Thousands Of Dead Pigs Found In Huangpu River, China

Editor's Choice
Main Category: Veterinary
Also Included In: Water - Air Quality / Agriculture
Article Date: 11 Mar 2013 - 17:00 PDT

Nearly 3,000 dead pigs have been found floating in the Huangpu River, one of Shanghai's main sources of water, according to local media reports today.

Concerns about environmental pollution and water and food safety have led to a public outcry. The Shanghainese are particularly concerned about pollution because urban industrialization has brought with it serious environmental problems.

According to Chinese media reports, the animals were most likely dumped in the Huangpu river in Zheijiang province. Shanghai blogs and environmental groups expect the number of dead pigs found to rise considerably.

According to the Global Times, a Chinese daily newspaper, dead pigs were also found on the roadside in Xinfeng town, Nanhu district, Jiaxing, Zhejiang Province. The newspaper quotes locals saying they found carcasses that appeared to have been thrown randomly into the bushes in the area.

The Huangpu River flows through downtown Shanghai and is an important source of water for the city

How did so many dead pigs end up in a river?

Blogs and websites in Shanghai and the immediate area are wondering openly how so many animals ended up floating in a river. As a number of them were found floating in the upper end of the Huangpu River, concern has grown - this is a major source of tap water for Minhang, Fengxian and Songjiang districts.

The Globe quoted a microblog belonging to an official of the Shanghai Municipal Government which explained that over 2,800 pig carcasses have been removed from the upper reaches of the Huangpu River by Shanghai City Appearance and Environmental Sanitation Administration workers.

The local water authority says it is now testing the water 6 times a day, and says that so far the water is not contaminated.

According to www.xinmin.cn, the first dead pigs were found near a local water treatment plant in the Hengliaojing Creek last Thursday.

Government laboratories in Shanghai say that after testing five pigs' carcasses, one of them tested positive for porcine circovirus (PCV). PCV is a common virus in pigs that is found worldwide.

There are two types of PCV:

• Porcine circovirus Type 1 (PCV1) - recognized for several decades. It is a common contaminant of laboratory cell cultures. Despite being common in commercial swine globally, it does not cause illness (it is nonpathogenic).


• Porcine circovirus Type 2 (PCV2) - its emergence coincided with the occurrence of post-weaning multisystemic wasting syndrome (PMWS), a new clinical syndrome of swine. PCV2 and PMWS are common among commercial swine worldwide.

Neither PCV1 nor PCV2 infect humans.

An expert (who preferred not to be named), in an interview with Global Times wondered whether the pigs might be carrying other diseases which affect humans, such as salmonella.

Written by Christian Nordqvist
Copyright: Medical News Today
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Eye Movement Analyzer May Diagnose Stroke

Featured Article
Academic Journal
Main Category: Medical Devices / Diagnostics
Also Included In: Stroke;  MRI / PET / Ultrasound;  Eye Health / Blindness
Article Date: 06 Mar 2013 - 14:00 PST

A bedside device that expertly analyzes eye movements could one day save lives by helping doctors determine whether stroke is the cause of a patient's disabling, severe, continuous dizziness, or a more benign condition like vertigo.

A small "proof of concept" study reported online this week in the journal Stroke shows how the device was able to diagnose stroke with 100% accuracy.

The electronic device is a small, portable, video-oculography machine that detects minute eye movements that are difficult for most physicians to notice.

Study leader David Newman-Toker, an associate professor of neurology and otolaryngology at the Johns Hopkins University School of Medicine in Baltimore, Maryland in the US, says in a statement:

"Using this device can directly predict who has had a stroke and who has not."

"We're spending hundreds of millions of dollars a year on expensive stroke work-ups that are unnecessary, and probably missing the chance to save tens of thousands of lives because we aren't properly diagnosing their dizziness or vertigo as stroke symptoms," he explains.

