medicalcondition:disease

  • Amazon, AI and Medical Records: Do the Benefits Outweigh the Risks? - Knowledge Wharton
    http://knowledge.wharton.upenn.edu/article/amazon-medical-records

    Last month, Amazon unveiled a service based on AI and machine-learning technology that could comb through patient medical records and extract valuable insights. It was seen as a game changer that could alleviate the administrative burden of doctors, introduce new treatments, empower patients and potentially lower health care costs. But it also carries risks to patient data privacy that calls for appropriate regulation, according to Wharton and other experts.

    Branded Comprehend Medical, the Amazon Web Services offering aims “to understand and analyze the information that is often trapped in free-form, unstructured medical text, such as hospital admission notes or patient medical histories.” Essentially, it is a natural language processing service that pores through medical text for insights into disease conditions, medications and treatment outcomes from patient notes and other electronic health records.

    The new service is Amazon’s latest foray into the health care sector. In June, the company paid $1 billion to buy online pharmacy PillPack, a Boston-based startup that specializes in packing monthly supplies of medicines to chronically ill patients. In January, Amazon teamed up with Berkshire Hathaway and JPMorgan Chase to form a health care alliance that aims to lower costs and improve the quality of medical care for their employees.

    “Health care, like everything else, is becoming more of an information-based industry, and data is the gold standard — and Amazon knows as well as anyone how to handle and analyze data,” said Robert Field, Wharton lecturer in health care management who is also professor of health management and policy at Drexel University. “It’s a $3.5 trillion industry and 18% of our economy, so who wouldn’t want a piece of that?”

    AI offers “enormous” promise when it comes to bringing in new and improved treatments for patient conditions, such as in the area of radiology, added Hempstead. Machine learning also potentially enables the continual improvement of treatment models, such as identifying people who could participate in clinical trials. Moreover, Amazon’s service could “empower a consumer to be more in charge of their own health and maybe be more active consumer of medical services that might be beneficial to their health,” she said.

    On the flip side, it also could enable insurers to refuse to enroll patients that they might see as too risky, Hempstead said. Insurers are already accessing medical data and using technology in pricing their products for specific markets, and the Amazon service might make it easier for them to have access to such data, she noted.

    #Santé_publique #Données_médicales #Amazon #Intelligence_artificielle


  • The controversial case of a rogue scientist responsible for the world’s the first gene-edited babies | Alternet
    https://www.alternet.org/controversial-case-rogue-scientist-responsible-worlds-first-gene-edited-ba

    Public perception

    This backlash may have caught He by surprise. According to one report, He commissioned a large-scale public opinion survey in China a few months prior to the announcement. The survey found that over 70 percent of the Chinese public was supportive of using gene editing for HIV prevention. This is roughly in line with a recent Pew poll in the United States that found 60 percent of Americans support using gene editing on babies to reduce lifetime risk of contracting certain diseases.
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    But polling tells only part of the story. The same Chinese poll also found very low levels of public understanding of gene editing and did not mention the details of He’s study. Abstract polling questions ignore the risks and state of the science, which were crucial to most objections to He’s experiment. It also obscures the involvement of embryos in gene editing. In the American Pew poll, despite overall support for gene editing, 65 percent opposed embryonic testing – a necessary step in the process of gene editing to address disease.

    Moreover, polling is a crude and simplistic way to engage in public debate and deliberation over the controversial issue of gene editing. Various bodies, such as the National Academies of Sciences, Medicine and Engineering in the U.S. and the Nuffield Council on Bioethics in the U.K., have emphasized that, for gene editing to proceed to human trials, a robust public discussion is first needed to establish its legitimacy.

    But looking a little closer reveals other, more problematic motivations.

    For such couples, it is possible to safely conceive an HIV-negative child using robust IVF procedures. Such therapy is expensive, prohibitively so for many couples. But He’s study offered a particularly enticing carrot – free IVF treatment and supportive care, along with a daily allowance and insurance coverage during the treatment and pregnancy. According to the consent form, the total value of treatments and payments was approximately US$40,000 – over four times the average annual wage in urban China.

    This raises a serious concern of undue inducement: paying research participants such a large sum that it distorts their assessment of the risks and benefits. In this gene editing context, where the risks are incredibly uncertain and there is substantially limited general understanding of genetics and gene editing, society should be especially concerned about the distorting effect of such a large reward on the participants’ provision of free and informed consent.

    #Gene_editing #Designer_babies #Ethique


  • Chinese scientists are creating #CRISPR babies - MIT Technology Review
    https://www.technologyreview.com/s/612458/exclusive-chinese-scientists-are-creating-crispr-babies

    According to Chinese medical documents posted online this month (here and here), a team at the Southern University of Science and Technology, in Shenzhen, has been recruiting couples in an effort to create the first gene-edited babies. They planned to eliminate a gene called CCR5 in hopes of rendering the offspring resistant to #HIV, smallpox, and cholera.

    #recherche #génétique #gattaca


  • A vaccine that could block mosquitoes from transmitting malaria
    http://theconversation.com/a-vaccine-that-could-block-mosquitoes-from-transmitting-malaria-105

    For some decades, researchers have being working on a novel idea called a “transmission-blocking vaccine.” This vaccine is different from traditional vaccines that protect the recipient from getting the disease. Here, the vaccine blocks the transmission of the parasite that causes malaria from an infected human host to mosquitoes.

    When a human receives such a vaccine, specific antibodies are generated in the blood. When a mosquito bites and ingests the blood of an infected human, both the parasite and antibody are taken up into the mosquito’s stomach. Once inside the mosquito, the antibody attaches to the parasite and inhibits its development. This prevents the mosquito from transmitting the disease to another person.

    The concept is bold but has not yet been tested in large-scale trials.

    #paludisme #vaccin #moustiques


  • Une belle histoire pour changer : comment le DNDi a trouvé et développé un nouveau médicament contre la #maladie_du_sommeil.

    Drugs for Neglected Diseases initiative (DNDi) is a collaborative, patients’ needs-driven, non-profit drug research and development (R&D) organization that is developing new treatments for neglected patients.

    A doctor’s dream
    https://stories.dndi.org/sleepingsickness-doctors-dream

    #Fexinidazole, the first all-oral drug for both stages of sleeping sickness was approved in November 2018
    Here are the stories of the doctors, patients, and scientists who contributed to this story

    https://www.youtube.com/watch?v=M9tsKmK5Yms&feature=youtu.be

    #santé MSF, pas de #brevets pas de #pharma

    • Un peu de #pharma quand même, puisque Sanofi est dans le coup, et doit bien y trouver son intérêt. Lors du développement d’un médicament contre la Malaria par DNDi il y a 10 ans, Sanofi en était déjà, et on pouvait lire dans Fortune :

      Sanofi’s aim was not entirely altruistic, says Bernard Pécoul, executive director of DNDi, a doctor and public health specialist who spearheaded the antimalaria project. “It’s good for their image,” he says, “but it will also help with the penetration of these countries’ markets.”

      Mais aussi :

      […] a nonprofit organization in Geneva, Drugs for Neglected Diseases Initiative (DNDi), had figured out a way to combine the two antimalaria drugs and was looking for a corporate partner to conduct clinical trials and market and produce the drug on a large scale. “It was the marriage of both of our needs,” says Robert Sebbag, a vice president for Sanofi.

      Source : http://archive.fortune.com/2008/02/22/news/international/malaria.fortune/index.htm?section=magazines_fortuneintl

      Je me suis intéressé à DNDi à cette époque pour mon mémoire de master sur la question des communs immatériels dans la coopération internationale (inspiré alors du logiciel libre). Une interrogation, posée un peu vite en fin de chapitre : l’open source en matière de recherche médicale est-elle soluble dans les monopoles ?

      Si des fois, le texte complet est là (en espagnol). Sur les médicaments, p22-30 :
      http://gofile.me/2faRd/eKo0ig4JV

    • EMA Panel Backs First Oral-Only Drug for Deadly Disease
      https://www.medscape.com/viewarticle/905009

      Fexinidazole was developed by Sanofi-Aventis in partnership with the Drugs for Neglected Diseases initiative (DNDi), a nonprofit drug research and development organization based in Switzerland. Fexinidazole is intended exclusively for markets outside the European Union.

