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New Vaccine Strategy Might Offer Protection Against Pandemic Influenza Strains
A novel vaccine strategy using virus-like particles (VLPs) could provide stronger and longer-lasting influenza vaccines with a significantly shorter development and production time than current ones, allowing public health authorities to react more quickly in the event of a potential pandemic.
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New York Times Examines Trend Of Posting Childbirth Videos On YouTube
The New York Times on Thursday examined how thousands of women have posted videos on YouTube showing themselves giving birth. According to the Times, the women believe the videos help "demystify" childbirth by candidly presenting the process in a manner that pregnant women and their partners otherwise might not see. Along with YouTube, Web sites like Internet chat rooms and pregnancy blogs are helping to shift dynamics between pregnant women and their care providers, the Times reports. Eileen Ehudin Beard, an adviser for the American College of Nurse-Midwives, said, "The more information you have, the more s you have, the more informed you are, the better questions you ask." However, she added that the videos could have negative effects, particularly if they make women more fearful of childbirth. The childbirth videos are relatively controversial because of their graphic nature, which has challenged some of YouTube"s rules and raised issues of propriety. Victoria Grand, the head of policy for YouTube, said that nudity generally is banned from YouTube but that the site "make[s] exceptions for videos that are educational, documentary or scientific." Most childbirth videos on YouTube are age restricted to ages 18 and older. A majority of them show home births because most U.S. hospitals prohibit patients from recording births due to liability concerns, the Times reports. Although childbirth education classes have shown edited videos of births since the 1970s, the Internet and YouTube could change the way such classes are taught, according to Jeanette Schwartz, president of the International Childbirth Education Association. She noted that most videos currently used in childbirth classes are heavily edited and out of date, adding that the YouTube videos "create a wonderful opportunity to show free, real life, candid videos in a classroom setting." Eugene Declercq, a professor at the Boston University School of Public Health, said, "A hundred and fifty years ago, women viewed birth on a pretty regular basis -- they saw their sisters of neighbors give birth." He said that changed with a trend toward hospital births beginning in the late 19th century. "But now, with YouTube, we"ve come back around and women have this opportunity to view births again," Declercq said (Wollan, New York Times, 6/11).
News of the day
Genetic Factors Implicated In Survival Gap For Breast, Ovarian Or Prostate Cancer
A new finding reveals that African-American patients with breast, ovarian, and prostate cancer tend to die earlier than patients of other races with these cancers, even when they receive identical medical treatment and when socioeconomic factors are controlled for. The finding, an analysis of almost 20,000 patient records from 35 clinical trials, points to biological or genetic factors as the potential of the survival gap. Dawn Hershman, M.D, M.S., a Columbia University Medical Center oncologist whose research is dedicated to examining racial and ethnic disparities in cancer outcome and in cancer survivorship, was the senior author of the research published online by the Journal of the National Cancer Institute (JNCI).
Endocrinology

Nation's First Bilateral Hand Transplant Recipient Speaks About Surgery And Progress

Jeff Kepner, the nation"s first bilateral hand transplant recipient, spoke at a news conference today about his surgery and showed the progress he has made since the May 4 procedure. Mr. Kepner, who lost both hands and feet following a bacterial infection in 1999, is the second patient to be treated with the "Pittsburgh Protocol," a new immune modulation therapy that aims to reduce the risk associated with toxic anti-rejection drugs. "I am looking forward to the opportunity to regain my independence. It will be great to hold my wife"s and daughter"s hands again and to be able to do things with them that I haven"t been able to do for over 10 years," said Mr. Kepner, 57, of Augusta, Ga. A transplant team composed of surgeons, hematologists, nurses, therapists and researchers has cared for Mr. Kepner since the nine-hour surgery. He receives daily occupational therapy at UPMC as his physicians monitor him closely for signs of rejection. "This ground-breaking surgery represents the culmination of more than 20 years of research in the field of hand transplantation," said W.P. Andrew Lee, M.D., chief of the Division of Plastic and Reconstructive Surgery and leader of the UPMC hand transplant surgical team. "Thus far, Jeff is meeting our expectations for recovery. He is making steady progress in hand therapy, and we expect him to regain movement and sensation in the transplanted hands in the next nine to 12 months as he works with a team of occupational therapists." Although surgeons from around the world have performed hand transplants successfully, they have used a traditional protocol of multiple immunosuppressive medications to prevent rejection of the grafts, increasing the risk of diabetes, infections, hypertension and other disorders. In contrast, surgeons at UPMC have implemented a two-phase protocol that involves initial antibody treatment followed by bone marrow cell therapy. The goal is not merely to suppress the immune system but to change the way it functions. Under the protocol, Mr. Kepner received antibodies to help overcome the initial overwhelming immune response. That was followed by a bone marrow infusion from the hand donor 15 days after the surgery. Patients are treated with tacrolimus, a drug that was first used in liver transplants by UPMC"s Thomas E. Starzl, M.D., Ph.D., more than two decades ago to maintain the low-grade immunosuppression needed to prevent long-term graft rejection. "Unlike a solid-organ transplant, which is needed to sustain or prolong life, a hand transplant enhances the quality of life," said Dr. Lee. "We have devoted many years of research to developing an immunomodulatory protocol that may reduce the risks of the procedure for the long-term health of our patients. This would allow more amputees to be considered for hand transplants in the future. Currently, we have three people approved for hand transplants awaiting suitable donors." UPMC and the Armed Forces Institute of Regenerative Medicine (AFIRM) are funding the hand transplant study. Surgeons performed the first unilateral hand transplant at UPMC on March 14, 2009. For more information on the hand transplant program, including photos and video of Mr. Kepner"s surgery and hand therapy, please visit http://www.upmc.com/handtransplant. UPMC


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