Eye Movement Tests

There is a series of three eye movement tests that specialists can do to find out if the cause of a patient's dizziness is due to stroke or a less serious condition like vertigo, which is linked to a disturbance in the inner ear.

Our sense of balance comes from the vestibular system in the inner ear working with the visual system to keep what we are looking at in focus when the head is moving.

The eye movement tests are in effect a stress test for the balance system, and have been shown to be extremely accurate. They are "nearly perfect, and even better than immediate MRI," says Newman-Toker, who led a study published in 2009 that first showed how a one-minute eye movement exam performed at the bedside worked better than an MRI to distinguish new strokes.

The test is called a horizontal head impulse test and requires the patient to keep looking at a target on the wall while a trained doctor or technician moves the patient's head from side to side and looks carefully to see if they are making the rapid, corrective side to side eye movements that indicate vertigo or some other benign condition is the cause of the dizziness as opposed to stroke.

Device is Conceptually Like an ECG

But, as the authors explain in their background information to the study, to make an accurate diagnosis, the doctor or technician carrying out the eye movement test requires a high level of expertise, one that is not routinely available in emergency departments.

So they decided to investigate the feasibility of replacing this expertise with a standard test "through the novel application of a portable video-oculography device measuring vestibular physiology in real time".

Newman-Toker likens the device to using an ECG (electrocardiogram) to rule out heart attack in patients with chest pain.

The Study

For their small study, the researchers tested how well the video-oculography machine was able to detect the minute eye movements that are difficult even for the most skilled physician to spot.

The device comes with a set of goggles that look like swimming goggles incorporating a webcam and accelerometer. The goggles connect to a laptop allowing a continuous picture of the eye to be viewed and recorded via the webcam. A program in the computer analyzes eye movements by following how the pupils change position, and the accelerometer measures the speed of the movement.

To test the device, the researchers recruited 12 patients admitted to emergency departments at The Johns Hopkins Hospital and the University of Illinois College of Medicine at Peoria whose symptoms included severe dizziness, vomiting, difficulty walking and intolerance to head motion.

The device diagnosed six patients with stroke and six with a benign condition. MRI later confirmed all 12 diagnoses.

Newman-Toker says if these results are confirmed in additional larger studies, the device could one day be used in all hospital emergency departments to "virtually eliminate deaths from misdiagnosis and save a lot of time and money".

The device he and his team used is one that is already approved for use in balance clinics outside the US but has not yet gained approval in the US.

It was made by a company called GN Otometrics, who had no involvement in the study, apart from loaning their machine to the team.

Misdiagnosis Is Not Uncommon

Making an accurate diagnosis of stroke in patients presenting with severe dizziness is difficult.

Newman-Toker estimates that some 4 million patients visit emergency departments every year in the US complaining of vertigo or dizziness, and at least half a million of these are at high risk for stroke.

While the most common causes are problems in the inner ear, many emergency room doctors struggle to tell the difference between these and stroke, so they often rely on brain imaging, usually a CT scan, to make the diagnosis.

Around 40% of patients presenting with dizziness are sent for CT scans.

This is an expensive and not very accurate method of making such a diagnosis, says Newman-Toker, explaining that CT scans miss more than 80% of acute strokes in the brainstem and cerebellum.

The only definitive way to rule out stroke is the MRI scan, but this equipment isn't readily available in many emergency departments and rural hospitals. The costs of an MRI scan is about four times that of a CT scan.

And even MRI scans can miss between 10% and 20% of acute strokes in the brainstem and cerebellum in the first 48 hours after symptoms begin, says Newman-Toker, who reckons the new device would probably prevent around 100,000 misdiagnoses a year.

Overlooked strokes lead to delayed or missed treatments, resulting in some 20,000 to 30,000 preventable deaths or disabilities in the US a year, he adds.

Grants from the the Swiss National Science Foundation, the Agency for Healthcare Research and Quality, and the National Institutes of Health's National Center for Research Resources and National Eye Institute helped to finance the study.

