Double-Arm Transplant Gives Marine Corps Veteran a Shot at New Life

Retired Marine Corps Sgt. John Peck lost all four of his limbs in an explosion in Afghanistan in 2010, but unlike many people who suffer such losses, Peck does not have to rely on prosthetic arms. Doctors performed a successful double arm transplant and now he is undergoing occupational and physical therapy at Walter Reed National Military Medical Center in Bethesda, Maryland. VOA’s Yahya Barzinji visited him and filed this report narrated by Jeff Custer.


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Superagers’ Brains Offer Clues for Sharp Memory in old age

It’s pretty extraordinary for people in their 80s and 90s to keep the same sharp memory as someone several decades younger, and now scientists are peeking into the brains of these “superagers” to uncover their secret.

The work is the flip side of the disappointing hunt for new drugs to fight or prevent Alzheimer’s disease.

Instead, “why don’t we figure out what it is we might need to do to maximize our memory?” said neuroscientist Emily Rogalski, who leads the SuperAging study at Chicago’s Northwestern University.

Parts of the brain shrink with age, one of the reasons why most people experience a gradual slowing of at least some types of memory late in life, even if they avoid diseases like Alzheimer’s.

But it turns out that superagers’ brains aren’t shrinking nearly as fast as their peers’. And autopsies of the first superagers to die during the study show they harbor a lot more of a special kind of nerve cell in a deep brain region that’s important for attention, Rogalski told a recent meeting of the American Association for the Advancement of Science.

These elite elders are “more than just an oddity or a rarity,” said neuroscientist Molly Wagster of the National Institute on Aging, which helps fund the research. “There’s the potential for learning an enormous amount and applying it to the rest of us, and even to those who may be on a trajectory for some type of neurodegenerative disease.”

What does it take to be a superager? A youthful brain in the body of someone 80 or older. Rogalski’s team has given a battery of tests to more than 1,000 people who thought they’d qualify, and only about 5 percent pass. The key memory challenge: Listen to 15 unrelated words, and a half-hour later recall at least nine. That’s the norm for 50-year-olds, but the average 80-year-old recalls five. Some superagers remember them all.

“It doesn’t mean you’re any smarter,” stressed superager William “Bill” Gurolnick, who turns 87 next month and joined the study two years ago.

Nor can he credit protective genes: Gurolnick’s father developed Alzheimer’s in his 50s. He thinks his own stellar memory is bolstered by keeping busy. He bikes, and plays tennis and water volleyball. He stays social through regular lunches and meetings with a men’s group he co-founded.

“Absolutely that’s a critical factor about keeping your wits about you,” exclaimed Gurolnick, fresh off his monthly gin game.

Rogalski’s superagers tend to be extroverts and report strong social networks, but otherwise they come from all walks of life, making it hard to find a common trait for brain health. Some went to college, some didn’t. Some have high IQs, some are average. She’s studied people who’ve experienced enormous trauma, including a Holocaust survivor; fitness buffs and smokers; teetotalers and those who tout a nightly martini.

But deep in their brains is where she’s finding compelling hints that somehow, superagers are more resilient against the ravages of time.

Early on, brain scans showed that a superager’s cortex – an outer brain layer critical for memory and other key functions – is much thicker than normal for their age. It looks more like the cortex of healthy 50- and 60-year-olds.

It’s not clear if they were born that way. But Rogalski’s team found another possible explanation: A superager’s cortex doesn’t shrink as fast. Over 18 months, average 80-somethings experienced more than twice the rate of loss.

Another clue: Deeper in the brain, that attention region is larger in superagers, too. And inside, autopsies showed that brain region was packed with unusual large, spindly neurons – a special and little understood type called von Economo neurons thought to play a role in social processing and awareness.

The superagers had four to five times more of those neurons than the typical octogenarian, Rogalski said – more even than the average young adult.

The Northwestern study isn’t the only attempt at unraveling long-lasting memory. At the University of California, Irvine, Dr. Claudia Kawas studies the oldest-old, people 90 and above. Some have Alzheimer’s. Some have maintained excellent memory and some are in between.

About 40 percent of the oldest-old who showed no symptoms of dementia in life nonetheless have full-fledged signs of Alzheimer’s disease in their brains at death, Kawas told the AAAS meeting.

