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Posts tagged ‘World Health Organization’

English texts for medical students 8.


This is Steve Ember. And this is Bob Doughty with SCIENCE IN THE NEWS, a VOA Special English program about recent developments in Science.

Today, we tell about the disease diabetes.

The World Health Organization estimates that as many as one-hundred-twenty-million people have the disease diabetes. Diabetes is the name for several diseases with one thing in common: there is too much glucose, or sugar, in the blood. The disease develops when the body does not produce enough insulin or produces no insulin. Or the disease develops when the body cannot use insulin.

Insulin is a hormone that is necessary to change sugar, carbohydrates and other food into energy. In healthy people, the body changes food into a sugar, called glucose. Glucose is the source of fuel for the body. When food is changed into glucose, it enters the bloodstream and is taken to all parts of the body to feed muscles, organs, and tissue.

When the body senses that there is too much glucose in the blood, it sends a signal to the pancreas. The pancreas is the organ that produces insulin. The pancreas sends insulin into the bloodstream. The insulin lowers the level of blood sugar by letting it enter cells. Insulin helps muscles, organs and tissues take glucose and change it into energy.

That is how the body operates normally, in most people. Diabetes is present when too much glucose remains in the bloodstream and does not enter cells. If the amount of glucose in the blood remains too high, the body begins showing signs of diabetes. Over time, the disease can cause blindness, kidney disease, and nerve damage. High glucose levels in the blood also can lead to strokes and heart disease. Blood circulation also is affected, especially in the legs. Often, victims of diabetes must have a foot or even a leg removed because of blood circulation problems linked to the disease.

There are two main kinds of diabetes, Type One and Type Two. Between five and ten percent of those suffering from diabetes have Type One. It usually begins before the age of thirty in people who are thin.

It is most commonly found in children under the age of sixteen. It is caused by the body’s defense system. The bodies of Type One diabetes victims produce a substance that attacks and kills some cells in the pancreas, blocking the production of insulin. These cells are called islet cells. Scientists are not sure why this happens. They believe there may be a number of causes.

They include viruses, the presence of insect-killing pesticides in the environment or molecules known as free radicals. Free radicals are produced as part of normal chemical processes in the body. In people with diabetes, too many of these free radicals are present in the body. Scientists are not sure which of these causes is the most important to the development of Type One Diabetes.

People suffering from Type One diabetes must carefully control their diets. And they must exercise often. People with this kind of diabetes almost always require insulin injections. Patients must always know their blood sugar levels. When the level of glucose in the blood is too high, they must inject insulin into their bodies to reduce the amount of glucose. The patients must inject insulin every day, often several times a day. In most developed countries, insulin is easy to get and does not cost much money. However, doctors believe that these injections can cause long-term problems. They believe that the injections cause levels of glucose to change often.

Scientists believe that many quick changes in glucose levels can, over time, result in damage to the body. This damage can be blindness, kidney failure, heart disease, or poor blood flow in the body.

Type One Diabetes also is known as juvenile onset diabetes, because it usually starts in children or young people. Scientists believe it is the form of the disease that they will most likely be able to cure some day. Among the treatments being studied is a vaccine to prevent the disease. A vaccine is injected into the body or taken by mouth in the form of a pill.

Another possible treatment for Type One Diabetes is placing new islet cells into the pancreas to help it make insulin. Doctors have been transplanting islet cells into diabetes patients for several years. However, these healthy islet cells have failed to permanently replace the need for insulin injections.

Scientists also are studying special cells called stem cells to treat the disease. Stem cells develop into all the different kinds of cells in the body. Scientists believe that stem cells from unborn babies could be used to treat diabetes and other diseases. However, it would be a long time before such treatment is possible.

While some scientists continue to seek ways to cure Type One Diabetes, others are searching for easier ways to get insulin into the body. New devices are being developed that could replace injections. One device being tested is an inhaler.

This device would permit patients to breathe insulin into their bodies. The insulin is in the form of a powder, like dust. When the insulin reaches the lungs, it quickly moves into the bloodstream to reduce glucose levels.

Type Two Diabetes generally is found in people more than forty years old. Most of these people are too fat. Their bodies can not produce enough insulin to reduce the levels of glucose in their blood. Or, their bodies do not react correctly to the action of insulin.