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations

"Quantitative Video-Oculography to Help Diagnose Stroke in Acute Vertigo and Dizziness: Toward an ECG for the Eyes"; David E. Newman-Toker, Ali S. Saber Tehrani, Georgios Mantokoudis, John H. Pula, Cynthia I. Guede, Kevin A. Kerber, Ari Blitz, Sarah H. Ying, Yu-Hsiang Hsieh, Richard E. Rothman, Daniel F. Hanley, David S. Zee, and Jorge C. Kattah; Stroke 108, 941-950, published online before print 5 March 2013; DOI:10.1161/STROKEAHA.111.000033; Link to Abstract.
Additional source: John Hopkins Medicine.
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Baby Survives With Heart Outside Of Chest

Editor's Choice
Main Category: Pediatrics / Children's Health
Also Included In: Heart Disease
Article Date: 28 Jan 2013 - 21:00 PST

Audrina Cardenas has certainly defied odds as she was finally being discharged from Texas Children's Hospital. The 3 month old baby was born with an extremely rare condition called ectopia cordis, which means she was born with her heart outside of her chest. She received her life-saving surgery in October and is now at home.

Ectopia cordis is a very uncommon congenital malformation which results in the heart developing either partially or completely outside the body, it only affects approximately eight in every million babies. Sadly, most infants who are born with the condition die within the first few days of life.

A multidisciplinary team of surgeons carried out a very risky surgical procedure to repair Audrina's heart immediately after she was born. She proved to be quite the survivor as she came out of the operation alive and well.

Dr. Charles D. Fraser, surgeon-in-chief at Texas Children's Hospital and professor of surgery and pediatrics at Baylor College of Medicine (BCM), said:

''

"This risky operation on such an uncommon condition required specialists from a variety of care teams including cardiovascular surgery, plastic surgery and general pediatric surgery. I have only seen this condition a few times in my career and these are always very tricky cases; in fact, many of these babies do not survive."

He added:

"If Audrina would not have been referred to a facility like ours that could provide this full spectrum of care from managing her in-utero to immediate heart surgery after birth, she would not be here today. Audrina is a true fighter and we are so excited that this was a good outcome."

Audrina's mother Ashley Cardenas found out about her child's condition sixteen weeks into her pregnancy. Her doctors told her that she could either choose comfort care, terminate the pregnancy, or have her child receive an extremely risky surgery immediately after birth. Cardenas opted for the surgery as it was in the best interest for her child's survival.

Cardenas said:

"After my doctors explained just how sick my baby was and what options I had, it didn't matter how scared I was, I knew I had to do anything possible to save my daughter's life. As soon as I made my decision to continue with the pregnancy, the physicians in Midland referred me to Texas Children's Hospital where a team of miracle workers provided the specialized treatment and care my baby and I both needed."

The doctors made an external chest shield to protect her heart as it continues to grow, in a few years she will have another surgery to place something even more protective and permanent. The cardiology team at Texas Children's Hospital will consistently check up on her progress.

Written by Joseph Nordqvist
Copyright: Medical News Today
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GP Judgement Not Enough To Accurately Diagnose Cases Of Pneumonia

Main Category: Respiratory / Asthma
Also Included In: Primary Care / General Practice
Article Date: 23 Jan 2013 - 16:00 PST

Pneumonia cannot be accurately diagnosed solely on a doctor's analysis of symptoms and patient history, according to new findings.

A new study, published online today ahead of print in the European Respiratory Journal, found that a majority of pneumonia cases could not be accurately diagnosed by a doctor's judgement alone, compared to a chest radiograph.

The major symptoms of pneumonia include acute cough and other lower respiratory tract symptoms, such as shortness of breath. Most people showing these symptoms are diagnosed with acute bronchitis, and only a minority with pneumonia. These conditions are treated very differently; pneumonia usually requires antibiotic treatment, whereas acute bronchitis does not. An accurate diagnosis is therefore essential.

