War and Ebola: A double nightmare in eastern DR Congo

First came the war, which developed into a brutal, bloody tussle between militias who abused civilians or killed them.

Now Ebola, a name almost as dreaded as death itself, has come.

In the Beni region, in the Democratic Republic of Congo’s eastern province of Kivu, the twin peril has bred fear and despair.

The region is haunted in particular by the Allied Defence Forces (ADF), a Ugandan Islamist rebel group blamed for hundreds of civilian deaths over the past four years.

On August 1, Beni declared an outbreak of Ebola epicentered in Mangina—a small town that had been a relative haven from the fighting—where six members of the same family died of the disease.

“I fled here from Kokola, where the ADF were committing atrocities,” said Pascaline Fitina, a 36-year-old woman, sitting alone, her head in her hands.

“I went to my elder sister, but she has died of Ebola and her husband is being quarantined at the treatment centre. I don’t what to do.”

Pascal Lukula, a 38-year-old farmer with five children, said he was stuck in Mangina, unable to get to other members of his family, because of the encroaching militia.

“We are caught between the hammer and the anvil,” he sighed. “The ADF’s on one side, and Ebola on the other.”

The Congolese health ministry said Wednesday the death toll in the east had reached 42 out of 66 probable and confirmed cases.

The outbreak—the country’s 10th since the disease was discovered in then-Zaire in 1976—was announced just a week after the end of an Ebola flareup in northwestern Equateur province that claimed 33 lives.

Chlorinated water

Ebola causes serious illness including vomiting, diarrhoea and in some cases internal and external bleeding. It is often fatal if untreated.

The disease is caused by a virus that is transmitted to people from wild animals and spreads among humans through close contact with the blood, body fluids, secretions or organs of an infected person.

In Mangina, located 30 kilometres (18 miles) southwest of the city of Beni, suspicion and rumour seem to have spread across the population.

Containers of chlorinated water have been installed in front of all shops and in the markets to provide rudimentary hand protection.

“I wear gloves to protect me from the epidemic,” said Jonas Mumbere, 26, who drives a motorcycle taxi.

“Customers have started to think twice about getting on the motorbike for fear of contamination.”

Elodie Zena, a 28-year-old sex worker, said, “Business has dropped off—customers are afraid. I’ve heard that even the sweat of someone who is infected can contaminate us. I’ve got two children and I don’t how I can feed them.”

Health experts have long fretted about the problems of combating Ebola in the DRC, a vast country that is poor and unstable and shares boundaries with nine countries.

On Tuesday, the World Health Organization (WHO) chief, Tedros Adhanom Ghebreyesus, also warned that conflict had helped create “a conducive environment for the transmission” of Ebola.

Hanna Leskinen of the International Committee of the Red Cross (ICRC) said the grassroots work in combating Ebola lies in locating and treating patients and isolating people who have been in contact with them.

In North Kivu, “people are moving around all the time, fleeing the latest wave of violence,” she said. “It enormously complicates search and followup of infected people.”

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Scientists discover chemical which can kill glioblastoma cells

Aggressive brain tumour cells taken from patients self-destructed after being exposed to a chemical in laboratory tests, researchers have shown.

The study could be the first step in tackling cancers like glioblastoma, which led to Dame Tessa Jowell’s death earlier this year.

The research, led by the University of Leeds, found that the synthetic chemical, named KHS101, was able to cut the energy source of tumour cells from glioblastoma, leading to the death of the cells.

Published in Science Translational Medicine, the research represents an important step forward in tackling this disease, which is one of the deadliest cancers, with a five-year survival rate of less than¬ five per cent.

Over 2,000 people are diagnosed with glioblastoma in the UK every year, and it has recently been discussed in Parliament as a disease which urgently requires improvements in treatment options.

Funded initially by the Medical Research Council, the new study showed promising results which may lead to the development of a therapy to fight brain cancer in years to come.

Dr. Heiko Wurdak, from the University of Leeds who led the international research team, said: “When we started this research we thought KHS101 might slow down the growth of glioblastoma, but we were surprised to find that the tumour cells basically self-destructed when exposed to it.

