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Aug. 3, 2022 – Americans are notorious for overfeeding their pets. In 2018, nearly 56 million cats and 50 million dogs were overweight or obese. But when you can’t manage to cut down on the kibble and pare back the pâté, could weight loss surgery be the answer for your overstuffed companions?

To answer the question, veterinarians at Cornell University performed slimming surgery on a pair of obese cats. A few days post-op, the animals were off pain medication and eating normally. Within 2 months, the cats shed half of the weight they gained during the study.

“There have been a lot of studies on weight loss surgery on animals, but for people,” said Nicole Buote, DVM, a veterinary surgeon at Cornell who performed the operations. “To my knowledge, this is one of the first times that the surgery was done to look at its benefit for animals, as opposed to benefits for people.”

Partial Gastrectomy – What Is It?

Buote and her colleagues performed a partial gastrectomy on the two cats after they’d been fattened up to be 50% more than their ideal body weight. Even then, neither kitty was awfully potbellied; one weighed 15 pounds before surgery, the other 9 pounds – a far meow, er, cry, from being a record holder.

As with people, partial gastrectomy involves the removal of a part of the stomach pouch to make it smaller. The refashioned organ holds less food, meaning patients – in this case, felines – feel full faster and eat less.

The laparoscopic procedure takes a little under 2 hours and requires general anesthesia. The cats were comfortable and recovered without complications, Buote says.

The cats in Buote’s study handled the surgery well, and they did lose weight: the 15-pounder was down to 12.5 pounds after the procedure, while the other went from 9 pounds to 7 pounds. But more research is needed to confirm if the surgery will help with obesity and diabetes, she says.

“Cats often get type 2 diabetes, and just like in people, there’s a benefit to weight loss in diabetes,” Buote says. “Our goal is to see if this is a great option for some animals with obesity.”

Of course, as with people, surgery shouldn’t be the first stop on a pet’s weight loss journey, she says.

“As much as I love surgery, I don’t want to be doing partial gastrectomies on cats and dogs just because their owners don’t want to create a more healthy environment for them,” she says.

Changes in diet and exercise are important first steps for your pet, and a veterinarian can help make those changes before doing anything else.

While this surgery is still in research phases, owners may be looking at a $2,500 to $3,500 hospital bill if they eventually chose that route for their feline friends, Buote says.

But rapid weight loss can be deadly for felines.

”If cats lose weight too fast, they can develop fatty liver and die from that,” says Raymond Kudej, DVM, PhD, a surgeon and instructor at Cummings School of Veterinary Medicine at Tufts University in Grafton, MA. “There could easily be complications from the surgery. The results would be unpredictable.”

The lesson for pet owners, in other words, is this: Watching what you put in their bowls is better than letting them go under the knife.

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Aug. 3, 2022 – If you grew up in the 1970s and 1980s, chances are high you’re familiar with Go Ask Alice.

What was then said to be the real diary of a 15-year-old promising teen turned drug addict was released in 1971 as a cautionary tale and has since sold over 5 million copies. The diary was harrowing against the backdrop of the war on drugs and soon became both acclaimed and banned from classrooms across the country.

Schools citied “inappropriate” language that “borders on pornography” as grounds to prohibit teenagers from reading Alice’s story. But as much as the book’s vivid writing offended readers, it drew millions in with its profanity and graphic descriptions of sex, drugs, and mental health struggles.

At the time, TheNew York Times reviewed the book as “a strong, painfully honest, nakedly candid and true story … a document of horrifying reality,” but the popular diary was later found to be a ploy – a fake story written by a 54-year-old Mormon youth counselor named Beatrice Sparks.

Now, Sparks, who died in 2012, has been further exposed in radio personality Rick Emerson’s new book, Unmask Alice: LSD, Satanic Panic, and the Imposter Behind the World’s Most Notorious Diaries. Emerson published the exposé in July, years after he had the idea to investigate Sparks’s work in 2015. The book details Sparks’s background, her journey in creating Alice, and her quest to be recognized for the teen diary she had published as “Anonymous.”

“After 30 years of trying, Beatrice Sparks had changed the world. And nobody knew it,” Emerson told the New York Post.

In his work, Emerson also dives into the profound impact of the diary at a time when not as much research existed on teen mental health.

When the teenager whose diary inspired Sparks’s writing “died in March 1971, the very first true study of adolescent psychology had just barely come out,” Emerson said to Rolling Stone. “Mental health, especially for young people, was still very much on training wheels.”

According to Emerson, a lack of insight into mental health issues allowed Sparks’s description to go relatively unchallenged and for the book’s influence to spread despite its misinformation.

“It’s indisputable that large sections of ‘Go Ask Alice’ are just embellished and/or false,” he told the Post.

Then vs. Now

When Go Ask Alice was published, child psychiatry and psychology literature contained relatively few references to depression, confirming a 2021 analysis of academic literature on childhood and adolescent depression from 1970 to 2019.

This landscape is in stark contrast to today, where thousands of studies on the topic have been done, compared to the mere dozens in the 1970s.

Anxiety and depression in minors have increased over time, a trend worsened by the COVID-19 pandemic, according to the CDC. Studies have shown that reported drug use in teens has decreased over time, proving significant during the pandemic, according to the National Institutes of Health.

While Alice from Go Ask Alice has not existed in either, comparing the two periods can offer insight into teens’ struggles in the 1970s vs. today and sheds light on how literature – fiction or faked fiction – can transform a nation.

