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Hormonal contraceptives taken by adolescents may influence development of the brain in a way that alters the recognition of risks, a new study in rats suggests.
Scientists at The Ohio State University are exploring how common synthetic hormones used for birth control affect the prefrontal cortex, an area of the brain that continues to develop throughout adolescence.
The researchers found that myelination, the formation of protective coating on axons projecting from the main body of brain cells, increased in rats given hormonal birth control compared to untreated rats, while the number of immune cells of the brain decreased. In behavior tests, the treated rats also showed signs of impulsivity.
"We start the rats on hormonal contraceptives as soon as they go through puberty and give them throughout adolescence, and then do behavioral tasks at the cusp of adulthood," said Benedetta Leuner, co-senior author of the study and associate professor of psychology at Ohio State. "By the end of adolescence, impulsivity shouldn't be as much of a thing, but that doesn't seem to be the case -- which, while highly speculative, suggests hormonal contraceptives might be stalling brain maturation."
In addition, the study was the first to detect synthetic forms of these hormones in adolescent rats' brain tissue.
"We now know that these synthetic hormones are actually getting to the brain, which is important. No one had ever shown that in adolescence," Leuner said.
The study was presented in a poster session today (Nov. 12, 2023) at Neuroscience 2023, the annual meeting of the Society for Neuroscience.
An estimated 2 in 5 teenage girls in the United States have sexual intercourse between age 15 and 19. Among those using birth control, almost 5% use hormonal contraceptives -- products that are also prescribed to treat acne and heavy periods.
Ohio State behavioral neuroscientists say it's important to understand hormonal birth control's effects on the developing brain so individuals can weigh the risks and benefits of their reproductive health choices.
The researchers gave a combination of synthetic estrogen and progesterone typically found in hormonal contraceptives to female rats from early to late adolescence and compared their behavior and brain tissue to untreated rats.
The study focused on myelination and immune cells called microglia because both have essential roles in prefrontal cortex development -- and communication between cells in particular -- that are controlled in part by natural hormones. Myelination facilitates signal transfer between cells, and microglia play a critical role in sculpting brain circuits.
Because synthetic hormones in contraceptives dampen ovaries' production of natural estrogen and progesterone to prevent ovulation, the research team is looking at how those hormonal differences affect the brain while it is still developing.
"Synaptic development and myelination are occurring during this adolescent window and are sensitive to pubertal onset of hormones," said co-senior author Kathryn Lenz, associate professor of psychology at Ohio State. "So we thought that disturbance of that normal pubertal hormonal activity could potentially shift the trajectory of some of those developmental processes."
When it comes to nervous system communication, keeping it steady is key -- too much or too little can lead to dysfunction that affects the mood and behavior. The finding that myelination increased and microglia decreased with hormonal contraception hints at disrupted communication, Lenz said -- especially since other research teams have suggested that microglia regulate myelination.
"Shifts in either one or the other direction for both is really important to document and understand," she said.
In behavior tests of threat appraisal, the rats given hormonal contraceptives were more likely than controls to remain in wide open elevated spaces and sample treats in unfamiliar settings -- both considered risk-taking behavior.
A sensitive lab technique called liquid chromatography/mass spectrometry confirmed that the synthetic ethinyl estradiol and levonorgestrel given to the treated rats were present in brain tissue -- a powerful piece of evidence that will guide future research.
"We don't know if these effects are due to shutting down natural hormone production or if these synthetic hormones are acting directly in the brain," Leuner said. "That's a very big, open question."
This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
First author Rachel Gilfarb, a graduate student in Leuner's lab, presented the poster. Additional co-authors include Sanjana Ranade, Meredith Stewart, Abhishek Rajesh and Courtney Dye.
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As flu season looms, the virus may not only leave people vulnerable to pneumonia, fever and body aches — but it may also increase the risk of heart attack, according to several past studies.
Those who had the flu were six times more likely to experience a heart attack a week after testing positive compared to the year before or after, according to a group of researchers from the Netherlands who presented their findings last spring at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) meeting in Copenhagen.
As the American Heart Association (AHA) stated on its website, one report showed a spike in cardiovascular-related deaths and influenza epidemics that occurred around the same time.
Yet another study published in 2020 found that in more than 80,000 U.S. adults who were hospitalized with the flu from 2010 to 2018, one in eight patients had sudden, serious heart complications.
"Several studies have demonstrated that there is a higher incidence of serious heart disease and heart attacks after a person has had the flu," Dr. Aaron E. Glatt, chair of the Department of Medicine and chief of infectious diseases at Mount Sinai South Nassau in Long Island, New York, told Fox News Digital.
"While the mechanism is not fully clear, it may represent an inflammatory response against the influenza virus, which can result in serious consequences — another very good reason that flu vaccination is strongly recommended for adults," Glatt added.
When someone has the flu, it creates an added stressor on the body, Dr. Frederick Davis, the associate chair of emergency medicine at Northwell Health Long Island Jewish Medical Center in New Hyde Park, New York, told Fox News Digital.
"During the infection, it can lead to elevated temperatures as well as an elevated heart rate, which causes your heart to work harder," he said.
"This added stress has been found to lead to an increase in cardiac complications after infection with the flu, with increases in heart attacks and congestive heart failure exacerbations," Davis went on.
"This is especially a concern in someone who is older or has underlying cardiac disease."
When a person gets the flu, the body has an inflammatory response to fight off the virus, health experts said.
This can potentially create blood clots, increased blood pressure, and sometimes swelling or scarring of the heart, medical experts from UCLA explained on the university’s website.
This can then create additional risks for those with a history of cardiovascular issues.
"If you have heart disease, fatty deposits called plaque build up in your arteries," the UCLA website states. "The added stress of a virus can cause the plaque to rupture, resulting in heart attack or stroke."
A previous report published by the AHA noted that the flu could play a role in plaque ruptures causing heart attacks.
The 2021 report, published in the Journal of the American Heart Association, also said that getting a flu vaccine could reduce the risk of a common type of heart attack in people age 60 and older.
Davis told Fox News Digital that when a person is recovering from the flu, it is important to be aware of some signs that the heart may be affected.
"Shortness of breath with minimal exertion might present after other viral symptoms have improved," Davis said.
The AHA and American College of Cardiology recommend getting the influenza vaccine to help prevent cardiovascular disease complications due to the virus, especially in people who have coronary or other atherosclerotic vascular diseases.
The Centers for Disease Control and Prevention (CDC) recommends a flu shot for everyone aged 6 months and older.
Flu season peaks between December and February, although it can extend into the spring, the CDC said on its website. | Epidemics & Outbreaks |
The racial disparities in metastatic triple-negative breast cancer are sobering. Research shows Black women have nearly three times the risk of getting it. They're also 28% more likely to die from the disease.Â
âThereâs an urgent need for clinical research surrounding racial disparities and metastatic disease,â says Ricki Fairley, CEO and co-founder of TOUCH, The Black Breast Cancer Alliance. Fairley is also a survivor of metastatic triple-negative breast cancer. âWe know Black women are more likely to develop this form of breast cancer, but we donât know why. When they do develop the disease, there are very few treatments available for them.âÂ
Most often, treatment is usually chemotherapy or immunotherapy. Doctors will use several systemic treatments until the disease gets worse or there is an unacceptable toxicity that puts the personâs overall health at risk.Â
 Additionally, triple-negative breast cancer itself makes up only about 10% to 15% of all breast cancers.Â
âItâs such a small number that drug companies arenât focused on that audience when they can develop drugs for the other 90% of breast cancer patients.âÂ
In addition, Black metastatic breast cancer patients only represent about 3% of people in clinical trials.Â
âAs a result, we donât know or even have a good sense of how well these drugs work in Black women,â says Marya Shegog, PhD, health equity and diversity director for the Lazarex Cancer Foundation in Danville, CA. âBut that information is crucial if we are going to make a dent in these racial disparities.â
What Might Be Some Reasons Black Women Are More at Risk?
âAnecdotally, we do know they do tend to be diagnosed with the condition later,â says Fairley. She recalls one 38-year-old Black women who went to her doctor with a breast lump. Her doctor dismissed her concerns for 2 years, until her first mammogram at age 40 revealed stage III triple-negative metastatic breast cancer. âShe ended up dying, and if her cancer had been caught 2 years earlier, that might not have happened,â says Fairley.
But more research needs to be done into the genetic reasons why Black women are at higher risk for triple-negative breast cancer, says Fairley. The International Center for the Study of Breast Cancer Subtypes (ICSBCS) at New York-Presbyterian/Weill Cornell Medical Center in New York City is currently conducting a study. That research has shown that triple-negative breast cancer is associated with African ancestry, particularly Western Sub-Saharan African ancestry.Â
One theory is that this is due to a mutation in ACKR1. About 70% of Americans with West African ancestry carry a mutation in the ACKR1 gene, which protects them against malaria. But it also may make Black women with this ancestry more likely to have cellular changes that can cause aggressive triple-negative breast cancer, says Fairley.Â
A 2022 study took triple-negative breast cancer cells from Black and white women, then grew them in a laboratory setting. They found that the cells from Black women grew more quickly, and when they were placed into mice, they grew into new tumors faster and spread more quickly.Â
âWhen we analyzed these cells, we found that two genes, GLI1 and Notch1, were more active in cells that came from African American women,â says study author Dipali Sharma, PhD, a professor of oncology at the Johns Hopkins University School of Medicine in Baltimore.Â
Sheâs currently studying using several experimental inhibitors for each of these two genes with various chemotherapies.Â
âEventually, hopefully weâll be able to find one that works well, and test it in patients,â she says. âOur hope is that this research can lead the way to close the survival gap between Black and white women with triple-negative breast cancer, particularly metastatic triple-negative breast cancer.â
Â
Clinical Trials for Metastatic Triple-Negative Breast Cancer
There is also some promising research on treatments for metastatic triple-negative breast cancer. They include:
Sacituzumab govitecan-hziy (Trodelvy) + pembrolizumab (Keytruda). Sacituzumab govitecan-hziy is approved as a second-line treatment for women with metastatic triple-negative breast cancer. Researchers are studying whether it can be used along with pembrolizumab as a first-line treatment for women with locally advanced or metastatic triple-negative breast cancer. Sacituzumab govitecan-hziy targets cancer-expressing cells, while pembrolizumab stimulates the immune system. The thought is that people given this combination will have a better response, says Oluchi Oke, MD, an assistant professor in the Department of Breast Medical Oncology at the University of Texas MD Anderson Cancer Center.
Enhertu. This drug is being studied for HER2-low breast cancer. Recent research has found that it cuts the risk of disease progression or death by 50%, and the risk of death by 36%, compared with chemotherapy. The hope is that it will soon be studied â and have similar effects â in those with triple-negative breast cancer, says Dorraya El-Ashry, PhD, chief scientific officer of the Breast Cancer Research Foundation.Â
ARTEMIS. This is a novel clinical trial at MD Anderson Cancer Center that develops personalized therapies for women with triple-negative breast cancer. âWe know that half of triple-negative breast cancer patients go into remission with standard chemotherapies,â says Oke. âBut about half donât, and they may go on to develop metastatic breast cancer. So we are using different immunotherapies and targeted therapies on them, to see if any help.â
Barriers to Clinical Trials
Unfortunately, while these trials are all promising, there are many barriers, says Oke.Â
âIn general, weâve seen a decrease in enrollment in clinical trials among African American patients across the board,â she says. But there are a few barriers for clinical trials on metastatic triple-negative breast cancer in particular:
Implicit bias. âDoctors do not invite black women into trials. They assume that since a woman is a single mom, she wonât comply or drop off, or she wonât have transportation to get there,â says Fairley. A survey by the Metastatic Breast Cancer Alliance, for example, found that while 80% of Black patients with metastatic breast cancer said they would consider joining a clinical trial, only 40% were offered the chance.Â
Medical mistrust. âEvery day, I speak to Black women with metastatic breast cancer who have a fear of the unknown, and that includes clinical trials,â says Fairley. âThey donât trust doctors, or researchers, or scientists. But once I explain to them what a clinical trial is, and how there are standards of care and no one gets a sugar pill and dies, they are much more willing to sign up.â
Poor marketing. âMedical researchers still donât recruit in minority or poorer communities,â says Fairley. âDrug companies themselves also donât know how to reach out to them. If you look at commercials for some of the breast cancer drugs, for example, there are images of beautiful white women sailing on boats or playing golf. That is not the life of a Black woman. They need to see women who look like them getting a certain drug.â
âI tell every Black woman with metastatic triple-negative breast cancer that her best option is to get involved in a clinical trial,â says Fairley.Â
But it can be daunting to look for one on your own. One of the best ways to find one is to reach out to TOUCH, which has a wide array of resources for Black breast cancer patients. They also have a clinical trial locator at Search Clinical Trials | When We Trial. Other resources include:
BreastCancerTrials.orgÂ
Triple Negative Breast Cancer Foundation
Metastatic Breast Cancer Alliance
Show Sources
Photo Credit: KTSDesign / SCIENCEPHOTOLIBRARY / Getty Images
SOURCES:
Ricki Fairley, CEO and co-founder of TOUCH, The Black Breast Cancer Alliance.
Dipali Sharma, PhD, professor of oncology, Johns Hopkins University School of Medicine, Baltimore.
Oluchi Oke, MD, assistant professor, Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston.
Dorraya El-Ashry, PhD, chief scientific officer, Breast Cancer Research Foundation.
Marya Shegog, PhD, health equity and diversity director, Lazarex Cancer Foundation, Danville, CA.
Cancer Medicine: âRelationship of Established Risk Factors with Breast Cancer Subtypes.âÂ
JAMA Oncology: âEvaluation of Racial/Ethnic Differences in Treatment and Mortality Among Women with Triple-Negative Breast Cancer.âÂ
American Cancer Society: âTriple Negative Breast Cancer.âÂ
Breast Cancer Research Foundation: âASCO 2022 Metastatic Breast Cancer Research Update.âÂ
University of Illinois Cancer Center: âIs an Anti-Malaria Gene Tied to Triple-Negative Breast Cancer?âÂ
eLife: âConcomitant Activation of GLI1 and Notch1 Contributes to Racial Disparity of Human Triple Negative Breast Cancer Progression.âÂ
Gilead Pharmaceuticals: âGilead Announces Clinical Trial Collaboration with Merck to Evaluate Trodelvy in Combination with KEYTRUDA.âÂ
Metastatic Breast Cancer Alliance: âBECOME: Black Experience of Clinical Trials and Opportunities for Meaningful Engagement.â | Disease Research |
A seventh person has been diagnosed with a locally acquired case of malaria in Florida's Sarasota County, state health officials reported this week.The rare outbreak is now in its third month after authorities in the Sunshine State reported the first case in May. When Florida had identified four cases by late June, the Centers for Disease Control and Prevention released a health alert to clinicians calling locally acquired malaria cases in the US a "public health emergency."
Florida's outbreak and a single, unrelated case in Texas from June collectively mark the first time in two decades that the US has seen locally acquired malaria cases, which, if left untreated, can be deadly. In the last instance, in 2003, Florida officials reported a small outbreak of at least seven people in Palm Beach.
The US usually sees around 2,000 malaria cases each year, usually all in people who had recently traveled from areas where the mosquito-borne pathogen is endemic. Outbreaks are uncommon but usually limited in scope. The mosquitoes that transmit malaria parasites, in the Anopheles genus, are typically evening and nighttime biters. Transmission is significantly hindered by people having screened windows and air conditioning. Thus, outbreaks in the US tend to fizzle out.
But, the Florida outbreak appears to be stubbornly hard to smack down. The Sarasota area has been under a mosquito-borne illness alert since June 19. In the last week of June, the area reported two new cases, bringing the total at the time to six. In the first week of July, there were no new cases, offering hope that the applications of insecticide by aircraft, vehicles, and crews had successfully knocked out the parasite's spread. But, this week, authorities identified a new case.
According to the Sarasota Herald-Tribune, authorities began investigating the new case last Thursday, and testing by the CDC has since confirmed the infection. So far, all of the cases have been in the Desoto Acres and Kensington Park areas in north Sarasota County, according to Wade Brennan, the manager of Sarasota County Mosquito Management Services. Brennan told reporters Tuesday night that "We still need everybody to be diligent about avoiding mosquito bites."The mosquito management officials have been trapping mosquitoes and sending them off for testing at the CDC. Of the 130 or so tested so far, three mosquitoes have been positive for the malaria parasite Plasmodium vivax, but those were all from early in the outbreak. No mosquitoes have tested positive since June 5, officials said.
P. vivax causes a relatively milder type of malaria than some other Plasmodium species, namely P. falciparum, the deadliest cause of the disease that is concentrated in some African countries. However, P. vivax is known for going dormant in the liver, leading to chronic and relapsing disease if left untreated. People infected are typically given an intravenous antimalarial treatment for several days to kill the parasite in the blood and then a longer oral course to kill parasites in the liver.
Dr. Manuel Gordillo, an infectious disease specialist at Sarasota Memorial Hospital, told NBC News that some of the local cases have required more extensive treatment.
“They are dehydrated, some of them. They have low blood counts, especially platelets, which puts them at risk for bleeding. Some of them have had renal kidney failure, which is one of the complications of malaria,” Gordillo said.
State health officials did not immediately respond to Ars' request for more information about the cases and the state of the outbreak. | Epidemics & Outbreaks |
Choosing exoskeleton settings like a Pandora radio station
Using a simple and convenient touchscreen interface, the algorithm learns the assistance preferences of the wearer
Taking inspiration from music streaming services, a team of engineers at the University of Michigan, Google and Georgia Tech has designed the simplest way for users to program their own exoskeleton assistance settings.
Of course, what’s simple for the users is more complex underneath, as a machine learning algorithm repeatedly offers pairs of assistance profiles that are most likely to be comfortable for the wearer. The user then selects one of these two, and the predictor offers another assistance profile that it believes might be better. This approach enables users to set the exoskeleton assistance based on their preferences using a very simple interface, conducive to implementing on a smartwatch or phone.
“It’s essentially like Pandora music,” said Elliott Rouse, U-M associate professor of robotics and mechanical engineering and corresponding author of the study in Science Robotics. “You give it feedback, a thumbs up or thumbs down, and it curates a radio station based on your feedback. This is a similar idea, but it’s with exoskeleton assistance settings. In both cases, we are creating a model of the user’s preferences and using this model to optimize the user’s experience.”
The team tested the approach with 14 participants, each wearing a pair of ankle exoskeletons as they walked at a steady pace of about 2.3 miles per hour. The volunteers could take as much time as they wanted between choices, although they were limited to 50 choices. Most participants were choosing the same assistance profile repeatedly by the 45th decision.
After 50 rounds, the experimental team began testing the users to see whether the final assistance profile was truly the best—pairing it against 10 randomly generated (but plausible) profiles. On average, participants chose the settings suggested by the algorithm about nine out of 10 times, which highlights the accuracy of the proposed approach.
“By using clever algorithms and a touch of AI, our system figures out what users want with easy yes-or-no questions,” said Ung Hee Lee, a recent U-M doctoral graduate from mechanical engineering and first author of the study, now at the robotics company Nuro. “I’m excited that this approach will make wearable robots comfortable and easy to use, bringing them closer to becoming a normal part of our day-to-day life.”
The control algorithm manages four exoskeleton settings: how much assistance to give (peak torque), how long to go between peaks (timing), and how the exoskeleton both ramps up and reduces the assistance on either side of each peak. This assistance approach is based on how our calf muscle adds force to propel us forward in each step.
Rouse reports that few groups are enabling users to set their own exoskeleton settings.
“In most cases, controllers are tuned based on biomechanical or physiological results. The researchers are adjusting the settings on their laptops, minimizing the user’s metabolic rate. Right now, that’s the gold standard for exoskeleton assessment and control,” Rouse said.
“I think our field overemphasizes testing with metabolic rate. People are actually very insensitive to changes in their own metabolic rate, so we’re developing exoskeletons to do something that people can’t actually perceive.”
In contrast, user preference approaches not only focus on what users can perceive but also enable them to prioritize qualities that they feel are valuable.
The study builds on the team’s previous effort to enable users to apply their own settings to an ankle exoskeleton. In that study, users had a touchscreen grid that put the level of assistance on one axis and the timing of the assistance on another. Users tried different points on the grid until they found one that worked well for them.
Once users had discovered what was comfortable, over the course of a couple of hours, they were then able to find their settings on the grid within a couple of minutes. The new study cuts down that longer period of discovering which settings feel best as well as offering two new parameters: how the assistance ramps up and down.
The data from that earlier study were used to feed the machine learning predictor. An evolutionary algorithm produces variations based on the assistance profiles that those earlier users preferred, and then the predictor—a neural network—ranked those assistance profiles. With each choice the users made, new potential assistance profiles were generated, ranked and presented to the user alongside their previous choice.
The study was funded by X, Google’s “Moonshot Factory,” Robotics at Google (now Google Deepmind), and the D. Dan and Betty Kahn Foundation. The concept is currently licensed by Alphabet spinoff Skip Innovations. | Medical Innovations |
The 2023 Nobel prize in physiology or medicine has been awarded to two scientists who developed the messenger RNA vaccine technology used in the first effective shots against COVID-19.
Katalin Karikó, a professor at the University of Szeged in Hungary and the Perelman School of Medicine at the University of Pennsylvania (Penn), and Dr. Drew Weissman, director of the Penn Institute for RNA Innovations, will share the 11 million Swedish krona ($1.02 million) prize.
The duo's work led to messenger RNA (mRNA) vaccines that do not generate an unwanted immune response, enabling the shots to enter the body without causing severe inflammation, the Royal Swedish Academy of Sciences in Stockholm said in a statement on Monday (Oct. 2). The COVID-19 vaccines made by Pfizer-BioNTech and Moderna are both built on the mRNA research developed by the scientists.
"mRNA vaccines, together with other COVID-19 vaccines, have been administered over 13 billion times," Rickard Sandberg, a member of the Nobel committee for physiology or medicine and the Royal Swedish Academy of Sciences, said during the committee's announcement on Monday. "Together [the two prize winners] have saved millions of lives, prevented severe COVID-19, reduced the overall disease burden, and enabled societies to open up again."
Vaccines work by prodding the immune system into generating an immune response to a particular germ, such as a virus. Prior to the advent of mRNA vaccines, the first vaccines worked by introducing a killed or severely weakened version of the virus into the body, giving the immune system a chance to acquire immunity before it encounters the full-fledged pathogen.
Later developed vaccines contained proteins snatched from a virus's surface. Upon exposure to these proteins, immune cells make antibodies that can block them and the viruses they came from. There are also shots, such as Ebola vaccines, that use empty carrier viruses to transport DNA "blueprints" of a pathogen into the body, producing a similar effect, according to the Nobel committee statement.
However, to manufacture vaccines like these, scientists have to cultivate large batches of cells, infect them with the necessary pathogens and then remove the viral and protein chunks necessary for the vaccine. This process is resource-intensive and slow, which can delay vaccine rollouts during outbreaks and pandemics.
To get around this, in the 1980s scientists began looking at more efficient ways of getting cells to make the required proteins. One method, called in vitro transcription, worked by generating mRNA (a molecule that transports instructions from DNA to the cell's protein construction factories) directly inside cells in culture.
But a huge hurdle remained: When animals were injected with lab-made mRNA, they experienced a massive immune response that led to dangerous levels of inflammation, destroying the vaccine and harming the animal.
The two prize winners refined the injected mRNA's building blocks (or nucleotides) to resemble those found in the body, meaning the immune response was no longer triggered.
In the early pandemic, this helped scientists to rapidly produce mRNA vaccines that acted against the coronavirus's "spike" protein — a pointy protein on the germ's surface.
The research has also opened the door for work on potential cancer vaccines and for the rapid development of vaccines in response to possible future viral threats, such as bird flu, the Nobel committee said in its announcement.
"During the biggest public health crisis of our lifetimes, vaccine developers relied upon the discoveries by Dr. Weissman and Dr. Karikó, which saved innumerable lives and paved a path out of the pandemic," Dr. J. Larry Jameson, executive vice president of the University of Pennsylvania for the Health System, said in a statement.
"Now, the same approach is being tested for other diseases and conditions," Jameson said. "More than 15 years after their visionary laboratory partnership, Kati and Drew have made an everlasting imprint on medicine."
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Ben Turner is a U.K. based staff writer at Live Science. He covers physics and astronomy, among other topics like tech and climate change. He graduated from University College London with a degree in particle physics before training as a journalist. When he's not writing, Ben enjoys reading literature, playing the guitar and embarrassing himself with chess. | Vaccine Development |
Private healthcare saw “record” levels of demand in the first quarter of the year, as firms look to guarantee healthcare for their employees – and stand out in the war for talent – amid crisis in the NHS.
Around 227,000 admissions were paid for using private medical insurance (PMI) in the first quarter of this year, according to the Private Healthcare Information Network, breaking the previous record of 219,000 set in the last quarter of 2022.
The expansion came mainly from insured plans, around 80 per cent of which are company-paid. Insured treatments climbed to 156,000 in the quarter, up from 149,000 at the end of last year.
Brett Hill, head of health and protection at consultancy firm Broadstone said firms were increasingly realising that protecting the health of their employees is “a mission-critical business investment”.
Lengthening waiting lists and acrimonious pay disputes were responsible for pushing firms to seek private insurance for their employees, Hill said.
The NHS has faced months of crisis with figures from August showing that 7.6m people were waiting to start routine hospital treatment, the highest number since records began in 2007.
Strike action has been partly responsible for the increase. At least 885,000 hospital appointments have been postponed since industrial action began in December last year, with the figure nearing 1m when mental health appointments were included.
But the trend of firms offering private medical insurance dates back before Covid. According to data from healthcare intelligence firm LangBuisson, the number of company-paid enrollees in PMI increased to 3.4m, up from just below 3m in 2011.
“PMI has often been used as a tool to attract high-calibre talent in a competitive labour market, with the overall benefit package seen as a factor in decision-making by prospective employees,” Tim Read, director of research at LangBuisson said.
“Ongoing NHS pressures could lead to individuals making more use of the insurance benefits available to them,” Read continued.
The rise of private healthcare highlights wider concerns for the UK labour market, which has failed to recover from the impact of Covid. Data out this morning showed that inactivity due to long-term sickness increased to another record high.
Last week the government announced a crackdown on people claiming sickness benefits in an attempt to get people back into work, although the policy will only take affect after the next election.
Charles Cotton, senior policy adviser for performance and reward at the CIPD, said: “It’s not too surprising that many people are turning to private medicine, given the challenges currently facing the NHS in both England and Scotland.
“Because of this, organisations are reporting increased interest from potential or existing staff about the wellbeing benefits on offer, such as digital GP services, group medical insurance, physiotherapy, occupational sick pay, or health cash plans. Offering such benefits at this time will help employers stand out in the labour market,” he added. | Health Policy |
Doctors are increasingly discouraging people from using e-cigarettes given the mounting evidence about the significant negative health impact of vaping-- even as a smoking cessation tool.
For current smokers, "there are other very powerful, safe and FDA approved interventions," Dr. Petros Levounis, the President of the American Psychiatric Association and Chair of the Department of Psychiatry at Rutgers New Jersey Medical School, said.
In July, new medical guidelines from the American College of Cardiology strongly discouraged the use of e-cigarettes, particularly in those with chronic heart disease. Even in young people, e-cigarettes have been shown to "increase heart rate, blood pressure and affect the ability of the blood vessels to relax," said Dr. Naomi Hamburg, Cardiologist and Professor of Medicine at Boston University. Using an alternative option that has been proven to be safe is ideal.
When compared to traditional cigarettes, e-cigarettes have often been portrayed as lesser of two evils. According to Levounis, the flavoring options, perceived reduction in harm when compared to classic cigarettes, more manageable odor and targeted campaigns towards vulnerable populations including youth may be the reason for this.
But studies show that e-cigarettes cause harm by affecting the whole body. A medical condition called EVALI – E-cigarette or Vaping-use Associated Lung Injury - not only causes damage to the lungs but can also cause issues in other organs' systems. Their long-term effects remain a mystery as they have not been on the market long enough to capture this information, experts say.
"We just cannot make a conclusion that it is safer than cigarettes," said Dr. Jason Rose, a Pulmonary and Critical Care Physician who is also the Associate Professor of Medicine and Associate Dean for Innovation & Physician Science at The University of Maryland.
Quitting tobacco from conventional cigarettes can be very challenging for most people.
But doctors are now warning that people who are trying to quit may start to use e-cigarettes in addition to conventional cigarettes -- a phenomenon Hamburg calls a "dual use pattern." This mixture is especially discouraged as the combined effect can be particularly harmful to blood vessels which increases the risk of heart disease, stroke and other cardiovascular issues.
Frances Daniels, a parent and volunteer at Parents Against Vaping, details the harrowing experience of watching her then 17-year-old who used e-cigarettes recreationally struggle in the Intensive Care Unit for 5 weeks after being diagnosed with EVALI.
"At some point they had 6 different chest tubes and was placed on a waitlist for transplants," Daniels said.
Fortunately, Daniels' child was able to make a full recovery without needing a lung transplant months after leaving the hospital, but the experience remains difficult to think and speak about.
"To watch your child struggle to do basic human functions like breathing, it's pretty tough," she said.
Doctors say anyone trying to quit smoking should stick to products approved by the Food and Drug Administration. Options include Nicotine Replacement Therapy (NRT) with a patch, gum or inhaler and medications such as Bupropion or Varenicline. Oftentimes, combinations of these NRTs such as the patch and the gum are recommended. In some cases, psychosocial options such as cognitive behavioral therapy are needed, Levounis says.
Regardless of the tool utilized, adherence and appropriate use is important. For the gum, it is important to note that "It is not exactly double spear mint gum," Levounis says. You need to chew and then park it between your gum and cheek till the tingling goes away.
E-cigarettes are not approved by the FDA as a smoking cessation tool, but companies continue to seek approval for this purpose. The FDA is insistent that further research is necessary to determine whether they can be safely utilized for those who wish to quit conventional tobacco cigarettes.
As smoking cessation tools, e-cigarettes "are not ideal and there are other options that are proven by science that are safe and effective," Hamburg said.
Adesola Oje, MD is a Gastroenterology Fellow at Vanderbilt University Medical Center and a member of the ABC News Medical Unit. | Disease Research |
1. Introduction
The Mysteries of the Brain
The human brain, a complex organ with billions of neurons, has always been a subject of intrigue and study. Its intricate networks and pathways govern not only our basic functions but also our emotions, memories, and even our very consciousness. Over the years, scientists have made significant strides in understanding the brain's structure and function. However, many mysteries remain, especially concerning how the brain processes social rewards and how certain substances can influence these pathways.
What is the Social Reward Learning Critical Period?
The Social Reward Learning Critical Period is a phase during which the brain is particularly receptive to learning from social rewards. This period is crucial for developing social behaviors and understanding social cues. As individuals age, the brain's plasticity, or its ability to change and adapt, diminishes. This reduction in plasticity means that as adults, our brains become less adaptable to new social learning experiences compared to when we were younger. However, recent research suggests that certain substances, namely psychedelics, have the potential to "reopen" this critical period, allowing for enhanced social reward learning even in adulthood.
2. Psychedelics Under the Microscope
The Role of LSD, Psilocybin, MDMA, and Ketamine
Psychedelics, once relegated to the fringes of scientific research, have recently gained significant attention in the scientific community. Substances like LSD (Lysergic acid diethylamide), Psilocybin (found in certain mushrooms), MDMA (commonly known as ecstasy), and Ketamine are being studied for their profound effects on the brain.
In a recent study, researchers administered these psychedelics to adult mice to determine their role in reopening the social reward learning critical period. The results were astonishing: pre-treatment with either LSD or Psilocybin reinstated social conditioned place preference (sCPP), a measure of social reward learning. This effect, however, was blocked when a 5-HT2AR antagonist was co-administered, suggesting a specific pathway through which these psychedelics operate.
The Science Behind the "Reopening" Phenomenon
The ability of psychedelics to "reopen" the social reward learning critical period is not merely about inducing a temporary state of heightened plasticity. Instead, it seems to involve a more profound metaplastic mechanism. Metaplasticity refers to the plasticity of synaptic plasticity itself, meaning the conditions under which synapses change their strength can be modified. This metaplastic effect of psychedelics contrasts with the hyperplastic effects of addictive drugs, which can induce robust bidirectional changes in synaptic strength.
Furthermore, the study found that the effects of psychedelics on the brain are both sparse and context-dependent, suggesting a more nuanced interaction with brain networks than previously believed. This finding is crucial as it differentiates the action of psychedelics from other substances and provides a foundation for understanding their potential therapeutic applications.
3. Therapeutic Implications
Potential Benefits for Neuropsychiatric Disorders
The therapeutic potential of psychedelics has been a topic of increasing interest in recent years. Beyond their traditional recreational use, these substances have shown promise in addressing a range of neuropsychiatric disorders. The ability of psychedelics to reopen the social reward learning critical period suggests that they could be instrumental in treating conditions where social behaviors and learning are impaired.
For instance, conditions like autism, where individuals often struggle with social interactions and understanding social cues, could benefit from treatments that enhance social reward learning. The findings from the study indicate that psychedelics might serve as a 'master key' for unlocking various critical periods in the brain. This could potentially expand the scope of disorders that might benefit from treatment with psychedelics, including autism, stroke, deafness, and even blindness.
Beyond Traditional Treatments: A New Hope
Traditional treatments for neuropsychiatric disorders often focus on managing symptoms rather than addressing the root causes. Psychedelics, with their ability to influence and modify brain activity, offer a fresh perspective on treatment. Recent evidence suggests that repeated application of substances like ketamine can reopen critical periods of plasticity, targeting specific components of the brain like the extracellular matrix. This approach could pave the way for more effective and long-lasting treatments for various disorders.
4. Mechanisms at Play
How Psychedelics Influence Brain Activity
Psychedelics, such as LSD, MDMA, and Psilocybin, interact with the brain in unique ways. Their ability to induce metaplasticity is particularly noteworthy. Metaplasticity refers to the changes in the conditions under which synapses modify their strength. This is different from the hyperplastic effects seen with addictive drugs, which can cause strong bidirectional changes in synaptic strength.
The study indicates that the effects of psychedelics on the brain are both sparse and context-dependent, suggesting a nuanced interaction with brain networks. This interaction is believed to be the reason behind the reopening of the social reward learning critical period in adulthood.
The Convergence at DNA Transcription and Extracellular Matrix
While the exact mechanisms through which psychedelics influence brain activity are still being unraveled, there is evidence to suggest a convergence at the level of DNA transcription and the extracellular matrix. The extracellular matrix plays a pivotal role in brain plasticity and is believed to be a target for substances like ketamine. By influencing these fundamental processes, psychedelics can modify the brain's activity and plasticity, offering new avenues for therapeutic interventions.
5. Conclusion
The Future of Psychedelic Research
These findings surrounding psychedelics and their potential to reopen the social reward learning critical period have opened new horizons in neuroscience and therapeutic research. By further exploring and understanding the intricate mechanisms of these substances, the future holds promise for more targeted and effective treatments. The study's revelations about psychedelics inducing metaplasticity, in particular, have set the stage for further exploration into how these substances can be harnessed for therapeutic purposes.
Implications for Mental Health Treatment
The potential of psychedelics to treat a range of neuropsychiatric disorders, especially those related to social behaviors, is immense. By reopening critical periods in the brain, these substances could offer innovative solutions to conditions that have long eluded traditional treatments. As research progresses, the hope is that these findings will translate into real-world applications, providing new avenues for mental health treatment and improving the quality of life for countless individuals. | Mental Health Treatments |
Researchers in Brazil have developed a vaccine designed to fight addiction to cocaine and its potent derivative crack — by preventing addicts from feeling the effects of the drugs and helping them stay on track for recovery.
The drug, known as Calixcoca, was developed by a team at Brazil's Federal University of Minas Gerais. Preliminary tests on animals were positive and the drug is set to move to human trials.
Should it receive regulatory approval, the drug would be the first vaccine used to fight cocaine addiction, said the coordinator for the research team, psychiatrist Frederico Garcia.
Garcia told Agence France-Presse the drug works by prompting the body to produce anti-cocaine antibodies that bind to the drug, making them too large to pass into the brain's mesolimbic system, or "reward center," where the drug normally stimulates high levels of pleasure-inducing dopamine.
Testing suggests the drug also could reduce the risk of overdosing, as cocaine molecules, bound to the antibodies produced by the vaccine, would be unable to act on the heart or the arteries.
Tests on pregnant rats indicated the antibodies are passed on through a mother's milk, suggesting the vaccine could protect nursing babies as well.
Garcia cautioned the vaccine would not be a panacea and said it would be most helpful for recovering addicts who do not want to get hooked on the drug again following rehabilitation.
He said clinical trials conducted by Brazil's health regulator Anvisa will be needed to determine how the drug might be used and discover any side effects or long-term impact on a patient's health.
The research team received a $530,000 award last week for their work, sponsored by the Brazil-based pharmaceutical company Eurofarma.
Some information for this report was provided by Agence France-Presse. | Vaccine Development |
Hospital toxicologist Ryan Marino has seen up close the violent reactions of children poisoned by liquid nicotine from electronic cigarettes. One young boy who came to his emergency room experienced intense nausea, diarrhea, and vomiting, and needed intravenous fluids to treat his dehydration.
Kids can also become dizzy, lose consciousness, and suffer dangerous drops in blood pressure. In the most severe case he’s seen, doctors put another boy on a ventilator in the intensive care unit because he couldn’t breathe, said Marino, of Case Western Reserve University School of Medicine.
Thousands of kids a year are exposed to the liquid nicotine in e-cigarettes, also known as vapes. For a toddler, even a few drops can be fatal.
Cases of vaping-related nicotine exposure reported to poison centers hit an all-time high in 2022 — despite a 2016 law, the Child Nicotine Poisoning Prevention Act, that requires child-resistant packaging on bottles of vaping liquid. In what doctors call a major oversight, the law doesn’t require protective packaging on devices themselves.
Refillable vapes are designed to hold liquid nicotine in a central reservoir, making them dangerous to kids, Marino said. Even vapes that appear more child-resistant — because their nicotine is sealed inside a removable cartridge — present a risk, because the cartridges can be pried open. And some disposable e-cigarettes, now the top-selling type on the market, allow users to take thousands of “puffs” and contain as much nicotine as multiple packs of cigarettes.
Many e-cigarettes and liquids seem designed to appeal to kids, with pastel packages, names such as “Candy King,” and flavors such as bubble gum and blue raspberry. That makes vapes far more tempting — and hazardous — than traditional cigarettes, which have lower doses of nicotine and a bitter taste that often prompts children to quickly spit them out, said Diane Calello, the executive and medical director of the New Jersey Poison Information and Education System.
“Nicotine liquid is an accident waiting to happen,” Calello said. “It smells good and it’s highly concentrated.”
Sen. Richard Blumenthal (D-Conn.), who co-sponsored the 2016 legislation, said he would push to expand the childproof packaging requirement to disposable and pod-based e-cigarettes.
“Every day that FDA allows flavored e-cigarette products to remain on the market is another day that children can be enticed by these dangerous, and sometimes deadly, products,” he said.
Although the FDA declined to comment for this article, on Aug. 2 the agency included a special feature about nicotine poisoning in children in its “CTP Connect” newsletter.
The number of reports to poison control centers about e-cigarettes has more than doubled since 2018, according to an FDA analysis. Poison control centers reported more than 7,000 vaping-related exposures in people of all ages from April 1, 2022, to March 31, 2023.
According to the FDA, 43 of those exposures resulted in hospitalization and an additional 582 in other medical treatment. About half of poison center reports had no information about whether patients needed medical care.
Nearly 90% of exposures involved children under 5. Authors of the report say their numbers likely underestimate the problem, given that poison control centers aren’t contacted in every case.
A 1-year-old died from vaping-related nicotine poisoning in 2014. The new FDA report also mentions the apparent suicide of an adult via e-cigarette poisoning.
A spokesperson for the vaping industry said companies take safety seriously.
“All e-liquid bottles manufactured in the United States conform to U.S. law,” said April Meyers, the president of the board of directors and CEO of the Smoke-Free Alternatives Trade Association, which represents the vaping industry. “Not only are the caps child-resistant, but the flow of liquid is restricted so that only small amounts can be dispensed.”
Yet many vaping products are made outside the U.S., which has recently been flooded with illegal e-cigarettes, mostly from China.
The increasing number of nicotine exposures among kids — especially curious toddlers who put virtually everything they can grab into their mouths — likely reflects the sheer volume of e-cigarette sales, said Natalie Rine, the director of the Central Ohio Poison Center at Nationwide Children’s Hospital.
E-cigarette unit sales grew 47% from January 2020 to December 2022, rising from 15.5 million every four weeks to 22.7 million, according to a report published by the Centers for Disease Control and Prevention.
“This isn’t something that parents see as a really big risk,” Marino said. “But with the popularity of e-cigarettes, the risk isn’t going away anytime soon.”
One effective strategy to reduce e-cigarette sales has been to ban flavored products. California, Massachusetts, New Jersey, New York, Rhode Island, and Washington, D.C., have banned all flavored e-cigarettes, while Utah and Maryland have banned some flavors. A study showed overall e-cigarette sales dropped 25% to 31% in states after flavor bans, compared with states that didn’t ban them.
Some doctors say the country needs to do more to protect children.
“If the numbers are rising, then the law ain’t working,” said Carl Baum, a professor of pediatrics and emergency medicine at Yale School of Medicine.
Pediatrician Gary Smith said the lack of child safety requirements for e-cigarette devices is a major problem. Refillable e-cigarettes are relatively easy for kids to open.
Although most poison control center reports don’t include brand information, disposable e-cigarettes — including Elfbar, Puff Bar, and Pop Vape — were some of the most common products mentioned in the FDA analysis. Elfbar is now known as EB Design.
Expanding the federal law to include devices would be “an important step,” said Smith, president of the Child Injury Prevention Alliance, an Ohio-based advocacy group that works to prevent injuries in children.
In addition, federal officials should limit the nicotine concentration in vape juices to make them less toxic, as well as ban candy-like flavors and colors on packaging, Smith said.
“The public health response should be comprehensive,” Smith said.
Kids have been known to pick up a vape and begin puffing, in imitation of their parents, Calello said.
Even if children don’t inhale the aerosol, sucking on a vape exposes their skin to nicotine, which can be absorbed into the bloodstream, said Robert Glatter, an assistant professor of emergency medicine at Lenox Hill Hospital in New York City. Glatter noted that e-cigarette liquids also contain numerous harmful chemicals, including arsenic and lead, which is toxic at any dose; carcinogens such as acetaldehyde and formaldehyde; and benzene, a volatile organic compound found in auto exhaust.
Fortunately, children who inhale nicotine get a much lower dose than those who ingest it, reducing the risk of serious harm, said Marc Auerbach, a professor of pediatric emergency medicine at Yale School of Medicine.
Only about 2% of exposures in the FDA study were recorded as having a moderate or major effect.
That may be because little kids who get into dangerous liquids — from vape juice to household cleaning products or gasoline — usually spill most of it, Baum said. “They often end up wearing it rather than swallowing it,” Baum said.
Although Stephen Thornton has seen a lot of children with nicotine exposure, he said, the human body has ways of protecting itself from toxic substances. “Fortunately, when kids do ingest these e-cig nicotine products, they self-decontaminate. They vomit — a lot — and this keeps the mortality rate very low, but these kids still often end up in emergency departments due to all the nausea and vomiting,” said Thornton, an emergency medicine physician and medical director of the Kansas Poison Control Center.
The FDA urges parents and guardians of young children to keep e-cigarettes and vaping liquid out of reach and in its original container.
For emergency assistance, call Poison Help at 800-222-1222 to speak with a poison expert, or visit poisonhelp.org for support and resources. | Epidemics & Outbreaks |
WASHINGTON -- Washington’s revolving door kept spinning this week as the Drug Enforcement Administration’s recently departed second-in-command returned for a new stint with the high-powered consulting firm where he previously advised Purdue Pharma and a drug distributor fighting sanctions over a deluge of suspicious painkiller shipments.
Louis Milione retired from the DEA a second time this summer amid reporting by The Associated Press on potential conflicts caused by his prior consulting for the pharmaceutical industry. Less than three months later, Milione again landed a plum job at Guidepost Solutions, a New York-based firm hired by some of the same companies he had been tasked with regulating when he returned to the DEA in 2021 as Administrator Anne Milgram’s top deputy.
Milione had spent four years at Guidepost prior to his return, leveraging his extensive experience and contacts from a 21-year DEA career.
“Should we say Welcome Back?,” Guidepost quipped in a social media post this week announcing Milione’s rehire as president of global investigations and regulatory compliance.
Milione is the most senior of a slew of DEA officials to have traded their badge and gun for a globe-trotting consulting job; that includes a dozen at Guidepost alone. His career stands out for two cycles through the revolving door between government and industry, raising questions about the potential impact on the DEA’s mission to police drug companies blamed for tens of thousands of American overdose deaths.
“Once someone reveals that they are willing to trade their public service expertise on the private market, they’re probably going to do it again,” said Jeff Hauser, the executive director of the Revolving Door Project, a watchdog for corporate influence in the federal government. “Knowing how lucrative that industry work can be, it’s hard to imagine he was ever truly firewalled in his emotions or self-interest from Guidepost while at the DEA.”
It’s unclear when Milione began preparing his return to Guidepost, but any employment negotiation with an entity with dealings before the DEA would have required him to file an ethics disclosure with the agency. Milione and Guidepost declined to comment about the new role. The DEA and Justice Department did not respond to questions.
Milione, 60, is perhaps best known at the DEA for leading the 2008 sting that nabbed Russia’s notorious arms trafficker Viktor Bout and, more recently, a two-year stint heading the division that controls the sale of highly addictive narcotics.
Like dozens of colleagues in the DEA’s Office of Diversion Control, he went to work as a consultant for some of the same companies he had been tasked with regulating. That included serving as a $600-per-hour expert for Purdue Pharma as it fought legal challenges over its aggressive marketing of Oxycontin other highly addictive painkillers, becoming the face of the opioid epidemic.
Pressed by members of Congress recently about her decision to rehire Milione, Milgram acknowledged she had been aware of his previous work for the drug industry but was more impressed by his legacy at the DEA.
“I asked the question of many former agents, current agents and prosecutors, who the best agent in America was,” she said during House oversight hearing in July. “The answer I got repeatedly was Lou Milione.”
But when he served as the DEA's No. 2, Milione never faced scrutiny from lawmakers over his consulting because the DEA for more than a decade has not filled the job of deputy administrator, which requires a presidential appointment and Senate confirmation. Instead, the DEA directly hired Milione to fill a career position with essentially the same duties but a slightly different title — “principal deputy administrator” — requiring no such oversight.
Milione's private-sector clientele also included Morris & Dickson Co., the nation’s fourth-largest wholesale drug distributor, as it tried to stave off DEA sanctions for disregarding thousands of suspicious, high-volume orders.
The DEA allowed the company to continue shipping drugs for nearly four years after a judge recommended its license be revoked for “cavalier disregard” of rules aimed at preventing opioid abuse. It was not until AP began asking questions this spring that the DEA moved to finally strip the Shreveport, Louisiana-based company of its license to distribute highly addictive painkillers.
Morris & Dickson is still challenging the ruling, which threatens to put the $4 billion a year company out of business. Its attorneys filed court papers this month reiterating Milione’s testimony in 2019 that the company “spared no expense” to overhaul its anti-diversion efforts.
The DEA has not explained the unusual delays in the administrative case but said Milione, after returning to the DEA, recused himself from agency business related to Morris & Dickson and other companies he advised.
“I believe in the recusal and ethics process at the Department of Justice,” Milgram told Congress. “I relied on that.”
___
Contact AP’s global investigative team at [email protected]. | Drug Discoveries |
Boris Johnson will today warn the Covid Inquiry that lockdowns caused more harm than good, as he defends his pandemic decisions.
The former prime minister has come under fire at the inquiry for delaying draconian restrictions and for constantly questioning their impact on the economy.
But during two days of evidence beginning this morning, he will suggest the inquiry has given too little consideration to the downsides of restrictions, which damaged education, health and the economy.
In written evidence, Mr Johnson said he had a duty to consider whether lockdowns 'would do (and did do) more harm than good'.
He added: 'We were between a rock and a hard place. We simply had no good choices, and it was necessary at all times to weigh up the harms that any choice would cause.'
He will also repeat his denials that he ever said to 'let the bodies pile high' rather than order a third lockdown, according to The Mirror.
Downing Street at the time strongly denied he made the comment, insisting it was 'just another lie'.
Mr Johnson's former chief of staff Lord Lister told the inquiry last month he heard the former PM say the words during a meeting in September 2020.
He is also set to be quizzed about Sir Patrick Vallance's diary entries in which he wrote about his frustrations in dealing with the then-prime minister.
'(Mr Johnson is) obsessed with older people accepting their fate and letting the young get on with life and the economy going,' he said.
'Quite bonkers set of exchanges,' he wrote, referring to a WhatsApp group including Mr Johnson.
An ally of Mr Johnson told The Mirror: 'He of course realises that as Prime Minister he had the ultimate responsibility for everything that happened in Government at every level and he does not shirk that.'
Tory MP Sir Michael Fabricant said the inquiry appeared at times to be more interested in 'salacious' WhatsApp messages between ministers and officials than in learning the lessons of the crisis.
And he appealed for Mr Johnson to be given a fair hearing: 'I have been a little worried that the inquiry has drifted into who swore what at whom rather than focusing on the lessons learned in case, God forbid, we have another pandemic.
'I just hope that Boris will be heard by people with an open mind rather than the prejudice which he has met in the past at other hearings.'
Another supporter of the former PM said the inquiry appeared to have started from a presumption that lockdowns were the right response to the pandemic and that the Government had been too slow.
'They only seem to be interested in asking whether we should have locked down sooner or for longer,' the source said.
'There has been very little discussion so far of the incredibly difficult trade-offs involved or of the constantly changing scientific advice, which was against locking down early on.
'If you really want to learn the lessons of the pandemic you – which is what Boris is interested in – you have to look at everything, not start with a pre-determined narrative.'
Mr Johnson is expected to acknowledge that the first lockdown of March 2020 was inevitable, given the lack of a vaccine or effective treatments against a deadly new virus.
