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Wednesday, May 28, 2014

Circumcision in Older Men Reduces Prostate Cancer Risk

By Esther Nakkazi
After the landmark research in 2007 that proved that adult male circumcision reduced the risk of acquiring HIV infection by 60 percent, a new research now proves that it has even more benefits, prevention of prostate cancer.

The findings, which are published in BJU International, May 29th, through the Wiley Press Room says research has found that circumcised men had a slightly lower risk, albeit not statistically significant, of developing prostate cancer than uncircumcised men.

The research shows that circumcision for especially black men who are older, 35 years and above, decreases their risk of prostate cancer acquisition by 45%, while those circumcised when they are children, one year or less have only 14% risk reduction.

"The strongest protective effect of circumcision was recorded in Black men, who had a 60% reduced risk if they were circumcised, but no association was found with other ancestral groups," researchers noted.

“This is a particularly interesting finding, as Black men have the highest rates of prostate cancer in the world and this has never been explained,” said Dr. Marie-√Člise Parent PhD of the University of Quebec’s INRS-Institut Armand-Frappier who led the research team.

But he also noted that this novel finding warrants further examination in future studies that have a larger number of Black participants. Dr. Parent, PhD and Andrea Spence, PhD, of the University of Quebec’s INRS-Institut Armand-Frappier designed the study, called PROtEuS (Prostate Cancer and Environment Study).

It was an observational study to investigate the possible association between circumcision and prostate cancer risk, which included 1590 prostate cancer patients diagnosed in a Montréal hospital between 2005 and 2009, as well as 1618 healthy control individuals. In-person interviews were conducted to gather information on sociodemographic, lifestyle, and environmental factors.

According to the Wiley Press Release, Dr. Parent noted that circumcision may reduce the risk of contracting and maintaining a sexually transmitted infection, which has been postulated to be a risk factor for prostate cancer. This may explain the reduced risk of prostate cancer observed in males circumcised at a younger age prior to any potential exposure to infection.

“We do not know why a protective effect was observed for men circumcised after the age of 35. These men may have had a pathologic condition of the foreskin that lead to them being circumcised,” she said.
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Thursday, May 22, 2014

Nutrition Key in First Months of HIV Medication

By Esther Nakkazi

At least one in every four HIV infected patients that are started on antiretroviral therapy (ART) die within the first three months of commencing the medication. Malnutrition, which causes the HIV-virus to develop more aggressively is to blame.

A team of researchers from University of Copenhagen, Denmark and Jimma University in Ethiopia have now shown that a dietary supplement given during the first three months of HIV treatment significantly improves the general condition of HIV patients.

For three months, patients received a daily supplement of 200 grams of peanut butter to which soy or whey protein, along with other vitamins and minerals, was added.

The advantage of the supplement is that it is rich in energy and nutrients and low in water content, allowing it to be better preserved in warm climates, said the study published in the journal BMJ May 15th 2014.

The supplement was originally developed for severely malnourished children, but modified for the research project to satisfy the needs of adults living with HIV.

The research project also demonstrated that it is possible to integrate short term nutritional supplementation into the lives of Ethiopian patients without disrupting cultural, social and religious practices regarding diet according to a press release on www.alphagalileo.org

According to this collaborative study, patients gained three times as much weight as those who took ART without the nutritional supplement. And, in contrast to the medication-only group, the supplement takers didn’t just gain fat – a third of their increased weight came from gained muscle mass.

"Furthermore, grip strength improved, and thereby the ability of patients to maintain their work and manage daily tasks," says PhD Mette Frahm Olsen, who is one of the project researchers and together with Alemseged Abdissa, the main author of the BMJ article.

About the the immune system, the study says it is suppressed by HIV, which was characterised by massive weight loss that made the role of nutrition impossible to ignore yet usually the significance of a nutritious diet in conjunction with HIV treatment is often forgotten.

"We know that malnutrition fuels the AIDS epidemic, in part because poor nutrition facilitates the virus’ attack on the human immune system. As a result, a patient’s doctor may believe, mistakenly, that the patient’s nutritional state has been normalised. However, if the patient has not had an adequate nutritious diet, the weight increase may be without benefit and consist mainly of fat," says PhD Mette Frahm Olsen.

About 25 million Africans live with HIV, many of whom now have access to antiretroviral treatment (ART).

Uganda and Kenya top the World in Newborn Deaths

By Esther Nakkazi
Uganda and Kenya, are among the only eight countries, which together account for more than half of all newborn deaths. Others are Afghanistan, Bangladesh, Democratic Republic of Congo, India, Nigeria and Pakistan. 

Research shows early 8,000 newborn babies die every day (2·9 million deaths per year) worldwide. Half of these 4,000 newborn deaths per day are only in eight countries. 
In Uganda alone, there are 38,500 stillborns and 34,600 neonatal deaths every year or 200 babies are dying in birth every day, largely from preventable causes.

If this is not checked, a whole century will pass before a child born in for instance Uganda has the same chance of survival as one born in the UK or US say the health experts. They also warn that if newborn deaths continue to fall at current rates, international targets to reduce mortality in children will not be met.

The study is published in The Lancet May 19th 2014, as part of its Every Newborn Series, (check http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60582-1/abstract) these are some of the countries with the highest burden of newborn and maternal deaths. The report provides comprehensive new data for 195 countries regarding neonatal deaths, stillbirths, rankings for countries, rates of progress and coverage of birth certification.

Among the factors identified by a group of global health experts led by Dr Kim Dickson, at UNICEF, USA, lack of skilled and competent healthcare workers was a common problem, lack of funding for newborn care, as was poor quality of care for mothers and their babies.

Additionally, the researchers found that with Kangaroo mother care, preventing and managing preterm births, providing inpatient care for small and ill babies, and managing infections were important impediments to progress across the countries studied. The study involved detailed consultations with more than 600 health professionals and policy makers.


For instance, in Uganda, these preventable deaths can be dramatically reduced via proven interventions like breastfeeding, neonatal resuscitation, Kangaroo mother care for preterm babies and antenatal corticosteroids. Better still, new data suggests that if these interventions were effectively implemented, Uganda could prevent 54,800 maternal and newborn deaths by 2025.

Dr Dickson said the findings show that increasing the numbers and skills of health care workers, as well as improving the quality of services available to mothers and their babies in many countries, will need immediate and deliberate attention if newborn health care is to improve in future decades, said a Press Release from http://www.alphagalileo.org/.

"Equitable access to high-quality, respectful care is a human right. To achieve the basic human right to survival, especially for small and ill babies, and a woman’s right to survival for both herself and her baby, needs a shift in norms to the universal resolve that no woman or baby should die needlessly – every woman, and every baby counts! To translate this shift into reality needs more investment, more medicines, and more health workers, including midwives and nurses with the skills and autonomy to provide the right care for every woman and every newborn baby,” he said.


Dr Elizabeth Mason, at the World Health Organization, Switzerland, and co-authors, identify priorities for action on improving maternal and newborn health, ahead of the World Health Assembly debate (scheduled for today 22 May) on the Every Newborn Action Plan, which provides an evidence-based roadmap towards care for every woman, and a healthy start for every newborn baby.