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Aug. 3, 2022 – We tend to think a good night’s sleep should be uninterrupted, but surprising new research from the University of Copenhagen suggests just the opposite: Brief awakenings may be a sign you’ve slept well.

The study, done on mice, found that the stress transmitter noradrenaline wakes up the brain many times a night. These “microarousals” were linked to memory consolidation, meaning they help you remember the previous day’s events. In fact, the more “awake” you are during a microarousal, the better the memory boost, the research suggests.

“Every time I wake up in the middle of the night now, I think – ah, nice, I probably just had great memory-boosting sleep,” says study author Celia Kjaerby, PhD, an assistant professor at the university’s Center for Translational Neuromedicine.

The findings add insight to what happens in the brain during sleep and may help pave the way for new treatments for those who have sleep disorders.

Waves of Noradrenaline

Previous research has suggested that noradrenaline – a hormone that increases during stress but also helps you stay focused – is inactive during sleep. So, the researchers were surprised to see high levels of it in the brains of the sleeping rodents.

“I still remember seeing the first traces showing the brain activity of the norepinephrine stress system during sleep. We could not believe our eyes,” Kjaerby says. “Everyone had thought the system would be quiet. And now we have found out that it completely controls the microarchitecture of sleep.”

Those noradrenaline levels rise and fall like waves every 30 seconds during non-rapid eye movement (NREM) sleep. At each “peak” the brain is briefly awake, and at each “valley” it is asleep. Typically, these awakenings are so brief that the sleeping subject does not notice. But the higher the rise, the longer the awakening – and the more likely the sleeper may notice.

During the valleys, or when norepinephrine drops, so-called sleep spindles occur.

“These are short oscillatory bursts of brain activity linked to memory consolidation,” Kjaerby says. Occasionally there is a “deep valley,” lasting 3 to 5 minutes, leading to more sleep spindles. The mice with the most deep valleys also had the best memories, the researchers noted.

“We have shown that the amount of these super-boosts of sleep spindles, and not REM sleep, defines how well you remember the experiences you had prior to going to sleep,” says Kjaerby.

Deep valleys were followed by longer awakenings, the researchers observed. So, the longer the valley, the longer the awakening – and the better the memory boost. This means that, though restless sleep is not good, waking up briefly may be a natural part of memory-related sleep phases and may even mean you’ve slept well.

What Happens in Our Brains When We Sleep: Piecing It Together

The findings fit with previous clinical data that shows we wake up roughly 100-plus times a night, mostly during NREM sleep stage 2 (the spindle-rich sleep stage), Kjaerby says.

Still, more research on these small awakenings is needed, Kjaerby says. She notes that professor Maiken Nedergaard, MD, another author of this study, has found that the brain cleans up waste products through a rinsing fluid system.

“It remains a puzzle why the fluid system is so active when we sleep,” Kjaerby says. “We believe these short awakenings could potentially be the key to answering this question.”

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Aug. 3, 2022 – When Joel Fram woke up on the morning of March 12, 2020, he had a pretty good idea why he felt so lousy.

He lives in New York, where the first wave of the coronavirus was tearing through the city. “I instantly knew,” says the 55-year-old Broadway music director. It was COVID-19.

What started with a general sense of having been hit by a truck soon included a sore throat and such severe fatigue that he once fell asleep in the middle of sending a text to his sister. The final symptoms were chest tightness and trouble breathing.

And then he started to feel better. “By mid-April, my body was feeling essentially back to normal,” he says.

So he did what would have been smart after almost any other illness: He began working out. That didn’t last long. “It felt like someone pulled the carpet out from under me,” he remembers. “I couldn’t walk three blocks without getting breathless and fatigued.”

That was the first indication Fram had long COVID.

According to the National Center for Health Statistics, at least 7.5% of American adults – close to 20 million people – have symptoms of long COVID. And for almost all of those people, a growing body of evidence shows that exercise will make their symptoms worse.

COVID-19 patients who had the most severe illness will struggle the most with exercise later, according to a review published in June from researchers at the University of California, San Francisco. But even people with mild symptoms can struggle to regain their previous levels of fitness.

“We have participants in our study who had relatively mild acute symptoms and went on to have really profound decreases in their ability to exercise,” says Matt Durstenfeld, MD, a cardiologist at UCSF School of Medicine and principal author of the review.

Most people with long COVID will have lower-than-expected scores on tests of aerobic fitness, as shown by Yale researchers in a study published in August 2021.

“Some amount of that is due to deconditioning,” Durstenfeld says. “You’re not feeling well, so you’re not exercising to the same degree you might have been before you got infected.”

In a study published in April, people with long COVID told researchers at Britain’s University of Leeds they spent 93% less time in physical activity than they did before their infection.

But multiple studies have found deconditioning is not entirely – or even mostly – to blame.

A 2021 study found that 89% of participants with long COVID had post-exertional malaise (PEM), which happens when a patient’s symptoms get worse after they do even minor physical or mental activities. According to the CDC, post-exertional malaise can hit as long as 12 to 48 hours after the activity, and it can take people up to 2 weeks to fully recover.

Unfortunately, the advice patients get from their doctors sometimes makes the problem worse.

How Long COVID Defies Simple Solutions

Long COVID is a “dynamic disability” that requires health professionals to go off script when a patient’s symptoms don’t respond in a predictable way to treatment, says David Putrino, PhD, a neuroscientist, physical therapist, and director of rehabilitation innovation for the Mount Sinai Health System in New York City.