      [...]

      This is the tenth medicine recommended by the EMA under Article 58, a regulation that allows the CHMP to assess and give opinions on medicines that are intended for use in countries outside the European Union.

      “The scientific opinion from the CHMP helps to support regulators in countries where regulatory capacity may be limited, by providing an expert evaluation of the medicine when used in local practice. National regulators can use the CHMP’s scientific assessment to decide on the use of the medicine in their countries,” the EMA explains.


  • “Is curing patients a sustainable business model?” Goldman Sachs analysts ask | Ars Technica
    https://arstechnica.com/tech-policy/2018/04/curing-disease-not-a-sustainable-business-model-goldman-sachs-analysts-

    One-shot cures for diseases are not great for business—more specifically, they’re bad for longterm profits—Goldman Sachs analysts noted in an April 10 report for biotech clients, first reported by CNBC.

    The investment banks’ report, titled “The Genome Revolution,” asks clients the touchy question: “Is curing patients a sustainable business model?” The answer may be “no,” according to follow-up information provided.

    Analyst Salveen Richter and colleagues laid it out:

    The potential to deliver “one shot cures” is one of the most attractive aspects of gene therapy, genetically engineered cell therapy, and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies... While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow.

    For a real-world example, they pointed to Gilead Sciences, which markets treatments for hepatitis C that have cure rates exceeding 90 percent. In 2015, the company’s hepatitis C treatment sales peaked at $12.5 billion. But as more people were cured and there were fewer infected individuals to spread the disease, sales began to languish. Goldman Sachs analysts estimate that the treatments will bring in less than $4 billion this year.

    “[Gilead]’s rapid rise and fall of its hepatitis C franchise highlights one of the dynamics of an effective drug that permanently cures a disease, resulting in a gradual exhaustion of the prevalent pool of patients,” the analysts wrote. The report noted that diseases such as common cancers—where the “incident pool remains stable”—are less risky for business.


  • A game of chicken: how Indian poultry farming is creating global #superbugs

    On a farm in the Rangareddy district in India, near the southern metropolis of Hyderabad, a clutch of chicks has just been delivered. Some 5,000 birds peck at one another, loitering around a warehouse which will become cramped as they grow. Outside the shed, stacks of bags contain the feed they will eat during their five-week-long lives. Some of them gulp down a yellow liquid from plastic containers - a sugar water fed to the chicks from the moment they arrive, the farm caretaker explains. “Now the supervisor will come,” she adds, “and we will have to start with whatever medicines he would ask us to give the chicks.”

    The medicines are antibiotics, given to the birds to protect them against diseases or to make them gain weight faster so more can be grown each year at greater profit. One drug typically given this way is colistin. Doctors call it the “last hope” antibiotic because it is used to treat patients who are critically ill with infections which have become resistant to nearly all other drugs. The World Health Organisation has called for the use of such antibiotics, which it calls “critically important to human medicine”, to be restricted in animals and banned as growth promoters. Their continued use in farming increases the chance bacteria will develop resistance to them, leaving them useless when treating patients.

    Yet thousands of tonnes of veterinary colistin was shipped to countries including Vietnam, India, South Korea and Russia in 2016, the Bureau can reveal. In India at least five animal pharmaceutical companies are openly advertising products containing colistin as growth promoters.

    One of these companies, Venky’s, is also a major poultry producer. Apart from selling animal medicines and creating its own chicken meals, it also supplies meat directly and indirectly to fast food chains in India such as KFC, McDonald’s, Pizza Hut and Dominos.

    https://www.thebureauinvestigates.com/stories/2018-01-30/a-game-of-chicken-how-indian-poultry-farming-is-creating-glob
    #inde #antibiotiques #santé


  • Advanced #analytics and its Importance in the #healthcare Sector
    https://hackernoon.com/advanced-analytics-and-its-importance-in-the-healthcare-sector-79603f5f9

    It is understandable that anyone can feel intimidated by the huge influx of data that keeps flowing through healthcare systems every second of the day. But to draw meaningful insights from it, and use it to treat patients and prevent diseases is a big step in healthcare. This is what Big Analytics or Advanced Analytics does. The data you receive on your machines is just a jumble of ones and zeros, and you have no use for it unless you can understand what it is trying to convey.According to the survey conducted by Health Catalyst, a whopping 90% of the respondents admitted that analytics is going to be either “extremely important” or “very important” to their organization within the next few years. And the respondents also rated the importance of healthcare trends and the role played by (...)

    #big-data-analytics #advanced-analytics #healthcare-analytics


  • #Angola : Les migrants africains en danger de mort

    Les autorités angolaises lancent « la chasse aux ressortissants sub-sahariens en situation irrégulière ». Une #opération dénommée « #expatriado » est en cours en ce moment. Elle vise à « expulser tous les immigrés en situation irrégulière en Angola ». Des ressortissants maliens témoignent des « cas d’#emprisonnement suivis de pires formes de #maltraitance et d’#humiliation ». Pour l’instant, difficile d’avoir des chiffres officiels sur le nombre de Maliens victimes. Mais ceux joints sur place appellent à l’aide des autorités maliennes.

    Selon certains Maliens, ces opérations d’expulsion ont débuté dans les zones minières. Elles se déroulent maintenant dans toutes les villes du pays, et concernent toutes les nationalités y compris les Maliens, qui sont parmi les plus nombreux. « Cela fait des jours que nous ne pouvons plus sortir pour aller au boulot par peur de nous faire arrêter », explique un ressortissant malien sur place. Selon lui, cette opération qui ne devrait concerner que les #sans-papiers, est aussi menée par les forces de l’ordre angolaises contre ceux qui sont en situation régulière. L’objectif, selon notre interlocuteur, est de soutirer de l’argent aux migrants.

    « Une fois entre les mains des autorités angolaises, il faut payer de l’argent ou partir en prison », témoignent certains migrants maliens, avant de confirmer que plusieurs d’entre eux sont actuellement en prison. En Angola certains Maliens ont l’impression d’être « laissés pour compte par les autorités maliennes ». Pour l’Association Malienne des Expulsés, « il est inacceptable qu’un pays membre de l’Union Africaine expulse d’autres africains de la sorte ». L’AME qui juge la situation « grave » en Angola, appelle les autorités maliennes à réagir.

    https://www.expulsesmaliens.info/Angola-Les-migrants-africains-en-danger-de-mort.html
    #migrations #asile #réfugiés #rafles #expulsions #renvois #chasse_aux_migrants #migrants_maliens

    • Briefing: Problems multiply in Congo’s Kasaï

      The Kasaï region in the Democratic Republic of Congo is struggling to recover from two years of intense conflict. The influx last month of more than 300,000 people from Angola, most of them long-standing migrant workers, has made a fragile humanitarian situation worse.

      Here’s our briefing on the risks for the region and the new challenges for the humanitarian response.
      What happened?

      In attempts to clamp down on what it called illegal diamond mining operations, Angola’s government ordered the expulsion of more than 360,000 Congolese nationals, forcing them to flee in October into the Kasaï region of neighbouring DRC.

      "This new shock is compounding an already dire situation in the same area that was the epicentre of the Kasaï crisis over the last couple of years,” explained Dan Schreiber, head of coordination in Congo for the UN’s emergency aid body, OCHA.

      Congolese migrants and officials said the crackdown was violent, telling Reuters that dozens of people were killed, with the worst attacks occurring in Lucapa in Angola’s diamond-rich Lunda Norte province. Angolan security forces denied the allegations.
      Where did they go?

      Most of those expelled crossed into Kamako in Kasaï province, where aid organisations are responding to the tail-end of the Kamuina Nsapu insurgency that first erupted in 2016. Some of the returnees include refugees who fled violence in Kasaï over the last two years, the Norwegian Refugee Council said.

