Day: May 6, 2025

Categories : Diseases, Syndromes and ConditionsTags :

Semaglutide Treats Liver Disease in Two Thirds of Patients

On By ModernMedia
Human liver. Credit: NIH

Results from the ESSENCE phase 3 clinical trial published in the New England Journal of Medicine shows that treating patients with semaglutide can halt and even reverse the disease.

The placebo-controlled outcome trial of participants with a life-threatening form of liver disease known as Metabolic dysfunction associated steatohepatitis (MASH) was conducted at 253 clinical sites across 37 countries around the world. This is the first regulatory-level trial showing the benefit of semaglutide for people with MASH.

The trial is led by two Chief Investigators, Professor Philip Newsome at King’s College London and Arun Sanyal at the VCU School of Medicine, United States, and funded by Novo Nordisk.

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is a long-lasting liver condition caused by having too much fat in the liver. MASH is a more severe form of MASLD. It is closely linked with obesity as well as conditions such as type 2 diabetes and heart and circulatory disease. Over time, the build-up of fat in the liver can lead to inflammation, liver fibrosis, cirrhosis and liver cancer. MASLD affects 1 in 5 people in the UK but there are no medicines licensed to specifically treat the disease.

Researchers chose to investigate semaglutide as a potential treatment because this class of drug helps reduce fat and liver scarring for people with MASH. Previous smaller but positive studies by Professor Newsome, published in the Lancet and NEJM, had shown using semaglutide as a treatment for MASH would have benefit for these patients.

Between May 27, 2021 and April 18, 2023, 800 participants were randomly assigned to receive once-weekly injection of 2.4milligrams of semaglutide or placebo, alongside lifestyle counselling. More than half of participants had type 2 diabetes and approximately three-quarters were living with obesity.

Results from the ESSENCE trials after 72 weeks of treatment found 62.9% of participants experienced a reduction in steatohepatitis (inflammation of the liver with fat accumulation in the liver) versus 34.3% for participants who took the placebo. The results also show 36.8% of the semaglutide group had improvements of their liver fibrosis versus 22.4% in the placebo group. Researchers also found other benefits. Those receiving semaglutide also saw improvements in liver enzymes and other blood measures of liver fibrosis, as well as 10.5% weight loss. Gastrointestinal adverse events were more common in the semaglutide group, such as nausea, diarrhoea, constipation, and vomiting.

I’ve been working with GLP-1 treatments for sixteen years and these results are hugely exciting. MASLD is a growing problem worldwide and this trial will provide real hope for patients with MASH. While these results must be treated with caution, the analysis shows semaglutide can be an effective tool to treat this advanced liver disease.

Professor Philip Newsome, Director of the Roger Williams Institute of Liver Studies

The research team will follow close to 1200 participants from 37 countries for up to five years to gather data on semaglutide’s impact on long-term liver complications.

Source: King’s College London

Categories : Cardiovascular Disease General InterestTags :

Two Heart Transplants, One Epic Ride

On By ModernMedia

Four Cyclists Take on the 2025 KAP sani2c to Inspire South Africans with a Message of Hope

L-R_Steph Bester CEO of AllLife with Billy McLeod

From 8 to 10 May 2025, four cyclists will take on one of South Africa’s most iconic and challenging mountain bike stage races – the KAP sani2c. Covering 265 kilometres over three days from the Southern Drakensberg to Scottburgh on the KwaZulu-Natal South Coast, the event is known for its tough terrain, stunning scenery, and relentless pace. But this year, one team will be racing with more than just medals in mind.

Team Change of Heart is made up of two heart transplant recipients – Billy Macleod (56) and Pedro Basson (20) – and their two experienced cycling partners: Steph Bester, CEO of AllLife, and long-time cycling companion Guy Dudley. Together, they’re not just riding to finish – they’re riding to inspire.

Billy, once an accomplished cyclist and triathlete, was sidelined for six years by heart disease and given just two weeks to live before receiving his transplant.          