Rogalski also found varying amounts of amyloid and tau, hallmark Alzheimer’s proteins, in the brains of some superagers.

Now scientists are exploring how these people deflect damage. Maybe superagers have different pathways to brain health.

“They are living long and living well,” Rogalski said. “Are there modifiable things we can think about today, in our everyday lives” to do the same?


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Cigars, Pipes Tied to Same Risks as Cigarettes

Cigarettes are not the only type of tobacco products that can lead to premature death or fatalities from smoking-related cancers, a U.S. study confirms.

While people who exclusively smoke cigarettes have twice the risk of premature death from all causes compared to people who avoid tobacco altogether, exclusive cigar smokers have a 20 percent higher risk of early death, researchers report in JAMA Internal Medicine.

When it comes to fatalities from specific cancers that have been tied to tobacco use, cigarette smokers have four times the risk of people who never used tobacco, but cigar smokers are 61 percent more likely to die of these cancers and pipe users have 58 percent higher odds.

“We knew exclusive users of cigars and pipes were at greater risk of disease than people who do not use tobacco,” said lead study author Carol Christensen of the U.S. Food and Drug Administration’s Center for Tobacco Products. “However, this study provides information that reflects today’s patterns of tobacco use.”

These data “underscore the importance of complete quitting,” Christensen said by email.

For the study, researchers examined nationally representative survey data, collected starting in 1985, from 357,420 participants who were followed through 2011. 

Overall, 203,071 people, or about 57 percent, never used tobacco at all. Another 57,251 participants were current daily cigarette smokers, while 9,414 said they had a less frequent habit and 77,773 were former cigarette smokers.

In addition, 531 people were current daily cigar smokers, while 608 individuals used cigars less frequently and 2,398 had quit.

For pipes, 1,099 participants had a current daily habit, while 78 people used pipes less often and 5,237 had quit.

During the study period, 51,150 people died of all causes.

With a daily cigarette, cigar or pipe habit, people had an elevated risk of death from tobacco-related cancers including malignancies of the bladder, esophagus, larynx, lung, mouth and throat, and pancreas.

Nondaily users

Even with a nondaily cigarette habit, people were more than six times more likely to die of lung cancer than individuals who never used tobacco. They also had more than seven times the risk of dying from chronic obstructive pulmonary disease, more than four times the odds of death from oral cancers, and 43 percent higher odds of death from a circulatory system disorder.

Current cigar smokers had more than three times the odds of dying of lung cancer, and for current pipe smokers the risk was 51 percent higher, compared with never-smokers.

The results were limited, however, by the relatively small numbers of cigar and pipe smokers in the sample, the authors noted.

Another limitation was that survey questions about tobacco use changed over time and didn’t determine how often nondaily smokers might have used cigarettes, cigars or pipes.

Even so, the results suggest that doctors may need to broaden how they discuss smoking with patients to make sure people understand they’re at risk even when they don’t have a daily habit, said Dr. Michael Ong of the University of California-Los Angeles and VA Greater Los Angeles Healthcare

System.

“Patients often do not associate occasional use of cigar or pipes with health risks, but this study shows that current, particularly daily, cigar use is associated with increased overall risk of death,” Ong, who wasn’t involved in the study, said by email.

Doctors also need to broaden their message about smoking and cigarettes to include other tobacco products that are becoming more popular, said Judith Prochaska, a researcher at Stanford University in California who wasn’t involved in the study.

Traditionally, doctors have asked just whether people smoked cigarettes, but they should instead be questioning patients more broadly about tobacco use, Prochaska said by email.

“The tobacco landscape has been changing dramatically,” Prochaska added. “While cigarettes remain the primary tobacco product used, cigars, smokeless tobacco, e-cigarettes, hookah, and even pipe tobacco have seen gains in use, while cigarette use in the U.S. has been declining.”


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European Space Probe Prepares to Sniff Martian Atmosphere

A European space probe has swung into position around Mars in preparation to analyze its atmosphere for possible signs of life.

The European Space Agency said Wednesday its Trace Gas Orbiter successfully performed a delicate maneuver known as aerobraking that involved dipping into the red planet’s upper atmosphere to slow the probe.