      The NRC said conditions returnees face in Congo are “shocking”, including the risk of waterborne disease due to ineffective water and sanitation; thousands sleeping outdoors because of insufficient shelter; food prices tripling; and extortion of goods on both sides of the border.

      “Hundreds of thousands of people have been robbed of their right to a dignified existence,” said Ulrika Blom, NRC’s country director in DRC. “This is not a crisis that is about to begin, it is a full-blown emergency.”
      What has the reaction been?

      While local communities have generally been welcoming to the returnees, OCHA’s Schreiber said skirmishes erupted in certain villages, mainly over the strain on limited food resources.

      “Experience in the DRC does show that when you have a large influx of people arriving in an area it can generate tensions between host communities and the people who arrive,” he said.

      Schreiber said OCHA has seen most returnees wanting to move away from the border areas and toward other destinations inland, which could help ease the humanitarian strain in Kasaï, but he also warned that more returnees could arrive from Angola.

      “We don’t expect the first wave to be the last wave,” he said. “Expulsions from Angola are a cyclical phenomena that go all the way back to 2002-2003. It’s not a new phenomenon, but in this case we are seeing a major influx, and clearly the absorption capacity is not there.”
      Why is their arrival in Kasaï in particular such a problem?

      Kasaï was a relatively stable region in an unstable country – one currently dealing with multiple conflicts, an Ebola outbreak in North Kivu province, and one of the world’s most neglected displacement crises.

      The situation in Kasaï changed dramatically in 2016 when conflict erupted between the Kamuina Nsapu anti-government movement and Congolese security forces. The inter-communal clashes spread far and wide, soon engulfing the entire region.

      The conflict escalated in 2017, with massacres and mass graves, as well as general insecurity marked by banditry, and poor harvests that led to food insecurity and malnutrition.

      An estimated 5,000 people have since been killed and more than 1.4 million displaced.

      Toward the end of 2017 and into 2018, the crisis eased slightly, as national authorities regained control over large parts of the region. Despite isolated bouts of violence, aid groups say most militias have been formally disbanded and displaced communities are tentatively returning home.

      “But those returns are accompanied by many needs, because people are returning to burned villages, destroyed homes, and a lot of destruction,” said OCHA’s Schreiber.

      Two years of violence and displacement also mean locals have been unable to grow crops for three seasons, which has led to concerns over malnutrition. “We have really seen food insecurity skyrocket. So even in areas where returns have occurred, humanitarian needs have not come to an end,” Schreiber added.
      What are the risks?

      Although the current influx of people from Angola isn’t directly linked to the Kamuina Nsapu rebellion, aid groups are concerned about the implications of piling one problem on top of another in the same geographic area.

      For the most vulnerable groups, specifically women and children, the challenges that affect those displaced by the insurgency also pose risks for the new returnees from Angola.

      In May for instance, UNICEF reported that 400,000 children were “at risk of death” in the Kasaïs, because of food shortages.

      Yves Willemot, a spokesman for UNICEF in Congo, said the rate of severe acute malnutrition among children living in the region has improved slightly since earlier this year but “remains challenging”.

      “The security situation has clearly improved, but the impact on children is not ending in the short term,” he said.

      Among those newly returned from Angola are 80,000 children. They now are also at risk, forced to walk long distances while exposed to inclement weather, hunger, and the threat of violence. Willemot said basic services are lacking for them, including access to drinking water, schooling, and treatment for diseases like malaria and measles.

      Médecins Sans Frontières is among the NGOs initiating primary healthcare services for the recent arrivals, while also continuing interventions to assist the local population.

      In a recent report, MSF documented alarming levels of rape in the Kasaï region, saying it treated 2,600 victims of sexual violence between May 2017 and September 2018; 80 percent of those interviewed said armed men raped them.

      “The sexual violence committed in Kasaï was perpetrated largely by armed groups against non-armed people,” Philippe Kadima, MSF’s humanitarian advisor for the Great Lakes region, told IRIN. “Although the main conflict is over, we still see some violence happening in Kasaï.”

      For the more than 300,000 returnees, he said there are clear humanitarian concerns, but also the risk of insecurity. “The question is, how do you keep people secure?”

      “Displaced people become vulnerable, so it’s not that different to what the existing IDPs in Kasaï are going through… Security concerns, humanitarian needs, and risks of sexual violence are all factors when people become vulnerable,” he said.
      What about the longer-term challenges?

      Humanitarian needs remain critically underfunded in the Kasai region, said OCHA’s Shreiber, emphasising that beyond the immediate concerns are much broader needs in the region and the DRC as a whole.

      He added that the humanitarian response must help minimise the long-term impact of the crisis on those affected.

      “The longer we remain in this critical phase, the more we can expect to see humanitarian needs spiral out of control,” he said. “The current trigger of new humanitarian needs (the returnees from Angola) may be time-bound, but I think the impact will be lasting.”

      Schreiber said the Kasaï region remains vulnerable because it faces particular challenges, including decades of underdevelopment and inaccessibility as a result of poor road infrastructure, and he urged more development actors to get involved.

      “People in the Kasaïs are eager to rebound, to be back on their feet, and move on. There is no expectation that humanitarian assistance should continue forever in the Kasaï region,” he said. “People want to be autonomous, but what they need is support to build up their resilience and be able to move towards a situation where their most basic needs are met and they are able to think about their futures again.”


      http://www.irinnews.org/news-feature/2018/11/08/briefing-congo-kasai-angola-aid-conflict

    • Les violations des droits humains des migrants africains en Angola

      Les violations des droits humains des migrants africains en Angola

      Depuis un certain moment, la communauté africaine vivant sur le territoire angolais est l’objet de toute sorte de violation de ses droits les plus fondamentaux par les autorités de ce pays. La Charte Africaines des Droits de l’Homme et des Peuples protège les droits des migrants dans tous ses aspects contre les violations des droits et l’Angola est justement membre de l’Union Africaine. Ainsi, ces violations se matérialisent par des arrestations musclées et arbitraires, des emprisonnements dans des conditions inhumaines et dégradantes (art.5 de la Déclaration Universelle des Droits de l’Homme et de la Charte Africaine des Droits de l’Homme et des Peuples) de même que les expulsions collectives pourtant interdites par la Charte Africaine dans son article 12.5.

      L’AME est vivement préoccupée par les récentes arrestations, détentions et expulsions des centaines de milliers de migrants africains dont des maliens. Selon des informations recueillies auprès de nos sources sur place, une centaine de maliens sont concernés par cette situation qui évolue et change de jour en jour.

      Nous attirons l’attention de l’Union Africaine et de ses pays membres sur la situation inacceptable que vivent les étrangers sur la terre africaine d’Angola et rappeler que les droits de l’homme sont des droits inaliénables de tous les êtres humains, quels que soient leur nationalité, leur lieu de résidence, leur sexe, leur origine ethnique ou nationale, leur couleur, leur religion…

      L’Angola comme la plupart des pays africains s’est engagé à protéger, respecter et réaliser les droits de l’homme, non seulement de ses nationaux, mais de toute personne sous sa juridiction. Dans ce contexte, tous les étrangers se trouvant sur le sol angolais auraient dû bénéficier de la protection des autorités angolaises quelque soient les raisons qu’elles mettent en avant pour justifier ces expulsions.

      L’Organisation des Nations Unies (ONU) n’est pas resté silencieuse comme la plupart des pays africains, le Haut-Commissaire des Nations Unies aux droits de l’homme a mis en garde sur les conséquences des expulsions massives de réfugiés depuis l’Angola, au cours des trois dernières semaines de ce mois d’octobre.

      Par ailleurs, le Secrétaire Général des Nations Unies a rappelé le 19 septembre 2017 que : « tout pays a le droit de contrôler ses frontières. Mais cela doit se faire de telle sorte que les droits des personnes ‘en mouvement’ soient protégés ».