But in his written testimony he said he had been 'very worried about the economic harm caused... and whether it would do more damage to the country than the virus itself'.
He is also expected to suggest that the inquiry should take more interest in the origins of the virus. Michael Gove was shut down at the hearings when he suggested that a 'significant body of judgment' now believed Covid-19 was man-made.
Mr Johnson will apologise for mistakes made by the Government during the pandemic.
But he will insist that ministers 'got the big calls right': achieving one of the fastest vaccine rollouts in the world, preventing the collapse of the NHS, developing innovative treatments like dexamethasone and emerging from the final lockdown quickly.
He will also reject claims that he 'switched off' during a half-term break in February 2020. | Epidemics & Outbreaks |
Patients will soon be able to use the NHS app to opt for private hospital treatment in an effort to cut waiting times, according to a report.
The NHS waiting list for routine treatment stands at more than seven million and is predicted to keep rising until next spring.
Both of the main political parties are relying on more people choosing to pay for private care to bring down waiting times and free up the NHS.
A report in The Times said that only 28 NHS hospitals currently allow patients to manage appointments via the app, although this is expected to be expanded, which is when the private hospital option will be offered for the first time.
A Whitehall source cited by the newspaper said: "There is definitely scope for that.
"The NHS app is increasingly well-used, there is already some functionality where patients can directly book, and we are looking to modernise those booking capabilities and update the options in the app."
The number of diagnostic centres offering checks for cancer and other conditions will also be expanded by adding facilities run by the private sector - from the current 106 to about 190.
Only 63.5% of patients given a cancer diagnosis begin treatment within two months of a referral for tests, against a target of 85% that has not been hit for nine years.
Read more:
Health inequality grows as waiting lists near likely peak
Waiting lists are a 'national scandal', BMA chairman says
NHS crisis: How the health service in your area is performing
A statement from the Department of Health and Social Care said: "Cutting waiting lists is one of the government's top five priorities with the NHS app playing a vital role in giving patients greater control over their own care and supporting elective care recovery.
"We have already started to implement the Elective Recovery Taskforce's work and a full plan will be published soon, outlining how we can go even further to unlock the independent sector to get patients treated more quickly and reduce waiting lists."
Prime Minister Rishi Sunak is expected to confirm the plans in the coming weeks, The Times said. | Health Policy |
An Australian mum-of-five has spoken about the reality of parenting a child with autism and how others in a similar position can receive support via a new app. Amanda Kenny, from Sydney, didn't work full-time for years to support her son Ashton, nine, who was diagnosed with autism when he was seven. The 40-year-old mum told FEMAIL she struggled finding the right school for him as he would just 'run away', and going into public spaces was also difficult. 'He would always run in the opposite direction to the school and I'd get a call an hour after dropping him off to come and pick him up, so working was out of the question,' she said. At the same time while caring for her five boys, Amanda was also supporting her husband and dad who were going through cancer treatment. Tough Sydney mum Amanda Kenny (pictured with son Ashton) spoke about the difficulties she's faced in the last few years. Her son Ashton was diagnosed with autism at age seven 'Ashton (second from left) would always run in the opposite direction to the school and I'd get a call an hour after dropping him off to come and pick him up, so working full-time was out of the question,' she said 'Life with Ashton is a constant challenge. He requires psychology, speech therapy, occupational therapy and behaviour therapy,' Amanda said. 'Often these sessions would need to be during school hours or directly after it making employment once again impossible.' As a toddler Ashton showed 'all the signs' of autism from delayed language skills to lack of social skills. What are the signs of autism in toddlers? Delayed language skillsDelayed movement skillsDelayed cognitive or learning skillsHyperactive, impulsive, and/or inattentive behaviourEpilepsy or seizure disorderUnusual eating and sleeping habitsGastrointestinal issues (for example, constipation)Unusual mood or emotional reactionsSource: cdc.gov.au 'I knew he was different to my other children and, if anything, the diagnosis helped clarify this because it meant we now knew how to help him,' Amanda said. It also meant she and husband Nick needed to shift their parenting tactics.'He would have meltdowns in shopping centres and other people would stare thinking he was just throwing a tantrum,' Amanda said. Amanda said Ashton is 'very particular' about his food and will only drink water from a clear plastic bottle. 'He loves tinned pineapple and only wears specialty socks - it's a sensory thing,' she said. 'He also doesn't like loud spaces as he has very sensitive hearing.'When going out to family events or to school, Amanda always packs snacks, brings his particular water bottle and ensures he's wearing his favourite socks. Early on she also was honest with her older three son's - Ethan, 14, Lucas, 13, Jackson, 12 - about Ashton's diagnosis. 'I said things like 'his brain is a little bit different to ours and thinks too fast' and how his ears hurt because they're so sensitive,' she said.'But the boys, when they were younger, didn't quite understand that.' As a toddler Ashton (pictured) showed 'all the signs' of autism from delayed language skills to lack of social skills. 'I knew he was different to my other children and, if anything, the diagnosis helped clarify this because it meant we now knew how to help him,' Amanda said Early on she also was honest with her older three son's (pictured) - Ethan, 14, Lucas, 13, Jackson, 12 - about Ashton's diagnosis Unfortunately in 2018 Amanda's husband Nick (pictured second from right) was diagnosed with hodgkin's lymphoma, which impacted the family financially and emotionally. 'At the time I thought he was going to die; I was preparing myself for the worst, it was an awful time,' Amanda said. What followed was an ongoing battle for the familyUnfortunately in 2018 Nick was diagnosed with hodgkin's lymphoma, which impacted the family financially and emotionally. 'At the time I thought he was going to die; I was preparing myself for the worst, it was an awful time,' Amanda said. 'I thought I was cursed; It was one thing after the other and everything kept getting worse.' What followed was an ongoing battle for the family with Nick going into surgeries and cancer treatments, while Amanda was taking care of the kids. Flash forward to this year and both Nick and Amanda's dad were in hospital. 'It was hell on earth, I felt completely torn and guilty because I couldn't be in two places at once,' she said. Unfortunately her father, 72, took his last breath on September 16 while Nick is in remission. Despite experiencing years of ongoing challenges, Amanda said she 'did what she had to do' and pushed through. Today she works from home for the new Aussie brand Kindship - a new app developed by four mums who also have a child with a disabilityDespite experiencing years of ongoing challenges, Amanda said she 'did what she had to do' and pushed through. 'At the time I was constantly questioning what bad thing will happen next. After my dad passed away I realised how short life is and how we don't know what's around the corner,' she said. 'But when you're in a situation like I was, you don't have time to pity yourself, you need to keep going and be strong for your kids and family.'Today Amanda works from home for the new Aussie brand Kindship - a new app developed by four mums who also have a child with a disability. What is Kindship? Kindship is the first social networking app built by and exclusively for parents raising children with disabilities, delays, and neurodiversity. The app offers mums and dads a safe, private, and fundamentally kind space to connect with and learn from like-minded parents on similar journeysThe founders are four mums who all have children living with a disability Kindship's app is already helping more than 1000 families each week The brand is set to launch an Australian first innovation called the Kindship Wallet that couples AI technology with community recommendations so parents are matched up to the best service providers for their needs The social networking platform offers a place for parents to receive support from others within the community also going through similar experiences.And the app is already helping more than 1000 families each week. The brand is set to launch an Australian first innovation called the Kindship Wallet that couples AI technology with community recommendations so parents are matched up to the best service providers for their needs. The Kindship Wallet allows parents to search for services by parent rating, waitlist times, and distance.'The Kindship team is built with so much heart I feel incredibly lucky to be a part of it and I’ll be forever grateful for the opportunity they have given me,' Amanda said. | Mental Health Treatments |
A team of researchers from the University of Oxford has shown for the first time that it is possible to track the progression of Parkinson’s Disease accurately using specially trained machine learning algorithms to analyse data derived from sensor devices worn by patients.
The novel methods described in this study led by Professor Chrystalina Antoniades in Oxford's Nuffield Department of Clinical Neurosciences can be used by clinicians alongside the more traditional clinical rating scales to not only improve the accuracy of diagnosis, but also track progression of Parkinson's Disease.
Being able to monitor the progression of motor symptoms in people with neurological disorders such as Parkinson's disease is important for two main reasons: clinicians need to be confident in their assessment of how the disease is progressing in individual patients, and researchers running clinical trials need to be able to measure how well therapeutic interventions are working.
This is an important development for clinical trials. Bringing a new drug for a disease like Parkinson's from early development to clinical use takes years and consumes vast resources, and many drugs that look promising in the lab turn out not to work in patients. It is critical to be able to spot the ones that are effective as early as possible, so work on them may be accelerated. I hope this will be made easier with these new objective measuring tools.
Professor Chrystalina Antoniades said: 'At the moment, clinicians use rating scales (scoring systems based on a physical examination) to assess the key symptoms of people with Parkinson's disease. One problem with this is that there is an element of subjectivity in the assessment and different clinicians may not provide identical scores. Another issue is that the scales are not evenly spaced – the difference between scores of 30 and 40 may not be the same as the difference between 40 and 50 for example. This means that the detection of disease progression could be delayed, and in clinical trials, the types of statistical analysis that can be performed on the data might be restricted.'
Professor Antoniades' NeuroMetrology Lab have been carrying out experiments to assess whether sensor devices worn by patients on their trunk, wrists, and feet, combined with machine learning, can track the progression of motor symptoms more accurately than traditional rating scales.
They and others have previously demonstrated that the analysis of data from wearable devices using machine learning algorithms can help with accurate diagnosis. It is already known that these new techniques can be used to discriminate between healthy older adults, individuals with different severity of Parkinson's disease, and individuals with other Parkinsonian-like disorders.
In this new study, the researchers asked whether it was possible to use the data collected during walking and standing tasks not only to diagnose but also to track the progression of motor symptoms in Parkinson's Disease over time. The study participants were assessed intensively with visits to the clinic every three months, in order that the team could determine the shortest time over which their analysis could detect disease progression. They found that progression could be detected in as little as 15 months with their technique.
Read the full article, 'Identification of motor progression in Parkinson’s disease using wearable sensors and machine learning', can be read in Nature. | Disease Research |
I suffer with terrible irritable bowel syndrome and nothing seems to ease it. I'm 83 and have read that probiotics might help, but no pharmacist will tell me which to get. Would you recommend one, and might it help?Irritable bowel syndrome, or IBS, causes pain, bloating and erratic bowel movements.However, it is very uncommon to develop it in older age so I'd be wary of assuming a diagnosis in someone over 80 as it is quite likely that there is another – more serious – underlying cause of the symptoms.Bowel cancer, for instance, is often mistaken for IBS.Having said that, if IBS is not a new problem, it is perfectly reasonable to try a probiotic. Irritable bowel syndrome, or IBS, causes pain, bloating and erratic bowel movements (stock image)Medical guidelines support taking the supplements for the condition to reduce pain, bloating and other bowel symptoms, but they state you must choose only one and take it consistently for three months.A probiotic can be taken as a capsule or powder and contains large numbers of 'friendly' bacteria that are similar to the type found naturally within the gut which help to keep the body working healthily. Sometimes they are sold as symbiotics – this means the probiotics are combined with a prebiotic, which are the sugars that the good bacteria feed on.The most effective seem to be those containing bifidobacterium and lactobacillus. However, also try to eat some foods naturally high in probiotics, such as yogurt and fermented foods such as kefir and sauerkraut.I have been suffering migraines that seem to be triggered by walking in the cold. A neurologist booked me in for Botox treatment but I'm not convinced it will help.Migraines are similar to headaches but are usually coupled with sickness, nausea and sensitivity to bright lights or loud noises. They can be aggravated by a host of triggers, including certain foods, stress, bright lights and even regular activities such as walking.It is common for sufferers to experience unusual sensations in the moments prior to an attack. These include seeing zig-zag lines or spots, or feeling pins and needles and numbness. More from Dr Ellie Cannon For The Mail On Sunday... 'My name is Dr Ellie and I take antidepressants' - Having suffered crippling anxiety since she was a teenager, GP ELLIE CANNON now keeps it at bay thanks to medication. And despite her critics, she has no plans to give it up 18/10/22 DR ELLIE CANNON: What can be done to ease pain of 'electric shocks' in my mouth? 06/08/22 What IS the truth about those bold claims that HRT fights dementia and heart disease? Last week, DR ELLIE CANNON raised the alarm over women taking menopause drugs they don't need - and now she tackles another controversy 02/07/22 Why I fear the menopause revolution has led some women to take HRT they really don't need: It will anger campaigners but DR ELLIE CANNON feels duty bound to speak out 25/06/22 DR ELLIE CANNON: With waiting lists growing our resident GP answers non-covid questions you are desperate to ask 10/10/20 DR ELLIE CANNON: Bleeding after the menopause must be checked out NOW 29/08/20 DR ELLIE CANNON: Can my wife cool her burning feet? 18/01/20 DR ELLIE CANNON: Why, for the first time in my career, I'm ashamed to work for the NHS 10/08/19 DR ELLIE CANNON: Did school spark my daughter's asthma? 03/08/19 VIEW FULL ARCHIVE Doctors advise sufferers to avoid known triggers, but this isn't always possible.If the symptoms are having a severely detrimental effect on quality of life, it is important for a specialist to rule out any other conditions that could mimic a migraine. These could include problems with blood pressure inside the head and blood vessel complications known as vasculitis, or painful conditions that affect the nerves inside the head and face, such as trigeminal neuralgia.A neurologist should be looking to rule out serious causes of severe migraines, but if there are none, treatment should focus on preventing attacks. This includes medications such as propranolol or topiramate, which can be taken daily. Alongside this, relaxation techniques and acupuncture may be helpful.There is also evidence to recommend the vitamin riboflavin, taken daily at a dose of 400mg. In addition, Botox, normally a cosmetic treatment to smooth wrinkles in the face, is an approved NHS treatment for chronic migraine. It is given as a series of injections around the forehead, and although it is unclear why it works it's thought it blocks pain signals in the brain.According to the charity The Migraine Trust, a 30 to 50 per cent reduction in migraine episodes is a good result from Botox. Specialists recommend two rounds of treatment before deciding if it has worked or not.I am 45 and perimenopausal – my periods have become irregular over the past year. But in the past few months I've started bleeding between periods and suffered pain after sex. I had a smear test last month and it came back normal. What could be going on?Both abnormal bleeding and pain after sex are common symptoms of the perimenopause.During this period, dropping oestrogen levels cause menstrual cycles to be erratic and vaginal dryness. Having said that, it is important to get both symptoms checked in case they are not menopause-related and something more serious. DO YOU HAVE A QUESTION FOR DR ELLIE? Email [email protected] or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT. Dr Ellie can only answer in a general context and cannot respond to individual cases, or give personal replies. If you have a health concern, always consult your own GP. Bleeding between cycles is always a reason to visit the doctor for a check. Normally this type of bleeding is due to hormonal or harmless changes, but it can also be a symptom of endometrial or cervical cancer.These diseases are more likely to develop as women get older.Tests for them involve a GP examination as well as a scan, and possibly a closer look at the cervix – known as a colposcopy. It may also be necessary to test the womb lining for signs of cancer. A common reason for women to have erratic bleeding or pain can be an infection within the vagina. Nurses in the GP surgery or sexual health clinics can offer full testing and swabs to check for infections. This can be treated using antibiotics.There are times in a woman's life, such as menopause or during pregnancy, when such symptoms are considered normal, but doctors must not assume it isn't something more serious.New mask-wearing advice just covers up NHS crisisI was one of the first, and biggest, champions of mask-wearing when Covid struck. But now that the UK Health Security Agency is recommending that people with colds and flu wear them again, I am exasperated. All it does is make health chiefs look as though they are actually doing something to combat the NHS winter crisis. But instead of fixing the fundamental problems in the health service to increase capacity, all they are doing is putting the responsibility on us.Someone on Twitter referred to the recommendation as 'placebo sandbags', which I thought was rather apt. I was one of the first, and biggest, champions of mask-wearing when Covid struck (stock image)The only environment where mask-wearing might be worth considering is in a medical waiting room, where there's a greater chance of coming into contact with someone vulnerable. But even then, unless the entire waiting room is masked up, the effort will be futile.Health bosses should stick to finding a solution to the crisis across the NHS and stop pushing pointless gimmickry.Easy ways to sort a sore throat Pharmacists are reporting shortages of cold and flu medicines such as Lemsip and Night Nurse across the UK.It's hardly surprising, with respiratory infections at their yearly high. But here's something you should know: there are cheaper remedies that work just as well which you probably have in a cupboard somewhere.The best thing for a sore throat is a mug of hot water (not boiling), with a teaspoon of honey (though not for babies under 12 months). And common painkillers such as paracetamol and ibuprofen will ease your aches and pains, as well as bring down body temperature.I promise that you'll see little difference between these treatments and anything you can buy in a pharmacy.And don't underestimate the benefit of a good night's sleep. | Disease Research |
European drug-safety regulators are probing popular weight-loss drug Ozempic after patients reported that the medicine triggered thoughts of suicide and self harm.
The European Medicines Agency (EMA) told Reuters on Monday that a safety committee was probing Novo Nordisk-made weight-loss drugs — including Ozempic, Saxenda and Wegovy — after Iceland’s health regulator flagged three cases of patients on the meds having suicidal and self harm-related thoughts.
The Icelandic Medicines Agency found that two Ozempic users and one Saxenda user reported experiencing suicidal thoughts, while one other Saxenda user reported thoughts of self-injury, Reuters reported.
Ozempic, which is billed on Denmark-based Novo Nordisk’s website as a once-a-week shot to treat Type 2 diabetes and cardiovascular disease, has recently gained mainstream popularity for its “miraculous” weight-loss effects.
The Post has reached out to Novo Nordisk for comment.
Since the Ozempic craze took both Hollywood and non-celebrities by storm, a series of bizarre side effects have emerged, including “Ozempic butt” where users are claiming that their derrières have flattened along with their tummies.
Users later warned of “Ozempic finger,” where finger and wrist sizes were rapidly shrinking too, causing women to fear that their engagement rings would fall off.
The latest alleged side effect is much more serious.
Novo’s earlier and reportedly less-effective weight-loss shot, Saxenda, was a developed as a “chronic weight management product,” along with obesity-management drug Wegovy.
While no Wegovy patients reported similarly destructive feelings, the EMA — which polices the safety of medicines used in the EU — has launched an investigation into all of Novo Nordisk’s weight-loss treatments, plus any other medicines that contain semaglutide or liraglutide.
Both Ozempic and Wegovy are semaglutide injections.
While Novo doesn’t warn Ozempic users about potential side effects to their mental health, the Mayo Clinic very clearly describes semaglutide as a medication that may “cause some people to have suicidal thoughts and tendencies or to become more depressed.”
However, Novo does include mental health-related warnings for Wegovy, which it says could cause “suicidal behavior and ideation”
Novo’s website recommends that patients taking Wegovy are monitored “for depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.”
Saxenda, meanwhile, is a daily liraglutide injection.
Liraglutide and semaglutide are in the same class of medication. The strong drugs mimic the actions of the GLP-1 hormone, which the pancreas releases after eating that makes people feel full.
Semaglutide is usually preferred for weight-loss treatments as it’s proven to be more effective. It has a longer half-life than its counterpart, meaning it stays in a person’s system for longer and therefore takes longer for the feeling of hunger to hit again.
Like Ozempic, Saxenda was most often used to maintain blood sugar levels in Type 2 diabetics before it became yet another trendy weight-loss solution.
Saxenda’s website does warn users against taking the drug if they have already experienced or are experiencing “depression or suicidal thoughts, or mental health issues.”
It also lists “depression or thoughts of suicide” as a possible side effect of the medication.
The same warnings are also listed as a potential consequence in leaflets tucked inside the packaging.
If you are struggling with suicidal thoughts or are experiencing a mental health crisis and live in New York City, you can call 1-888-NYC-WELL for free and confidential crisis counseling. If you live outside the five boroughs, you can dial the 24/7 National Suicide Prevention hotline at 988 or go to SuicidePreventionLifeline.org. | Drug Discoveries |
When the first wave of Covid hit the U.S., it became clear that the majority of patients being placed on ventilators had a series of underlying conditions. Among those were metabolic disorders like obesity and diabetes, both of which have been surging in the U.S. over the past few years.A question that puzzled people at the beginning of the pandemic was: Why does diabetes make it harder to fight a respiratory virus?First, we know that the SARS-CoV-2 virus can make blood sugar control worse in the short term and can potentially throw people with diabetes into a very dangerous blood sugar state, studies show. It does this by binding itself to the receptors found on the beta cells of the pancreas, which produce insulin.As an allergist and immunologist, I frequently tell my patients that having diabetes means you're in a chronic low-grade inflammatory state, which taxes the body's innate immune system and makes it slower to jump on pathogens when they enter the body.When it comes to our immune system, what we eat matters a lot. And no ingredient is more detrimental to your immune health than sugar, especially during Covid.Sugar: The worst food ingredient for your immune systemWhen you have high blood sugar — which is caused by many factors, but the biggest is consuming too much of it in your diet — it starts a vicious cycle of insulin resistance and obesity that drives up inflammatory cytokines, damages blood vessels, and activates the immune system to repair those areas.This creates a major distraction for the immune system and paves the way for dangerous bacteria and viruses to slip through our body's defenses.If you've already been diagnosed with prediabetes or diabetes, this may sound like bad news. But it's not; Type 2 diabetes doesn't have to be permanent.Eliminating excess sugar from your diet can not only help end this cycle, but it can reverse it completely. Dialing back your sugar consumption is one of the most effective ways to improve your immune system.Sugar is hiding everywhereYou might be thinking: I'm not really a sweets person, so I don't need to worry about this!But even if you don't eat donuts, candy, cakes or cookies regularly, having too many simple carbs like bread, pasta, rice, cereal or even certain fruits and juices may be silently driving up your blood sugar.People often forget — or don't realize — that sugar is in ketchup, salad dressings and lattes, as well as in juice, yogurt, cereal and protein bars.I'm all about preventative care, especially when it comes to an insidious disease like diabetes, and recommend that the first step you take in your nutrition journey — regardless of age — is to ask your doctor to perform a fasting hemogoblin A1c test, even if your fasting blood glucose is normal.Hemogoblin A1c tests measure average blood sugar over the previous three months, so even if your blood sugar is normal the day you see your doctor, the test can catch underlying issues.How to protect your blood sugar healthOnce you have an idea of where you stand on the blood sugar spectrum, take the steps below for better health:1. Cut back on obvious sugars.This means candy, soda, cake and those seasonal flavored lattes we all love. These foods and drinks don't provide any nutritional value, and they contain massive amounts of sugar.Instead, opt for dark chocolate, berries or another low-sugar treat. I'm not saying you have to take out all sugary foods forever. The occasional dessert is fine! But at the beginning, it's important to get to a place where your blood sugar is stable and healthy.2. Read the labels.Now it's time to check the amount of added sugar in every item in your pantry — and I mean everything, even things advertised as "low in sugar" or "healthy."The average American takes in about 17 teaspoons (71 grams) of added sugar a day, but the American Heart Association recommends no more than six teaspoons (25 grams) of added sugar a day for women, and nine teaspoons (36 grams) for men.Remember, we still get natural sugars from fruits, vegetables and grains, so we're certainly not deficient!3. Eat more fiber.If sugar is poison, then fiber is the antidote. Fiber not only keeps your digestion regular, it also helps slow the absorption of sugar into your bloodstream, which protects you from sugar spikes.Lack of fiber is another reason why sodas, fruit juices and sugared coffee drinks are so detrimental to your health. They contain a ton of sugar and none of the blood-sugar-protecting fiber that fresh whole plant-based foods have.Some of my favorite high-fiber foods are black beans and lentils, steel-cut oats, avocados, buckwheat, pears, raspberries, barley and flaxseeds.4. Chose nutrients over calories.Instead of worrying about cutting calories, focus on adding more nutrient-dense foods to your diet, with lots of proteins and healthy fats.You don't need to go low-carb, just choose the "right" carbs. In fact, eating carbs in the form of vegetables, beans, whole fruits, and nuts and seeds — all mineral- and vitamin-rich foods — is a great way to keep those hunger pangs at bay.There are several apps to help you track your intake. I have all my patients log their eating for a few days to see how much added sugar, fiber and other nutrients they're actually getting. It's often very eye-opening.Dr. Heather Moday is a board-certified allergist, immunologist and functional medicine physician. She is also the author of "The Immunotype Breakthrough: Your Personalized Plan to Balance Your Immune System, Optimize Health, and Build Lifelong Resilience." Follow her on Instagram @theimmunityMD and Facebook.Don't miss:A longevity expert shares the diet, exercise and sleep rules he lives by for a longer, stronger life: These are ‘non-negotiable'A Harvard nutritionist and brain expert shares the 5 foods she eats every day to sharpen her memory and focus3 brain exercises for a stronger memory—and the mistake that can 'harm' it, according to neuroscience | Nutrition Research |
A policy win for Biden that would help us all breathe easier
In 2019, Kristen Ann Ehrenberger at University of Pittsburgh Medical Center lost one of her patients. It wasn’t the breast cancer she’d been diagnosed with; it was an asthma attack — a footnote on her medical record that could have easily been handled by an inhaler. But Dr. Ehrenberg’s patient couldn’t afford one.
As the Biden administration begins its negotiations to bring down the price of 10 of the most expensive drugs through the Inflation Reduction Act, it should not forget out-of-control drug prices affecting patient access to other, more mundane treatments, like asthma inhalers.
Inhalers are not expensive to make. Yet millions of patients struggle to afford them every year — primarily because pharmaceutical companies are gaming a regulatory system that the Food and Drug Administration (FDA) has failed to fix.
Like many necessary drugs, inhaler prices have increased drastically over the last several decades. Albuterol, the most standard asthma medication — originally developed in 1972 — can cost $100 per inhaler, compared to $15 just ten years ago. Pulmicort, developed in 1973, costs over $175 per inhaler here in the U.S., despite costing $20 abroad. The basic small-molecule medications used to treat asthma — i.e., the actual treatments — have not changed or been improved in decades, but the price keeps going up.
Pharmaceutical companies have become masters at gaming the FDA’s “Orange Book” to keep inhaler prices high. The FDA requires drug companies to list patents they have for any approved drugs in this Orange Book. If a generic company tries to enter to sell the drug themselves, the manufacturer can sue the generic company, forcing the FDA to automatically block the new company from selling the drug for two and a half years. Without a competitor, the drug company can keep raising prices.
Drug companies do this all the time, and it’s among the main reasons they’ve been able to keep the prices for asthma inhalers high for decades. What’s worse, in the case of inhalers, the patents they are listing in this Orange Book aren’t even supposed to be there. Rather than patents for improvements of the actual asthma medication or treatment, drug companies are listing patents for minor cosmetic tweaks to the devices delivering asthma medication — the inhalers themselves.
It’s not legal: federal courts have found it improper to list patents for devices in the Orange Book, not only for inhalers but for other medical devices like insulin injectors. In short, inhalers are expensive because Big Pharma is breaking the law, and the government has not stopped them.
Lax government enforcement endangers the lives of a large — and politically important — swath of the American public. Around 26 million Americans, almost 8 percent, are diagnosed with asthma, and that incidence is even higher among minority and low-income communities. Primarily due to differences in pollution exposure from geographic segregation and housing policy, almost 12 percent of black children have asthma, compared to less than half that for white children. In Detroit, for example, where asthma rates are higher than the rest of Michigan largely due to air quality differences and pollution (14.6 percent of Detroit children relative to 11.3 percent statewide), asthma also disproportionally falls on black communities within the city.
The Biden administration has confronted enforcement failures previously to improve healthcare for Americans. Through the 2021 executive order on competition, the administration made hearing aids over-the-counter, lowering their price by as much as $3,000 for as many as 30 million Americans in just over a year. As would be the case with inhalers, this was swift executive action to cut through bureaucratic red tape, where FDA rules requiring prescriptions kept the market for hearing aids in the hands of a few companies charging exorbitant prices.
In July, President Biden announced the core of his reelection strategy, Bidenomics — the idea that the economy should grow bottom up and expand the middle class, rather than from the top down. This includes a focus on antimonopoly policies to rein in corporate power over the economy. A strategy without clear political wins to show for it, however, will fail to inspire the voters Biden needs to turn out to beat the eventual Republican nominee.
The generational infrastructure projects promoted by the administration, such as the bipartisan infrastructure law, the Inflation Reduction Act and the CHIPS Act, while hugely impactful, may take time to fully take effect and be felt by voters. By contrast, Biden’s biggest and most popular wins to date have given clear, tangible benefits to everyday Americans, like his initiative on bank junk fees, those annoying extra charges that powerful companies have added onto everything we buy.
The Biden administration can repeat this success by making inhalers cheap again for the millions of Americans who depend on them. Through swift executive action, he could deliver for working-class Americans by changing FDA regulations to remove all of these bogus device patents from the Orange Book, allowing many other generic companies to enter and bring prices down for inhalers and many other medical devices, such as EpiPens and insulin injectors.
The Federal Trade Commission already has a head start, voting to pass a policy statement to combat improper listing of device patents in the Orange Book on Sept. 14. This is just one example of the sorts of antimonopoly policies that can be a big win for Bidenomics, both in fixing a broken regulatory system to directly reduce consumer prices for critical healthcare and paying political dividends in 2024.
Dr. Ehrenberger’s patient should not have died for lacking a cheap medication, and nobody else should either.
Morgan Harper is the director of policy and advocacy at the American Economic Liberties Project.
Erik Peinert is research manager and editor at the American Economic Liberties Project.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Drug Discoveries |
Boris Johnson’s government was overly reliant on scientific advice during the pandemic and did not listen more to economists on how lockdowns and other lengthy restrictions might affect the economy, the Covid inquiry has been told.
The current and former chief medical officers for England have both suggested that the expertise the government received through the Sage committee should have been balanced with economic advice on the costs of lockdowns to the economy and society.
An excerpt of the written submission by current Chief Medical Officer, Professor Sir Chris Whitty, to Baroness Hallett’s inquiry reveals he recommends that the “cost effectiveness of particular interventions” and “health economics” should be taken into account alongside medical and scientific advice in future pandemics.
His predecessor, Dame Sally Davies – who gave oral testimony to the inquiry on Tuesday – was more explicit in her written evidence, published following her appearance.
She says that ministers “need a balance to the biomedical input from Sage and to look at the health emergency/pandemic from the perspective of the economy and well-being of society”.
Dame Sally also says emergency exercises that test resilience for a pandemic outbreak are not sufficient as they only cover the immediate impact rather than longer-term effects of drawn-out lockdowns.
In the early stages of the pandemic in 2020, Mr Johnson – regularly flanked by Sir Chris and Sir Patrick Vallance, who was chief scientific adviser, at Downing Street press conferences – insisted his government was “following the science”.
Later in 2020, Mr Johnson faced criticism for not doing so, when it emerged he was ignoring Sage advice for a “circuit-breaker” lockdown.
In written evidence, Sir Chris, who will testify in person before Lady Hallett on Thursday, says: “There may be a need to look at operational issues and the cost effectiveness of particular interventions within CMO or SAGE advice, so health economics may be relevant to the medical and scientific advice.
“This is because giving advice which is operationally unfeasible or substantially disproportionate in cost or difficulty is not especially helpful.”
Dame Sally’s written statement says: “I have previously stated that whilst it is desirable for biomedical experts to confine their advice to biomedical matters, ministers also need advice from economists and anthropologists and people from other points of view who can help balance the issues.
“Again, I can confirm to the inquiry that I still hold those views. I would further add that I now think ministers need a balance to the biomedical input from Sage and to look at the health emergency/pandemic from the perspective of the economy and well-being of society.
“This could, for instance, include contributions from the CSA [chief scientific adviser] at the Department for Education or the Chief Economist at the Treasury. There needs to be an institutional framework to ensure that there are a full range of opinions from each discipline.”
Dame Sally, who was chief medical officer for England from 2010 to 2019, says pandemic planning exercises were effective at testing resilience for the short-term effects of a virus hitting the health service, but added that they “in my experience gave rise to no concerns about the sustainability of an emergency response over a few months”.
She adds: “It is now apparent to me that government preparedness exercises could have done more to prepare for long-term emergencies that went on for more than a few months.
“This is important given the need for government to balance the biomedical model with economic factors and societal well-being in the context of a longer term crisis such as Covid-19.
“In respect of Covid-19, there were plans in place to respond to an initial outbreak. From there, scaling up the response was obviously challenging but doable. What had not been fully considered was how to sustain the response once scaled-up and mitigate the impacts for those working on the front line.” | Health Policy |
Image source, Getty ImagesMore than 650,000 deaths were registered in the UK in 2022 - 9% more than 2019. This represents one of the largest excess death levels outside the pandemic in 50 years.Though far below peak pandemic levels, it has prompted questions about why more people are still dying than normal.Data indicates pandemic effects on health and NHS pressures are among the leading explanations. Is it Covid?Covid is still killing people, but is involved in fewer deaths now than at the start of the pandemic. Roughly 38,000 deaths involved Covid in 2022 compared with more than 95,000 in 2020.We are still seeing more deaths overall than would be expected based on recent history. The difference in 2022 - compared with 2020 and 2021 - is that Covid deaths were one of several factors, rather than the main explanation for this excess. So what else might be going on?The crisis in healthcareA number of doctors are blaming the wider crisis in the NHS.At the start of 2022, death rates were looking like they'd returned to pre-pandemic levels. It wasn't until June that excess deaths really started to rise - just as the number of people waiting for hours on trolleys in English hospitals hit levels normally seen in winter.On 1 January 2023, the president of the Royal College of Emergency Medicine suggested the crisis in urgent care could be causing "300-500 deaths a week". It's not a figure recognised by NHS England, but it's roughly what you get if you multiply the number of people waiting long periods in A&E with the extra risk of dying estimated to come with those long waits (of between five and 12 hours).It's possible to debate the precise numbers, but it's not controversial to say that your chances are worse if you wait longer for treatment, be that waiting for an ambulance to get to you, being stuck in an ambulance outside a hospital or in A&E.And we're seeing record waits in each of those areas. In November, for example, it took 48 minutes on average for an ambulance in England to respond to a suspected heart attack or stroke, compared to a target of 18 minutes. Lasting effect of pandemicSome of the excess may be people whose deaths were hastened by the after-effects of a Covid infection. A number of studies have found people are more likely to have heart problems and strokes in the weeks and months after catching Covid, and some of these may not end up being linked to the virus when the death is registered. As well as the impact on the heart of the virus itself, some of this may be contributed to by the fact many people didn't come in for screenings and non-urgent treatment during the peak of the pandemic, storing up trouble for the future. We can see that the number of people starting treatment for blood pressure or with statins - which can help prevent future heart attacks - plunged during the pandemic and, a year later still hadn't recovered. No evidence of vaccine effectThe rise in cardiac problems has been pointed to by some online as evidence that Covid vaccines are driving the rise in deaths, but this conclusion is not supported by the data. One type of Covid vaccine has been linked to a small rise in cases of heart inflammation and scarring (pericarditis and myocarditis). But this particular vaccine side-effect was mainly seen in boys and young men, while the excess deaths are highest in older men - aged 50 or more.And these cases are too rare - and mostly not fatal - to account for the excess in deaths.Finally, figures up to June 2022 looking at deaths from all causes show unvaccinated people were more likely to die than vaccinated people. While this data on its own can't tell us it's the vaccine protecting people from dying - there are too many complicating factors - if vaccines were driving excess deaths we would expect this to be the other way around. | Epidemics & Outbreaks |
Sir Keir Starmer is to propose introducing new NHS targets on cutting deaths in England from heart disease, strokes and suicide.
A Labour government would aim to reduce deaths from heart disease and strokes by a quarter over 10 years and see suicide figures decline within five.
The Labour leader is giving a speech on the party's NHS policy later.
The Tories accused Labour of seeking to frustrate its own reforms by repeatedly voting against them.
Labour's new targets for the health service will be part of a wider package of reforms if it is elected, Sir Keir will say, with a focus on modernisation, hitting existing cancer targets, and cutting waiting lists.
Sir Keir is expected to call for three "big shifts" in approach for the NHS, promoting digital methods, community care and preventative measures.
He will say it is "not serious" to argue the health service's problems can be solved with extra funding, and call for "serious, deep, long-term changes".
More than 5,500 deaths were registered as suicides in England and Wales in 2021, according to the Office for National Statistics (ONS) - around three quarters of which were men. Women under the age of 24 have seen the largest increase of any group since data started being collected in 1981, an ONS study found in 2022.
Sir Keir is expected to tell an audience in the east of England that suicide rates among young people "should haunt us", adding: "Our mission must be and will be: to get it down."
The party also wants existing NHS targets to be tackled - for example the aim for 85% of cancer patients to start treatment within 62 days of an urgent GP referral. This has not been achieved since 2015.
A Conservative Party source said cutting waiting times is one of the government's top five priorities, and that there had already been major progress on reducing very long waits.
They accused Labour of voting "against Conservative plans for more doctors" and said it was prioritising the hiring of thousands more NHS managers.
"If Labour were serious about NHS reform they would have taken action where they are in power in Wales where waiting lists are higher," they added.
Sir Keir's speech on Monday will be his third on Labour's five "missions" for government if it wins power, the areas which are likely to form the backbone of the party's manifesto at the next general election.
It came after Wes Streeting, the shadow health secretary, highlighted the party's aim to give people a greater choice over where they receive hospital treatment.
He told the BBC's Sunday with Laura Kuenssberg that Labour's plan for regional waiting lists would give patients more flexibility to receive care elsewhere if queues are shorter in another area.
- If you've been affected by self-harm or emotional distress, help and support is available via the BBC Action Line | Health Policy |
Across the United States, thousands of people with COVID-19 are being hospitalized each week and the number is steadily trending up — a sure sign that overall cases have also been on the rise.
Levels of detectable coronavirus in wastewater samples and the proportion of tests that come back positive have certainly been ticking up since June, data from the U.S. Centers for Disease Control and Prevention show. Both metrics indicate rising cases at the national level, albeit indirectly. It’s hard to get a good grasp of the start of new surges or know what’s happening within communities, in part because states are no longer required to report new cases, a result of the U.S. public health emergency ending in May (SN: 5/4/23).
We do know the worst of the pandemic is largely behind us. While the virus can, and does, still spread far and wide, its transmission isn’t the overwhelming crush that characterized the pandemic’s first years.
Amid a backdrop of ever-evolving variants — including a new version of omicron designated BA.2.86 that is under close watch from global and U.S. health agencies — most infections are now less deadly than the pandemic’s early days. Data from blood banks show that as of September 2022, around 96 percent of people in the United States had been vaccinated, infected with the virus or both, which can help reduce the severity of future infections. And, a new booster shot — designed to target relatives of a viral lineage dubbed XBB — should be available at the end of September (SN: 1/13/23).
Even with those rays of hope, our future with SARS-CoV-2, the virus that causes COVID, is unclear. The virus is not going anywhere; new variants will continue to appear with varying degrees of infectiousness and severity. How many people might fall ill or die on average each year? We don’t know.
Answering that question requires the virus to have entered its endemic phase — when it regularly circulates at some baseline amount. Even then, endemic does not mean benign. In that phase, people will still get sick with COVID, some severely so. But far fewer will land in the hospital or die in a “normal” year than during the pandemic years.
To see if this fall — our fourth with COVID and the first without a public health emergency in place — could possibly be the start of the coronavirus’ endemic phase, Science News spoke with epidemiologist Aubree Gordon of the University of Michigan in Ann Arbor. This conversation has been edited for length and clarity.
SN: How are things different this fall than in previous years?
Gordon: One of the big differences … is that at this point pretty much everybody … has some sort of immunity against SARS-CoV-2.
A majority of people have hybrid immunity, meaning that most people in the United States, or a good chunk of them, have been not only vaccinated but had an infection. For a majority of people that did not choose to get vaccinated, most of those individuals have been infected a few times. And some of the people who were vaccinated have been infected a few times.
What that means is that we have a higher level of immunity against the virus. Obviously, that’s not preventing people from getting infected or reinfected. But it’s certainly helping to reduce the severity of those infections when they happen.
SN: What have we learned about what reinfections tend to look like?
Gordon: They tend to be a lot milder than a first infection. But severe reinfections still do occur. And when you talk about severe, you’re not only thinking about fatal infections, which are of course the most severe, but also infections that cause hospitalization or may cause long-term symptoms.
SN: A new booster this fall will replace the omicron variant with a new one. Is it important to get this booster?
Gordon: I think booster shots are definitely advised, particularly for individuals who are more likely to have severe disease.
I had really hoped that we would have arrived at a point where SARS-CoV-2 was looking like a seasonal coronavirus, one that causes symptoms of the common cold, and was therefore less severe than influenza. What we’re still seeing for SARS-CoV-2 is that it is more severe than flu. It’s still causing a lot more deaths on an annual basis than flu is causing. I’d say it’s not clear if we’ve gotten to the fully endemic level yet [when transmission falls into an average range from year to year].
SN: Where do you think we are on the spectrum between pandemic and endemic?
Gordon: I think we’re getting pretty close to what endemic will look like. I don’t know if we’ll be fully at that level for this next season, or if it might take another season or two for us to get there.
I will say that I’m kind of hoping we’re not at the endemic level yet. At least based on last year, because there were a substantial number of deaths in the United States — 244,000 was the CDC estimate. It’s four or five times higher than a severe seasonal influenza season in the United States.
But [COVID disease severity] has been trending downward over the last many months. The hope would be that we continue to see that downward trend in the number of severe and fatal cases. If [COVID] had hit its endemic level, we would expect some season-to-season fluctuations, but it’d be fluctuating around that number rather than continuing a downward trend of being less and less severe.
SN: Have researchers learned anything over the past year about what endemic might look like?
Gordon: I think we’re zeroing in on what endemic will look like. It’s, I think, become fairly clear that this is going to be a regular infection that people may get more often than flu. Maybe the virus will start changing less. For adults [who are more likely than kids to get severely ill], it is probably looking like it’s going to [be as dangerous as] influenza if not [more dangerous]. We will see for sure.
I had thought that everybody would need maybe a vaccination and then one or two infections to get at whatever the endemic level would be. It’s possible that you need a little bit broader immunity [to protect against more variants of the virus] and more exposures to hit that endemic level.
SN: What do you think experts might learn this fall?
Gordon: One thing that we’ll look at this fall is how different it is from last fall. Because if we’re still seeing a downward trajectory, then maybe we haven’t yet hit the endemic level. Or we may see something that looks quite similar to last fall, which would tell us that perhaps we’ve arrived at that endemic level.
There is season-to-season variability, there are differences in variants, and we have new variants arising, which will all contribute on a yearly basis to how severe the SARS-CoV-2 season is. We have that for flu. CDC estimates for recent flu seasons, excluding the pandemic ones, were anywhere from 12,000 to 52,000 deaths a year. That’s quite a bit of variability. | Epidemics & Outbreaks |
A new study at Columbia University has found that shortening sleep by just 90 minutes for six weeks increased insulin resistance in women who are accustomed to getting adequate sleep. The effect was even more pronounced in postmenopausal women.
The recommended amount of sleep for optimal health is between seven and nine hours per night, yet about one-third of Americans get less than the minimum recommended amount.
The findings are the first to show that a mild sleep deficit, maintained for six weeks, causes changes in the body that raise the risk of developing diabetes in women. Previous trials showing the adverse impact on insulin sensitivity included mostly men and focused on the effects of very severe sleep restriction over a short period of time.
Women and sleep
The new study looked at women in particular because studies suggest that poor sleep may have a greater impact on women's cardiometabolic health than men's.
"Throughout their lifespan, women face many changes in their sleep habits due to childbearing, child-rearing, and menopause," says study leader Marie-Pierre St-Onge, PhD, associate professor of nutritional medicine and director of the Center of Excellence for Sleep and Circadian Research at Columbia University Vagelos College of Physicians and Surgeons. "And more women than men have the perception they aren't getting enough sleep."
Studying the health impacts of chronic sleep loss is difficult. Some studies, performed in a laboratory setting, have shown that a brief period of total or partial sleep deprivation impairs glucose metabolism. But such studies do not reflect the typical experience of being mildly sleep-deprived, which means getting by on roughly six hours of sleep for long periods of time.
Study design
To look at the impact of mild, chronic sleep deprivation, the researchers enrolled 38 healthy women, including 11 postmenopausal women, who routinely slept at least seven hours each night.
In the study, the participants underwent two study phases in random order. In one phase, they were asked to maintain their adequate sleep; in the other, they were asked to delay their bedtime for an hour and a half, shortening their total sleep time to around six hours. Each of these phases lasted for six weeks.
Remarkably, all of the study participants were able to reduce their nightly sleep duration during the arduous six-week sleep-restriction phase. Compliance with sleep schedules was measured with wearable devices. Throughout the study, the researchers measured insulin, glucose, and body fat.
Study results
The study found that curtailing sleep by 90 minutes for six weeks increased fasting insulin levels by over 12% overall and by more than 15% among premenopausal women.
Insulin resistance increased by nearly 15% overall and by more than 20% among postmenopausal women. Average blood sugar levels remained stable for all participants throughout the study.
"Over a longer period of time, ongoing stress on insulin-producing cells could cause them to fail, eventually leading to type 2 diabetes," St-Onge says.
Although increased abdominal fat is a key driver of insulin resistance, the researchers found that the effects of sleep loss on insulin resistance were not due to increases in fat.
"The fact that we saw these results independent of any changes in body fat, which is a known risk factor for type 2 diabetes, speaks to the impact of mild sleep reduction on insulin-producing cells and metabolism," St-Onge says.
"The bottom line is that getting adequate sleep each night may lead to better blood sugar control and reduced risk for type 2 diabetes, especially among postmenopausal women."
Next steps
In recent years, epidemiological studies have suggested that people whose sleep varies from day to day also have a higher risk of developing diabetes. St-Onge and colleagues will look at whether stabilizing sleep patterns among people with variable sleep schedules improves blood sugar control. Additional studies will look at whether restoring sleep for people who routinely don't get enough may improve glucose metabolism.
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It's the summer holidays - when your weeks are a mixture of late nights, day trips and events - coupled with back-to-work slumps and early wake-up calls.
Social jetlag is the shift in internal body clock - when sleeping patterns change between workdays, weekends and holidays.
Late nights when on holiday and at the weekends can mean a struggle when it's time to go back to work again and bedtimes need to be sensible for early starts.
The mix can throw body clocks into disarray - and now new research suggests irregular sleep patterns may be linked to harmful bacteria in your gut.
The study, published in The European Journal of Nutrition, is the first to find a link between social jetlag - and poorer diets.
Even a 90-minute difference in the mid-point of sleep - half-way between sleep time and wake-up time - can encourage microbiome (bacteria) that has negative associations with health, the study found.
Previous research has suggested that working shifts disrupts the body clock and can increase risk of weight gain, heart problems and diabetes.
However, even small differences in sleeping habits between work and free days can affect the body's biological rhythms, according to researchers from King's College London.
Read more:
Just one alcoholic drink a day could raise blood pressure
Eco diet could reduce risk of death from chronic illness by 25%
They assessed a group of 934 people from the ZOE Predict study, the largest ongoing nutritional study of its kind.
The group comprised of mainly lean and healthy individuals with most of them getting more than seven hours sleep throughout the week.
Researchers looked at blood, stool and gut microbiome samples, as well as glucose measurements in people whose sleep was irregular compared to those who had a routine sleep schedule.
Having social jetlag was associated with poor diet quality, higher intakes of sugar-sweetened beverages, and lower intakes of fruits and nuts, according to their findings.
This may directly influence the abundance of specific species of bacteria in the gut, they say. Some are better than others so may positively or negatively affect people's health.
They found three out of the six microbiota species more abundant in the social jetlag group are linked with poor diet quality, indicators of obesity and cardiometabolic health, like heart attack, stroke, and diabetes, and markers in blood related to higher levels of inflammation and cardiovascular risk.
Dr Sarah Berry, from King's College London and chief scientist at ZOE, said: "Maintaining regular sleep patterns, so when we go to bed and when we wake each day, is an easily adjustable lifestyle behaviour we can all do, that may impact your health via your gut microbiome for the better." | Nutrition Research |
US big data company Palantir is facing more opposition to its bid to win the £480m NHS England Federated Data Platform (FDP) contract as doctors across the UK call on the government to step in and pause the tender process. A new report outlining seven risks posed by choosing Palantir has been sent to MPs, and says that nearly half of NHS patients will opt out of sharing data if a private company is selected to develop and run the platform.
The paper, The NHS Federated Data Platform and Planatir – 7 Key Risks, has been sent to MPs today, Politico reports. It puts forward concerns around lobbying and inside dealing during the procurement process for the FDP, a vague scope for the project and a failure to design for patient consent.
Produced jointly by law firm Foxglove and non-profit membership organisation Doctor’s Association UK (DAUK), the report says that Palantir has a “poor reputation” and would “exacerbate” problems with public trust in the NHS. Both organisations are part of a joint effort with other campaign groups to sue the UK government over its plan to “hand over confidential data” to Palantir.
Critics of US-based Palantir have long believed that the company’s secretive nature and close ties to US security agencies such as the CIA make it unsuitable to work with public bodies in the UK. But it has been heavily involved in the development of the FDP, which is being set up to help data sharing across the NHS to improve patient care.
The report also criticises NHS England, highlighting that data projects within the national health service have failed because of a “lack of public trust” and says that senior leadership has been steered away from developing in-house solutions or drawing from open-source projects.
The two stakeholders provide alternatives for NHS England and the UK government, saying that none of the Palantir sceptics lacks belief in the potential of data. It points to Open SAFELY, an open source platform for health record data, and OneLondon, which joins up healthcare across the capital, as case studies of how data platforms in healthcare can be designed to be transparent.
Foxglove and UK doctors point to a ‘rigged’ procurement process for FDP
According to the report, the FDP procurement fails to meet the standard of being “transparent and scrupulously fair” due to lobbying by Palantir and the waiving of procurement procedures during the Covid-19 pandemic.
“Prior to gaining a tow-hold in the NHS, at a time when procurement rules had been suspended, Palantir had no track record in health,” the report explains. It points to Palantir’s Foundry Platform, which is normally used in sectors such as aerospace and energy, but said it focused on the healthcare market in 2019.