“We’re not so good at dealing with somebody who, for all intents and purposes, can appear healthy and non-disabled on one day and be completely debilitated the next day,” he says.

Putrino says more than half of his clinic’s long COVID patients told his team they had at least one of these persistent problems:

  • Fatigue (82%)
  • Brain fog (67%)
  • Headache (60%)
  • Sleep problems (59%)
  • Dizziness (54%)

And 86% said exercise worsened their symptoms.

The symptoms are similar to what doctors see with illnesses such as lupus, Lyme disease, and chronic fatigue syndrome – something many experts compare long COVID to. Researchers and medical professionals still don’t know exactly how COVID-19 causes those symptoms. But there are some theories.

Potential Causes Of Long COVID Symptoms

Putrino says it is possible the virus enters a patient’s cells and hijacks the mitochondria – a part of the cell that provides energy. It can linger there for weeks or months – something known as viral persistence.

“All of a sudden, the body’s getting less energy for itself, even though it’s producing the same amount, or even a little more,” he says. And there is a consequence to this extra stress on the cells. “Creating energy isn’t free. You’re producing more waste products, which puts your body in a state of oxidative stress,” Putrino says. Oxidative stress damages cells as molecules interact with oxygen in harmful ways.

“The other big mechanism is autonomic dysfunction,” Putrino says. It’s marked by breathing problems, heart palpitations, and other glitches in areas most healthy people never have to think about. About 70% of long COVID patients at Mount Sinai’s clinic have some degree of autonomic dysfunction, he says.

For a person with autonomic dysfunction, something as basic as changing posture can trigger a storm of cytokines, a chemical messenger that tells the immune system where and how to respond to challenges like an injury or infection.

“Suddenly, you have this on-off switch,” Putrino says. “You go straight to ‘fight or flight,’” with a surge of adrenaline and a spiking heart rate, “then plunge back to ‘rest or digest.’ You go from fired up to so sleepy, you can’t keep your eyes open.”

A patient with viral persistence and one with autonomic dysfunction may have the same negative reaction to exercise, even though the triggers are completely different.

So How Can Doctors Help Long COVID Patients?

The first step, Putrino says, is to understand the difference between long COVID and a long recovery from COVID-19 infection.

Many of the patients in the latter group still have symptoms 4 weeks after their first infection. “At 4 weeks, yeah, they’re still feeling symptoms, but that’s not long COVID,” he says. “That’s just taking a while to get over a viral infection.”

Fitness advice is simple for those people: Take it easy at first, and gradually increase the amount and intensity of aerobic exercise and strength training.

But that advice would be disastrous for someone who meets Putrino’s stricter definition of long COVID: “Three to 4 months out from initial infection, they’re experiencing severe fatigue, exertional symptoms, cognitive symptoms, heart palpitations, shortness of breath,” he says.

“Our clinic is extraordinarily cautious with exercise” for those patients, he says.

In Putrino’s experience, about 20% to 30% of patients will make significant progress after 12 weeks. “They’re feeling more or less like they felt pre-COVID,” he says.

The unluckiest 10% to 20% won’t make any progress at all. Any type of therapy, even if it’s as simple as moving their legs from a flat position, worsens their symptoms.

The majority – 50% to 60% – will have some improvements in their symptoms. But then progress will stop, for reasons researchers are still trying to figure out.

“My sense is that gradually increasing your exercise is still good advice for the vast majority of people,” UCSF’s Durstenfeld says.

Ideally, that exercise will be supervised by someone trained in cardiac, pulmonary, and/or autonomic rehabilitation – a specialized type of therapy aimed at re-syncing the autonomic nervous system that governs breathing and other unconscious functions, he says. But those therapies are rarely covered by insurance, which means most long COVID patients are on their own.

Durstenfeld says it’s important that patients keep trying and not give up. “With slow and steady progress, a lot of people can get profoundly better,” he says.

Fram, who’s worked with careful supervision, says he’s getting closer to something like his pre-COVID-19 life.

But he’s not there yet. Long COVID, he says, “affects my life every single day.”

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By Amy Norton
HealthDay Reporter

THURSDAY, Aug. 4, 2022 (HealthDay News) — Researchers are reporting early but encouraging findings on a potential new way to prevent malaria — an old foe that still ranks as a major killer worldwide.

In a small trial of healthy volunteers, U.S. government researchers found that a lab-engineered antibody protected most participants from infection with the malaria parasite — including all of those who received a higher dose of the antibody.

The investigators also showed it was possible to give the antibody with a standard injection, rather than the IV infusions typically used to deliver monoclonal antibodies. That will be critical, the researchers said, for use in the “real world.”

Experts cautioned that much work remains. But they also described the findings as an “exciting” development against a major killer of children in developing countries.

Malaria is caused by a parasite that is transmitted by certain types of mosquitoes. Despite various prevention efforts — from insecticide-treated bed nets to disease-preventing medications — malaria continues to exact a huge toll.

In 2020, more than 240 million people contracted malaria and over 600,000 died — mostly children younger than 5 in sub-Saharan Africa.

“Imagine being a parent living in a place with high malaria transmission,” said Dr. Robert Seder, of the U.S. National Institute of Allergy and Infectious Diseases. “Your child could die of a mosquito bite.”

Last year saw a major step in battling the disease: The World Health Organization approved the first-ever malaria vaccine, for use in young children. The vaccine, called Mosquirix, is given in three doses between the ages of 5 and 17 months, with a fourth dose about 18 months later.