Most doctors are required to diagnose pneumonia based on a patient's medical history and physical examination, as a chest radiograph is not feasible for every patient who displays these symptoms. However, it is largely unknown how accurate this method of diagnosis is.

To test this method, researchers analysed 2,810 patients across 12 European countries. Each patient had an acute cough and their attending doctor was asked whether pneumonia was present after looking at the patient's signs and symptoms. All patients then received a chest radiograph by a different medical professional.

Out of the total study, 140 patients were diagnosed with pneumonia after a chest radiograph. Out of this group, 29% had been correctly diagnosed by their doctor as having pneumonia. Only 31 patients (1%) were incorrectly diagnosed as having pneumonia from an initial assessment that was later disproved by the chest radiograph. In patients without a doctor's diagnosis of pneumonia, 96% indeed had no pneumonia after chest radiography.

The researchers concluded that doctors accurately excluded pneumonia. However, the majority of radiographically confirmed cases of pneumonia were not identified.

Lead researcher, Saskia van Vugt, from Utrecht Julius Center for Health Sciences and Primary Care, in the Netherlands, said: "The results of the study are encouraging to some extent as the findings might support physicians to rely more on their ability to correctly exclude pneumonia which might result in better targeted antibiotic prescriptions. However, a majority of the pneumonia cases in this study were not picked up by an initial assessment alone.

"Tests that could support a doctor's ability to detect or exclude pneumonia are urgently needed. We should also remember that GPs tell patients to revisit them if symptoms get worse or persist, as a 'safety net' for initially missed cases.

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'Diagnosing pneumonia in patients with acute cough: clinical judgment compared to chest radiography', SF van Vugt, Th JM Verheij, PA de Jong, CC Butler, K Hood, S Coenen, H Goossens, P Little, BDL Broekhuizen, on behalf of the GRACE Project Group
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Anti-Depressants In Pregnancy Not Linked To Stillbirth And Infant Deaths

Editor's Choice
Academic Journal
Main Category: Pregnancy / Obstetrics
Also Included In: Depression
Article Date: 02 Jan 2013 - 11:00 PST

A pregnant woman taking anti-depressant SSRI (selective serotonin reuptake inhibitor) drugs does not have an increased risk of stillbirth or infant mortality.

The finding was published in JAMA and came from new research involving almost 30,000 females from Denmark, Finland, Iceland, Norway and Sweden who were taking SSRI drugs during pregnancy.

The researchers found no notable link between SSRI drug use and risk of neonatal death, postneonatal death, or stillbirth, even after controlling for variables such as maternal psychiatric disease.

On the other hand, prior research demonstrated that kids have a higher chance of being born with high blood pressure in the lungs if the mother was taking anti-depressants during pregnancy, and a different study, published in The Lancet, indicated that children whose moms were taking SSRI drugs during pregnancy may be born with withdrawal syndrome.

Backround information in the report stated:

"Depression during pregnancy is common with prevalences ranging between 7 percent and 19 percent in economically developed countries. Maternal depression is associated with poorer pregnancy outcomes, including increased risk of preterm delivery, which in turn may cause neonatal morbidity and mortality.

Use of selective serotonin reuptake inhibitors during pregnancy has been associated with congenital anomalies, neonatal withdrawal syndrome, and persistent pulmonary hypertension of the newborn. However, the risk of stillbirth and infant mortality when accounting for previous maternal psychiatric disease remains unknown."

The team of experts, led by Olof Stephansson, M.D., Ph.D., of the Karolinska Institutet, Stockholm, Sweden, set out to analyze whether a pregnant woman taking SSRI drugs has a higher chance of neonatal death, stillbirth, and postneonatal death.

The women observed in the study had single births between 1996 and 2007. The information on their SSRI drug use was gathered from prescription registries. Patient and medical birth registries were used to obtain information on pregnancy, maternal characteristics, and neonatal outcomes.