He made a remarkable comeback in 2024 when he became the first South African heart transplant recipient to complete the KAP sani2c. This year, Billy returns with a renewed purpose – not just to ride, but to support 20-year-old Pedro through his very first stage race. For Billy, this ride is about passing the baton of hope and helping another transplant recipient believe in the impossible.

Pedro, the youngest team member at just 20 years old, will be attempting his first-ever mountain bike stage race. Having received his transplant as a teenager, Pedro’s journey to recovery has been nothing short of remarkable. Taking on sani2c is a bold and symbolic step, one he hopes will encourage other young people with chronic health conditions to dream big and push boundaries.

“This is more than a race – it’s a celebration of life and second chances,” says Steph Bester, who was set to ride alongside Billy last year but had to withdraw at the last minute due to a sudden illness. “Missing out in 2024 was heartbreaking for me, especially because this cause and this team are so close to my heart. I can’t wait to finally be on the bike with them this year. Billy and Pedro are living proof that your story doesn’t end with a diagnosis. At AllLife, we believe in the power of resilience, and this team embodies that belief. It’s an honour to support them – not only on the bike but in sharing their powerful message with the country.”

The team will be riding on e-bikes, enabling them to manage pace, terrain, and energy levels more effectively while still tackling the full challenge of the race. For Pedro, who has never raced before, the support of his three teammates – all experienced sani2c finishers – is crucial.

“Knowing I have a team behind me who understands the journey and is there to support every climb and descent makes all the difference,” Pedro shared. “It’s not just about the bike – it’s about proving to myself that anything is possible.”

AllLife is once again using this race to raise awareness for Hero777, a non-profit foundation focused on increasing organ and tissue donor registrations in South Africa. The foundation is deeply personal to the AllLife family as they deal with so many people in need of transplants daily.

It takes a community that truly understands both the unique challenges individuals face and the deep love for cycling to make something like this possible. The team is incredibly grateful for the support from AllLife, the wider cycling community, and especially race founder Glen Haw (Farmer Glen). Pedro will ride an e-bike generously sponsored by Cannondale, allowing him to tackle this life-affirming challenge alongside his team.

Whether it’s climbing steep hills or sharing laughs around the campfire, Team Change of Heart is ready to show that with support, courage, and a whole lot of heart – anything is possible.

Follow their journey on Instagram and Facebook (https://www.facebook.com/AllLifeSA and https://www.instagram.com/alllife_sa), and visit www.odf.org.za to learn more about organ and tissue donation or register as a donor today.

Categories : Cardiovascular DiseaseTags :

Micronanoplastics Found in Artery-clogging Plaque in the Neck

On By ModernMedia
Transmission Electron Microscopy (TEM) picture of nanoplastic particles derived from carotid plaque. Copyright University of New Mexico

People with plaque in the blood vessels of their neck have a higher amount of tiny plastic particles in those vessels compared to people with healthy arteries. This increase was significantly higher in people who had experienced a stroke, mini-stroke or temporary loss of vision due to clogged blood vessels, according to preliminary research presented at the American Heart Association’s Vascular Discovery 2025 Scientific Sessions: From Genes to Medicine.

Micronanoplastics are tiny pieces of plastic created in industrial processes or from larger plastic objects as they degrade in the ocean or the soil. Micronanoplastics are not uniform in size and are a mixture of micro and nano plastic sizes. While microplastics are sometimes visible at less than 5 millimetres in size, nanoplastics are microscopic (invisible to the naked eye), less than 1000 nanometres across. This makes them more easily dispersed and able to penetrate cells and tissues in living organisms. Researchers suggest that terminology should gradually transition to nanoplastics because that is more precisely what is being studied.