      Au regard de tout ce qui vient d’être évoqué :
      1. L’Association Malienne des Expulsés (AME) pour sa part, exhorte le gouvernement Malien à tout mettre en œuvre pour la sécurisation de nos compatriotes et de leurs biens dans les pays d’accueil ;
      2. Appelle le gouvernement à communiquer davantage sur cette situation en donnant beaucoup plus d’informations aux familles des maliens vivants en Angola ;
      3. Encourage le gouvernement de continuer à œuvrer pour le respect des droits des migrants maliens et aussi pour le développement d’une relation franche entre les Etats africains en vue de la réalisation de l’unité africaine comme le prévoit l’article 117 de la Constitution ;
      4. Invite l’Union Africaine à dénoncer et prendre des mesures contre les violations des droits humains dans les pays membres ;
      5. Invite également les Etats membres de l’Union Africaine à renoncer aux expulsions massives des ressortissants d’autres pays africains et à mettre fin sans délais aux opérations actuelles en cour ;
      6. Exhorte l’U.A et les Etats à une plus grande implication des organisations de la société civile aux différents processus pour la gestion de la migration.

      http://www.expulsesmaliens.info/Les-violations-des-droits-humains-des-migrants-africains-en-Angola


  • Gaza’s drinking water spurs blue baby syndrome, serious illnesses
    https://diasp.eu/p/7956750

    Gaza’s drinking water spurs blue baby syndrome, serious illnesses

    Contaminated and scarce water owing to Israel’s brutal siege and bombing of infrastructure leads to death and disease.

    Independent, peer-reviewed medical journals have also documented increased infant mortality, anaemia, and an “alarming magnitude” of stunting among Gaza’s children.

    A Rand Corporation study has found that bad water is a leading cause of child mortality in Gaza.

    Simply put, Gaza’s children are facing a deadly health epidemic of unprecedented proportions.

    https://www.aljazeera.com/indepth/features/gaza-drinking-water-spurs-blue-baby-syndrome-illnesses-181029110434881.ht

    #politics #gaza #health #palestine #israel (...)


  • The Real Reasons Saudi Crown Prince Mohammed bin Salman Wanted Khashoggi ‘Dead or Alive’
    https://www.thedailybeast.com/the-real-reasons-saudi-crown-prince-mohammed-bin-salman-wanted-khasho

    Christopher Dickey 10.21.18
    His death is key to understanding the political forces that helped turn the Middle East from a region of hope seven years ago to one of brutal repression and slaughter today.

    The mind plays strange tricks sometimes, especially after a tragedy. When I sat down to write this story about the Saudi regime’s homicidal obsession with the Muslim Brotherhood, the first person I thought I’d call was Jamal Khashoggi. For more than 20 years I phoned him or met with him, even smoked the occasional water pipe with him, as I looked for a better understanding of his country, its people, its leaders, and the Middle East. We often disagreed, but he almost always gave me fresh insights into the major figures of the region, starting with Osama bin Laden in the 1990s, and the political trends, especially the explosion of hope that was called the Arab Spring in 2011. He would be just the man to talk to about the Saudis and the Muslim Brotherhood, because he knew both sides of that bitter relationship so well.

    And then, of course, I realized that Jamal is dead, murdered precisely because he knew too much.

    Although the stories keep changing, there is now no doubt that 33-year-old Saudi Crown Prince Mohammed bin Salman, the power in front of his decrepit father’s throne, had put out word to his minions that he wanted Khashoggi silenced, and the hit-team allegedly understood that as “wanted dead or alive.” But the [petro]buck stops with MBS, as bin Salman’s called. He’s responsible for a gruesome murder just as Henry II was responsible for the murder of Thomas Becket when he said, “Who will rid me of that meddlesome priest?” In this case, a meddlesome journalist.

    We now know that a few minor players will pay. Some of them might even be executed by Saudi headsmen (one already was reported killed in a car crash). But experience also tells us the spotlight of world attention will shift. Arms sales will go ahead. And the death of Washington Post columnist Jamal Khashoggi risks becoming just one more entry in the annals of intensifying, murderous repression of journalists who are branded the “enemy of the people” by Donald Trump and various two-bit tyrants around the world.

    There is more to Khashoggi’s murder than the question of press freedom, however. His death holds the key to understanding the political forces that have helped turn the Middle East from a region of hope seven years ago to one of brutal repression and ongoing slaughter today. Which brings us back to the question of the Saudis’ fear and hatred of the Muslim Brotherhood, the regional rivalries of those who support it and those who oppose it, and the game of thrones in the House of Saud itself. Khashoggi was not central to any of those conflicts, but his career implicated him, fatally, in all of them.

    The Muslim Brotherhood is not a benign political organization, but neither is it Terror Incorporated. It was created in the 1920s and developed in the 1930s and ‘40s as an Islamic alternative to the secular fascist and communist ideologies that dominated revolutionary anti-colonial movements at the time. From those other political organizations the Brotherhood learned the values of a tight structure, party discipline, and secrecy, with a public face devoted to conventional political activity—when possible—and a clandestine branch that resorted to violence if that appeared useful.

    In the novel Sugar Street, Nobel Prize-winning author Naguib Mahfouz sketched a vivid portrait of a Brotherhood activist spouting the group’s political credo in Egypt during World War II. “Islam is a creed, a way of worship, a nation and a nationality, a religion, a state, a form of spirituality, a Holy Book, and a sword,” says the Brotherhood preacher. “Let us prepare for a prolonged struggle. Our mission is not to Egypt alone but to all Muslims worldwide. It will not be successful until Egypt and all other Islamic nations have accepted these Quranic principles in common. We shall not put our weapons away until the Quran has become a constitution for all Believers.”

    For several decades after World War II, the Brotherhood’s movement was eclipsed by Arab nationalism, which became the dominant political current in the region, and secular dictators moved to crush the organization. But the movement found support among the increasingly embattled monarchies of the Gulf, including and especially Saudi Arabia, where the rule of the king is based on his custodianship of Mecca and Medina, the two holiest sites in Islam. At the height of the Cold War, monarchies saw the Brotherhood as a helpful antidote to the threat of communist-led or Soviet-allied movements and ideologies.

    By the 1980s, several of the region’s rulers were using the Brotherhood as a tool to weaken or destroy secular opposition. Egypt’s Anwar Sadat courted them, then moved against them, and paid with his life in 1981, murdered by members of a group originally tied to the Brotherhood. Sadat’s successor, Hosni Mubarak, then spent three decades in power manipulating the Brotherhood as an opposition force, outlawing the party as such, but allowing its known members to run for office in the toothless legislature, where they formed a significant bloc and did a lot of talking.

    Jordan’s King Hussein played a similar game, but went further, giving clandestine support to members of the Brotherhood waging a covert war against Syrian tyrant Hafez al-Assad—a rebellion largely destroyed in 1982 when Assad’s brother killed tens of thousands of people in the Brotherhood stronghold of Hama.

    Even Israel got in on the action, initially giving Hamas, the Brotherhood branch among the Palestinians, tacit support as opposition to the left-leaning Palestine Liberation Organization (although PLO Chairman Yasser Arafat once identified with the Brotherhood himself).

    The Saudi royals, too, thought the Brotherhood could be bought off and manipulated for their own ends. “Over the years the relationship between the Saudis and the Brotherhood ebbed and flowed,” says Lorenzo Vidino, an expert on extremism at George Washington University and one of the foremost scholars in the U.S. studying the Brotherhood’s history and activities.

    Over the decades factions of the Brotherhood, like communists and fascists before them, “adapted to individual environments,” says Vidino. In different countries it took on different characteristics. Thus Hamas, or its military wing, is easily labeled as terrorist by most definitions, while Ennahda in Tunisia, which used to be called terrorist by the ousted Ben Ali regime, has behaved as a responsible political party in a complex democratic environment. To the extent that Jamal Khashoggi identified with the Brotherhood, that was the current he espoused. But democracy, precisely, is what Mohammed bin Salman fears.

    Vidino traces the Saudis’ intense hostility toward the Brotherhood to the uprisings that swept through much of the Arab world in 2011. “The Saudis together with the Emiratis saw it as a threat to their own power,” says Vidino.