Type Two Diabetes is more complex than Type One. Experts say Type Two Diabetes is really a group of diseases, with many possible causes. Scientists see little hope in developing a cure for this kind of diabetes. Instead, they are searching for better ways to control it. Many people suffering from the disease can control it with exercise and by carefully controlling their diet. Also, many of them do not need to inject insulin into their bodies. Type Two Diabetes is sometimes called non-insulin dependent. Still, patients often need drugs to treat the disease.

There are a number of drugs that can be used. However, many of them can cause other problems. One of the drugs is called sulfonylurea. It has been used for many years to help the pancreas make more insulin. But after several years, the drug loses its effects on the pancreas. Also, it can cause patients to gain weight.

The drug metformin appears to be more effective. It lowers the amounts of glucose in the blood. It does this by helping the body make better use of its own natural insulin. It does not cause weight gain. However, metformin can be dangerous for people with damaged kidneys. It should not be used by people who drink large amounts of alcohol, or those with kidney, liver or heart problems.

Genes seem to be more important in the development of Type Two Diabetes than in Type One. About ninety percent of those with Type Two Diabetes have parents and ancestors who also had the disease. In recent years, scientists have found several genes that may be linked to Type Two Diabetes. Some of these genes also are linked to extreme overweight, known as obesity. About eighty to ninety percent of people with Type Two Diabetes are obese. Often doctors do not discover that patients have diabetes until one of the disease’s serious results is found. For example, a doctor examines a patient suffering several health problems.

The doctor carries out tests and finds the problems are the results of poor kidney performance. Tests then show the patient is suffering from diabetes, which can cause kidney problems and even failure.

Although great progress has been made in the treatment of diabetes, it is still widespread and threatens the health of millions of people. Scientists hope that their research will lead to a cure for Type One Diabetes. And they hope they can find new ways to improve treatment of Type Two Diabetes. In future programs we will discuss new developments in diabetes research as they are reported.

This SCIENCE IN THE NEWS program was written by Oliver Chanler. This is Steve Ember. And this is Bob Doughty. Join us again next week for more news about science in Special English on the Voice of America.

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English texts for medical students 5.

Millions Suffer From Asthma

I’m Sarah Long. And this is Bob Doughty with the VOA Special English programSCIENCE IN THE NEWS.

Today, we tell about the disease asthma. It affects as many as one hundred fifty million people around the world.

Asthma is a serious lung disease that causes breathing problems. These problems, called asthma attacks, can kill. Asthma can affect people of all age groups but often begins in childhood. It can be controlled but not cured. Sufferers must deal with the disease every day.

Stavros Kontzias (cun-ZEE-ahs) is an eight-year-old boy living near Washington, D-C. He developed asthma when he was about two years old. His parents, Susie and Zack, say the breathing problems would appear whenever Stavros got sick with a cold or lung infection.

His father remembers those experiences as very frightening. He says Stavros coughed a lot. The boy struggled to breathe. His breathing became very loud and had a strange sound. That kind of breathing is called wheezing. Mr. Kontzias says his son never turned blue from a lack of oxygen. But, he says it was apparent that little air was getting into Stavros’s lungs.

The Kontziases made several emergency visits to the hospital when Stavros became sick. Once there, doctors gave the boy drugs called steroids. Mr. Kontzias says the steroids worked very fast to open his son’s air passages. But, he says he began to worry about long-term effects of high amounts of steroids as the trips to the hospital increased.

So, his parents took Stavros to a pulmonary pediatric specialist. That is a doctor who is an expert in diseases that affect children’s lungs. The doctor listened to the boy’s lungs. He also used measuring devices to test the child’s airflow limitations. The combination of the test results and Stavros’s medical history showed he had asthma.

Stavros began a treatment of four medicines a day to control his asthma. The Kontziases also took other steps to control their son’s asthma. They removed all floor coverings in Stavros’s room and most of the house. They also changed the activities he was involved in.

For example, the boy stopped playing European football, or soccer. The continuous running required to play the sport severely decreased his breathing ability. So Stavros began to play baseball instead. It gave him more time to rest and requires much less running.

Stavros and his family saw improvement in the boy’s health over the next several years. His trips to the hospital emergency room grew increasingly rare. Also, Stavros’s doctor slowly reduced the amount of medicine the boy took.

