Categories : Cancer COVIDTags :

Cancer Patients Have a Higher Mortality Risk from COVID

On By ModernMedia
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Patients hospitalised with active cancer are more likely to die from COVID than those with a cancer history or diagnosis, according to a new study.

The findings published by Wiley early online in CANCER, a peer-reviewed journal of the American Cancer Society, also indicate that the greatest risk of death due to COVID was in those with active blood cancers. No mortality risk increase was found in patients who received cancer treatments in the three months (or longer) prior to hospitalisation.

To find out how cancer, or the various therapies used to treat it, could affect the health of patients with COVID infections, a team analysed the NYU Langone Medical Center’s records of 4184 hospitalised patients who tested positive for SARS-CoV-2, the virus that causes COVID.

This group included 233 patients who had a current, or ‘active’, cancer diagnosis. They found that more patients with an active cancer diagnosis (34.3 percent) were likely to die from COVID than those with a history of cancer (27.6 percent) and those without any cancer history (20.0 percent).

Among patients with active cancer, those with blood-related cancers had the greatest risk of death. However, undergoing systemic anticancer therapy, including chemotherapy, molecularly targeted therapies, and immunotherapy, within three months prior to hospitalisation was not linked to a higher risk of death, and the investigators found there were no differences according to the type of cancer therapy being received.

Senior author Daniel Becker, said, “We completed a large chart review-based study of patients hospitalised with COVID and found that patients with active cancer, but not a history of cancer, were more likely to die. Notably, however, among those hospitalised with active cancer and COVID, recent cancer therapy was not associated with worse outcomes.”

“People with active cancer should take precautions against getting COVID, including vaccination, but need not avoid therapy for cancer.”

Source: Wiley

Categories : Ageing Neurodegenerative DiseasesTags :

Molecule Found to Play a Key Role in Brain Rejuvenation

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Image source: Pixabay

A new study shows that a molecule could play a key role in support cells in the brain, allowing them to repair and properly communicate.

Studies have shown that new brain cells continually formed in response to injury, physical exercise, and mental stimulation. Glial cells, and in particular oligodendrocyte progenitors, are highly responsive to external signals and injuries. They can detect changes in the nervous system and form new myelin, which forms a sheath around nerves, providing metabolic support and accurate transmission of electrical signals. However, less myelin is formed with age, and this progressive decline has been linked to the age-related cognitive and motor deficits observed in older people. Impaired myelin formation also has been reported in older individuals with neurodegenerative diseases such as Multiple Sclerosis or Alzheimer’s and identified as one of the causes of their progressive clinical deterioration.

A new study from the Neuroscience Initiative team at the Advanced Science Research Center at The Graduate Center, CUNY (CUNY ASRC) has identified a molecule called ten-eleven-translocation 1 (TET1) as a necessary component of myelin repair. shows that TET1 modifies the DNA in specific glial cells in adult brains so they can form new myelin in response to injury. The study was published in Nature Communications.

“We designed experiments to identify molecules that could affect brain rejuvenation,” said lead author Sarah Moyon, PhD, a research assistant professor with the CUNY ASRC Neuroscience Initiative. “We found that TET1 levels progressively decline in older mice, and with that, DNA can no longer be properly modified to guarantee the formation of functional myelin.”

The authors are currently exploring whether raising levels of TET1 in older mice could rejuvenate the oligodendroglial cells, restoring their regenerative functions.

Combining whole-genome sequencing bioinformatics, the authors showed that the DNA modifications induced by TET1 in young adult mice were essential to promote healthy communication among central nervous system cells and for ensuring proper function. The authors also showed that young adult mice with a genetic modification of TET1 in the myelin-forming glial cells could not produce functional myelin, and so behaved like older mice.

“This newly identified age-related decline in TET1 may account for the inability of older individuals to form new myelin,” said Patrizia Casaccia, founding director of the CUNY ASRC Neuroscience Initiative, a professor of Biology and Biochemistry at The Graduate Center, CUNY, and the study’s primary investigator. “I believe that studying the effect of aging in glial cells in normal conditions and in individuals with neurodegenerative diseases will ultimately help us design better therapeutic strategies to slow the progression of devastating diseases like multiple sclerosis and Alzheimer’s.”

The findings could also hold important implications for molecular rejuvenation of ageing brains in healthy individuals, the researchers noted. Future studies aimed at increasing TET1 levels in older mice are underway to define whether the molecule could restore new myelin formation and favour proper neuro-glial communication. The long-term goal of the team is to promote recovery of cognitive and motor functions in older people and in patients with neurodegenerative diseases.

Source: Advanced Science Research Center

Categories : General Interest Neurodegenerative DiseasesTags :

A Neurologist Confronts His Alzheimer’s Disease

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Image by valelopardo from Pixabay

Neurologist Daniel Gibbs, MD, PhD, related his experiences of having been diagnosed with Alzheimer’s disease and taking part in clinical trials of possible treatments for it.

“I’m fascinated by this disease that, for my entire career as a scientist and a neurologist, I could only observe from the outside,” Dr Gibbs wrote in his new book, A Tattoo on my Brain: A Neurologist’s Personal Battle against Alzheimer’s Disease. “Now I’ve got a front-row seat — or rather, I’m in the ring with the tiger.”