While the vaccine was welcomed as a breakthrough, it is not a home run. On average, it reduces a child’s risk of malaria by about 36% over four years.

“We want to improve upon that,” said Seder, the senior researcher on the new study.

Creating a highly effective vaccine against malaria is difficult, Seder explained, due to the complexity of the parasitic infection.

The malaria parasite goes through different life stages in the human body. When an infected mosquito bites someone, it “spits” a small number of parasites into the blood, in a form called a sporozoite. Those sporozoites then travel to the liver, where they multiply and mature.

Eventually, the parasites make their way into blood cells, which is when they cause illness — typically a fever and other flu-like symptoms. Without prompt treatment, there can be severe complications like organ failure and brain swelling.

Seder and his colleagues have been developing a different approach to prevention: a monoclonal antibody that recognizes a protein on the sporozoite’s surface, with the aim of keeping it from invading the liver. The antibody is a lab-modified version of a natural one that was isolated from a patient who’d been vaccinated against malaria.

In theory, a monoclonal antibody could work better than a vaccine, Seder said: Vaccines rely on training the immune system to produce antibodies against a foreign invader, and that response will vary from person to person.

Monoclonal antibodies are more predictable.

“They’re delivered at a protective dose, like filling up a gas tank,” said Dr. Johanna Daily, an infectious disease specialist at Albert Einstein College of Medicine, in New York City.

Daily, who studies malaria, wrote an editorial published Aug. 4 with the new findings in the New England Journal of Medicine.

“I’m excited about this,” Daily said of the antibody approach.

Monoclonal antibodies are “very specific” to the invader they’re targeting, she said, and if this one can be delivered by a standard jab, that would make it feasible for use in the countries where it’s most needed.

The current study involved 23 healthy U.S. adults, 17 of whom were given the monoclonal antibody, either by IV or injection. The remaining six served as a comparison group. All were voluntarily exposed, under controlled conditions, to mosquitoes carrying the malaria parasite.

Of the 17 who’d received the antibody, 15 were completely protected, showing no detectable parasite in their blood three weeks after the controlled infection. That included all volunteers given a higher dose of the antibody.

In contrast, all six people in the comparison group had parasites in their blood (and were treated with standard malaria drugs).

The antibody Seder’s team used is a more potent form of one they tested in an earlier trial, published a year ago. The researchers estimate that this new version could, after one injection, protect a young child against malaria for 6 to 12 months.

“We’ve shown that you can give it through the standard route, instead of IV, and you don’t have to give very much — which gets at the cost issue,” Seder noted.

The downside of monoclonal antibodies is that they are eventually depleted, and injections would need to be repeated to get children through the high-risk years.

An upside, Seder said, is that all of the engineered antibodies are highly targeted to the parasite — versus the varied response a vaccine produces, where some antibodies are very effective and others not so much.

“It’s like having a team where everyone is Michael Jordan,” Seder said.

A real-world study of the approach is already underway in Mali, and another is set to begin in Kenya, Seder noted.

If the tactic proves effective, Daily said, one question will be how to fit it in with existing prevention efforts, including the vaccine. One possibility, Seder said, could be to vaccinate babies, then give the antibody as a booster — perhaps yearly, over several years.

A larger question, for both the vaccine and antibody, is whether the parasite will evolve to evade them. That’s something that only time will tell, Daily said.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more on malaria.

SOURCES: Robert Seder, MD, Vaccine Research Center, U.S. National Institute of Allergy and Infectious Diseases, Bethesda, Md.; Johanna Daily, MD, MS, professor, medicine, microbiology and immunology, Albert Einstein College of Medicine, Bronx, N.Y.; New England Journal of Medicine, Aug. 4, 2022

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Aug. 4, 2022 – New COVID-19 vaccine boosters, targeting new Omicron strains of the virus, are expected to roll out across the U.S. in September – a month ahead of schedule, the Biden administration announced this week.

Moderna has signed a $1.74 billion federal contract to supply 66 million initial doses of the “bivalent” booster, which includes the original “ancestral” virus strain and elements of the Omicron BA.4 and BA.5 variants. Pfizer also announced a $3.2 billion U.S. agreement for another 105 million shots. Both vaccine suppliers have signed options to provide millions more boosters in the months ahead.

About 83.5% of Americans have received at least one COVID-19 shot, with 71.5% fully vaccinated with the initial series, 48% receiving one booster shot, and 31% two boosters, according to the CDC. With about 130,000 new COVID cases per day, and about 440 deaths, officials say the updated boosters may help rein in those figures by targeting the highly transmissible and widely circulating Omicron strains.

Federal health officials are still hammering out details of guidelines and recommendations of who should get the boosters, which are expected to come from the CDC and FDA. For now, authorities have decided not to expand eligibility for second boosters of the existing vaccines – now recommended only for adults over 50 and those 12 and older with immune deficiencies. Children 5 through 11 are advised to receive a single booster, 5 months after their initial vaccine series.

For a preview of what to expect from the CDC and FDA, we spoke with Keri Althoff, PhD, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. Excerpts of that interview follow.

Q: Based on what we know now, who should be getting one of these new bivalent boosters?

A: Of course, there is a process here regarding the specific recommendations, but it appears there will likely be a recommendation for all individuals to get this bivalent booster, similar to the first booster. And there will likely be a recommended time frame as to time since the last booster.