“These types of plastics are commonly found in the environment, especially in ocean garbage patches. Over many years, these plastics break down, mix into the soil and water, and can build up in the food chain,” said lead study author Ross Clark, MD, MBA, RPVI, a vascular surgeon-scientist at the University of New Mexico in Albuquerque. “Many people think that micro and nanoplastics mainly come from using plastic utensils, cutting boards, packaging, water bottles and other plastic items. However, the main source is the food and water we eat and drink.”

In 2024, researchers in Italy reported finding micronanoplastics in plaque from some people without symptoms who underwent surgery to remove carotid artery plaque. Symptoms caused by carotid plaque buildup may include stroke, mini-stroke or temporary blindness. Followed for almost three years after surgery, people with micronanoplastics in their carotid plaque were significantly more likely to die or to have a non-fatal heart attack or stroke.

The current study, which included fewer than 50 participants, was built on the previous research conducted in Italy. Researchers compared the levels of micronanoplastics found in the carotid arteries of three groups: people with healthy arteries; those with plaque but no symptoms; and those experiencing symptoms due to plaque buildup. Researchers also compared plaques with low and high plastic levels to assess the effects of micronanoplastics on markers of inflammation, the gene activity of immune cells called macrophages and stem cells that help stabilise plaque.

The analysis found that the concentration of micronanoplastics in carotid arteries was:

  • 16 times higher (895 micrograms/gram vs. 57 micrograms/gram) in plaque among people without symptoms compared to the levels found in artery walls of deceased tissue donors of similar age with no plaque; and
  • 51 times higher (2888 micrograms/gram vs. 57 micrograms/gram) in plaque from people who had experienced stroke, mini-stroke or temporary loss of vision due to blockage of blood flow to the retina, in comparison to samples from age-matched, deceased tissue donors.

Comparing high-plastic and low-plastic plaque levels, the analysis found:

  • no link between the amount of micronanoplastics and signs of sudden inflammation; and
  • differences in gene activity in plaque-stabilizing cells and less activity in anti-inflammatory genes of plaque macrophage immune cells.

“These findings indicate that the biological effects of micronanoplastics on fatty deposits are more complex and nuanced than simply causing sudden inflammation,” Clark said. In their next phase of work, they will focus on better understanding the immunological effects of micronanoplastics in clogged arteries.

“It’s very important to study what these materials do to our bodies. However, we should be cautious about the early results of this study. We won’t fully understand the biological effects for many years to come,” Clark said.

The study has several limitations. It cannot prove that micronanoplastics in plaque were the cause of symptoms of carotid artery disease; micronanoplastics might be a sign of another health issue that caused these symptoms. Researchers did not have access to data detailing the sex or race/ethnicity of the tissue donors. Additionally, pyrolysis gas chromatography-mass spectrometry, used to measure plastic in biological samples may have limitations. This technique allows measurements to include nanoplastics and larger microplastic particles and uses high temperatures to break down plastics into smaller organic molecules. However, parts of the biological samples may also break down into similar molecules. For instance, fatty acids found in artery-clogging plaque could break down into compounds appearing similar to polyethylene.

“We are constantly improving our method to reduce the amounts of lipids in the samples to lessen their impact on the results. Lipids have a very similar spectral signature on gas chromatography as some plastic polymers (in particular polyethylene). It can be challenging to distinguish between the lipids and the polyethylene in the results. That’s why removing the lipids is so important. We believe our methods are currently the best way to address this specific criticism. However, new discoveries might change how we understand this data in the future,” Clark said.

“This is a very interesting and troubling study. To date, we have not considered exposure to plastic micronanoparticles a modifiable risk factor for stroke. Although it is important to understand the mechanism at play in the pathophysiology of symptomatic carotid atherosclerosis, this association presents a novel potential target for stroke prevention,” said Karen L. Furie, MD, MPH, FAHA, volunteer vice chair of the American Heart Association Stroke Brain Health Science Subcommittee and professor and chair of neurology at the Warren Alpert Medical School of Brown University in Providence, Rhode Island. Furie was not involved in this study.