“This is the first step in a long process, but our findings pave the way for drug developers to start investigating the uses of this chemical, and we hope that one day it will be helping to extend people’s lives in the clinic.”

The study revealed that the chemical was disrupting the mitochondria and metabolism within the tumour cells, and shutting off the energy supply leading to their self-destruction.

To test whether KHS101 could cross the blood brain barrier in mammals, essential for it to be effective in stopping brain cancers, tumour cells were transferred from humans into mice. The blood brain barrier stops most molecules from entering the brain and severely limits treatment options.

The chemical successfully crossed the blood-brain barrier and significantly decreased tumour growth (by around 50 per cent) in mice treated with KHS101 compared with those given a placebo, leading to an increase in survival. Importantly, normal brain cells were unaffected by the chemical.

The team also reviewed how effective KHS101 would be against the different genetic profiles of cells within a tumour, and between tumours in different patients. Genetic variation in tumours has complicated efforts to identify treatments in the past, but the team found that all tested variations of glioblastoma subtype cells responded to the treatment.

Professor Richard Gilbertson, Cancer Research UK’s brain tumour expert who wasn’t involved in the research, said: “Treatment for glioblastoma has remained essentially unchanged for decades, so there is a pressing need for preclinical research like this to identify and characterise potential new drugs.

“While the findings are encouraging, as an experimental chemical, further rigorous testing and refinement of KHS101 is required before trials in people can begin.”

Further research into the properties of KHS101 may lead scientists to discover similar drugs which also disturb the energy sources causing self-destruction of tumour cells, and thus broaden the range of treatment options available in the fight against brain tumours.

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This matrix delivers healing stem cells to injured elderly muscles

A car accident leaves an aging patient with severe muscle injuries that won’t heal. Treatment with muscle stem cells from a donor might restore damaged tissue, but doctors are unable to deliver them effectively. A new method may help change this.

Researchers at the Georgia Institute of Technology engineered a molecular matrix, a hydrogel, to deliver muscle stem cells called muscle satellite cells (MuSCs) directly to injured muscle tissue in patients whose muscles don’t regenerate well. In lab experiments on mice, the hydrogel successfully delivered MuSCs to injured, aged muscle tissue and boosted the healing process while protecting the stem cells from harsh immune reactions.

The method was also successful in mice with a muscle tissue deficiency that emulated Duchene muscular dystrophy, and if research progresses, the new hydrogel therapy could one day save the lives of people suffering from the disease.

Inflammation war zone

Simply injecting additional muscle satellite cells into damaged, inflamed tissue has proven inefficient, in part because the stem cells encounter an immune system on the warpath.

“Any muscle injury is going to attract immune cells. Typically, this would help muscle stem cells repair damage. But in aged or dystrophic muscles, immune cells lead to the release a lot of toxic chemicals like cytokines and free radicals that kill the new stem cells,” said Young Jang, an assistant professor in Georgia Tech’s School of Biological Sciences and one of the study’s principal investigators.

Only between 1 and 20 percent of injected MuSCs make it to damaged tissue, and those that do, arrive there weakened. Also, some tissue damage makes any injection unfeasible, thus the need for new delivery strategies.

“Our new hydrogel protects the stem cells, which multiply and thrive inside the matrix. The gel is applied to injured muscle, and the cells engraft onto the tissues and help them heal,” said Woojin Han, a postdoctoral researcher in Georgia Tech’s School of Mechanical Engineering and the paper’s first author.

Han, Jang and Andres Garcia, the study’s other principal investigator, published their results on August 15, 2018, in the journal Science Advances. The National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health funded the research.

Hydrogel: watery nets

Hydrogels often start out as water-based solutions of molecular components that resemble crosses, and other components that make the ends of the crosses attach to each other. When the components come together, they fuse into molecular nets suspended in water, resulting in a material with the consistency of a gel.