    Other regimes in the region thought they could use the Brotherhood to extend their influence. First among these was the powerful government in Turkey of Recep Tayyip Erdogan, who has such longstanding ties to the Islamist movement that some scholars refer to his elected government as “Brotherhood 2.0.” Also hoping to ride the Brotherhood wave was tiny, ultra-rich Qatar, whose leaders had used their vast natural gas wealth and their popular satellite television channel, Al Jazeera, to project themselves on the world stage and, they hoped, buy some protection from their aggressive Saudi neighbors. As one senior Qatari official told me back in 2013, “The future of Qatar is soft power.” After 2011, Jazeera’s Arabic channel frequently appeared to propagandize in the Brotherhood’s favor as much as, say, Fox News does in Trump’s.

    Egypt, the most populous country in the Arab world, and the birthplace of the Brotherhood, became a test case. Although Jamal Khashoggi often identified the organization with the idealistic hopes of the peaceful popular uprising that brought down the Mubarak dynasty, in fact the Egyptian Brotherhood had not taken part. Its leaders had a modus vivendi they understood with Mubarak, and it was unclear what the idealists in Tahrir Square, or the military tolerating them, might do.

    After the dictator fell and elections were called, however, the Brotherhood made its move, using its party organization and discipline, as well as its perennial slogan, “Islam is the solution,” to put its man Mohamed Morsi in the presidential palace and its people in complete control of the government. Or so it thought.

    In Syria, meanwhile, the Brotherhood believed it could and should lead the popular uprising against the Assad dynasty. That had been its role 30 years earlier, and it had paid mightily.

    For more than a year, it looked like the Brotherhood’s various branches might sweep to power across the unsettled Arab world, and the Obama administration, for want of serious alternatives, was inclined to go with the flow.

    But then the Saudis struck back.

    In the summer of 2013, Gen. Abdel Fattah al-Sissi, the commander of the Egyptian armed forces, led a military coup with substantial popular support against the conspicuously inept Brotherhood government, which had proved quickly that Islam was not really the “solution” for much of anything.

    Al-Sissi had once been the Egyptian military attaché in Riyadh, where he had many connections, and the Saudis quickly poured money into Egypt to shore up his new regime. At the same time, he declared the Muslim Brotherhood a terrorist organization, and launched a campaign of ruthless repression. Within weeks of the coup, the Egyptian military attacked two camps of Brotherhood protesters and slaughtered hundreds.

    In Syria, the efforts to organize a credible political opposition to President Bashar al-Assad proved virtually impossible as the Qataris and Turks backed the Brotherhood while the Saudis continued their vehement opposition. But that does not mean that Riyadh supported moderate secular forces. Far from it. The Saudis still wanted to play a major role bringing down the Syrian regime allied to another arch enemy, the government of Iran. So the Saudis put their weight behind ultra-conservative Salafis, thinking they might be easier to control than the Muslim Brothers.

    Riyadh is “okay with quietist Salafism,” says Vidino. But the Salafis’ religious extremism quickly shaded over into the thinking of groups like the al Qaeda spinoff called the Nusra Front. Amid all the infighting, little progress was made against Assad, and there to exploit the chaos was the so-called Islamic State (which Assad partially supported in its early days).

    Then, in January 2015, at the height of all this regional turmoil, the aged and infirm Salman bin Abdelaziz ascended to the throne of Saudi Arabia. His son, Mohammed bin Salman, began taking into his own hands virtually all the reins of power, making bold decisions about reforming the Saudi economy, taking small measures to give the impression he might liberalize society—and moving to intimidate or otherwise neutralize anyone who might challenge his power.

    Saudi Arabia is a country named after one family, the al Saud, and while there is nothing remotely democratic about the government, within the family itself with its thousands of princes there traditionally has been an effort to find consensus. Every king up to now has been a son of the nation’s founder, Abdelaziz ibn Saud, and thus a brother or half brother of the other kings.

    When Salman took over, he finally named successors from the next generation. His nephew Mohammed bin Nayef, then 57 and well known for his role fighting terrorism, became crown prince. His son, Mohammed bin Salman, became deputy crown prince. But bin Nayef’s position between the king and his favorite son clearly was untenable. As one Saudi close to the royals put it: “Between the onion and the skin there is only the stink.”

    Bin Nayef was pushed out in 2017. The New York Times reported that during an end-of-Ramadan gathering at the palace he “was told he was going to meet the king and was led into another room, where royal court officials took away his phones and pressured him to give up his posts as crown prince and interior minister. … At first, he refused. But as the night wore on, the prince, a diabetic who suffers from the effects of a 2009 assassination attempt by a suicide bomber, grew tired.” Royal court officials meanwhile called around to other princes saying bin Nayef had a drug problem and was unfit to be king.

    Similar pressure was brought to bear on many of the richest and most powerful princes in the kingdom, locked up in the Ritz Carlton hotel in 2017, ostensibly as part of an extra-legal fight against corruption. They were forced to give allegiance to MBS at the same time they were giving up a lot of their money.

    That pattern of coerced allegiance is what the Saudis now admit they wanted from Jamal Khashoggi. He was no prince, but he had been closely associated in the past with the sons of the late King Faisal, particularly Turki al-Faisal, who was for many years the head of the Saudi intelligence apparatus and subsequently served as ambassador to the United Kingdom, then the United States.

    Although Turki always denied he had ambitions to be king, his name often was mentioned in the past as a contender. Thus far he seems to have weathered the rule of MBS, but given the record of the crown prince anyone close to the Al Faisal branch of the family, like Khashoggi, would be in a potentially perilous position.

    Barbara Bodine is a former U.S. ambassador to Yemen, which has suffered mightily since MBS launched a brutal proxy war there against Iran. Both MBS and Trump have declared the regime in Tehran enemy number one in the region. But MBS botched the Yemen operation from the start. It was dubbed “Decisive Storm” when it began in 2015, and was supposed to last only a few weeks, but the war continues to this day. Starvation and disease have spread through Yemen, creating one of the world’s greatest humanitarian disasters. And for the moment, in one of those developments that makes the Middle East so rich in ironies, in Yemen the Saudis are allied with a branch of the Muslim Brotherhood.

    “What drives MBS is a ruthless effort toward total control domestically and regionally; he is Putin of the Desert,” says Bodine. “He has basically broken the back of the princelings, the religious establishment and the business elite, brought all ministries and agencies of power under his sole control (’I alone can fix it’), and jailed, killed or put under house arrest activists and any and all potential as well as real opposition (including his mother).”

    In 2017, MBS and his backers in the Emirates accused Qatar of supporting “terrorism,” issuing a set of demands that included shutting down Al Jazeera. The Saudis closed off the border and looked for other ways, including military options, to put pressure on the poor little rich country that plays so many angles it has managed to be supportive of the Brotherhood and cozy with Iran while hosting an enormous U.S. military base.

    “It was Qatar’s independent streak—not just who they supported but that they had a foreign policy divorced from the dictates of Riyadh,” says Bodine. “The basic problem is that both the Brotherhood and Iran offer competing Islam-based governing structures that challenge the Saudi model.”

    “Jamal’s basic sin,” says Bodine,“was he was a credible insider, not a fire-breathing radical. He wrote and spoke in English for an American audience via credible mainstream media and was well regarded and highly visible within the Washington chattering classes. He was accessible, moderate and operated within the West. He challenged not the core structure of the Kingdom but the legitimacy of the current rulers, especially MBS.”

    “I do think the game plan was to make him disappear and I suspect the end game was always to make him dead,” said Bodine in a long and thoughtful email. “If he was simply jailed within Saudi there would have been a drumbeat of pressure for his release. Dead—there is certainly a short term cost, whether more than anticipated or longer than anticipated we don’t know yet, but the world will move on. Jamal will become a footnote, a talking point perhaps, but not a crusade. The dismembered body? No funeral. Taking out Jamal also sends a powerful signal to any dissident that there is no place safe.”

