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World-first phage therapy treats teenager with drug-resistant bacterial infection

09/05/2019

A British teenager has become the first person in the world to have a drug-resistant bacterial infection treated by genetically engineered viruses. Isabelle Holdaway, 17, was given just a 1% chance of survival after a double lung transplant to treat her cystic fibrosis left her with an intractable bacterial infection that could not be treated with antibiotics. Her arms, legs and buttocks had numerous big, black, festering lesions where the bacteria were pushing up through her skin. She finally ended up in intensive care after her liver began to fail. Every previous patient in Isabelle’s situation died – some within a year, despite aggressive treatment. Desperate for a solution, Isabelle’s mother researched alternative treatments online and came across phage therapy. It’s not new; doctors have been using it for nearly a century, but its use has been eclipsed by antibiotics because they are much easier to use. Isabelle’s care team at Great Ormond Street Hospital contacted Prof Graham Hatfull at the Howard Hughes Medical Institute, in the US, who had the world's largest collection of phages (approximately 15,000). Hatfull and his team identified three potential phages that would be effective in tackling Isabelle’s bacterial infection and genetically modified two of them to make them more effective. Isabelle was injected with the cocktail of phages twice daily and they were also applied to the lesions on her skin. Within just six weeks, a liver scan showed that the infection had essentially disappeared. Phage therapy involves injecting bacteria-killing viruses into a patient’s body which track down, infect and ultimately kill bacteria. The phages hijack the bacterial cell and turn it into a phage factory until the viruses burst out of the bacteria killing it in the process. While Isabelle’s fatal infection has not been completely cured, it is under control and she is beginning to lead a normal life. She still has two infusions of phages every day and is currently waiting for a fourth phage to be added to the mix, which will hopefully clear the infection completely.

Children should not be given decongestants, says review

23/10/2018

Children are more prone to catching colds than adults. In fact, kids get around six to eight colds a year – that’s twice as many as adults. But what are the best remedies for youngsters with a common cold? Well, according to a review of over-the-counter treatments published in The BMJ, there’s little evidence that any of them work, and some, like decongestants, could actually do more harm than good. That’s because decongestants and combination drugs that contain decongestants can cause drowsiness, headaches, insomnia and upset stomach. Furthermore, if they are given to children under the age of 2, they can cause serious complications such as convulsions and rapid heart rate. In reality, there is no cure for the common cold. While it can cause irritating and uncomfortable symptoms, including a sore throat, cough, congestion, sneezing and a raised temperature, after a week or so, they usually go away on their own. So what’s the answer? Saline nasal washes, says Dr Rahul Chodhari, consultant paediatrician and spokesman for the Royal College of Paediatrics and Child Health. They can be applied several times a day, with zero side effects, and help to clear mucus from the nasal cavity, reducing congestion. Dr Chodhari advises that cough syrups are not recommended for children because they stop them coughing up mucus and getting rid of it. Also, because antibiotics only work to combat bacterial infections, they do nothing to relieve colds.

Tuberculosis rates in England have fallen by a third in six years

02/04/2018

New figures show that rates of tuberculosis (TB) in England are at their lowest level in 35 years, having fallen by a third in the last six years. According to data from Public Health England, tuberculosis rates have declined by 38% since 2012. In fact, there was a 9.3% decline in 2017 alone, highlighting how the country’s efforts to eradicate the disease are proving effective. Improved diagnosis, treatment and awareness are being credited for the decline. However, despite the fall, England still has one of the highest rates of TB in Western Europe, with 5,200 people affected in 2017. Dr Sarah Anderson, head of the National TB Office at Public Health England, said: "People often think that TB is a Victorian disease that is no longer a problem in England, but in fact it still affects over 5,000 people a year and there is still a lot to do until the target to eliminate TB is met.” TB is a bacterial infection that primarily affects a person’s lungs and it is spread through coughs and sneezes. But despite its infectious nature, it is actually quite difficult to catch. Nevertheless, it can be fatal if left untreated. Another issue is that TB is becoming resistant to some of the major drugs used to treat it, which is why the BCG vaccine that offers protection against TB is recommended for babies, children and adults alike who are at risk of catching the disease.

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