If stem cells or a drug are mixed into the solution, when the net, or matrix, forms, it ensnares the treatment for delivery and protects the payload from death or dissipation in the body. Researchers can easily and reliably synthesize hydrogels and also custom-engineer them by tweaking their components, as the Georgia Tech researchers did in this hydrogel.

“It physically traps the muscle satellite cells in a net, but the cells also grab onto chemical latches we engineered into the net,” Han said.

This hydrogel’s added latches, which bond with proteins protruding from stem cells’ membranes, not only increase the cells’ adhesion to the net but also hinder them from committing suicide. Stem cells tend to kill themselves when they’re detached and free-floating.

The chemical components and the cells are mixed in solution then applied to the injured muscle, where the mixture sets to a matrix-gel patch that glues the stem cells in place. The gel is biocompatible and biodegradable.

“The stem cells keep multiplying and thriving in the gel after it is applied,” Jang said. “Then the hydrogel degrades and leaves behind the cells engrafted onto muscle tissue the way natural stem cells usually would be.”

Stem cell breakdown

In younger, healthier patients, muscle satellite cells are part of the natural healing mechanism.

“Muscle satellite cells are resident stem cells in your skeletal muscles. They live on muscle strands like specks, and they’re key players in making new muscle tissue,” Han said.

“As we age, we lose muscle mass, and the number of satellite cells also decreases. The ones that are left get weaker. It’s a double whammy,” Jang said. “At a very advanced age, a patient stops regenerating muscle altogether.”

“With this system we engineered, we think we can introduce donor cells to enhance the repair mechanism in injured older patients,” Han said. “We also want to get this to work in patients with Duchene muscular dystrophy.”

“Duchene muscular dystrophy is surprisingly frequent,” Jang said. “About 1 in 3,500 boys get it. They eventually get respiratory defects that lead to death, so we hope to be able to use this to rebuild their diaphragm muscles.”

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Many Americans not being assessed for depression

(HealthDay)—Many Americans aged 35 and older are not being assessed for depression, according to a study recently published in the Journal of the American Board of Family Medicine.

Elisabeth Kato, M.D., from the Agedncy for Healthcare Research and Quality in Rockville, Md., and colleagues used a nationally representative survey to evaluate whether adults aged 35+ were being assessed for depression by their health care providers in 2014 and 2015. The health and sociodemographic characteristics of patients associated with depression assessment were examined.

The researchers found that 48.6 percent of U.S adults aged 35+ were being assessed for depression. The likelihood of being assessed was lower for men versus women, adults 75+ versus adults aged 50 to 64 years, uninsured versus those with private insurance, and adults without recognized depressive symptoms versus those with recognized symptoms (odds ratios, 0.58, 0.47, 0.30, and 0.39, respectively). The likelihood of being assessed was lower for Asians, Hispanics, and African-Americans versus non-Hispanic whites (odds ratios, 0.35, 0.47, and 0.42, respectively).

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Three scientists share $500,000 prize for work on cancer therapy

Tumors once considered untreatable have disappeared and people previously given months to live are surviving for decades thanks to new therapies emerging from the work of three scientists chosen to receive a $500,000 medical prize.

The recipients of the annual Albany Medical Center Prize in Medicine and Biomedical Research, announced Wednesday, are being recognized for their studies of the immune system that have led to innovative treatments for cancer, HIV and other diseases.

They are James Allison of the University of Texas MD Anderson Cancer Center; Dr. Carl June of the Perelman School of Medicine, University of Pennsylvania; and Dr. Steven Rosenberg of the National Cancer Institute. They’ll receive the award at a ceremony Sept. 26 in Albany, New York.

“Their research has given hope to many who otherwise faced a certain death sentence, and has inspired the work of hundreds of other researchers to investigate new pathways for treatment,” said Dr. Vincent Verdile, dean of Albany Medical College. “Their impact on the development of cancer immunotherapy – and where it goes from here – is unsurpassed.”

Immunotherapy harnesses the power of the immune system to attack cancer cells and tumors. In the 1980s, Rosenberg theorized that stimulating white blood cells called T cells could provoke immune reactions. His work led to the first immunotherapy drug approved by the U.S. Food and Drug Administration to treat cancer in 1992.

