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Melatonin: Possible New Drug in COVID Fight

On By ModernMedia

Medical Xpress reports that results from a study Cleveland Clinic indicate that melatonin may be of value in treating COVID. The urgency of the need to treat COVID has resulted in a “fall surge”, where currently available drugs are being assessed for repurposing in treating the pandemic.

The study used artificial intelligence to sift through patient data to uncover possible candidates for use in treatment, and turned up a surprising one – melatonin. The patient data showed that taking melatonin resulted in a 30% decreased chance of contracting COVID after adjusting for confounding variables, with an even greater decreased chance of 52% in African Americans.

The study sifted through clinical manifestations and pathologies COVID and other diseases had in common. They measured the proximity between host genes/proteins and those well-associated with 64 other diseases across several types of disease, with closer proximity indicating a higher likelihood of pathological associations between the diseases.

One of their findings was that proteins associated with respiratory distress syndrome and sepsis, two major mortality causes in severe COVID patients, were strongly connected with multiple SARS-CoV-2 proteins.

“Recent studies suggest that COVID-19 is a systematic disease impacting multiple cell types, tissues and organs, so knowledge of the complex interplays between the virus and other diseases is key to understanding COVID-19-related complications and identifying repurposable drugs,” said Dr. Cheng. “Our study provides a powerful, integrative network medicine strategy to predict disease manifestations associated with COVID-19 and facilitate the search for an effective treatment.”

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Reduced Fat Mass but Not Lean Mass Lowers Heart Failure Risk

On By ModernMedia

Simple reduction in weight may not result in improved cardiovascular health, according to a new study from University of Texas Southwestern (UTSW).

Fat mass is the weight of fat in different parts of the body, while lean mass is the weight of muscle. Senior author of the study, Ambarish Pandey, MD, and assistant professor of internal medicine at UTSW explained, “We have long counseled patients to lower their body-mass index into the ‘healthy’ range. But that doesn’t tell us whether a patient has lost ‘fat mass’ or ‘lean mass,’ or where the weight came off. We didn’t know how each of these factors might affect patients’ risk of heart disease.”

The study, using calculated lean and fat mass from the data of 5103 participants in the Look AHEAD (Action for Health in Diabetes) Trial, showed that the more fat mass and waist circumference were lowered, the lower their risk of developing heart failure. A 10% reduction in fat mass led to a 22% lower risk of heart failure with preserved ejection fraction and a 24% lower risk of heart failure with reduced ejection fraction, two subtypes of this condition. Reduced waist circumference lowered the risk of heart failure with preserved injection fraction, but not heart failure with reduced ejection fraction. Reduction in lean mass had no effect on heart failure.

Study author Kershaw Patel, MD, study author and a cardiologist at Houston Methodist Hospital, said, “We showed that reductions in specific, not all, body composition parameters are linked to heart failure.”

Further research is needed to see whether, for example, gains in lean muscle mass is linked to reduced rates of heart failure.

Source: Medical Xpress

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Dolphins, Seals and Whales Are Vulnerable to COVID

On By ModernMedia

The COVID pandemic may infect susceptible marine mammals from wastewater discharge into the oceans, according to researchers from the Department of Pathology at Dalhousie.

The team used genomic mapping to identify which animals would be vulnerable to the virus. Key amino acids which the viruses bound to were found to be shared across humans and certain marine mammals. 
“Many of these species are threatened or critically endangered,” said Dr Graham Dellaire, director of the study. “In the past, these animals have been infected by related coronaviruses that have caused both mild disease as well as life-threatening liver and lung damage.”

18 out of 21 dolphin and porpoise species were predicted to have the same or higher susceptibility to the virus as humans, as well as eight out of nine seal species. SARS-CoV-2 is excreted in faeces, and can survive in the water for 25 days, creating a new pathway for infection. Thus far, no infection in marine animals has been observed.

The animals can be monitored for infection in a number of ways, including with the colourfully named SnotBot drone, which can sample whale mucus from blowholes.

Plans include vaccinating the animals, limiting contact at zoos and monitoring and treating wastewater.