“Liam Fox and officials in the Trade Department held closed-door meetings with Palantir bosses at Davos,” the report continues. “Briefing notes say these meetings were set up to discuss the ‘untapped’ commercial potential of NHS data.”
Foxglove and Doctors Association UK claim that from mid-2019 the US firm continued to lobby the NHS through closed-door dinners and private meetings in California. By 2020, Palantir was selected to provide its Foundry platform for a new ‘datastore’ – the contract was worth a token £1. As reported by Tech Monitor, by the contract’s first renewal, the firm increased the price to £1m and then to £23m by the second and has since won another £11.5m extension.
“For Palantir, the most valuable outcome of these Covid-19 contracts was not the £34m, but the opportunity to install itself, without any competitive tender process, in the heart of the NHS,” the report states.
The scope for FDP remains vague with patient data at risk
The report hones in on the scope of FDP and that NHS England has failed to ensure it will be a good value for money due to its vagueness.
It references a report conducted by the National Audit Office (NAO) in 2020, Lessons Learnt From Major Programmes, which examined different programmes for the government. NAO said that the scope of the programmes was one of the “root causes” of challenges seen during the programmes.
Foxglove and DAUK say that this problem is now seen in the scope of the FDP, which they say has been “difficult for even experts to follow.” The initial tender states five uses of the FDP, however, it also says that these uses will expand, which leads the report to conclude that nobody knows exactly what the government is planning to do with it.
“The documents also state the customer base for the FDP is ‘wider than just NHS England’ without clearly explaining who else will have access,” the report states. “Integrated care systems will have access, but so too, it is suggested, will providers commissioned under a contract to provide NHS services, which potentially includes a raft of public and private organisations.”
Foxglove and DAUK also argue that the lack of precision in the FDP scope increases the likelihood of the NHS getting poor value for money: “It increases the risk of being left with a system which doesn’t fulfil the NHS’ core needs, and of paying for features it doesn’t need at all,” it claims, pointing out that any changes to the scope later in the project are liable to increase project costs.
But another risk of the FDP project is the failure to design the database for patient consent. The report says that this is one of the “greatest risks of this system” and another lesson not learned from previous NHS data projects, pointing to the failure of care.data and its subsequent abandonment in 2016.
“By the time care.data was abandoned in 2016, over 1.6 million NHS patients had opted out of the scheme – enough to seriously degrade the quality of the data,” Foxglove and DAUK say. It also says that the NAO found there had been “insufficient focus on how to gain patient acceptance to share their data.” This happened again in 2021 when another programme known as General Practice Data for Planning and Research was put on hold after over 1m patients in a month opted out of data sharing.
Research from YouGov shows this could happen again with the FDP – nearly half of the English adults who haven’t yet opted out of NHS data-sharing said they would be likely to do so if the FDP was introduced and run by a private company. This means an additional 20 million patients removing consent.
Palantir would create a monopoly lock-in
Foxglove and DAUK say that for the FDP to be successful, it needs to be able to work alongside other systems such as OneLondon. It also says that if the NHS wanted to switch to another supplier, FDP needs to enable that.
However, it says that the feedback from data scientists and NHS managers says that selecting Palantir would create the opposite effect: “By technical design, Palantir has explicitly avoided creating a system that you can easily extract data from or that works well with other industry–standard data analytics systems. Palantir’s system pushes people to its own proprietary systems, and switching costs will be very high.”
It points to Jupyter, an industry-standard data science tool used by most NHS data scientists. “Palantir offers its own proprietary tool that does not work with this system.” It also says that “insiders” report that another pilot of a central government use of Foundry, unrelated to health, took months to have data extracted.
A monopoly could also mean higher prices for the NHS more generally. The Competition and Markets Authority (CMA) flagged a similar issue when it announced its investigation of the United Health proposed acquisition of EMIS. As reported by Tech Monitor, the government agency said that competition could be “substantially reduced” if the acquisition went ahead and could result in contract costs going up for the NHS for “lower quality offerings.”
Palantir’s ‘failed pilots’ and ‘bad reputation’ are causes for concern
The last two risks from the report call out Palantir’s ‘dodgy’ reputation and examples of failed pilots, which could be foreshadowing what could happen with the FDP.
“To defend the FDP plan, Palantir and some officials have leant heavily on two supposedly successful uses of the Foundry software – in supporting the vaccine rollout, and in a pilot of the software in a single digitally immature NHS trust, Chelsea and Westminster,” it says.
But the authors argue that these isolated examples are not success stories and that there is a lack of transparency around the data or documentation used to support the claims, and that NHS managers, data scientists and health tech experts have told them differently.
“These experts say that the FDP system is poorly designed,” they say. The report also says that several Foundry pilots have failed, but this has never been acknowledged, that further pilots of the ‘elective care recovery system’ have been indefinitely suspended and that FDP unnecessarily duplicates existing NHS infrastructure.
Palantir told Tech Monitor that its pilots haven’t been paused or suspended in 11 NHS Trusts and that it is currently live in four of the Trusts referred to in the report. Another is “on to be live.”
“We’re proud that our software supported the COVID vaccine rollout and, since then, has helped deliver a 28 per cent waiting list reduction and faster cancer treatment at Chelsea and Westminster NHS Foundation Trust,” a Palantir spokesperson said.
“As a software company, we don’t collect or monetise customers’ data – we simply provide tools that help them organise and understand their own information.” | Health Policy |
For the 30% of children who have problems falling or staying asleep — their genes may be to blame.
That’s according to a 15-year study recently published in the Journal of Child Psychology and Psychiatry, which found that certain genetic variants can have an impact on children’s sleep quality and quantity.
Researchers from the Department of Sleep and Cognition at the Netherlands Institute for Neuroscience in Amsterdam analyzed the sleep patterns of 2,458 children, as reported by their mothers.
Those who were "genetically predisposed" to insomnia — based on polygenic risk scores that had previously been used for adults — were more likely to have sleep problems between 1½ and 15 years of age.
Those problems included having trouble falling asleep, sleeping less than most children during the day and/or night, and waking up often during the night.
"Our study shows that genetic susceptibility for poor sleep translates from adults to children," said corresponding author Desana Kocevska, PhD, of the Netherlands Institute for Neuroscience and the Erasmus MC University Medical Center Rotterdam, in a press release.
"This finding emphasizes the importance of early recognition and prevention."
Other studies have found that insomnia is inherited in about 40% of cases, sleep quality is 44% inherited and sleep duration is 46% inherited, according to the researchers’ summary.
One of the primary potential limitations of the study is that the sleep behaviors were reported by the children’s mothers and may be influenced by "maternal perceptions and expectations," the study authors wrote.
For future studies, reports from fathers or other caregivers could help remove some potential bias, they noted.
Fox News Digital reached out to the study authors for comment.
"Our study shows that genetic susceptibility for poor sleep translates from adults to children."
Dr. Christopher Winter, a sleep medicine doctor and neurologist in Charlottesville, Virginia, said he wrote the book "The Rested Child" in an attempt to break the stereotype that poor sleep quality is just an adult problem.
He was not involved in the study, but shared his insights on the findings.
"There are many factors that could predispose [people] to poor sleep quality," he told Fox News Digital. "Underlying virtually all of these factors are genes we inherit."
Genes can determine many factors influencing quality and quantity of slumber, Winters noted, including sleep timing, airway size and structure, predisposition to anxiety, and even how much a person needs to sleep.
"I think this study offers some insight into the idea that younger people can be predisposed to poor sleep, even at an early age," he said.
Tips to improve kids' sleep
Although genetics play a role, Winter noted that many other environmental factors can disrupt sleep.
These can include electronics/technology, schoolwork, extracurricular activities, medications, employment and social factors.
For kids who have enough opportunity for rest but who are still getting poor quality of sleep, Winter suggested seeking early intervention from a sleep specialist.
"This is the key to not only solving the sleep issue, but also for keeping a relatively benign and acute sleep problem from slowly transforming into a more chronic and difficult-to-treat disorder."
He added, "Sleep disorders are solvable. While there are plenty of resources out there for kids and parents when it comes to sleep, make sure you are enlisting the help of a behavioral sleep specialist early — and not simply throwing melatonin gummy bears at the problem."
"For most of these kids, sleeping pills and/or sedatives are not the proper long-term solution," he also said.
Funke Afolabi-Brown, M.D., a Pennsylvania-based pediatric sleep medicine physician and BabyCenter Medical Advisory Board member, who was not involved in the study, also provided her suggestions to improve kids’ sleep.
"I recommend establishing a consistent bedtime routine, limiting screen time before bed, ensuring a comfortable sleep environment free of devices and other distractions, and getting regular physical activity," she told Fox News Digital.
It’s also important to maintain a consistent sleep schedule, even on weekends, to regulate a child's sleep patterns, the expert added.
"Finally, if issues persist, consult with a pediatrician or sleep expert." | Disease Research |
UK regulators are investigating the Ozempic and Saxenda weight loss drugs over reports that patients experienced suicidal and self-harming thoughts while taking the medications. The drugs skyrocketed in popularity in the U.S. as doctors began prescribing them to people who struggled with obesity, but new reports are coming to light that the so-called miracle drugs may not be such a miracle after all.
The Food and Drug Administration (FDA) has not approved Ozempic as a weight loss drug, but some physicians are still prescribing it for that use in the U.S. and abroad. The Medicines and Healthcare Products Regulatory Agency (MHRA) told Sky News that “it is commonly used off-label for that purpose” in the UK.
Ozempic is approved to treat Type-2 diabetes and contains the active ingredient semaglutide which is also found in Wegovy, a drug that is FDA-approved to treat obesity and promote weight loss. The UK’s review into allegations that Ozempic is causing depression in patients also includes Saxenda, an approved weight-loss treatment containing the active ingredient liraglutide.
Although Ozempic does not list depression or thoughts of suicide as a possible side effect, precautions for Wegovy state that “suicidal behavior and ideation have been reported in clinical trials with other weight management products.”
It is unclear if the patients who reported having depressive or suicidal thoughts had pre-existing conditions prior to taking Ozempic or Saxenda but the EU is conducting a separate investigation of the drugs after 150 people were reported to cause self-injury or have suicidal thoughts.
All three drugs are sold by Novo Nordisk, a Danish drugmaker, and are known as GLP-1 receptor agonists, which mimic hormones produced in the patient’s gut to suppress their appetite and help them feel full longer.
Nova Nordisk said in an emailed statement to Gizmodo that it hasn’t found any safety data that “demonstrated a causal association between semaglutide or liraglutide and suicidal and self-harming thoughts.” The company said it received a request from the MHRA on Monday informing the company that it would be reviewing whether the reported suicidal and self-harming side effects are related to the drugs. Novo Nordisk said: “The review is ongoing and a response will be provided within the requested timelines.”
The MHRA did not immediately respond to Gizmodo’s request for comment.
The investigation comes as some doctors warn Ozempic and Wegovy may cause stomach paralysis after some cases were reported by patients who took the medications. Stomach paralysis can lead to cyclic vomiting syndrome which causes the person to throw up several times each day. As the number of people taking weight loss drugs continues to soar, doctors say more patients are reporting issues, but extreme cases are still considered to be rare.
“Patient safety is our top priority,” the MHRA said in a statement to CNBC. “We will carefully consider all available evidence and communicate any further advice to patients and healthcare professionals as appropriate.” | Drug Discoveries |
My fit and healthy step-father died after ear-ache turned out to be meningitis - he was brain-damaged within hours
- Gareth Rowlands, 50, from Gwynedd, Wales, died after contracting meningitis
- The painter and decorator was a 'fit and healthy man' before, Daily Post reports
- READ MORE: Fears as life-saving meningitis vaccine given to toddlers is cancelled by its manufacturer for 'commercial reasons'
A 'fit and healthy man' who complained of an ear ache has died after contracting meningitis, which left him 'brain damaged'.
Gareth Rowlands, 50, ended up in an induced coma and was 'fighting for his life' all within days, before tragically passing away on Saturday.
The painter and decorator, from Gwynedd, Wales, was given 'very little chance of survival' after an MRI scan confirmed most of his brain was damaged.
Now his family are raising funds to give him 'the best send off possible'.
Gareth Rowlands, 50, ended up in an induced coma and was 'fighting for his life' all within days, before tragically passing away on Saturday. Pictured with his partner Angie
'He complained of an ear ache on the Saturday' his step-daughter Linzi wrote on GoFundMe. By Sunday, January 17, he had developed a headache.
'And very early on the Monday morning, my mum found him literally fighting for his life, his brain being starved of oxygen,' she said.
He was put an induced coma, and then left sedated while being cared for in Intensive Care.
An MRI scan heartbreakingly revealed that the brain damage 'wasn't compatible with life'.
'Gareth was bought out of the coma, taken off the sedation and ventilation and tragically passed away at Ysbyty Gwynedd on February 4th 2023,' Linzi added.
She also wrote that her step-father a 'it and healthy young man' until contracting meningitis.
He leaves behind Angie, his partner of 29 years, and his three step-children: Linzi, Jamie, and Sam.
It comes as doctors have raised the alarm over plans to stop giving toddlers a meningitis vaccine, claiming it would leave children vulnerable to the life-threatening infection.
WHAT IS MENINGITIS?
Meningitis is inflammation of the membranes that surround and protect the brain and spinal cord.
Anyone can be affected but at-risk people include those aged under five, 15-to-24 and over 45.
People exposed to passive smoking or with suppressed immune systems, such as patients undergoing chemotherapy, are also more at risk.
The most common forms of meningitis are bacterial and viral.
Symptoms for both include:
- Pale, blotchy skin with a rash that does not fade when compressed with a glass
- Stiff neck
- Dislike of bright lights
- Fever, and cold hands and feet
- Vomiting
- Drowsiness
- Severe headache
Headache is one of the main symptoms
Bacterial meningitis
Bacterial meningitis requires urgent treatment at hospital with antibiotics.
Some 10 per cent of bacterial cases are fatal.
Of those who survive, one in three suffer complications, including brain damage and hearing loss.
Limb amputation is a potential side effect if septicaemia (blood poisoning) occurs.
Vaccines are available against certain strains of bacteria that cause meningitis, such as tuberculosis.
Viral meningitis
Viral is rarely life-threatening but can cause long-lasting effects, such as headaches, fatigue and memory problems.
Thousands of people suffer from viral meningitis every year in the UK.
Treatment focuses on hydration, painkillers and rest.
Although ineffective, antibiotics may be given when patients arrive at hospital just in case they are suffering from the bacterial form of the disease.
Source: Meningitis Now
All youngsters in the UK receive the jab, which protects against meningococcal group C (MenC) bacteria, around their first birthday. These bugs cause meningitis – a rare infection of the protective membranes around the brain and spine.
The condition, which strikes healthy children without warning, is difficult to distinguish from milder childhood illnesses in the early stages and can lead to death within 24 hours.
Bacterial meningitis can cause life-threatening blood poisoning called septicaemia and lead to serious injuries, including loss of limbs, deafness and brain damage. | Epidemics & Outbreaks |
My son was diagnosed with autism at the age of nine, had a tough time at school and with family issues, and at 13 began to isolate himself away and would go into periods of depression.But that was nothing compared to what he was like when he turned 16. A relationship breakdown saw him become suicidal. He stopped wanting to interact with anyone, to the point that he would react badly if I even asked him about his day.His school knew he was very depressed and advised him to phone the GP. That was the first kick in the teeth for him. The GP in effect said “here are some leaflets and some helplines”. He felt even more alone then since he’d sought help and basically been turned away.At one point he went missing. I then realised that he had begun to express suicidal thoughts, and when he disappeared he had left very worrying messages with a few people about how he intended to slit his throat.The day he disappeared I got a message to say that he hadn’t turned up at school. He wouldn’t answer the phone to me or anyone else. He’d gone off with his girlfriend and neither would say where they were. I was so worried because he’d taken a knife from our kitchen.I spent the morning looking all round the town for him. After two hours, the police found him hiding behind the boundary fence of our local cricket ground. He was in a bad way and the police kindly drove us both to A&E.He did have an assessment with someone from the child and adolescent mental health services (Camhs) team. However, the A&E doctor made clear that there was nothing more the hospital could do for my son that day and that we should go home. He had had a Camhs assessment and that service would be in touch.They wouldn’t tell me what was making him so distressed, because he had asked them not to. That meant I had no real guidance about how to keep my child safe at home. They did say that I should lock away all the knives, as he had taken a knife before, and the very strong pain medicine I take.When we went to A&E I hoped he would be admitted because I felt that I couldn’t make him better and that I was unprepared and inadequate. I felt very alone. I was out of my depth and petrified that I was going to lose my child. I just wanted someone to take him off me and look after him and make him better.I was very confused when the A&E doctor said we had to go home. I assumed they would keep my son in, given how distressed and vulnerable he was. I just thought: what state do you need to be in to be kept in? I was in a complete state of shock.I still have no idea what state you would need to be in to actually be admitted, because my son was in a very bad state and admission wasn’t even discussed. It wasn’t a “shall we, shan’t we” thing, it was just “go home”.I think that young people having a mental health crisis are just dismissed. I’ve spoken to other parents and the story is the same. Young people can have eating disorders, they can have clear plans for suicide, and Camhs will say they aren’t severe enough for inpatient care. It leaves me with no faith that a young person who presents at a GP surgery or A&E will get the help they need.Camhs were eventually very good for my son. They did everything they were meant to do. But it all came too late. He is coping really well now. He has a girlfriend and is more aware of his mental health. I just hope that we never have to go through a crisis like that again. In the UK and Ireland, Samaritans can be contacted on 116 123, or email [email protected] or [email protected]. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befriend. | Mental Health Treatments |
A study lasting 7 days looked at how engaging in prosocial behavior affected people’s psychological well-being. It found that participants felt happy when they helped others, but this was true only when they chose to help freely, the person they helped wasn’t responsible for their problem, the person they helped showed gratitude, the help improved the situation, and they didn’t expect to blame themselves if they didn’t help. The study was published in the Journal of Applied Social Psychology.
People engage in different activities in pursuit of happiness. Some believe that their dream job will make them happy, others believe that earning lots of money will achieve this, while some try to achieve happiness through exercise or meditation. Generally, people tend to expect much more happiness from individual positive events than these events actually bring.
Many people focus on their own needs and feelings when they want to feel good, but studies indicate that acting kindly towards others can also lead to a great sense of satisfaction. An increasing number of studies indicate that being kind and helpful to others can improve the well-being of the helper. However, not all situations of helping others are the same – some will benefit the well-being of the helper more than others.
Study author Jana S. Kesenheimer and her colleagues wanted to explore the factors that affect how much the act of helping benefits the well-being of the helper. They conducted a 7-day diary study with 363 participants, most of whom were university students.
The study was carried out through a series of online surveys. The whole procedure was explained to participants in the first survey. This survey took around 15 minutes to complete. After this, for the next seven days, participants received an email at 7 p.m. containing a link to the survey for that day.
Each day, the survey started by asking the participant “How many times have you engaged in a prosocial act today that consisted of helping or doing something good for someone else? Please think carefully and review your day in your mind”. This was followed by examples of prosocial acts. These included donating, giving someone something, giving another person joy, consideration, and comforting or supporting someone.
If the participant confirmed that he/she acted prosocially, the survey asked them to describe the act in details. The survey then presented a list of characteristics of that prosocial act and the situation surrounding it and participants rated how much each of those characteristics corresponded to the act they performed. Finally, participants reported their well-being on that day by using an 11-point scale ranging from very bad to very good.
The results showed that participants reported better well-being when they performed more prosocial acts. This was the case both on the daily level and when looking at averages for the whole period. The group that acted more prosocially in terms of the number of prosocial acts per day reported better average well-being compared to group that did not report prosocial acts for the period of the study.
Detailed analysis identified autonomy, gratitude, responsibility, improvement and self-blame as factors with significant positive effects on well-being and on the relationship between prosocial acts and well-being. Prosocial acts were associated with well-being in situations when the participant could freely decide whether to help/act prosocially or not, but not when he/she did not have that choice. Similarly, prosocial acts resulted in better well-being when the person receiving help was not responsible for the situation (due to which help was needed), when the action resulted in substantial improvement of the situation, when the recipient of help showed high levels of gratitude, and when the expected self-blame (for not helping) was low i.e., when the participant would not blame him/herself for not helping if he/she decided so.
“The correlational results of this dairy study replicated the positive effects of prosocial behavior on well‐being and showed under which circumstances the effect is particularly pronounced,” the researchers concluded. “A helper feels particularly good when their autonomy is high, the person in need is grateful and irresponsible for the plight, when the situation improves significantly as a result of the help, and when the expected self‐blame (if not‐helping) is low.”
“Importantly, in other words, helping does not improve well‐being when autonomy is low, the person in need is not grateful and/or responsible for their need, or when helping is ineffective. In addition, helping to avoid self‐blame inhibits the positive effect on well‐being. Helping helps the helper, but only under the right set of circumstances.”
The study sheds light on the link between prosocial behavior and well-being. However, it also has limitations that need to be taken into account. Notably, all participants were from German-speaking countries. Results in other countries and cultures might not be the same. Additionally, the study design does not allow for any cause-and-effect conclusions to be derived and the assessment of well-being was based on just a single item.
The paper “When do I feel good when I am nice? A diary study about the relationship between prosocial behavior and well‐being” was authored by Jana S. Kesenheimer, Andreas Kastenmüller, Lea‐Sophie Kinkel, Beril Fidan, and Tobias Greitemeyer. | Stress and Wellness |
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PARIS (AP) — When Clarisse Agbégnénou won her sixth world judo title, confirming the reigning Olympic champion as one of the athletes to watch at next year’s Paris Games, the French star’s smallest but greatest fan was less wild about her mother’s newest gold medal than she was about her breast milk.
After a peckish day of few feeds — because mum had been busy putting opponents through the wringer — 10-month-old Athéna made amends that night.
“She didn’t let my boobs out of her mouth,” Agbégnénou says. “I was like, ‘Wow, okay.’ I think it was really something for her.”
READ MORE: New workplace accommodations for pregnant people are now in effect. Here’s what they cover
Breastfeeding and high-performance sports were long an almost impossible combination for top female athletes, torn for decades between careers or motherhood, because having both was so tough.
But that’s becoming less true ahead of the 2024 Olympics, where women will take another step forward in their long march for equality, competing in equal numbers with men for the first time, and with pioneering mothers like Agbégnénou showing that it is possible to breastfeed and be competitive.
They don’t pretend that late-night feeds, broken sleep, pumping milk and having to eat for two people are easy. But some female athletes are also discovering that juggling their careers with the rigors of motherhood can pay off with powerful emotional well-being.
Speaking in an interview with The Associated Press, Agbégnénou said she stunned even herself by coming back so quickly from childbirth to win at the worlds in May, with Athéna in tow and expecting to be fed every few hours.
In training, Agbégnénou would stop for quick feeds when Athéna needed milk, nestling her hungry baby in the folds of her kimono, while other athletes in the judo hall paid them no mind, carrying on with their bouts.
“I was sweating on her, poor baby,” she says. “But she didn’t pay attention. She just wanted to eat.”
Women who have breastfed and carried on competing say that support from coaches and sports administrators is essential. Agbégnénou credits the International Judo Federation for allowing her to take Athéna to competitions. IJF officials sounded out other competitors and coaches about whether the baby was a nuisance for them and were told, “‘No, she was really perfect, we didn’t hear the baby,'” she says.
“It’s amazing,” she says of her peers’ acceptance and support. “They are part of my fight and I am really proud of them.”
READ MORE: Costly and complex cleanup of Seine River underway ahead of 2024 Paris Olympics
As well as Agbégnénou, three other women also asked and were allowed to nurse their babies at IJF World Tour competitions in the past six years, with arrangements made each time that enabled the moms “to care for the child and to not disturb other athletes’ preparation,” says the governing body’s secretary general, Lisa Allan. She says the IJF is now drawing up specific policies for judokas who are pregnant or postpartum because “more and more athletes are continuing their careers whilst balancing having a family.”
The Paris Olympics’ chief organizer, Tony Estanguet, says they’re also exploring the possibility of providing facilities for nursing athletes at the Games.
“They should have access to their children — for the well-being of the mothers and the children,” he said in an AP interview. “The status of athletes who are young mothers needs to evolve a bit. We need to find solutions to perhaps make it easier for these athletes to bring babies” into the Olympic village where athletes are housed.
For some breastfeeding athletes, being a pioneer is part of the kick.
Two-time Olympic rowing champion Helen Glover, now aiming for her fourth Summer Games, gave birth to twins at the start of the COVID-19 outbreak, breastfed them and then came out of what she’d intended to be retirement to compete at the pandemic-delayed Tokyo Games in 2021. Glover was the first rower to compete for Britain at the Olympics as a mother.
Glover’s eldest, Logan, lost interest in her milk about the time of his first birthday, but twins Kit and Willow kept feeding to 14 months old. She says that mixing her punishing rowing training with long feeds for two babies was “very draining. It was taking every calorie I had.”
“But I could do it because it was my own time and my own choice,” she says.
“Everyone should have the choice,” Glover adds. “Our bodies … are sometimes very changed through childbirth and pregnancy and breastfeeding. So the answers are never going to be one-size-fits-all. But I think it’s really exciting that these conversations are even being had.”
READ MORE: Breastfeeding Olympians allowed to bring babies to Tokyo
For some athletes, Milk Stork has also been a help. The U.S.-based transporter ships working moms’ milk when they’re separated from their babies. It says it shipped milk pumped by athletes who competed at the 2021 Paralympic Games in Tokyo and also transported 21 gallons (80 liters) of milk from coaches, trainers and other support staff at the Olympics that year.
The daughter of British archery athlete Naomi Folkard was just 5 1/2-months old and breastfeeding exclusively when her mother traveled to Tokyo for her fifth and final Olympic Games.
Nursing mothers successfully pushed to be able to take babies to those Olympics, held with social distancing and without full crowds because of the coronavirus pandemic. Rather than put her daughter, Emily, through the ordeal of having to live apart from her, in a Tokyo hotel outside of the athletes’ village, Folkard reluctantly left her behind with a large stock of frozen milk. She built that up over months, pumping into the night so Emily wouldn’t go hungry while she was in Japan.
But that created another problem: Because Folkard’s breasts had become so good at making milk, she had to pump regularly at the Games to stop them from becoming painfully swollen. She threw that milk away.
“I was having to get up in the night and pump just because my supply was so much,” she says. “It wasn’t great for performance preparation really. But I did what I had to do to be there.”
And with each drop, progress.
“There’s still a long way to go, but people are talking about it now. Women aren’t retiring to have children. They’re still competing,” Folkard says.
“I feel like things are changing.”
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DUBAI, United Arab Emirates -- Over the past three months, hundreds of young girls attending different schools in Iran have become overpowered by what are believed to be noxious fumes wafting into their classrooms, with some ending up weakened on hospital beds.
Officials in Iran's theocracy initially dismissed these incidents, but now describe them as intentional attacks involving some 30 schools identified in local media reports, with some speculating they could be aimed at trying to close schools for girls in this country of over 80 million people.
The reported attacks come at a sensitive time for Iran, which already has faced months of protests after the September death of Mahsa Amini following her arrest by the country's morality police.
The authorities have not named suspects, but the attacks have raised fears that other girls could be poisoned apparently just for seeking an education — something that's never been challenged before in the over 40 years since the 1979 Islamic Revolution. Iran itself also has been calling on the Taliban in neighboring Afghanistan to have girls and women return to school.
The first cases emerged in late November in Qom, some 125 kilometers (80 miles) southwest of Iran’s capital, Tehran. There, in a heartland of Shiite theologians and pilgrims, students at the Noor Yazdanshahr Conservatory fell ill in November. They then fell ill again in December.
Other cases followed, with children complaining about headaches, heart palpitations, feeling lethargic or otherwise unable to move. Some described smelling tangerines, chlorine or cleaning agents.
At first, authorities didn't link the cases. It's winter in Iran, where temperatures often drop below freezing at night. Many schools are heated by natural gas, leading to speculation it could be carbon monoxide poisoning affecting the girls. The country's education minister initially dismissed the reports as “rumors."
But the schools affected at first only taught young women, fueling suspicion it wasn't accidental. At least one case followed in Tehran, with others in Qom and Boroujerd. At least one boys' school has been targeted as well.
Slowly, officials began taking the claims seriously. Iran's prosecutor-general ordered an investigation, saying "there are possibilities of deliberate criminal acts.” Iran's Intelligence Ministry reportedly investigated as well.
On Sunday, Iran's state-run IRNA news agency filed multiple stories with officials acknowledging the scope of the crisis.
“After several poisonings of students in Qom schools, it was found that some people wanted all schools, especially girls’ schools, to be closed,” IRNA quoted Younes Panahi, a deputy health minister, as saying.
A Health Ministry spokesman, Pedram Pakaieen, said the poisoning didn't come from a virus or a microbe. Neither elaborated further.
Ali Reza Monadi, a national parliament member who sits on its education committee, described the poisonings as “intentional.”
The ”existence of the devil's will to prevent girls from education is a serious danger and it is considered a very bad news," he said, according to IRNA. “We have to try to find roots” of this.
Already, parents have pulled their students from classes, in effect shuttering some schools in Qom in recent weeks, according to a report by Shargh, a reformist news website based in Tehran.
The poisonings come as getting verifiable information out of Iran remains difficult given the crackdown on all dissent stemming from the protests and internet slowdowns put in place by the government. At least 95 journalists have been arrested by authorities since the start of the protests, according to the New York-based Committee to Protect Journalists.
Overall, the security force crackdown has killed at least 530 people and seen 19,700 others detained, according to Human Rights Activists in Iran.
Attacks on women have happened in the past in Iran, most recently with a wave of acid attacks in 2014 around Isfahan, at the time believed to have been carried out by hard-liners targeting women for how they dressed. But even in the chaos surrounding the Islamic Revolution, no one targeted schoolgirls for attending classes.
Jamileh Kadivar, a prominent former reformist lawmaker and journalist, wrote in Tehran's Ettelaat newspaper that as many as 400 students have fallen ill in the poisonings.
She warned “subversive opposition” groups could be behind the attacks. However, she also raised the possibility of “domestic extremists" who “aim to replace the Islamic Republic with a caliphate or a Taliban-type Islamic emirate.”
She cited a supposed communique from a group calling itself Fidayeen Velayat that purportedly said, “the study of girls is considered haram" and threatened to "spread the poisoning of girls throughout Iran” if girls' schools remain open.
Iranian officials have not acknowledged any group called Fidayeen Velayat, which roughly translates to English as “Devotees of the Guardianship.” However, Kadivar's mention of the threat in print comes as she remain influential within Iranian politics and has ties to its theocratic ruling class. The head of Ettelaat newspaper also is appointed by Supreme Leader Ayatollah Ali Khamenei.
Another prominent reformist politician, Azar Mansouri, also linked the suspected poisoning attacks to hard-line groups, referencing the Isfahan acid attacks.
“We said the acid attacks were organized. You said: ‘You are disturbing public opinion!’" Mansouri wrote online. “If operatives of the attacks were identified and punished then, today a group of reactionaries would not have ganged up on our innocent girls in the schools.”
Activists also worry this could be a disturbing new trend in the country.
“This is a very fundamentalist thinking surfacing in society,” said Hadi Ghaemi, the executive director of the New York-based Center for Human Rights in Iran. “We have no idea how widespread this group is but the fact they have been able to carry it out with such impunity is so troubling.” | Epidemics & Outbreaks |
Victorian-era disease hits Scotland's poorest
A disease linked to poverty and malnutrition that once crippled the crowded slums of 19th-century Britain is on the rise in Scotland, according to data published at the weekend.
A total of 442 cases of rickets—a skeletal disease caused by a sustained lack of Vitamin D—were recorded in 2022 compared to 354 in 2018, data from 13 of 14 Scottish health boards showed.
"Generally preventable conditions such as these are indicative of Scotland having the lowest life expectancy in the UK," Chris Williams, the joint chair of the Royal College of General Practitioners Scotland, told The Sunday Times newspaper.
He also suggested environmental factors such as a colder climate could be behind the increase.
Rickets, which can lead to skeletal deformities such as bowed legs or knock knees, has been linked to a lack of exposure to sunlight and Vitamin D which is found in foods like oily fish or eggs.
Some 482 cases of the disease, which largely disappeared from Britain more than half a century ago after efforts to improve diet and exposure to sunlight, were found across England.
Most of the cases in Scotland were recorded in the Greater Glasgow and Clyde area with 356 diagnoses.
Glasgow is one of the most deprived local authority areas in Scotland with 32 percent of all children in the city were estimated to be living in poverty in 2021-2022, according to Glasgow Centre for Population Health.
According to the latest data from 2019, men living in the most deprived areas of the city on average live 15.4 years less than those in the most affluent parts.
For women, the gap has increased from 8.6 to 11.6 years.
Health workers suggested an increase in diversity in the city plus lifestyle changes to more sedentary, indoor activities and cheaper, unhealthy food may have contributed to the increase in rickets.
Other so-called Victorian-era diseases such as tuberculosis and scarlet fever are also increasing in Scotland.
Data collated by The Times showed 112 cases of tuberculosis in 2022 and a sharp rise in scarlet fever diagnosis, with 223 cases in 2022 compared with 39 the year before.
In England there had been 171 cases of scurvy in 2022, with three recorded in Scotland.
"Victorian diseases are diseases of poverty and they are common in parts of the world where people are poor," Stephen Baker, a molecular microbiologist at the University of Cambridge, told the paper.
"Rickets is associated with a poor diet and the likelihood of a poor diet may be encouraged by the cost of living."
© 2023 AFP | Epidemics & Outbreaks |
Tai Chi, the Chinese martial art that involves sequences of very slow controlled movements, may curb the symptoms and complications of Parkinson’s disease for several years, reveals research, published online in the Journal of Neurology Neurosurgery & Psychiatry.
Its practice was associated with slower disease progression and lower doses of required drugs over time, the findings show.
Parkinson’s disease is a debilitating and progressive neurodegenerative disorder, characterised by slowness of movement, resting tremor, and stiff and inflexible muscles.
It is the fastest growing neurological condition in the world, with the numbers of those affected projected to reach nearly 5 million by 2030 in China alone. In the UK 2 people are diagnosed with the disease every hour according to the charity, Parkinson’s UK.*
As yet, there is no cure for Parkinson’s, and while drugs can improve clinical symptoms, they don’t treat all the manifestations of the disease. And there’s no evidence that they slow progression either, explain the researchers.
Previously published research suggests that Tai Chi eases Parkinson’s symptoms in the short term, but whether this improvement can be sustained over the long term isn’t known.
In a bid to find out, the researchers monitored two groups of patients with Parkinson’s disease for more than 5 years from January 2016 to June 2021.
One group of 147 patients practised Tai Chi twice a week for an hour, aided by the provision of classes to improve their technique. The other group of 187 patients continued with their standard care, but didn’t practise Tai Chi.
Disease severity was formally assessed in all the participants at the start of the monitoring period, and disease progression, including increases in the need for medication, were subsequently monitored in November 2019, October 2020, and June 2021.
The extent of movement and other symptoms, such as autonomic nervous system function (to include bowel movements, urinary and cardiovascular issues); mood, sleep quality, and cognition; and the prevalence of complications, such as dyskinesia (involuntary movement); dystonia (abnormal muscle tone); decline in responsiveness to drug treatment over time; mild cognitive impairment; hallucinations; restless leg syndrome were also tracked, using validated scales.
Disease severity, medication use, sex, age, and education level, were similar in both groups.
Disease progression was slower at all monitoring points in the Tai Chi group, as assessed by three validated scales to assess overall symptoms, movement, and balance.
The number of patients who needed to increase their medication in the comparison group was also significantly higher than it was in the Tai Chi Group: 83.5% in 2019 and just over 96% in 2020 compared with 71% and 87.5%, respectively.
Cognitive function deteriorated more slowly in the Tai Chi group as did other non-movement symptoms, while sleep and quality of life continuously improved.
And the prevalence of complications was significantly lower in the Tai Chi group than in the comparison group: dyskinesia 1.4% vs 7.5%; dystonia 0% vs 1.6%; hallucinations 0% vs just over 2%; mild cognitive impairment 3% vs 10%; restless legs syndrome 7% vs 15.5%.
Falls, dizziness, and back pain were the three side effects reported by study participants, but these were all significantly lower in the Tai Chi group. While 23 people sustained a fracture, these all occurred during routine daily life and were fewer in the Tai Chi group: 6 vs 17.
This is an observational study, and as such, can’t establish cause and effect. And the researchers acknowledge that the number of study participants was relatively small and they weren’t randomly assigned to their group.
But they conclude: “Our study has shown that Tai Chi retains the long-term beneficial effect on [Parkinson’s disease], indicating the potential disease-modifying effects on both motor and non-motor symptoms, especially gait, balance, autonomic symptoms and cognition.”
They add: “[Parkinson’s disease] can worsen motor function and non-motor symptoms progressively with time, resulting in disability and influencing the quality of life. The long-term beneficial effect on [the disease] could prolong the time without disability, leading to a higher quality of life, a lower burden for caregivers, and less drug usage.”
Journal
Journal of Neurology Neurosurgery & Psychiatry
Method of Research
Observational study
Subject of Research
People
Article Title
Effect of long-term Tai Chi training on Parkinson’s disease: a 3.5-year follow-up cohort study
Article Publication Date
24-Oct-2023
COI Statement
None declared | Medical Innovations |
A tumor with teeth has been discovered in Egypt.
The ovarian mass - which is about the size of a nickel - was found among the remains of a woman who died more than 3,000 years ago.
The woman, between 18 and 21 at death, was unearthed at the Amarna non-elite cemetery, wrapped in a plant fiber mat and adorned with gold beads and jewelry.
The three-centimeter by two-centimeter growth was lodged in her pelvic bone, where researchers spotted the teeth with distinct enamel-covered crowns.
It is the oldest known example of teratoma, a tumor made of various tissues like muscle, hair, bone or teeth, discovered by archeologists, with previous cases found in Europe and Peru.
Teratomas are so rare there are no reliable figures for how many occur - but modern women still suffer from them. They happen when germ cells turn into different cells.
Amarna is a site on the east bank of the Nile River and is home to at least 1,000 pit-grave burials for non-elite citizens of the ancient city Akhetaten.
The project investigating the Amarna cemeteries began in 2005 and is currently directed by Anna Stevens from the University of Cambridge and Gretchen Dabbs from Southern Illinois University, who unearthed the woman's remains.
The team determined the sex of the skeleton based on the morphology of the pelvis and metric analysis of the humeral and femoral heads.
Her age was estimated using a combination of assessments based on how her teeth developed in the dental arch.
Along with the growth-encasing team, archaeologists also found a gold ring around the woman's finger featuring an image of Bes - the god of fertility.
They speculate that the ovarian tumor may have hindered her ability to bear children.
'The presence of a gold ring decorated with the god Bes on Individual 3051′s [the label given to the woman] left hand, and perhaps the positioning of the hand and ring close to the mass, may suggest the teratoma was not asymptomatic and Individual 3051 was attempting to invoke Bes to protect her from pain or other symptoms, or aid in her attempts to conceive and birth a child,' reads the study published in Science Direct.
Dabbs told Live Science that the woman was likely someone's wife and 'little doubt she was working,' unlike most others her age who were laboring on state-level building projects, brewing beer, or tending to household gardens and livestock.
Another case of teratoma was uncovered in Lisbon, Portugal, but this ovarian tumor was twice the size of at least five malformed teeth.
The tumor was discovered at a graveyard at the Church and Convent of Carmo In Lisbon, where 42 burials were excavated in 2010 and 2011.
Allison Foley, a bioarchaeologist at the College of Charleston in South Carolina who was not involved in the study, told Live Science that the ancient Egyptian woman's tumor is of grave importance because 'teratomas are very rarely identified archaeologically.'
'The presence, location, and possible symbolic importance of the Bes ring as a token of protection and fertility is particularly fascinating and evocative,' Foley said. | Disease Research |
Scientists have long speculated about the physical changes that occur in the brain when a new memory is formed. Now, research from the National Institute for Physiological Sciences (NIPS) has shed light on this intriguing neurological mystery.
In a study recently published in Nature Communications, The research team has succeeded in detecting the brain neuronal networks involved in trauma memory by using a novel method that combines optical and machine-learning-based approaches, capturing the complex changes that occur during memory formation and uncovering the mechanisms by which trauma memories are created.
Animals learn to adapt to changing environments for survival. Associative learning, which includes classical conditioning, is one of the simplest types of learning and has been studied intensively over the past century. During the last two decades, technical developments in molecular, genetic, and optogenetic methods have made it possible to identify brain regions and specific populations of neurons that control the formation and retrieval of new associative memories. For instance, the dorsal part of the medial prefrontal cortex (dmPFC) is critical for the retrieval of associative fear memory in rodents. However, the way in which the neurons in this region encode and retrieve associative memory is not well understood, which the research team aimed to address.
"The dmPFC shows specific neural activation and synchrony during fear-memory retrieval and evoked fear responses, such as freezing and heart rate deceleration," explains lead author Masakazu Agetsuma. "Artificial silencing of the dmPFC in mice suppressed fear responses, indicating that this region is required to recall associative fear-memory. Because it is connected with brain systems implicated in learning and associated psychiatric diseases, we wanted to explore how changes in the dmPFC specifically regulate new associative memory information."
The research team used longitudinal two-photon imaging and various computational neuroscience techniques to determine how neural activity changes in the mouse prefrontal cortex after learning in a fear-conditioning paradigm. Prefrontal neurons behave in a highly complex manner, and each neuron responds to various sensory and motor events. To address this complexity, the research team developed a new analytical method based on the 'elastic net,' a machine-learning algorithm, to identify which specific neurons encode fear memory. They further analyzed the spatial arrangement and functional connectivity of the neurons using graphical modeling.
"We successfully detected a neural population that encodes fear memory," says Agetsuma. "Our analyses showed us that fear conditioning induced the formation of a fear-memory neural network with 'hub' neurons that functionally connected the memory neurons."
Importantly, the researchers uncovered direct evidence that associative memory formation was accompanied by a novel associative connection between originally distinct networks, i.e., the conditioned stimulus (CS, e.g., tone) network and the unconditioned stimulus (US, e.g., fearful experience) network. "We propose that this newly discovered connection might facilitate information processing by triggering a fear response (CR) to a CS (i.e., a neural network for CS-to-CR transformation)."
Memories have long been thought to be formed by the enhancement of neural connections, which are strengthened by the repeated activation of groups of neurons. The findings of the present study, which were based on both real-life observations and model-based analysis, support this. Furthermore, the study demonstrates how combined methods (optics and machine learning) can be used to visualize the dynamics of neural networks in great detail. These techniques could be used to uncover additional information about the neurological changes associated with learning and memory.
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The US has announced sanctions on 25 China-based firms and individuals allegedly involved in the production of chemicals used to make fentanyl.
Fentanyl, a potent opioid used as a painkiller or sedative, plays a major role in the US drug crisis.
Attorney General Merrick Garland said the drug's supply chain "often starts with chemical companies in China".
China criticised the imposition of sanctions, saying the fentanyl crisis was rooted in the United States itself.
"We firmly oppose the United States' sanction and prosecution against Chinese entities and individuals, and the severe infringement of the lawful rights and interests of the relevant enterprises and persons," the Chinese foreign ministry told AFP news agency.
"The Chinese government has been strictly cracking down on drug crimes... and we deploy the harshest control on precursor chemicals.
"Imposing pressure and sanctions cannot solve the United States' own problems. It will only create obstacles in the China-US co-operation on drug control," it said.
In April, a spokesperson for the Chinese foreign ministry said there was "no such thing as illegal trafficking of fentanyl" between China and Mexico.
This came after Mexican President Andrés Manuel López Obrador called on the Chinese government to help stop the alleged flow of fentanyl and its precursors into his country.
The US authorities blame Mexican drug gangs for supplying fentanyl to users across the US.
Fentanyl can be legally prescribed by doctors, but a dramatic increase in opioid addiction in the US in recent decades has led to a rise in illegal production and overdoses.
In 2022, the drug was linked to a record 109,680 deaths.
The US treasury department announced sanctions against what it called a "China-based network responsible for the manufacturing and distribution" of precursors of fentanyl and a number of other illegal drugs.
Officials say companies in the fentanyl supply chain routinely use false addresses and mislabelling to avoid their products being identified by law enforcement.
Those affected by the sanctions include 12 entities and 13 individuals based in China, as well as two entities and one individual based in Canada, the treasury said.
The sanctions will freeze the entities' US assets and bar Americans from dealing with them.
Merrick Garland is due to travel to Mexico with other senior officials for meetings on how to tackle the supply of illegal drugs.
"We know who is responsible for poisoning the American people with fentanyl," Mr Garland told reporters.
"We know that this network includes the cartels' leaders, their drug traffickers, their money launderers, their clandestine lab operators, their security forces, their weapons suppliers, and their chemical suppliers.
"And we know that this global fentanyl supply chain, which ends with the deaths of Americans, often starts with chemical companies in China."
The US justice department has also unsealed indictments charging eight Chinese companies and 12 of their employees with crimes related to fentanyl and methamphetamine production, the distribution of opioids and sales resulting from precursor chemicals.
No-one has been arrested and the Chinese government did not work with US authorities on the investigations, Mr Garland said. | Drug Discoveries |
Clinical cases of Candida auris, an emerging fungus considered an urgent threat, nearly doubled in 2021, according to new data from the US Centers for Disease Control and Prevention.
There was also a tripling of the number of cases resistant to echinocandins, the first-line treatment for Candida auris infections.
The research, published Monday in the Annals of Internal Medicine, evaluated cases of Candida auris reported to the CDC from 2016 – the year in which cases were first reported in the US – to 2021.
The study authors found that clinical cases increased each year, rising from 53 in 2016 to 330 in 2018 and then skyrocketing from 476 in 2019 to 1,471 in 2021.
Cases of Candida auris also expanded geographically. Although it was initially confined mostly to the New York City and Chicago areas, Candida auris is now present in more than half of US states. Between 2019 and 2021, 17 states identified their first cases.
The CDC has called Candida auris an “urgent threat” because it is often multidrug-resistant, easily spreads through health care facilities and can cause deadly disease. It is also resistant to some common disinfectants and can be carried on people’s skin without causing symptoms, facilitating its spread to others.
The researchers wrote that the timing of this increased spread suggests that it may have been exacerbated by “pandemic-related strain on the health care and public health system.”
“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” CDC epidemiologist Dr. Meghan Lyman, lead author of the study, said in a news release.
Increasing fungal threats
The spread of Candida auris in the US comes amid growing concerns about health-threatening fungi.
Late last year, the World Health Organization released its first list of “fungal priority pathogens,” including Candida auris.
“Fungal pathogens are a major threat to public health as they are becoming increasingly common and resistant to treatment with only four classes of antifungal medicines currently available,” WHO says.
The organization says the expanding incidence and geographic range of fungal disease may be due to global warming and the increase of international trade and travel.
Candida auris itself first appeared as four strains on four continents between 2009 and 2015. All four strains have now been identified in the US, probably introduced through international travel, the CDC says.
Transmission of the fungus within the US is largely driven by “poor general infection prevention and control practices in healthcare facilities,” the authors of the new study say. Most spread happens in post-acute care facilities and ventilator-capable skilled-nursing facilities.
Controlling the spread
Dr. Scott Roberts, an infectious-disease specialist at the Yale School of Medicine who was not involved with the new study, warns that the increased prevalence and drug resistance of Candida auris is a serious health threat.
“I think this problem is not going to go away. I think it’s really only going to increase over time,” he said.
Unlike other fungi that are typically acquired from the environment, Candida auris is easily spread from person to person, Roberts said.
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“Once it sets up shop, in a nursing home for example, it’s almost impossible to eradicate,” he said. “Once it’s on patients too, it can kind of just be colonized for years, if not their life.”
Public health officials have enhanced surveillance efforts to detect Candida auris, including testing for the fungus on the bodies of asymptomatic people. According to the new study, screening cases tripled from 2020 to 2021, for a total of 4,041.
Healthy people don’t usually get sick from Candida auris, according to the CDC. Rather, it’s more likely to affect people who have serious medical problems and require long stays in health care facilities, people with weakened immune systems and people with medical devices going into their bodies, such as breathing tubes or catheters. Screening for Candida auris can help protect people at increased risk of serious infection. | Epidemics & Outbreaks |
Dentists could be losing money on most active NHS treatments they perform, the British Dental Association (BDA) in Northern Ireland has said.
Preliminary figures suggest carrying out treatments like fillings, crowns and extractions for NHS patients can cost dentists money.
The Department of Health said it supported dentists with investment and uplifts in allowances and expenses.
Some dentists are going private because of the costs.
In 2022, a BBC investigation found nine in 10 NHS dental practices across the UK were not accepting new adult patients for treatment under the health service.
The BDA in Northern Ireland has warned that without change, patients in need will be denied essential care.
Dental practices are paid set fees by the government for every treatment they provide to NHS patients.
But according to BDA NI, those fees are likely being outstripped by what it costs to provide the treatments - meaning dentists are making a loss.
It has warned that without more government funding, there could be no future for NHS dentistry.
Ciara Gallagher, chair of the BDA's Northern Ireland Dental Practice Committee, runs a dental practice in Downpatrick, County Down.
She told the BBC: "Everyone's talking about the cost of living crisis, I'm going to talk about a cost of providing care crisis.
"Within this building, all our materials have increased in price. Our staff wages have gone up, our electricity costs, our heating costs, they are all sky-rocketing.
"The increase in fees is not matching those increases in costs. What has happened is the fees have gone up a little bit, but we've come to this point where the cost to provide care is now more than we are being paid for that care."
Figures compiled from Dr Gallagher's practice, as well as five others, indicate the majority of active treatments performed are loss-making - a pattern she says is being felt by dentists across Northern Ireland.
These are preliminary figures. The BDA is now undertaking a wider study at practices across Northern Ireland and the rest of the UK.
What do the figures show?
According to the figures, for each single-tooth extraction that a dentist carries out under the NHS, the government currently pays the dental practice £19.47. But according to these figures, by the time the practice covers its own costs to actually carry out the procedure and pays the dentist, it's typically making a loss of £18.58.
Likewise, to perform one amalgam filling with one surface and the anaesthetic required, the government pays a dental practice £11.18.
But according to these figures, by the time that filling is performed, the practice will have typically lost £21.55.
