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world: a "coffee machine" to quickly diagnose TB


TB, or tuberculosis, is an infectious disease caused by mycobacteria, including Mycobacterium tuberculosis, also known as "Koch's bacteria" because it was isolated and described by Robert Koch in 1882. According to data from the WHO (World Health Organization), a third of the world population is infected.
mortality and morbidity statistics in 2004 showed 14.6 million active cases, 8.9 million new cases and 1.6 million deaths, mostly in developing countries. Many infections remain latent and asymptomatic, but about one in ten
disease becomes active, if untreated, kills more than half of the people.
In 1946, with the development of the antibiotic streptomycin, si cominciò a pensare che l'eradicazione della malattia fosse possibile, ma speranza che la malattia potesse essere definitivamente sconfitta è venuta meno con l'insorgenza di ceppi resistenti agli antibiotici negli anni ottanta.
Attualmente dati dell'OMS mostrano che il trattamento standard non è efficace nel 20 % circa dei casi, mentre il 2 % dei ceppi resistenti agli antibiotici standard è resistente anche ai farmaci di seconda linea.
Nei paesi in via di sviluppo una diagnosi precoce equivale spesso a salvare una vita. Ora una specie di "coffee machine" dà la possibilità di diagnosticare la tubercolosi in circa 100 minuti anziché in 30-90 giorni. Si tratta di un test molecolare inserito in un "piattaforma diagnostica" capable of supporting several types of tests on different diseases.
Diagnosis is achieved in one hour and 45 minutes, starting from the sputum of the patient, and is completely automotizzata. Simply insert a cartridge pre-packaged with a saliva sample of the patient in the door of the machine. The operator only needs to know how to turn on the computer and the test can also be made for one case.
The ease of diagnosis is a big advantage because the machine can also be used in centers without specialized technicians, for example, just in developing countries.
In the future, the platform can also be used for other texts, such as malaria and HIV. The cost of the machine is $ 17,000, while each cartridge, and in the West now costs € 50, will cost for developing countries with low or medium $ 16.86, with plans to reach $ 10 within three years, according to WHO.
The machine is the result of a public-private collaborazone see also Italy among the leaders. In fact it is the product of a U.S. company (Genexpert), the department "Stop TB" WHO, directed by Italian Mario Raviglione, and "find", the "Foundation for Innovative Diagnostics, chaired by the Italian Giorgio Roscigno .

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How much to save a smoker?

Following a study conducted by the IEO (European Institute of Oncology) in a large sample of heavy smokers, Umberto Veronesi announced today (November 25, 2010) that spiral CT can detect lung cancer in the very early stages and, therefore, operable with excellent prospects in terms of prognosis for the patient (http://www.repubblica.it/ salute/medicina/2010/11/25/news/tumori_polmone_tac_spirale_dimezza_mortalit-9501468 /? ref = HRER2-1)
Along with the scientific result, Veronesi has announced its intention to propose that both the NHS to pay for these (rather expensive) early screening campaigns, as is the case for the PAP test (ovarian cancer) and mammograms (breast cancer).
Beyond the affordability of such an interesting initiative, two ethical issues they pose to our attention.
1) Due to the stakeholders of smokers, would be reasonable that it should be society as a whole to bear the burden for a diagnostic risk factor that the subjects could easily be avoided?
2) The PAP smears and mammograms do not distinguish between those most at risk and those less exposed to the possibility of contracting ovarian cancer and / or breast cancer. The reason that spiral CT should instead be carried out only in inveterate smokers is that this diagnostic test is very expensive. The cost of access to a medical practice, however, is not a good moral argument for excluding non-smokers from the possible benefits of a screening that could save his life. Unless it is proven that the risk of contracting lung cancer for nonsmokers is insignificant, it seems legitimate to non-smokers take up the spiral CT scan itself free (perhaps less frequently than smokers). After all limit the diagnostic service for smokers seems to be rewarding irresponsible behavior and punish (through taxation and spending may be supported in its) citizens who choose to abstain from risky behavior is known.
These two questions arise, as often happens, the encounter between the daily demands of care and the most advanced medical technologies. I hope that readers of this blog will intervene and say their subject.

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The European Union and the right to be forgotten


The European Commission has prepared a new draft document to regulate the protection of personal data. Viviane Rein, a member of the EU Commission for Justice, said that "The protection of personal data is a fundamental right" and that it is necessary to develop measures to protect the privacy updated in the light of new information technologies. In particular, the draft specifically mentions a "right to be forgotten" when personal data are no longer needed, or when the person wants to be deleted.

