Year: 2021

Categories : COVIDTags :

US Health Workers’ Vaccine Hesitancy Is Cause for Concern

On By ModernMedia

Health care workers in various parts of the United States are showing extraordinarily high rates of COVID vaccine hesitancy: 20% to 40% of front line workers in Los Angeles, and 60% of nursing home workers said they would refuse to take the vaccine. This has generated great concern along with some instances of shaming, but failing to address these worries is potentially going to worsen the progression of the pandemic.

Fortunately, national surveys show that vaccine hesitancy is decreasing with some 60% of Americans now intending to receive a vaccine, but the high numbers among healthcare workers demands attention. Speaking to the Guardian, Dr Whitney Robinson, an epidemiologist at the University of North Carolina, said that if this is not addressed, “It could mean after all this work, after all this sacrifice, we could still be seeing outbreaks for years, not just 2021, maybe 2022, maybe 2023.”

In Atlanta, while hundreds of healthcare workers were on the list for vaccines, the doses were literally “sitting in the freezers” because no-one would take them.In one survey, up to 55% of New York firefighters said would not take the vaccines, so the Uniformed Firefighters Association president put together a 50 minute video with a virologist friend, addressing their concerns. Subsequent calls from firefighters showed the video had helped to change minds and increase vaccination numbers.

The concerns are varied. Some are concerned about possible side effects and long term consequences, or have read misinformation online. Others are worried about the effect it will have on pregnant and breastfeeding women. Still others believe that having the vaccine is unnecessary after having recovered it, as they have the antibodies in their system. A lot of the distrust may be from minority groups’ deep-rooted distrust of large-scale health programs such as vaccinations, according to Dr Nikhila Juvvadi, the chief clinical officer at Loretto hospital in Chicago. Many specifically mentioned the Tuskegee Study, where federal health officials studied African-American men with sexually transmitted diseases which were deliberately not treated.

“I’ve heard Tuskegee more times than I can count in the past month – and, you know, it’s a valid, valid concern,” said Juvvadi.
However, she said that individual conversations were effective in helping alleviate concerns about the vaccines.

Source: The Guardian

Categories : AddictionTags :

Withdrawal Symptoms of Discontinuing Medical Cannabis

On By ModernMedia

A new study on the long terms effects of having used medical cannabis show that over half of people who used it experience withdrawal symptoms between use. And about one in ten experienced worsening alterations in sleep, mood, mental state, energy and appetite over two years.

Patients who use cannabis usually turn to it because of the failure of other pain medications, or to avoid the long-term risks of opioid use. However, the perception that it is “harmless” is incorrect, as it has cannabinoids that act on receptors in the brain, and from which the brain can experience withdrawal symptoms. This can even lead to cannabis use disorder.

Addiction psychologist Lara Coughlin, PhD, who led the analysis said, “Some people report experiencing significant benefits from medical cannabis, but our findings suggest a real need to increase awareness about the signs of withdrawal symptoms developing to decrease the potential downsides of cannabis use, especially among those who experience severe or worsening symptoms over time.”

After they had gone a significant time without cannabis, the 527 participants in the study were asked whether they had any one of 15 symptoms, ranging from irritability to nausea. Using an analytic method, they empirically grouped them into three groups ranging from mild or moderate symptoms to severe, with most of the symptoms. They then surveyed the patients again after one year and then again after two years. Those in the mild class showed the most stability in symptoms over time.

Younger participants were more likely to be in the severe group, and were more likely to have a worsening trajectory. Coughlin concluded that patients seeking cannabis use for pain need to discuss it with their health care providers, and seek psychosocial treatments such as cognitive behavioural therapy.

Source: Medical Express

Journal information: Coughlin, LN et al. Progression of cannabis withdrawal symptoms in people using medical cannabis for chronic pain. Addiction. 2021. DOI: 10.1111/add.15370

Categories : Mental HealthTags :

Autism Theory Treats its Characteristic Traits as Favoured by Society

On By ModernMedia

For decades, scientists have fruitlessly sought a unifying aetiology for autism and an explanation for its prevalence, but now a new theoretical model describes the condition as a combination of traits that are common in autism and which are socially valued, combined with co-occurring disabilities.

An estimated 1 in 54 people have autism, which has been on the increase in developed countries. TA Meridian McDonald, PhD, a research instructor in Neurology at Vanderbilt University Medical Center, said: “Up until now there have been a lot of theories about the possible causes of autism but none of those theories account for the majority of autism cases. There are also a lot of theories as to why the prevalence of autism has been increasing in the population but, to date, there hasn’t been a theory that provides an explanatory model that accounts for all of those phenomena, including the genetics, social history, or characteristics of autism.”