To perform a root canal on an incisor or canine tooth, the government will pay a dental practice £59.94, but the practice will make a loss of £7.03.
"I don't know how to even begin to describe the despair of dentists who can't provide care," Dr Gallagher said.
"And let's talk about the patients, who are unable to get the care they want, unable to get their children registered because practices are unable to take on the losses that that will incur.
"Unless the funding covers the cost to provide care there is no future for NHS dentistry and that means there's no care for patients who need it the most."
The Department of Health said the figures did not appear to include various allowances that are paid to dentists - although this is something the BDA disputes.
The department referenced a £6.5m investment that has gone to dentists over the last two years, in helping to fund new technologies and things like ventilation.
It also pointed to an uplift in fees which was put in place as a response to the Covid pandemic.
A spokesperson added: "Whilst the department recognises the challenges that dental practices will be experiencing due to the cost of living increases, the pressures facing the department's budget are also considerable and without precedent, leading to difficult financial decisions having to be made to align funding with key priorities." | Health Policy |
About 80% of China’s population has been infected with Covid-19 since restrictions were lifted in early December, Chinese health authorities have said.The figure, which would equate to about 1.2 billion people but cannot be confirmed by outside bodies, prompted some pandemic experts to estimate that more than 1 million may have died – far more than the government’s official tally of about 72,000.A wave of Omicron cases engulfed China after the government abruptly ended its zero-Covid policy last December, lifting restrictions shortly before the start of the lunar new year and Spring festival. On Saturday, China’s Center for Disease Control and Prevention (CDC) said about 80% of the country’s 1.41 billion people had been infected in this wave. In the week leading up to the lunar new year, the CDC reported 12,658 deaths, adding to the official pandemic toll of almost 60,000, which most observers believe is far below the real figure. Until a dramatically increased update earlier this month, the official toll from this wave was reported as being below 60 deaths.Rising case numbers in December quickly overwhelmed data collection processes. Coupled with a narrow definition of a Covid-attributed death, official tallies soon appeared far below the reality on the ground, and the government was accused of lacking data transparency by the WHO. Beijing rejected the accusation and defended the zero-Covid policy and its sudden dismantling. Some health officials have acknowledged the data discrepancies but said now is the time to focus on the health response.The data and transparency concerns have left experts looking for other ways to estimate the impact of the outbreak.Prof Robert Booy, an infectious diseases paediatrician at the University of Sydney, said the death toll was likely to be between 600,000 and 1 million. Booy, and other experts who spoke to the Guardian, said the virus was probably already spreading far more widely than acknowledged prior to the lifting of restrictions.“China might have dropped its zero-Covid policy in the first week of December, but they were probably already flailing and failing,” he said. “In 2022, China lost population for the first time since the Great Leap Forward – a drop of 850,000 people. They’re going to lose at least that number in the coming weeks of Covid, mostly of very old people who haven’t been fully vaccinated.”Dr Xi Chen, an associate professor of health policy and economics at Yale, said no one had good enough data to accurately gauge China’s death toll, but making conservative assumptions that it had the lowest case fatality rate of 0.11% would suggest that about 1.23 million people had died.“Of course, this assumes China has healthcare resources like South Korea and New Zealand do,” he added. Prof Antoine Flahault, the director of the institute of global health at the University of Geneva, based his estimate on excess mortality rates – the number of deaths from all causes that are beyond the average – of other countries that have passed their major first Covid waves.“If you take Hong Kong, you have nowadays an excess mortality … which is roughly 2,000 deaths per million. If you convert that rate to China, you get to a bit below 3 million deaths,” he said, adding the caveat that China’s health system was not as consistently developed as systems in other places, including Hong Kong.“If you take Brazil, the figure is close to 4,000 per million, so it’s double,” Flahault said.James Trauer, the head of the epidemiological modelling unit at Monash University, cautioned against making estimates so early in the wave, noting that it was not clear how China’s CDC was able to produce the 80% figure, given the issues with data collection.The CDC notice had said holiday travel may further spread the virus in the short term, but that because so many were already infected, “the possibility of a large-scale epidemic rebound or a second wave of epidemics across the country is very small”.Trauer warned against thinking that an Omicron wave brought high levels of herd immunity. “In Australia we had a huge first wave with B.A.1 last summer, and then the second wave with B.A.2 came straight on the heels of it within a couple of months. I don’t think they should assume that because numbers are coming down that they don’t have to worry,” he said.“Probably the most important thing from the Chinese perspective at the moment is to manage the epidemic better and increase the resources to treat the people getting sick.” | Epidemics & Outbreaks |
Masks are a rarity now on streets and trains. We don’t leave empty seats in theatres or limit how many people browse in our shops. It seems like it’s all over – but Prof Sir Jeremy Farrar, director of Wellcome, once a key member of the government’s scientific advisory body Sage and an enormously influential figure in global health, says the Covid pandemic could still have unpleasant surprises in store.
Farrar is not a doom-monger. But from where he is sitting, with long experience of epidemics from flu to Sars to Ebola, we are still in a risky place. We need to be ready for what this – or quite possibly another – bug could do to us.
“I would be less sanguine that the pandemic is over. I think the overwhelmingly likely scenario is we are in a completely different place and it’s much better. The world has immunity now, largely. But there may still be surprises in this pandemic,” he says.
Speaking to the Guardian as he prepares to leave Wellcome – he is to become chief scientist of the World Health Organization – Farrar explains how China’s zero-Covid policy has been his biggest concern over the past year.
It was never sustainable. China, in his view, will go through a series of waves of infection now that restrictions have been lifted.
“They’re going through a horrible wave at the moment. I don’t think there’s full transparency about cases or about deaths or about the impact of that.”
Meanwhile on the streets of the UK and in every other country, Covid transmission is extremely high. The Office for National Statistics says one in 55 people in England has the virus.
We need new vaccines that actually stop infection, he says.
“We are not in a good enough position to be sure this is not coming back until we can get transmission-blocking vaccines. And I don’t know if they’re possible, but I think the ambition should be there by the end of this decade or as soon as possible.
“I think if we allow this amount of virus to continue to circulate we are constantly running the risk of a new variant.”
And, he warns, “this Covid pandemic doesn’t stop any other virus emerging”.
What comes next may not be a twist in the coronavirus tail.
It could be influenza. Just because we have had scares that turned out to be false alarms in the past doesn’t mean flu is not something to fear. It really is.
H5N1 has been circulating among wild birds in the UK since 2021, and has infected poultry, which have to be kept indoors as a result. The virus has jumped into wild animals such as foxes and otters and a few poultry farm workers in Europe have tested positive, although without symptoms.
“The current pandemic of avian H5N1 is a really concerning issue,” says Farrar.
“You want to be really sensible and calm about it – you’re not saying the world is suddenly going to face an H5N1 pandemic tomorrow and it’ll be devastating.”
Yet it’s a worry. Historically, he says, of the hundreds of people who have been infected with the virus, 30% have died.
“We’re not going to face that scenario, I don’t think, but if we allow an avian virus to which none of us has got any immunity to continue to circulate in birds and then increasingly, whether it’s minks or seals, come across into the mammalian sector and therefore start to adapt, there’s a risk there. You can’t quantify it. But we don’t have an H5N1 vaccine tomorrow ready to go.”
Farrar’s concern is that the UK and the world should be ready for whatever the microbial world is going to throw at us. The time to think of how to prepare for a Covid pandemic was not 31 December 2019 after 20 years of underinvestment in public health.
Given what we’ve been through since then, we should have everything we need in place. There have been breakthroughs. Wellcome supported the trialling of the first Ebola vaccine during the epidemic of 2014 in west Africa.
Now it is accepted that research can and must be done in a pandemic. The Recovery trial based in Oxford was set up as the UK locked down for the first time in March 2020 and quickly found treatments for Covid.
But our healthcare workers are not ready. They are exhausted and feel undervalued. Strikes in the UK are a sorry part of that story.
“This is a global issue, which I think is hugely concerning,” he says. “It’s certainly true in this country. The resilience of healthcare workers, broadly defined from ambulance drivers to nurses to doctors, to care workers in social care, etc. They’re shattered. They are absolutely shattered.”
Farrar, 61, who spent 18 years leading the clinical research unit at the Hospital for Tropical Diseases in Ho Chi Minh City in Vietnam, has been through many epidemics.
“You can cope with it for a certain amount of time. But if that becomes the norm, over the months and years while you are also frightened yourself personally … and your family’s sick … The resilience in healthcare workers around the world is really thin at the moment, and people are leaving those professions. Just to go back to delivering non-pandemic healthcare is going to be a huge challenge.”
It’s all about people, he says. Suppose there is what he terms “another event” in the next five to 10 years. “If you stretch people beyond their resilience they won’t be there when you need them,” he says.
“I think we have to address the morale, staffing, the training, everything from public health physicians to care workers, to doctors and nurses and physios and everybody in between because there’s very little spare capacity in any system globally.
“It’s particularly true in the UK. As you can see from the strikes, morale and resilience is very thin.”
We can’t rely on stealing those who have trained in the Philippines, Ghana or India, who are needed in their own countries, he adds.
In his book Spike, published in July 2021, he was highly critical of Boris Johnson’s government’s handling of the pandemic and its sluggish response to Covid.
He singled out for special condemnation the test, trace and isolate system led by Dido Harding and the dismantling of Public Health England (Harding was given charge of its replacement body, the National Institute for Health Protection).
Johnson himself, with his “absence of political leadership” in the early weeks and backing for those who touted theories that herd immunity would free the UK from the virus, and the then health secretary, Matt Hancock, come off badly.
Farrar thought about resigning over the failure to lock down in September 2020 and talks of a moral dilemma: “Does staying in an advisory role mean being complicit in the outcomes of bad decisions?” He adds: “To be honest, I still don’t know the answer.” He wrote of the “carnage” of January and February 2021. “Many of those deaths were preventable,” he wrote.
Wellcome has a huge endowment worth £38bn, up from £15bn when he became director in October 2013.
Politico called him the Bill Gates of Europe, but Farrar points out that it’s not his money. He says there are issues around the roles of philanthropy versus government. “Philanthropy shouldn’t allow governments to get away from their responsibilities,” he says. It must be a complementary relationship.
Like other leading scientists – Anthony Fauci in the US, for instance – he has been targeted on social media. He and his children have been subjected to death threats.
“It’s intimidating. You try not to be, but when it starts to involve not just you but also your family members and some degree of protection, it’s a terrifying place to be in.”
Moving to the WHO in Geneva will not protect him from that. There was sniping when his new role was announced from those who claimed he tried to stifle debate about the origins of the virus, publicly supporting its natural emergence from animals while his private emails showed him discussing whether a lab leak was possible.
Farrar’s position is that while it is likely to have come from animals, it is important to stay open-minded and gather evidence. Above all, we need transparency, he says.
There is a responsibility on scientists to speak out or they will leave a vacuum for others, he adds.
“That would be a very dark place to be. Conspiracy theories may be amplified now. They may get more airtime through whatever vehicle but there have always been conspiracy theories. This is not a total 21st-century phenomenon. And in the main, I think humanity works through them and comes out into better places, but it doesn’t do that by chance.”
His role at the WHO is relatively new and yet to be defined.
Farrar is optimistic about what could be achieved with the help of science, even at this time of wars and suspicion and economic crisis. World leaders may not be able to agree on ways to bring down inflation, “but there are some things you can agree on. And you can agree, whether you’re sitting in Beijing or Washington or Geneva or Delhi or Prague or Rio de Janeiro, that climate affects you all.”
Science has got a role to play in tackling the climate crisis, in drug resistance, pandemics, in mental health and in the more equal manufacture and distribution of drugs and vaccines.
He hopes he’s not being naive or over idealistic, “but I hope the world could say, ‘Look, I can’t necessarily agree on this trade deal or where balloons fly or the South China Sea. These are deeply historic and sensitive issues. But maybe we can agree on these other things. And why don’t we start working on those?’
“Can you use science to enhance green shoots diplomacy? I wouldn’t be doing it unless I thought you could. Because otherwise we’re in danger just at a time when the world does face these global existential crises.
“If we do revert to a lack of evidence, a lack of information – if we’re going back to the era where we’re just making policies up with no evidence behind them, the world is in a worse place. And we’re moving away from an era of sort of 20th-, 21st-century enlightenment to something darker. And we can’t let that happen.” | Epidemics & Outbreaks |
- The diabetes drug Mounjaro is more effective for weight loss than Ozempic in overweight or obese adults, according to a large analysis of real-world data.
- Patients taking Eli Lilly's Mounjaro were significantly more likely to lose weight and saw larger reductions in body weight compared to those on Novo Nordisk's Ozempic.
- The results come as both drugs and similar treatments approved for weight loss soar in demand in the U.S. for their ability to help patients shed unwanted pounds over time.
The blockbuster diabetes drug Mounjaro is more effective for weight loss than another highly popular treatment, Ozempic, in overweight or obese adults, according to a large analysis of real-world data published Monday.
Patients taking Eli Lilly's Mounjaro were significantly more likely to lose weight and saw larger reductions in body weight at specific time points compared to those on Novo Nordisk's Ozempic in the study by Truveta Research. The firm compiles and analyzes patient data from a collective of health-care systems.
The results come as both drugs and similar treatments approved for weight loss soar in demand in the U.S. for their ability to help patients shed unwanted pounds over time. The wider adoption has boosted shares of Eli Lilly and Novo Nordisk this year.
Mounjaro and Ozempic are only approved for the treatment of Type 2 diabetes, but many people use the weekly injections off-label to lose weight.
Previous head-to-head studies have similarly suggested that Mounjaro is more effective than Ozempic for weight loss and controlling blood sugar in adults with Type 2 diabetes.
But Monday's study confirms Mounjaro's edge over Ozempic in a real-world setting, specifically among adults who are overweight or obese. Notably, head-to-head clinical trials in that population are not yet available, according to Truveta Research.
Eli Lilly is pitting Mounjaro against Wegovy, a higher dose version of Ozempic approved for weight loss, in an ongoing clinical trial in obese or overweight patients. But results won't be released until next year.
"We've been able to compare the head-to-head efficacy of these two important medications for weight loss in advance of randomized clinical trials," said Dr. Nick Stucky, an author of the study and vice president of Truveta Research, in a statement. "This study can help to inform patient care and outcomes today, not months from now."
Truveta Research specifically examined health-care data on roughly 18,000 adults who are overweight or obese and first started taking Mounjaro or Ozempic between May 2022 and September 2023. Nearly 52% of those patients had Type 2 diabetes.
Researchers found that patients taking Mounjaro were three times more likely to lose 15% of their weight than those on Ozempic. Patients on Mounjaro were also 2.6 times more likely to achieve 10% weight loss and 1.8 times more likely to lose 5% of their weight.
Those taking Mounjaro also experienced "significantly larger reductions" in body weight at specific time points, according to Truveta Research.
At three months, patients on Mounjaro lost 5.9% of their weight, while those on Ozempic lost 3.6%. At six months, people taking Mounjaro lost 10.1% of their weight, while patients on Ozempic lost 5.9%. And at one year, those on Mounjaro lost 15.2% of their weight, while those on Ozempic lost 7.9%.
Truveta Research also found that patients without Type 2 diabetes lost more weight than those with the condition. But the differences in effectiveness between Mounjaro and Ozempic were similar in both populations.
Rates of adverse gastrointestinal events were similar between patients taking Mounjaro and Ozempic.
Mounjaro and Ozempic are both weekly injections that change the way patients eat and lead to decreased appetite by mimicking certain hormones in the gut. They both have weight loss drug counterparts that use the same active ingredient: Eli Lilly's newly approved Zepbound and Novo Nordisk's Wegovy.
Ozempic and Wegovy only mimic one hunger-regulating hormone called glucagon-like peptide-1, known as GLP-1. Meanwhile, Mounjaro and Zepbound mimic GLP-1 and another hormone called glucose-dependent insulinotropic polypeptide, or GIP, which is thought to improve how the body breaks down blood sugar.
The distinction means that Mounjaro and Zepbound have a dual effect on regulating appetite and blood sugar levels, which some experts say could potentially lead to more significant weight loss than medications only targeting GLP-1.
In a late-stage study of more than 2,500 adults with obesity but not diabetes, those taking 5 milligrams of Zepbound for 72 weeks lost about 16% of their body weight on average. Higher doses of the drug were associated with even more weight loss, with a 15-milligram dose leading to 22.5% weight loss on average.
More than two in five adults have obesity, according to the National Institutes of Health.
About one in 11 adults have severe obesity. | Drug Discoveries |
Boston Children’s Hospital has paid $15 million to the parents of a baby boy who died after being left without enough oxygen for more than 30 minutes during a routine sleep study.
Like his parents, Jackson Kekula was born with dwarfism, which left him with sleep apnea and needing oxygen.
When he was six months old in February last year, he went to the children’s hospital for a second round of what was supposed to be a routine car-seat test and sleep study.
Less than an hour after he was put in the seat, he went into cardiac arrest and suffered a traumatic brain injury from spending too long without oxygen as staff focused on fiddling with machinery, according to a detailed timeline by the Boston Globe.
Just 12 days later, his parents, Ryan and Becky, made the agonizing decision to take him off of care.
“We went from February 18th just doing a routine study — to March 2nd to saying goodbye [and] March 3rd calling the funeral home,” grieving mom Becky Kekula told WBZ-TV.
Video of the sleep test showed that Jackson started whimpering just three minutes after it started at 9:39 p.m., the family’s attorney, Robert Higgins, told the Globe.
Within 10 minutes, his oxygen readings started plummetting — and at 9:50 p.m. had dropped to 65%, a perilously low level that can cause organ failure, the paper noted.
By then, mom Becky felt her baby’s fussiness “seemed off.”
“Of course looking back, I wish we just were like, ‘Can we go home? Do this another time?’ But I still wanted to trust the process,” she told the paper.
As Jackson’s oxygen levels continued to drop, his heart rate also began to falter, plummeting from 104 beats per minute to just 40. Soon, his breathing also fell from the expected rate of around 64 breaths per minute to just six to eight.
“I definitely started getting more of a spidey sense of what the heck is happening,” recalled his mom — with hospital staff constantly checking equipment but not examining the fast-faltering baby.
A technician first looked at Jackson at 10:11 p.m. — 32 minutes into the test, and more than 20 minutes after his oxygen levels plunged to dangerously low levels.
They only seemed to realize something was seriously wrong at 10:21 p.m., soon before the lab lights were switched on and the technicians picked up and tried to wake up Jackson, with one saying, “Come on. Hello buddy.”
A nurse rushed in and started CPR. “They were able to revive him and get a pulse, but at that point there had been a severe traumatic brain injury,” dad Ryan told WBZ-TV.
“How do we say goodbye to our son? Or do we bring our son home and make the best of this? It was just a decision that we weren’t prepared for,” he said.
Mom Becky said one of the hardest things now is seeing other parents vowing to “always protect” their kids.
“In that moment, there was nothing I could do to protect him,” she told the Globe.
The Kekulas met with attorneys the day after their son died, and on June 15 sent a notice letter of a potential claim.
Months later, before they filed a lawsuit, Boston Children’s Hospital agreed to the $15 million payout.
“We express our deepest condolences and apologize to the family for the loss of their son,” a spokesperson for the hospital told WBZ-TV.
The hospital “immediately stopped all sleep studies and began a thorough review of what occurred,” and “identified and implemented several improvements for how we conduct” them, the rep said.
“After this review and implementation of these improvements, sleep studies were reinstated in a phased manner to ensure patient safety.”
The hospital would not say if staff involved in Jackson’s case were still employed, the Globe said.
Now, the Kekulas want to try for another baby, exploring IVF as it allows for screening of potentially fatal genetic abnormalities.
“We just emotionally don’t want to face another tragedy, if we can prevent it,” Becky said.
“We’re now struggling to grow our family, when we had a perfect boy,” Becky said of the “accident that could have been prevented.” | Medical Innovations |
Mother Jones illustration; Getty Facts matter: Sign up for the free Mother Jones Daily newsletter. Support our nonprofit reporting. Subscribe to our print magazine.In his draft opinion overturning the constitutional right to an abortion, Supreme Court Justice Samuel Alito asserts that returning the question of abortion to the states would end difficult legal disputes over abortion, as each state forges their own consensus. Legal experts warn, however, that the opposite is true. Red and blue states are already moving in the direction of a cross-border legal war over abortion access that could fundamentally change how states interact and cooperate. “We are going to see threats to basic assumptions of how states work together,” warns David Cohen, an abortion rights expert at Drexel University’s law school, as red states enact laws that limit the ability of their citizens to cross state lines and seek reproductive health care. “Normally, states cooperate. Normally, states leave their laws within their borders. But because anti-abortion states are going to get so aggressive in trying to solve this problem of what do we do for people traveling out of state, it’s going to create all these issues.”
It would be as if South Carolina, which still criminalizes marijuana possession, tried to prosecute dispensaries in Oregon that sold their wares to vacationing Alabamians, or if Utah, one of two states banning gambling, started prosecuting Las Vegas casinos that allow Utahans to play the slots.
This is would be a new kind of cross-state legal hardball, yet it is one predicted in “The New Abortion Battleground,” a Columbia Law Review draft paper released in February. “We feel fairly confident that states will increasingly try to reach outside of their borders,” says Greer Donley, one of its three co-authors and an expert on reproductive rights law at the University of Pittsburgh School of Law. “The anti-abortion movement has been quite clear that their goal is to end abortion nationwide.”
Missouri has already contemplated how to do this; a lawmaker there introduced a bill this year that if it had been adopted would have allowed vigilante civil suits against anyone who helps a Missouri resident secure an out-of-state abortion. The language would have put abortion providers in blue states at risk of civil liability in red states. “States are going to start trying to ban travel, going after providers in other states for killing a citizen of that state,” says Cohen, another co-author of the Columbia Law Review paper. “The blue states need to be ready for that ahead of time. They can’t wait until that happens.”
States that support abortion rights but that don’t prepare, risk having abortion providers, anyone else who might help someone seeking to end a pregnancy, or even backers of abortion funds that help people pay for travel and the procedure, extradited to another state on charges of accessory to murder. “It can be the person who drove you, your mom who gave you gas money to drive there, the person who scheduled your appointment, the person who you call to find out where the nearest clinic is in the state that borders you,” says Cohen. “They could go after a lot of people as accessories to this crime.”
Connecticut is one of a small number of liberal-leaning states readying legal defenses. Just last week, it passed the Reproductive Freedom Defense Act to prepare and help shield providers who perform abortions on out-of-state patients. Now, if a Connecticut resident were to be sued civilly by a resident of another state for assisting an out-of-state patient obtain an abortion, the law would allow them to counter-sue in Connecticut courts to recover costs. The new law also bans extraditions to other states for criminal charges related to abortions performed legally under Connecticut law, and blocks medical records of reproductive health care services from being subpoenaed by other states.
It’s easy to imagine how such conflicting legal regimes would play out. A Missouri resident travels to Connecticut for an abortion. Missouri law enforcement issues subpoenas and demands extradition of a Connecticut abortion provider. A vigilante sues in Missouri court for civil damages. The abortion provider countersues in Connecticut court. Connecticut law enforcement does not comply with Missouri’s request for records or cooperation. There’s a stalemate.
Of course blue states can only protect their residents when they are in the state. Imagine a state like Missouri, or any one of the approximately 25 states that are likely to ban abortion if Roe v. Wade is indeed overturned, issuing warrants for abortion providers, advocates, or others in different states. “They would have to think, you know, can I fly across country? Or maybe my plane is going to get diverted because of weather into St. Louis? What do I do then?” says Cohen.
It’s hard to imagine this kind of interstate brinksmanship. But for decades, it was also hard to imagine the Supreme Court overturning Roe v. Wade, yet a leaked draft opinion suggests it is only a few weeks away from doing so. “There are people who might say that that bill in Missouri, it was a red herring and some wacky, wacky laws get introduced all the time that go nowhere,” Donley says of the thwarted bill. “We think it’s likely that people will try this because there are just people in the anti-abortion movement who are so zealous about their cause that they will try anything.”
What would be the result of such cross-state conflict? “This is going to create a situation where the country devolves into warring camps that are pulling out all stops,” predicts Cohen. “Ultimately, these issues get resolved in the Supreme Court, and the Supreme Court saying one or the other isn’t allowed to do what they want to do.”
In other words, if Missouri wants to extradite an abortion provider and Connecticut refuses, Justice Alito may step into the breech. | Women’s Health |
How did your team conduct the study?
We used mouse models of airways. People have many different types of cells in their lungs. Some are called ciliated cells, which are responsible for knocking out any debris or pathogens that enter the lung.
Other cell types secrete mucus, which plays a big role in trapping pathogens and maintaining a healthy lung. To recreate the most basic aspects of lung architecture outside of the body, we grew these cells in something called an air-liquid interface using a cell culture device known as a transwell insert. The cells are grown on a thin, porous membrane where the bottom half is submerged in media, which supplies nutrients, and the top half is exposed to air. Using this culture method, you can study the different types of airway epithelial cells outside of the body.
Is it possible to use human cells for this research?
Ideally, it would be wonderful, but it’s a little invasive. We get the cells through bronchial brushings, and that can be a bit hard on an individual. Before taking that step, we wanted to prove the merits of this system and the study using a widely accepted mouse model of Down syndrome.
What were your main findings?
They included the following:
• We found a significant reduction in the frequency of ciliated cells in the Down syndrome airway model. We looked at a whole battery of measurements for how these cells function and behave normally. In addition to frequency, we also looked at how ciliated cells “beat.” The cilia on the ends of these cells beat back and forth, and that’s how they clear mucus buildup, particles, debris and dust out of the lung. The combination of fewer of these cells and a defect in their functions suggests there can be a problem with that process.
• We took videos of the cells and recorded them as the cilia were beating back and forth in order to measure the beating in cells. We found that the cells from the Down syndrome were beating at a slower rate.
• Even without any exposure to a virus, cells from the Down syndrome model appear to have deficiencies in the basic function of the lung. If cells aren’t even functioning well at baseline, that could help explain why they’re not responding well to infection.
• After exposure to influenza, we found that the cells from the Down syndrome model were hyper-responsive to infection when compared to control cells. They produced more inflammatory proteins despite showing the same amount of virus shedding.
Did the results show other reasons why people with Down syndrome have such severe infections?
We didn’t see any difference between the amount of virus that was produced in the Down syndrome model when compared to controls. Despite that, the cells from the Down syndrome model had an excessive immune system response aimed at fighting the infection. If your immune system is too activated, it can cause a lot of collateral damage in healthy cells while trying to clear the infection.
Are you doing future research on this topic?
Yes. We will be looking at how these immune cells actually impact the infected space. For example, we would like to see if the recruited immune cells cause differing levels of collateral damage in Down syndrome. Our work is a stepping-stone to better understand the biology of respiratory infections. It’s helping clarify what’s going on so we know what to target with treatments.
What are possible treatments?
We could inhibit immune cell recruitment, but before we use that as a treatment, we need more information about its impact. The immune cells may or may not be contributing to damage. Inhibiting them actually may cause further problems. We’re gearing up to do a set of studies that look at how certain immune cells, known as monocytes, respond to infection and how their response differs using a combination of Down syndrome models.
Guest contributor: Carrie Printz is a freelance writer specializing in health and science. | Disease Research |
For a fourth consecutive summer, COVID-19 is on the rise, though this year's warm-weather wave appears milder than those in the emergency period of the pandemic.
COVID-19 indicators of hospital admissions, emergency department visits, test positivity, and wastewater levels have all been increasing in the past month, with a peak not yet clearly in sight, according to data tracking by the Centers for Disease Control and Prevention. From June 10 to July 29, test positivity rose from 4.1 percent to 8.9 percent. For reference, the most recent winter wave had a peak test positivity of 10.6 percent on December 31, 2022.
On the brighter side, however, weekly COVID-19 hospital admissions and deaths continue to be at their lowest points since the start of the pandemic. For now, deaths do not appear to be rising, though there are lags in data reporting. Weekly new hospital admissions are ticking up only slightly—with admissions rising to about 8,000 in the week of July 22, up from around 6,300 the week of June 24.
Death counts for the most recent weeks with complete data show tallies of 500 to 400. And excess deaths—the number of deaths above expected baseline levels—are no longer being observed in CDC data. That is, the weekly number of deaths in the US from all causes is currently tracking with the pre-pandemic number of expected deaths.
The seemingly milder wave is likely due to a combination of factors, including immunity from vaccines and past infections and the fact that many people vulnerable to the virus died in previous waves. The cumulative US death toll of the COVID-19 pandemic stands at over 1.1 million.
Still, the virus is surging again this summer, raising questions of whether summer waves will be a fixed seasonal cycle for this virus. Many health experts see SARS-CoV-2 as predominately a cold-weather virus, much like other respiratory germs, such as the common cold and flu viruses that thrive and surge in the fall and winter. The Food and Drug Administration, for instance, has modeled its COVID-19 vaccine booster plans around those used for annual flu shots.
But SARS-CoV-2's seasonality is still unclear, and researchers don't know exactly what's driving the summer waves, which often start in the southern part of the country. A leading hypothesis is that the upticks coincide with summer vacations, travel, and get-togethers.
Another potential factor for waves is newly emerging variants. Currently, a new omicron subvariant—EG.5, which is related to XBB.1.9.2—is gaining dominance in the US over the previously reigning variants, XBB.1.5 and XBB.1.16. However, monitoring for SARS-CoV-2 variants has declined so steeply that the CDC only has enough data to estimate variant prevalence for three of the country's 10 health regions (the areas around California, New York, and the Southeast).
Based on an FDA advisory committee meeting in June, vaccine manufacturers will likely roll out updated COVID-19 booster shots this fall aimed at an XBB subvariant lineage, possibly XBB.1.5. | Epidemics & Outbreaks |
Pfizer discontinues development of obesity pill due to elevated liver enzymes
Pfizer announced on Monday it was discontinuing the development of one of its obesity pill candidates due to elevated levels of liver enzymes being detected during clinical trials, while the development of another obesity pill is set to continue.
The pharmaceutical company has been developing two oral treatments for treating obesity and type 2 diabetes mellitus, danuglipron and lotiglipron.
According to Pfizer, elevated levels of the enzyme transaminase were detected during both Phase 1 and Phase 2 studies for lotiglipron. Higher levels of this enzyme can indicate liver disease or drug-induced liver damage.
Despite these observations, Pfizer said none of the trial participants experienced “liver related symptoms or side effects, there was no evidence of liver failure, and none needed treatment.”
When it came to the other drug candidate, danuglipron, none of the patients enrolled in the program were observed to have higher transaminase levels, the company stated, and development is set to continue depending on the results of an ongoing Phase 2 trial.
“If successful in clinical trials and approved, danuglipron could be in a prime position to differentiate based on profile, including full receptor agonism, which we believe has the potential to translate to robust efficacy.” William Sessa, Pfizer’s Chief Scientific Officer for Internal Medicine, said in a statement.
The drug candidate from Pfizer differs from the well-known diabetes medication Ozempic in that it is taken orally instead of being injected and it is specifically indicated for obesity. Ozempic has grown in public awareness due to its off-label use as a weight-loss drug and its alleged popularity among public figures.
The drug also garnered heightened attention earlier this year when it went into short supply, with criticisms arising from diabetes patients unable to obtain the medication when doctors were prescribing it for off-label use to patients who did not have diabetes.
Both medications are glucagon-like peptide-1 (GLP-1) agonists. This class of drugs mimic the hormone GLP-1, which is released in the gut in response to food intake, slows how quickly food is digested, induces a feeling of satiety and stimulates the release of insulin.
Other pharmaceutical companies like Eli Lilly and Novo Nordisk, which manufactures Ozempic, are also currently developing oral treatments for weight loss and diabetes.
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. | Drug Discoveries |
Tiny biobots made from human cells promote neuron growth without DNA mods
Researchers have used human tracheal cells to create tiny biological robots that can move on their own and work together to encourage healing in damaged neurons without requiring genetic modifications. The tiny bots have the potential to transform regenerative medicine and the treatment of disease.
Micro-sized robots created with living cells – biobots – are being developed to carry out various tasks inside the human body, from drug delivery to recognizing cancer cells. Now, researchers at Tufts University and Harvard’s Wyss Institute have taken a crack at creating their own biobot using human tracheal cells.
The researchers built upon previous work by Tufts, in collaboration with the University of Vermont, using frog embryo cells to create a multicellular biobot, called a Xenobot, capable of navigation, recording information and self-healing. At the time, researchers were unsure if these capabilities were because the Xenobot was made from frog cells or if a biobot could be constructed from cells from other species.
In the present study, the researchers wanted to see whether cells could be removed from their natural environment and recombined into different ‘body plans’ to carry out other functions. They discovered that bots could be created using adult human cells without genetic modification and with enhanced capabilities.
“We wanted to probe what cells can do besides create default features in the body,” said Gizem Gumuskaya, the study’s lead and corresponding author. “By reprogramming interactions between cells, new multicellular structures can be created, analogous to the way stone and brick can be arranged into different structural elements like walls, archways or columns.”
They began with tracheal cells taken from the surface of a human airway and developed a novel protocol that capitalizes on the existing ability of bronchial epithelial progenitor cells to form multicellular spheroids complete with cilia, microscopic hairlike structures that vibrate to move. They modified this process to yield cilia-coated spheroids; that is, the hairlike structures were on the outside rather than the inside.
Within a few days, the novel cells, which the researchers called Anthrobots, began moving, driven by the cilia. When fully grown, ranging in size from 30 to 500 microns, some bots were spherical and fully covered in cilia, while others were irregular or football-shaped with a patchy cilia covering. The distribution of cilia determined how the bots moved, either looping or wiggling in straight or curved paths. The Anthrobots usually survived for 45 to 60 days in laboratory conditions before they naturally biodegraded.
“Anthrobots self-assemble in the lab dish,” Gumuskaya said. “Unlike Xenobots, they don’t require tweezers or scalpels to give them shape, and we can use adult cells – even cells from elderly patients – instead of embryonic cells. It’s fully scalable – we can produce swarms of these bots in parallel, which is a good start for developing a therapeutic tool.”
The researchers grew a 2D layer of human neurons in a lab dish and scratched the cells with a thin metal rod to create a ‘wound’ devoid of cells. They placed a swarm of Anthrobots into the dish and observed them moving over the surface of the neurons. The bots encouraged new growth, filling the gap caused by the wound and creating a bridge of neurons as thick as the healthy cells. Neurons didn’t grow in the wound where the Anthrobots were absent.
“The cellular assemblies we construct in the lab can have capabilities that go beyond what they do in the body,” said Michael Levin, another corresponding author. “It is fascinating and completely unexpected that normal patient tracheal cells, without modifying their DNA, can move on their own and encourage neuron growth across a region of damage. We’re now looking at how the healing mechanism works and asking what else these constructs can do.”
An advantage of using human cells includes the ability to construct bots from a patient’s own cells to perform therapeutic work without triggering an immune response or requiring immunosuppressant medication.
Further development of the bots could lead to other applications, like clearing plaque buildup from arteries, repairing damaged spinal cords or retinal nerves, recognizing bacteria or cancer cells, or delivering drugs to targeted tissues. In theory, the Anthrobots could help heal tissue while delivering pro-regenerative drugs.
The study was published in the journal Advanced Science. | Medical Innovations |
We've all felt it: At first comes the trickle, and then the flood. It's embarrassed us, and even torpedoed a presidential campaign. But when was the last time you were grateful for … sweat?
Many are actually squeamish about sweat. Perhaps, said science writer Sarah Everts, because sweating is utterly out of our control. "Think of most other bodily fluids – peeing? Tears? You can usually hold those back to go to a private place to release them. But sweat? No way. You have zero control."
Everts is the author of "The Joy of Sweat." When asked why humans sweat, she replied, "Well, we sweat so that we don't die! Even just a few degrees up is a fever. So, we have to keep our body temperature in a very tight window, and sweat is how we do it."
During, Everts said no other body function is so essential yet so misunderstood.
Salie asked, "What's in our sweat?"
"Everything, it's not just salt," Everts replied. "Because we source sweat from blood, anything that's circulating in your blood comes out in sweat. So, our blood is very, very salty, and you have lactic acid or vitamins, hormones. It sort of reveals our secrets."
The myth that you can detoxify by "sweating it out" dates to the ancient Greek doctor Galen, who mistakenly thought that the body excreted superfluous serums as sweat. "Detoxing by sweating is just not a thing," Everts said. "The way our body works is, you know, you filter the bad stuff in your blood out through your kidneys, and that goes out in your pee."
To understand perspiration, first you need a little science lesson. Glands remove water from our blood and secrete it through pores onto the surface of the skin. We have between 2-5 million "eccrine sweat glands" all over the body.
Andrew Best, who teaches of biology at the Massachusetts College of Liberal Arts, has been collecting data to study why there's such a variation in sweat gland numbers. He offered to measure Salie's sweat glands, with a "sweat inducer."
"Your sweat glands can double in size, kind of like a muscle," Best said. "You work out a muscle, it gets bigger. Sweat glands do that, too. And they can increase how much sweat they make by about 50% as you acclimatize."
Best said our ability to sweat has played a fundamental role in our becoming human. "I don't think that's widely appreciated, but it's up there with walking on two legs," he said.
While humans have sweat glands all over, most mammals only have them on their paws, hands or feet. According to Best, "It's linked with the fight-or-flight response. Having a little bit of moisture on your fingertips gives you better gripping. This evolved in early mammals tens of millions of years ago to give mammals that ability to have a little extra traction in a moment of panic."
And that ancient response still kicks in today when we find ourselves perspiring when we're nervous. Not only did sweaty hands and feet help us escape our predators; Best says that we have sweat to thank for empowering us as hunters. As sweat glands evolved to spread over increasingly hairless bodies, our meat-eating ancestors could chase down their prey without overheating. While animals could outrun us, humans could "outsweat" them. "And therefore outrun them over a longer distance," said Best.
It's why today we can run marathons. Humans are among the rare mammals who sweat to cool themselves. Other animals use different means.
"Dogs and many furry animals use their tongue and saliva – they'll lick themselves and evaporate the heat off that way," said Best. "But as you can imagine, when you have a big bunch of fur, it's not as efficient cooling. Some animals will urinate on themselves – seals, for example. Vultures poop on their legs (it's very watery poop). Bees vomit on themselves. So, the next time you're on the subway or a bus and you are grossed out by your fellow humans sweating away, just be glad that, you know, it's just sweat, because they could be peeing and vomiting and licking themselves to stay cool."
Everts calls sweating a "human superpower" because of its astonishing efficiency as a cooling mechanism.
So, what about the maxim "It's not the heat, it's the humidity"?
"If you're, like, in a desert, you often don't even notice that you're sweating, and that is because there is very little water in the air around you," said Everts. But when there is a lot of moisture in the air, it is harder chemically for evaporation to occur - the air can only contain so much. "It gets harder to cool down when there is a lot of humidity around," she said.
And as for the saying "Never let them see you sweat"? You can thank the antiperspirant industry's advertising for that. We buy more than $80 billion worth of antiperspirants every year.
Salie did let them see her sweat, all in the name of science. Best measured Salie to have about 103 sweat glands per square centimeter. It turns out she has low sweat gland density. But her glands did produce a lot of sweat.
And Everts reminds us not to feel bad about that: "I kind of think we all need a sweat pep talk. It is this amazing thing that has allowed humans to live anywhere in the world. It also keeps us from dying."
"Sweat is a miracle?" asked Salie.
"It is! I really wish we would all, you know, find a lot less shame and a lot more joy in sweat."
For more info:
- "The Joy of Sweat: The Strange Science of Perspiration" by Sarah Everts (W.W. Norton), in Hardcover, Trade Paperback, eBook and Audio formats, available via Amazon, Barnes & Noble and Bookshop.org
- saraheverts.com
- Andrew Best, assistant professor, Biology, Massachusetts College of Liberal Arts, North Adams, Mass.
Story produced by Anthony Laudato. Editor: Chad Cardin.
See also:
for more features. | Stress and Wellness |
During the proceedings of the Covid Inquiry yesterday it was revealed that professor Chris Whitty, then the chief medical officer, referred to the “Eat out to help out” scheme as “Eat out to help out the virus”.
The scheme, launched by the Treasury and fronted by then-chancellor Rishi Sunak, subsidised meals in August 2020 in a bid to boost the hospitality industry.
The revelation at the inquiry came after Hugo Keith KC, counsel for the inquiry, pointed out that in the notebook of Imran Shafi, Boris Johnson’s private secretary for public services at the time, he referred to the “Eat out to help out” scheme as “Eat out to help out the virus”.
When Keith asked if it was Professor Whitty who used the term, Shafi confirmed that was correct.
Giving evidence to the inquiry on an earlier occasion, the British Medical Association (BMA) said the government failed to “provide clear, consistent public health messaging” throughout the pandemic, including on the former chancellor’s flagship initiative to help pubs and restaurants.
It said: “The Eat Out to Help Out initiative encouraged social mixing and confused public health messaging during 2020, suggesting that it was safe for people to socialise before vaccines were available and when the risks of Covid-19 remained high.”
The exchange took place on 20 September 2020, with the message sent by Dame McLean.
Lead counsel Hugo Keith asked Professor John Edmunds whether the comments could have been made in relation to the “eat out to help out” scheme, championed by Sunak, which ran in August 2020.
Professor Edmunds replied: “Honestly, it’s so long ago I wouldn’t know, but it could well be.”
Naomi Fulop, spokesperson for Covid-19 Bereaved Families for Justice UK, responded at the time: “This inquiry has made clear that there was absolutely no consultation with the government’s scientific advisers on Eat Out to Help Out, that it contributed to the loss of thousands of lives, put unnecessary pressure on the NHS and plunged the country into a brutal second lockdown.
“It’s unbearable to think that if it wasn’t for Rishi Sunak’s reckless, unscientific and callous approach, my mum might still be with me.
“When our current chief scientific adviser has referred to our prime minister as ‘Dr Death’, how can any of us have faith in our government if another pandemic strikes?”.
The Covid inquiry also heard yesterday that Boris Johnson had a 10-day break in February 2020 during which he appeared to receive no messages from his team at No 10 about coronavirus.
The claim made by Hugo Keith KC was not denied by Martin Reynolds, Johnson’s principal private secretary at the time.
It was also revealed in a note from the diary of Shafi, Boris Johnson asked why damage was being inflicted on the economy during the pandemic “for people who will die anyway soon” in a meeting with Rishi Sunak.
The note was from a meeting during which Johnson was believed to have said: “We’re killing the patient to tackle the tumour. Large ppl [taken to mean large numbers of people] who will die, why are we destroying economy for people who will die anyway soon.”
Shafi told the inquiry he thought it was Johnson who made the comments. It came after a series of diary entries and WhatsApp messages suggested the low regard in which the former Tory leader was held by senior advisers.
In a WhatsApp message seen by the inquiry from Whitehall’s highest ranking civil servant, Simon Case, he complained that Johnson “cannot lead” and wanted to “let it rip” when it came crucial choices over how the UK should handle Covid-19.
Politics.co.uk is the UK’s leading digital-only political website, providing comprehensive coverage of UK politics. Subscribe to our daily newsletter here. | Epidemics & Outbreaks |
The Chancellor Jeremy Hunt today (15 March) used the final part of the Budget to address the long-running issues around Britain’s childcare system, which negatively impacts women’s ability to work and the wider economy.
Hunt announced a series of measures on both the accessibility and supply side of childcare which he believes will “transform the lives of thousands of women and build a childcare system comparable to the [world’s] best”.
On the accessibility side, Hunt announced that the 30 hours of free childcare currently available to working parents for children aged between three and five will be extended to all children, from nine months old up to five years. The provisions will only apply to term time – as it currently functions – which equates to 38 weeks of the year. Another pledge surrounding accessibility is Hunt’s push for all schools to provide “a full wraparound offer” of pre- and after-school childcare, either on their own or in partnership with other schools.
These pledges will have a staggered introduction. The extension of free childcare will begin gradually, from April 2024, when working parents of two-year-olds will be able to access 15 hours of childcare; later that year, in September, those 15 hours will be opened to all children from nine months up to four years old, with the full 30 hours eventually being open to all eligible parents of under-fives from September 2025. Meanwhile, Hunt set a September 2026 deadline for schools to offer wraparound services.
[See also: Jeremy Hunt’s Budget is too late]
But these measures have caused concern in the childcare sector, which is struggling with a workforce shortage and financial pressures that are forcing businesses to shutter. “It’s disappointing, to be honest,” said June O’Sullivan, the CEO of the London Early Years Foundation, which runs 40 social enterprise nurseries across the capital. She told Spotlight that Hunt’s measures are “half thought-out”. If, for example, schools are to offer complete wraparound care for all of its youngest students before and after school as part of the 30 hours of free care, then the private care “market doesn’t become a market anymore and instantly becomes [insignificant compared] to schools”.
On the funding side, Hunt announced a £204m increase to nurseries that provide 30 free hours of care from this September, rising to £288m next year. It marks a 30 per cent increase on the current rate for two-year-olds, which is “just as the sector has requested”, Hunt said. Sectoral leaders dispute this, however. Its current shortfall for children aged two to four is estimated to be around £1.8bn, according to Neil Leitch, the CEO of the Early Years Alliance. This means that today’s funding announcement “is highly unlikely to match what’s needed to put providers on a steady footing”, said Leitch. It “raises serious questions about the government’s entire approach to costing this policy”, he added.
It is unclear whether Hunt’s plans will be enough to bolster the sector’s workforce issues. A pilot scheme will offer incentive payments of £600 to new childminders entering the profession, rising to £1,200 if they join through an agency. But there was “no reference or plans for the fact that staff [retention] is the major problem”, said O’Sullivan, who called for more incentives to retain staff already in the profession that are leaving for better-paid roles in retail and hospitality. Staffing ratios are also to be relaxed, but will be optional to operators, Hunt confirmed, but it’s a move that Leitch labelled “utterly appalling”.
A report published this month from the Centre for Progressive Policy revealed that the UK is losing a minimum of £27bn per year – equivalent to 1 per cent of GDP – because a lack of suitable childcare is preventing mothers from working the hours they would like. Hunt’s Budget is designed to address that. Will it work?
Ambiguities in the plans’ funding, from what sectoral experts say is needed to make care affordable, casts a shadow of doubt over their success. “We know from bitter experience that expansions of so-called free childcare without adequate investment are a recipe for utter disaster,” said Leitch. “From what has been announced so far, we are far from convinced.” The childcare industry has done all the necessary calculations, said O’Sullivan: “We’ve done all the figures for Hunt. He just has to put the money behind it.”
“If he’s serious about women going back to work,” she added, “and he’s serious about making sure children have good experiences, then he needs to fund it.”
[See also: Is Jeremy Hunt the Tory saviour?] | Health Policy |
Bird flu: Health officials draw up COVID-style model looking at pandemic possibilities
The plans to boost the UK's preparedness for a bird flu pandemic come after an 11-year-old girl died from the virus in Cambodia. The WHO warns that even if the world is more prepared than for COVID, "we are not yet prepared enough".
Friday 24 February 2023 13:54, UK
A COVID-style plan for dealing with bird flu is being drawn up by health officials, modelling what would happen if the virus starts spreading between humans.
The UK Health Security Agency (UKHSA) says there is "no evidence so far that the virus is getting better at infecting humans or other mammals" but warned the high level of transmission in birds presents a "constant risk".
To make sure the country is prepared for a possible bird flu outbreak in humans, health officials are modelling scenarios of human transmission.
It comes after an 11-year-old girl in Cambodia died from bird flu. The girl's father also tested positive for the virus but it is unclear whether he caught the virus from his daughter or through contact with an infected bird.
At least 11 other people in the country have also been tested.
If this is an example of human-to-human transmission, it would be one of the first instances of that happening.
There has been some evidence of people catching the virus from family members or in healthcare setting, the UKHSA said, but no or little evidence of "sustained" transmission between humans.
The UKHSA is modelling what happens if that changes, looking at two scenarios: a mild scenario where the infection-fatality rate is similar to COVID, at about 0.25%, and a more severe scenario similar to the 1918 flu pandemic, where about 2.5% of people who caught the virus died.
That would mean under the mild scenario, one in 400 people with the virus would die, and under the severe scenario one in 40 infected people would die.
Read more:
Bird flu has jumped to mammals - so how worried should humans be?
Don't assume bird flu risk to humans will remain low, WHO warns
Even with a fairly low infection-fatality rate, a severe scenario could lead to "significant behavioural differences relative to the recent pandemic experience", the UKHSA said.
In light of the modelling, the UKHSA is looking at how it could detect outbreaks in humans, including using COVID-style lateral flow tests.
It is also developing a blood test that detects antibodies against the virus and analysis of the genetic mutations that would signal an increased risk to human health.
The world's leading experts on influenza will meet on Friday to discuss the threat of bird flu to humans.
The group of scientists, regulators and vaccine manufacturers meets twice a year to decide which strain of seasonal flu to include in the vaccine for the upcoming winter season.
This meeting will also address the risk of the virus spilling over to humans and causing a pandemic.
The virus has already jumped from birds to otters, foxes and cats, while an outbreak at a mink farm prompted fears the virus was spreading between animals.
"We are more prepared (than for COVID), but even if we are more prepared, we are not yet prepared enough," Sylvie Briand, WHO director of global infectious hazard preparedness, said ahead of the meeting.
"We need to really continue the efforts for a flu pandemic." | Epidemics & Outbreaks |
Matt Rourke/AP
toggle caption
A nurse treats a man's skin wounds in a community outreach storefront in the Kensington neighborhood of Philadelphia in May. Xylazine, a powerful animal sedative that's moving through the illicit drug supply in the U.S., is causing gruesome skin wounds and scrambling longstanding methods for treating addiction and reversing overdoses.
Matt Rourke/AP
A nurse treats a man's skin wounds in a community outreach storefront in the Kensington neighborhood of Philadelphia in May. Xylazine, a powerful animal sedative that's moving through the illicit drug supply in the U.S., is causing gruesome skin wounds and scrambling longstanding methods for treating addiction and reversing overdoses.
Matt Rourke/AP
A new study from the Centers for Disease Control and Prevention released Friday found the street drug xylazine surged much earlier than previously reported.
The CDC concluded that by 2021, the "rate of drug overdose deaths involving xylazine was 35 times higher than the 2018 rate."
