National Health Interview Survey. The study was published in this month's Clinical Pediatrics.

"In order to assist planning efforts by healthcare systems and policymakers, we aimed to examine the impact on trauma systems of increases in young people with health insurance" says Flaura Koplin Winston, MD, PhD, lead author and Scientific Director of the Center for Injury Research and Prevention at CHOP. "This study signals a need to prepare for potential large increases in demand for care of minor and moderate pediatric and young adult injuries in both emergency department and outpatient settings."

According to the study, a significant portion of the increase will come from currently uninsured young adults (18-26 year olds), who will now be able to remain on their parents insurance until age 26 or find affordable care through exchanges. Researchers found that the causes and nature of medically attended injuries differed between insured and uninsured young adults. The uninsured sought medical care for more serious injuries like fractures when compared to other types of injury. The insured sought medical care for a wider distribution of injuries-- with the most common being sprains and strains, as well as open wounds. Of interest, among children under age 18, 11 percent of medically attended injuries among insured kids were related to overexertion, but this injury mechanism did not cause uninsured children to seek care.

Winston and her colleagues based their estimates on recent injury care data and the assumption that those new to insurance would have a probability of medically attended injury that equals that of those who already have insurance. With these assumptions, they predict that each year as many as 510,553 additional children and young adults could be seen for injury treatment in outpatient settings, nearly 195,838 in Emergency Departments or admitted to hospital, with another 30,689 being attended to through phone- only encounters. Winston cautions that the actual health system utilization rates and sites of care may vary as newly insured people may access care differently from those who are already insured.

"Health care delivery systems across the US need to have sufficient numbers of general and pediatric healthcare providers who are trained in treating moderate trauma and injury and can staff urgent carecenters, health centers, primary care practices, call centers, and emergency departments," says Dr. Winston. "In keeping with the aims of the Affordable Care Act, the goal should be that all young patients who seek care for their injuries get the appropriate care at the right time and right place."

The study authors recommend several steps health care systems can take to manage the potential increase in patients and avoid both the expensive overuse of emergency services and the long-term effects on communities of inadequately treated injury:

Train medical students and residents with relevant course content on diagnosis and treatment of concussions, musculoskeletal injury, sports medicine and open wound care. Expand programs such as Poison Control Centers and call centers, and remote medical command for triage and treatment of non-life-threatening injuries. Prevent injuries to children by allocating federal and state resources to proven injury prevention strategies. They cost less than medical care needed to treat injuries. Implement the Centers for Disease Control and Prevention's National Action Plan for Childhood Injury Prevention. Develop or expand proven off-the-job injury prevention strategies. The cost of insuring this new population of youth, the majority of whom currently live with an employed head of household, may fall to employers.

"Injury is the leading health risk for children and young adults. Proven prevention strategies and appropriate acute care will reduce fatalities and the long-term consequences that injury can have on quality of life," says Dr. Winston.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pediatrics / children's health section for the latest news on this subject.

Dr. Winston's co-authors include Mark R. Zonfrillo, MD, MSCE of CHOP, J Felipe Garcia-Espana, PhD of Coriell Institute for Medical Research, and Ted R. Miller, PhD of the Pacific Institute for Research and Evaluation. The study was supported by National Science Foundation Center for Child Injury Prevention Studies, Pennsylvania Department of Health, and the Health Resources and Administration's Children's Safety Network.

Children's Hospital of Philadelphia

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Key role in HPV prevention played by vaccination of boys

Main Category: Cervical Cancer / HPV Vaccine
Also Included In: Men's Health;  Pediatrics / Children's Health;  Cancer / Oncology
Article Date: 25 Jul 2013 - 0:00 PDT Current ratings for:
Key role in HPV prevention played by vaccination of boys

Improving vaccination rates against the human papillomavirus (HPV) in boys aged 11 to 21 is key to protecting both men and women, says new research from University of Toronto Professor Peter A. Newman from the Factor-Inwentash Faculty of Social Work.

HPV has been linked to anal, penile and certain types of throat cancers in men. Since the virus is also responsible for various cancers in women, vaccinating boys will play a crucial role in reducing cancer rates across the sexes.

"HPV is the single most common sexually transmitted infection," says Newman, Canada Research Chair in Health and Social Justice. "But now a vaccine is available that can change that and help to prevent the cancers that sometimes result."

Newman's research grouped data from 16 separate studies involving more than 5,000 people to analyze rates of HPV vaccine acceptability and examined what factors play a role when determining if young men receive the vaccine.

Vaccinations, particularly new ones, can have difficulty gaining traction among the citizens they were developed to help. This problem can be compounded by a lack of information, misinformation and even conspiracy theories about the efficacy and safety of vaccines. Unfortunately, says Newman, misinformation and unfounded vaccine fears can result in cancer deaths that could have been avoided with a simple vaccination.

Logistical barriers can also stifle the spread and acceptance of new vaccines. Basic impediments like out-of-pocket cost, transportation to a clinic and wait times for the vaccine can contribute to overall low vaccination rates.

The biggest factor affecting male HPV vaccination rates is the lack of a well-established connection linking HPV in men to a life-threatening illness. The correlation between HPV and cervical cancer in women is responsible for popularizing the vaccine among young women. Unfortunately, a similar connection that would motivate males to get the vaccine has not yet been established. That needs to change, says Newman.

"The idea of an HPV vaccine for boys is new in Canada and so far it has had a low adoption rate," says Newman. "So we need physicians, social workers and public health care institutions to be more active conveying the benefits of the vaccine for boys and the positive role it can help play keeping Canadians safe and healthy."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cervical cancer / hpv vaccine section for the latest news on this subject.

The study can be found online and is available without a subscription in the journal Sexually Transmitted Infections: HPV vaccine acceptability among men: a systematic review and meta-analysis. Peter A Newman, Carmen H Logie, Nick Doukas, Kenta Asakura, Sex Transm Infect doi:10.1136/sextrans-2012-050980

University of Toronto

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