Former President Jimmy Carter credited the new immune therapy drug Keytruda with shrinking his brain tumors in 2015. The drug, developed using an approach pioneered by Allison, is among a new class of genetically engineered antibody-based medicines that are transforming treatment for several kinds of cancer with drugs that are often less toxic than chemotherapy.

June has led groundbreaking work in developing CAR-T cell therapies, which alter a patient’s own blood cells to turn them into specialized cancer killers. CAR-T therapy became the first FDA-approved personalized cellular therapy for cancer in 2017 with the approval of Kymriah to treat certain pediatric and young adult leukemia patients.


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New research suggests it’s all about the bass

When we listen to music, we often tap our feet or bob our head along to the beat – but why do we do it? New research led by Western Sydney University’s MARCS Institute suggests the reason could be related to the way our brain processes low-frequency sounds.

The study, published in PNAS, recorded the electrical activity of volunteers’ brains while they listened to rhythmic patterns played at either low or high-pitched tones. The study found that while listening, volunteer’s brain activities and the rhythmic structure of the sound became synchronized – particularly at the frequency of the beat.

Co-author of the paper, Dr. Sylvie Nozaradan from the MARCS Institute, say these findings strongly suggest that the bass exploits a neurophysiological mechanism in the brain – essentially forcing it to lock onto the beat.

“There is mounting evidence supporting the hypothesis that selective synchronization of large pools of neurons of the brain to the beat frequency may support perception and movement to the musical beat,” says Dr. Nozaradan.

While this research is an important step in answering the mystery of why we “dance to the beat of the drum,” according to co-author Dr. Peter Keller from the MARCS Institute, these findings could also prove important in clinical rehabilitation.

“Music is increasingly being used in clinical rehabilitation of cognitive and motor disorders caused by brain damage and these findings, and a better understanding of the relationship between music and movement, could help develop such treatments,” says Dr. Keller.

The research team – also comprising of co-authors Dr. Manuel Varlet and Tomas Lenc – suggests that while this research is an important step in understanding the relationship between bass and movement, there are still many open questions about the mechanisms behind this phenomenon.

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Overall stroke death rates decline in Europe but level off or increase in some countries

New research, published in the European Heart Journal today, has shown deaths from conditions that affect the blood supply to the brain, such as stroke, are declining overall in Europe but that in some countries the decline is levelling off or death rates are even increasing.

Cerebrovascular disease includes strokes, mini-strokes, and narrowing, blockage or rupturing of the blood vessels supplying blood to the brain, and it is the second single largest cause of death in Europe after heart disease, accounting for 9% of deaths in men and 12% of deaths in women each year.

The EHJ study used data from the World Health Organization (WHO) to examine mortality trends in three particular types of cerebrovascular disease in Europe for 37 years between 1980 and 2016: ischaemic stroke (a lack of blood flow to the brain), haemorrhagic stroke (bleeding in the brain) and sub-arachnoid haemorrhage (SAH), in which bleeding occurs between the brain and the surrounding membrane. Not all countries had data available for the full 37 years.

The researchers, led by Dr. Nick Townsend, associate professor in public health epidemiology at the University of Bath (UK), found that across the whole of the WHO European region for the most recent period for which data were available, there had been significant decreases in death rates from all three types of cerebrovascular disease in 33 (65%) countries for men and women. However, there had been increases in three countries (6%) for men (Azerbaijan, Georgia and Tajikistan) and in two countries (4%) for women (Azerbaijan and Uzbekistan).

There was evidence of a recent plateau in trends (where the rate of reductions in mortality in the most recent period was less pronounced than in the previous period) in seven countries in men (Austria, Denmark, France, Germany, Greece, Czech Republic and Hungary) and six countries in women (Austria, Belgium, France, Germany, Ireland and Switzerland). There were also a number of countries (eight in men and ten in women) in which death rates showed no change over the most recent period. This means that in both sexes, more than one third of countries showed either a slowing of the decrease in death rates, no decrease, or an increase in the most recent trend.