But the report shows the explosion of xylazine-related deaths began in 2018 with overdose fatalities rising to 627 in 2019 — doubling to 1,499 in 2020 — and then doubling once more to 3,468 in 2021.
This spring, the Biden administration declared illicit xylazine, also known as tranq on the street, an "emergent" threat.
At the time, officials warned the chemical, used by veterinarians as a horse tranquilizer, was spreading fast in street drugs, causing overdose deaths and terrible flesh wounds in people struggling with addiction nationwide.
"I'm deeply concerned about what this threat means for the nation," said Dr. Rahul Gupta, head of the White House Office of National Drug Control Policy when speaking to reporters in April.
Public health officials say it remains unclear why so many drug dealers began using xylazine as an additive.
Men suffered xylazine-related deaths at twice the rate of women, and Black men appeared particularly vulnerable.
Because drug death data is gathered and analyzed slowly, it's impossible to say with clarity what has happened in the months since 2021. But government officials say there are troubling indicators.
When data for this report was collected, illicit xylazine use was still largely concentrated in the mid-Atlantic states and the Northeast.
According to the White House Office of National Drug Control Policy, xylazine is now turning up in street samples collected across the U.S., surging in the South and West.
Speaking earlier this month Dr. Nora Volkow, head of the National Institute on Drug Abuse, said public health data on rapidly spreading street drugs like xylazine is often dangerously outdated.
"What is happening right now? I don't know," Volkow told NPR.
"If you want to actually be nimble and flexible and do the interventions on the basis of what you are observing, you need timely data," she said. "Otherwise, you're doing it with your eyes closed."
In most cases, drug policy experts say xylazine is mixed by dealers in a high-risk cocktail with fentanyl, methamphetamines or other illicit drugs.
On Thursday, the CDC released a separate report finding that by 2022, xylazine was being detected in nearly 11% of all fentanyl-related overdoses.
"These data show that fentanyl combined with xylazine is increasingly dangerous and deadly," Gupta said in a statement Thursday.
Xylazine has been widely used for years as a horse tranquilizer. Some in Congress are scrambling to tighten regulations and criminal penalties for misusing the chemical.
U.S. drug deaths, fueled largely by fentanyl but also increasingly by complex street drug cocktails, hit another devastating new record last year, with roughly 110,00o fatal overdoses nationwide. | Drug Discoveries |
Don’t go bananas to avoid this common smoothie slip-up
25 August 2023
If you’re looking for health-giving flavanols from the berries in your smoothie, order the banana on the side, say researchers.
In a study, published today (25 August) in Food and Function, scientists used smoothies to test how polyphenol oxidase – an enzyme found in many fruits and vegetables that is responsible for the browning when these are cut or bruised – affects the absorption of flavanols by the human body. This enzyme is found in particularly high levels in bananas.
The study was led by University of California, Davis, in collaboration with the University of Reading.
Adding banana to a berry smoothy reduces the flavanols taken in by the consumer by 84%, compared to the control group, who took a flavanol capsule.
Flavanols are bioactive compounds that have been proven to support good heart and cognitive health. We should all be consuming 400-600 milligrams of flavanols, daily, according to a dietary recommendation from the Academy of Nutrition and Dietetics in the USA.
Gunter Kuhnle, Professor of Nutrition and Food Science at the University of Reading and co-investigator of the study said: “If you don’t consume enough flavanols, it can negatively affect cardiovascular health. In older adults, a deficiency of flavanols is also linked to cognitive decline. So, it’s clear we need them, but the question is how best to get flavanols from the food and drinks we consume.”
Lead scientist Javier Ottaviani, director of the Core Laboratory of Mars Edge, which is part of Mars, Inc., and an adjunct researcher with the Department of Nutrition at the University of California, Davis said: “We sought to understand, on a very practical level, how a common food and food preparation like a banana-based smoothie could affect the availability of flavanols to be absorbed after intake.”
Professor Kuhnle said: “Smoothies are a popular way to pack fruit and vegetables into our morning routines. We know from previous studies that flavanols can be broken down by polyphenol oxidase. The extent of the effect from adding a single banana was still very surprising – it had enough polyphenol oxidase to destroy the vast majority of flavanols found in the berries.
“Bananas may be ruled out of the morning smoothie if you want to boost your flavanol intake, but on their own, they are still great fruits an can play an important role in many healthy diets.”
Flavanols are found in applies, pears, blueberries, blackberries, grapes, and cocoa, which are all common smoothie ingredients. But is blitzing them up in a smoothie an effective way to get what you need?
Participants were given a smoothie with banana and berries, one with just mixed berries, or a flavanol capsule. The researchers then took blood and urine samples to measure the flavanols that actually made it through and into the participants body.
The researchers found that both the flavanol levels in the smoothie, and the levels absorbed by the body, were reduced when banana was included.
Professor Kuhnle said: “We still know very little about food-food and food-nutrient interactions, even though they can have a huge impact on the uptake of nutrients and bioactives like flavanols.
“Here, we could show that the uptake of flavanols can vary by more than five-fold depending on the combination of foods.
“Bananas are a great ingredient in smoothies to provide a nicer texture - but they can affect flavanol uptake.
“If you want to boost your flavanol intake with a smoothie, you should combine flavanol-rich fruits like berries with foods that have a low polyphenol oxidase activity like pineapple, oranges, mango or yoghurt.” | Nutrition Research |
AI could be used to predict if a person is at risk of having a heart attack up to 10 years in the future, a study has found. From a report: The technology could save thousands of lives while improving treatment for almost half of patients, researchers at the University of Oxford said. The study, funded by the British Heart Foundation (BHF), looked at how AI might improve the accuracy of cardiac CT scans, which are used to detect blockages or narrowing in the arteries.
Prof Charalambos Antoniades, chair of cardiovascular medicine at the BHF and director of the acute multidisciplinary imaging and interventional centre at Oxford, said: "Our study found that some patients presenting in hospital with chest pain -- who are often reassured and sent back home -- are at high risk of having a heart attack in the next decade, even in the absence of any sign of disease in their heart arteries. Here we demonstrated that providing an accurate picture of risk to clinicians can alter, and potentially improve, the course of treatment for many heart patients."
About 350,000 people in the UK have a CT scan each year but, according to the BHF, many patients later die of heart attacks due to their failure in picking up small, undetectable narrowings. Researchers analysed the data of more than 40,000 patients undergoing routine cardiac CT scans at eight UK hospitals, with a median follow-up time of 2.7 years. The AI tool was tested on a further 3,393 patients over almost eight years and was able to accurately predict the risk of a heart attack. AI-generated risk scores were then presented to medics for 744 patients, with 45% having their treatment plans altered by medics as a result.
Prof Charalambos Antoniades, chair of cardiovascular medicine at the BHF and director of the acute multidisciplinary imaging and interventional centre at Oxford, said: "Our study found that some patients presenting in hospital with chest pain -- who are often reassured and sent back home -- are at high risk of having a heart attack in the next decade, even in the absence of any sign of disease in their heart arteries. Here we demonstrated that providing an accurate picture of risk to clinicians can alter, and potentially improve, the course of treatment for many heart patients."
About 350,000 people in the UK have a CT scan each year but, according to the BHF, many patients later die of heart attacks due to their failure in picking up small, undetectable narrowings. Researchers analysed the data of more than 40,000 patients undergoing routine cardiac CT scans at eight UK hospitals, with a median follow-up time of 2.7 years. The AI tool was tested on a further 3,393 patients over almost eight years and was able to accurately predict the risk of a heart attack. AI-generated risk scores were then presented to medics for 744 patients, with 45% having their treatment plans altered by medics as a result. | Medical Innovations |
Image source, SWNSImage caption, Lucy Letby is accused of murdering seven babies and trying to kill 10 othersDoctors used three adrenaline doses in a 20-minute battle to resuscitate a premature baby allegedly attacked by nurse Lucy Letby, a court has heard. Manchester Crown Court heard the girl, referred to as Child H, suffered two "profound" collapses at the Countess of Chester Hospital in September 2015.The jury was told doctors could not find a "trigger" for her deterioration.Ms Letby, 32, denied murdering seven babies and attempting to murder 10 others between 2015 and 2016.Jurors heard an emergency crash call went out to medics to attend Child H, who was born six weeks premature, in the early hours of 26 September 2015. Dr Alison Ventress, who was working a night shift on the neonatal unit, responded to the call. She told the court that Child H's heart rate had dropped to 50 beats per minute and CPR was commenced at 03:26 BST. The jury heard over the next 20 minutes, three doses of adrenaline were administered and Child H was eventually stablished at 03:46. Dr Ventress' notes stated there was "no trigger identified" for Child H's sudden deterioration. 'Clearly unwell'The court earlier heard that in the days leading up to the "profound" collapse, Child H had suffered a number of other desaturations which required treatment. Dr Ventress' notes, recorded at 01:25 on 25 September, showed Child H's oxygen levels had dropped to about 30% and in response, the medic performed an emergency procedure, which involved inserting a needle into the infant's chest to drain air. The court was told the air was being trapped by a suspected collapsed lung and the doctor said the amount drained was "quite a lot for a baby that size". In the hours that followed, Child H had several more large doses of air drained from her chest and needed a number of chest drains inserting. Questioned by defence counsel Ben Myers KC, Dr Ventress agreed desaturations in babies like Child H were not "uncommon". She also agreed with Mr Myers' assertion that Child H had had three chest drains inserted and numerous desaturations in the run-up to the collapse and those procedures were "likely to put strain on a little body like hers". She added that Child H was "clearly unwell".Mr Myers previously told the court Child H was another example of "sub-optimal care" by the Countess of Chester and was "nothing to do with Lucy Letby".Why not follow BBC North West on Facebook, Twitter and Instagram? You can also send story ideas to [email protected] Internet LinksThe BBC is not responsible for the content of external sites. | Epidemics & Outbreaks |
Fewer high school students are vaping this year, the government reported Thursday.
In a survey, 10% of high school students said they had used electronic cigarettes in the previous month, down from 14% last year.
Use of any tobacco product — including cigarettes and cigars — also fell among high schoolers, according to the Centers for Disease Control and Prevention report.
"A lot of good news, I'd say," said Kenneth Michael Cummings, a University of South Carolina researcher who was not involved in the CDC study.
Among middle school student, about 5% said they used e-cigarettes. That did not significantly change from last year's survey.
This year's survey involved more than 22,000 students who filled out an online questionnaire last spring. The agency considers the annual survey to be its best measure of youth smoking trends.
Why the drop among high schoolers? Health officials believe a number of factors could be helping, including efforts to raise prices and limit sales to kids by raising the legal age to 21.
"It's encouraging to see this substantial decrease in e-cigarette use among high schoolers within the past year, which is a win for public health," said Brian King, the Food and Drug Administrations tobacco center director.
The FDA has authorized a few tobacco-flavored e-cigarettes intended to help adult smokers cut back but has struggled to stop sales of illegal products.
Other key findings in the report:
- Among students who currently use e-cigarettes, about a quarter said they use them every day.
- About 1 in 10 middle and high school students said they recently had used a tobacco product. That translates to 2.8 million U.S. kids.
- E-cigarettes were the most commonly used kind of tobacco product, and disposable ones were the most popular with teens.
- Nearly 90% of the students who vape used flavored products, with fruit and candy flavors topping the list.
In 2020, FDA regulators banned those teen-preferred flavors from reusable e-cigarettes like Juul and Vuse, which are now only sold in menthol and tobacco. But the flavor restriction didn't apply to disposable products, and companies like Elf Bar and Esco Bar quickly stepped in to fill the gap.
The growing variety in flavors like gummy bear and watermelon has been almost entirely driven by cheap, disposable devices imported from China, which the FDA considers illegal. Those products now account for more than half of U.S. vaping sales, according to government figures.
In the latest survey, about 56% of teens who vape said they used Elf Bar, trailed by Esco Bar and Vuse, which is a reusable e-cigarette made by R.J. Reynolds. Juul, the brand widely blamed for sparking the recent spike in teen vaping, was the fourth most popular brand, used by 16% of teens.
The FDA tried to block imports of both Elf Bar and Esco Bar in May, but the products remain widely available. Elf Bar has thwarted customs officials by changing its brand name, among other steps designed to avoid detection.
On Thursday, the FDA announced another round of fines against 20 stores selling Elf Bar products. The agency has sent more than 500 warning letters to retailers and manufacturers of unauthorized e-cigarettes over the past year, but those citations are not legally binding and are sometimes ignored.
In the latest report, the CDC highlighted one worrisome but puzzling finding. There was a slight increase in middle schools students who said they had used at least one tobacco product in the past month, while that rate fell among high school students. Usually those move in tandem, said Kurt Ribisl, a University of North Carolina researcher. He and Cummings cautioned against making too much of the finding, saying it might be a one-year blip. | Epidemics & Outbreaks |
A woman’s active case of tuberculosis has prompted health officials in Washington state to alert the public. The woman has reportedly turned down treatment for over a year and disobeyed multiple court orders to stay isolated from others. The health department may pursue further legal action against the woman should she continue to not comply, which could include detention at a local jail.
Tuberculosis, or TB, is caused by Mycobacterium tuberculosis. Many people infected with tuberculosis bacteria do not become sick, and often, the infection will enter a latent state, where levels of the bacteria remain low and people aren’t sick or contagious to others. If left untreated, though, the infection can reemerge and even become life-threatening, especially in people with weakened immune systems. Active tuberculosis typically affects the lungs, causing respiratory symptoms, but the infection can migrate to other parts of the body as well.
On January 30, the Tacoma-Pierce County Health Department announced that it was monitoring a case of active tuberculosis in a resident. It went on to state that the woman had declined antibiotic medication, though officials were still working with her and her family to persuade her otherwise.
“Most people we contact are happy to get the treatment they need,” said Nigel Turner, division director of Communicable Disease Control, in a statement at the time. “Occasionally people refuse treatment and isolation. When that happens, we take steps to help keep the community safe.”
A few days later, reporting by The News Tribune revealed that this case has been a drawn-out saga. According to court records viewed by the local outlet, the health department first obtained a court order against the woman last year, on January 18, 2022. The court order called for her to be involuntarily isolated at home (outside of required medical care) until tests confirmed that she was no longer a public health threat. In their arguments, officials alleged that she had started but not finished taking treatment and that she was unwilling to resume treatment or isolate on her own accord.
Both active and latent TB is curable, but it can take four to nine months of taking several antibiotics to fully eradicate the infection. A small but important proportion of cases are caused by drug-resistant TB bacteria, which are even harder to treat successfully. One major risk factor for the emergence of these strains is people failing to complete treatment, which can allow some bacteria to survive and evolve resistance to frontline drugs.
According to The News Tribune, the woman flouted the initial court order and subsequent ones obtained by the health department. But the last straw appears to have occurred this January. In a petition filed on January 11, the department claimed that the woman had recently gotten in a car accident. A day later, she sought care at an emergency room for chest pain and was given X-rays. The woman reportedly didn’t inform the ER of her TB status, potentially exposing them and others to the infection. Her nondisclosure even led to staff to assume that her symptoms might have been caused by lung cancer. And the woman reportedly also tested positive for covid-19 at the same time.
In a ruling later that month, The News Tribune went on to report, the court declared that if the woman continued to not obey these isolation orders, she could be found guilty of contempt. That would then open up the possibility of stricter measures, ranging from electronic home monitoring to outright detention at a county jail. And the health department does seem ready to go that far if need be, though not until every other alternative has been exhausted.
“Incarceration detention is the very, very last option that we want to take and we don’t do that lightly. But occasionally that becomes necessary if there is a risk to the public,” Turner told The News Tribune.
TB is rare in the U.S., with Washington seeing about 200 cases a year, according to the Tacoma-Pierce County Health Department. But it remains a huge killer worldwide, with an estimated 1.6 million tuberculosis deaths reported in 2021—making it the second leading cause of death from a single infectious disease that year, behind covid-19. | Epidemics & Outbreaks |
The medicine in the diabetes drug Mounjaro helped people with obesity or who are overweight lose at least a quarter of their body weight, or about 60 pounds on average, when combined with intensive diet and exercise, a new study shows.
By comparison, a group of people who also dieted and exercised, but then received dummy shots, lost weight initially but then regained some, researchers reported Sunday in the journal Nature Medicine.
“This study says that if you lose weight before you start the drug, you can then add a lot more weight loss after,” said Dr. Thomas Wadden, a University of Pennsylvania obesity researcher and psychology professor who led the study.
The results, which were also presented Sunday at a medical conference, confirm that the drug made by Eli Lilly & Co. has the potential to be one of the most powerful medical treatments for obesity to date, outside experts said.
“Any way you slice it, it's a quarter of your total body weight," said Dr. Caroline Apovian, who treats obesity at Brigham and Women's Hospital and wasn't involved in the study.
The injected drug, tirzepatide, was approved in the U.S. in May 2022 to treat diabetes. Sold as Mounjaro, it has been used “off-label” to treat obesity, joining a frenzy of demand for diabetes and weight-loss medications including Ozempic and Wegovy, made by Novo Nordisk.
All the drugs, which carry retail price tags of $900 a month or more, have been in shortage for months.
Tirzepatide targets two hormones that kick in after people eat to regulate appetite and the feeling of fullness communicated between the gut and the brain. Semaglutide, the drug used in Ozempic and Wegovy, targets one of those hormones.
The new study, which was funded by Eli Lilly, enrolled about 800 people who had obesity or were overweight with a weight-related health complication — but not diabetes. On average, study participants weighed about 241 pounds (109.5 kilograms) to start and had a body-mass index — a common measure of obesity — of about 38.
After three months of intensive diet and exercise, more than 200 participants left the trial, either because they failed to lose enough weight or for other reasons. The remaining nearly 600 people were randomized to receive tirzepatide or a placebo via weekly injections for about 16 months. Nearly 500 people completed the study.
Participants in both groups lost about 7% of their body weight, or almost 17 pounds (8 kilograms), during the diet-and-exercise phase. Those who received the drug went on to lose an additional 18.4% of initial body weight, or about 44 pounds (20 kilograms) more, on average. Those who received the dummy shots regained about 2.5% of their initial weight, or 6 pounds (2.7 kilograms).
Overall, about 88% of those taking tirzepatide lost 5% or more of their body weight during the trial, compared with almost 17% of those taking placebo. Nearly 29% of those taking the drug lost at least a quarter of their body weight, compared with just over 1% of those taking placebo.
That's higher than the results for semaglutide and similar to the results seen with bariatric surgery, said Apovian.
“We’re doing a medical gastric bypass,” she said.
Side effects including nausea, diarrhea and constipation were reported more frequently in people taking the drug than those taking the placebo. They were mostly mild to moderate and occurred primarily as the dose of the drug was escalated, the study found. More than 10% of those taking the drug discontinued the study because of side effects, compared with about 2% of those on placebo.
Lilly is expected to publish the results soon of another study that the firm says shows similar high rates of weight loss. The U.S. Food and Drug Administration has granted the company a fast-track review of the drug to treat obesity, which Eli Lilly may sell under a different brand name. A decision is expected by the end of the year.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content. | Drug Discoveries |
Another day, another brazen shooting in Cocaine City. Sounds like the start of a juicy crime noir novel. But this is not fiction, this is Sydney right now – last week and the previous few months. Eleven dead that we know of. In response, a decades-old government approach – the war on drugs – continues to fail.
Our communities are vulnerable, our streets unsafe, because this policy empowers drug gangs rather than stopping them. Surely, it’s beyond time to consider new approaches, including one that can, and will, drive organised drug gangs out of business overnight: legalisation.
Two police insider comments last week reveal why. Senior police admitted that their operations could be partly to blame for recent gang-related violence, telling the media that drug busts that do not result in arrests can lead to criminals seeking retribution. Then, an unnamed police source told this newspaper late last week: “These gangsters will be on Centrelink in six months if you legalised drugs.”
In stark contrast, senior police bureaucrats, media and politicians have instead all been saying the same thing: that Sydney has a drug problem and getting tougher is the answer, despite the evidence it doesn’t work.
The police minister called for “hundreds and hundreds” more police officers even though top cops said they weren’t needed, while announcing a hastily pulled-together Taskforce Magnus that didn’t really do anything new other than combining eight existing strike forces. Utopia, eat your heart out.
Despite mounting evidence of its abject failure, the pointless war on drugs cycle continues. Nothing from the NSW government, from police bureaucrats or from conservative media is any different from what’s been said or attempted in recent decades.
Meanwhile, the same drug narratives keep being peddled. Cocaine is a deadly, dangerous drug that must be kept off our streets, along with cannabis, ketamine, MDMA, magic mushrooms and others.
Each year, many more people die from overdoses from legal drugs like alcohol, prescription opioids and antidepressants than they do from cocaine. In 2021, the National Drug and Alcohol Research Centre reported the rate of drug overdose deaths involving opioids in Australia doubled between 2002 and 2019, with 1008 overdose deaths reported that year alone.
That same year, 183 died unintentionally from consuming alcohol, while 77 died from cocaine. Some cocaine deaths were a result of deadly substances it was cut with, like Lidocaine, which can stop your heart beating if taken in large doses.
Alcohol kills 3 million people worldwide, according to the WHO. In 2021, there were 1559 alcohol-related injury deaths and 30,000 hospitalisations in Australia, the most reported in 10 years.
Time to wage war on alcohol and make it illegal? We tried that, and it failed. So we regulate alcohol, ensuring that bottles are clearly labelled, with health warnings and alcohol content on every bottle. We advise pregnant women not to consume it. We take Responsible Service of Alcohol seriously. And we boost the federal budget by about $8 billion in tax each year.
Why are some drugs legal and others not? It’s certainly not because of the harm they cause. Coca has been used by indigenous groups for thousands of years. It’s used as medicine to alleviate pain, combat altitude sickness and improve concentration, and to feel good. Of course, too much cocaine can get you into trouble, and even cause death. Just like alcohol and Panadol.
Latest estimates have Australians consuming about 5.6 tonnes of cocaine every year, or 5.6 million baggies. The amount we’re consuming has doubled in a decade. Anyone who says we just need to keep telling people not to take drugs has rocks in their heads.
The only people benefiting from this stupid and dangerous mentality are criminals – and the police union and bureaucrats who demand more resources they don’t need. They already have enough to deal with the problem.
Isn’t it time to ask ourselves what harm it would do if we created a strictly regulated cocaine market? We’d say goodbye to the black market and police resources could be deployed elsewhere to focus on other very pressing problems like family violence.
The thrill of buying something on the black market would also disappear (yes, really), there’d be no unknown substances mixed in and there’d be mandatory health warnings.
Then, say the government taxed it at 50 per cent (tobacco is taxed at 65 per cent), we could pay nurses more and fund more health services including alcohol and other drug treatment centres, particularly in the regions where they’re sorely needed.
We urgently need a new approach, starting with acknowledging that the war on drugs has failed. Then all options must be on the table, including giving ganglords what they fear most: Centrelink.
Cate Faehrmann is a Greens MP and drug law reform and harm reduction spokesperson. | Health Policy |
A four-year-old girl almost died after her Strep A turned into a deadly flesh-eating bug.Reign Passey, from Dudley in the West Midlands, spent three weeks in hospital with the usually-mild bug. In exceptionally rare cases, the bacteria can penetrate deep into the body and trigger necrotising fasciitis — which can cause tissue to killed by the toxins released, giving it the grim moniker 'the flesh-eating disease'. She had to undergo a four-hour operation to remove all the dead tissue to prevent the infection from spreading further. Four-year-old Reign Passey was left fighting for her life in hospital and forced to undergo a four-hour operation after contracting an infection of flesh eating bacteria caused by a Strep A infection Her mum Leanne Passey said she feared she might lose her daughter to the bug but Reign is now on her way to recovery Reign has been left with a huge scar from the life-saving procedure — and she tells people it came from 'winning a fight with a crocodile'.Her mother Leanne claims had to stubbornly fight with medics to even get her 'lifeless' daughter seen, a decision that may have saved her life. 'It’s horrendous, you never expect it to happen to you until it does,' the 31-year-old said.'I just want people to understand that it’s so serious.'It is thought the bug may have entered Reign's body through a chickenpox sore.She came down with chickenpox on July 4 last year and, while poorly, appeared fine.But three days later Ms Passey, an aesthetic practitioner, noticed her daughter had a temperature and was fatigued.She also spotted a red ring around one of the sores, a sign that a wound has potentially become infected, which prompted her to take her daughter to a doctor for help. Upon seeing Reign, a GP advised them take her to A&E immediately. However, upon arriving at Russells Hall Hospital, Ms Passey claimed staff told her to give her daughter antibiotics and take her home, due to the fact she had the highly contagious chickenpox. But she refused to leave because she was concerned for her daughter's health.Ms Passey claimed she was eventually told that the hospital had no beds available, and staff would not be able to treat her daughter.By this point, she said Reign was rapidly deteriorating. 'By this point the red ring had almost tripled in size,' she said. 'They were adamant they were too busy, she was too contagious and I needed to take her home.'I said the only way I was leaving was if they kicked me out — she was deteriorating by the second.NECROTISING FASCIITIS: THE VICIOUS FLESH-EATING BACTERIANecrotising fasciitis, more commonly known as 'flesh-eating disease', is a rare but extremely vicious bacterial infection. 'Necrotising' refers to something that causes body tissue to die, and the infection can destroy skin, muscles and fat.The disease develops when the bacteria enters the body, often through a minor cut or scrape. As the bacteria multiply, they release toxins that kill tissue and cut off blood flow to the area.Because it is so virulent, the bacteria spreads rapidly throughout the body.Symptoms include small, red lumps or bumps on the skin, rapidly-spreading bruising, sweating, chills, fever and nausea. Organ failure and shock are also common complications.Sufferers must be treated immediately to prevent death, and are usually given powerful antibiotics and surgery to remove dead tissue. Amputation can become necessary if the disease spreads through an arm or leg.Patients may undergo skin grafts after the infection has cleared up, to help the healing process or for aesthetic reasons. There are 500 to 1,500 cases reported a year, but 20 to 25 percent of victims die. 'They came back again and said there’s no beds. I was crying at this point. I said, "My child is really poorly and you’re dismissing her". 'Everyone I spoke to says they would have left and took her home — but I said, "No she needs to be seen, there’s no way I’m leaving".' Ms Passey eventually did did leave and took Reign to Birmingham Children’s Hospital, entering the hospital's A&E at 9.30pm.However, staff told them due to the contagious nature of chickenpox, they needed to wait outside to avoid infecting others.Ms Passey said the family were given a chair and sat outside until 3.30am.'We got to the hospital at 9.30pm — we sat there until 3.30am,' she said. 'Between those times, her temperature had gone up to almost 42C, she was hallucinating and talking to me.'She’d gone past the point of screaming and was lying there almost lifeless.'It was at this point that Ms Passey decided she needed to take more drastic action. 'I picked her up and carried her through the doors and said "Someone needs to see my daughter, I feel like she’s dying".' Reign still wasn't seen by a doctor until 8.30am, at which point Ms Passey said they realised how poorly her daughter was. '[The doctors] thought she might have necrotising fasciitis as there was a black mark around the red ring,' she said. 'I’d gone from a child with chickenpox to her needing to go in for major op — I was screaming and I thought there’s a chance she was going to die.'Ms Passey only had a brief chance to give Reign a kiss and a cuddle before she was rushed to the operating theatre. Surgeons were not only forced to cut away a large amount of tissue but also had to leave the wound open for cleaning and examination to ensure every trace of the bacteria had been eradicated. During this time Reign was put into an induced coma due to the pain and also put on breathing support. UK Health Security Agency (UKHSA) figures show some 54,430 infections were recorded in 2022. It was more than 20 times the 2,659 seen in the previous year, and the highest on record since 1953, when 61,180 infections were posted MailOnline analysis today shows the North West was the worst-hit region, recording close to 3,000 cases in December. It was followed by the East Midlands (2,890), South East (2,701) and London (2,405). The North East — the least affected area — recorded 769 over the same periodBut the family was dealt another blow, with the Reign contracting sepsis, a life-threatening over-reaction by the body to an infection. Ms Passey said medics then gave Reign a 'ridiculous amounts of antibiotics' which helped her pull through.After recovering from sepsis, Reign was then transferred to the hospital's burns unit for skin grafts for the massive wound on her side spending three weeks there before she was well enough to go home. A spokesperson for Birmingham Women’s and Children’s NHS Foundation Trust, which manages the Birmingham Children’s Hospital defended making the family sit outside. 'When a child arrives at our Emergency Department with an infectious condition, such as chicken pox, steps are taken to move them to a side room or cubicle to safely isolate them from other patients,' they said. 'However, in times of very high demand when we are unable to offer this immediately, we identify somewhere for patients to wait away from the waiting room to minimise the risk of infection to other vulnerable patients.'This is only done when considered safe following an assessment with a clinical professional and we communicate with families that should they have any concerns to notify a member of the clinical team immediately.'The spokesperson added they hoped Reign was recovering well. A spokesperson for Malling Health, which operates the Dudley Urgent Care Centre at Russells Hall Hospital said where the family initially sought help said: 'We are sorry to hear about the experience recently shared with us.'They added they were unable to comment on specific cases due to patient confidentiality but added they were committed to provided quality care. 'We are proud of the standards of care provided at our centres and we continue to work tirelessly and collaboratively with local NHS partners to ensure all patients are being provided with safe and high-quality care and support,' they said.Strep A is normally a mild bacterial illness that causes respiratory symptoms like a cough or sore throat.However, it can also, albeit very rarely, lead to far more serious complications, which can be fatal.This includes necrotising fasciitis, the flesh-eating disease, where bacteria enter the surface tissue through a cut, scrape or open sore.The UK is currently experiencing its worst Strep A outbreak in years with over 40 children having been killed so far this season. A total of 30 under-18s have died of the usually-harmless bug, which causes scarlet fever, in England since the season kicked off in September. For comparison, 27 youngsters died from the bacterial infection during the 2017/18 season, which health chiefs consider to be the last 'bad' year.And five Strep A deaths have been recorded in Wales this winter, three in Scotland and one in Northern Ireland. Some experts have suggested the rise in cases is linked to the Covid pandemic with lockdowns having left some youngsters with reduced immunity to Strep A — with a high number of children never having encountered the bacteria in their lifetime.High rates of other respiratory viruses — including flu, RSV and norovirus — may also be putting children at higher risk of co-infections with Strep A, leaving them more susceptible to severe illness, the World Health Organization said.Symptoms of a Strep A infection can include a sore throat, headache, fever, nausea and vomiting.The infection can easily be treated with antibiotics if it is caught early, which also limits the spread and reduces the risk of complications. From the 'bubbly' seven-year-old whose father desperately tried CPR to save her, to the four-year-old who loved exploring: The victims of Strep A so far Muhammad Ibrahim AliThe four-year-old boy attended Oakridge School and Nursery in High Wycombe, Buckinghamshire.He died at home from a cardiac arrest in mid-November after contracting a Strep A infection.He was prescribed antibiotics.His mother Shabana Kousar told the Bucks Free Press: 'The loss is great and nothing will replace that. 'He was very helpful around the house and quite adventurous, he loved exploring and enjoyed the forest school, his best day was a Monday and said how Monday was the best day of the week. Muhammad Ibrahim Ali, who attended Oakridge School and Nursery in High Wycombe, Buckinghamshire, died after contracting the bacterial infectionHannah Roap The 'bubbly' and 'beautiful' seven-year-old is the only child to have died from Strep A in Wales so far.Her devastated parents told how their 'hearts had broken into a million pieces'. The first signs of the infection were mild. Hannah's father Abul took his daughter to the GP after a cough got worse overnight. She was prescribed steroids and sent home, but she died less than 12 hours later. Mr Roap recalled how he desperately tried to resuscitate his child: 'She stopped breathing at 8pm but we were not immediately aware because she was sleeping.'I did CPR, I tried to revive her but it didn't work. Paramedics arrived and continued the CPR but it was too late.' Mr Roap said the family was 'utterly devastated' and awaiting answers from the hospital.The family believe she might have lived if she was initially given antibiotics. Hanna Roap, who attended Victoria Primary School in Penarth, Wales, died after contracting Strep A last month. Her family say they have been 'traumatised' by her deathStella-Lily McCorkindaleFive-year-old Stella-Lily McCokindale died following a Strep A infection, the first death from the infection in Northern Ireland. She died on December 5 at Royal Belfast Hospital.In a tribute on social media, her father Robert said the pair had 'loved every minute' of being together as they went on scooter and bike rides.'If prayers, thoughts, feelings and love could have worked she would have walked out of that hospital holding her daddy's hand,' he said. Stella-Lily attended Black Mountain Primary School, which said she was 'a bright and talented little girl' and described her death as a 'tragic loss'. Five-year-old Stella-Lily McCokindale who attended Black Mountain Primary School in Belfast died in early December after contracting Strep A Jax Albert JefferysA five-year-old boy who died of Strep A was misdiagnosed as having flu, his family has said.Jax Albert Jefferys, from Waterlooville, Hampshire, died on December 1.His mother Charlene told how she had sought medical advice three times during the four days leading up to Jax's death and was told he was suffering from influenza A. She described Jax as a 'cheeky little chappy'. Later tests revealed he actually had Strep A. Jax Albert Jefferys, a five-year-old from Waterlooville, Hampshire, died on , December 1, from Strep A | Epidemics & Outbreaks |
School closures in January 2021 could have been avoided if ministers had taken action earlier the previous autumn, Matt Hancock has said.
The former health secretary told the Covid inquiry that avoiding a lockdown led to tougher measures later on.
WhatsApp messages from October 2020 showed he was worried then-Chancellor Rishi Sunak was putting "pressure" on Boris Johnson "not to do enough again".
He also accused local leaders of putting "politics over public health".
The Mid-Suffolk MP suggested that politicians in Greater Manchester such as the mayor, Andy Burnham, had been "actively unhelpful" when the government tried to put local restrictions in place.
This was the inquiry's second day of hearing evidence from Mr Hancock, who was health secretary for the bulk of the pandemic.
He was forced to resign in June 2021 after being caught breaching social distancing guidance by kissing his aide, Gina Coladangelo.
Asked about the incident, he acknowledged it could have damaged public confidence in the rules.
More on Covid and the Covid Inquiry
Questions at the start of Friday's session focused on decisions made from September 2020, when Covid cases started to rise after a lull in the summer.
WhatsApp messages from October 2020 show Mr Hancock asking civil service head Simon Case for information about a meeting, from which he claims he was "blocked".
"Rishi is in the room... so the PM will be under enormous pressure to not do enough once again," he wrote.
Mr Case responded: "Rishi has already resigned himself to the choice ahead... his only question (and a fair one) is about nonessential retail - where obviously we have no evidence of transmission.
"He thinks better to do something in secondary schools (where we know transmission takes place) instead of closing all shops (where we know it doesn't seem to)."
Speaking to the inquiry counsel, Hugo Keith KC, Mr Hancock rejected suggestions that there was a trade-off between health and economic considerations, saying: "If we don't lock down there will be more deaths and we will have to have a tougher lockdown in the future."
"So on reflection and with hindsight if we had taken action sooner in September of 2020, then we might for instance have avoided the need to close schools, which in the end we had to because cases were so high by January."
Mr Hancock added that, by January, the situation had become so serious that "every lever had to be pulled".
There has been concern about the damaging effect of schools closures on children - particularly those from disadvantaged backgrounds.
Earlier this year, MPs warned it could take 10 years for the gap between disadvantaged children and others to narrow to what it was before the pandemic.
'In despair'
In mid-October 2020, in a bid to slow the spread of the virus, the government introduced the tier system, whereby different rules were implemented in areas depending on the local case numbers.
In his statement to the inquiry, Mr Hancock said he was "in despair" when the policy was announced because he knew it "would not work".
He argued that was because the toughest restrictions were not strong enough, but also because negotiations with local leaders had led to delay and confusion.
He had praise for Joe Anderson, who was Liverpool mayor at the time, saying they were able to work together to put in place an "effective" package of support.
However, he raised eyebrows when he said Mr Anderson was "sadly, no longer with us", despite the fact the former mayor is still alive.
Comparing Mr Anderson to other local leaders, Mr Hancock, said they were "not so constructive and in some cases actively unhelpful".
Mr Keith KC asked if that is what former Chief Scientific Adviser Sir Patrick Vallance was referring to when, in his diaries, he mentioned "difficult negotiations in Manchester".
Mr Hancock said it was and stressed that his comments related to the local leadership, adding "I have got no beef with the fine city of Manchester."
Greater Manchester was placed into tier three restrictions on 20 October, meaning pubs and bars had to close and household mixing was restricted.
The decision triggered a row between Mr Burnham and the government over how much financial support should be provided for the area.
Responding to the criticism, Mr Burnham said: "That may be Mr Hancock's opinion, but he's wrong.
"The mayor and 10 leaders in Greater Manchester, including a Conservative leader, spent many hours trying to negotiate a deal with the government... it would not have been right to place further restrictions on the residents of Greater Manchester without the financial package to support them."
'Therapy sessions'
Mr Hancock also said the way then-First Minister of Scotland Nicola Sturgeon communicated UK-wide decisions was "unhelpful and confusing" and "undermined" the response to Covid.
The inquiry was shown messages in which Mr Hancock said he wanted to make a particular announcement as soon as possible, saying: "It will leak anyway - and the Scots will try to get their announcement out first."
He told the inquiry: "Sometimes, [she] would leave a meeting and begin communication of a decision, for instance, sooner than agreed."
He said he had a good relationship with health ministers in Wales, Scotland and Northern Ireland and compared their meetings to "therapy sessions". | Epidemics & Outbreaks |
There is not enough evidence to suggest medical-grade face masks protect vulnerable people from Covid, health officials have admitted.
A rapid review report published by the UK Health Security Agency (UKHSA) investigated if high-quality masks, such as the N95, KN95 and FFP2 coverings, protect clinically vulnerable people in the community from catching Covid.
However, the report was unable to find a single piece of scientific research which had usable data.
“The review did not identify any studies for inclusion, and so could provide no evidence to answer the research question,” the authors state. “No studies matching the inclusion criteria were found, so no evidence could be presented.”
The rapid review looked at 4,371 studies specifically about Covid but there were none that examined the effectiveness of N95 and equivalent face masks as wearer protection against Covid-19 when used in the community by people at higher risk of becoming seriously ill.
Government scientists collected data up until September 2022 and the at-risk groups included people with Down’s Syndrome, some cancer patients and people with immune system disorders.
Contentious debate
Throughout the pandemic there has been a contentious debate about the pros and cons of wearing face coverings among scientists with little decisive evidence either way.
Various studies have purportedly shown masks to reduce transmission and disease, while others have shown them to be ineffective.
Some vocal academics entrenched in scientific politicking have vociferously defended their own position for the last three years while other scientists calling for more research have often been met with criticism.
Now, health officials are struggling with a lack of data which experts warn leaves us just as in the dark now as we were three years ago about whether masks work or not.
Prof Carl Heneghan, professor of evidence-based medicine at the University of Oxford, told The Telegraph it is “a significant failing” that there have not been high-quality trials done on the effectiveness of masks.
“I do not understand why there's been a lack of will to do high-quality trials in this area,” he said. “We have completely failed to address this issue and I actually consider that to be an issue that the [Covid] inquiry needs to look at.
“For those people at low risk, these questions don't necessarily matter too much, but if you're at high risk, you really want this question to be addressed. You want to know the answer.”
He added that the scientific field’s inability to conduct good clinical trials that gather robust data leaves us exposed and at risk of making the same mistakes in the next pandemic as we did in the last one.
“If there's another pandemic around the corner, we still haven't addressed any of these issues. We've not learned anything,” Prof Heneghan said.
A previous UKHSA which was wider in scope concluded that all types of face coverings are effective in reducing transmission of SARS-CoV-2 to some extent in both healthcare and community settings. In this review, it was noted that N95 respirators are likely to be the most effective.
However, a Cochrane review published last month found insufficient evidence to inform on the effectiveness of masks. It is impossible to say if masks work or not because there is not enough good data, the review found.
Prof Paul Hunter, Professor in Medicine at the Norwich School of Medicine, led a study at the end of 2020 looking at how effective masks were and used data on flu, as well as other viruses.
“Masks did reduce risk of transmission by about 20 per cent and in the early days of the pandemic that was really important,” Prof Hunter told The Telegraph. “But they were never the cast-iron guarantee that some people seem to have been saying. However, since the appearance of omicron masks no longer provide much if any value.
“The exception is people who remain particularly vulnerable to severe disease as there is some evidence that if you catch Covid whilst wearing a mask you generally get a less severe infection.
'No good evidence'
“In my view, there is no good evidence that N95 masks work any better than surgical masks.”
Dr Aodhán Breathnach, a Consultant Global Health Microbiologist at UKHSA and a Consultant Medical Microbiologist at St George’s University Hospitals, recently published a study which found masks in hospitals had little impact on Covid transmission in the omicron wave.
He told The Telegraph that conducting randomised clinical trials for mask-wearing would be very difficult to do in practice.
“It is maybe surprising that there is no conclusive evidence one way or another [as to whether masks work], given that SARS-CoV-2 is perhaps the most studied virus ever, and masking was always a debated topic,” Dr Breathnach said.
“Nonetheless, the fact that the studies that do exist (including our own late addition) fail to show convincing evidence of benefit from masking suggests that, if there is a benefit, it is a rather modest one, i.e. masks may reduce the risk slightly but do not guarantee you won’t get infected.” | Epidemics & Outbreaks |
It's known as the synthetic street drug that turns users into 'zombies' within minutes – and can even lead to psychosis and death.
Now, scientists at the University of Bath have developed a pocket-sized device that can instantly detect the presence of 'Spice', also known as 'fake weed'.
The small hand-held machine lights up in the presence of the illegal substance if it's been soaked into paper or fabric – a common method for smuggling into prisons.
Experts think the device will be handed out to police officers and prison guards to check for Spice 'within months', once it's been cleared for rollout.
With further engineering, the scientists think it will also able to detect all types of synthetic drugs, which are chemically produced in a lab.
Scientists at the University of Bath have described their invention in a paper published in the journal Analytical Chemistry.
The machine detects Spice with 95 per cent accuracy, according to their results.
'Our device is truly ground-breaking,' Professor Christopher Pudney who led the research at the university's Department of Life Sciences.
'It's battery-operated, ultra-portable, low-cost and gives instant results that anyone can interpret.'
Spice – which was made illegal in the UK in 2016 – can be fatal and often causes severe side effects, including psychosis, stroke and seizures.
The common street drug particularly causes harm among homeless communities, but it's also routinely smuggled into prisons.
In many cases, Spice use has proved lethal – for users both in and out of jail.
The substance was involved in almost half of non-natural deaths between 2015 and 2020 in English and Welsh prisons, according to a recent report from Middlesex University.
Spice takes the form of the liquid and can be sprayed on plant material that's smoked – giving a similar experience to using real marijuana.
But when it is smuggled into prisons it tends to be in its pure liquid form, illicitly soaked into paper or fabric such as clothing.
'Typically, Spice enters prisons on paper, and once it's inside, it's divided into smaller paper sheets in the prison and then sold,' Professor Pudney said.
'The paper is crumpled up and inserted into a vape pen and smoked, so detection in the prison environment is incredibly challenging.'
The new device works by detecting the fluorescent properties that make up the core part of the synthetic cannabinoid molecule, which is called tetrahydrocannabinol (THC).
'The core of the molecules give back some specific energies of light when we shine a bright UV light on them,' Professor Pudney told MailOnline.
'We detect these energies and that allows us to identify that the material is soaked in something suspect.'
When the device touches a material, it first identifies the material it's on and then tests for the presence of Spice.
'We shine a UV light on the sample and we detect how that interacts with the material,' the academic said.
If the material tests positive, an 'alarm' for Spice shows up as a glowing ring of LEDs, visible to the operator to alert them to the presence of the substance.
And the greater the concentration of Spice, the brighter the LEDs glow.
According to Professor Pudney, if a material can soak up a liquid, it can be potentially analysed by the device for the presence of Spice.
'In reality, even if the surface doesn't absorb liquid – e.g. plastic – we can detect the dried on Spice,' he said.
'But the major smuggling routes are still paper and fabric.'
Recently, Spice has also been added to liquids in vapes, putting unsuspecting smokers at risk.
Generally, smokers are duped into smoking Spice when they have bought their vape liquid from a dealer and believe they are smoking vape liquid containing THC or cannabis oil.
Even when hidden this way, however, the drug can be easily detected by the new device.
'We can spot Spice easily simply by opening a vape and testing the mouth filter,' said Professor Pudney.
Developed with funding from the UK government's Defence and Security Accelerator (DASA) fund, the device should be ready for mass production this autumn. | Drug Discoveries |
The largest ever outbreak of bird flu is spilling over into mammals, including otters and foxes in the UK.
Figures released to the BBC show the disease has led to the death of about 208 million birds. There have also been at least 200 recorded cases in mammals.
There will now be more targeted surveillance and testing of animals and humans exposed to the virus in the UK.
The UK Health Security Agency (UKHSA) still advises that avian flu is primarily a disease of birds, but experts across the globe are looking at the risks of it spilling over into other species.
Worldwide, the virus has been found in a range of mammals, including grizzly bears in America and mink in Spain, as well as in dolphin and seals.
In the UK, the Animal and Plant Health Agency (APHA) has tested 66 mammals, including seals, and found nine otters and foxes were positive for highly pathogenic avian influenza (HPAI) H5N1.
It is believed they had fed on dead or sick wild birds infected with the virus.
The animals were found to have a mutation of the virus that could make it easier to infect mammals, but there was no evidence of transmission between mammals.
The APHA added that there was "a very low likelihood of any widespread infection in GB mammals".
Prof Ian Brown, APHA's director of scientific services, said: "A sick or a dead wild bird contains an awful lot of virus. So scavenging mammals that will be opportunistic and predate on dead or sick birds will be exposed to very large quantities of virus. That gives a possibility for the virus to enter a host population that it doesn't normally maintain in."
Prof Brown said that the UK's national avian flu taskforce was now ramping up its surveillance of cases in mammals and genome analysis of the virus itself while keeping a close eye on its spread in global populations of wild birds.
"The virus is absolutely on the march. And it's almost remarkable - it's a single strain," he said, adding that greater international action to tackle its spread was needed.
He told the BBC he was "acutely aware of the risks" of avian flu becoming a pandemic like Covid-19.
He said: "This global spread is a concern. We do need globally to look at new strategies, those international partnerships, to get on top of this disease.
"If we don't solve the problem across the globe, we're going to continue to have that risk."
Since October 2021, when the latest outbreak began, there have been five confirmed human cases of the H5N1 virus, including one in the UK, and one death, in China.
The World Health Organization (WHO) said that, in the past 20 years, there have been almost 870 cases of human infection with the avian influenza H5N1 virus reported from 21 countries. Of these, 457 were fatal.
It said the virus has "not acquired the ability for sustained transmission among humans. Thus the likelihood of human-to-human spread is low."
But it added: "Due to the constantly evolving nature of influenza viruses, WHO continues to stress the importance of global surveillance to detect and monitor virological, epidemiological, and clinical changes associated with emerging or circulating influenza viruses that may affect human (or animal) health, and timely virus-sharing for risk assessment."
Intergovernmental organisation the World Organisation of Animal Health (WOAH) told the BBC it has recorded almost 42 million individual cases in domestic and wild birds since the outbreak began in October 2021.
Almost 15 million domestic birds, including poultry, have died from the disease, and more than 193 million more have been culled.
It also shows 119 outbreaks affecting mammals, with about 200 individual cases recorded - although a WOAH spokesperson warned the spread to mammals was likely to be under-reported.
Dr Gregorio Torres, WOAH's head of science, said there had been an increase in reports of non-avian species being affected by the virus over the past 18 months.
He said it "could be a signal of very sensitive surveillance - an indicator that we are doing a good job".
But he added: "On the other hand, it could also be an indicator that there is a change in the epidemiology of the disease or a change in the dynamic of the disease. And that will require close monitoring.
"There is a risk for further transmission between species and we cannot underestimate the potential adaptation to humans."
The agency also raised concerns about limited wild bird and mammal surveillance and genomic data collection in England, and warned that there was not enough testing of people who had been contact with infected birds.
It is now looking to develop new ways of testing humans who have been exposed to the disease but may be asymptomatic
Dr Meera Chand, incident director for avian influenza at UKHSA, said: "Latest evidence suggests that the avian influenza viruses currently circulating in birds do not spread easily to people. We remain vigilant for any evidence of changing risk.
"There have recently been some detections of avian influenza viruses in a small number of mammals in the UK. However, the risk assessment conducted by UKHSA and partners did not identify any signals of increased risk to the general public from avian influenza at present."
Meanwhile, the public is being warned not to touch any dead or sick birds, but to report any dead birds of prey, three or more dead wild waterfowl or gulls or five or more dead birds of any species that they find to the Department for Environment, Food and Rural Affairs. | Epidemics & Outbreaks |
The soothing tones of a classical lullaby may help to relieve the pain newborns can feel from routine medical procedures. The mellifluous method could be a beneficial addition to other pain-easing tactics.
In a randomized clinical trial at a hospital nursery, newborns received a sugar solution — a standard method to lessen pain — before a heel prick. Around half of the infants also had a classical lullaby playing from speakers near their beds before, during and after the procedure. The lullaby group scored lower on a newborn pain scale at the time of the prick and after, compared with the group that only got sugar, researchers report August 29 in Pediatric Research.
“Since they gave sucrose, it’s hard to say yes, music by itself would help,” says Mallory Perry-Eaddy, a pediatric intensive care unit nurse and a nurse scientist at the University of Connecticut in Storrs. But combining music with other pain-relieving methods “could be really useful.”
Until fairly recently, the medical community did not believe newborns experienced pain. But over the last several decades, studies have revealed that infants do perceive pain, and they may be more sensitive to painful stimuli than adults are. Enduring repeated pain-inducing procedures without pain-relief treatment can have lasting neurological consequences for infants, including a heightened perception of pain.
“It’s very important that we do try to stay on top of [pain] prior to procedures,” says Perry-Eaddy, rather than just trying to alleviate pain afterwards.
Heel pricks and shots are among the routine procedures newborns have soon after birth that can cause pain. The heel prick produces a few drops of blood for tests, including to check for certain disorders. Generally, for minor procedures like a heel prick, doctors and nurses turn to pain-reducing methods that don’t involve medication, says Saminathan Anbalagan, a neonatologist at Lincoln Medical and Mental Health Center in the Bronx, N.Y. Among these methods are skin-to-skin contact between a parent and an infant, breastfeeding and giving a newborn a sugar solution.