Study details, background and design:

  • Researchers tested 48 samples of carotid arteries from 48 different adults collected in 2023-2024 at the University of New Mexico and the Office of the Medical Investigator (a state agency and part of the Department of Pathology at the University of New Mexico).
  • About one-third of the samples were from people aged 60 to 90 who had surgery to remove plaque from their carotid arteries. These people had symptoms including stroke, mini-stroke or temporary blindness (called amaurosis fugax).
  • About one-third of the samples came from people of similar age with no symptoms. They were having surgery to remove plaque buildup in their carotid arteries because a blockage was found during screening or a physical exam.
  • The last one-third of the samples came from tissue donors. These age-matched donors had died of any cause and did not have carotid artery blockage.
  • The researchers also compared plaques with low vs high amounts of micronanoplastics on inflammation-related measures. All samples were analysed to measure inflammation by looking at levels of inflammatory molecules TNF-α and IL-6. The levels were compared to the amount of plastics to find any connections. For the RNA sequencing studies, researchers examined samples with the highest and lowest concentrations of plastics.

Source: American Heart Association

Categories : Ethics and LawTags :

Déjà Vu: Moss v Road Accident Fund

On By ModernMedia
Photo by Tingey Injury Law Firm on Unsplash

By Raynold Tlhavani, Partner & Micaela Pather, Senior Associate from Webber Wentzel

The recent judgment in Moss v Road Accident Fund,1 handed down by the Western Cape High Court, has reignited debate regarding the Road Accident Fund’s (RAF’s) liability to compensate accident victims for past medical expenses already covered by their medical aid.

If this sounds familiar, that’s because it is. Recently, the same court in Rahldeyah Esack v the Road Accident Fund1 dealt with the same legal question raised in Moss: can a claimant’s right to compensation under the RAF Act 56 of 1996 be diminished by third-party payments? The court in Moss followed the earlier ruling in Esack, which held that the RAF is liable for a claimant’s past hospital and medical expenses, even if these were covered by a medical scheme.

The facts in Moss were that, in September 2017, the 77-year-old plaintiff sustained bodily injuries when he was struck by a vehicle while cycling. He claimed ZAR 34 286.59 in past medical expenses, of which ZAR 4 173.80 had been paid out of pocket, while the balance had been settled by his medical aid. The RAF opposed the claim, relying on its internal directives from 2022 and 2023, which instructed staff to reject past medical expense claims where the expenses had already been paid by a medical scheme. These directives were not formally introduced before the court. The defence was described as ill-conceived and procedurally inappropriate. Although the court declined to rule substantively on the legal issues raised by the RAF’s directives, it noted that the directive touches on complex areas of law, including common and statutory law, champerty, subrogation, and medical scheme law, which it would not address in context of this judgment.

The court also remarked on the RAF’s litigation practices, observing that the fund had drastically reduced its reliance on external counsel and instead “overburdened” a handful of attorneys at the State Attorney’s office.

It noted with concern that counsel from previously disadvantaged backgrounds, who had historically relied on RAF work, were no longer being briefed, undermining transformation imperatives. It further highlighted the impact on practitioners who, through no fault of their own, were forced to juggle multiple RAF matters in a single day.

Ultimately, the court’s decision in Moss mirrored that in Esack, granting the plaintiff a full award for past medical expenses, regardless of third-party payments. It remains to be seen whether this approach in the Western Cape Division, at odds with a Full Bench decision of the Gauteng Division, will gain traction in other divisions.

