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Creative Minds: Lessons from Halfway Around the Globe

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Transporting a patient in Nepal

Caption: Duncan Maru (right) and Community Health Director Ashma Baruwal (left) evaluating a patient in rural Nepal.
Credit: Allison Shelley

A decade ago, as a medical student doing volunteer work at a hospital in India’s capital of New Delhi, Duncan Maru saw a young patient who changed the course of his career: a 12-year-old boy in a coma caused by advanced tuberculosis (TB). Although the child had been experiencing TB symptoms for four months, he was simply given routine antibiotics and didn’t receive the right drugs until his parents traveled hundreds of miles at considerable expense to bring him to a major hospital. After five weeks of intensive treatment, the boy regained consciousness and he was able to walk and talk again.

That’s quite an inspiring story. But it’s also a story that haunted Maru because he knew that if this boy had access to good primary care at the local level, his condition probably never would have become so critical. Determined to help other children and families in similar situations, Maru has gone on to dedicate himself to developing innovative ways of providing high-quality, low-cost health care in developing areas of the world. His “lab” for testing these efforts? The South Asian nation of Nepal—specifically, the poverty-stricken, rural district of Achham, which is located several hundred miles west of the national capital of Kathmandu.


Reprogramming Genes to Keep Joints Healthy

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Caption: [Left] The knee joint of a normal mouse that endured an ACL-type injury. The injury triggered osteoarthritis and caused the cartilage on the femur (red) and tibia (green) to degrade, allowing the bones to sandwich together. [Right] This is the knee joint of a mouse that received gene therapy after the ACL injury. The cartilage is thick and healthy, and covers the bones completely, providing a cushion.

Credit: Brendan Lee and Zhechao Ruan, Department of Molecular and Human Genetics,
Baylor College of Medicine, Houston, TX

Our joints are pretty amazing marvels of engineering, but they don’t last forever. As we age, or if we suffer certain injuries, the smooth, slippery white cartilage covering the ends of our bones begins to fray and degrade. This causes osteoarthritis (OA), or ‘wear-and-tear’ arthritis. As the cartilage thins and disappears, the bones can even grow spurs that grate against each other, causing swelling and pain. It’s a major cause of disability, and there’s currently no cure—other than joint replacement, which is a pretty big deal and isn’t available for all joints. About 27 million Americans already have osteoarthritis; about 1 in 2 will suffer from some form of the disease over their lifetime. Those are lousy odds.


Weighing in on Sugary Drinks

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Drinking the occasional sugar-sweetened beverage, be it soda, an energy drink, sweetened water, or fruit punch, isn’t going to make you fat. But it’s now clear that many children and adults are at risk for gaining weight if they consume too much of these products.

An illustration showing that 10 spoonfuls of sugar can be found in a 12oz can of soda, 13 spoonfuls of sugar can be found in a 16oz cup of soda and 26 spoonfuls of sugar can be found in 32oz bottle of soda.I want to share new research from three recent papers in the New England Journal of Medicine (NEJM) because, together, they provide some of the most compelling evidence of the role of sugary drinks in childhood obesity, which affects nearly one-fifth of young people between the ages of 6 and 19.

In the first study [1], researchers randomly assigned 641 normal-weight school children between the ages of 4 and 12 to one of two groups. The first group received an 8 oz sugary drink each day; the second received the artificially sweetened version. After 18 months, it was clear that the kids consuming the sugary drink had gained about 2.25 pounds more weight, compared with the kids drinking the zero calorie drinks. They also packed on more fat.


Tackling Health Disparities: Childhood Asthma

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Photo of a young girl using an asthma inhaler. Image used courtesy of NICHD.

 

One condition for which NIH researchers are working to reduce disparities is asthma, the most common chronic condition that keeps kids home from school.

Compared to white children, Puerto Rican youngsters are 2.4 times more likely to suffer from asthma, African Americans, 1.6 times; and American Indians/Alaska Natives, 1.3 times.

Source: National Heart, Lung, and Blood Institute, NIH


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