Right now, we have a recommendation for adults over the age of 50 or adults who are at higher risk for severe COVID-related illness [to get] a second booster. For them, there will probably be a timeline that says you should get the booster if you’re X amount of months or more from your second booster; or X amount of months or more from your first booster, if you’ve only had one.

Q: What about pregnant women or those being treated for chronic health conditions?

A: I would imagine that once this bivalent booster becomes available, it will be recommended for all adults.

Q: And for children?

A: That’s a good question. It’s something I have been digging into, [and] I think parents are really interested in this. Most kids, 5 and above, are supposed to be boosted with one shot right now, if they’re X amount of days from their primary vaccine series. Of course those 6 months to 4.99 years are not yet eligible [for boosters].

As a parent, I would love to see my children become eligible for the bivalent booster. It would be great if these boosters are conveying some additional protection that the kids could get access to before we send them off to school this fall. But there are questions as to whether or not that is going to happen.

Q: If you never received a booster, but only the preliminary vaccine series, do you need to get those earlier boosters before having the new bivalent booster shot?

A: I don’t think they will likely make that a requirement – to restrict the bivalent booster only to those who are already boosted or up to date on their vaccines at the time the bivalent booster becomes available. But that will be up to the [CDC] vaccine recommendation committee to decide.

Q: Are there any new risks associated with these boosters, since they were developed so rapidly?

A: No. We continue to monitor this technology, and with all the mRNA vaccines that have been delivered, you have seen all that monitoring play out with the detection, for example, of different forms of inflammation of the heart tissue and who that may impact. So, those monitoring systems work, and they work really, really well, so we can detect those things. And we know these vaccines are definitely safe.

Q: Some health experts are concerned “vaccine fatigue” will have an impact on the booster campaign. What’s your take?

A: We have seen this fatigue in the proportion of individuals who are boosted with a first booster and even boosted with a second. But having those earlier boosters along with this new bivalent booster is important, because essentially, what we’re doing is really priming the immune system.

We’re trying to expedite the process of getting people’s immune system up to speed so that when the virus comes our way – as we know it will, because [of] these Omicron strains that are highly infectious and really whipping through our communities – we’re able to get the highest level of population immunity, you don’t end up in the hospital.

Q: What other challenges do you see in persuading Americans to get another round of boosters?

A: One of the things that I’ve been hearing a lot, which I get very nervous about, is people saying, “Oh, I got fully vaccinated, I did or did not get the booster, and I had COVID anyway and it was really nothing, it didn’t feel like much to me, and so I’m not going to be boosted anymore.” We are not in a place quite yet where those guidelines are being rolled back in any way, shape, or form. We still have highly vulnerable people to severe disease and death in our communities, and we’re seeing hundreds of deaths every day.

There are consequences, even if it isn’t in severity of disease, meaning hospitalization and death. And let’s not let the actual quality of the vaccine being so successful that it can keep you out of the hospital. Don’t mistake that for, “I don’t need another one.”

Q: Unlike the flu shot, which is reformulated each year to match circulating strains, the new COVID boosters offer protection against older strains as well as the newer ones. Why?

A: It’s all about creating a broader immune response in individuals so that as more strains emerge, which they likely will, we can create a broader population immune response [to all strains]. Our individual bodies are seeing differences in these strains through vaccination that helps everyone stay healthy.

Q: There haven’t been clinical trials of these new mRNA boosters. How strong is the evidence that they will be effective against the emerging Omicron variants?

A: There have been some studies – some great studies – looking at things like neutralizing antibodies, which we use as a surrogate for clinical trials. But that is not the same as studying the outcome of interest, which would be hospitalizations. So, part of the challenge is to be able to say, “OK, this is what we know about the safety and effectiveness of the prior vaccines … and how can we relate that to outcomes with these new boosters at an earlier stage [before] clinical data is available?”

Q: How long will the new boosters’ protections last – do we know yet?

A: That timing is still a question, but of course what plays a big role in that is what COVID strains are circulating. If we prep these boosters that are Omicron-specific, and then we have something totally new emerge … we have to be more nimble because the variants are outpacing what we’re able to do.

This turns out to be a bit of a game of probability – the more infection we have, the more replication of the virus; the more replication, the more opportunity for mutations and subsequent variants.

Q: What about a combined flu-COVID vaccine; is that on the horizon?

A: My children, who like most children do not like vaccines, always tell me: “Mom, why can’t they just put the influenza vaccine and the COVID vaccine into the same shot?” And I’m like, “Oh, from your lips to some scientist’s ears.”

At a time like this, where mRNA technology has totally disrupted what we can do with vaccines, in such a good way, I think we should push for the limits, because that would be incredible.

Q: If you’ve received a non-mRNA COVID vaccine, like those produced by Johnson & Johnson and Novavax, should you also get an mRNA booster?

A: Right now, the CDC guidelines do state that if your primary vaccine series was not with an mRNA vaccine then being boosted with an mRNA is a fine thing to do, and it’s actually encouraged. So that’s not going to change with the bivalent booster.

Q: Is it OK to get a flu shot and a COVID booster at the same time, as the CDC has recommended with past vaccines?

A: I don’t anticipate there being recommendations against that. But I would also say watch for the recommendations that come out this fall on the bivalent boosters.

I do hope in the recommendations the CDC makes about the COVID boosters, they will say think about also getting your influenza vaccine, too. You could also get your COVID booster first, then by October get your influenza vaccine.

Q: Once you’re fully boosted, is it safe to stop wearing a mask, social distancing, avoiding crowded indoor spaces, and taking other precautions to avoid COVID-19?