    #Arabie_Saoudite #Turquie #politique #terrorisme #putsch


  • Not exercising worse than smoking, diabetes and heart disease study...
    https://diasp.eu/p/7891268

    Not exercising worse than smoking, diabetes and heart disease study finds

    Being unfit should be treated as a disease that has a prescription, called exercise, the study’s author said. Article word count: 764

    HN Discussion: https://news.ycombinator.com/item?id=18264436 Posted by nikolasavic (karma: 503) Post stats: Points: 97 - Comments: 48 - 2018-10-20T17:45:05Z

    #HackerNews #and #diabetes #disease #exercising #finds #heart #not #smoking #study #than #worse

    Article content:

    [1]High intensity workouts can help you live to 100

     Fitness leads to longer life, researchers found, with no limit to the benefit of aerobic exercise  Comparing those with a sedentary lifestyle to the top exercise performers, the risk of premature death was 500% higher.

    Atlanta, Georgia (CNN)Weʼve (...)


  • How Tuberculosis Shaped Victorian Fashion | Science | Smithsonian
    https://www.smithsonianmag.com/science-nature/how-tuberculosis-shaped-victorian-fashion-180959029

    By the mid-1800s, tuberculosis had reached epidemic levels in Europe and the United States. The disease, now known to be infectious, attacks the lungs and damages other organs. Before the advent of antibiotics, its victims slowly wasted away, becoming pale and thin before finally dying of what was then known as consumption.

    The Victorians romanticized the disease and the effects it caused in the gradual build to death. For decades, many beauty standards emulated or highlighted these effects. And as scientists gained greater understanding of the disease and how it was spread, the disease continued to keep its hold on fashion.

    “Between 1780 and 1850, there is an increasing aestheticization of tuberculosis that becomes entwined with feminine beauty,” says Carolyn Day, an assistant professor of history at Furman University in South Carolina and author of the forthcoming book Consumptive Chic: A History of Fashion, Beauty and Disease, which explores how tuberculosis impacted early 19th century British fashion and perceptions of beauty.

    During that time, consumption was thought to be caused by hereditary susceptibility and miasmas, or “bad airs,” in the environment. Among the upper class, one of the ways people judged a woman’s predisposition to tuberculosis was by her attractiveness, Days says. “That’s because tuberculosis enhances those things that are already established as beautiful in women,” she explains, such as the thinness and pale skin that result from weight loss and the lack of appetite caused by the disease.

    The 1909 book Tuberculosis: A Treatise by American Authors on Its Etiology, Pathology, Frequency, Semeiology, Diagnosis, Prognosis, Prevention, and Treatment confirms this notion, with the authors noting: “A considerable number of patients have, and have had for years previous to their sickness, a delicate, transparent skin, as well as fine, silky hair.” Sparkling or dilated eyes, rosy cheeks and red lips were also common in tuberculosis patients—characteristics now known to be caused by frequent low-grade fever.

    “We also begin to see elements in fashion that either highlight symptoms of the disease or physically emulate the illness,” Day says. The height of this so-called consumptive chic came in the mid-1800s, when fashionable pointed corsets showed off low, waifish waists and voluminous skirts further emphasized women’s narrow middles. Middle- and upper-class women also attempted to emulate the consumptive appearance by using makeup to lighten their skin, redden their lips and color their cheeks pink.


  • Linguistic red flags from Facebook posts can predict future depression diagnoses — ScienceDaily
    https://www.sciencedaily.com/releases/2018/10/181015150643.htm

    Research finds that the language people use in their Facebook posts can predict a future diagnosis of depression as accurately as the tools clinicians use in medical settings to screen for the disease.

    In any given year, depression affects more than 6 percent of the adult population in the United States — some 16 million people — but fewer than half receive the treatment they need. What if an algorithm could scan social media and point to linguistic red flags of the disease before a formal medical diagnosis had been made?

    Ah oui, ce serait fantastique pour les Big Pharma : la dépression est une maladie complexe, dont les symptômes graves sont souvent confondus avec la déprime qui est un état sychologique que nous connaissons tous. Notre Facebook, couplé avec notre assistant vocal Amazon nous gorgerait de Valium, et tout irait pour le mieux dans le Meilleur des mondes.

    Considering conditions such as depression, anxiety, and PTSD , for example, you find more signals in the way people express themselves digitally."

    For six years, the WWBP, based in Penn’s Positive Psychology Center and Stony Brook’s Human Language Analysis Lab, has been studying how the words people use reflect inner feelings and contentedness. In 2014, Johannes Eichstaedt, WWBP founding research scientist, started to wonder whether it was possible for social media to predict mental health outcomes, particularly for depression.

    “Social media data contain markers akin to the genome,” Eichstaedt explains. “With surprisingly similar methods to those used in genomics, we can comb social media data to find these markers. Depression appears to be something quite detectable in this way; it really changes people’s use of social media in a way that something like skin disease or diabetes doesn’t.”

    Il y a au moins une bonne nouvelle sur la déontologie scientifique :

    Rather than do what previous studies had done — recruit participants who self-reported depression — the researchers identified data from people consenting to share Facebook statuses and electronic medical-record information, and then analyzed the statuses using machine-learning techniques to distinguish those with a formal depression diagnosis.

    Les marqueurs considérés sont aussi des marqueurs sociaux et économiques, qu’il faudrait traiter autrement qu’avec des médicaments.

    They learned that these markers comprised emotional, cognitive, and interpersonal processes such as hostility and loneliness, sadness and rumination, and that they could predict future depression as early as three months before first documentation of the illness in a medical record.

    La conclusion est fantastique : il faut rendre le balayage obligatoire !!!

    Eichstaedt sees long-term potential in using these data as a form of unobtrusive screening. “The hope is that one day, these screening systems can be integrated into systems of care,” he says. “This tool raises yellow flags; eventually the hope is that you could directly funnel people it identifies into scalable treatment modalities.”

    Despite some limitations to the study, including its strictly urban sample, and limitations in the field itself — not every depression diagnosis in a medical record meets the gold standard that structured clinical interviews provide, for example — the findings offer a potential new way to uncover and get help for those suffering from depression.

    #Dépression #Facebook #Foutaises #Hubris_scientifique #Big_pharma #Psychologie


  • Opinion | We Know How to Conquer Tuberculosis - The New York Times
    https://www.nytimes.com/2018/09/26/opinion/we-know-how-to-conquer-tuberculosis.html

    And so, tuberculosis remains the world’s leading infectious disease killer, by far. It infects some 10 million people around the world every year, killing roughly 1.5 million. That’s some 4,000 deaths per day. By comparison, Ebola killed four people in 2017. America’s opioid epidemic kills about 115 people a day.

    Still, tuberculosis is rarely the stuff of headlines. It’s ancient. It normally affects only the poorest people in the poorest countries. And when it does spread through wealthier areas, it’s generally curable with antibiotics. But a contingent of doctors, scientists and public health officials have spent the past two decades battling a global epidemic of the disease. And on Wednesday, they got their first hearing at the United Nations General Assembly. In a high-level meeting exclusively about tuberculosis control, those experts called on world leaders to devote more attention and far more resources to the disease. Both are urgently needed. Tuberculosis receives significantly less funding than H.I.V. or malaria, even though TB kills more people each year than both of those diseases combined. The World Health Organization estimates a $3.5 billion funding shortfall for TB control efforts, and says that gap could double in five years.

    But policymakers, industry leaders and doctors on the front lines might also consider a change in strategy: Treat tuberculosis outbreaks in poor countries the same way they are treated in rich ones. That is, don’t just treat those who are sick; find and test their household members, neighbors, classmates and colleagues — and then treat the ones who test positive. Give them medications to kill the bacteria before they develop symptoms and before they pass the bacteria on, through their own coughing, to the next victim.

    #Tuberculose #Maladie_des_pauvres


  • Neonatal Abstinence Syndrome: An Update
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843557

    Purpose of review

    This review provides an update focused on the evolving epidemiology of neonatal abstinence syndrome (NAS), factors influencing disease expression, advances in clinical assessment of withdrawal, novel approaches to treat NAS, and the emerging role of quality improvement work in the field of NAS.