Age-standardised mortality rates from stroke, which adjust to take account of differences in population size and age structure, were higher in men than in women for all countries. For stroke, they were much lower in western Europe than the rest of the continent. In men, death rates in western Europe ranged from 49 per 100,000 of the population in France to 131 per 100,000 in San Marino. In central Europe, male death rates ranged from 110 per 100,000 in the Czech Republic to 391 per 100,000 in Bulgaria. In eastern Europe, male death rates ranged from 82 in Estonia to 331 in Russia per 100,000. In central Asia, they ranged from 152 in Armenia to 345 in Azerbaijan per 100,000. In the UK, the death rate was 68 per 100,000 in men and 65 per 100,000 in women.

When the researchers looked at each of the three types of stroke individually, data were only available by stroke subtype for 43 countries; most of the countries with missing data were in eastern Europe and central Asia. Over the whole period since 1980, more than half of countries with available data had significant decreases in age-standardised death rates from ischaemic stroke (56% of countries in men and 51% in women) and haemorrhagic stroke (58% and 67% of countries respectively). However, eight countries (19%) had increases in death rates from ischaemic stroke among men and nine countries (21%) in women, compared to none for haemorrhagic stroke. Although significant decreases in death rates from SAH occurred in 56% of countries for men they only did so in 42% of countries in women. Two countries (5%) showed increases in SAH among men and four countries (9%) did so for women.

“When we looked at the type of stroke and for the most recent period for which data were available, the trends could be quite different,” said Dr. Townsend. “This shows that considering all cerebrovascular disease over the whole period hides a lot of the story. In the most recent period, there were increases in ischaemic stroke in eight countries among men and nine for women, increases in haemorrhagic stroke in three countries in men and one for women, and increases in SAH in five countries for men and eight countries for women.”

He continued: “Over the last 35 years there have been large overall declines in deaths from cerebrovascular disease in the majority of European countries. While these declines have continued in more than half of the countries, these have not been consistent across Europe and our analysis has revealed evidence of recent plateauing and even increases in stroke deaths in certain countries. We have seen this in both sexes and in countries across the whole of Europe, particularly in eastern and central Europe and central Asia. We have also found differences in death rates by stroke type. Therefore, it is not enough to consider cerebrovascular disease as just one condition and we must consider each individual stroke type.

“Our findings highlight a need to counter inequalities by understanding local contexts in disease occurrence and treatment. In particular, we need to encourage the implementation of evidence-based recommendations in the prevention and treatment of stroke in all countries. Many countries have been able to reduce the mortality burden from stroke in recent years. We must understand why this is not happening in all countries and identify barriers to the implementation of evidence-based recommended practice in countries that are slow to adopt them. In addition, we only studied between-country inequalities, but we must consider within-country inequalities as well if we are to have an impact on the disease.”

The researchers say that SAH amongst women was the only type of stroke for which more countries demonstrated plateauing or increasing trends than decreases in recent years. A less pronounced decrease, no significant change, or a significant increase in death rates from SAH, was found in 25 countries for women.

“General risk factors for SAH include familial predisposition and disorders of the blood vessels, leading to aneurysms. Smoking, hypertension and heavy drinking have also been found to be significant risk factors, as with other stroke types and cardiovascular disease,” said Dr. Townsend. “Interestingly, when we compare mortality from stroke sub-type by age we find that death from SAH is more common at younger ages. In the UK, for example, around 60% of deaths from SAH in women occur before the aged of 75, commonly termed premature. This is much lower in cerebral haemorrhage, which is closer to 25%, and lower still in ischaemic haemorrhage, which is around 15%. Despite SAH being much less common than the other stroke subtypes, this greater mortality at younger age groups need further investigation and intervention.”

Although this study did not look at the reason behind these changes, he said it was unlikely that there was a single reason for the overall decline in cerebrovascular disease. Improvements in treating the disease, including new drugs and improved surgical techniques, played a role, as did prevention strategies that encouraged people to improve their lifestyles by stopping smoking, drinking less alcohol, improving their diet and taking more physical exercise. Possible reasons why the trends towards lower death rates might be levelling off or even increasing in some countries could include the increasing prevalence of obesity, diabetes and higher cholesterol levels in recent years.