The relative risks of neonatal death, postneonatal death, and stillbirth linked to SSRI exposure during pregnancy were approximated by the scientists, while adjusting for variables including prior psychiatric hospitalization and maternal characteristics.

Results showed that out of the 1,633,877 births examined, there were 3,609 neonatal deaths, 1,578 postnatal deaths, and 6,054 stillbirths. There were 1.79% (29,228) of women who were taking SSRI drugs during pregnancy.

The team discovered that mothers who took an SSRI had higher rates of stillbirth (4.62 vs. 3.69 per 1000) and postneonatal death (1.38 vs. 0.96 per 1000) compared to subjects who were not exposed.

The SSRI group and the group who was not exposed to the drugs had similar rates of neonatal death (2.54 vs. 2.21 per 1000). "Yet in multivariate models, SSRI use was not associated with stillbirth, neonatal death, or postneonatal death. Estimates were further attenuated when stratified by previous hospitalization for psychiatric disease," the researchers said.

The authors concluded:

"The present study of more than 1.6 million births suggests that SSRI use during pregnancy was not associated with increased risks of stillbirth, neonatal death, or postneonatal death. The increased rates of stillbirth and postneonatal mortality among infants exposed to an SSRI during pregnancy were explained by the severity of the underlying maternal psychiatric disease and unfavorable distribution of maternal characteristics such as cigarette smoking and advanced maternal age.

However, decisions regarding use of SSRIs during pregnancy must take into account other perinatal outcomes and the risks associated with maternal mental illness."

Written by Sarah Glynn
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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"Selective Serotonin Reuptake Inhibitors During Pregnancy and Risk of Stillbirth and Infant Mortality
Olof Stephansson, MD, PhD; Helle Kieler, MD, PhD; Bengt Haglund, PhD; Miia Artama, PhD; Anders Engeland, PhD; Kari Furu, PhD; Mika Gissler, PhD; Mette Nørgaard, MD, PhD; Rikke Beck Nielsen, MSc; Helga Zoega, PhD; Unnur Valdimarsdóttir, PhD
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Stopping Gun Massacres With Extensive Background Checks And Denial Criteria

Editor's Choice
Academic Journal
Main Category: Public Health
Also Included In: Psychology / Psychiatry
Article Date: 28 Dec 2012 - 11:00 PST

Extensive background checks and denials on gun purchases can aid in gun violence prevention, especially mass shootings, such as the ones that occurred at Sandy Hook, Virginia Tech, Aurora, or Columbine, suggests a top expert on gun violence prevention and an emergency medicine physician at UC Davis, Garen Wintemute.

Wintemute, director of the UC Davis Violence Prevention Research Program and inaugural Susan P. Baker-Stephen P. Teret Chair in Violence Prevention at UC Davis says:

"To reduce the number of deaths and injuries from firearms in the United States, we need to develop policies that require background checks for all firearm purchases, including private-party sales, the most important source of firearms for criminal buyers and others who are prohibited from purchasing guns."

Wintemute's views were published in the New England Journal of Medicine as a perspective article. The focus of his article was geared towards putting in place harsher credentials for individuals who try to obtain a firearm. He believes criminals who have previously been convicted of a misdemeanor or violent crime should not be allowed to buy a gun.

He also recommends more criteria be set to differentiate between treatable non-violent mental illness and those with a past of mental illness, violence and substance abuse.

The United States only accounts for five percent of the world's population, and yet holds 40 percent of all firearms that are owned by civilians, according to Wintemute. Additionally, the current laws and policies regarding gun ownership and purchase allow for the broadest group of people to use them under the broadest range of conditions.

Specifically, Wintemute cites the "Stand Your Ground" laws, put into effect at the state level, as harmful and used to validate shootings that should be known as murder.