  1. [2025] JOL 68686 (WCC). ↩︎
  2. [2025] ZAWCHC 27. ↩︎

Categories : Expert Opinion Medical IndustryTags :

Opinion Piece: U.S. Funding Halted, Futures at Stake

On By ModernMedia

Finding a path forward for South Africa’s healthcare workers

Donald McMillan

By Donald McMillan, Managing Director at Allmed Healthcare Professionals

06 May 2025

South Africa’s healthcare system is under serious pressure. The sudden suspension of critical US funding has resulted in the loss of around 15 000 healthcare jobs – many of them linked to HIV/AIDS programmes that served as lifelines for vulnerable communities. Combined with broader public sector budget cuts and a national hiring freeze, the situation threatens to undo decades of progress in healthcare delivery. As public hospitals struggle with fewer staff and shrinking resources, the country is at risk of losing not only jobs, but skills, infrastructure, and hope. But in the face of these challenges, there are still ways to keep services running and people employed. One of them is through Temporary Employment Services (TES), which provides a flexible staffing approach that can help stabilise the system while longer-term solutions are explored.

A healthcare system under pressure

The US aid cut has had an immediate and devastating impact. Programmes focused on HIV, tuberculosis, and reproductive health, many of which were propped up by international donor funding, have been forced to scale back or shut down entirely. Thousands of community healthcare workers, nurses, counsellors, and administrators have found themselves jobless, while patients are left facing longer wait times and reduced access to care.

At the same time, cost-cutting across the public sector has put a freeze on new hires, even in essential departments like health and the impact is already being felt. With public hospitals and clinics stretched thin, they’re unable to take on newly trained doctors and nurses. And while the private sector plays a role, it simply cannot absorb the overflow. This isn’t just a staffing issue, it’s a setback for the entire healthcare system, affecting everything from medical training to frontline care.

Young professionals left in limbo

Every year, South Africa produces thousands of highly trained doctors and healthcare workers, many of whom move into the public health system after completing their compulsory community service. These roles used to be a given but with hiring freezes and shrinking budgets, many young professionals are now finishing their training with nowhere to go. Despite their skills and frontline experience, these workers are left in limbo. This is a double blow as South Africa loses out on the return from its investment in their education, while the risk of a growing skills drain looms large. With countries like the UK, Australia, and Canada actively recruiting healthcare workers, there’s a real chance they may leave and not come back.

A flexible solution in Temporary Employment Services

In response to this crisis, temporary employment solutions have become a practical and effective solution. TES providers offer qualified healthcare professionals short- to medium-term flexible contracts, enabling them to continue working in their field while delivering essential support to overburdened healthcare facilities.

This approach offers a lifeline not just for displaced workers, but for clinics and hospitals struggling with limited resources. TES employees can be rapidly deployed where they are needed most, whether to cover staff shortages, serve remote communities, or support seasonal fluctuations in demand. Unlike permanent hires, they don’t carry long-term costs such as medical aid or pension contributions, making them a more budget-conscious option in uncertain times.

The benefits of the TES model have already been proven. During the COVID-19 pandemic, temporary staff played a key role in scaling up testing, vaccination, and treatment efforts across the sector. That same adaptability is needed now to respond to the healthcare funding crisis.

Rethinking the future of healthcare work

While temporary employment solutions cannot not solve the problem alone, it can provide an important stopgap and potentially a new way of thinking about workforce planning in the healthcare sector. Rather than relying solely on permanent positions, South Africa may need to adopt a more fluid, demand-based deployment model that allows professionals to move between roles, regions, and areas of urgent need.

Shifting to this model calls for a change in mindset. Permanent posts have traditionally been seen as the gold standard in healthcare, valued for their stability and benefits. But in a time of uncertainty, contract and locum roles – especially when managed by trusted TES providers – can offer a practical alternative, combining income, ongoing experience, and flexibility.

Retaining talent, restoring hope

Avoiding long-term damage to South Africa’s healthcare system will require urgent, coordinated action. Government departments must urgently reprioritise spending toward essential services like health and education. At the same time, private healthcare providers and staffing agencies must step up and work together to ensure that skilled professionals are not lost to the system or the country.

Despite the current turbulence, South Africa’s healthcare workers remain among the best trained and most resilient in the world and with the right support structures, including flexible employment options like TES, we can preserve our healthcare capacity and continue to serve those who need it most.