At Anbalagan’s hospital, the sugar solution combined with any of the other non-pharmacological approaches is the standard protocol, he says. He and his colleagues wanted to study music as another potential option that could be easily implemented and is cost-effective.
The research team randomly sorted 100 infants born at Lincoln into a lullaby and a no-music group. For the lullaby group, the song “Deep Sleep” from Bedtime Mozart: Classical Lullabies for Babies began playing 20 minutes before the heel prick and continued for another five minutes after. The researchers assessed pain with a neonatal infant pain scale that considers newborns’ facial expressions, whether they cry, their breathing patterns and other signs. The pain scale ranges from 0 to 7.
During the heel prick, the no-music group had an average pain score of just under 7. But serenading the infants with a classical lullaby reduced the score to below 5. After that peak, the overall score steadily dropped for both groups in the next five minutes, with the lullaby group continuing to score lower.
More research is needed to better understand neonatal pain and determine the most effective ways to relieve it, including the optimal combination of methods, Anbalagan says. But “proven and safe therapies are currently underused for routine minor, yet pain procedures,” according to the American Academy of Pediatrics. Along with investigating the effectiveness of music as a pain-relief method, Anbalagan and his colleagues sought to bring awareness to newborn pain with their study.
“While the misconception [about newborns and pain] has faded, it continues to be a common way of thinking in some health care settings,” he says. “Why some hospitals don’t have protocols for pain relief from minor procedures in neonates remains puzzling.” | Medical Innovations |
Scientists investigating the origin of the pandemic reported Thursday that they had found genetic data from a market in Wuhan, China, that adds evidence supporting an animal origin for covid.
The result, first reported by The Atlantic, suggests that a raccoon dog — a small animal related to foxes, native to East Asia and known to be illegally trafficked at the market — may have been infected with SARS-CoV-2 (the covid-19 virus) and potentially capable of spreading it.
The raccoon dog now joins a long list of animal species known or suspected to harbor covid, including bats, minks and deer, and highlights the complicated ecology at play when it comes to virus transmission and spillover. An infected raccoon dog in Wuhan, the center of the original outbreak, could have acted as a secondary reservoir or intermediate host, a sort of subcontractor for viral transmission for the horseshoe bats many experts still believe to be the most likely original source.
This potentially complicated transmission pathway is a remarkably common occurrence in the animal kingdom.
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“It happens all the time,” said Christine Petersen, a professor of epidemiology and director of the Center for Emerging Infectious Diseases at the University of Iowa. The new report, which is based on a study that has neither yet been publicly released nor peer-reviewed, does not definitively answer the still-swirling questions surrounding covid’s origins. But it does offer another look at the delicate interplay between animal hosts and viruses in a world where humans continue to encroach on the wild.
Horseshoe bat meets raccoon dog?
The adorable raccoon dog might be making the news, but bats remain the more likely primary host of covid-19. Bats are known to be excellent at harboring a wide variety of coronaviruses, generally without ever getting sick from them. That ability to play host without suffering ill effects is what makes them a “primary” reservoir.
“No signs of disease, pumping out viruses to the world — that’s a primary reservoir. That is a classic definition,” Petersen said.
And though the bats — most likely horseshoe bats, a family of about 106 species with a horseshoe-shaped nose-leaf that aids in echolocation — may have been happily harboring the virus for some time, jump-starting a global pandemic wouldn’t necessarily require contact with humans. Secondary hosts are animals that can also contract a virus but then show signs of disease, perhaps making them more likely to shed viral material in a way that could spread to people.
So how did covid-19 potentially end up in a raccoon dog in a cage in Wuhan?
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“We’re not 100 percent sure that the interaction between the bat and the raccoon dog even happened in the market,” Petersen said. “It’s possible it happened at a farm site, and then [the raccoon dog] got shipped, and then the raccoon dog in that stressed-out state then had that virus amplify and [it] went across the market that way. We don’t know.”
In the early days of the pandemic, scientists considered other animals as possible bridge species between bats and humans. They included pangolins, the scaly mammals at the center of the global illegal wildlife trade, though they were eventually let off the hook.
Viral stepping stones
There are plenty of examples of the multistep process of viral transmission. For example, the dangerous Nipah virus, depicted with some editorial flourishes in the 2011 movie “Contagion,” has been known to spread from primary host fruit bats into pigs, who then have passed it along to humans. The virus that caused MERS — a relative of SARS-CoV-2 — shared a similar path, going from bats to camels before making it to people.
And it’s not just viruses. Lyme disease, caused by bacteria, also has a complicated ecological web that keeps the disease relevant. Its primary reservoir is likely the white-footed mouse, which carries the relevant disease-causing spirochetes but does not get sick itself. Tiny ticks feed on the blood of those mice and then move on to bite other mammals, most notably the white-tailed deer. The deer do show some symptoms of Lyme disease, but most importantly, they can move a lot farther and faster than mice or ticks can — so they can spread it to other ticks in other places, and so on. But the mouse, with its ability to act as a conduit for the Lyme bacteria, is the keystone species driving the broader cycle of infections.
“The mouse, then, is what keeps it in the environment,” Petersen said. “It’s what providing it to the ecology.”
Another concerning example right now is avian influenza, known as H5N1. The virus is known to be infecting more and more migratory birds, which sometimes may set down from their voyages among flocks of chickens or other fowl, which can pass it along to humans. There is evidence that the birds are giving it to other mammals as well, like seals and sea lions.
“As H5N1 infects more species, it also increases its geographical range and produces more viral variants that could have new biological properties,” wrote University of Colorado researchers Sara Sawyer, Emma Worden-Sapper and Sharon Wu, recently.
The same concern has come up for covid. After the initial transmission event, whether bat-raccoon dog-human or by some other method, SARS-CoV-2 has spread widely among animals ranging from pet cats and dogs to captive gorillas and lions and leopards, monkeys, armadillos, and more. Some of particular concern have included mink, leading to massive culls of the animals in Denmark in particular, and white-tailed deer, which, when they’re not running around with Lyme disease spirochetes, seem to have managed to become very effective harbors for the coronavirus as well. The more animals that have the virus, the more opportunities for mutation, and the more chance it might jump back to humans in somehow worse form.
A confused picture
Again, the new reporting on the raccoon dog is far from a definitive answer for covid’s origins. The data it is based on was posted to an international virus database called GISAID but was quietly removed sometime later; further, there may have been other animal DNA mixed in with the raccoon dog material. There is definitively no smoking gun, an actual genetic sample from a specific animal that tests positive for covid.
But the genetic sequences “and knowing that it comes from an animal in that market in a specific place where we know there were other creatures that were positive and … that there were, epidemiologically, people who were in that area that then became positive” paint a compelling portrait of the virus’s potential origins, Petersen said.
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Knowing what we do about the complicated ecological interplay between viruses and primary and secondary hosts, the details of the pandemic’s tangled origins may never get unraveled.
“Chances are at this point, three years out,” Petersen said, “we’re never going to know exactly how that happened.”
Thanks to Brett Zach for copy editing this article. | Epidemics & Outbreaks |
The UK’s remarkable capability and capacity in clinical research was catapulted on to the world stage during the pandemic. The Recovery trial, led by Oxford University, studied existing drugs in seriously ill patients with Covid-19 and identified the first proven and effective life-saving treatments.
The Oxford/AstraZeneca vaccine was tested in a trial of more than 10,000 people across the UK, using repurposed research infrastructure in our hospitals and universities, and saved more lives globally than any other vaccine. The mix-and-match vaccine studies known as Com-Cov showed the world how different types of Covid-19 vaccines could be used together, while Cov-Boost provided key data on booster doses that has informed global vaccine policy.
The pandemic provides crystal clarity on the importance of clinical research for our health in the grave circumstances of a global crisis. But just as important are the regular research activities across all disease areas, from diabetes to cancer, which provide the innovations and advances that transform patient outcomes. The testing of new devices, drugs and vaccines is a core activity for our future health.
The UK has long been a leader in clinical research, with the National Institute for Health Research providing infrastructure and funding for people and research programmes across the NHS. But it is clear from the recent House of Lords science and technology committee inquiry into clinical academics in the NHS that all is not well in clinical research. Recent reports suggest the number of industry-backed clinical trials has fallen by 41% since 2017, and that trials are being conducted in other countries instead.
The review correctly identifies a multitude of factors that have led to a decline in clinical trials, including the pressures on the Medicines and Healthcare products Regulatory Agency, which has a reduced capacity and increased workload post-pandemic and post-Brexit, and other aspects of the national and local trial approvals systems, which have undermined the competitiveness of the UK clinical research environment.
Furthermore, there has been an ongoing decline in the number of senior clinical academics, that is doctors who also conduct academic research, leaving a leadership gap at the highest levels. Perhaps the greatest cause for concern is the huge pressure on the workforce in the NHS, which is chronically understaffed to deliver patient care and often does not have the time to provide the essential work of clinical research.
It is very difficult for doctors to undertake detailed discussions with patients as part of the research consent process, and manage the complexity of a highly regulated study, when there are so many sick patients needing urgent treatment, which rightly takes priority over research. And for clinical teams across the NHS, where research should be fully embedded in their work, time is not routinely allocated in their contract.
A key underlying problem across the whole system is also the general shortage of critical medical and nursing staff, who are also vital to running a trial. The reasons for this shortage are not simple – there are insufficient numbers being trained, some leave the NHS early in their careers or retire early or move to better-paid jobs elsewhere, compounded by a decline in European doctors coming to the UK.
On top of this, the ageing population will increase the system pressure over the next few decades, which means we need a large increase in capacity to get ahead of frontline patient care, let alone sustain world-class research. The current support for strike action appears to me to be as much about these workload pressures and dissatisfaction with conditions for the staff to best serve their patients as it is about the money.
The ambition for an NHS that can really transform health must be to develop the clinical research leaders for the next generation, and for every clinician in the NHS capable – that is, trained – and having the capacity, in terms of protected time allocated, to deliver clinical research. But this cannot be achieved while doctors and nurses are drowning in a chronically understaffed system.
The benefits are clear. Much has been made of the health and direct economic benefits that come with testing and developing cutting-edge drugs, including early access to new medicines, and the revenues the NHS generates by running clinical trials. But health innovation can also have wider economic benefits for society including a more economically productive healthy workforce, and reduced costs of social care that come with an expectation of a healthy old age. And in the US, there is evidence that hospitals with doctors active in clinical science have better patient outcomes. So we know research is essential for future health innovation.
The NHS is in a unique position to deliver world-class clinical research at a national scale. We need the system geared towards research as an essential part of clinical care, and research leaders incentivised to pursue a career that can have a positive impact on the health of wider society. But we can’t ask our doctors to drive research in the NHS if they have so many patients to see each day they can’t even find time for lunch.
Prof Sir Andrew Pollard was chief investigator of the Oxford Covid-19 vaccine trials and is director of the Oxford Vaccine Group | Vaccine Development |
Cholesterol has some important jobs in the body — such as creating hormones, aiding digestion, building cell membranes and generating vitamin D — but too much of the waxy substance can pose a health risk.
"Cholesterol only becomes problematic when cholesterol levels — and particularly LDL cholesterol — become too high," said Dr. Robert Pilchik, a cardiologist with Manhattan Cardiology and contributor to LabFinder.com, in a statement to Fox News Digital.
"As total cholesterol and triglyceride levels increase, plaque begins to build up in the blood vessels and arteries," he went on.
"This increases blood pressure, puts strain on the cardiovascular system and increases the risk of heart disease, heart attack and stroke."
The best way to avoid these effects is to prevent high blood cholesterol to begin with.
Pilchik, who has expertise in cardiovascular disease and nuclear cardiology, offered six tips to keep it at a healthy level.
1. Make dietary changes
The first and perhaps most controllable way to prevent high cholesterol is to make healthy food choices, Pilchik said.
He recommended avoiding foods that are high in:
- Saturated fat
- Trans-fatty acids (trans fats)
- Sodium (salt)
- Added sugars
"Instead, try to consume a diet high in fiber and unsaturated fat," the doctor suggested.
"The Mediterranean diet is often a good choice, as it shifts focus away from dairy and red meat and onto seafood, fruits and vegetables, nuts and seeds, and whole grains."
2. Ramp up physical activity
"In the United States today, there are an extraordinary amount of people who are not maintaining what would be considered a healthy amount of physical activity," said Pilchik.
Adults need at least 2.5 hours of moderate physical activity per week, he noted, while children and adolescents need at least one hour per day.
This can include moderately paced walks, cycling or other types of exercise that maintain an elevated heart rate.
"Exercise can be habitual, and forming habits early can be helpful for preventing health issues later in life," said Pilchik.
3. Maintain a healthy weight
Maintaining a healthy weight has numerous health benefits, one of which is improving the body’s ability to use and remove excess blood cholesterol, according to Pilchik.
"While not a perfect tool, a body mass index (BMI) calculator can help indicate whether a person’s weight is healthy or not," he said.
For those who have a weight loss goal, the safest and most effective approach is a combination of dietary choices and physical activity.
"A doctor can help determine if specific weight loss goals or plans are safe to pursue," Pilchik said.
4. Avoid smoking
"Smoking is generally very hard on a person’s cardiovascular system on its own, and the effects can be exacerbated by high cholesterol," said Pilchik.
For people who have never smoked or who have already quit the habit, maintaining that lifestyle can be beneficial for heart health.
For those who do smoke, quitting can ease strain on the heart and allow some amount of healing, Pilchik advised.
5. Minimize alcohol intake
Along with smoking, alcohol consumption can have negative health impacts on the body, including increased cholesterol and triglyceride levels, according to Pilchik.
"While avoiding alcohol entirely isn’t always necessary, alcohol consumption should be limited to two drinks per day for men and one drink per day for women at a maximum," he said.
6. Take medication as needed
If all other methods have been explored and cholesterol is still elevated, Pilchik said it might be appropriate to take medication to help get the levels under control.
There are several types of cholesterol medications, including statins, bile acid sequestrants, niacin, fibrates and PCSK9 inhibitors.
"Medications are a very important and helpful tool in fighting high cholesterol, but all medications also include some risk of side effects," Pilchik noted.
"Getting ahead of high cholesterol with healthy choices earlier in life is always the preferred option."
What is a healthy cholesterol level?
There are two types of cholesterol.
Low-density lipoprotein (LDL), which is sometimes called "bad cholesterol," is associated with negative health effects when present in high amounts.
High-density lipoprotein (HDL), which is known as "good cholesterol," can help lower the risk of certain diseases.
The liver produces cholesterol, which moves through the bloodstream by attaching to a fatty substance called lipoprotein, Pilchik said.
Additional cholesterol is consumed with food.
"Blood cholesterol levels are measured in mg/dL. Having 150 mg/dL of total cholesterol is a good healthy target, and levels above 200 mg/dL are considered high," he noted.
"LDL cholesterol should ideally be around 100 mg/dL," he said.
"HDL cholesterol should be 40 mg/dL or higher for men, and 50 mg/dL or higher for women."
Blood cholesterol levels can be measured with a simple blood test.
Added Pilchik, "It’s a good idea for healthy adults to have it checked during each annual physical." | Nutrition Research |
Blood Clotting Risk Quickly Drops After Stopping Hormonal Contraceptives
Findings inform decisions on when to stop using birth control to reduce clotting risk before medical events.
(WASHINGTON, Nov. 8, 2023) – Using birth control pills and other hormone-based contraceptives is known to elevate the risk of blood clots about three-fold, but a new study suggests that this risk largely goes away within two to four weeks after one stops using these contraceptives, according to research published today in Blood.
The findings – the first to provide such confirmatory guidance on the best timing to stop contraception – can help patients and doctors weigh the benefits and risks of hormonal contraceptives and guide when to stop using them ahead of events that could further increase the risk of dangerous clots, such as major surgery, prolonged periods of immobility, or when tapering anticoagulant medications after a blood clot (deep vein thrombosis or pulmonary embolism). Based on the findings, researchers say stopping contraceptives two to four weeks ahead of time should be sufficient in most cases.
Combined hormonal contraceptives have long been known to increase the risk of blood clots, affecting roughly 10 in 10,000 individuals on estrogen-containing birth control per year, according to the Centers for Disease Control and Prevention. What has been less clear is how long this effect lingers once a person stops using contraceptives. Several medical guidelines recommend stopping hormonal contraceptives ahead of certain medical events, such as major surgery, but most do not specify how long someone should be off birth control beforehand.
“Our goal was not to look at the thrombotic risk of contraceptives, but to determine how long that risk takes to normalize after stopping contraceptives,” Marc Blondon, MD, an expert in vascular medicine at the University Hospitals of Geneva, Switzerland, and the study’s corresponding author. “It’s reassuring to know that that possible harm of the pill goes away rapidly when one stops taking it.”
The study focused on birth control methods known as combined hormonal contraceptives, which include birth control pills, vaginal rings, and transcutaneous patches. These methods prevent pregnancy by releasing estrogen and progestin to stop ovulation and are the most common contraceptives in Europe and North America.
For the study, researchers collected blood samples from 66 women on hormone-based birth control at six timepoints before and after the women stopped using their contraceptives. Participants voluntarily stopped using hormonal contraceptives for personal reasons. Dr. Blondon and team then compared the samples with blood from a control group of 28 women who were not using hormone-based birth control.
The researchers measured several biomarkers that are associated with combined hormonal contraceptives and clotting activity. These include global markers of coagulation activation due to hormones and individual coagulation factors (factor VIII and factors that inhibit clotting).
As expected, participants showed elevated levels of clotting markers before they stopped using their contraceptives. However, these coagulation markers dropped precipitously within one to two weeks after they stopped taking birth control, and by week 12, all markers were similar to the control group.
Overall, around 80% of the total drop in clotting markers seen in these women occurred within two weeks of stopping their birth control and 85% of the drop occurred within four weeks. This suggests that the likelihood of developing clots due to birth control returns to nearly normal levels within the first few weeks of stopping birth control.
“These findings can help to inform discussions around whether combined hormonal contraceptives are right for the patient, as well as patient-surgeon discussion of whether the benefit of stopping for a short time actually exceeds the risks,” said Dr. Blondon. “It’s very important to talk about the benefits of contraception because it’s crucial to avoid unwanted pregnancy and for women to have the choice of a planned pregnancy.”
He adds that in addition to reducing the risks of unwanted or unplanned pregnancies, combined hormonal contraceptives have been found to ease pelvic pain disorders, decrease the risk of anemia, and lower the risk of developing endometrial and ovarian cancers. Stopping hormonal contraceptives early when venous thromboembolism (VTE) occurs may also lead to abnormal uterine bleeding, a risk that Dr. Blondon explains leads many doctors to advise patients to continue using hormonal birth control for a period while they are taking anticoagulants to treat the VTE.
Researchers noted that the study was conducted in Switzerland and that most participants were young, Caucasian, and of healthy weight. Subgroup analyses did not show any indication that the results would be different in older women, different racial groups, or people who are overweight, though a larger study would be needed to increase confidence in the generalizability of the results across groups. In addition, Dr. Blondon explained that the study used biomarkers as a proxy for clotting risk; additional studies are needed to confirm whether this translates to a reduction in the risk of actual clotting events.
Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field of hematology, is available weekly in print and online. Blood is a journal of the American Society of Hematology (ASH) (www.hematology.org).
Contact:
Kira Sampson, American Society of Hematology
[email protected]; 202-499-1796 | Women’s Health |
Millions of workers in the UK are struggling with ill-health that is affecting their ability at work.
The Health Foundation analysis found 12% of people in work - 3.7 million - had a "work-limiting" condition.
That is up from 8.5% a decade ago - a rise of 1.4 million.
Working young people have experienced a particularly sharp rise - and are now as likely to report ill-health affecting their work as a middle-aged person a decade ago.
More than 10% of those aged 16 to 34 in work cited poor health as an issue.
One of those is health and safety specialist Shaney Wright, who is 33 and struggles with long-Covid.
Before the pandemic he managed a team of six, but has had to step back from management duties and even spent a period working part-time as he battled a range of symptoms, including fatigue, dizziness, allergies and eyesight difficulties.
"It has been really debilitating and my health has completely affected my career aspirations," he said.
"My employer has been wonderful, but I would not feel confident putting myself forward for some of the roles I used to dream about."
Huge burden
The most common causes of ill-health were chronic illnesses like heart disease, mental health conditions and joint and bone problems.
The Health Foundation - a charity which says it aims to bring about better health and care - said the analysis showed how big a problem the UK was facing with ill-health - and it is now setting up a commission of experts to investigate the issue further.
It said while much of the focus had been on those unable to work because of poor health, this report showed there were as many people with work-limiting illnesses in employment as there were out of work.
The think tank said it showed workers needed more support from the government and employers to improve their health.
Those with work-limiting conditions were more likely to be women and people living in deprived areas.
On average, they earned 15% less than other workers.
Health Foundation chief executive Dr Jennifer Dixon said: "The impact of poor health on individuals and their families, whether they are in work or not, is considerable.
"For the country, poor health in the working-age population will drag down productivity, the economy and add a huge avoidable burden on public services and employers."
It is unclear exactly what has caused the rise - some may be down to better reporting of conditions like mental ill-health, but other factors include the rising number of people waiting for treatment and the health impact of the pandemic.
The findings are based on the Labour Force Survey, which has recently been stopped by the Office for National Statistics because the numbers taking part had fallen.
However, the Health Foundation believes the data it has used is still accurate enough for its analysis.
A spokesman for the Department of Work and Pensions said a newly-announced £2.5bn Back to Work plan was helping people with health problems look for and stay in work by heralding a "huge expansion of employment and health support". | Epidemics & Outbreaks |
Lisa Marie Presley's tragic early death at the age of 54 has further deepened despair amongst her father's fans who insist the family has been cursed since the stillbirth of his identical twin brother Jesse.Ms Presley, The King's only child and sole heir to his $100million estate, went into cardiac arrest at her LA home yesterday afternoon and died in hospital with Priscilla by her side.Lisa Marie suffered a tragic and chaotic life that began for her when she found her father dead on the floor of the bathroom when she was just nine and he was 42 in August 1977. And heartbreakingly, today it emerged she was also found unresponsive at home when her ex-husband brought their two children back from school, just days after she appeared vulnerable and unsteady at the Golden Globe Awards as she struggled to cope with the suicide of her son two years ago.Many Elvis fans believe that the Presley family is cursed in the same way the Kennedy dynasty has been and Lisa Marie's sudden and early passing will further fuel that theory.Elvis, his brother, his parents and now his daughter died young. At the star's funeral two young fans were killed trying to see his coffin when a car plowed into crowds outside Graceland. And a fortnight later grave thieves tried to steal his body, which was holding a bangle left there by his beloved Lisa Marie. Lisa Marie with her parents in 1970. She would find her father dead in 1977 and was found unconscious by her family yesterday and later died in hospital with her mother at her side Two year old Elvis Presley poses for a family portrait with his parents Vernon Presley and Gladys Presley in 1937. His twin Jesse was stillborn 35 minutes before Elvis arrived in a moment that would mark his family and some claim would begin the family curse Lisa Marie Presley, who died on Thursday at 54 after suffering cardiac arrest, penned an essay about her overwhelming grief at her son Benjamin's suicide back in August of 2022; seen together in 2012. She never recoveredSome pointed out on social media that her passing came hours before Friday the 13th in California - but on the day itself in the rest of the world. Elvis Presley, arguably the greatest star of the past century, was born to a poor Mississippi family 82 years ago but his life was marked with tragedy from the start.35 minutes before he entered the world his identical twin brother Jesse was born without a heartbeat - a moment that would mark his mother Gladys, lead to alcoholism that would claim her life at 46 and spark a stifling obsession with her only surviving son until she died of liver failure.Gladys encouraged Elvis to believe that he was destined for great things. When one twin dies, she said, the survivor grows up with all the additional qualities of the other. One family insider said recently: 'The curse began when Elvis was born on January 8, 1935, in Tupelo, Mississippi, and his identical twin brother, Jesse Garon was stillborn'.Others have claimed that an error by an undertaker who misspelled his name as Jessie on the tombstone could be the cause of the curse.Money had never come easily to Gladys and Elvis's father Vernon Presley. They met in 1933 at a Pentecostal church in the scabby little town of Tupelo, Mississippi. Gladys was 22 and Vernon 17 and while she worked as a sewing-machine operator in a local clothing factory, he did whatever work he could find in the Great Depression. The home they moved into after their marriage that same year was a two-room shack with no electricity or running water. When Gladys became pregnant with twins — they ran in hers and Vernon's families — they couldn't afford medical check-ups and only when there were complications with the birth on January 8, 1935, did they call a doctor, his fee paid by a charity.He couldn't save Elvis's twin Jesse, who was stillborn. He was buried in an unmarked grave in a local cemetery a day or so later, by which time Gladys, who had lost a lot of blood, had been taken, with her surviving baby, to a hospital. Having lost one son, Gladys was always terrified that she would lose Elvis, too.When she came out of hospital, she didn't go back to the clothing factory. Instead, she waited a few months and then went cotton picking which was hard, dry, scratchy work but meant she could lay Elvis down on a sack and drag him along the rows beside her. Elvis Presley with his parents Gladys and Vernon. Elvis and his mother would both become addicted to amphetamines Elvis, Priscilla and their beloved daughter in 1968. The couple would divorce five years later Lisa Marie Presley , 54, pictured at the Golden Globes on Tuesday, had been rushed to a hospital after EMTs responded to her home for a 'full cardiac arrest'. She was pronounced dead a few hours laterWhen he was a little older, it's said that he would help her with the cotton, picking the bolls off the stems. And the bond between mother and son strengthened still further when Elvis was three and his father received a short prison sentence for cheque fraud.Left to fend for herself and Elvis, Gladys was unable to pay the rent while Vernon was incarcerated and so they were evicted, thereafter moving from house to house.'Don't worry, Mama,' he told Gladys when he overheard his parents worrying about money one day. 'When I grow up, I'm going to buy you a fine house and pay everything you owe at the grocery store, and buy two Cadillacs, one for you and Daddy and one for me.'Wherever they lived, the three of them always slept in the same room.But whenever Vernon was away, seeking work in other towns, Gladys and little Elvis spent the night in the same bed, talking in their own private baby language.For Gladys, further proof that Elvis was a child apart came when he fell so ill with tonsillitis that they thought they might lose him.Once again unable to afford a doctor, they knelt by his bed and prayed and when the fever eventually passed Gladys was convinced that it was a message from God, proof that her boy really was special.And so it proved - and he became the brightest star on the world stage. When she saw him going off to engagements out of town, she was uneasy. The world outside frightened her, and as his success grew, her fears increased.He had noticed that she had begun taking some pills - amphetamines - she was getting from the doctor and that they were making her fretful and overactive in the house — always running around and cleaning.He pretended not to notice her drinking, because he never touched alcohol himself and didn't like drunks —he had been told that Vernon's father, Jesse, had been an alcoholic. But he had noted how the pills also gave her energy — something he needed for what he was doing on stage every night — and soon began taking some himself. A grieving Priscilla Presley is seen leaving the West Hills Hospital and Medical Center hours after her daughter's tragic death This is the gated community in Calabasas where Lisa Marie Presley was livingElvis moved to Graceland and bought his mother a house - but she would say that she 'wished we were poor again' after posher neighbours suggested she was bringing down the area, especially because she loved speaking to her son's fans - offering them lemonade and a dip in her pool in hot weather.Much like Elvis, Gladys suffered a sudden period of intense health decline and substance abuse, leading to her death at 46 of heart failure. Some said she died of a broken heart. Elvis was in the US Army hit him hard and he was in a state of "near hysteria" and at her funeral where he began yelling: 'Oh God, everything I have is gone. I lived my life for you. I loved you so much'.Gladys' death has long been attributed to hepatitis, caused by liver problems due to drinking. Gladys had three brothers, each of whom also died in their forties from heart failure or lung complications.In the recently published biography, Elvis: Destined to Die Young, author Sally Hoedel argued the deaths of Elvis, his mother, and his uncles, were likely caused by a genetic defect brought on by the incestuous marriage of Elvis's maternal grandparents, who married despite being first cousins.Vernon died when he was 63 after a heart attack in June 1979 - two years after his son had passed away. He was living on the Graceland estate with his second wife, Dee.Elvis met his future wife Priscilla when she was 14 and they married when she was 22 - it was an unhappy union but would bring him his beloved daughter.As a child at Graceland, she had ponies, private access to an amusement park for herself and her friends, and staff at her beck and call.When Elvis found out that Lisa Marie wanted to see snow for the first time, he ordered his private jet to fly her to Idaho to play in the snow for twenty minutes, before flying her home again.By 1977, the year he died, Elvis was addicted to prescription drugs and bingeing on junk food, weighing approaching 30 stone when he died.On August 16, 1977, Lisa Marie, then just nine, may have been the last person to see her dad alive.She said in later life: "I don’t like talking about this. It was 4am I was supposed to be asleep, actually. He found me.” Later that morning she walked into a bathroom to find Elvis face down and Ginger Alden trying to wake him up. But he was already dead."My daddy’s dead! He’s smothered in the carpet!” she apparently said, she added later: 'His body was in the house for three days and there was something very oddly comforting about that, which made it not necessarily real to me'. Even his hasty funeral two days later was marked by tragedy when a car hit a group of mourning fans trying to see the coffin outside the gates of Graceland, killing two young women. Then a fortnight later someone tried to steal his body from his mausoleum - some claimed it was a ransom plot, others believed it was to find out more about his death. As the only daughter of Elvis and Priscilla Presley, she was quickly thrust into the limelight as a child and has had her fair share of tragedy Lisa Marie (right) and her mother Priscilla (left) were at the Golden Globe Awards on Tuesday night to see Austin Butler (center) who played her father in the movie 'Elvis'Her mother Priscilla, who divorced Elvis in 1973, turned out to be a business genius, and turned around the estate.She made Graceland a global tourist destination, and capitalized on merchandising, image deals, and royalties from songs recorded after the RCA deal - leaving the trust with $100 million by 1993.Lisa Marie lived most of her life in Los Angeles, but in 2010 she and then-husband Lockwood bought a 15th Century manor house set in 50 acres of rural England, in East Sussex.Coes Hall boasted an orangery, pond and indoor swimming pool plus spectacular grounds including walled gardens, tennis courts and parkland.She sold the house in 2021 for £3.5million ($4.3m), after five years on the market.Presley had in March 2020 bought a 3,500-square-foot five bedroom Calabasas home for $1.8 million. But scarcely four months later, her son Benjamin Keough, 27, took his own life on the premises, shooting himself in the head. She sold the home for $2 million in March 2021 in an off-market deal.In August 2022 Ms Presley penned an essay about her attempts to move on from her son Benjamin's death to mark National Grief Awareness.'I can understand why people may want to avoid you once a terrible tragedy has struck. Especially a parent losing their child because it is truly your worst nightmare,' she wrote in her essay, which was published by People.Benjamin Keough was 27 at the time of his death. He died of a self-inflicted gunshot wound, the Los Angeles County Medical Examiner's Office announced following the incident.Presley shared her son with her first husband Danny Keough, whom she married in 1988 and divorced in 1994.In the emotional essay, Presley admitted that she had kept her distance from the parents of other people whose children died by suicide, something that seemed to haunt her.'I can recall a couple of times in my life where I knew parents who lost their child and while I could be there for them when it happened, I avoided them after and never bothered to follow up with them because they quite literally became a representative of my biggest fear,' she wrote. Lisa Marie fought to keep her addiction private, but details of her battle for sobriety emerged as she filed paperwork to divorce her fourth husband – musician Michael Lockwood In August last year, Lisa Marie opened up about life after the loss of her son Benjamin Keough to suicide aged 27, who's father Danny Keough Lisa Marie is seen posing with Lisa Marie was married to pop idol Michael Jackson from 1994 until 1996'I also low-key judged them, and I swore I'd never do whatever it was that I felt they either did or neglected in their parental actions and choices with their child.'At the time of her death, Presley was living at another Calabasas home with her first husband Danny Keough, to whom she remained close. It was unclear whether she owned it.Lisa Marie Presley's death has left unresolved legal battles over her finances, and questions as to how she managed to lose the $100 million fortune left to her by her father.Presley, whose death on Thursday was confirmed by her mother Priscilla, was still battling her fourth and final husband Michael Lockwood when she died.Lockwood, father of her twin daughters Harper Vivienne and Finley, was seeking $40,000 a month in child support and insisted she had more money than she claimed in court documents.Presley, in turn, said she was at one point $16 million in debt, following disastrous business deals made by her business manager Barry Siegel.She sued him in 2018, accusing him of mismanaging her inheritance.Presley was married to actor Danny Keough, Michael Jackson, and Nicholas Cage before Lockwood, but is not believed to have gained financially from her marriages to the King of Pop and Oscar-winning actor. She appointed Barry Siegel in 2003 to manage the money - the same year she launched an ill-fated musical career of her own.Siegel, senior managing director of Provident Financial Management and a prominent entertainment business manager, counted Al Pacino, Elijah Wood, Pulitzer Prize-winning playwright David Mamet, and Frankie Valli and the Four Seasons as his clients.But in 2005 Siegel sold off 85 percent of her share in Elvis Presley Enterprises, which saw her lose control of her father's name and image rights.Siegel said the deal 'cleared up over $20m in debts that Lisa had incurred and netted her over $40m cash and a multi-million dollar income stream'.Presley said it lost her millions thanks to a subsequent investment in Core Entertainment, the company behind American Idol that went bankrupt in 2016.He then allegedly began liquidating Presley's assets in order to supplement her trust income. She also claimed his business decisions left her with a $500,000 credit card debt.In 2021, Priscilla reportedly sold her LA mansion for a profit to try to assist with her daughter's debt.Lisa Marie, meanwhile, begged a judge to ‘declare her officially single’ from her Lockwood, after five years of separation. He refused to divorce her.She said there was ‘no hope’ for the couple to reconcile and wanted to ‘move forward’ with her life. | Mental Health Treatments |
The chairman of the health select committee lobbied the head of the NHS on behalf of a firm paying him £1,600 a month, The Telegraph can reveal.
Steve Brine, a former health minister, told Michael Gove he had been “trying for months” to convince the NHS to hire anaesthetists through Remedium, a recruitment company he worked for.
A WhatsApp message seen by the Telegraph reveals Mr Brine contacted Simon Stevens, then chief executive of NHS England, as well as the Department of Health to suggest they use the company, in an apparent breach of two lobbying rules.
The message, which was forwarded to Matt Hancock by Mr Gove on Feb 2, 2021, said:
MPs condemned Mr Brine’s conduct as “disgraceful” on Wednesday and called for his resignation from the health committee.
It has previously been reported that, earlier in the pandemic, Mr Brine suggested that Mr Hancock use Remedium to hire staff to work in Nightingale Hospitals.
At the time in March 2020, he was working as an ad-hoc consultant for the firm, at a rate of £800 per day.
Mr Brine denied any wrongdoing and said he had merely passed on a letter to the then health secretary, and had not lobbied him.
The letter was dated six months and 15 days after his last payment from Remedium, which placed him outside of the restricted lobbying period for MPs.
However, in July 2020, the firm then began paying him £1,600 for eight hours' work each month – an arrangement that continued until the end of December 2021.
The latest revelations from the WhatsApp message show Mr Brine claimed he had spent “months” trying to persuade both the Department of Health and Lord Stevens that they should use Remedium to hire anaesthetists.
He has since been elected chairman of the health and social care select committee in Parliament.
The message could mean Mr Brine has breached two different lobbying rules.
Under the first rule, set by the Government, former ministers are banned from using contacts from their time in government to lobby for two years after they return to the backbenches.
When Mr Brine requested advice on the role from the Advisory Committee on Business Appointments, the lobbying watchdog for former ministers, he was told that for two years after leaving office in March 2019, he should not “become personally involved in lobbying the UK Government/NHS organisations on behalf of Remedium Partners” or use “Government and/or Whitehall contacts…to secure business on behalf of Remedium Partners”.
Under the second rule, set by Parliament, MPs are not allowed to lobby for an organisation from which they are receiving “a reward” for six months after receiving a payment.
The message shows that Mr Brine was lobbying in favour of the firm to both ministers and NHS organisations within this period.
Request passed to NHS England
Separate messages between Mr Hancock and his team show that Mr Brine's request was passed to NHS England via Allan Nixon, the health secretary’s special adviser:
“I told him team were sorting it and he hasn’t come back to me about it since,” Mr Nixon said.
The adviser then appeared to complain about the volume of requests Mr Brine had sent to the Department of Health.
“Steve’s being a nob right now and I’ve no idea why. Been chasing my tail trying to sort loads of stuff for him (not least his hospital) and he still acts like this.”
The next day, Feb 3, 2021, Mr Nixon said that “Prerana’s team” had been in contact with David Green, the CEO of Remedium.
It is thought Mr Nixon was referring to Prerana Issar, the NHS’s Chief People Officer.
Anneliese Dodds, chairman of the Labour Party, said: "While NHS heroes and other key workers battled the virus, and the British people did their bit by staying at home, it's disgraceful that a Conservative MP appeared more interested in making a fast buck out of the pandemic.
"If Steve Brine has broken lobbying rules he must face the consequences. Rishi Sunak has been too weak to stand up to his party or his Cabinet. Will he take the appropriate action in this case?"
Daisy Cooper, the Liberal Democrat health spokeswoman, said Mr Brine should resign from the committee pending an investigation.
"These messages suggest Steve Brine was desperate to help his corporate employers whilst the country was pulling together during a pandemic and leaves him with serious questions to answer,” she said.
"Frankly, the whole thing stinks. Rishi Sunak should launch an independent investigation into this damning evidence immediately."
Mr Brine told the Telegraph: "This was about responding in the national interest to an urgent public call from ministers and the NHS in a national crisis even if, ultimately, it led nowhere let alone secure any business for Remedium.”
The rule against MPs lobbying is regulated by the Parliamentary Commissioner for Standards, who can recommend sanctions, including suspension from the House of Commons for a fixed period.
The rules on paid advocacy were broken in a widely publicised way by Owen Paterson, the former MP for North Shropshire, who received support from Boris Johnson, then prime minister, after the commissioner recommended he be suspended for 30 days.
The incident resulted in a major debate over standards in public life and caused a rift between Mr Johnson and his backbenchers that precipitated his downfall. | Health Policy |
By Amy McMillin, as told to Kendall Morgan
When I found out I had lung cancer, I was working full time. That hasnât changed. I am still working full time, and my family tries to stick with the same routine we had prior to my diagnosis, with some exceptions and adjustments, of course.Â
I have two kids. My oldest is away at college and my youngest can drive now, so I donât have to do the morning school routine. This is a huge help since fatigue is one of the biggest side effects of my treatment. Thankfully, also, my mother-in-law lives close by. She is such a huge help to our family. She comes and deep cleans our home once a month and helps in any other way we may need.
Itâs important to have a support system, both at home and at work. I am so fortunate to work from home and have a great work support system. When I was diagnosed, I went to my supervisor, and we discussed options that allow me some flexibility in my work schedule. I can rest at times when I am in pain or not feeling well. I find that a quick power nap at lunch can help me to get through the day.
I have set up my home office so that I can stay on top of deadlines and priorities. My memory is a bit of a struggle at times, and things take me longer than they used to. To stay on track, I use a large desktop calendar, to-do lists, and other organizational tools. These help me know where I left off the day before and what I need to do next. Iâve adapted.
One of the things that was brand new to me with the cancer diagnosis was medication management. The targeted medicine I take for my lung cancer type is very specific about when I need to take it. I have to take two pills twice a day. They also must be taken 12 hours apart. On top of that, you canât eat for 2 hours before and 1 hour after taking the pills. It took some trial and error to land on a schedule that would work with our familyâs schedule.
I find that taking it at 5 a.m. and 5 p.m. allows me to have dinner with my family in the evenings at a time that works for everyone. Along with the targeted medication, I take another medicine now to help with digestive issues from radiation, and that has to be taken at specific times also.Â
Prior to my diagnosis, I went to see my primary care doctor once a year or on the rare occasion I had a bad cold. These days, it feels as though I am at a doctor all the time. I see my local doctor once a month at least for checkups related to the medications I take. They help me to manage my side effects and any other issues I might be having.
I also travel to [a specialty hospital] once every 3 months for scans. I get checkups with my oncology team and my cardiology team. Iâve had to learn to live with a long list of side effects, including fatigue, stomach issues, skin issues, sun sensitivity, bloating, and weight gain. Each of these side effects requires a different doctor to manage them. Managing all the medicines and all the doctor appointments on top of my usual work schedule and home life is probably one of the biggest challenges in terms of day-to-day life.
But even with all the side effects, medications, and doctor visits, I think itâs important for me mentally to maintain as much of a normal lifestyle as I possibly can. Itâs good for me as well as my family. Iâm still young and have so much to contribute to my family and friends. I want to keep moving and grooving as long as I can.Â
Some days it's wonderful and some days it's very hard, but I find that having a solid support system in all aspects is what's most important. Trust your team of doctors. Lean on your friends and family to help you because they want to and you need it. Beyond that, just keep putting one foot in front of another. Keep fighting.
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Photo Credit:Â Artfoliophoto / Getty Images
SOURCE:
Lung cancer survivor Amy McMillin, of Weatherford, TX, was diagnosed in April 2019 with stage IIIB lung adenocarcinoma, the most common form of non-small-cell lung cancer, which later progressed. She's been married to her husband, Wade, for 23 years and has two sons, Hunter and Logan. | Disease Research |
Around the World With Crohnâs
Crohnâs hit Erron Maxey suddenly in 2009, about halfway into his 18-year career playing pro basketball abroad. A bout of food poisoning in Argentina seemed to trigger it.
âActually, the whole team got food poisoning,â says Maxey, who also has played in Australia, Finland, China, and other countries. But only his symptoms seemed to linger and worsen.
Later that year, Maxey had his first surgery in Uruguay to repair infected sores in his intestines and to remove fistulas -- tunnel-like passageways that reroute waste to the wrong places.
But it took 5 more years and several more surgeries before doctors officially diagnosed Maxey with Crohnâs.
That was a difficult time for Maxey. âI'd have upset stomach, chronic diarrhea, constant pain.â
âThereâd be days when my energy level was really low, and, you know, Iâd just go ahead and tell my coaching staff, âHey, you know what? I ate something bad. I just don't have it today.â"
For a world traveler, getting the right treatment wasnât always easy. It was often tough just to get his medication on the road.
Even when Maxey managed to get the drugs shipped to him, a complex web of laws and regulations in other countries sometimes barred him from taking delivery. Once, a customs official destroyed $4,500 worth of medication right in front of him.
After so many years with Crohnâs and numerous surgeries, including a major one at Emory University in Atlanta in 2018, Maxey says he has learned to be very clear with those closest to him about his needs.
âAs graphic and as vulgar as it might be, you have to go through it so your loved ones know how to help take care of you. You can't sugarcoat it. Otherwise you're going to be in some serious trouble when you need help.â
But itâs also important, he says, to reassure those who care for you most.
âI mean, you're definitely nervous because you know that this stuff can take you out,â Maxey says. âBut at the same time, hey, you know what? We're going to get through this. We're going to figure it out. You know, this isn't my first rodeo.â
For now, Maxey is waiting in limbo in Atlanta for the pandemic to pass. He hopes to play professional basketball for at least 2 more years.
Life Beyond Crohnâs
Natalie Hayden got her diagnosis in July 2005, 2 months after finishing her undergraduate degree at Marquette University in Milwaukee, WI.
âUp until that point, I was a picture of health.â
Symptoms started soon after graduation. âI knew something was wrong because any time I would eat or drink anything, I was in horrible pain. So I just stopped eating and lost about 15 pounds.â
Finally, her worried mother, a nurse, rushed Hayden to the hospital. It took the emergency room doctor only a physical exam and a CT scan to declare that Hayen had Crohnâs. She was admitted immediately.
Hayden says she has blocked out much of those first blurry days. She remembers the shock. She remembers a lot of tears.
âThe hardest part of the diagnosis is dealing with the change to your identity. You think of this disease as a scarlet letter. You feel as though you're forever changed.â
Since her diagnosis 15 years ago, Hayden has built a career as a journalist and blogger and a rich family life with her husband, Bobby, and their two children, Reid and Sophia.
She also has gained a new perspective.
Having Crohnâs âdoesn't mean you can't follow your career aspirations. It doesn't mean you're not going to find love. It doesn't mean you canât be a parent someday,â Hayden says. âYou can do all those things with IBD. Your journey might just look a little bit different than your peers.'â
âThe disease is a big part of you, it's not all of you,â she says.
Hayden has been in remission since she had surgery in 2015. But she still has bad days.
âDon't try to be a superhero and fight it at home. If you can nip it in the bud before it becomes a full-out flare, then you can save yourself a hospitalization.â
Something people donât talk about enough, Hayden says, is the loneliness that can come with Crohnâs. Even supportive friends and family canât quite grasp how it may shape every facet of your life.
The internet can offer a way to connect with others who truly understand.
âI just want people to know that they're not alone in their journey,â Hayden says. âWe've all been there in your shoes, and we understand the severity of what you're going through.â
âAn Invisible Diseaseâ
Vern Laine was extremely active and ice skated competitively while growing up in a small town in British Columbia, Canada. Then, in 1988, out of nowhere, he started getting terrible stomach pain that lasted for days at a time.
For months, Laineâs doctors suggested his symptoms were âjust gasâ or dismissed them as âin your head.â
When he finally got his diagnosis, the first thing Laine wanted to know was how to fix it.
âUnfortunately,â his doctor replied, âthere is no cure.â
The shock of that answer took a long time to sink in fully, Laine recalls. That started a 3-decade journey in managing the effects of Crohnâs, both physical and mental.
One of the hardest parts of the disease is the uncertainty. âYou could be fine for months and then you're in the hospital. Sometimes it can hit in minutes.â
That, Laine says, is especially hard on relationships. âYou can never be firm on plans -- ever!â
Another challenge is that many people simply donât understand how ill Crohnâs can make a person.
âThe disease is invisible. Just because I donât look sick, does not mean I'm not suffering inside.â
Even after multiple surgeries, including one for an ostomy to remove his waste in a pouch, some people tell him, âYou donât look sick.â
That can take a psychological toll, which is something Laine wished he knew more about in the early years of his disease. At one point, he tried to take his own life.
âMany doctors treat the symptoms and the disease itself and forget about the mental stress. There's stigma and embarrassment behind having a bowel disease.â
Over the years, Laine has turned to painting as his own art therapy.
âI can put paint to canvas and paint what I feel at that moment in time,â he writes on his blog.
âIt's helped me tremendously to divert any pain or thoughts of depression. It can help take my mind off things and I can be in my own world.â
No Regrets: Choosing an Ostomy
Stephanie Hughes is a writer, triathlete, mom, and wife. Her journey with Crohnâs started when she was diagnosed in 1999 at 13 years old.
Though Hughes clearly has a sense of humor about her disease -- her blog is called The Stolen Colon -- there have been plenty of difficulties along the way.
One of the hardest moments, says Hughes, was in 2012, when she decided to have the surgery for a permanent ostomy, a hole in your abdomen that empties waste into a bag.
At the time, says Hughes, she was very sick and in and out of the hospital. Still, she knew that once she made the decision, there was no going back.
âI thought I was going to have to give up a lot in living with an ostomy, but the truth is that I gave up nothing and gained more than I had imagined.
âI have had an ostomy for over 8 years and it has dramatically increased my quality of life.â
For others struggling with the decision, she says, âTalk to your doctor and talk to someone who has lived with an ostomy. ⦠I realize now that I had a flawed perspective on what living with an ostomy would be like prior to my surgery.â
Thereâs no doubt, says Hughes, that Crohnâs changed her life, but not always for the worse, she says.
âLiving with a chronic illness will change your life. It will bring some of the biggest challenges you may ever face in your life, but it also brings the opportunity to find whatâs important to you and to not let the lesser things in life distract you from those things that mean the most.
âItâs hard, and itâs OK to acknowledge that itâs hard ⦠but I have found that experiencing the hard has helped me appreciate the good and the beautiful even more.â | Disease Research |
Johns Hopkins researchers looking to develop a long-acting, injectable malaria preventive using atovaquone have shown in a new study that resistance may not be the challenge scientists thought it was, particularly when using atovaquone as a malaria preventive. Malaria parasites in infected patients being treated with atovaquone tend to develop a resistance to the drug. Because of this, atovaquone by itself is not used as a malaria treatment nor has not been seen as a strong candidate for use as a preventive.
The study, led by a team of researchers at the Johns Hopkins Malaria Research Institute and the Johns Hopkins University School of Medicine, in conjunction with colleagues at the University of Liverpool, was published online October 12 in Nature Communications. The Malaria Research Institute is based at the Johns Hopkins Bloomberg School of Public Health.
In their study, the researchers found that the same genetic mutation that renders malaria parasites resistant to atovaquone in patients also destroys the parasite’s ability to live within mosquito hosts—meaning atovaquone-resistant malaria parasites would not be transmissible. The researchers concluded that atovaquone, despite concerns over resistance, holds promise as a long-acting, injectable “chemical vaccine” that could prevent infection in malaria-endemic areas.
“These findings should reduce concerns about the transmission of atovaquone resistance with atovaquone therapy, particularly when it is used as a chemical vaccine,” says study senior author Theresa Shapiro, MD, PhD, professor of Clinical Pharmacology in the Johns Hopkins University School of Medicine and professor in the W. Harry Feinstone Department of Molecular Microbiology and Immunology at the Bloomberg School.
Malaria continues to be a major global health burden. According to the World Health Organization, the mosquito-borne parasitic disease afflicted nearly a quarter of a billion people in 2021, killing more than 600,000. Researchers generally agree that, despite the impact of insecticides and other malaria control measures, and the recent development of a malaria vaccine, new approaches against this deadly parasitic pathogen are needed.
One new approach, described by Shapiro and colleagues at the University of Liverpool in a 2018 preclinical study, would use an injectable, slow-release formulation of atovaquone to provide vaccine-like protection for weeks at a time. Atovaquone is generally considered safe for long-term use even at higher doses, and has the further advantage that it interrupts the malaria life-cycle in human hosts even at the pre-symptomatic stage, when the parasite is developing in liver cells.