Wintemute recommends taking a comprehensive stance:

"It may be impossible to predict the next mass shooting incident, and we cannot expect interventions designed for specific circumstances to eliminate the risk of firearm violence. But we can change our firearms laws, based on existing evidence, to reduce harm and better ensure public safety."

He points out that 40 percent of all firearm sales involve private-party sellers and they do not need to conduct background checks or maintain records. Wintemute suggests policies be put into action to avoid these anonymous and unreported sales, as well as those that prevent sales of guns to those who are more inclined to be violent.

The author's research has proven that among people who buy firearms legally, those with a prior charge for a misdemeanor violent crime are nine times more inclined to be arrested again for a violent crime. For individuals with two or more prior convictions, the risk rises by 10 or 15. Also, previous research has established that gun owners who abuse alcohol are at a higher risk than others to participate in violence-related firearm behavior.

He explains:

"We know that comprehensive background checks and expanded denial criteria are feasible and effective, because they are in place in many states and have been evaluated. In California, the denial policy reduced the risk of violence and firearm-related crime by 23 percent among those whose purchases were denied. But we need to broaden these and other effective state-level regulations to eliminate the flow of firearms from states where laws are lax to states where laws are stricter."

Policies for background checks and sales denials for violent criminals has gained significant public support, even from gun owners. Wintemute's research came from survey data and several public polls conducted by the Mayors Against Illegal Guns.

Wintemute stresses that putting into action stricter background check and denial policies for gun sales may not get rid of gun violence but it will surely reduce it. He believes we can only change the outcome of horrible tragedies such as that of Sandy Hook by addressing access to guns.

Written by Kelly Fitzgerald
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Findings Support Safety Of Whooping Cough Vaccine For Older Adults

Main Category: Respiratory / Asthma
Also Included In: Immune System / Vaccines
Article Date: 28 Nov 2012 - 21:00 PST

A new study of the safety of the tetanus-diphtheria-acellular pertussis (Tdap) vaccine supports the recommendation that those 65 and older get the vaccine to protect themselves and others, particularly young babies, from pertussis. Published online in Clinical Infectious Diseases, the findings come as reported U.S. cases of the bacterial infection, also known as whooping cough, are at the highest level since the 1950s.

An extremely contagious respiratory illness, pertussis puts infants at greatest risk for severe complications, including death. More than half of infants younger than 1 year old who get pertussis are hospitalized, according to the Centers for Disease Control and Prevention (CDC), and 1 or 2 in 100 hospitalized infants die. Immunity is difficult to maintain in the community because infants cannot be vaccinated until they are 2 months old. As a result, they may be at risk, especially from family members and care givers who have the disease.

In their study, Hung Fu Tseng, PhD, MPH, and his team at Kaiser Permanente Southern California found that adverse events following Tdap vaccination in seniors were mostly minor. "Although there is a small increased risk of injection site reaction following Tdap vaccination in the elderly, it is no more common than that following the traditional tetanus and diphtheria (Td) vaccine," Dr. Tseng said.

The researchers' study included 119,573 seniors who received the Tdap vaccine and the same number of people who received the traditional Td vaccine. Safety data were collected from seven health maintenance organizations across the U.S. The risk for adverse events following vaccination was comparable among both groups.

The authors hope the findings will allay any fears among older adults about the safety of the Tdap vaccine and prompt more doctors to urge across-the-board immunization, which is crucial in the wake of recent pertussis outbreaks, such as those in Minnesota, Washington state, Wisconsin, and elsewhere. Current recommendations call for infants older than 2 months, children, teens, adults (including pregnant women, parents, and health care workers), and those over 65 to be vaccinated.

"Pertussis immunization is important, particularly since one of the most common sources of pertussis in infants is their relatives, including their grandparents," Dr. Tseng said. "We suggest that clinicians follow CDC's recommendation and talk to older adult patients about vaccination against pertussis to protect themselves and their family members."

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