She has worked on autism for 25 years, culminating in a theory called, “The Broader Autism Phenotype Constellation-Disability Matrix Paradigm (BAPCO-DMAP) Theory”, a focuses on the genetic basis of autism in line with current science but shifts the emphasis to positive traits selected for by events occurring over the past century.”The BAPCO-DMAP theory describes how people are attracted to other people who are very similar. They are attracted to certain traits that are very common in the population, and this leads to offspring who are more likely to have certain traits, as well as a greater intensity of traits,” said McDonald.

“The [BAPCO] traits are not what people expect. They expect the traits to be about challenges or difficulties, but instead there are six main traits—increased attention, increased memory, a preference for the object world vs. the social world and their environment, increased nonconformity, increased differences in sensory and perception, as well as systemising.”

These BAPCO traits are thus not necessarily negative, and can be combined with social skills. Counterintuitively, babies with increased memory and attention spans learn language later, because babies normally rely on their tiny attention span to break words down into their simplest sounds. With greater memory and attention spans, infants engage in echolalia, speaking long phrases without understanding them.

“You can often see children with autism engaging in sense-making activities, such as watching the same show over and over and memorising information,” McDonald said.The BAPCO traits are not by themselves significant impediments, but when combined with a disability such as an information processing disorder, then the combination leads to greater difficulties.

According to McDonald, the increased prevalence of autism in developed countries is due to men and women with BAPCO traits being able to pursue similar careers and passions, as opposed to being limited by circumstance, and results in relationships. This effectively concentrates BAPCO traits in any children they have.Since the BAPCO traits are socially valued, there simply is no “cure” for them, according to McDonald.”When we talk about autism we need to address the developmental disabilities that these individuals are experiencing but also find way to support and enhance their broader autism trait constellations,” she concluded.

Source: Medical Xpress

Journal information: T.A. Meridian McDonald, The broader autism phenotype constellations–disability matrix paradigm: Theoretical model for autism and the broader autism phenotype, Medical Hypotheses (2020). DOI: 10.1016/j.mehy.2020.110456

Categories : UncategorizedTags :

FDA Approves New Medication for the Treatment of Progeria

On By ModernMedia

On Friday, the FDA gave approval for the first medication able to actually treat the rare disease, Hutchinson–Gilford progeria syndrome (HGPS), which causes premature aging. Prior to the development of this medication in 2007, only palliative care was available to treat the disease.  

HGPS is an extremely rare disease affecting only some 400 people worldwide, the disease is caused by a chance genetic mutation that causes the buildup of a protein called progerin in the cells of the afflicted person, giving the disease its name. The disorder causes stunted growth, alopecia, and aged skin appearance. Children who have the disease develop atherosclerosis, and most die of stroke. The average life expectancy for sufferers is 14 1/2 years. The medication blocks the buildup of progerin, impeding the premature aging effect. 

A clinical trial followed participants for 11 years, and the medication was found to extend life by 2 1/2 years. The oldest participant is 24, having taken the medication for 13 years.

The new medication, Zokinvy, also known as lonafarnib, is expected to be expensive due to the small number of patients but the manufacturer, Eiger, said that it will offer finance plans to make it affordable for all patients. Eiger also helped finance the research for the treatment, along with the Progeria Research Foundation.

“This is just the first. We’ll find more and better treatments,” said Dr Leslie Gordon, the foundation’s medical director.

Source: Medical Xpress

Categories : COVID Lab Tests and ImagingTags :

COVID Variants May Increase False Negative Results, FDA Warns

On By ModernMedia

The UK variant of the SARS-CoV-2 virus, known as B.1.1.7 could affect the accuracy of certain molecular COVID tests, causing increased false negative results, the US Food and Drug Administration (FDA) has warned.

A false negative from the UK variant could happen if the variant’s mutation happened to be in a part of the virus’ genome that was assessed by that test. However, genetic tests that target multiple parts of the virus genome are less likely to be affected by the new variants, the FDA advises.

Although the possibility of false negative results are to be expected from almost all tests, the effect of the COVID variants could impact the ability to properly monitor the disease, as well as complicating diagnosis.  

The FDA issued an alert on Friday, saying that they monitor tests which have received an Emergency Use Authorisation (EUA). They highlight three tests as being affected, with potentially less sensitivity to the mutations:

  • Accula SARS-Cov-2 Test, from Mesa Biotech
  • TaqPath COVID-19 Combo Kit, from Thermo Fisher Scientific)
  • Linea COVID-19 Assay Kit, from Applied DNA Sciences

However, the warning for Accula test was a result of “an abundance of caution”, and the latter two assess multiple genetic targets, so they are not likely to be impacted. The FDA issued recommendations for the users of these devices.The FDA’s warning was prompted by computer simulations showing reduced efficacy in certain tests for the virus variant.

