New York: Ebola virus, which can persist in certain areas of the body, can re-emerge to cause fatal disease, even long after treatment with monoclonal antibodies, according to a study.
The study, published in the journal Science Translational Medicine, was conducted using a nonhuman primate model of Ebola virus infection.
The research team from US Army Medical Research Institute of Infectious Diseases found that about 20 per cent of monkeys that survived lethal Ebola virus exposure after treatment with monoclonal antibody therapeutics still had persistent Ebola virus infection specifically in the brain ventricular system, in which cerebrospinal fluid is produced, circulated, and contained even when Ebola virus was cleared from all other organs.
"Ours is the first study to reveal the hiding place of brain Ebola virus persistence and the pathology causing subsequent fatal recrudescent Ebola virus-related disease in the nonhuman primate model," explained Xiankun (Kevin) Zeng, from the institute.
In particular, two monkeys that initially recovered from Ebola virus-related disease after treatment with antibody therapeutics had recurrence of severe clinical signs of Ebola virus infection and succumbed to the disease, Zeng said.
Severe inflammation and massive Ebola virus infection were present in the brain ventricular system; no obvious pathology and viral infection were found in other organs.
Previous research using nonhuman primate survivors as a model has showed that the virus, despite being cleared from all other organs, can hide and persist in specific regions of immune-privileged organs, such as the vitreous chamber of eyes, the seminiferous tubules of testes, and the ventricular system of the brain reported in this study.
"The persistent Ebola virus may reactivate and cause disease relapse in survivors, potentially causing a new outbreak," said Jun Liu, from USAMRIID. Recurrence of Ebola virus disease has previously been reported in human survivors, according to the researchers.
For example, a British nurse experienced Ebola virus relapse in the brain, suffering from meningoencephalitis nine months after recovering from severe Ebola virus disease. She had received therapeutic antibodies during the 2013-2016 outbreak in Western Africa, the largest such outbreak to date.
In addition, a vaccinated patient who had been treated with monoclonal antibody therapeutics for Ebola virus disease six months earlier relapsed and died at the end of the 2018-2020 outbreak in the Democratic Republic of the Congo.
Unfortunately, that case also led to many subsequent human-to-human transmissions Ebola virus causes one of the deadliest infectious diseases known to humankind. It is still a major threat in Africa, and there were three outbreaks in Africa in 2021 alone, according to the World Health Organization.
Two vaccines and two monoclonal antibody therapeutics have been approved to prevent and treat Ebola virus disease in recent years.
"However, our study reinforces the need for long-term follow-up of Ebola virus disease survivors even including survivors treated by therapeutic antibodies in order to prevent recrudescence.
This will serve to reduce the risk of disease re-emergence, while also helping to prevent further stigmatization of patients," Zeng said. (agency)
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About 60 per cent of people suffering stroke in India face various degrees of disability, some lifelong, said experts here.
A stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients.
As brain cells begin to die in minutes, prompt treatment is crucial and early action can reduce brain damage, other complications and death.
"While the numbers of stroke patients continue to rise exponentially, like many other brain diseases, there is still a remarkable lack of awareness regarding this condition. Timely treatment in stroke will go a long way in improving a patient's quality of life, and reducing lifelong morbidity and mortality," said Pankaj Agarwal, Senior Consultant -Neurology, Head, Movement Disorders Clinic & In-Charge, Deep Brain Stimulation (DBS) Programme, Global Hospital Mumbai.
"Stroke patients who get help from paramedics are more likely to reach hospital for care -- in India, that number is only 1.8 per cent. We need uniform emergency medical services (EMS) system and certification of stroke ready hospitals across the country so that people know where to go when they recognise the signs of stroke," added Dr P.N Sylaja, Professor and HoD, Neurology, In-Charge, Comprehensive Stroke Care Programme, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST).
While traditionally stroke affects older age groups, a large number of ischemic strokes are now known to also affect young people - in their 30s or 40s. Sometimes even adolescents in their teenagers or early 20s are affected.