A: The virus is going to do what it does, which is infect whomever it can, and make them sick. So, if you see a lot of community transmission – you know who is ill with COVID in your kids’ schools, you know in your workplace and when people go out – that still signals there’s some increases in the circulation of virus. So, look at that to understand what your risk is.

If you know someone or have a colleague who is currently pregnant or immune-suppressed, think about how you can protect them with mask-wearing, even if it’s just when you’re in one-on-one closed-door meetings with that individual.

So, your masking question is an important one, and it’s important for people to continue to hang onto those masks and wear them the week before you go see Grandma, for instance, to further reduce your risk so you don’t bring anything to here.

The high-level community risk nationwide is high right now. COVID is here.

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Aug. 4, 2022 — Many women seeking abortion pills online have unknowingly been ordering the pills from one of many fake clinics making false claims, pharmacy experts report. 

While some online sites are licensed and legitimately connect consumers with the pills, the illegal sites may sell either counterfeit or expired pills or deliver no pills and just steal payment information. Al Carter, PharmD,  executive director of the nonprofit National Association of Boards of Pharmacy says that since the the Supreme Court struck down Roe v. Wade in June, there has been an increase in his team’s discovery of illegal online sites selling what they claim are abortion medications.

“Ninety-six percent of the online pharmacies out there are illegitimate,” he says. “They’re violating some type of state or federal law in almost every incidence.”

The court ruled that individual states could ban abortion procedures. The resulting patchwork of laws and access barriers have made conditions ripe for a growing black market online for mifepristone and misoprostol, two drugs used in combination to induce abortions.

Interest in the drugs soared after the Supreme Court ruling was leaked in May.

Within 3 days of the leak, online searches for abortion medications jumped 162% compared with the 3 days before the ruling, according to a report in JAMA Internal Medicine.

Red Flags

Among red flags that an abortion-pill website is fraudulent, Carter says, are that the site doesn’t ask for a prescription for the abortion drugs. Mifepristone and misoprostol can be legally accessed only with a prescription.

If there is no contact where you can speak with a pharmacist, that’s another clue, he says.

Sites that make false claims about abortion pills are growing just as the illegal sites that popped up in the pandemic peddling COVID-19 “cures” and non-approved vaccines and treatments, Carter says, adding that the same fear-based tactics are being used.

Where to Check Websites

The NABP is trying to bring attention to illegal websites not only for abortion drugs, but pain medications and others as well with its safe pharmacy site. There you can plug in the website address in question and check its legitimacy.

Libby Baney, JD, a senior adviser to the Alliance for Safe Online Pharmacies (ASOP), an advocacy group, says in addition to the NABP safe pharmacy site, they recommend that consumers looking for an online site to buy abortion pills check legitscript.com, which accredits legitimate online pharmacies and telemedicine companies.

“Verify before you buy,” she says. “It’s very easy to bypass the rules on the internet and operate anonymously from some unknown jurisdiction offering counterfeit or substandard pills.”

Baney says as more states consider banning access to abortion procedures and pills, the number of illegal websites will grow.

“Criminals are suppliers and there’s consumer demand,” she says.

The key is in checking the website address. Even sites that seem to belong to major chain pharmacies may have a slightly altered URL, she warns.

Consumers have become accustomed to trusting the first entries that come up on a browser search because they assume they have been vetted as the most accurate, Baney says. While that might work for checking a country’s capital, algorithms for buying online medicines should be viewed with caution.

According to a survey commissioned by ASOP, almost half (45%) of Americans mistakenly believe all websites offering health care services/prescription medications to Americans have been approved by the FDA or state regulators.

“This misconception is even higher (59%) among those who have previously purchased prescription medicines online,” the research says.

Baney warned against trusting an algorithm with online pharmacies selling abortion pills.

“Criminals know how to game it,” she says.

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Aug. 4, 2022 – Most vaccines don’t come as one-shot deals. You need a series of boosters to step up your immunity to COVID-19, tetanus, and other infectious threats over time. That can mean multiple visits with a health care provider, costing you time and sometimes money.

But what if you could receive just one shot that boosts itself whenever you need a bump in protection?

Researchers at the Massachusetts Institute of Technology (MIT) have developed microparticles that could be used to create self-boosting vaccines that deliver their contents at carefully set time points. In a new study published in the journal Science Advances, the scientists describe how they tune the particles to release the goods at the right time and offer insights on how they can keep the particles stable until then.
How Self-Boosting Vaccines Could Work

The team developed tiny particles that look like coffee cups – except instead of your favorite brew, they’re filled with vaccine.

“You can put the lid on, and then inject it into the body, and once the lid breaks, whatever is in there is released,” says study author Ana Jaklenec, PhD, a research scientist at MIT’s Koch Institute for Integrative Cancer Research.

To make the tiny cups, the researchers use various polymers (synthetic plastic-like materials) already used in medical applications, such as dissolvable stitches. Then they fill the cups with vaccine material that is dried and combined with sugars and other stabilizers.

The particles can be made in various shapes and fine-tuned using polymers with different properties. Some polymers last longer in the body than others, so their choice helps determine how long everything will stay stable under the skin after you get the shot and when the particles will release their cargo. It could be days or months after the injection.

One challenge is that as the particles open, the environment around them becomes more acidic. The team is working on ways to curb that acidity to make the vaccine material more stable.

“We have ongoing research that has produced some really, really exciting results about their stability and showing that you’re able to maintain really sensitive vaccines, stable for a good period of time,” says study author Morteza Sarmadi, PhD, a research specialist at the Koch Institute.