Source: Phys.org 

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Urgent Plea as COVID Leaves SA Blood Stocks Critically Low

On By ModernMedia

The Citizen reports that blood stocks in South Africa are running critically low, and the South African National Blood Service is appealing to businesses, universities, schools and churches to help achieve its minimum requirement of 4 000 units a day.

Demand has surged since lockdown as elective surgeries are now being conducted, as well as a return to increased numbers of accidents.

A statement released by the SANBS reads: “Blood stocks have dropped to critically low levels. The immediate impact is an inability to issue blood in emergencies and the possible loss of lives. We need healthy donors to give blood now.”

Dr Karen de Berg of the SANBS says that the shortfall is resulting from not being able to station blood donation drives at businesses, universities and schools. The SANBS is appealing for donors to visit their website or social media pages to locate their nearest blood donation centres, and is hoping to set up donation drives at churches and petrol stations.

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Controversy Reigns over Remdesivir FDA Approval

On By ModernMedia

According to an article by Science, the approval of remdesivir by the US Food and Drug Administration (FDA) has shown irregularities in the approval process.

Remdesivir is particularly well-remembered for being approved by the FDA for emergency use, and again for the results of the Solidarity trial, which was organised by the WHO across the world. The Solidarity trial had shown no benefit for mortality benefit for remdesivir – or any other measures. There were high hopes for remdesivir initially: early on, an NIH trial found that it shortened the disease – but a similar Chinese study found no evidence of that. A later study sponsored by remdesivir’s manufacturer, Gilead, found that it reduced recovery time for a 5 day course – but not for a 10 day course. Gilead was aware of the Soldiarity results early on, and then when they became public because they were conducted across multiple countries with different standards of care.

Meanwhile, the FDA went ahead with its approval process. The Solidarity researchers described the results to the FDA on Oct. 10, and in a preprint paper five days later, but the FDA still gave approval, apparently ignoring the Solidarity results in favour of those of the NIH and other studies. Furthermore, the FDA had not convened a key advisory group – yet it had for all of the COVID vaccine approvals.

Meanwhile, the European Commission signed a procurement for 500 000 doses of remdesivir worth $1.2billion. A European Commission spokesperson confirmed that it only received word of the failure of remdesivir in the Solidarity trial the following day.

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“Long COVID” Linked to Pre-existing Conditions

On By ModernMedia

Studies on re-admission of diseases other than COVID, such as influenza, concluded that they were caused by complex interactions within the immune system.

Patients are currently considered cleared of COVID after two sequential negative tests.

Researchers from the bio-information firm “nference” performed a retrospective analysis of 266 patients treated for COVID.
This analysis compared patients admitted or re-admitted after viral clearance with patients hospitalised before viral clearance but did not require hospitalisation after viral clearance.
The researchers at nference used neural network models to draw out factors such as comorbidities in their dataset. The results showed that the hospitalised post-viral clearance group showed acute kidney injury (n=15 (16.1%)), anaemia (n=20 (21.5%)), and cardiac arrhythmia (n=21 (22.6%)) in the year preceding the onset of COVID.

The authors of the study by nference hope the information will guide further research into risk factors for COVID.

Source: News-Medical.Net

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Ask Patients about Any Cannabis Use Frankly

On By ModernMedia

With legalisation and increasingly widespread use of cannabis, healthcare providers should be as open-minded about cannabis use in their patients as possible

Marian Wilson, registered nurse and associate professor at the Washington State University College of Nursing, argues in a recent paper that enquiring about it like they would alcohol or tobacco is necessary to obtain adequate patient histories and build trust.

Many studies have indicated that patients are using it to treat pain in much the same way they do opioids. Since they are using it in this way, they need to be asked about it for pain management. Since patients are reluctant to disclose this information with clinicians, there is currently a lack of information on prevalence and usage habits.

“We want this paper to guide providers in how they can start opening up this conversation and normalising it,” Wilson said. “Central to patient-centred conversations is understanding the top priorities of patients. Researchers have suggested that clinicians should ask ‘What matters to you?’ as well as ‘What is the matter?'”