"Stroke affects as many as 18 lakh Indians every year, which means one Indian suffers stroke every 40 seconds. One-fourth of these people are aged less than 50 and increasingly, a large proportion of stroke patients are found in the age group of 19 to 30 years. The burden of stroke on the most productive sections of society not only affects the person and their family but leaves a cascading effect on the countrya¿s socio-economic condition," said Kamal Narayan, CEO, Integrated Health and Wellbeing (IHW) Council.
Covid has also increased the risk of stroke, particularly among the young patients between 20 and 30,as the virus triggers abnormal and severe clotting in blood. While the risk is around 1 per cent (higher if other risk factors for stroke are present), it is still life-threatening or leads to severe disability.
"In India, about 30 per cent of people suffering stroke die and a whopping 60-70 per cent people suffer various degrees of disability. The number of disabled people is more as we move into the interiors where hospitals do not even have a CT scan machine. We need to ensure they get treatment," said Prof M.V. Padma Srivastava, Head, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi.
Eating a well-balanced diet, avoiding processed foods and sugary drinks, limiting salt, alcohol, smoking, and exercising daily can lower the risk of stroke, the doctors said.
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San Francisco, Sep 5 (IANS) Google is all set to collaborate with researchers to develop new artificial intelligence (AI) algorithms to improve brain stimulation devices to treat people with psychiatric illness and direct brain injuries, such as stroke.The tech giant has tied up with researchers at Mayo Clinic to develop a set of paradigms, or viewpoints, that simplify comparisons between effects of electrical stimulation on the brain.They developed a new type of algorithm called "basis profile curve identification"."Our findings show that this new type of algorithm may help us understand which brain regions directly interact with one another, which in turn may help guide placement of electrodes for stimulating devices to treat network brain diseases," said Kai Miller, a Mayo Clinic neurosurgeon."As new technology emerges, this type of algorithm may help us to better treat patients with epilepsy, movement disorders like Parkinson's disease, and psychiatric illnesses like obsessive compulsive disorder and depression," he added.The new technique was demonstrated for an array of implanted brain surface electrodes in a human patient. A patient with a brain tumour underwent placement of an electrocorticographic electrode array to locate seizures and map brain function before a tumour was removed.Every electrode interaction resulted in hundreds to thousands of time points to be studied using the new algorithm.The framework enables straightforward interpretation of single-pulse brain stimulation data, and can be applied generically to explore the diverse milieu of interactions that comprise the connectome, the researchers explained in the study published in PLOS Computational Biology."Neurologic data to date is perhaps the most challenging and exciting data to model for AI researchers," said Klaus-Robert Mueller, member of the Google Research Brain Team.--IANSrvt/vd
London, Aug 15 (IANS) Researchers at University College London conducted a study of people with cerebral venous thrombosis (CVT) following Covid-19 vaccination, to provide a clearer guide for clinicians trying to diagnose and treat such patients.The research, published in The Lancet, is the most detailed account of the characteristics of CVT, when it is caused by the novel condition vaccine-induced immune thrombotic thrombocytopenia (VITT).VITT is a condition characterised by a blockage of the veins and a marked reduction of platelets, blood components which are an important part of the blood clotting system. The commonest and severest manifestation of VITT is CVT, in which veins draining blood from the brain become blocked.The study looks in detail at 70 patients with VITT-associated CVT following vaccination, who were then compared to 25 patients with CVT but without the evidence of VITT.The study provides support for the three principles of treatment established so far by the Expert Hematology Panel, based on early work at UCL and two other European sites.The use of non-heparin-based anticoagulation; give treatments to try to reduce the level of the abnormal antibody that is implicated in this condition; and avoid the strategy of trying to bring the platelet count back up to normal levels by giving platelet transfusions."We found that those patients who were given intravenous immunoglobulin -- the treatment in which the body is flooded with normal antibodies to try to reduce the effects of the abnormal one -- were more likely to leave hospital alive and able to live an independent life rather than depending on carers or family to look after them," Dr Alastair Webb, consultant neurologist at the John Radcliffe Hospital in Oxford said.On the other hand, platelet transfusions were associated with a worse outcome in patients with VITT-associated CVT. Although observational data cannot prove harm from this treatment approach, the study provides support for the concern that has already been raised about the potential harm of platelet transfusions.However, the researchers also suggest that some treatments such as intravenous immunoglobulin seem to be associated with better outcomes but caution against reading too much into the findings of the observational study, saying that reliable evidence about treatments can only be obtained in a randomised clinical trial.--IANSrvt/skp/