In their press release, the FDA did not specifically mention whether any tests may be affected by mutations in the South African virus variant.

Source: MedPage Today

Categories : Allergies Uncategorized UrogenitalTags :

New Research Links Bladder Pain Flare-ups to Pollen

On By ModernMedia

High pollen counts have long been associated with allergic rhinitis with its well known symptoms such as itching eyes, running nose and sneezing, but now new research suggests that it may be aggravating a completely unexpected condition: chronic bladder pain.

In the United States, more than 10 million people are believed to suffer from urologic chronic pelvic pain syndrome (UCPPS) – a mysterious cluster of problems which include bladder pain syndrome and interstitial cystitis in women, chronic pelvic pain syndrome, and in men, chronic prostatitis.

Researchers regard it as “one of the most frustrating urologic conditions to understand and manage”, requiring a multidisciplinary and multimodal approach to management. However, it has been known to be associated with flare-ups of allergies, prompting Washington University epidemiologist Siobhan Sutcliffe to lead a team to investigate a possible connection. Their study recruited 290 participants diagnosed with UCPPS, and tracked pollen levels from three days before and on the day against UCPPS symptoms. Daily pollen counts did not correlate with UCPPS symptoms, but in participants with when pollen count was medium or high, there was a significant association with symptoms. The mast cell activation involved in pollen allergies release histamines which may be a contributing factor in UCPPS. Evidence for this comes from animal studies which have shown that exposure to histamine makes the bladder hypersensitive. Histamines also stays resident in the bladder longer than in the bloodstream as they are excreted via urine.

Sutcliffe said: “Our study provides evidence to suggest increased pollen counts may trigger symptom flares in people living with UCPPS.”This research may bring an avenue for some now forms of relief to UCPPS sufferers, but further research is needed to eliminate confounding factors, such as environmental factors associated with high pollen counts – strong levels of wind and thunderstorms may trigger pollen allergies but also exert some other kind of separate influence.

“Patients may benefit from taking antihistamines on days with high pollen levels, or from allergy testing and immunotherapy,” concluded Sutcliffe.

Source: Science Alert

Journal information: Javed I, Yu T, Li J et al. Does Pollen Trigger Urologic Chronic Pelvic Pain Syndrome Flares? A Case-Crossover Analysis in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network. Journal of Urology. 2020. doi:10.1097/ju.0000000000001482

Categories : COVID UncategorizedTags :

Pfizer/BioNTech Vaccine Effective against SA and UK COVID Variants

On By ModernMedia

Amidst concerns that the SARS-CoV-2 virus might escape the protection of vaccines, initial results from new research shows that the Pfizer/BioNTech vaccine remains effective against the South African and UK COVID variants.

The new variants, which are much more transmissible, had created concern that due to mutations in their structure, they might not achieve the full protection of the current vaccines, especially in the SA variant.

However, this is a preliminary study that has not yet been through a peer review process, and the worrying E484K mutation in the South African strain which has been shown to reduce antibody recognition has not been tested on – that is still to be done.

Using blood samples from 20 individuals who had received the Pfizer/BioNTech vaccine, antibodies in the samples successfully defended against the virus variants. The results were made available on the bioRxiv site. Pfizer chief scientific officer Dr Philip Dormitzer said that “it was a very reassuring finding that at least this mutation, which was one of the ones people are most concerned about, does not seem to be a problem” for the vaccine.

However, should future mutations of SARS-CoV-2 achieve viral escape from the vaccines, the necessary adjustments to counter this could be made to the vaccines within a matter of weeks. Dormitzer said that this work was only the start “ongoing monitoring of virus changes to see if any of them might impact on vaccine coverage.”

Source: Medical Xpress

Categories : GeneticsTags :

Not Quite Mirror Images: DNA of Identical Twins Differs Slightly

On By ModernMedia

The popular depiction of identical twins is that they are exactly that – individuals from a single zygote that are identical because their DNA is identical. But new research has shown that there can be a surprisingly large amount of mutations that differentiate one twin from another.

Twin studies have been popular in identifying the genetic basis of traits and conditions, such as vulnerabilities to disease, as well as in psychological studies examining the effects of genetic “nature” versus environmental “nurture”.

Sequencing the DNA of 387 pairs of identical twins, along with their parents, children and spouses, scientists in Iceland were able to find small numbers of early mutations between twins.Identical twins have an average of about 5.2 mutations between them, but in 15%, there were as many as 100 mutations. Such a number of genetic mutations could influence height differences or susceptibility to cancer.

Jan Dumanski, a geneticist at Uppsala University in Sweden, who was not involved in the new paper, said of the results, “The implication is that we have to be very careful when we are using twins as a model” for discerning the influences of nature and nurture.