Source: News-Medical.Net

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Biden to Hit the Ground Running with COVID Response

On By ModernMedia

Mounting an effective response to COVID was one of presidential hopeful Joe Biden’s campaign promises, and now that he has won the US elections, he is seeking to implement this response as soon as possible.

This comes at a critical time, as the US has been struggling with record new cases, breaking 100 000 per day in the last few days, with sombre predictions of another 100 000 deaths by January, stoked by the advent of winter and people socialising for the festive season. Biden has begun assembling a science-focussed team to prepare to take on managing the COVID pandemic as soon as he takes office.

Numerous challenges will face Biden’s team when he assumes office. One of them is the extreme distrust that has emerged as a result of the politicisation of the virus. 

Angela Rasmussen, a virus researcher at Columbia University in New York, said: “The past year of misinformation, confusion and gaslighting from the White House has really left people without any trust that our government is capable of handling this. It’s going to be critical to begin communicating that, yes, this administration will be led by the science.” 

 Some believe that, unfortunately, that it is a case off too little, too late, and that attitudes cannot be so easily changed. Kris Mathews, the administrator of Decatur Health, a small hospital in rural Kansas, said, “I think the damage is done. People have made up their minds about how they react to it.”  

Biden has also promised to have the US rejoin the World Health Organization on the first day of his presidency. Dr. Soumya Swaminathan, the WHO’s chief scientist, said: “Everyone recognises that for a pandemic, you cannot have a country-by-country approach. You need a global approach.” She expressed optimism that the US under Biden would join the global Covax scheme led by the WHO to distribute the vaccine to the needy.

Source: Medical Xpress

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Earlier Immunotherapy and Chemo May Help Stomach Cancer Treatment

On By ModernMedia

New research indicates that earlier immunotherapy in combination with normal chemotherapy may be needed to treat stomach cancer, which is often resistant to the treatment.

“Patients with advanced stomach cancer have limited treatment options,” says Woosook Kim, PhD, first author of the paper. “Many are not eligible for surgical resection, and response to radiotherapy or chemotherapy is often low.”

Many cancers release proteins that prevent the immune system from attacking them; immunotherapy blocks these proteins, re-enabling the immune system’s attack. However, current immunotherapy drugs do not work very well for stomach cancer. Looking at advanced tumours in mice, researchers discovered that they have abundant myeloid-derived suppressor cells (MDSCs), which release even more immune system-blocking proteins, swamping the immunotherapy drugs.

“Our study suggests that adding chemotherapy to immunotherapy may improve responsiveness in part through the targeting of MDSCs,” said Timothy Wang, MD, the study leader. “While we do not have enough information to determine if the level of MDSCs may predict response to this dual regimen, our findings show that administering immunotherapy in combination with chemotherapy earlier in the course of the disease, when MDSC levels are much lower, may boost response rates in stomach cancer,” Wang concluded.

Source: Medical Xpress

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Impact of COVID Lockdown on Soweto Residents’ Mental Health

On By ModernMedia

A new study reported by Health-e has revealed the mental health toll that COVID and the lockdown to control it took on residents of Soweto, with 957 participants interviewed before the lockdown and then six weeks into the lockdown.

The interviews revealed that some 14% of those surveyed were at risk of depression, which was worsened by factors such as childhood trauma as well as their level of knowledge about COVID. Feeling unable to take precautions against the virus caused anxiety levels to skyrocket. 

“While participants believed that the pandemic did not affect their mental health or their ‘mind,’ the strong relationship between perceived risk and depressive symptoms raises the concern that they may not be aware of the potential threats to their mental health during Covid-19,” said Dr Andrew Wooyoung Kim, co-director of the study. “This discrepancy may be due to different ideas of mental health, including mental health stigma.”

Kim acknowledges that the challenging South African environment of poverty and poor services may also have had significant impacts.
“Our study re-emphasises the importance of prioritising and provisioning accessible mental health resources for resource-limited communities in Soweto and across South Africa,” Kim added.