Anders Sandberg Oxford University commented on the news blog "Practical Ethics" (Http://www.practicalethicsnews.com/practicalethics/2010/11/retaining-privacy-the-eu-commission-and-the-right-to-be-forgotten.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed% 3A PracticalEthics 28Practical + +% + Ethics% 29) and an ironic note caveaut of the draft EU: The committee wants to implement a right to control personal information, but on the other side has also developed a directive requiring that the information storage personal.


should also be noted that some important domains of privacy protection are likely to be excluded from the EU directive, for example, under the agreement SWIFT (http://www.dw-world.de/dw/article/0,, 4952263.00. html) personal financial information can be exported to U.S. demands to the authorities, in order to prevent terrorist attacks. As Sandberg says, so it is very unlikely that the U.S. authorities will respect the EU directive concerning the "right to be forgotten."

I am reminded about a great movie and book, titled "Eternal Sunshine of the Spotless Mind" (http://www.imdb.com/title/tt0338013/) by Michel Gondry, 2004, translated in horribly Italian with the title: "If Spotless Mind." In the movie, Clementine (Kate Winslet) and Joel (Jim Carrey), a couple in crisis, decided to enlist the services of a company to cancel each other's memories altrui, e provare a iniziare una nuova vita partendo da una tabula rasa, senza il peso di ricordi malinconici.
Se, come sembra, non sarà così facile implementare il diritto ad essere dimenticati, si possono sempre immaginare vari modi a cui ricorrere per implementare il diritto a dimenticare.

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The scientific debate in light of the profit ethic


Riflettendo sul disappunto del prelato Ignacio Carrasco De Paula rivolto ai saggi del Karolinska per l’assegnazione del Nobel per la Medicina al padre dell’inseminazione artificiale, Robert Edwards, colpevole di aver introdotto il mercato degli ovociti e causato il congelamento di numerosi embrioni che hanno un’altra probabilità di trovare la morte nell’ecobox, non posso fare a meno di domandarmi quale sia il principio bioetico a cui si riferisce il pensiero cattolico.
Ragionando sulle posizioni della Chiesa in relazione alle tematiche bioetiche mi sono resa conto che non tutti gli interventi artificiali dell’uomo sulla vita sono da essa avversati.
Basti pensare all’espianto d’organi, che è procedura difesa dalla Chiesa in quanto utile a salvare vite. Chi subisce espianto è biologicamente ancora vivo, in quanto, affinchè gli organi possano funzionare nel nuovo corpo non deve essere iniziato nessun processo di necrosi e la fine naturale, in questo caso, sarebbe attendere che la morte cerebrale avanzi fino a comportare l’arresto cardiaco e l’inizio della necrosi cellulare in all organs.
addition, the donor is a person that size, compared to an embryo, has its own meaning as it has for the biographical and with a social role, with his death, you stop and leave a vacuum that is much larger than may result in an embryo's life. However
for Catholic thought no objection: it is acceptable to manipulate human life to give organs to someone else, that God has previously proposed to the disease and possibly death, as we must use all the tools of medicine to prolong life to the bitter end the meaning is not only growing and biographical, but it is not acceptable to use all the tools available to the science give birth to new healthy lives, which are not the result of the death of someone else and fill with joy the life of those who grow.
Moreover, if science were to act in compliance with the natural processes in their totality, could not help but stop to work, because the natural course of any disease progression until the outcome is unfortunate: the nature created by God proceeds this direction and allow the scientific instruments to act only in certain areas certainly not more ethically justifiable than others is nothing more than a philosophical source of contradictions and confusion of public opinion is very confused in relation to these issues.
The result of this attitude ambivalence of Catholic thought leads to situations of ethical utilitarianism, especially among those who declare themselves practicing Catholics and excoriate the father of fertilization in the wake of the statement of the Holy See, but then when infertility threatens them, do not struggle to take flights to Barcelona with a rosary close at hand to deploy a heterologous fertilization, and to return to Italy, they fill their church candles for the miracle attributed to the Lord by the zeal of the scientists.
The issues discussed do not emphasize that they are likely to be misleading in some direct intervention and regulatory contemporary bioethical debate: the role of religious institutions, in my parere, dovrebbe essere proprio di chiarificazione e di agevolazione del dibattito su queste tematiche a micro livello, dove le persone spesso non hanno gli strumenti per comprendere le argomentazioni scientifiche e riflettere su di esse, senza assumere posizioni rigide o criticare secondo un’etica utilitarista, che porta a salvare quello che serve dopo averlo condannato o a sollevare l’intervento utile da ogni condanna.