The study went beyond previous ones that had already discovered small mutations between twins, to include parents, spouses and children, enabling them to pinpoint mutations in two kinds of cell: those present in just one individual and those passed on to their children. In addition, they found mutations occuring before the zygote split into two embryos.

Study co-author Kari Stefansson, a geneticist at the University of Iceland and the company deCODE genetics, said that his team had discovered cases where pairs of twins had mutations that were present in all cells of one twin, but not found in the other twin at all. However, “sometimes the second twin may show the mutation in some cells, but not all cells,” he said.

Source: Medical Express

Journal information: Hakon Jonsson et al. Differences between germline genomes of monozygotic twins, Nature Genetics (2021). DOI: 10.1038/s41588-020-00755-1

Categories : COVID Diseases, Syndromes and ConditionsTags :

A Four Century Old Manual for Social Distancing Rules

On By ModernMedia

A feature article from the BBC details how one doctor in the era of the Plague created an eerily familiar set of social distancing guidelines that matches a lot of our non-pharmaceutical COVID controls.

Staying at home and only sending out one person to do the shopping, keeping six feet apart and disinfecting goods – all of these feature in a manual created over four centuries ago to help protect Alghero, a small Italian town against the plague. The methods by a doctor named  Quinto Tiberio Angelerio, published in a 57-page booklet on his methods, titled Ectypa Pestilentis Status Algheriae Sardiniae.

Unlike most plague outbreaks, it failed to spread to neighbouring areas and died out within eight months – though not without claiming about 60% of the town’s initial population of 6000. Angelerio’s rules are thought to be at least partly responsible.

Ravaging Europe as well as Asia and North Africa, the plague left an unimaginable mark on Western society; tunnelling projects in London regularly run into mass graves of plague victims. Italian poet Francesco Petrarca wrote that future generations would likely not be able to grasp the scale of the calamity, and he is probably right in that regard. The plague continued to reappear, and devastated regions when it did – The Great Plague of London saw 24% of its populace dying over 1665 to 1666.

Although the germ theory of disease was then still centuries in the future, and bathing in urine was thought to be effective treatment, physicians in Europe believed in the contagion theory, thinking that diseases were spread through “miasmas” or “bad air”. This enabled them to come up with the idea of quarantines, from the Italian for “forty days” which was the standard isolation period.

Facing huge obstacles from a recalcitrant citizenry, Angelerio nevertheless persevered and soon a lockdown was enacted. This was not unique, as whole cities would be quarantined. Other rules that were enforced included a social distancing of six feet (as measured by a pole to be carried around by anyone outside), advising people to be careful shaking hands during mass, as well as railing preventing customers coming into contact with shopkeepers. He also used superstition to keep people in line, as European people of the time believed the plague to be divine punishment – although rule breakers were common, as they are now with COVID. He also advised cleaning and disinfecting houses, and household goods (or burning if replaceable), in addition to the contemporary practice of disinfecting newly arrived cargo. This was accomplished by fire or exposure to the wind, among others. However, the common practice of killing cats in response to plague was likely counterproductive, as rats hosted plague-carrying fleas.

Nevertheless, Angelero’s work was ahead of its time, and helped lay the foundations of modern disease control.

.Source: BBC Future

Categories : Addiction CancerTags :

Nearly a Fifth of Cancer Patients on Opioids Misuse Them

On By ModernMedia

A new report reveals that 19% of cancer patients receiving opioids are misusing them, referred to a nonmedical opioid use (NMOU) behaviour. 

Opioid addiction remains a persistent and serious problem in the United States, and is growing elsewhere in the world, with some 16 million individuals worldwide suffering from opioid misuse disorder.
The study,  led by Sriram Yennurajalingam, MD, MS, of MD Anderson Cancer Center in Houston, included 1554 patients at a supportive care clinic for a comprehensive cancer centre. Of those engaging in NMOU behaviour, the most common (29%) was an early request for a refill, followed by self-directed dose escalation (15%), co-using illicit or non-prescribed drugs (13%), and impaired daily function due to opioids (11%).

Independent risk factors that increased the risk of NMOU behaviour included being single or divorced, as well as pain levels, opioid risk screening score, and morphine equivalent daily dose.

In their recommendations, Yennurajalingam and co-authors wrote: “Based on these findings, a universal screening, setting limits on opioid use by limiting supply, more intense follow-up with an interdisciplinary team to provide optimal use of medications for pain and symptom management, and the provision of counseling and support to patients and their family members may help prevent the development of these NMOU behaviors.”

Source: MedPage Today

Journal information: Yennurajalingam S, et al. Frequency of and factors associated with nonmedical opioid use behavior among patients with cancer receiving opioids for cancer pain, JAMA Oncol 2020; DOI: 10.1001/jamaoncol.2020.6789.