However, when atovaquone is used not as a preventive but as a treatment for symptomatic malaria infection, it often fails due to the emergence of genetically acquired resistance. Shapiro notes that by the time an infection is symptomatic, it involves billions of individual malaria organisms, and in this vast population it is likely that a resistance mutation will appear, if only by random genetic variation. Under atovaquone treatment, parasites with this mutation will come to dominate the infection. Because of the resistance problem, atovaquone is used to treat malaria only in combination with another antimalarial called proguanil.
Resistance should be much less likely when using atovaquone as a preventive in people who are malaria-free, Shapiro says. The drug in such cases would be acting against a far smaller number of individual parasites that are only in the early, liver-infection stage.
“In fact, there are no reported cases of atovaquone resistance when the drug has been given prophylactically,” she says.
Nevertheless, fear of resistance has left a cloud over the drug’s use even as a preventive. Indeed, there have been concerns that the mutation, once it emerged—for example, in a large population treated prophylactically with atovaquone—could spread via human-to-mosquito-to-human transmission.
In the study, Shapiro’s team examined the resistance problem, focusing on a key resistance mutation, cytochrome-b Y268S, that has been found in clinical investigations involving the major malaria parasite of concern, Plasmodium falciparum. The researchers confirmed that P. falciparum parasites carrying this mutation are thousands of times less susceptible to atovaquone, compared to unmutated parasites.
However, the scientists also found that the Y268S mutation, while it enables P. falciparum to survive in human hosts being treated with atovaquone, essentially destroys its ability to live within its Anophelesmosquito hosts. This means that atovaquone-resistant mutant parasites cannot spread via transmission from humans to mosquitoes and back again—as the researchers demonstrated using mosquitoes and a P. falciparum-infectable mouse model. For the study, the mice were engrafted with human liver cells and human red blood cells.
“Testing the mutant parasites for their ability to infect humanized mice is the best in vivo assay we have short of using humans, and strongly supports the inability of drug-resistant parasites to be transmitted by mosquitoes,” says Photini Sinnis, MD, deputy director at the Johns Hopkins Malaria Research Institute and one of the paper’s senior authors.
The findings suggest that a “chemical vaccine” strategy for protecting people from malaria with atovaquone remains viable and should continue to be investigated. Shapiro and colleagues are collaborating with Andrew Owen, PhD, a professor at the University of Liverpool, and his team to complete preclinical studies and launch a Phase I trial. Owen is principal investigator for LONGEVITY, an international project funded by Unitaid that aims to translate long-acting medicines for malaria and other diseases that disproportionately affect people in low- and middle-income countries.
“Many advances in malaria medicines that have started at small scale for the protection of travelers, later see wider use in endemic areas where they are most needed—and this may be the path atovaquone takes as a chemical vaccine,” Shapiro says.
The study’s first author was Victoria Balta, PhD, a graduate student working with coauthor David Sullivan, MD, a professor in the Bloomberg School’s Department of Molecular Microbiology and Immunology.
“Clinically relevant atovaquone-resistant human malaria parasites fail to transmit by mosquito” was co-authored by Victoria A. Balta, Deborah Stiffler, Abeer Sayeed, Abhai Tripathi, Rubayet Elahi, Godfree Mlambo, Rahul Bakshi, Amanda Dziedzic, Anne Jedlicka, Elizabeth Nenortas, Keyla Romero-Rodriguez, Matthew Canonizado, Alexis Mann, Andrew Owen, David Sullivan, Sean Prigge, Photini Sinnis and Theresa Shapiro.
Funding was provided by Unitaid (2020-38-LONGEVITY); the Johns Hopkins Malaria Research Institute and Bloomberg Philanthropies; and the National Institutes of Health (R01AI132359, R01AI1095453, T32AI138953).
Disclosures
Johns Hopkins co-authors Rahul P. Bakshi, Godfree Mlambo, Theresa A. Shapiro, Abhai K. Tripathi, and co-author Andrew Owen of the University of Liverpool, are co-inventors on PCT/GB2017/ 051746 (Atovaquone long-acting injectable formulation).
Additional author disclosures appear in the Competing interests section at the end of the paper, which is open access.
# # #
Journal
Nature Communications
COI Statement
Johns Hopkins co-authors Rahul P. Bakshi, Godfree Mlambo, Theresa A. Shapiro, Abhai K. Tripathi, and co-author Andrew Owen of the University of Liverpool, are co-inventors on PCT/GB2017/ 051746 (Atovaquone long-acting injectable formulation). Additional author disclosures appear in the Competing interests section at the end of the paper, which is open access. | Disease Research |
Britain’s top scientist has blown apart the Government’s performance during the pandemic in evidence to the Covid-19 Inquiry.
Tough talking Dame Angela McLean said it “made the same mistake three times” and cost many lives with late and more far-reaching lockdowns than would have been needed if advice to implement earlier “circuit breakers” had been heeded. Dame Angela was appointed by PM Rishi Sunak to succeed Sir Patrick Vallance as the UK Government’s Chief Scientific Adviser earlier this year.
WhatsApp messages previously revealed to the probe show she branded the then-Chancellor “Dr Death” over his Eat Out to Help Out scheme, which she blamed for increasing social mixing and infections. The professor said it contributed to the “worst moment of the pandemic” in September 2020 at the start of a devastating second wave which she and other scientific advisers had warned of if the Government didn’t act.
She said: “It was very frustrating for us to have been asked to advise the Government… so we said ‘you should do something now’. And nothing happened.” She added: “We waited until the last possible moment, delay and delay, then we had to slam the brakes on as hard as possible, with all the social and economic costs.”
Prof McLean is the first woman to take up the role of Chief Scientific Adviser since the role was established in 1967, succeeding Sir Patrick Vallance whose deputy she was during the pandemic. She also chaired Sage sub-committee, the Scientific Pandemic Influenza Group on Modelling (SPI-M-O). In one crucial meeting in September 2020 she and other advisers told Cabinet the UK faced half a million deaths if it didn’t lockdown - after she said Mr Sunak joined the meeting and asked experts “what should we do?”
Her advice was that the Government needed to “get a grip” and Sage advised a fortnight circuit breaker lockdown but with schools kept open. She explained: “I couldn't understand why we weren't doing things to try harder to prevent a second Autumn wave. We’d been telling them since it started there was going to be an Autumn wave… and nothing was done.”
At the time of the September 25 meeting - including Boris Johnson and Rishi Sunak - only 7% of the UK population had caught Covid-19 but it had killed 50,000 people. The hearing was shown a message from Dame Angela to Patrick Vallance prior to the meeting in which she said: “Does it fit your plan if I rock up and say ‘RWCS [reasonable worst case scenario] assumes someone gets a grip at this stage and it would be great if this happened’.”
The Government waited until 5 November 2020 when it was forced into a second national lockdown around the time the UK reached about 600 daily deaths with Covid-19. Dame Angela told the inquiry this was a “terrible moment”, adding: “It felt like March all over again.
“All of these things should have been done in September while incidence was low, when we could have kept it low and given us time to come to terms with the fact that ‘yes, we are having an Autumn wave, we don't know when we're getting vaccines, what are we going to do about it?’”
There was a third national lockdown in January 2021 and the pandemic would eventually claim 227,000 lives.
Dame Angela said she was not consulted about Mr Sunak’s earlier Eat Out to Help Out scheme implemented in July and neither were other scientists. Asked what advice she would have given about it, she said: "It would have been along the lines of advice that we were giving routinely, which is that there wasn't much room for increasing mixing and the kind of mixing that should be avoided is between households indoors. So, we would have said 'could you not find some other way to stimulate the economy?"'
She said the second wave of Covid in the autumn "was foreseeable for the simple reason that virtually nobody had had it (Covid)."
Dame Angela said hospitals would have saved more people and contact tracing would have worked if infections had been controlled. She added: “Keeping infections low maybe with a circuit breaker for two weeks then you go back to normal for four weeks, that’s not as damaging as the rollercoaster where you let infections grow until you just about break the NHS and then you bring in a massive, massive lockdown.
“There are plenty of reasons why short, intermittent lockdowns are better than the long, hash lockdowns we had to live through because we put them off to the last moment.”
Dame Angela submitted evidence to the inquiry that she believed if the whole country had been placed into lesser restrictions much earlier then the Autumn wave could have been controlled and full lockdowns possibly prevented. She suggested Tier 2 restrictions which only prevented meetings between different households indoors and allowed restaurants to stay open if serving “substantial meals”. | Epidemics & Outbreaks |
What stinks? The role of hydrogen sulfide in the gut
Whoever smelt it dealt it … especially if what's been dealt smells like rotten eggs. The culprit behind that eggy stink is hydrogen sulfide (H2S), a colorless, pungent gas produced by both mammalian and bacterial cells in the gut.
Besides possessing the ability to clear a room, H2S is also implicated in myriad processes that promote health—and disease. So, what's the lowdown on this gas from below?
Stinking it up: H2S production in the gut
Most people have likely experienced the stink of H2S at some point in their lives. The gas—an electron-rich molecule consisting of a sulfur atom flanked by 2 hydrogens—is used in/generated by various industrial processes (e.g., production of food, textiles, oil and natural gas, among others). It can also be found wafting from sewers, hot springs and decaying organic matter. Plants produce H2S, as do bacteria—including those that call our guts home.
Some gut microbes (e.g., Salmonella, Escherichia, Fusobacterium and more) generate H2S by breaking down sulfur-containing amino acids, like cysteine or taurine, for energy. Such sulfurous substrates may be sourced from the host diet, or the host itself (for example, taurine is often derived from microbial metabolism of bile acids).
Certain anerobic bacteria, namely members of the Desulfovibrio genus, also produce H2S via the reduction of sulfate (SO42-), a compound naturally found in various foods and drinking water. While host cells do produce H2S from cysteine and other co-substrates (known as endogenous H2S), a large fraction of the stuff floating around the gut is produced by bacteria (exogenous H2S).
Most people are familiar with gut-generated H2S as a component of flatus (as much as they wish they weren't). But how H2S is produced (and released) is one thing; how it interacts with both bacterial and host cells in the gut to impact numerous physiological processes is another.
How does H2S affect bacteria?
The conversion of sulfur to H2S provides an energy source for bacteria. Yet, the gas itself is more than just a byproduct of metabolism; it also protects microbes from environmental assaults, like oxidative stress. How? The gas scavenges for free radicals and other molecules that can damage DNA and augments the activity of endogenous, antioxidant enzymes. Further establishing its protective role, H2S has been shown to confer protection against the deadly effects of antibiotics, some of which impose oxidative stress on bacterial cells.
H2S may also be beneficial for microbial survival in the context of host-imposed stressors. For example, a 2018 study showed that strains of avirulent Escherichia coli and methicillin-resistant Staphylococcal aureus that were unable to generate H2S were more susceptible to killing by leukocytes in vitro. A lack of H2S production also facilitated bacterial clearance in mouse models of sepsis and severe burns.
Though not specific to the gut microbiota, these findings collectively suggest that H2S acts as a bacterial defense mechanism against host immune responses—including leukocytic production of reactive oxygen species (ROS)—which could be protective in the context of intestinal survival and growth.
When being gassy is good
When it comes to host health, scientists have known for several decades that H2S does a lot of good in the human body. It largely functions as a signaling molecule and is involved in everything from gene transcription and ROS reactions to cellular respiration and proliferation. The gas also serves as an important energy source for colonic epithelial cells.
Furthermore, H2S produced in the gut doesn't stay there; it diffuses out of the intestine into circulation, where it contributes to the function of organs throughout the body, including the heart, lungs and brain. Indeed, data from animal studies suggest that circulating H2S largely originates from the metabolic activity of the gut microbiota.
To that end, microbe-generated H2S may, in turn, shape the composition of the gut microbial community itself. This has a plethora of impacts on host health, including helping to train and regulate the immune system so it can recognize microbial friends from foes. Thus, H2S is both a bacterial defense against host responses, as well as a tool that shapes those responses to maintain intestinal homeostasis.
The gas also directly interacts with immune cells to influence their activation and activity. Moreover, microbial H2S production can inhibit enzymes needed for aerobic respiration by some bacterial pathogens (e.g., Klebsiella pnuemonieae), thus potentially helping to resist infection.
When H2S in the gut is rotten (eggs)
But there's a catch: H2S is toxic. Or, more accurately, it can be toxic, depending on the concentration. This "bell-shaped response" is a defining feature of H2S; it's fine in small quantities. However, if the amount of H2S overwhelms the ability of cells to use and detoxify it, then it becomes a problem.
What exactly are these problems? For one, too much H2S inhibits host cellular respiration by inhibiting a component of the electron transport chain in mitochondria and damages DNA. Large amounts of exogenous H2S have also been shown to denature the protective mucus layer that coats the intestine. When this happens, bacteria may be granted access to the underlying epithelium and trigger inflammation.
In fact, there are links between H2S-producing bacteria and inflammatory intestinal conditions, such as inflammatory bowel disease (IBD), irritable bowel syndrome and colorectal cancer. Given these links are largely associative, more research is needed to better understand the explicit roles of H2S in disease manifestation and progression. This is within the broader need for greater mechanistic insights into the gas' effects on the intestinal microbiota, and subsequent impact on host processes (e.g., the immune system).
Harnessing H2S to promote health
Outstanding research questions aside, the associations between H2S and health have motivated scientists to examine whether modulating its concentration may be therapeutically useful. For instance, exogenous administration of H2S reduced inflammation, promoted mucus production and restored the microbiota biofilm in a mouse model of IBD, highlighting its therapeutic potential.
Another recent study showed that H2S from gut microbes reacts with compounds (azo xenobiotics) commonly found in food dyes and drugs; altering dietary concentrations of a xenobiotic (Red 40) decreased sulfide levels in the mouse gut, demonstrating how diet and drugs could be tweaked to adjust intestinal H2S concentrations.
There has also been exploration into using the abundance and metabolic activity of of H2S-producing bacteria as indicators to aid in the diagnosis and monitoring of intestinal diseases.
The more researchers learn about H2S, the better able they will be to determine how it can be used for good. It's a smelly endeavor, but somebody's got to do it.
Provided by American Society for Microbiology | Disease Research |
A nurse manager has been given just months to live after her cancer symptoms were dismissed as side-effects of having the Covid jab.
Katie Pritchard, 37, is having to crowdfund £200,000 for private treatment after she was twice misdiagnosed before finding out she had cervical cancer.
The mum-of-two, from Tysoe, Stratford-upon-Avon, went to her GP after finding a lump but was told there was "nothing to worry about" and her symptoms may have been down to the Pfizer vaccine.
She was also told that it may be a prolapsed bladder from having children and was left insulted by another suggestion it was an STI despite 17 years with her partner.
Unhappy with her treatment, Katie independently scheduled an appointment with a gynaecologist and was diagnosed with cervical cancer later that same month.
But she was then forced to wait an agonising three months for her treatment to begin - by which point the cancer had spread.
Katie began five weeks of gruelling radiotherapy, chemotherapy and brachytherapy in April last year and was told the treatment was a success.
But, in December, after undergoing further scans, she received the heartbreaking news that her cancer had returned and she has now been given months to live.
At the start of this year, Katie was diagnosed with lung, shoulder, spine, and pelvic cancer and started palliative chemotherapy three weeks ago.
Katie will now tie the knot with her long term partner Tom Cronin, 35, a teacher, in an emotional ceremony next Monday.
The couple are also trying to raise money to fund a potentially life-prolonging drug not available on the NHS so they can spend more time together as a family.
Katie said: "When I first went to the doctors with my symptoms, I knew something wasn't right. I had to really push for the nurse practitioner to examine me for the second time in my appointment and she told me there was nothing to worry about.
"I knew it was more than a bladder prolapse and I had been with my soon-to-be husband for 17 years, so I knew it wasn't an STI.
"I was left with no faith, and it didn't make any sense so that is when I booked myself into see a gynaecologist."
Katie said her gynaecologist was "astonished" the cancer hadn't been picked up by the nurse practicioner.
Katie says she was then "passed about" from appointment to appointment for two-and-a-half months waiting for treatment to start at Coventry Hospital.
Feeling frustrated, she referred herself to Oxford University Hospitals NHS Trust last April where she worked and began treatment almost immediately.
Throughout her five weeks of intense chemotherapy Katie was sick almost every day and lost two stone. She had to make multiple trips to the hospital for IV fluids and had two blood transfusions but in June was told the cancer had gone.
Katie was able to enjoy a family wedding and made such a good recovery she even returned to playing rugby Stratford RFC.
But, more heartache was to follow after a routine check-up scan in September revealed a small dot on her lung, indicating something was wrong.
"It wasn't until I started getting excruciating pain in my shoulder that [doctors] decided to examine further. In this time, the growth in my lung, which was wrongly suggested as an infection, had grown considerably," she said.
Last week, Tom set up a GoFundMe page to help raise money for a private immunotherapy drug for Katie to take alongside her ongoing treatment.
The drug named Pembrolizumab costs an eye-watering £6,000 every three weeks and so far, the fundraising page has racked up over £107,000 in donations.
Katie, who is mum to sons Percy, four, and Cass, two, said she started palliative chemotherapy three weeks ago and would continue on it "as long as [her] body can tolerate it".
Katie also said she was "so excited" to marry Tom and said it had been a "long time coming".
"I want to tell people how important it is to live your life and to go on lots of adventures," she said. "Turn off Netflix and go outside and enjoy yourself. You need to live for now and not for the future.
Tom said: "It has been a horrific time. It feels like the entire last year has been waiting, it's extremely frustrating.
"We've got a to-do list, which includes a will and making videos for the boys. So, if the worst does happen, we're prepared for it.
"We're being realists and positive at the same time. It's a weird balance."
Shipston Medical Centre, where Katie says she was misdiagnosed, said they could not comment on individual cases.
A spokesperson for the practice said: "We are unable to comment on an individual's care and treatment, but we would encourage Ms Pritchard to get in touch with us so we can investigate her concerns." | Disease Research |
What IS bacterial meningitis? Everything you need to know about bug that kills up to one in 10 people who catch it after death of legendary guitarist Jeff BeckJeff Beck died 'peacefully' last night after contracting bacterial meningitis The 78-year-old had recently finished touring with actor Johnny Depp Experts estimate that up to 1 in every 10 cases of bacterial meningitis is fatal Bacterial meningitis symptoms strike suddenly and worsen very quickly Published: 07:41 EST, 12 January 2023 | Updated: 08:20 EST, 12 January 2023 Legendary British guitarist Jeff Beck died 'peacefully' last night after contracting bacterial meningitis, it was revealed yesterday. The 78-year-old, who just weeks ago finished touring the US and Europe with actor Johnny Depp, was so revered that his fingers and thumbs were famously insured for £7million. A representative said that Beck - an eight-time Grammy winner - had been ill over the Christmas period and passed away at a hospital close to his home in Surrey, after suddenly contracting the infection. Bacterial meningitis, which requires urgent hospital treatment, affects the membranes that affect the spinal cord and brain Jeff Beck passed away peacefully last night at the age of 78. Pictured above, Beck performing at a Crystal Palace garden party event in London in 1972 His sudden death comes just weeks after the former Yardbirds star finished a transatlantic tour with Johnny Depp as they promoted their debut album '18'British rockers including Rod Stewart and Mick Jagger led tributes overnight.Bacterial meningitis, which requires urgent hospital treatment, affects the membranes that affect the spinal cord and brain. The World Health Organization estimates that up to 1 in every 10 cases of bacterial meningitis is fatal.Experts say one of the reasons behind its lethality is that it is hard to spot early. Meningitis symptoms strike suddenly and worsen very quickly. These can include headaches, a fever, stiff neck, nausea, vomiting and drowsiness, easy to mistake for other common conditions including the flu. Photophobia - sensitivity to light - and developing a skin rash are other tell-tale signs of infection. Caused by bacteria that enters the bloodstream, when the membranes become infected, they swell and press on the spinal cord or brain. This can cause life-threatening problems. But if treated promptly in hospital, bacterial meningitis is less likely to become lethal. It usually needs to be treated in hospital for at least a week, through antibiotics and fluids given directly into a vein and oxygen through a face mask. According to experts, at least 1.2million cases of bacterial meningitis are estimated to occur every year around the world. Watchdog NICE estimate that one in every 100,000 people are affected by acute bacterial meningitis in the UK. While in the United States, approximately 2,600 cases are reported each year, according to the Centers for Disease Control and Prevention. It can affect anyone of any age, but it is more common in babies and young children as their immune system is not yet fully developed. Teenagers and young people are also at increased risk - particularly during their first year at university - as they mingle more meaning bacteria can be passed on more easily. Infection can be spread through coughing, sneezing and kissing, as it is usually caught through people who carry the bacteria in their throat or nose, but are not actually ill themselves. The majority of people with bacterial meningitis who are treated quickly will also make a full recovery. But in some rarer cases, people may be left with serious long-term problems, including recurring seizures, vision or hearing loss, problems with memory or concentration or even amputation of limbs. The eight-time Grammy winner was also inducted into the Rock and Roll Hall of Fame twice – as a solo artist and as a member of The Yardbirds. Pictured, Jeff Beck and guitarist Eric Clapton performing at the 2010 Crossroads Guitar Festival in Bridgeview, IllinoisVaccines are the most effective way to protect against certain types of bacterial meningitis, there is no vaccine that protects against all types of meningitis. These vaccines are offered to babies, from the age of eight weeks and over and to teenagers and students. Viral meningitis - which is far more common - is caused when viruses enter the bloodstream. But it tends to be treated at home and according to experts, gets better on its own within seven to ten days. In other health news...NHS emergency care crisis laid bare: 999 response times are worst ever - with heart attack victims facing waits of up to four hours, as 1,800 patients spend 12 hours in A&E every day From Michelle Pfeiffer and Jamie Lee Curtis, to Jared Leto and Martin Freeman: As study reveals people who look older than they are face higher risk of conditions like cataracts, the 12 surprising celebrity pairs who are the SAME age Millions MORE Brits to get statins: Health chiefs recommended even patients at low risk of heart attacks are offered the cheap cholesterol-busting pills WHAT IS MENINGITIS?Meningitis is inflammation of the membranes that surround and protect the brain and spinal cord.Anyone can be affected but at-risk people include those aged under five, 15-to-24 and over 45.People exposed to passive smoking or with suppressed immune systems, such as patients undergoing chemotherapy, are also more at risk.The most common forms of meningitis are bacterial and viral.Symptoms for both include:Pale, blotchy skin with a rash that does not fade when compressed with a glassStiff neckDislike of bright lights Fever, and cold hands and feetVomitingDrowsiness Severe headache Headache is one of the main symptomsBacterial meningitis Bacterial meningitis requires urgent treatment at hospital with antibiotics. Some 10 per cent of bacterial cases are fatal.Of those who survive, one in three suffer complications, including brain damage and hearing loss. Limb amputation is a potential side effect if septicaemia (blood poisoning) occurs.Vaccines are available against certain strains of bacteria that cause meningitis, such as tuberculosis.Viral meningitis Viral is rarely life-threatening but can cause long-lasting effects, such as headaches, fatigue and memory problems. Thousands of people suffer from viral meningitis every year in the UK. Treatment focuses on hydration, painkillers and rest.Although ineffective, antibiotics may be given when patients arrive at hospital just in case they are suffering from the bacterial form of the disease. Source: Meningitis Now Advertisement | Disease Research |
A breast cancer patient has said she was moved to tears after Amy Dowden's surprise Strictly appearance last week.
The dancer, from Caerphilly, went on the show without a wig and has since spoken of the "trauma" of losing her hair following cancer treatment.
Charlotte Walker, 51, from Llandeilo, Carmarthenshire, said she was "so proud" of Amy, who she first met after featuring on her Dare to Dance TV show.
She was diagnosed with breast cancer a week after filming in August 2022.
"For her to go on TV last week, without a wig, I was so proud of her. She made me cry and everybody else I know cry," Charlotte said, adding that losing her own hair was "the most heart-breaking feeling".
After filming Dare to Dance she remained friends with Amy, who is also a patron of the Tenovus Cancer Care charity, which Charlotte said helped her massively through her journey.
After her diagnosis, Charlotte had surgery followed by chemotherapy and radiotherapy and is now on medication for up to 10 years to try and prevent it returning.
"Losing your hair becomes worse than the fact you've got the cancer, because suddenly you feel like 'now I'm going to look like a patient'," she said.
"It just starts to come out in clumps and you then get obsessed with it, because your sort of pulling it out and thinking 'oh my goodness, there's another clump, there's another clump'.
"Like Amy, I decided that I needed to take control, because it was breaking me basically."
"Walking out with a 'chemotherapy hairdo' - a shaved head or a bald head, whatever you want to call it - is major, and you know what, there's nothing wrong with it," said Charlotte.
"What I was so proud of [Amy], it shows other people that you don't need hair to define you, it doesn't have to define you.
"If you look back at pictures of Amy on strictly last week, you don't look and say, 'oh there's a bald head' you look and you say, 'gosh, look at her beautiful smile, her beautiful dress', she is incredible."
Following their recent friendship, Amy had a surprise for Charlotte, tickets to Strictly Come Dancing on Saturday.
"I'm going strictly! I'm absolutely thrilled. I cannot wait to go, I bought a new dress so I'm going to wear lots of sparkles," said Charlotte.
Like Charlotte, Georgia O'Connell, who was diagnosed with breast cancer in 2015, aged 35, said she hoped Amy's Strictly appearance would inspire others going through similar experiences.
"It's been a bit of a whirlwind... it was everything at once, new motherhood and cancer all came hand-in-hand," said Georgia, from Abergavenny in Monmouthshire, who was diagnosed shortly after the birth of her first son.
She said she was "so glad" to see Amy on Strictly without a wig due to the stigma many women face following cancer treatment.
Georgia said she had long blonde hair down to her waist before it started to fall out following "gruelling" chemotherapy treatment.
"There's such a stigma around losing your hair, as a woman particularly⦠you look in the mirror and you're like 'who the hell is that looking back at me?'," she said.
"I had lost control, basically, when you get your diagnosis your control goes out the window, you feel completely helpless."
After her hair initially began to fall out, Georgia said she wanted "take control of it instead of it controlling me".
She asked her parents to shut down the family hair salon and gathered her extended family over to take part in the process of shaving her head.
"So everybody piled around my parents salon and I asked them all to shave a strip of my head, which they did⦠and we took control, it was extremely liberating."
"You do have to own it, and Amy did."
Judi Rhys, of Tenovus Cancer Care, said the charity was "so proud" to have Amy as their patron.
"Her selfless determination to raise awareness of breast cancer, following her own diagnosis and during her treatment, has been nothing short of remarkable," she said.
"We are sure the positive messages Amy has delivered has made a huge difference and been a source of inspiration and strength to many people on the same journey.
"We wish Charlotte and Amy all the best for the future, and hope Charlotte has a Fab-u-lous time in the Strictly Come Dancing studio this weekend!" | Women’s Health |
Heart disease continues to be a predominant cause of morbidity and mortality globally. Research consistently points to the adoption of a lifestyle centered on cardiovascular health as an effective preventive strategy. A key component of such a lifestyle is regular physical activity. A review of empirical studies reveals a multitude of physiological benefits conferred by consistent exercise, all of which contribute to improved cardiovascular function and reduced disease risk.
Hypertension Regulation: Hypertension is a well-established risk factor for cardiovascular disease. Regular aerobic exercise has been demonstrated in numerous studies to exert an antihypertensive effect, helping to regulate blood pressure within recommended clinical parameters.
Lipid Profile Modulation: Maintaining optimal levels of serum lipids is vital for cardiovascular health. Physical activity has been shown to increase high-density lipoprotein (HDL) concentrations while decreasing levels of low-density lipoprotein (LDL) and triglycerides, thereby promoting a lipid profile that is protective against atherosclerosis.
Body Weight Regulation: Obesity, specifically central obesity, is directly linked to cardiovascular risk. Regular physical activity, in conjunction with a balanced diet, facilitates weight management, thereby attenuating the associated cardiovascular risks.
Enhanced Insulin Sensitivity: A decrease in insulin sensitivity can lead to conditions like metabolic syndrome and type 2 diabetes, both of which elevate cardiovascular disease risk. Exercise promotes glucose uptake by muscle cells, thereby enhancing insulin sensitivity and reducing associated risks.
Psychological Stress Reduction: Chronic psychological stress has been implicated in the exacerbation of cardiovascular disease. Regular physical activity induces the release of endorphins and other neurochemicals, which have been shown to reduce perceived stress and anxiety levels, thereby offering indirect cardiovascular protection.
Endorphin Release and Its Implications: Endorphins, released during physical activity, not only play a role in mood regulation but also in promoting a consistent exercise habit. This positive reinforcement mechanism encourages sustained physical activity, leading to long-term cardiovascular benefits.
Improved Cardiac Output and Endurance: Regular exercise enhances the efficiency of the cardiovascular system. It strengthens the myocardium, improves stroke volume, and enhances oxygen utilization, leading to improved cardiac output and overall cardiovascular endurance.
Anti-inflammatory Effects: Chronic low-grade inflammation is recognized as a contributing factor to atherosclerotic processes. Regular physical activity has been shown to reduce markers of inflammation, such as C-reactive protein, thus contributing to a reduced risk of inflammation-associated cardiovascular events.
Recent Findings:
- Endothelial Cell Integrity and Vascular Health:
- Regular endurance exercise helps maintain endothelial cell integrity through various mechanisms such as improving the release of circulating angiogenic cells, inhibiting neointima formation, enhancing angiogenesis, activating antioxidant scavenger mechanisms via mitohormesis, and reducing endothelium-derived adhesion molecules and angiotensin II-mediated vasoconstriction in patients with symptomatic coronary heart disease (CHD)1.
- Lipid Profile Modulation and Inflammation Attenuation:
- Exercise training improves blood lipid profiles, specifically improving high-density lipoprotein (HDL) cholesterol levels. It also enhances insulin sensitivity and attenuates systemic chronic low-grade inflammation, promoting cellular maintenance and repair processes which include protection against DNA damage and reduction in vascular reactive oxygen species in patients with CHD1.
- Anti-atherogenic Adaptations:
- Regular exercise improves elastin and collagen content, leading to less lipid accumulation and stenosis, stabilizes atherosclerotic plaque, and reduces both the necrotic core area and plaque burden. This exercise-induced plaque composition might be more benign and potentially associated with fewer cardiovascular disease (CVD) events1.
- Myocardial Regeneration and Cardiac Preconditioning:
- Exercise prior to myocardial infarction (MI) might reduce infarct size and improve cardiac function post-MI. Exercise training post-MI can induce favorable left ventricular remodeling, reducing diastolic volume, and N-terminal pro–B-type natriuretic peptide among patients with moderate systolic dysfunction. Mechanisms responsible for exercise-mediated improvement in myocardial regenerative capacity include reduced myocardial wall stress and improved autonomic balance among others1.
- Microcirculatory Efficiency and Antioxidant Capacity:
- A study found that regular physical activity improved microcirculatory efficiency and increased plasma antioxidant capacity in elderly athletes2.
- Psychological Benefits in Individuals with Depression or Anxiety:
- Regular physical activity nearly doubled the cardiovascular benefit in individuals with depression or anxiety compared to those without these conditions3.
- General Cardiovascular Benefits:
- Exercise contributes to primary and secondary prevention of CVD, with self-reported moderate and vigorous physical activity inversely associated with CVD and overall mortality. Recommendations include 150-300 minutes per week of moderate-intensity or 75-150 minutes per week of vigorous-intensity aerobic exercise, in addition to muscle-strengthening activities1.
- Impact of Exercise on Cardiovascular Health:
- A recent study estimated the impact of exercise on cardiovascular health, emphasizing the multifaceted role of regular physical activity in preserving cardiovascular health4.
In summary, regular physical activity plays a multifaceted role in the preservation of cardiovascular health. It acts both directly, by modulating key physiological parameters, and indirectly, by influencing behaviours and psychological states that are linked to cardiovascular risk. The integration of consistent exercise into daily routines remains a cornerstone recommendation for cardiovascular disease prevention.
References:
- American College of Cardiology. (2023). Exercise Benefits in CVD: Key Points. Retrieved from https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/04/10/15/09/exercise-benefits-in-cvds;.
- News Medical. (2023). The beneficial effects of regular physical activity on the… Retrieved from https://www.news-medical.net/news/20231020/The-beneficial-effects-of-regular-physical-activity-on-the-cardiovascular-profile-in-the-elderly.aspx;.
- ScienceDaily. (2023). Exercise holds even more heart health benefits for… Retrieved from https://www.sciencedaily.com/releases/2022/03/220324104415.htm;.
- News Medical. (2023). What are the benefits of exercise on cardiovascular health? Retrieved from https://www.news-medical.net/news/20230501/What-are-the-benefits-of-exercise-on-cardiovascular-health.aspx;. | Disease Research |
Sean Crawford cried when he saw the trailer for new Hollywood film The Whale.
He says the movie about a reclusive English teacher with severe obesity, played by Brendan Fraser, resonated with his life.
Mirroring the plot of the film, Sean rapidly gained weight after someone close to him died. He now weighs 30 stone (190kg).
The father-of-one from Athelstaneford in East Lothian says the film has given a voice to people in his situation.
And he says there are many similarities between his life and that of the film's lead character, Charlie.
"He instructs a class from behind a computer because he is ashamed of his weight, I hid away from things because I was ashamed of mine," said Sean.
"The main focus is making sure our daughters turn out to be good human beings just in case we aren't there to see them grow up.
"I think people need to realise big people are human beings."
Sean says health and depression are among the issues that can lead to weight gain.
He said: "I often get adults looking at me in disgust, kids stare and make comments - but I understand this is the innocence of youth.
"I so often hear people talk about the likes of anorexia and bulimia with a degree of sympathy, whereas obesity is frowned upon.
"Both are illnesses at the end of the day."
Sean said he had been a confident person before he started gaining weight.
One of his best friends passed away in 2019, then two months later he took voluntary redundancy from his role as a maintenance supervisor after 12 years in the job.
This was followed by the Covid lockdown, and he ended up out of work for a few years.
In this time he became a bit of a hermit - and put on 12 stones (76kg) in 18 months.
"My doctor said if there was an award for putting on weight in the shortest space of time then he would give it to me," said Sean.
"I neglected my life and spent 99.9% of my time watching TV, eating and drinking fizzy juice.
"I don't sleep much so I have 18 to 19 hours a day to do this."
He went from working with 200 people every day to sitting on his own in his house.
Sean said he gave up - particularly during lockdown, when he found the isolation very stressful.
He started getting back pains and it became too painful to walk.
He tried to find out how much he weighed, but there were no scales big enough at his doctor's surgery.
He eventually got weighed at the hospital, and found that he weighed 30 stone (190kg).
"It was soul destroying and I lost all my confidence," he said.
At the end of 2020, when his vacuum cleaner broke and he did not have enough money to replace it, a friend gave him a number for the charity DadsWork, which is funded by the National Lottery Community Fund.
The community project in East Lothian provides support groups, positive parenting classes, workshops on the role of fathers, home visits, trips and outings for fathers and their children.
They gave him a vacuum cleaner and told him about drop-in groups and workshops he could attend with his daughter.
Sean, who is 5ft 11ins , said: "I didn't know what they did but after meeting them I've seen them just about every week since.
"I started going to their drop-in groups and it was great to meet other dads and hear their stories and what they were struggling with.
"These sessions helped normalise struggles of fatherhood to me and now I realise that I'm not alone - and not the only one who may feel that they don't know what they're doing all of the time."
Sean said this had made him a better dad.
He also now has a job volunteering as a supervisor in a food bank.
"DadsWork have really helped me be more productive with the time I spend with my daughter too," he added.
He said they now do "all sorts of things together" and had been supported with swimming passes.
"My daughter loves it and it's helping me get into shape and get my confidence back," he said.
Kevin Young, project manager of DadsWork, said the organisation was there to offer support.
He said: "Sean has made a remarkable turnaround. When we first met him he was low in confidence and self esteem and wouldn't go out.
"We have spent a lot of time building our relationship with him to establish trust.
"He has gone from the vacuum cleaner, which was a small thing but huge thing for his family, to engaging with us hugely."
Now Sean feels in a better place and hopes to lose weight so he can meet a new partner.
"I hate being on my own and I hate being lonely," he said. "I'm in a terrible place with my weight and hate having my picture taken or looking at myself.
"But now I'm working again I feel ready to lose weight."
He also wants to see The Whale at the cinema.
"I'm desperate to see it," he added. "I ended up in tears when I watched the trailer, I related to it so much.
"I couldn't tell you the last time I wanted to see a film at the cinema but this one massively ties into my situation.
"I empathise with him and it also gives a voice to people in my position.
"He is a teacher and is helping society. It shows people benefitting from his life, as normally overweight people are hidden away and are not given the credit they are due." | Mental Health Treatments |
Oct. 27, 2023 â Eleven-year-old Evan Hines is a typical pre-teenager. He loves fishing with his dad, chess club, and of course video games. Heâs passionate about taekwondo and loves to bake. He also has hard-to-manage migraine headaches.
Evan was diagnosed about a year ago. He was admitted to Johns Hopkins All Childrenâs Hospital in St. Petersburg, FL, because his migraines were not responding to any medication.
During his hospital stay, the family was told about the hospitalâs acupuncture clinic.
âI checked with Evan,â said his mother, Kathryn. âAnd I said this is what acupuncture is, are you game? And he said, âIâll do whatever; it canât be worse than having this kind of pain.ââ
âI thought it might hurt, but it really doesnât.â Evan said. âI donât really have a word for it, but it will tingle sometimes, and it makes me feel very relaxed.â
Acupuncture is a traditional Chinese medicine practice that has been used in some form for at least 2,500 years.Â
Very fine needles, some as thin as a human hair, are placed into the skin at various points to stimulate the body to heal itself. Itâs often used for pain management, digestive issues, emotional conditions, and stress, taking a âwhole bodyâ approach rather than treating each symptom individually.Â
And parents are beginning to turn to acupuncture as a safe, effective, and holistic way to treat their childrenâs anxiety and physical ailments.
âItâs given him the opportunity to feel like heâs doing something where he has some control, like heâs made the choice to do acupuncture,â Kathryn Hines said. âWhen you look at the risks, you know, I think, like, every medicine I put my child on has more risks than going for acupuncture does.âÂ
Kym Householder is a registered nurse, doctor of acupuncture, and chronic pain coordinator at All Childrenâs. In the 6 years sheâs been doing pediatric acupuncture, she has treated hundreds of patients, including Evan.
âAcupuncture balances and regulates all of the bodyâs systems,â she said. âIt is safe, itâs natural, itâs drug-free, itâs not painful, it has very minimal side effects, itâs been helping people heal for thousands of years.â
The practice restores âhomeostasis,â or balance, in the body, she said, while it also triggers the bodyâs self-healing. It stimulates the brain to produce natural painkillers, calms down the nervous system, and influences how the brain interprets pain signals.Â
âIt relaxes muscles, tendons, and ligaments in the body,â Householder said. âIt can increase blood flow, bringing more oxygen to the tissues, it can even possibly allow you to decrease the amount of medications that you take.â
She said even infants can receive acupuncture.
âAn acupuncturist has more tools in their toolbox than just acupuncture needles,â she said.Â
One form of pediatric acupuncture doesnât even use needles. Called sho ni shin, it uses various tools and instruments that donât puncture the skin. âItâs a form of medical massage,â Householder said. âIt is similar to acupressure. Acupressure is also a technique that acupuncturists use on the pediatric population that is equally effective, and it doesnât use needles.â
She believes acupuncture is a great alternative to drugs.Â
âIt offers patients and families an excellent nondrug option to try to help them possibly avoid medication or use less medications.â
Itâs one of the reasons Caroline Klein decided to treat her daughterâs anxiety with acupuncture.
Maya Klein is a 10-year-old from Chicago who loves circus art. Sheâs an aerialist.
She recently had her first acupuncture session and says it went well.Â
âI was a little nervous at first,â Maya said. âIt sounds scary, but itâs not at all, and it makes you feel great, and you can barely feel the needles going into you, and the anticipation is worse than the actual thing!â
Maya recently transferred to a new school, causing her a little bit of anxiety. So her mother, who has successfully used acupuncture for several years, decided it might help.
âWhen Maya started feeling anxious at school, I was wondering if it would be an appropriate technique to try to alleviate some of that anxiety,â Caroline Klein said. âI think that pursuing a lot of different ways to alleviate anxiety is important and not to just rely on medication and therapy. And I think that itâs good to try a variety of different techniques to see what works for you.â
Maya said acupuncture worked for her.
âYou feel kind of relaxed, youâre in your comfort zone, and it feels like you just woke up from a really good sleep.â
Gudrun Wu Snyder, founder of Moon Rabbit Acupuncture in Chicago, is a doctor of acupuncture who treats Maya.
âAcupuncture on children can help kids have better sleep, better focus, and also then fewer of the other things that come with anxiety, whether itâs heart palpitations, sweaty palms â things that would naturally come up when you think about anxiety in a kid. These are all things that acupuncture can do,â she said. âItâs like meditation.â
â[For] children who really struggle in classroom settings, itâs going to take a few more treatments and it might be an ongoing therapy, just like talk therapy might be,â she said
According to Snyder, acupuncture has been shown to increase dopamine and serotonin â known as feel-good hormones that give you a sense of happiness â and decrease cortisol, the hormone that regulates the bodyâs response to stress. She says recent studies have shown it also helps decrease overall inflammatory response in the body.
âAcupuncture works on the meridian system,â she said. âItâs energy channels within the body through which we believe the âchiâ flows.â
Chi is considered the vital energy that circulates through the body. âWhen that chi is blocked, thatâs when disease results, thatâs when psycho-emotional disorders result,â she said. âSo we help unblock the chi and create smooth flow of energy. It's kind of like how exercise does that for you, right? All of a sudden, you get your blood flowing, you feel really good. Acupuncture does the same thing.â
Snyder said board-certified, licensed acupuncturists typically have 4-plus years of training, 3,000-plus clinical hours, and have taken board certification exams before theyâre allowed to touch a patient outside a student clinic. She said they know what theyâre doing, and children are in very good hands.
David Miller, MD, is the founding chair and immediate past chair of the American Society of Acupuncturists. He is also the medical director for pediatric integrative medicine at Rainbow Babies and Childrenâs Hospital in Cleveland.
He agrees it can provide parents with a nice nondrug treatment option, but he said parents must make sure they pick someone who has the right training to lessen any risks.
âYou definitely need a trained provider who knows how to apply it appropriately to the age group,â he said. âKids' bodies are different than adult bodies, and so if you were to go too deep in the needling, you could puncture the lung, you could puncture an organ.â
Miller said the style of treatment matters, as does the environment. Some treatments can be too strong, or the setting may not be comforting to a child, which could make the whole experience traumatizing. âSo it is really important that the provider is mindful of the unique issues with kids.â
Miller has been in private practice for 14 years and has given thousands of treatments to hundreds of children.Â
âAlmost any age group, including infants from a couple months old, can get acupuncture, but the style of the acupuncture, itâs very important that the style is appropriate to the age and that the practitioner understands how to treat those different age groups,â he said.Â
There are acupuncture styles that are very gentle and light.Â
âThat type of style you can do on almost any age group. Heavier, more intensive acupuncture I seldom do with kids at all of any age almost until they become adolescents,â Miller said.Â
It's important, he said, for people to understand that generally, acupuncture is applied as a series of treatments, much like physical therapy or athletic training.
âYouâre not just necessarily going to go once and expect a fix,â Miller said. âItâs applied sort of regularly for a course of treatment in order to try to change a given health condition.â
Eventually, once progress is seen, treatments become more spread out and are used mostly for maintenance.Â
According to Miller, thereâs quite a bit of research about acupuncture on adults, and while studies in children tend to be smaller and more preliminary in nature, they still show positive signs of potential benefit.
Ira Cohen, MD, is a pediatric anesthesiologist and acupuncture specialist at Childrenâs National Hospital in Washington, DC, where they started doing acupuncture 10 years ago as an outgrowth of their chronic pain clinic.
âI havenât found any children who are not alarmed by hearing that there is going to be needles, but once theyâve gotten one or two treatments, itâs like theyâve been getting it all their life in terms of their acceptance of it.â
Cohen has performed acupuncture on hundreds of children, some as young as 6 years old, but most of his patients are adolescents looking for pain relief.
âIf it allows them to have 2 good days in the week as opposed to no good days in the week, from their point of view, thatâs a significant change.â
Is it on the rise in children? These practitioners all say yes. And as families become more comfortable with it, the hope is that rise will continue. Florida, for example, passed a law in 2019 that requires pain providers to inform patients about nonopioid treatment options, including acupuncture.
Evan wants other kids to know thereâs nothing to fear.
âAlthough it may seem a bit scary that it really isnât something to be afraid of, itâs gonna feel really good and calm you down, and in the long run, youâre gonna feel much better with whatever youâre dealing with,â he said. | Medical Innovations |
Bad Air Has Left Mumbai Sick And Doctors Alarmed
Cases of respiratory ailments have spiked as Mumbai's AQI dips, possibly causing long-lasting impact on health.
Mumbai is grappling with a bout of respiratory ailments as the air quality of India's financial hub has been poor for about three months.
The city has seen a spike in cases of cold, headache, throat infection, persistent dry cough and breathing difficulties. These, according to doctors, could have possible long-lasting impact on human health.
"The visits to the outpatient department for breathing difficulty issues and dry cough have doubled in the past couple of weeks," Dr Salil Bendre, head of pulmonology and chest medicine at Nanavati Max Super Specialty Hospital, told BQ Prime. "We are also seeing around 5% hospitalisations among asthma and chronic obstructive pulmonary disease, or COPD patients as they've been facing increased issues."
A haze of dust and smoke—more identified with India's northern cities during the winter—now hangs over Mumbai as construction and multiple infrastructure projects have added to industrial pollution. The changed wind patterns could also have possibly aided the drop in air quality by affecting the "natural cleansing mechanism of the city", Dr Gufran Beig, founder project director, SAFAR, the government's research based initiative on health advisories, wrote in the Indian Express. Whatever the cause, doctors are worried.
Individuals complaining about having coughs, sore throats, and headaches have risen in the last month, according to Dr Prashant Chhajed, senior consultant in pulmonology and chest medicine at Nanavati Max. The patients are taking longer to recover, the doctor said, as the cause is multifactorial. "There has been an increase in pollution, seasonal variation, or climate change, and an increase in viral respiratory tract infections."
Almost 25-30% patients in the ICU currently have been hospitalised due to acute respiratory ailments, Dr Kedar Toraskar, critical care and pulmonology consultant from Wockhardt Hospital in South Mumbai, told BQ Prime. "Especially, patients with COPD, asthma, and interstitial lung diseases are presenting with respiratory failure and are requiring ICU care in the form of non-invasive or invasive ventilation," he said.
"Post the Omicron wave, and in the last three months, Covid cases are almost negligible. However, there has been a surge in influenza A (H3N2) cases, followed by swine flu (H1N1), respiratory syncytial virus, and adenovirus infections, apart from community-acquired bacterial pneumonia. Also, dry cough that usually lasted for two to three days in the winter is now lasting for over a month, which is attributed to postviral bronchiolitis," Dr Toraskar said.
"People from extreme age groups—pediatric or children and the elderly which is 65 plus age group—are suffering more and are prone to complications ."
Pollution—A Slow Poison
Pollution is damaging health and wrecking havoc with lungs, said Dr Sanjeev Mehta, consultant in chest, allergy, and sleep medicine at Lilavati and Arogya Nidhi hospitals in Mumbai. "There is no coming back from the damage it is causing."
In the past couple of months, Mumbai's AQI has worsened and dipped even below Delhi's on some occasions, Dr Mehta said.
Dr Toraskar highlighted how the exponential construction and metro plans taking place since the last four to five years have been impacting Mumbai's air quality. Industries located within city limits and the season, too, have been adding to the pollution problem.
Some of the pollution-related health issues identified by Dr Mehta:
India has the unfortunate status of having a very high number of COPD cases and consequent deaths, which are also among the highest in the world.
Post-Covid, patients with asthma and COPD are showing increasing health disturbances. This seems to be correlated with an increase in activity and pollution.
Pollution like smoking affects the growing lung. Long-term exposure of growing children to smoke and pollution may result in weaker lungs. Also, pregnant women exposed to smoke and pollution could potentially birth babies with impacted lungs. Such impacted individuals are at a higher risk of developing COPD and lung-related health issues.
A study conducted by him showed poor lung function in what would otherwise be a young, healthy population that does not smoke or is not exposed to biomass fuel. "This makes us think that pollution could be playing a negative role in the health of such individuals."
With every passing generation, according to Dr Mehta, the health especially the lung capacity is worsening due to exposure to pollutants.
Long exposure to pollution would leave a long-lasting impact on the lung function, according to Dr Toraskar. "The pulmonary function progressively deteriorates with each infective or non-infective exacerbation."
Chronic exposure to pollution could lead to development of chronic bronchitis which can cause heart diseases and increase the risk of stroke and cancer, said Dr Chhajed of Nanavati Max.
Precaution And Prevention
Wear masks for prevention and get flu shots to protect yourself against influenza if eligible, advised to Dr Chhajed. Also, individuals with chronic lung conditions must continue to take their medications regularly, he said.
While Dr Mehta suggests avoiding smoking and reducing exposure to pollutants—smoke, dust and biomass fuel to protect lungs especially, the developing ones.
Air pollution menace should be taken up more actively by environmental activists and the governmental agencies, according to Dr Toraskar. Curbing construction activities and replacing polluting old trucks and transport vehicles needs to be undertaken by the government, he said.
Aiming for an all electric vehicles in the near future will also go a long way in improving our air quality index significantly. | Epidemics & Outbreaks |
Andy Wong/AP
toggle caption
Residents wearing face masks line up behind barricaded tapes for COVID mass testing near a residential area on May 15, 2022, in Beijing. The World Health Organization says it's made an official request to China for information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children.
Andy Wong/AP
Residents wearing face masks line up behind barricaded tapes for COVID mass testing near a residential area on May 15, 2022, in Beijing. The World Health Organization says it's made an official request to China for information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children.
Andy Wong/AP
GENEVA — The World Health Organization says it has made an official request to China for information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children.