The agency says the orbiter will start looking for trace gases such as methane, which can result from biological or geological activity, in April. It will also search for ice that could help future Mars landings.

A NASA-made radio on board will also help relay signals from U.S. rovers on the surface back to Earth.

Europe plans to land its own rover on Mars in 2021. A European test lander crashed on the surface of Mars in 2016.


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With Medicine Running Out, Venezuelans With Transplants Live in Fear

Yasmira Castano felt she had a fresh chance at life when she received a kidney transplant almost two decades ago. The young Venezuelan was able to finish high school and went on to work as a manicurist.

But late last year, Castano, now 40, was unable to find the drugs needed to keep her body from rejecting the organ, as Venezuela’s health care system slid deeper into crisis following years of economic turmoil.

On Christmas Eve, weak and frail, Castano was rushed to a crumbling state hospital in Venezuela’s teeming capital, Caracas. Her immune system had attacked the foreign organ and she lost her kidney shortly afterward.

Now, Castano needs dialysis three times a week to filter her blood. But the hospital attached to Venezuela’s Central University, once one of South America’s top institutions, frequently suffers water outages and lacks materials for dialysis.

“I spend nights not sleeping, just worrying,” said Castano, who weighs around 77 pounds (35 kg), as she lay on an old bed in a bleak hospital room, its bare walls unadorned by a television or pictures.

Her roommate Lismar Castellanos, who just turned 21, put it more bluntly.

“Unfortunately, I could die,” said Castellanos, who lost her transplanted kidney last year and is struggling to get the dialysis she needs to keep her body functioning.

The women are among Venezuela’s roughly 3,500 transplant recipients. After years leading normal lives, they now live in fear as Venezuela’s economic collapse under President Nicolas Maduro has left the once-prosperous OPEC nation unable to purchase sufficient foreign medicine or produce enough of its own.

Some 31 Venezuelans have seen their bodies start to reject their transplanted organs in the last month due to lack of medicine, according to umbrella health group Codevida, a nongovernmental organization.

At least seven have died due to complications stemming from organ failure in the last three months.

A further 16,000 Venezuelans, many hoping for an elusive transplant, are dependent on dialysis to clean their blood — but here, too, resources and materials are sorely lacking.

Nearly half of the country’s dialysis units are out of service, according to opposition lawmaker and oncologist Jose Manuel Olivares, a leading voice on the health crisis who has toured dialysis centers to assess the scale of the problem.

‘Straight to the cemetery’

In the last three weeks alone, seven people have died due to lack of dialysis, according to Codevida, which staged a protest to decry the critical drug shortages.

Once-controlled diseases like diphtheria and measles have returned, due partly to insufficient vaccines and antibiotics, while Venezuelans suffering chronic illnesses like cancer or diabetes often have to forgo treatment.

Hundreds of thousands of desperate Venezuelans, meanwhile, have fled the country over the past year, including many medical professionals.

Amid a lack of basics like catheters and crumbling hospital infrastructure, doctors who remain struggle to cope with ever scarcer resources.

“It’s incredibly stressful. We request supplies; they don’t arrive. We call again and they still don’t arrive. Then we realize it’s because there aren’t any,” said a kidney specialist at a public hospital, asking to remain anonymous because health workers are not allowed to speak publicly about the situation.

Venezuela’s Social Security Institute, tasked with providing patients with drugs for chronic conditions, did not respond to a request for comment.

Terrified transplant patients are indebting themselves to buy pricey medicine on the black market, begging relatives abroad to funnel drugs into the country or dangerously reducing their daily intake of pills to stretch out stock.

Larry Zambrano, a 45-year-old father of two with a kidney transplant, resorted to taking immunosuppressants designed for animals last year.

Guillermo Habanero and his brother Emerson both underwent kidney transplants after suffering polycystic kidney disease.

Emerson, a healthy 53-year-old former police officer, died in November after a month without immunosuppressants.

“If you lose your kidney, you go to dialysis but there are no materials. So you go straight to the cemetery,” said Habanero, 56, who runs a small computer repair shop in the poor hillside neighborhood of Catia.

Blaming Maduro, who blames sanctions

A Reuters reporter went to the Health Ministry to request an interview, but was asked at the entrance to give her contact details instead. No one called or emailed.