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Completing sepsis bundle within an hour cuts pediatric mortality

(HealthDay)—Completion of a one-hour sepsis bundle within one hour cuts mortality in pediatric patients, according to a study published in the July 24/31 issue of the Journal of the American Medical Association.

Idris V.R. Evans, M.D., from the University of Pittsburgh, and colleagues assessed whether completing the pediatric sepsis bundle elements (blood cultures, broad-spectrum antibiotics, and at least one 20-mL/kg bolus of intravenous fluid) within one hour improves outcomes. The analysis included 1,179 patients (mean age, 7.2 years) with sepsis and septic shock reported to the New York State Department of Health who had a sepsis protocol initiated.

The researchers found that the entire sepsis bundle was completed in one hour in just about one-quarter of patients (24.9 percent). Within the one-hour timeframe, antibiotics were administered to 67.7 percent of patients, blood cultures to 62.8 percent, and the fluid bolus to 46.5 percent. Completing the entire bundle within one hour was associated with a lower risk of in-hospital mortality (odds ratio [OR], 0.59; 95 percent confidence interval [CI], 0.38 to 0.93; P = 0.02). However, there was not a significant lower risk-adjusted mortality associated with completing each element in the bundle within an hour (blood culture: OR, 0.73 [95 percent CI, 0.51 to 1.06; P = 0.10]; antibiotics: OR, 0.78 [95 percent CI, 0.55 to 1.12; P = 0.18]; and fluid bolus: OR, 0.88 [95 percent CI, 0.56 to 1.37; P = 0.56]).

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One antiplatelet drug after heart valve replacement

Current treatment guidelines say patients who undergo minimally invasive aortic heart valve replacements should receive two antiplatelet drugs to reduce the risk of dangerous blood clots.

A new Loyola Medicine study has found that giving patients a single antiplatelet drug may work as well as giving two drugs, with significantly lower risks of life-threatening bleeding and other complications.

The meta-analysis by senior author Verghese Mathew, MD, and colleagues is published in the July, 2018 issue of the American Journal of Cardiology (published online March 28). Dr. Mathew, an internationally known interventional cardiologist, is chair of Loyola’s division of cardiology.

The aortic valve regulates blood flow from the left ventricle (the heart’s main pumping chamber) to the aorta (the body’s largest artery). Narrowing of the aortic valve, known as aortic stenosis, can cause fatigue, chest pain and other symptoms and lead to heart failure and death.

Replacing a diseased aortic valve traditionally required open heart surgery. Since 2011, a minimally invasive technique to implant an artificial valve with a catheter has been commercially available in the United States. The technique is called transcatheter aortic valve replacement (TAVR). The catheter typically is inserted into an artery in the groin and guided up to the heart, where the valve is deployed.

To reduce the risk of clots that may form on the new valve, cardiologists prescribe antiplatelet drugs. Such medications stop blood cells called platelets from sticking together and forming clots, which can cause heart attacks and strokes. Among the most commonly used antiplatelets are aspirin and clopidogrel (Plavix).

Current guidelines recommend TAVR patients receive two antiplatelets, known as dual-antiplatelet therapy. However, treatments vary. Some cardiologists prescribe just one antiplatelet, known as mono-antiplatelet therapy. Mono-antiplatelet therapy usually is prescribed in certain patients if there’s an increased concern of bleeding from using two drugs.

In the new study, Dr. Mathew and colleagues pooled results of eight previous studies that compared mono-antiplatelet therapy to dual-antiplatelet therapy. The studies included 2,439 patients. In four studies, patients received the Sapien aortic valve. In two studies, they received the CoreValve device. In two studies, both valves were used.

At 30 days, patients who received two antiplatelet agents were 2.06 times more likely to die, 2.04 times more likely to have major or life-threatening bleeding and 2.15 times more likely to have major vascular complications. But there were no statistically significant differences between the single-drug and dual-drug groups in stroke, heart attack or transient ischemic attack (mini stroke).