Recently, Zack and Suzie Kontzias reported good news. They say their son has not taken any steroid medicine since last summer. And they say he has not had an asthma attack. His parents also noted that those months included a season of American football, Stavros’s latest interest. The Kontziases now hope the asthma may completely disappear as their son gets older.

Doctors do not know the cause of asthma. Yet they have identified most of its triggers. For example, the common cold can cause an asthma attack in a person who has the disease. There also are several air pollutants that can lead to an asthma attack. Pollen is one such pollutant. Pollen is a fine dust that comes from plants that produce seeds. However, almost any kind of dust can cause an asthma attack if enough of it is in the air. This includes common dust found in houses.

Air pollution from burning fuel also can cause an asthma attack. Tobacco smoke can do the same. Some kinds of animal hair are a trigger for asthma. And, even some insects in the home can lead to asthma attacks.

Several things happen in the lungs when an asthma sufferer has an attack. Cells in the air passages begin to produce too much of a thick, sticky substance called mucous. The mucous creates blocked areas in the air passages. The tissue that lines the air passages begins to expand at the same time. And, the muscles in the passages tighten.

All these changes cause the air passages to narrow. This reduces the amount of air that can flow in and out of the lungs. The sufferer can not get a good, deep, breath of air. The narrowed airways also cause coughing and a tight feeling in the chest.

Health experts say asthma cases are increasing around the world. The World Health Organization says asthma rates worldwide are increasing on average by fifty percent every ten years. W.H.O. officials say asthma cases in western Europe have increased by two times in ten years. They say the number of asthma sufferers has increased in the United States by about sixty percent in the past twenty years.

American experts give an even higher number. The American Academy of Allergy, Asthma and Immunology says the rise was seventy-five percent in about the same time period. It also says more than twenty million Americans report having the disease.

The number of deaths from asthma also has risen in the United States. The W.H.O. says about five thousand Americans die from asthma attacks each year. In the early nineteen-eighties, the yearly death rate from asthma in the United States was about half that.

The World Health Organization says asthma is not just a problem in industrial countries. It says the disease affects people in developing nations, too. However, the incidence of the disease differs greatly from area to area. W.H.O. officials say as many as twenty million people suffer from the disease in India.

The officials say an estimated fifteen percent of Indian children suffer from the disease. They also say almost twenty percent of children in Kenya show signs of asthma. Brazil, Costa Rica, Panama, Peru and Uruguay also have a high rate of childhood asthma. The W.H.O. says as many as thirty percent of children in those countries show signs of asthma.

Asthma kills about one hundred eighty thousand people a year. The W.H.O. says the disease also has huge economic costs. The costs linked to asthma are believed to be higher than those of tuberculosis and AIDS combined. The W.H.O. says the United States spends six thousand million dollars a year on health care and other economic costs of asthma. It says Britain spends almost a third of that on health care for the disease and lost productivity of workers.The World Health Organization says greater international action is needed to deal with asthma. It says asthma sufferers, healthcare providers and the general public must learn more about the disease and the problems linked to it. The W.H.O. says a worldwide system should be put into effect to observe and record asthma rates around the world. And, it says more research is needed to find the cause of asthma and develop new ways to treat it.

Medical experts have suspected for some time that there was a genetic link to asthma. A child has a greater chance of developing asthma if his or her parent is asthmatic. British and American scientists say they may have found a gene involved in the disease.

Three groups of researchers took part in the study. One group worked for Genome Therapeutics, a drug company in Waltham, Massachusetts. The other scientists were from the drug maker Schering-Plough and the University of Southampton in Britain.

The gene is called ADAM thirty-three. The scientists identified it through genetic testing of more than four-hundred families in the United States and Britain whose members have the disease. The scientists say the gene alone does not cause asthma. But, they say its presence appears to increase a person’s chances of developing the disease.

They say the gene may be involved in the main condition of asthma — the narrowing of airway passages. However, the scientists say it is too early to say what percentage of asthma sufferers may have an abnormal gene.

Scientists say the finding could lead to new research about the causes of asthma and new drugs to treat the disease. It could also lead to methods to identify people most at risk for asthma and early treatment to help prevent the development of the disease.

This SCIENCE IN THE NEWS program was written by Caty Weaver. It was produced by Jill Moss. Dwayne Collins was our engineer. I’m Bob Doughty. And this is Sarah Long. Join us again next week for more news about science in Special English on the Voice of America.

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