The U.N. health agency cited unspecified media reports and a global infectious disease monitoring service as reporting clusters of undiagnosed pneumonia in children in northern China. In a statement late Wednesday, WHO said it was unclear whether those were linked to a rise in respiratory infections reported by Chinese authorities.
Outside scientists said the situation warranted close monitoring, but were not convinced that the recent spike in respiratory illnesses in China signaled the start of a new global outbreak.
The emergence of new flu strains or other viruses capable of triggering pandemics typically starts with undiagnosed clusters of respiratory illness. Both SARS and COVID-19 were first reported as unusual types of pneumonia.
WHO noted that authorities at China's National Health Commission on Nov. 13 reported an increase in respiratory diseases, which they said was due to the lifting of COVID-19 lockdown restrictions. Other countries also saw a jump in respiratory diseases such as respiratory syncytial virus, or RSV, when pandemic restrictions ended.
WHO said media reports about a week later reported clusters of undiagnosed pneumonia in children in northern China.
"It is unclear if these are associated with the overall increase in respiratory infections previously reported by Chinese authorities, or separate events," WHO said, adding that it had requested more details from China about currently circulating viruses and any increased burden on hospitals, via an international legal mechanism.
Dr. David Heymann of the London School of Hygiene and Tropical Medicine said there was a likely background of seasonal respiratory infections.
"The challenge is to discern the outbreaks and determine the cause," Heymann said in a statement, adding that genetic sequencing and isolating cases would be critical. He led WHO's response to the 2002-2003 SARS outbreak.
Francois Balloux of University College London said the current wave of disease in China was likely due to respiratory illnesses like flu, RSV or a bacterial infection.
He said China was probably experiencing a significant wave of childhood infections since this was the first winter since lockdown restrictions were lifted, which likely reduced children's immunity to common bugs.
"Unless new evidence emerges, there is no reason to suspect the emergence of a novel pathogen," Balloux said.
WHO said that northern China has reported a jump in influenza-like illnesses since mid-October compared to the previous three years. It is rare for the U.N. health agency to publicly ask for more detailed information from countries, as such requests are typically made internally.
The outbreaks have swamped some hospitals in northern China, including in Beijing, and health authorities have asked the public to take children with less severe symptoms to clinics and other facilities.
The average number of patients in the internal medicine department at Beijing Children's Hospital topped 7,000 per day, exceeding the hospital's capacity, state-owned China National Radio said in an online article earlier this week.
China's National Health Commission, in a written Q&A posted online by the official Xinhua News Agency, suggested Thursday that children with mild symptoms "first visit primary healthcare institutions or pediatrics departments of general hospitals" because large hospitals are crowded and have long waiting times.
The health commission said it has been paying close attention to the high incidence of infectious diseases among children and is "guiding local authorities to enhance coordinated scheduling and implement a tiered diagnosis and treatment system."
After SARS broke out in southern China in 2002, Beijing officials told doctors to hide patients, with some being driven around in ambulances while WHO scientists were visiting the country. That prompted WHO to threaten to close its office in China.
Nearly two decades later, China stalled on sharing critical details about the coronavirus with the U.N. health agency after the new virus emerged in late 2019. WHO publicly applauded China's commitment to stopping the virus — weeks before it started causing explosive epidemics worldwide.
"While WHO seeks this additional information, we recommend that people in China follow measures to reduce the risk of respiratory illness," the agency said, advising people to get vaccinated, isolate if they are feeling ill, wear masks if necessary and get medical care as needed. | Epidemics & Outbreaks |
Cannabis should not be considered an effective long-term strategy for reducing opioid use, according to a new study released amid the global shift towards cannabis legalisation.
A study led by the University of Sydney, published on Wednesday in the American Journal of Psychiatry, followed 615 people with heroin dependence, many of whom also used cannabis, over 20 years.
The lead author of the study, Dr Jack Wilson, from the Matilda Centre for Research in Mental Health and Substance Use, said the study was the longest to have ever looked at the relationship between cannabis and illicit opioid use.
“There are claims that cannabis may help people with opioid use disorders because cannabis may be used as a method of reducing pain or helping people manage their opioid withdrawal symptoms.”
However, the study found there is no evidence cannabis reduces long-term illicit opioids use.
In 2001, the researchers recruited and interviewed a group of people with heroin dependence from Australia and then followed them up on six occasions over the next 20 years: at three months, 12 months, 24 months, 36 months, 10-11 years, and 18-20 years later.
About two-thirds were using cannabis when they were first recruited in 2001, which is representative of use among people with opioid-use dependence, Wilson said. Of those who were using cannabis, “throughout 20 years, we did not find there was a clear relationship between the use of these substances. Those using cannabis, it didn’t seem to help them with their opioid use.”
Wilson said the results showed that clinicians and policymakers should not rely on cannabis to reduce problematic opioid use in the context of growing access to cannabis products, with the global shift towards legalisation and recognition as a therapeutic product.
The non-medical use of opioids can lead to opioid dependence and other health problems, including difficulties breathing and death in the case of overdose. The burden of opioids in Australia and North America is significant, with opioid use responsible for more death and disability than any other illicit drug, Wilson said.
The cohort of people with heroin dependence in the study were typical of people with opioid use disorders, with poor physical and mental health, unstable housing, more likely to be men and went in and out of different treatment settings, Wilson said.
“Opioid use disorders are complex and unlikely to be resolved by a single treatment,” Wilson said. “The best way to support them is evidence-based, holistic approaches that look at the bigger picture and include physical, psychological and pharmacotherapy therapies.”
“Even though we found no evidence to suggest a long-term relationship between cannabis and opioid use, I wouldn’t make any conclusions around the efficacy of cannabis as a treatment for pain,” Wilson cautioned.
Previous studies have not extended beyond several years, with most restricted to a single follow-up point.
Mark Connor, a professor of Pharmacology at Macquarie Medical School, who wasn’t involved in the study, lauded the successful follow-up rates. “It’s a pretty amazing achievement to be able to speak to two-thirds of people you spoke to 20 years ago who were entering a heroin treatment program.”
Connor said while “people would like to think that a potentially less harmful drug like cannabis might be able to substitute for a potentially more harmful opioid, there is no evidence of that from this study and that doesn’t surprise me at all”.
“It’s like a naturalistic study; there’s no experiment here. They’re not asking people to do anything. They’re not trying to change their behaviour.”
Prof Suzanne Nielsen, the deputy director of the Monash Addiction Research Centre in Melbourne, said the findings were consistent with other new research showing cannabis use does not have a role in reducing opioid-use disorder.
She said the idea that it ever did came from low-quality research studies when cannabis was first legalised in the US. These suggested there was a correlation in reduction in opioid overdose, but when the studies were repeated they found a reversal of the association and that the laws actually created greater opioid-related harm, Nielsen addded.
She said because the initial study was taken as evidence cannabis would reduce opioid use, at least one state added opioid use disorder as a reason that people could prescribe medical cannabis. | Drug Discoveries |
More than 58 million domestic fowl in the US have died or been culled over the past 12 months due to a large outbreak of the avian flu — the deadliest outbreak in the country’s history, according to the Department of Agriculture.
The specter of an avian flu pandemic is always on health authorities’ minds. Should we be worried this time? According to the CDC, the risk to humans right now is low.
“They’re not considering this anything that needs to be on people’s minds continuously,” said Geoffrey Lossie, an avian diagnostician at Purdue University College of Veterinary Medicine.
However, this avian virus — the H5N1 strain of influenza — has a mortality rate in humans of 50%, which is one reason scientists are keeping a close watch on it.
So many chickens have been killed it’s contributing to an egg shortage in the US that’s driving up prices. Egg prices more than doubled in 2022 but have since declined, and other factors, like inflation and demand, have played a role in the cost of eggs.
The H5N1 virus has been detected in more than 120 wild mammals in the US in 2022 and 2023 including red foxes, skunks, and even grizzly bears — a troubling step in the road toward human infection.
An outbreak at a mink farm in Spain suggested the virus can now spread in mammals and 52,000 infected animals had to be culled. This week, four dead seals tested positive for bird flu in Scotland, as did 585 sea lions in Peru, suggesting cases are growing globally in mammals.
Past avian flus have moved from birds to other animals, but the number of mammals that have been infected recently is unusual, Gregory C. Gray, an infectious disease epidemiologist at the University of Texas Medical Branch in Galveston. “There’s concern that it could further change and jump to humans,” he said.
The H5N1 strain of influenza is a mix of DNA from a Eurasian lineage of the virus and a North American lineage, Lossie said. The strain has had a 53% death rate among humans, based on 858 reported cases globally since 2003, according to the World Health Organization. The “H” and “N” refer to proteins on the surface of the influenza virus that affect how the virus behaves.
What is bird flu?
Different influenza viruses tend to target different species, said Dr. William Schaffner, a spokesperson for the Infectious Diseases Society of America.
Avian flu is carried by wild migratory birds like wild ducks and geese and usually follows certain patterns. The virus typically doesn’t sicken or kill wild birds, though it does kill domestic fowl. In this case, though, influenza is making some wild birds sick, Lossie said.
Usually the virus passes from wild birds to domestic birds through feces. In the current outbreak there is some evidence that the avian flu is also passing through respiratory droplets in wild birds. It’s definitely being shed through the respiratory route in domestic birds like chickens and turkeys, Lossie said.
And while the number of birds who have perished from the avian flu is about the same as in a 2015 avian flu outbreak, the outbreak has now visited double the number of states.
“This does suggest that bird flu is more widely distributed geographically,” Schaffner said.
Also, Lossie added that scientists have detected far more infections in wild birds during this outbreak than in past outbreaks.
How does bird flu get to humans?
It’s rare for the exact same virus that infects birds to reach humans. “The appropriate receptors in the mucous membranes in our throats, noses, and upper part of our respiratory tract are not very receptive to bird flu,” Schaffner said.
When it does happen, it’s usually in someone who lives and works closely with birds — and the infection stops there. Since the outbreak began, there have only been four cases in humans and one death.
“Quite a number of different strains of avian flu have spilled over to humans, but they’ve had limited, if any, human-to-human transmission,” Gray said. “Often it’s a dead end.” Only one person in the US, a poultry worker in Colorado, was infected by the current strain in April while culling poultry infected with H5N1. He reported only fatigue and was treated with antivirals. He has since recovered, Lossie said. (There was also a second human case in South West England detected at the end of 2021.)
Usually there’s another step involved: The virus has to mutate enough to infect a mammal and mutate again to infect people. Every time a virus replicates, DNA can mutate, giving it opportunities to infect different life forms. New strains of a virus also happen through genetic drift, which is when two virus strains — say one human and one avian — combine to create a new variant, Lossie said.
“Most pandemics generate when there is a species jump and usually with an intermediate host where the virus can evolve,” said Dr. Cesar Arias, chief of infectious diseases at Houston Methodist Hospital. “The concern here is the Spanish report of mink transmission. There could be a genetic adaptation in which the virus can become airborne from human to human.”
So far, the CDC said that the circulating virus lacks the genetic changes which would allow it to easily cause illness in humans.
How deadly is bird flu in humans?
It can be very deadly, with a mortality rate as high as 50% in the cases where bird flu has jumped directly from birds to farmers and other handlers, Schaffner said.
Every time the virus replicates, it can mutate into a version the human immune system has never seen before. “That makes it harder for our immune systems to fight the infection,” Arias said. “When they get to humans, the adaptations tend to be accompanied by high virulence, which means infections are severe with high mortality.”
Basically, our bodies have never encountered these new viruses and have no defenses. This is effectively what happened with SARS-CoV-2, the virus that causes COVID.
How worried should we be?
Right now the avian flu doesn’t warrant five-alarm concern, experts said.
But things could change. While it takes time for a pandemic to develop, “I think we’re headed in that direction,” Arias said.
Right now, the biggest risk is to humans who have a lot of contact with birds, especially poultry, Lossie said. That includes not only people in commercial poultry operations but also people with backyard flocks, which are on the rise due to the rising price of eggs in stores.
Are there ways to protect ourselves?
The current outbreak remains a matter mainly for public health organizations for the foreseeable future. The USDA has a surveillance system in place to track avian flu in birds — one they say is the strongest in the world.
“We need to be sure the US government is very vigilant through surveillance and be alert for novel viruses that might spill into humans,” Gray said.
There aren’t any avian flu vaccines widely available, but there are prototypes. “The vaccines have basically been constructed then the question would be how quickly to manufacture them,” Schaffner said.
The CDC cautions against unprotected contact with wild or domestic birds. They recommend wearing an N95 respiratory or surgical mask, eye protection, disposable gloves, and boots as well as washing your hands after any contact and don’t touch your mouth, nose, or eyes, all possible points of entry for the virus.
If you have chickens or other birds (including pet birds), keep them protected from wild birds. “Try to shelter your backyard herd or flocks of chickens from migratory birds,” Schaffner said.
Avian flu in wild and domestic birds isn’t in and of itself a cause for panic, Schaffner added. “There’s no immediate threat but public health authorities are on the alert.” ● | Epidemics & Outbreaks |
The World Health Organization is looking into whether the breakout of monkeypox should be of international concern. WHO Director-General Tedros Adhanom Ghebreyesus announced during a Tuesday media briefing that the international agency will be convening shortly to discuss whether monkeypox is the next "public health emergency." TAMPON SHORTAGE HITS MAJOR RETAILERS NATIONWIDE "The outbreak of monkeypox is unusual & concerning. For that reason, I have decided to convene the emergency committee under the International Health Regulations next week to assess whether this outbreak represents a public health emergency of international concern," Tedros said during the briefing. The director-general said the WHO has published interim guidance for the disease, which reached more than 1,600 cases reported in 39 countries as of Tuesday. The guidelines said that for the time being, mass vaccination is not required and that the application of smallpox or monkeypox vaccines should be based on a full assessment of risks and benefits on a case-by-case basis. While smallpox vaccines have provided some protection, there is limited data to affirm the notion that the vaccines will inoculate people against monkeypox, Tedros said. The decision to use vaccines must be made by the affected person and the healthcare providers, too. CLICK HERE TO READ MORE FROM THE WASHINGTON EXAMINER Tedros added that health experts are working with the agency to consider renaming the disease and intend to make announcements about the renaming as soon as possible. The U.S. government has begun taking action to prepare for outbreaks of monkeypox. Preparations include the ordering of hundreds of thousands of vaccine doses and the development of distribution methods. At least 49 cases of monkeypox have been reported in the United States, according to the Centers for Disease Control and Prevention. | Epidemics & Outbreaks |
HERSHEY, Pa. — Cannabidiol (CBD) and cannabigerol (CBG) might someday help bone fracture patients manage their pain, according to a Penn State study. In a study in mice, the researchers unexpectedly found that the cannabinoids also promoted fracture healing.
The results were published in the Journal of Bone and Mineral Research.
Scientists estimate that more than 178 million people suffer from bone fracture injuries annually around the globe. According to corresponding author Reyad Elbarbary, associate professor of orthopaedics and rehabilitation at Penn State College of Medicine, current methods for managing pain, often nonsteroidal anti-inflammatory drugs (NSAIDS) like aspirin, are not optimal.
“NSAIDS may help patients manage pain, but they also reduce inflammation, which is a crucial first step in fracture healing,” Elbarbary said. “An alternative for pain management is needed that does not prevent inflammation from occurring.”
Elbarbary and his team’s primary goal was to measure CBD and CBG’s separate abilities to alleviate pain in mice. The team, in what they called the first study to analyze cannabinoids in the context of fracture healing and pain management, found that the cannabinoids were comparable to the NSAIDS in their ability to manage pain. But they said they were also surprised to find that CBD and CBG helped with the fracture healing process. With immunofluorescence microscopy, microcomputer tomography imaging and biomechanical testing, the researchers studied the fracture healing process — everything from bone density and bone strength to the expression of genes that are necessary for the progression of fracture healing.
In the early phase of treatment, the cannabinoids were associated with an increase in the abundance of periosteal bone progenitors, which later develop into specialized bone cells that help bone tissue form. During the later phase of healing, CBD and CBG accelerated the process by which the body absorbs minerals to strengthen newly formed bone.
“Both treatments led to higher bone volume fraction and mineral density than with NSAID treatments, which leads to a functional and healthy newly formed bone,” Elbarbary said. “We still have a lot to learn about the biological mechanisms behind what we observed.”
According to Elbarbary, future research will focus on defining the cellular and molecular processes behind the cannabinoids’ role in early and late stages of fracture healing, as well as developing a clinical formulation for use in adult fracture patients. While CBD is already approved by the Federal Drug Administration to treat seizures in children, finding a formulation, or dose, that is suitable for adults in the context of bone fractures will be a critical next step, Elbarbary said.
“There is already robust safety information gathered on CBD,” Elbarbary explained. “CBG is more investigational at this stage. It’s more likely that CBD would be repurposed for treating fractures once a formulation is found and its efficacy for treatment in the context of bone fractures is determined.”
Deepak Kumar Khajuria, Vengadeshprabhu Karuppagounder, Irena Nowak, Diana Sepulveda, Gregory Lewis, Christopher Norbury, Wesley Raup‑Konsavage, Kent Vrana and Fadia Kamal of Penn State College of Medicine also contributed to this research. The authors declare no conflicts of interest.
The National Institutes of Health and PA Options for Wellness supported this research. | Drug Discoveries |
April 19, 2023 â New research is shedding light on how an infection with COVID-19 may reactivate, or even cause, psoriasis.Â
The  skin condition affects about 7.5 million adults in the United States, according to the National Psoriasis Foundation.  Psoriasis has several well-established triggers, including stress, skin injury, cold or warm air, and allergies. Illnesses like strep throat can also cause a psoriasis flare in some people â and it appears COVID may also do so.Â
âPsoriasis flares have long been associated with bacterial and viral infections, particularly a form of psoriasis called guttate, which is characterized by tons of tiny red scaly bumps all over the body,â said Joel M. Gelfand, MD, a professor of dermatology and epidemiology at the University of Pennsylvaniaâs Perelman School of Medicine in Philadelphia. âInfection with COVID-19 has been associated with flares of guttate and pustular psoriasis, and even psoriasis that affects 100% of the skin, which is called erythroderma, in many published case reports.âÂ
Israeli researchers recently found that psoriasis patients have a slightly higher risk of getting COVID,  although they are not at higher risk of hospitalization or death. This could be because psoriasis is sometimes treated with immune-modulating therapy, which can leave patients more at risk of infections.
If you have psoriasis and test positive for COVID, arm yourself with information. Although we donât know everything yet about the possible link between the two conditions, there are ways to treat the problem.
How Could COVID Cause Psoriasis to Flare?Â
A study from Albany Medical College/Weirton Medical Center found that people in the study who were already diagnosed with the skin condition had an unexpected flare within a week to a month after testing positive for COVID. New psoriasis after a COVID infection was also found. The researchers think this could be because COVID causes inflammation in the body, which negatively affects previously well-controlled psoriasis. They also think itâs possible that COVID-related inflammation could trigger a genetic tendency to have psoriasis, which may explain why it can appear for the first time after a positive test.
Inflammation in the body commonly manifests itself through skin conditions.Â
âThe skin is the largest organ in the body,â said Robert O. Carpenter, MD, director of wellness at Texas A&M College of Medicine in Bryan, TX. âA viral infection like COVID-19 can signal the release of pro-inflammatory factors that can appear as rashes, such as with psoriasis.â
What are the Symptoms of COVID-Related Psoriasis?
The signs are the same as those of any form of psoriasis. According to the Mayo Clinic, these signs can include:Â
- A patchy, scaly, raised red rash. Psoriasis can also be purple, pink, gray, brown or silver. The rash can appear anywhere on the body. Psoriasis can also look like dandruff.Â
- Dry, cracking skin that sometimes peels
- Itching, burning, or painful skin
If I Have Psoriasis, Will COVID Automatically Make It Worse?
Not necessarily.
âPsoriasis is a common condition, so people should be aware that new psoriasis that develops may not be related to COVID-19,â said Esther Freeman MD, PhD, director of global health dermatology at Massachusetts General Hospital in Boston.
As with every aspect of COVID, doctors and scientists are still learning about how serious and widespread a problem psoriasis after COVID-19 may be. âWe have seen case reports that psoriasis can flare after COVID-19,â said Freeman, who is also an associate professor of dermatology at Harvard Medical School. âI will say, this has not been a tidal wave â more like sporadic cases here and there. So I do not think psoriasis flares are a major post-COVID finding, nor do they necessarily mean you have long COVID. That being said, we know that many different infections can cause psoriasis flares, and so in that respect, it's not that surprising that SARS-CoV-2, like other infections, could trigger a psoriasis flare.â
Could getting COVID more than once cause psoriasis to flare? Itâs possible.
âYour body can change after having COVID-19,â said Carpenter. âWe donât know the long-term implications, but having COVID-19 repeatedly can increase the risk of long COVID, which can cause many systemic changes in your body."Â
Another important point: If you take biologics, the immune-modulating therapy to treat psoriasis, getting vaccinated and boosted for COVID is an important step to take to help protect yourself.Â
Is Psoriasis Itself a Potential Symptom of COVID?Â
âYes, but we donât know the frequency at which this may occur, and a causal relationship is difficult to establish from just case reports,â said Gelfand, whoâs also medical director of the Clinical Studies Unit in the Department of Dermatology at his university. âTypically, if a patient presents with a flare of psoriasis, particularly guttate, pustular, or erythrodermic forms, an infectious trigger should be considered, and testing for strep and possibly COVID-19 may be appropriate.â
If you do have a flare of psoriasis, or get one for the first time after testing positive for COVID, you should also ask your dermatologist about new treatment options.
âYou could need to change the medication you take for psoriasis, or utilize medication for the first time,â Carpenter said.Â
Itâs important to know that the problem can be controlled.Â
âFlares of psoriasis caused by infections typically improve over a period of months,â Gelfand said. âWe have many safe and effective ways to treat flares of psoriasis, including new topical medications, ultraviolet light phototherapy, and pills. There is no reason to suffer with psoriasis â most patients can be helped with all of the recent advances in treatment.â | Disease Research |
HAYWARD — For a change of pace, Hayward city staff have decided to let residents take the lead in the coming year and develop 12 community-approved projects, including a tutoring program and roller skating event, to the tune of $350,000 paid out of the city’s general fund.
For the program, which Hayward officials call the “People’s Budget,” the city was divided into six areas. People could submit project ideas, and then residents 10 and older voted online and at parks and schools, choosing two top two favorites for each area. About 1,000 residents, or 1% of those eligible, voted, 1%.
“We were pleased with turnout considering this is our first time doing this and the voting occurred in the middle of the current COVID wave,” Mary Thomas, a Hayward management analyst, wrote in an email.
The costs of the projects range from $14,000 to $48,000. Each project will have a lead or team of leads spearheading it. Hayward residents who are interested in getting involved with any of the programs can email [email protected] and they will be connected to the respective project leads. The first of the projects is expected to launch in July. “Once we announced the projects, we received emails and social media posts of people wanting to be notified when events are happening, and a couple of people have even reached out to see how they can volunteer and help with some of these projects,” Thomas said.
Though the projects have been selected, details are still being worked out in terms of timing, location and frequency.
Sector 1 (southwest) will have a night market, and Palma Ceia Park will be spruced up. The market, which will reflect the neighborhood’s cultural heritage and have local food and entertainment, will be at Eden Shores Park, at 2841 Sea Haven Court. A total of $25,000 has been set aside for the night market, which may be a one-time event or take place several times. Palma Ceia Park, 27679 Melbourne Ave., will receive small upgrades such as park benches and public art.
Sector 2 (south) will have a street food bonanza and a roller and inline skating event. The street food bonanza will be a festival allowing local businesses to compete with their most popular street food dish, with residents deciding the winners. The roller and inline skating event will be a partnership with Avanta Boot Labs, a Hayward business. Whether it will be a pop-up or a long-term, sustained event has not been decided. Time and location of the events also have not been determined.
Will Murillo, who runs Avanta Boot Labs along with his wife, said they wanted to give back to Hayward after receiving a city grant during the pandemic that helped them keep their doors open. They plan on matching the $48,000 that they will receive from the city for the skate event. “We always had that in the back of our heads, you know, we gotta do something to give [back to the city],” Murillo said in an interview.
The pair have been living in Hayward for five years and Murillo said he believes Hayward is the most important location for manufacturing ice skates and roller skates because there are so many rinks in the surrounding area. There are over 20 ice skating and roller skating rinks in the Bay Area, though none in Hayward. The city does have some skate parks, however.
“Roller skating is very popular now throughout the nation,” Murillo said. “We want to be the capital of roller skating if possible, let the world know where Hayward is, the amazing things that are in here.”
Sector 3 (northwest) will get Stackfest, a monthly festival that promotes live music from local artists, and a mental health camp for teens.
Sector 4 (center) will start English and math tutoring for English as a Second Language students and expand the Tennyson community farm. This new round of funding will offer a stipend for student workers at the farm and allow for the creation of a community farm stand.
Elena Lepe, an immigrant who has lived in Hayward for over 18 years, has two children in schools and saw the need to help ESL students get tutoring, which is why she applied to the People’s Budget. Her tutoring program will receive $45,000.
“Everyone wants to integrate themselves; they want to learn the language [and] integrate into everything, including education, community and the new system of the United States,” Lepe said in Spanish. “I’m an immigrant and the truth is, it was a barrier to come and look for resources.”
She said she wanted to be a voice for residents who are immigrants like her, hoping to demonstrate that Latinx youth have the talent to get educated and go to college.
Sector 5 (east) will have tree plantings and begin a small community garden with raised beds in a yet-to-be-determined local park.
Sector 6 (north) will begin a Hazel Garden community connect program, where residents will host free community events such as movie nights, and form a community space at the Sun Gallery that will include a 3D printer and vinyl cutter for residents to use. | Mental Health Treatments |
This makes you more vulnerable to Covid-19 02:15 - Source: CNN CNN — It’s been three years since the first Covid-19 case was diagnosed in the United States, on January 20, 2020. In the time since, nearly 1.1 million Americans have died from the coronavirus; the US has reported 102 million Covid cases, more than any other country, according to Johns Hopkins University. Both figures, many health officials believe, are likely to have been undercounted. There have also been remarkable scientific achievements in our response to the pandemic, not least of which is the development of Covid-19 vaccines. But there are still many unanswered questions. To help with reflections on what we’ve learned and what more we need to understand, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician, public health expert and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.” CNN: You’re a physician caring for patients, a public health researcher and professor. What are the key lessons you’ve learned from the last three years of Covid-19? Dr. Leana Wen: There are three main lessons that come to mind. First, we have seen how much the global scientific community has come together and delivered some truly incredible achievements. Less than a year after Covid-19 was declared a pandemic, we had a vaccine developed, authorized and being distributed. The scientific community has rallied on many other aspects of the response to Covid-19, including to identify treatments and improve surveillance testing. Many of the scientific developments will last beyond this pandemic and help with other aspects of our infectious disease response. For instance, the technology behind mRNA vaccines could be used to make vaccines for other diseases. The wastewater surveillance being used to identify and track Covid-19 may be helpful for detecting other viruses. Second, Covid-19 has unmasked many existing crises and amplified them for the world to see. The coronavirus didn’t create health disparities — these long-predated the virus — but exacerbated existing ones. There were also many faults with the public health infrastructure that, while long known to those of us in the field, have been exposed for all to see. Data systems are not integrated between public health agencies, for example, and city and county health departments are woefully underfunded given their many responsibilities. These stem from the fragmented health care system we have in the US, as well as the ongoing lack of investment in local public health agencies. At the same time, Covid has also demonstrated how crucial public health is. There is a saying that “public health saved your life today, you just don’t know it.” I think there is much more recognition among many that public health is essential to preventing problems that can have a major impact on people’s health and well-being. With that said, Covid-19 occurred during a time of deep division. Virtually every aspect of the pandemic has become politicized and polarized. So thirdly, there has been rampant misinformation and disinformation that’s made the response much more challenging. We are seeing the lasting effects, such as reduced uptake of routine childhood immunizations. I’m very concerned that public health itself has become politicized in a way that could harm our response to future pandemics. CNN: You mentioned that we’ve learned a lot scientifically. What more do we need to understand about Covid-19? Wen: At this point in the pandemic, a lot of people have moved on from Covid-19 and no longer think about it as a major factor in their everyday lives. However, there are millions of Americans vulnerable to severe illness who remain very concerned about the coronavirus. These are people who are immunocompromised, elderly or with multiple underlying illnesses. To me, the most important research questions pertain to these individuals. There are some antiviral medications that are effective for Covid-19 treatment, such as Paxlovid. Some patients are not eligible for Paxlovid, though, and other options are becoming more limited. The US Food and Drug Administration has revoked their authorization for monoclonal antibodies that could treat Covid-19 infection, as they no longer appear to be effective against new circulating variants. Recently, the FDA has also said that the preventive antibody Evusheld may be ineffective against some variants, including the XBB.1.5 variant that’s currently dominant in the US. It should be an urgent priority to focus on developing better treatments for those most vulnerable to severe disease from Covid-19. I also hope that there will be much more investment into finding better vaccines. The vaccines that we have are excellent at protecting against severe disease, which is most important. However, they are not very effective at preventing infection. The ideal vaccine would be more effective at reducing infection, and target the virus broadly so that we are not always trying to anticipate what variant will develop next — and then scrambling to find a vaccine that works against that variant. There is research being undertaken into nasal vaccines and pan-coronavirus vaccines, for example. I hope these efforts will be expedited. CNN: We are learning more about long Covid, but is this an area that needs more research? Wen: Absolutely. We know that many people have lingering symptoms after a Covid-19 infection. According to a large study from Israel, most symptoms resolve within the first year after infection for people with mild illness. However, there are some who have lasting symptoms, like fatigue, headache, palpitations and shortness of breath, that are so debilitating they can no longer work. There is a lot that we don’t yet know about long Covid. The most important is how to treat patients who have it. The physiological mechanisms behind what’s causing their lingering symptoms are also unclear, along with exactly how common they are. There are long waits to get into specialized clinics that treat this condition at present, so a lot more education needs to be done for primary care physicians and other clinicians who will probably end up being the main health care providers for many people suffering from long Covid. CNN: What do you anticipate will happen in this coming year around Covid-19? Wen: Right now, China is undergoing a massive surge of cases. It’s the last major country to have enforced a strict zero-Covid policy, and now that policy has been reversed. Once China’s infection numbers stabilize, Covid-19 will probably become endemic there, as it has become in most other parts of the world. There will, no doubt, be new variants that arise. We need to keep on top of them and monitor accordingly to see if they are more deadly and/or evade the effectiveness of existing vaccines. The key, as I said earlier, is to develop vaccines that can more broadly cover variants. And we must again remember that, while many people have resumed pre-pandemic lives, others have not. In the next year of Covid-19, I believe that the focus needs to be much more specific to these individuals who need our help the most. We should target boosters and treatments to those most vulnerable, for example. Finally, there should be a much greater effort to rebuild our public health infrastructure. This is long overdue. Doing so is critical not just for preparing for the next pandemic, but also for improving health and well-being for all Americans. | Epidemics & Outbreaks |
The Illinois Department of Public Health (IDPH) recently reported its first case of measles since 2019.
This comes on the heels of a Centers for Disease Control and Prevention (CDC) warning for the public to get fully vaccinated against measles before traveling internationally this summer.
On Oct. 10, the Cook County Department of Public Health (CCDPH) reported a suspected case of measles for an unvaccinated patient who had international exposure.
The public health departments are working together to identify potential locations in the U.S. where people may have been exposed, according to the IDPH statement.
One of the first warning signs of measles is a red rash that starts on the face and moves downward on the body, as stated on the CDC website.
"Unfortunately, you can be infectious with measles before the rash appears, which in most cases means before diagnosis happens," Dr. Anthony Moody, professor of pediatrics and immunology at Duke University School of Medicine in Durham, North Carolina, told Fox News Digital.
People are generally infectious in an eight-day window, he said — "up to four days before the rash appeared and then for four more days after the rash started."
Since the rash in the Illinois case likely started around Oct. 9, the period of time that the patient could spread the infection was between Oct. 5-13, the statement added.
Key measles symptoms
Measles is a highly contagious virus that can lead to serious complications, such as pneumonia or swelling in the brain known as encephalitis, according to the CDC.
Someone susceptible to measles can develop symptoms anywhere from seven to 21 days after exposure to someone with the disease, the public health statement said.
"The classic symptoms of measles are fever and rash accompanied by the ‘three C’s’: cough, coryza and conjunctivitis," Moody said.
"That is, cough, runny nose and red eyes."
The fever is often 104 degrees Fahrenheit or higher, while a classic appearance of the rash is "flat red spots that merge together," Moody said.
"The rash starts on the head (around the ears) and then rapidly spreads to the face and the rest of the body," he told Fox News Digital.
The measles vaccine is often combined with two other vaccines, mumps and rubella, which is collectively known as the MMR vaccine.
"Because there are lots of diseases that cause rash, and because few clinicians these days have seen active measles cases, the symptoms can be incorrectly diagnosed," the doctor added.
Anyone who thinks they have measles should contact their health care provider before going to the emergency room or clinic, said the IDPH, so that special infection control precautions can be initiated to protect patients and staff.
The disease was "eliminated" in the U.S. in 2000 based on an "absence of continuous disease transmission for greater than 12 months" — which means many practicing clinicians have never seen an active measles case, per the CDC.
What to know about the measles vaccine
Most children get the primary measles vaccine series, which consists of two vaccines given right after their first birthday and again around 4 to 6 years of age before they enter school, Moody explained.
The measles vaccine is often combined with two other vaccines, mumps and rubella, collectively known as the MMR vaccine.
The MMR vaccine contains a live "attenuated" virus — which is a weak form of the actual measles virus, per the CDC.
The vaccine works by causing a harmless infection.
People generally will have very few symptoms or none at all as their immune system kicks into gear to fight the infection caused by the virus, the CDC explained.
"One dose of MMR vaccine is 93% effective against measles, 78% effective against mumps and 97% effective against rubella," the CDC noted on its website. "Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps."
Some people, or roughly three out of 100, who get fully vaccinated against measles may still get the infection after being exposed to someone with the virus, according to the CDC.
It is recommended that children 1 year or older who are traveling outside the U.S. receive two doses of the MMR vaccine separated by at least 28 days, according to the agency's summer health alert.
If people are unvaccinated, they should complete the MMR series at least two weeks prior to travel to ensure full immunity by the time they travel.
Transmission of measles
"Measles is one of the most contagious diseases known, rivaling the most aggressive SARS-CoV-2 variants," Moody said.
"The rule is, if you are in a room with someone who has contagious measles, and you are susceptible, you will get it."
The best way to prevent measles is to get vaccinated, Moody said.
"We know that 95% (or more) of people need to be vaccinated against measles to prevent outbreaks."
"Based on how contagious it is, we know that 95% (or more) of people need to be vaccinated against measles to prevent outbreaks."
Moody credits the high levels of vaccine coverage starting in the 1960s for the fact that there have been very few cases per year for several decades.
Measles cases are rising, however, amid reduced vaccination rates in the population, Moody said.
When kids miss their regular appointments where they would typically get their vaccinations, this eventually leads to a larger susceptible population, with pockets of people falling below the critical 95% coverage level, he added.
"If people want to avoid getting sick, they need to get vaccinated," Moody said.
Amy McGorry contributed reporting. | Epidemics & Outbreaks |
A new class of weight-loss drugs is giving some patients with obesity new hope that they’ll be able to lose excess pounds and improve their health without experiencing the dangerous side effects of older medications. But despite mounting evidence that the drugs are both safe and effective, doctors say relatively few of the country’s millions of eligible patients are taking them. “This drug is something that transforms lives for some people,” said Thomas Wadden, the director of Penn Medicine’s weight and eating disorders program in Philadelphia. But, he said, “I don’t think any of these weight-loss medications are being prescribed as much as they should be.”More than 70 percent of adults in the U.S. are overweight or obese, according to the Centers for Disease Control and Prevention. Obesity can lead to a variety of other medical conditions, including high blood pressure and cholesterol, Type 2 diabetes and stroke.The drugs mimic a hormone produced in the gut called GLP-1, which tells the pancreas to secrete more insulin to control blood sugar. They’re not new to medicine; they’ve been used to treat Type 2 diabetes for years. But when doctors noticed that patients also lost weight, drugmakers got on board, offering the medications in higher dosages specifically to treat obesity. It’s still unclear exactly how the drugs help with weight loss. Wadden said they seem to slow down stomach-emptying so people stop eating sooner and feel full longer.It’s also believed that the drugs target certain receptors in the brain that affect appetite. “It may be acting upon areas of reward in the brain,” Wadden said. So patients may eat less frequently for pure pleasure, which he calls “hedonic eating.” So far, two of the new drugs, both from drugmaker Novo Nordisk, have been approved by the Food and Drug Administration. Saxenda was approved in 2020. The most recent, Wegovy, was approved last year for patients with body mass indexes of 30 or greater or those with BMIs of 27 or greater plus at least one weight-related condition. Studies found the weekly self-injectable helped patients lose, on average, about 15 percent of their body weight over 16 months, making it twice as effective as older weight-loss drugs already on the market, such as Qsymia.A newer GLP-1 medication called tirzepatide, also a weekly injectable, appears to be even more effective. A study published last week in the New England Journal of Medicine found it helped patients lose more than 20 percent of their weight over 72 weeks. The medications do come with side effects. Most commonly, patients complained of nausea, vomiting, diarrhea and stomach pain. And experts emphasize the drug is not a magic bullet. “I don’t care how wonderful the drug is, it will not work for everyone,” said Dr. Zhaoping Li, the director of the Center for Human Nutrition at UCLA. “This is a tool, but it’s not the tool.” Still, obesity doctors and researchers say that compared with the older class of weight-loss drugs, the new medications are impressive, especially for those whose obesity has caused other chronic conditions, such as heart disease and Type 2 diabetes.Denied by insuranceGiven the benefits, why do Wadden and others believe the drugs are so underused? It all comes down to money, said Dr. W. Scott Butsch, the director of obesity medicine at the Cleveland Clinic’s Bariatric and Metabolic Institute.Wegovy costs about $1,300 a month, and most insurance doesn’t cover it.Insurance companies push back against coverage for weight-loss drugs, arguing that obesity is not a disease but a behavioral problem, Butsch said. “There are individuals who will have a significant amount of weight loss” from these drugs, he said, but they can’t take them because they can't afford them. Some doctors, he said, hesitate to prescribe them at all, knowing “there’s already an up-front barrier.”That barrier got in the way for Qamara Edwards, 40, of Philadelphia. Weighing more than 300 pounds and diabetic, she took Wegovy as part of a clinical trial at Penn Medicine in 2018. Qamara Edwards, left, weighed more than 300 pounds when she enrolled in a clinical trial for Wegovy in 2018.Courtesy Qamara Edwards.“I like to eat bad food and drink a lot,” said Edwards, who says she faced those challenges daily working in the restaurant industry. But she said that while she had some gastrointestinal side effects on Wegovy, she was eating more healthfully. “The overall feeling is that it makes you not hungry,” she said. “It’s like having a gastric bypass without having surgery.”She lost 75 pounds in the 17-month study, which ended right before the coronavirus pandemic began and lockdown threw off her routine. She gained almost all of the weight back.So when Wegovy was approved last June, her doctor wrote her a prescription, but her insurance wouldn’t pay for it. “The biggest tragedy is just how expensive it is,” she said. “I had all these great results, and I may not be able to continue because insurance and the pharmaceutical industry feels like weight loss is not a medical issue.”Butsch echoed the sentiment, blaming the lack of insurance coverage on the stigmatization of obesity.Qamara Edwards, right, in 2019, after losing 75 pounds. Courtesy Qamara Edwards.“The premise is that it’s behavioral, and then they’re being stereotyped as overeaters,” Butsch said. “Not everybody who has obesity eats chips and pizza and drinks pop.”Indeed, a growing body of evidence finds that for some people, obesity may not be caused by overeating but by insulin resistance and hormonal issues — factors that are affected by the new class of weight-loss drugs.Insurance companies’ coverage decisions are worsening existing health disparities, Butsch said. Those who can afford to pay out of pocket can get the medications. But study after study shows that obesity rates are higher among those who live in poor communities, which typically have fewer grocery stories and lack access to health care.That means that “those who really need these drugs are likely not going to get them,” he said.An ongoing shortageFurther compounding the problem of access are ongoing production issues, forcing drug manufacturer Novo Nordisk to tell doctors not to prescribe Wegovy to new patients because it doesn’t have the supply available to meet the demand.But Bonnie Drobnes, 42, of Lower Gwynedd, Pennsylvania, said her doctor never got the message. Drobnes, a mother of two, was prescribed Wegovy two months ago after a thyroid problem made it seem impossible for her to lose weight. It took three weeks for her pharmacy to fill her prescription because of the drug shortages. Once she started it, however, she felt an immediate change.“One of the things I’ve always dealt with was a constant hunger in the back of your mind,” Drobnes said. “It’s always there. It went away. It allows you to focus on being a human being.”“One of the things I’ve always dealt with was a constant hunger in the back of your mind,” she said. “It’s always there. It went away. It allows you to focus on being a human being.”She lost 7 pounds in the first month, more than she’d lost after weeks working with a nutritionist, a wellness coach and a workout partner. But when it was time to get her monthly refill, the pharmacy told her the drug was on back order and that it was unclear when it would get it in again. She called dozens of pharmacies in the Philadelphia area, where she lives. None of them had the medication. Novo Nordisk says in a statement on its website that the company expects the supply of Wegovy to stabilize later this year.That doesn’t offer much comfort to Drobnes. “I feel as though without the Wegovy, I’m losing my lifeline,” she said. “I finally allowed myself to start picturing a happier and healthier me, but now that picture is slipping away.”Indeed, weight gain after discontinuing the drugs is a concern; studies have found that two-thirds of patients gained the weight back after they stopped taking Wegovy. But obesity experts disagree about how long a patient should stay on the drugs.Li, of UCLA, said more research is needed before the drugs are prescribed for the long term. Others, like Wadden and Butsch, argue that if obesity were treated like a chronic disease, like high blood pressure or diabetes, staying on the drugs for years wouldn’t be an issue. Li does prescribe the drugs for some of her patients but only after other lifestyle changes and treatments have failed. “This is a cane that’s going to help you walk,” she said. “But you’re going to have to do the walk yourself.” For Edwards, of Philadelphia, the “cane” changed her life. She’s in another clinical trial for a pill form of Wegovy, which she hopes will be more affordable. Since she started the study in November, she has lost 45 pounds.Follow NBC HEALTH on Twitter & Facebook. | Drug Discoveries |
Dear Public Health England,
Regarding developments within the United States of America (US) relating to the Centre of Desease Control (CDC) and Informed Consent Action Network (ICAN).
ICAN requested from the CDC to supply the studies relied upon to substantiate the claim that vaccines do not cause Autism, specifically relating to those vaccines administered to babies within the first 6 months of life.
The CDC appeared to initially refuse to provide the requested information, however after legal proceedings they did agree to supply 20 studies. Representing their entire body of evidence supporting the claim that vaccines do not cause Autism.
From a layman's position the provided studies did not seem to properly address and fulfil the request. Leaving some doubt as to whether sufficient studies have actually taken place in order to put the issue 'to bed'.
As Public Health England are responsible for the immunisation program in England the request is coming your way, as opposed to the NHS.
Much like the CDC the NHS website clearly states (https://www.nhs.uk/conditions/vaccinatio...) that Vaccines do not cause autism. Although the NHS goes on the specifically mention the MMR, please note this request is NOT necessarily about the MMR.
In the same vain as the MMR caveat when answering this request, the request is regarding studies of the vaccines as a whole, NOT individual ingredients.
Now of course if there are studies that evaluate individual ingredients relating to the subject concerned, which when these 'individual' studies are packaged together make up to whole sum of a given vaccine, then this will be of great interest.
REQUEST: To summerise, can you provide details of the studies relied upon to substantiate the NHS claim that vaccines DON'T cause autism for the following vaccinations administered from birth to 6 months. NOTE: the specific formulations and manufacturer.
1. DTaP/IPV/Hib/HepB (Infanrix hexa). Provide all studies proving that the vaccine does not cause autism.*
2. MenB (Bexsero)
Provide all studies proving that the vaccine does not cause autism.*
3. Rotavirus (Rotarix)
Provide all studies proving that the vaccine does not cause autism.*
4. Pneumococcal conjugate vaccine (Prevenar 13)
Provide all studies proving that the vaccine does not cause autism.*
5. Cumulative. Provide all studies proving that the prescribed/recommended vaccine cumulative exposure does not cause autism.*
*In babies from birth to 6 months.
Yours faithfully,
Jack Parsons
OFFICIAL
Dear Jack Parsons,
We acknowledge receipt of your email and request for information, which will be treated as a request for information under statutory access legislation.
Please note that requests under the Freedom of Information Act and the Environmental Information Regulations (EIRs) will receive a response within 20 working days from the day following the date of receipt of your request.
If the request is for your personal data (i.e. a Subject Access Request) under the Data Protection Act, then we will respond within one month of the receipt of the request.
Kind Regards,
FOI Team
Public Accountability Unit
Public Health England
[PHE request email]
www.gov.uk/phe Follow us on Twitter @PHE uk
Dear Jack Parsons,
Please find attached Public Health England's response to your request.
Kind regards,
FOI Team
Public Accountability Unit
Public Health England
[PHE request email]
www.gov.uk/phe Follow us on Twitter @PHE uk
We work to defend the right to FOI for everyone
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Why do we need fiber? it feeds the bacteria in our gut, which in turn produces something that could prevent food allergies and irritations such as those triggered by peanuts, a study this year showed.
A short-chain fatty acid called butyrate is produced by Clostridium bacteria in our stomach as they ferment fiber that reinforces the walls of the GI tract and protects against colon cancer, among other things.
In a mouse model, researchers at the University of Chicago used an oral solution of butyrate to stymie a life-threatening anaphylactic response in the allergic animals when they were exposed to peanuts.
Without enough fiber in the diet, humans can experience die-offs of these beneficial, butyrate-producing gut microbes. Too much eating of simple sugars and carbs instead makes room for harmful species, resulting in a condition known as “gut dysbiosis.”
Without butyrate, the gut lining can become permeable, and bits of food leak out of the GI tract and into circulation, triggering an anaphylactic response in one pattern of allergic reactions.
One of the ways to rapidly treat this has been a microbiome transplant, also known unpleasantly as a fecal biota transplant. But this has had mixed results in the lab, said Dr. Jeffery Hubbell, Ph.D., one of the project’s principal investigators.
“So we thought, why don’t we just deliver the metabolites like butyrate that a healthy microbiome produces?” he said in a news release.
Hubbell and his colleagues at the University of Chicago did just that in a mouse model in early 2023, but the solution is vile to taste and smell, so a new configuration of polymers that cloak the butyrate has been developed by him and his team.
The researchers administered these “polymer micelles” to the digestive systems of mice lacking either healthy gut bacteria or a properly functioning gut lining.
The treatment restored the gut’s protective barrier and microbiome, in part by increasing the production of peptides that kill off harmful bacteria, which made room for butyrate-producing bacteria.
“We were delighted to see that our drug both replenished the levels of butyrate present in the gut and helped the population of butyrate-producing bacteria to expand,” said Cathryn Nagler, Ph.D., a senior author of the study.
MORE WORK ON ALLERGIES: Researchers Find the Key to Fixing Human Allergies to Dogs
“That will likely have implications not only for food allergy and inflammatory bowel disease, but also for the whole set of non-communicable chronic diseases that have been rising over the last 30 years, in response to lifestyle changes and overuse of antibiotics in our society.”
Nagler and Hubbell co-founded a company called ClostraBio to further develop the butyrate micelles into a commercially available treatment for peanut allergies, reports Univ. of Chicago press. They are working with the FDA on an investigational new drug application and hope to begin clinical trials in patients with moderate ulcerative colitis within the next 18 months.
SHARE This Simple Yet Potentially Huge Drug Target On Social Media… | Drug Discoveries |
A woman in the southern Indian state of Kerala who suffered through years of excruciating pain because of a botched surgery says she is still waiting for the doctors responsible to be punished. The BBC's Imran Qureshi talks to her about her ongoing fight for justice.
KK Harshina, 31, says she lived with unbearable pain in her stomach for years, that is until a scan last year showed that a pair of forceps had been left inside her body during a surgery.
"I cannot describe the pain that I suffered for five years," Ms Harshina tells the BBC.
A mother of three, Ms Harshina underwent Caesarean operations (also known as C-section) for each of their births.
She got two of these at a government hospital in Kozhikode's Thamarassery town in 2012 and 2016. Her last surgery was a C-section at the Government Medical College Hospital in Kozhikode district in 2017 for the birth of her son.
It was only after this procedure that she started getting stomach pain, Ms Harshina says.
"When I complained, I was told by the doctors that it was because I had a third Caesarean operation," she says. "I was also told that many other women also had a similar complaint."
As the pain persisted, Ms Harshina consulted several doctors over the years. The process of trying to trace the source of the pain also took a mental and financial toll on her.
It was only in September 2022, when she had tests conducted for a urinary bladder infection, that she found out what the problem was - a scan showed there was a piece of metal inside.
The metal turned out to be a pair of forceps - 6.1cm long and 5 cm wide - used by doctors to clamp down on bleeding vessels during surgeries. She underwent another surgery to have the instrument removed.
Ms Harshina complained to the state health minister Veena George, which led to the appointment of a committee to investigate the matter. The Kozhikode Government Medical College Hospital also conducted an internal inquiry.
Both investigations led to a dead end.
The Kozhikode Government Medical College Hospital said that none of its surgical equipment had gone missing and referred to the two surgeries Ms Harshina had undergone before coming to them. The health department's investigation also failed to fix responsibility.
A separate government probe was unable to trace the origins of the forceps - both the hospitals where Ms Harshina underwent surgeries did not have a record of the instrument.
The BBC reached out to Ms George for comment but is yet to receive a response.
Earlier this week, Ms Harshina went on a hunger strike outside the hospital, demanding that the state government take action against those responsible.
On Thursday, local Opposition leaders persuaded her to give up the hunger strike, saying it was impacting her health.
Ms Harshina called off her hunger strike but continues to sit in protest outside the hospital.
"I will sit on strike [until I gets justice]," she says.
BBC News India is now on YouTube. Click here to subscribe and watch our documentaries, explainers and features. | Medical Innovations |
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