The Potential Public Health Impact

This research, funded by the Bill & Melinda Gates Foundation, started with the developing world in mind.

“The intent was actually helping people in the developing world, because a lot of times, people don’t come back for a second injection,” says study author Robert Langer, ScD, the David H. Koch Institute professor at MIT.

But a one-shot plan could benefit the developed world, too. One reason is that self-boosting vaccines could help those who get one achieve higher antibody responses than they would with just one dose. That could mean more protection for the person and the population because as people develop stronger immunity, germs may have less of a chance to evolve and spread.

Take the COVID-19 pandemic, for example. Only 67% of Americans are fully vaccinated, and most people eligible for first and second boosters haven’t gotten them. New variants, such as the recent Omicron ones, continue to emerge and infect.

“I think those variants would have had a lot less chance to come about if everybody that had gotten vaccinated the first time got repeat injections, which they didn’t,” says Langer.

Self-boosting vaccines could also benefit infants, children who fear shots, and older adults who have a hard time getting health care.

Also, because the vaccine material is encapsulated and its release can be staggered, this technology might help people receive multiple vaccines at the same time that must now be given separately.

What Comes Next

The team is testing self-boosting polio and hepatitis vaccines in non-human primates. A small trial in healthy humans might follow within the next few years.

“We think that there’s really high potential for this technology, and we hope it can be developed and get to the human phase very soon,” says Jaklenec.

In smaller animal models, they are exploring the potential of self-boosting mRNA vaccines. They’re also working with scientists who are studying HIV vaccines.

“There has been some recent progress where very complex regimens seem to be working, but they’re not practical,” says Jaklenec. “And so, this is where this particular technology could be useful, because you have to prime and boost with different things, and this allows you to do that.”

This system could also extend beyond vaccines and be used to deliver cancer therapies, hormones, and biologics in a shot.

Through new work with researchers at Georgia Tech University, the team will study the potential of giving self-boosting vaccines through 3D-printed microneedles. These vaccines, which would stick on your skin like a bandage, could be self-administered and deployed globally in response to local outbreaks.

Source


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Even before the Supreme Court overturned the Roe v. Wade decision on June 24, the ability to use health insurance to pay for an abortion depended on many things, including the insured woman’s state, the type of insurance involved, and where the procedure took place.

Lack of coverage means that most Americans who get an abortion pay out of pocket for it, says Katie Keith, JD, a research faculty member at Georgetown University’s Center on Health Insurance Reforms.

“That’s not to say you shouldn’t try to use insurance if you have it,” she says. “The average cost for abortion is above $500, and if you add in travel and everything else, the cost can be a huge barrier.”

Here are answers to common questions about whether health insurance covers abortion:

How do you know whether your plan covers abortion?

As with any medical procedure or medication, you can find out whether your plan covers abortion by looking at your plan documents (available through your online portal) or by calling your insurer and asking directly. If you have health insurance through your job and you feel OK asking your HR department about coverage, they likely could also answer the question or direct you to someone who can.

Even if your insurer covers abortion services, you’ll need to find a provider who accepts your insurance and is in network for your plan. In 2020, about 80% of abortion providers accepted insurance, down from 89% in 2017, according to a Health Affairs study.

Your company will not know if you have an abortion from your medical bills or health records.

Even self-insured employers usually have a different entity handling the health benefits. “They get reports on the aggregate level about the types of procedures funded, but they wouldn’t identify the individual who used them,” says Joelle Abramowitz, PhD, a health policy economist at the University of Michigan’s Institute for Social Research. “That information is protected by HIPAA.”

HIPAA, or the Health Insurance Portability and Accountability Act, is a law that protects the privacy of your health records.

Does insurance treat mifepristone (RU-486), the so-called abortion pill, differently from abortion procedures?

A medication abortion from a provider would likely fall under the same rules as the medical procedure. But that’s not always the case if it’s done through telehealth.

“The question would be whether telehealth generally, and a telehealth medication abortion specifically, would be covered,” Abramowitz says. “It is best to check with the insurance plan.”

If you do have coverage, is it protected by law, or does that vary by state?

It varies widely by state. Eleven states have limits on whether private insurers can cover abortion, and seven states require that insurance plans cover abortion.

That said, state laws only apply to fully insured employers, meaning those in which the employer pays an insurer to provide policies to workers on its behalf. Only about one-third of workers are in these types of plans.

Most large employers are self-insured, which means that they assume all the financial liability for people in the plan.

“Even in states where the law says you’re not allowed to cover an abortion, a self-insured plan would not be bound by those types of laws,” Abramowitz says.

The rules also vary for those who do not get their insurance from employer-provided plans.

An analysis by the Kaiser Family Foundation finds that 34 states and Washington, DC, limit Medicaid coverage of abortion to only cases of rape, incest, or to save the life of the mother, while about half of states have limits on plans available through the state health insurance Marketplace. You can check out the rules in your state here.

If your plan covers abortion, but you are in a state that doesn’t offer what you need, are you covered if you must travel to get one?

It’s unclear. Health insurance plans may cover abortions performed out of state (most likely at out-of-network rates), but they may not cover the travel expenses – or they could cover both. Check your plan’s details or contact your health insurance company.

Some employers have promised to help cover the costs of employees who need to travel to get an abortion. But legal experts say that companies’ ability to do so will depend on the rules in their state.

