research

Can Computers Diagnose Melanoma?

With so many advances in technology and computer learning, is it possible that one day computers could replace doctors? Robots already assist in surgeries and 3D bio-printers can create synthetic body parts. But can computers reliably make a medical diagnosis?   Medical researchers in California think so – in a collaboration between Stanford’s Department of Electrical Engineering, the Department of Dermatology and the Department of Pathology, among others, scientists have developed a computer algorithm that can diagnose melanoma from a typical photo of a mole taken by any smartphone.   Image: Source   The researchers programmed a computer learning algorithm called a “convolutional neural network” or “CNN,” by using 129,450 clinical images showing 2,032 different diseases to “teach” the CNN what a specific carcinoma looks like. The authors then put the CNN to the test against 21 board-certified dermatologists in a challenge to accurately diagnose the most common and most deadly skin cancers. The authors of the study report that their method performs with a similar success rate as the board-certified dermatologists when it comes to distinguishing malignant melanoma and keratinocyte carcinoma from benign lesions.   Current apps in the U.S. provide information and education about skin cancer and allow users to save pictures of any skin abnormalities, but do not suggest a diagnosis. However, in countries like Australia, Canada and the U.K, you can already download an app...

Genetic Engineering, Salmonella and Brain Tumors

By Janet Taylor   Glioblastomas are tumors that form from the astrocytes in the brain. These tumors are aggressive and lethal largely because they can be composed of multiple types of tissues and because the brain provides such a large blood supply, which helps them to grow. While they rarely invade the body outside of the brain and spinal cord, they inflict their damage quickly. Patient survival is an average of two years, while those with more aggressive types are given a life expectancy of about fifteen months. The standards for treatment consist of surgery plus chemo or radiation but recurrence occurs quite often and because there are multiple cell types in each tumor, targeted therapy isn’t successful. Genetic biomarkers have been investigated to identify tumor changes as well as why some patients respond better than others with the same treatments. While several have been identified, their utility has yet to be seen for predictive factors or treatment alternatives.   Image: Source   Researchers at Duke University have taken an alternative approach to fighting this disease using genetically engineered Salmonella typhimurium. The bacteria contain a mutation that depletes their purine stores. Since tumor cells are loaded with purine, the Salmonella would be expected to seek out those tumors. Once inside the tumor, they rapidly reproduce. Second, the addition of a p53 tumor suppressor protein and Azurian allows the bacteria...

When Epidemics Turn Endemic

By Laurie Breen   In 2016 the Zika virus epidemic dominated medical news headlines, especially with the drama that played out when some health experts called for the Olympic Games in Rio de Janeiro to be cancelled. But by September WHO officials announced that there had been no confirmed Zika cases coming out of the Olympic games among visitors or athletes and on November 18th the WHO ended Zika’s designation as a “Public Health Emergency of International Concern.”   However, when diseases are no longer drawing the urgent attention of the public or the media, the interest in funding research dies out too. In December, the WHO issued a Report to Donors that highlighted the need for continued funding to seek answers to remaining questions on the Zika outbreak and its ongoing effects.   Image: Source   In a JAMA Viewpoint article, Catharine I. Paules, MD and Anthony S. Fauci, MD, the Director of National Institute of Allergy and Infectious Diseases (NIAID), draw a comparison between Zika and to two other recent mosquito-borne epidemics that have become boring old endemic diseases – West Nile Virus and Chikungunya.   According to the authors, West Nile first appeared in 1999 with cases reported in New York. There was surge in diagnoses in 2002 as the virus spread throughout the United States, but as the rate of infection flattened out, public interest also...