    The rise in the incidence of NAS disproportionately occurred in rural and suburban areas. Polysubstance exposure and genetic polymorphisms modified NAS expression and severity. Several centers have explored the use of new bedside assessments, focused on fewer factors to identify infants with NAS, that resulted in a decreased proportion of infants receiving pharmacotherapy for NAS. In addition, buprenorphine was shown to be a promising therapeutic alternative to morphine for treatment of NAS. Lastly, local, state and national quality improvement initiatives aimed to improve outcomes for infants with NAS emerged as an effective manner to advance the care of infants with NAS.

    NAS remains a critical public health issue associated with significant medical, economic and personal burden. Emerging data on drivers of disease, assessment of withdrawal and treatment for NAS provide clinicians and hospitals with new knowledge and an urgency to promote standardization of care for infants with NAS.

    #Bébés #Opioides #Syndrome_sevrage_neonatal


  • Offline: Why has global health forgotten cancer? - The Lancet
    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32162-7/abstract

    Nothing illustrates the embedded irrationality of global health more than our attitudes to cancer. In 2016, according to the Global Burden of Disease, 8·9 million people died from cancer (23% of total worldwide deaths from NCDs, and 16% of deaths from all causes). The leading causes of cancer death are tumours of the trachea, bronchus, and lung (1·7 million deaths); gynaecological cancers (breast, cervix, ovary, and uterus: 1 million deaths); gastric cancer (834 000 deaths); colorectal cancer (829 600 deaths); and liver cancer (828 000 deaths). So why the indifference?

    The NCD community has become trapped in an ideology that privileges prevention over treatment. A similar mistake disfigured the early response to AIDS. I can recall senior WHO leaders two decades ago agreeing that a generation of people living with HIV would have to die before the pandemic could be controlled by prevention. Only anger and activism overturned the complacency of traditional public health practice. But the NCD community has no time for anger or activism

    #cancer #OMS #prévention #traitement (again)


  • United States Patent : 9861628
    http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=98,61,628.PN.&OS=PN/98,61,628&RS=PN/98,61,628

    Buprenorphine-wafer for drug substitution therapy

    Abstract

    The present invention relates to oral pharmaceutical dosage forms comprising buprenorphine with the dosage form releasing buprenorphine instantly upon oral, preferably sublingual, application of the dosage form. The present invention also relates to the use of such dosage forms for treating pain in a human or animal or for drug substitution therapy in drug-dependent human subjects.

    BACKGROUND OF THE INVENTION

    Chronic pain, which may be due to idiopathic reasons, cancer or other diseases such as rheumatism and arthritis, is typically treated with strong opioids.

    Over the last decades prejudices in the medical community as to the use of strong opioids for treating chronic pain in patients has significantly decreased. Many of the se prejudices were due to some of the characteristics being inherent to opioids.

    While opioids have always been known to be useful in pain treatment, they also display an addictive potential in view of their euphorigenic activity. Thus, if opioids are taken by healthy human subjects with a drug seeking behaviour they may lead to psychological as well as physical dependence.

    These usually undesired characteristics of opioids can however become important in certain scenarios such as drug substitution therapies for drug addicts. One of the fundamental problems of illicit drug abuse by drug addicts (“junkies”) who are dependent on the constant intake of illegal drugs such as heroin is the drug-related criminal activities resorted to by such addicts in order to raise enough money to fund their addiction. The constant pressures upon addicts to procure money for buying drugs and the concomitant criminal activities have been increasingly recognised as a major factor that counteracts efficient and long-lasting withdrawal and abstinence from drugs.

    Therefore, programmes have been developed, particularly in the United States and western European countries, in which drug addicts are allowed to take prescription drugs under close supervision of medical practitioners instead of illegal drugs such as street heroin.

    The aim of drug substitution theory is thus to first enable addicts to lead a regular life by administering legal drugs to prevent withdrawal symptoms, but because of their legal character and prescription by medical practitioners do not lead to the aforementioned described drug-related criminal activities. In a second and/or alternate step in the treatment of drug addiction may be to slowly make the drug addict less dependent on the drug by gradually reducing the dose of the substitution drug or to bridge the time until a therapy place in a withdrawal programme is available.

    The standard drug used in drug substitution therapy programmes has for a long time been methadone. However, in recent years the potential of other opioids as substitution drugs in substitution therapy has been recognised. A particularly suitable drug for that purpose is the opioid buprenorphine, which is a mixed opioid agonist/antagonist.

    Nowadays, buprenorphine preparations are administered in drug substitution programmes in the form of a tablet for sublingual administration. One of the reasons that the tablets are formulated for sublingual administration is that this the preferred route of administration for buprenorphine. Furthermore, if a patient swallows such tablets they will not provide euphorigenic activity.

    One example of sublingual tablets for drug substitution therapy is the preparation Subutex.RTM. (being marketed in Germany by Essex Pharma).

    Nevertheless, drug addicts sometimes still try to divert these sublingual buprenorphine tablets by removing them from the mouth when the supervising healthcare professional’s attention is directed to other activities. Later the tablets may be sold or the active agent buprenorphine isolated/extracted to apply it parenterally.

    Another buprenorphine preparation aimed at preventing this potential possibility of abuse has recently gained administrative approval in the United States (Suboxone.RTM.). The Suboxone.RTM. preparation comprises buprenorphine hydrochloride and the opioid antagonist naloxone hydrochloride dihydrate. The presence of naloxone is intended to prevent parenteral abuse of buprenorphine as parenteral co-administration of buprenorphine and naloxone in e.g. an opioid-dependent addict will lead to serious withdrawal symptoms.

    However, there remains a need for other diversion and/or abuse-resistant dosage forms of buprenorphine, which can be used in drug substitution therapy as described above. Additionally, it would be desirable to have a buprenorphine preparation available which is diversion and/or abuse-resistant in cases where the preparation is used for drug substitution therapy and which could also provide efficient analgesia in cases where the preparation is administered to alleviate pain in a patient.

    OBJECT AND SUMMARY OF THE INVENTION

    It is an object of the present invention to provide an oral pharmaceutical dosage form of the active agent buprenorphine that is less prone to diversion and/or abuse in drug substitution therapy. It is another object of the present invention to provide an oral dosage form of the active agent buprenorphine that can be used for drug substitution therapy and/or pain treatment.

    In one embodiment the present invention relates to an oral pharmaceutical dosage form comprising at least buprenorphine or a pharmaceutically acceptable salt thereof with a dosage form releasing buprenorphine or said pharmaceutically acceptable salt thereof instantly upon or oral, preferably sublingual, application of the dosage form. It is, however, understood that the invention and its various embodiments which are set out below, can be extended to any opioid or analgesic whose preferred route of administration is oral, prefereably sublingual, as is the case for buprenorphine.

    An instant release of buprenorphine or a pharmaceutically acceptable salt thereof upon oral, preferably sublingual, application means that substantially all of the buprenorphine or said pharmaceutically acceptable salt thereof will be released within less than three minutes, preferably within less than two minutes or less than one minute. Even more preferably, substantially all of the buprenorphine or said pharmaceutically acceptable salt thereof will be released within less than thirty seconds, twenty seconds, ten seconds or even within less than five seconds after oral, preferably sublingual, application of the dosage form. In one of the preferred embodiments these oral dosage forms will comprise between approximately 0.1 mg and approximately 16 mg buprenorphine or the equivalent amounts of a pharmaceutically acceptable salt thereof.

    In a further preferred embodiment these oral pharmaceutical dosage forms will achieve an average C.sub.max of between 1.5 ng/ml and approximately 2.25 ng/ml in the case of a dose of 0.4 mg buprenorphine hydrochloride being administered. In the case of a dose of 8 mg buprenorphine HCl being administered, the C.sub.max will typically be between approximately 2.5 and 3.5 ng/ml and if a dose of 16 mg buprenorphine hydrochloride is administered the C.sub.max will preferably be between 5.5 to 6.5 ng/ml.

    Yet another preferred embodiment of the invention relates to oral pharmaceutical dosage forms which may provide for the above-mentioned characteristics and/or an average Tmax of from approximately 45 to approximately 90 minutes.