Reuters was also unable to contact the Health Ministry unit in charge of transplants, Fundavene, for comment. Its website was unavailable. Multiple calls to different phone numbers went unanswered. An email bounced back and no one answered a message on the unit’s Facebook page.

Maduro’s government has said the real culprit is an alleged U.S.-led business elite seeking to sabotage its socialist agenda by hoarding medicine and imposing sanctions.

“I see the cynicism of the right-wing, worried about people who cannot get dialysis treatment, but it’s their fault: They’ve asked for sanctions and a blockade against Venezuela,” Socialist Party heavyweight Diosdado Cabello said in recent comments on his weekly television program.

Health activists blame what they see as Maduro’s inefficient and corrupt government for the medical crisis and contend that government announcements of more imports for dialysis are totally insufficient.

Despite his unpopularity, Maduro is expected to win a new six-year term in an April 22 presidential election. The opposition is likely to boycott the vote, which it has already denounced as rigged in favor of the government.

Maduro has refused to accept food and medicine donations, despite the deepening health care crisis. Health activists and doctors smuggle in medicines, often donated by the growing Venezuelan diaspora, in their suitcases, but it is far from enough.

In the decaying hospital and dialysis center visited by Reuters, patients clamored for humanitarian aid.

Dolled up for her birthday and surrounded by cakes, the 21-year-old Castellanos took selfies with her friends and spoke excitedly about one day returning to dance, one of her passions.

But fears for her future permeated the room. A hospital worker stopped by to wish Castellanos many more birthday celebrations, but her worried face betrayed doubts.

“Other countries need to help us,” Castellanos said.


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Study: Seas to Rise About a Meter Even If Climate Goals Met

Sea levels will rise between 0.7 and 1.2 meters (27-47 inches) in the next two centuries even if governments end the fossil fuel era as promised under the Paris climate agreement, scientists said Tuesday.

Early action to cut greenhouse gas emissions would limit the long-term rise, driven by a thaw of ice from Greenland to Antarctica that will re-draw global coastlines, a German-led team wrote in the journal Nature Communications.

Sea-level rise is a threat to cities from Shanghai to London, to low-lying swaths of Florida or Bangladesh, and to entire nations such as the Maldives in the Indian Ocean or Kiribati in the Pacific.

By 2300, the report projected that sea levels would gain by 0.7-1.2 meters, even if almost 200 nations fully meet goals under the 2015 Paris Agreement, which include cutting greenhouse gas emissions to net zero in the second half of this century.

Ocean levels will rise inexorably because heat-trapping industrial gases already emitted will linger in the atmosphere, melting more ice, it said. In addition, water naturally expands as it warms above four degrees Celsius (39.2°F).

The report also found that every five years of delay beyond 2020 in peaking global emissions would mean an extra 20 centimeters (8 inches) of sea-level rise by 2300.

“Sea level is often communicated as a really slow process that you can’t do much about … but the next 30 years really matter,” lead author Matthias Mengel, of the Potsdam Institute for Climate Impact Research, told Reuters.

Governments are not on track to meet the Paris pledges.

Global emissions of carbon dioxide, the main greenhouse gas emitted by burning fossil fuels, rose last year after a three-year plateau.

And U.S. President Donald Trump, who doubts that human activities are the prime cause of warming, plans to quit the Paris deal and instead promote U.S. coal, oil and natural gas.

‘Brink of inundation’

Maldives Environment Minister Thoriq Ibrahim, who chairs the 44-member Alliance of Small Island States, said Tuesday’s findings showed a need for faster action to cut emissions, especially by rich nations.

“Unfortunately, the study confirms what small island nations have been saying for years: Decades of procrastination on climate change have brought many of us to the brink of inundation,” he told Reuters.

Professor John Church, of the Climate Change Research Center at the University of New South Wales, who was not involved in the study, said 100 million people now live within one meter of the high tide mark.

“More people are moving to live within the coastal zone, increasing the vulnerable population and infrastructure,” he said in a statement. “Adaptation to sea-level rise will be essential.”