Adult Asthma? – Why It’s Worthwhile to Re-Evaluate

By Laurie Breen Asthma is a chronic condition with no known cure that can be diagnosed at any age. In the United States alone there are over 25 million people with diagnosed asthma, and 7 million are children. Children with asthma typically have intermittent asthma attacks, but asthma symptoms in adults are usually persistent and require treatment with daily medication.   Image: Source   Children with chronic asthma have been shown to outgrow their condition about 75% of the time, but what about adults? A new study published in JAMA by authors Aaron, Vandemheen & FitzGerald suggests that potentially up to one-third of adults diagnosed with asthma don’t show symptoms a year later.   Image: Source   The study gathered over 700 participants who had been diagnosed with asthma at some point over the past five years and weaned them off their asthma medications. Then, for over 12 months, researchers followed up with a series of bronchial challenge tests to determine if the patients were still showing asthmatic reactions. By the end of 12 months, 613 participants had completed the study and researchers could rule out an asthma diagnosis in 203 of the participants – a recovery rate of 33%.   Image: Source   Another interesting finding during this study was that 2% of participants were found to have had a serious condition that had been misdiagnosed as asthma....

Medical Advancements To Look Forward To This Year #2: Precision Medicine

2. Precision Medicine On January 20, 2015 in his State of the Union address, President Obama announced the Precision Medicine Initiative, which laid out an endeavor to improve health care for the better. As I sat there listening to his speech, I asked myself: “So what exactly is precision medicine?” Let’s try to understand it with an example.   A large majority of people in the medical community and the populated world recognize that the obesity epidemic is real. Compared to 10 or 20 years ago, human beings are on a much more accelerated track towards cardiovascular disease, stroke, cancers, and many other grave conditions. Conventional management of obesity focuses on losing weight by eating less and exercising more, simple as that. After all, that must be the one answer to solve this seemingly humongous global problem? Perhaps not.   Precision medicine advocates for a different approach. Rather than painting the whole world in such broad strokes, the initiative strives to integrate genetics, lifestyle, environmental factors, and any other such crucial contributors in order to develop a model that best predicts the reasons behind disease and consequently how best to tackle it. As we already know, most people who try to lose weight gain it back soon afterwards. So there must be a reason (or perhaps multiple) behind this conundrum that expands beyond the mere fact of calorie control....

Medical Researchers Raise the Red Flag on Gun Violence Research Funding

By Laurie Breen   In a JAMA Research Letter likely intended to draw political attention, authors David E. Stark and Nigam H. Shah compared data on gun violence with other leading causes of death and questioned whether adequate funding was being given to research on gun violence, considering the high rates of death from gun violence in the U.S.     Although research into gun violence is not directly banned, a congressional appropriations bill from 1996 stated that no funding allocated for injury prevention or control at the CDC “may be used to advocate or promote gun control.” Supporters argued that a gun is not a disease and therefore falls outside the realm of the CDC, ignoring the fact that the CDC already has an Injury Prevention & Control Center. The authors argue that this ban has had a knock-on effect for all funding of gun violence research, as government agencies and institutes seeking funding will steer clear of the subject, from fear of running afoul of the appropriations ban and risking the loss of funding.   Image: Source   The letter’s authors reviewed CDC mortality statistics from 2004 – 2014. They identified the top 30 causes of death and allocated each to a Medical Subject Heading (MeSH) term. Then, for each MeSH term, the authors queried the number of Medline publications from 2004-2015 and also turned to the...

U.S. Rate of Birth Defects from Women with Zika

By Laurie Breen   In early 2016, The U.S. Centers for Disease Control and Prevention (CDC) announced the creation of the National Zika Pregnancy Registry to track and collect information in the United States and its territories on women who tested positive for possible Zika virus. By June of that year the CDC was reporting 265 pregnant women were being monitored in U.S. States and 216 in U.S. territories.   Image: Source   As these pregnancies progress, researchers are carefully monitoring the birthing outcomes for these women to identify the rate of birth defects. Reports from other countries have varied, showing risk rates from 1% up to 13%. Published in JAMA, Honein, Dawson & Peterson reviewed 442 completed pregnancies who had lab results showing possible Zika infection, and found that 6% of the fetuses and infants had birth defects potentially related to Zika infection, with similar overall results when comparing symptomatic and asymptomatic women. The most common birth defect was microcephaly with brain abnormalities, and a few had various brain abnormalities without microcephaly.   Image: Source   However, there were no reported birth defects among infants or fetuses whose only exposure to Zika virus occurred in the 2nd or 3rd Trimester, but when women presented symptoms and were infected in the first trimester, the risk of birth defects rose to 11%.   The researchers concluded that this evidence strongly...