    In a particularly preferred embodiment the dosage forms will additionally comprise an opioid antagonist, preferably naloxone or a pharmaceutically acceptable salt thereof.

    In yet a further preferred embodiment, the pharmaceutical dosage form will comprise buprenorphine and the opioid antagonist, which preferably is naloxone, in a weight ratio of from approximately 1:1 to approximately 10:1.

    One embodiment of the present invention also relates to oral pharmaceutical dosage forms, which may have some or all of the aforementioned characteristics and wherein the dosage form has a film-like or wafer-like shape.

    Another embodiment relates to a method of manufacturing the afore-mentioned described dosage forms.

    Embodiments of the present invention also relate to the use of the afore-described oral, preferably sublingual, pharmaceutical dosage forms in the manufacture of a medicament for treating pain in a human or animal and/or for drug substitution therapy in drug-dependent human subjects.

    One aspect of the invention also relates to a method of drug substitution therapy in drug-dependent human subjects wherein the aforementioned oral pharmaceutical dosage forms are administered to a drug-dependent subject in need thereof.

    #Opioides #Sackler #Brevet #Cynisme #Capitalisme_sauvage



  • AWESOMELY GROSS MEDICAL ILLUSTRATIONS FROM THE 19TH CENTURY.
    https://www.wired.com/2014/05/awesomely-gross-medical-illustrations-from-the-19th-century

    IN THE 19TH century, doctors couldn’t use photographs to teach their students to distinguish between benign or cancerous growths. Or how teeth looked in patients affected by hereditary syphilis. Or the stages of cholera.

    So the physicians, surgeons, and anatomists of the 1800s built close relationships with artists, craftsmen, and publishers to produce beautiful (yet horrifically off-putting at times) illustrations. In The Sick Rose: Disease and the Art of Medical Illustration, Richard Barnett collects up the best examples of these images. They—and the accompanying chapters of text, organized by disease—are endlessly fascinating.

    https://dangerousminds.net/comments/bloody_disgusting_a_gruesome_gallery_of_vintage_medical_illustration
    https://www.theguardian.com/artanddesign/gallery/2014/jun/02/shocking-vintage-medical-drawings-sick-rose-in-pictures
    http://www.slate.com/articles/news_and_politics/history/2014/11/old_medical_photographs_are_images_of_syphilis_and_tuberculosis_patients.html

    #bloody_sundy


  • Fool’s gold: what fish oil is doing to our health and the planet | Life and style | The Guardian
    https://www.theguardian.com/lifeandstyle/2018/jul/25/fish-oil-hype-health-planet-supplements-study-no-benefit?CMP=soc_567

    After comparing 79 trials involving 112,059 people, the researchers could find “little or no difference to risk of cardiovascular events, coronary heart deaths, coronary heart disease events, stroke or heart irregularities”.

    I can’t say that I was particularly surprised. Over the past 15 years, more than 20 studies have shown a similar lack of effect. But what does surprise me is how we continue to look at the world of fish and seafood through the amber lens of a fish oil capsule. Omega-3s do something in our bodies – and probably something important. But without the larger context of the marine organisms that contain them, omega-3s get lost in the noise of human metabolism and modern marketing.

    The confusion arises in part from the historical baggage of fish oil and the $30bn (£23bn) industry associated with omega-3 extraction. Once upon a time, fish oil solved a major human health problem. But it had nothing to do with coronary heart disease. During the Industrial Revolution, a disease became increasingly prevalent throughout northern Europe: rickets. Malnourished children in sunlight-poor urban slums often ended up bowlegged by adolescence. Researchers eventually pieced the puzzle together and concluded that the disease was caused by a deficiency in vitamin D, which the body naturally generates in the presence of sunlight. And, as it turned out, vitamin D is stored in high amounts within the liver of codfish.

    A Norwegian pharmacist named Peter Möller seized upon this finding (and many other anecdotal stories about the curative properties of cod-liver oil). Using a patented chemical process, he arrived at a product that, he announced to the world, “didn’t taste fishy”. Möller and his advertising team then launched a campaign to institutionalise the regular use of cod-liver oil, regardless of whether you were at risk of rickets or not.

    In the early 1970s, the chemist Hans Olaf Bang read in a Danish journal that there were extremely low incidences of cardiovascular disease in Inuit communities of Greenland. He and his assistant, Jørn Dyerberg, travelled to Uummannaq on the north-west coast of Greenland to investigate. (...)

    The result of their analysis was a hypothesis that is an exemplary “association study”. In an association study, multiple factors are logged and a hypothesis of correlation is drawn from the findings. In the case of the Bang and Dyerberg Inuit study, they found that: 1) Inuit people in Greenland had a diet high in omega-3 fatty acids and blood lipid levels of omega-3s much higher than their western contemporaries. 2) Inuit people also had, according to public health records, markedly lower rates of coronary heart disease. They hypothesised that therefore 3) omega-3s might reduce the risk of coronary heart disease.

    Ça, c’est pour @reka !

    #poisson #santé #oméga_3 #industrie_halieutique #pêche #marketing #big_fish #fishy


  • This Economist Reveals the Deadly Truth About the Trump Administration’s Assault on Breastfeeding – Mother Jones
    https://www.motherjones.com/politics/2018/07/this-economist-explains-the-inexplicable-hostility-of-the-trump-adminis

    According to a Sunday New York Times scoop, President Donald Trump’s delegation to the United Nations-affiliated World Health Assembly recently bullied smaller, less wealthy nations in an ultimately failed effort to crush a resolution urging mothers to breastfeed infants.

    According to Trump himself, the account was just more “fake news” from the “failing” New York Times.

    The World Health Organization states that “breastfeeding is so critical that it could save the lives of over 820,000 children under the age of 5 years each year.” The American Academy of Pediatrics cites “unequivocal evidence that breastfeeding protects against a variety of diseases and conditions in the infant.” The World Health Assembly’s concern about misleading promotion of infant formula is also grounded in fact. A recent report found more than 800 violations of the World Health Organization’s guidelines for marketing breast milk substitutes in 79 countries between 2014 and 2017.

    As for the Trump team’s push to stop the World Health Assembly from advising women to breastfeed and calling out misleading marketing of substitutes, Berkeley’s Gertler said he was “deeply disgusted” by the revelation. “There are things we should do because they’re the right thing to do, not because we get something out of it, and [promoting breastfeeding] is the right thing to do,” he said. “There is no one who claims infant formula is superior to breast milk.”

    #fake_fake_news, donc ?



  • Genomic Inquiries
    https://hackernoon.com/genomic-inquiries-5c675aff55ec?source=rss----3a8144eabfe3---4

    Photo by NeONBRAND on UnsplashI’ve been reading a book personalized #medicine called Genomic Messages by George Annas and Sherman Elias. It is an excellent book that gives the lay of the land when it comes to #genomics as it relates to the everyday person.In some regards, this book may be considered not that recent as it was published in 2015. It seems as though everyday there is a new headline of a breakthrough at a university for genetics or translational medicine in relation to curing disease. And, though these things may be true, there are significant ramifications of moving forward with these discoveries and technologies.Personalized MedicineAlong with the word blockchain and AI — personalized medicine or precision medicine has joined the ranks of hype. In fact, it has been the dream of (...)

    #healthcare #health #genomic-inquiries


  • The siege of Hodeidah, Washington’s war crime in Yemen - World Socialist Web Site

    https://www.wsws.org/en/articles/2018/06/15/pers-j15.html

    The siege of Hodeidah, Washington’s war crime in Yemen
    15 June 2018

    The siege of Yemen’s Red Sea port of Hodeidah launched by Saudi and United Arab Emirates-led forces at dawn on Wednesday could cost the lives of some quarter of a million people in the crowded city itself, according to a UN estimate, while threatening to kill millions more across the country through hunger and disease.

    Inflicting mass suffering upon civilians is the main purpose of the attack on Hodeidah, which is the principal lifeline for food, fuel and medicine for at least 70 percent of the population in a country that depends on imports for up to 90 percent of its food. The aim is to starve the impoverished Yemeni people into submission.

    #yémen #états-unis #arabie_saoudite