New Delhi, Aug 14 (IANS) The All India Institute of Medical Sciences (AIIMS) has jointly developed a telerobotic ultrasound system in collaboration with IIT Delhi and Addverb Technologies.The research collaboration between IIT Delhi and AIIMS allows remote ultrasound access through a robotic arm.The research team at AIIMS was led by Chandrashekhara, while Chetan Arora and Subir Kumar Saha led the IIT-D team. The lead contributor for the research was Suvayan Nandi from Addverb Technologies along with other researchers.This system allows performing ultrasound from remote locations through the robotic arm. In the routine ultrasound setting, the doctor (radiologist) stands in close contact with the patient for the entire scan duration. However, cross-sectional imaging is preferred in the current pandemic scenario with stringent social distancing requirements -- a more expensive and less dynamic technique. Ultrasonography is a non-invasive, non-ionizing, cost-effective, rapid, bedside, and readily available modality with immense use in point-of-care and follow-up examinations.Chandrashekhara said, "This system will promote healthcare and make our system more prepared for further pandemics. Besides its role in the pandemic, it will allow a better outreach of ultrasound imaging to remote and rural areas of India. The radiologist manipulates the ultrasound probe remotely from a remote location, acquires the ultrasonographs, and then transmits them to the monitors at the doctor's end through a WiFi network. "Sitting at a remote location, the doctor can now visualise all the images and assess the patient, similar to a clinical setting. The facility can also be extended for global outreach."--IANSavr/arm
New Delhi, Aug 10 (IANS) Doctors at a Delhi hospital conducted a lifesaving heart surgery on a two-day old baby boy with a rare heart tumour.Baby Virin was born, to residents of Noida, with a rare congenital tumour called "intrapericardial teratoma" -- arising from the surface of the heart. The tumour was detected on a routine ultrasound of his mother at 20 weeks of gestation, the Indraprastha Apollo Hospitals said in a statement on Tuesday.The tumour had the potential of impacting the foetus growth within the womb. Hence, after the detection, his condition was monitored regularly every week by the means of foetus echocardiogram (to assess the growth of tumour and any effects on the functioning of the heart).To reduce the pressure on his heart and carry his mother's pregnancy to term, an excessive amount of fluid surrounding his heart needed to be removed once.At birth, the baby weighed 3.2 kg but had trouble breathing. He was immediately intubated and put on a ventilator. A CT Angio was conducted, and showed a 7 cm across, lobulated giant intrapericardial tumour that was pushing the heart to the left and compressing the lung, said the doctors."The baby's condition was precarious, and we planned to operate on him immediately. On day two after birth, we successfully removed the tumour, which was larger than the heart and was found to be attached to the surface of the heart, displacing the heart to the left. It had an attachment to the aorta and the right AV groove," said Rajesh Sharma, Senior Pediatric Cardiac Surgeon at the hospital."Since tumour manipulation was causing a fall in the blood pressure, and due to its proximity to the right coronary artery, the removal of the tumour was accomplished by putting the baby on the heart-lung machine, on cardiopulmonary bypass. We managed to remove the tumour in one piece," he added.An intrapericardial teratoma arising from the heart is an exceedingly rare tumour of the foetus and the newborn. A major concern with such tumours during pregnancy is the life-threatening pressure that the tumour puts on the foetus' heart and lungs."Fortunately there have been no significant deleterious effects of the tumour on the functioning of lungs or heart. Though the removal of tumour is supposed to be curative in most cases, but due to the rarity of the diagnosis, the baby will need regular follow-ups with tumour marker levels and regular echocardiographic examinations in the future. For now, the baby has shown good recovery and has been discharged," said Ashutosh Marwah, Consultant Surgeon, Pediatric Cardiology, from the hospital.--IANSrvt/in
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