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Ebola’s Impact Reached Beyond Death Toll to Basic Health Care

More than 100,000 malaria cases went untreated when Liberia’s health care system buckled under the 2014-2015 Ebola outbreak, according to a new study.

The research, published in the journal PLOS Medicine, shows how the toll of the Ebola outbreak goes beyond the 11,000 killed in West Africa by the virus itself. Basic health care took a major hit as well.

Ebola kills about half of the people it infects. It causes flu-like symptoms, followed by vomiting and diarrhea, and can lead to internal and external hemorrhaging. The disease spreads through contact with an infected person’s bodily fluids. 

The countries of West Africa were ill-equipped to deal with the 2014-15 outbreak. Many clinics lacked the most basic tools for dealing with the disease, including latex gloves and face masks. 

“Rightfully so, people were afraid to go to the clinic because they might get Ebola when they’re at the clinic,” said study lead author Brad Wagenaar at the University of Washington.

Wagenaar and colleagues found that by four months into the epidemic, clinics were delivering one-third to two-thirds fewer basic services, which he described as a “huge, dramatic decrease.” 

‘Huge, dramatic decrease’

The researchers studied monthly data on health visits from 379 clinics outside the capital, Monrovia, from 2010 through 2016. 

They found measles vaccinations dropped by 67 percent. Anti-malarial treatment fell by 61 percent. Thirty-five percent fewer pregnant women came in for their first pre-natal visits.

It took more than a year-and-a-half for all services to return to pre-outbreak levels. 

Lost opportunities

In that time, more than three-quarters of a million clinic visits were lost, the researchers estimate, based on extrapolations from pre-outbreak trends. 

That includes more than 5,000 births at health care facilities, in a country with one of the world’s highest rates of maternal death, along with a loss of 100, 000 malaria treatments. These figures, Wagenaar adds, suggest a loss of other services that may have a long-term impact, such as distributing bed nets and spraying houses with insecticides.

“Some of these other things didn’t happen during the Ebola outbreak because the health system and other partners were busy with other issues,” he said. “And now, the cases have been increasing.”

Malaria cases were 50 percent higher in December of 2017 than they were before the Ebola epidemic.

Wagenaar says the research highlights how more attention must be devoted to maintaining basic services during a health emergency. The data his group analyzed could be used in other outbreaks to prioritize services that have been overlooked. 

Funding for public health systems

And after the emergency, funding should focus on strengthening public health systems. 

“We know that this epidemic happened in Liberia due to multiple factors, but one being the public sector ministry of health system has been underfunded,” he said, adding that remains the case.

Donors earmarked funds for strengthening the health system, he said. But, “that money never really materialized,” he added.


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Experts: Underwater Archaeology Site Imperiled in Mexico

Pollution is threatening the recently mapped Sac Actun cave system in the Yucatan Peninsula, a vast underground network that experts in Mexico say could be the most important underwater archaeological site in the world.

 

Subaquatic archaeologist Guillermo de Anda said the cave system’s historical span is likely unrivaled. Some of the oldest human remains on the continent have been found there, dating back more than 12,000 years, and now-extinct animal remains push the horizon back to 15,000 years.

 

He said researchers found a human skull that was already covered in rainwater limestone deposits long before the cave system flooded around 9,000 years ago.

 

De Anda said over 120 sites with Maya-era pottery and bones in the caves suggest water levels may have briefly dropped in the 216-mile (347-kilometer) -long system during a drought about 1,000 A.D. And some artifacts have been found dating to the 1847-1901 Maya uprising known as the War of the Castes.

 

Humans there probably didn’t live in the caves, de Anda said, but rather went down to them “during periods of great climate stress, to look for water.”

 

Sac Actun is “probably the most important underwater archaeological site in the world,” he said.

 

But de Anda said pollution and development may threaten the caves’ crystalline water.

Some of the sinkhole lakes that today serve as entrances to the cave system are used by tourists to snorkel and swim. And the main highway in the Caribbean coast state of Quintana Roo runs right over some parts of cave network. That roadway has been known to collapse into sinkholes.

 

Also, the cave with the stone-encased skull has high acidity levels, suggesting acidic runoff from a nearby open-air dump could damage skeletal remains.

 

The world’s other great underwater site, the sunken Egyptian city of Alexandria, is also threatened by pollution.


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