“These data suggest a safety concern with dual-antiplatelet therapy and underscore the need for a large randomized trial to definitely address this question,” Dr. Mathew and colleagues wrote.

The study did not include TAVR patients who required anticoagulants such as warfarin (Coumadin) or newer direct oral anticoagulants (DOACS) for other indications that increase the risk of blood clots, such as atrial fibrillation. In such cases, adding antiplatelet drugs increases the risk of bleeding.

Numerous ongoing prospective studies are designed to determine which regimen achieves the best balance between clotting risk and bleeding risk after TAVR.

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Aretha Franklin's Death Is 'Imminent' as Source Confirms 'She Has Been Ill for a Long Time'

Aretha Franklin—who has previously struggled with her health—is very sick and her death is “imminent,” PEOPLE confirms.

“She has been ill for a long time,” a longtime friend tells PEOPLE. “She did not want people to know and she didn’t make it public.”

A source close to the singer spoke to the Associated Press on Monday to confirm that Franklin is “seriously ill,” although they did not provide any additional details as to the severity or the cause of the 76-year-old singer’s illness.

Showbiz 411 reporter Roger Friedman was first to report the singer is “gravely ill,” sharing that Franklin’s family are “asking for prayers and privacy.”

The Queen of Soul’s family also told Local 4 in Detroit that Franklin is “gravely ill.”

“I am so saddened to report that the Queen of Soul and my good friend, Aretha Franklin is gravely ill,” wrote Detroit news anchor Evrod Cassimy. “I spoke with her family members this evening. She is asking for your prayers at this time. I’ll have more details as I’m allowed to release.”

He revealed Monday that Franklin is alert and speaking, tweeting, “Just got a chance to speak to Aretha Franklin. She is resting and surrounded by close friends and family.”

According to another source close to Franklin, those in the singer’s circle were told two weeks ago that “she could go any time” and that her weight was down to 85 lbs., TMZ reported.

Another source also told the outlet that Franklin has been battling cancer, a rumor that has existed for many years, which the singer has previously chosen not to address. “I am not going to even deal with that,” Franklin previously told JET.

Ahead of scheduled concerts in March and April of this year, the singer was forced to cancel the performances under doctor’s orders.

“Aretha Franklin has been ordered by her doctor to stay off the road and rest completely for at least the next two months,” Franklin’s management said in a statement at the time. She is expected to release her next album, entitled A Brand New Me, in November.

Franklin previously announced in February of 2017 that she was retiring from music. “I will be recording, but this will be my last year in concert. This is it,” she told a Detroit TV station, before admitting that she would still take the stage at “some select things.”

Despite her failing health in recent years, Franklin returned to the stage last August for a performance at the Mann Center in Philadelphia, despite noticeable changes in her appearance that caused concern about her well-being. She also sang at the Elton John AIDS Foundation’s Enduring Vision benefit gala in November 2017.

In April 2011, Franklin sat down for an interview with PEOPLE just months after being hospitalized for an unspecified operation. Though she strongly denied having bariatric surgery, the singer — who had lost 85 lbs. at the time— did not directly address the rumors that she had cancer.

“I feel fabulous, really,” she told PEOPLE. “And I’m so thankful to all of the people who said a little prayer for me. People at the check out line in the market were telling me that they prayed for me. It’s amazing how beautiful people can be.”

On Dec. 1, 2010, a vigil was held in Franklin’s hometown of Detroit after it had been announced she was headed to the hospital for unspecified surgery. Only the night before, Franklin was nominated for another Grammy, this time for her duet with Ron Isley, “You’ve Got a Friend.”

By the middle of that month, as news spread from family members that she was suffering from pancreatic cancer, Franklin was recovering at home, and saying she was up and about — and feeling better, too. In January 2011, the Queen went so far as to pronounce the matter resolved.

Franklin also canceled six months of tour dates and personal appearances in November 2010, under doctor’s orders — a sudden announcement that both disappointed and worried her fans, who could see she was not in the best of health.

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