Late treatment for many Philippine typhoon victims

Arab News: Many people who suffered serious injuries when a super typhoon devastated the central Philippines have had to wait nearly a month for treatment, the World Health Organization said Tuesday.

“With some of the more remote areas now accessible, we’re... seeing a second wave of people reaching hospitals with injuries,” WHO’s Philippines representative, Julie Hall, said in a statement nearly four weeks after the disaster.

Super Typhoon Haiyan destroyed some local hospitals, debris blocking access to many of those still working, when it slashed across the central islands on November 8, requiring the air evacuation of some of the injured to Manila and other cities.

The government’s National Disaster Risk Reduction and Management Council now lists 26,233 people injured, which the WHO Western Pacific in Manila said were the same figures it is using. The official figure had stood at just 12,500 in mid-November, a week after the typhoon swept out of the region....

Polluted air leads to disease by promoting widespread inflammation

Ohio State University Research: Chronic inhalation of polluted air appears to activate a protein that triggers the release of white blood cells, setting off events that lead to widespread inflammation, according to new research in an animal model. This finding narrows the gap in researchers’ understanding of how prolonged exposure to pollution can increase the risk for cardiovascular problems and other diseases.

The research group, led by Ohio State University scientists, has described studies in mice suggesting that chronic exposure to very fine particulate matter triggers events that allow white blood cells to escape from bone marrow and work their way into the bloodstream. Their presence in and around blood vessels alters the integrity of vessel walls and they also collect in fat tissue, where they release chemicals that cause inflammation.
Sanjay Rajagopalan

The cellular activity resembles an immune response that has spiraled out of control. A normal immune response to a pathogen or other foreign body requires some inflammation, but when inflammation is excessive and has no protective or healing role, the condition can lead to an increased risk for cardiovascular diseases, diabetes and obesity, as well as other disorders.

…“Our main hypothesis is that particulate matter stimulates inflammation in the lung, and products of that inflammation spill over into the body’s circulation, traveling to fat tissue to promote inflammation and causing vascular dysfunction,” said Sanjay Rajagopalan, professor of cardiovascular medicine at Ohio State and senior author of the study. “We haven’t identified the entire mechanism, but we have evidence now that activation of TLR4 influences this response.”

…In an editorial in the same issue of Circulation Research, Daniel Conklin of the University of Louisville wrote, “Is the mystery solved regarding the mechanism how inhaled [fine particulate matter] exposure stimulates vascular inflammation and injury? Well, probably not completely, but the present scenario laid out … connects findings from their study with many disparate human and animal epidemiological/exposure studies into a plausible story.”

A plate from Gray's Anatomy (not the TV show)

High temperatures reduce the load of antibiotic resistance genes

Laura Cassiday in Chemical & Engineering News: Bacteria are evolving resistance to antibiotics at an alarming rate, fueled by decades of overuse of the drugs in medicine and agriculture. Now researchers have developed a method that could slow the spread of resistance genes in the environment by reducing their release through treated sewage (Environ. Sci. Technol., DOI: 10.1021/es102765a).

When people take antibiotics, they can excrete resistant bacteria from their guts and flush them into the sewer system. The wastewater and associated solids then travel to a treatment plant. Farmers often apply treated wastewater solids, known as sewage sludge, to their fields as fertilizer. Bacteria in the sludge can share antibiotic resistance genes with other microbes in the environment. Yet according to Timothy LaPara, an environmental engineer at the University of Minnesota, Twin Cities, scientists lack a good method to remove antibiotic resistant bacteria during sewage treatment.

Most treatment plants incubate sludge in "digester" tanks at 37°C, where sewage bacteria decompose organic material and destroy pathogens, including other bacteria. Two types of digesters – aerobic digesters with added oxygen, and anaerobic without – select for different populations of bacteria. "A lot of these digesters are operated at our body temperature, which actually is a very good condition for resistant bacteria to survive," says LaPara.

…Quantitative polymerase chain reaction revealed that in the anaerobic reactor, the amounts of antibiotic resistance genes declined with increasing temperature. LaPara presumes that higher temperatures killed resistant bacteria or caused them to lose resistance genes. The effect was most dramatic for the integrase gene: At the highest temperature, the scientists could remove 99.99% of it, LaPara says. In contrast, during aerobic digestion, higher temperatures did not substantially change the prevalence of antibiotic-resistance genes. LaPara was surprised by the aerobic digestion results and plans further study.

Raising the temperature of anaerobic digestion at wastewater treatment plants should not be cost prohibitive, he says, because the digesting bacteria produce methane gas that can heat the reactor….

A schematic representation of how antibiotic resistance is enhanced by natural selection, by Wykis

New device detects who will suffer most from global warming heat waves

Randy Shore in the Vancouver Sun: SFU researchers have fashioned a device that can detect who will be most at risk of death during heat waves associated with global warming, a potential boon to elderly people and heart patients. The End-Tidal Forcing (ETF) system looks like the breathing apparatus that professional sports teams use to assess athletes, but it allows environmental physiologist Matthew White and his colleagues to measure a person’s ability to withstand periods of extreme heat or rising carbon dioxide levels.

“Global warming may only raise the temperature by a few degrees on average, but it is increasing the frequency of heat waves,” said White. “There is a substantial risk of death among the elderly during heat waves. “The elderly have a lower chemo-sensitivity in the heat, a lower ability to adapt.”

The ETF can alter the mix of nitrogen, oxygen and carbon dioxide that a person breathes allowing researchers to measure how well the body delivers oxygen to the body’s tissues and how well it regulates respiration under extreme conditions. White can create the experience of breathing at the top of Mount Everest or 20,000 leagues under the sea.

…White expects the device may be used to assess heart patients and determine those most at risk of adverse reactions to heat and even changing barometric pressure, such as people experience during air travel. White plans to study how people with heart and lung disease respond to climate change-induced hot environments…..

Suffering in the summer heat in New York's Time Square, shot by Alex Guerrero, Wikimedia Commons via Flickr, under the Creative Commons Attribution 2.0 Generic license.