In Texas, for example, anyone who helps someone travel across state lines for an abortion could face civil penalties for “aiding and abetting” them, and employers and insurers may need to consider their potential liability for doing so.

Flexible spending accounts (FSAs) may be a way to cover some of the travel costs. “Even if the travel expenses are not covered by the insurance plan, they could be reimbursable through accounts like FSAs,” Abramowitz says.

If your plan changes mid-year, do they have to notify you?

Yes, although it’s rare that insurers would make such changes.

“They could change coverage for abortion before a new year, so when people are looking at their plans during open enrollment, that might be something to think about or inquire about at that point,” Abramowitz says.

If the pregnant woman has a medical condition that could be life-threatening, does that affect coverage?

Yes. Even in some states that now prohibit abortion, there is often an exception to save the life of the mother. In most cases, if providers perform the abortion as part of a live-saving medical intervention, insurance will cover it.

“Any kind of emergency procedure is medically necessary, so there shouldn’t be any questions about coverage,” Keith says. “If someone is in the emergency room and needs care because they have an ectopic pregnancy or something else, that should be covered.”

Source


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By Amy Norton
HealthDay Reporter

THURSDAY, Aug. 4, 2022 (HealthDay News) — If your diet is low in fiber, you can do your gut some good by adding more — regardless of the fiber source, new research suggests.

Many people know fiber as the nutrient that keeps you regular. But it’s also a key player in the makeup of the gut microbiome — the vast collection of bacteria and other microbes that reside in the digestive tract.

When bacteria in the gut break down the fiber, they produce certain short-chain fatty acids that are the main source of nutrition for cells in the colon. Research also suggests the fatty acids play a role in regulating functions as vital as metabolism and immune defenses.

But it hasn’t been clear whether any one type of fiber supplement is better for people’s gut bacteria than others.

In the new study, researchers tested three common fiber-powder supplements: inulin (an extract of chicory root), wheat dextrin (in this case, the brand Benefiber), and galactooligosaccharides (Bimuno).

They recruited 28 healthy adults and gave them each of the supplements to use for one week, with one week off in between each product.

Overall, the study found, no one supplement outperformed the others in changing consumers’ gut microbiome. Each supplement boosted the production of butyrate — an important fatty acid that helps control inflammation.

If a study participant churned out more butyrate after using one fiber supplement, they responded just as well to the other two, said Jeffrey Letourneau, a doctoral student at Duke University in Durham, N.C., who was part of the research team.

But while the fiber supplement didn’t matter, the person did: Supplements revved up butyrate production only in participants who normally ate few fiber-rich foods, the study found.

That does make sense, according to Letourneau: It’s the “low fiber consumers” who would be making a substantial change by adding a daily fiber supplement.

But that term also describes most Americans, he pointed out.

Experts generally recommend that women strive for 25 grams of fiber per day, while men should aim for 38 grams. The average U.S. adult, however, consumes only in the neighborhood of 30% of those amounts.

And in the grand scheme of human history, Letourneau said, even the recommended fiber amounts probably fall far short of what our ancestors downed. He pointed to research showing that members of the Hadza tribe, in Tanzania, still consume a whopping 100 to 150 grams of fiber a day — owing to diets high in foods like berries, honey and tubers.

So the new research — published July 29 in the journal Microbiome — emphasizes the importance of getting more fiber, whatever the source.

The study focused on supplements, in part, because they are easy to study, Letourneau said. Researchers gave each participant pre-measured individual doses of the fiber supplements, so they simply had to dump the powder into a drink once a day.

Those doses amounted to 9 grams of either inulin or wheat dextrin, or 3.6 grams of galactooligosaccharides, per day.

Fiber from food, however, would be preferable, according to a registered dietitian who was not involved in the study.

Plant foods provide not only various forms of fiber, but also a range of vitamins, minerals and beneficial “phytochemicals,” said Nancy Farrell Allen, a spokeswoman for the Academy of Nutrition and Dietetics and an instructor at Rosalind Franklin University of Medicine and Science in North Chicago, Ill.

“I believe that food is the best way to meet fiber needs,” she said.

Farrell Allen pointed to a long list of fiber-rich foods, including an array of vegetables and fruit; bran cereals and whole grains like farro; “pulses” such as lentils and chickpeas, and legumes like soybeans and peanuts.

She also had a caution on fiber supplements: They can cause unpleasant gas, bloating and prolonged indigestion.

Letourneau agreed that whole foods have “real benefits” that cannot be captured in a supplement. But given the importance of fiber — and the dearth of it in Americans’ diets — he supports getting more of it, however you can.

“My attitude is: Whatever you can fit into your life, in a sustainable way, is good,” Letourneau said.

In some more good news, it doesn’t take long for any added fiber to make a difference to your gut bacteria. In a separate study, the Duke researchers found that fiber supplements began to alter people’s gut bacteria within a day — changing the microbiome makeup and activity.

“Things do seem to change really quickly,” Letourneau said.

The research was funded by the U.S. National Institutes of Health and other government and foundation grants.

More information

Harvard University has more on fiber and health.

SOURCES: Jeffrey Letourneau, BS, doctoral student, molecular genetics and microbiology, Duke University, Durham, N.C.; Nancy Farrell Allen, MS, RDN, spokeswoman, Academy of Nutrition and Dietetics, Chicago, and nutrition instructor, Rosalind Franklin University of Medicine and Science, North Chicago, Ill.; Microbiome, July 29, 2022, online; ISME Journal, July 23, 2022

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