Dr Gibbs stumbled upon his diagnosis accidentally, when he and his wife tested their DNA to learn about their ancestry that he discovered he had two copies of the APOE4 allele, the most common genetic risk factor for Alzheimer’s disease.

Because he had an early diagnosis, Dr Gibbs has volunteered to participate in several Alzheimer’s clinical trials in recent years, including one for aducanumab, the controversial Alzheimer’s treatment the FDA is expected to decide upon in June.

During a trial of aducanumab, he developed a serious amyloid-related imaging abnormality (ARIA) involving both brain oedema and intracerebral haemorrhage, which he recovered from. Dr Gibbs went on to co-author a case report about the clinical course and treatment of his complication. In the wake of much controversy, aducanumab has today received FDA approval.

MedPage Today interviewed Dr Gibbs on his experiences and perspectives since his Alzheimer’s diagnosis.

Dr Gibbs said that “as a patient and as a neurologist” it is a coping mechanism which gives hime “a huge advantage” to be able to look at the disease through his two “masks”. “Looking at it from the neurologist scientist’s point of view is a lot less threatening and is intellectually very satisfying. I enjoy reading and writing about it,” he said.

Regarding his future, he said: “One of the messages I try to get across in the book is that you need to plan for the future while you are still cognitively intact, and make very clearly known what you want done when you’re unable to give instructions about your care. I’ve done that. My family knows, my doctor knows: I don’t want anything done if I can’t participate in making decisions.” 

Dr Gibbs said he was excited to volunteer for the aducanumab study partly because of the way aducanumab was discovered; a reverse-engineered antibody found in cognitively normal aged people. Another reason was the more aggressive nature of the trial. He explained the meaning of “tattoo on my brain” alluded to in the title of his book, an adverse effect of the experimental drug.

“For me, a ‘tattoo on my brain’ has two forms. In the ARIA — the amyloid-related imaging abnormality complication I had from aducanumab — there was both leakage of fluid causing swelling in my brain and leakage of blood, microhaemorrhages. Those went away, as did the swelling in my brain, but they left behind this haemosiderin, this iron-containing pigment which is not dissimilar to tattoo ink, if you will.

“I haven’t had a recent MRI scan, but at least the last one I looked at a year or two ago still showed those little dots of hemosiderin. In a literal sense, that is the tattoo on my brain. In the figurative sense, the tattoo is a symbol of a kind of coming out of the closet and showing something that you’re not ashamed of.” 

The book, he said, is about people with early disease and the children of people with Alzheimer’s disease because they’re at risk. The aim is to “loosen up the conversation” so that interventions such as lifestyle changes can take place.

He suspects that the first disease-modifying drugs will be effective in early stages, which are going to be really hard studies to do. Recruiting participants without cognitive impairment but the pathology of  of Alzheimer’s disease is extremely difficult.
Finally, he offered some advice on dealing with Alzheimer’s.

“What I would recommend is for everybody to start doing things that are good for them. A heart-healthy diet is good for you in so many ways. It’s hard to say that’s not a good idea, although we’re a country of hamburger-loving people. And exercise — I don’t know how you overcome that bar of convincing people if you want to be a healthy 70- or 80-year-old, you have to exercise and get a good diet. And good sleep.”

Source:MedPage Today

Categories : Metabolic Disorders New Compounds and TreatmentsTags :

‘Game-changing’ Weight Loss Drug Semaglutide Approved by FDA

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Image source: Neonbrand on Unsplash

The US Food and Drug Administration approved a ‘game changing’ weight loss drug called Wegovy (semaglutide) for chronic weight management in adults with obesity or overweight.

This injection is the first drug for chronic weight management in adults with general obesity or overweight to be approved since 2014. The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater, and is to be used in conjunction with diet and exercise.

“Today’s approval offers adults with obesity or overweight a beneficial new treatment option to incorporate into a weight management program,” said John Sharretts, MD, deputy director of the Division of Diabetes, Lipid Disorders, and Obesity in the FDA’s Center for Drug Evaluation and Research. “FDA remains committed to facilitating the development and approval of additional safe and effective therapies for adults with obesity or overweight.”

Approximately 70% of American adults have obesity or overweight, and >67% of sub-Saharan Africans. This is a serious health issue linked to leading causes of death such as heart disease, stroke and diabetes, and also to increased risk of certain types of cancer. Losing 5% to 10% of body weight through diet and exercise has been associated with a reduced risk of cardiovascular disease in adult patients with obesity or overweight.

Wegovy works by mimicking a hormone called glucagon-like peptide-1 (GLP-1) that targets areas of the brain regulating appetite and food intake. The medication dose must be increased gradually over 16 to 20 weeks to 2.4 mg once per week to reduce gastrointestinal side effects.

The drug’s safety and efficacy were studied in four 68-week trials. Over 2600 patients received Wegovy for up to 68 weeks in these four studies and more than 1500 patients received placebo.

The largest placebo-controlled trial enrolled diabetes free adults with an average age of 46 years, and 74% of whom were female. The average body weight was 105 kg and average BMI was 38 kg/m2. Individuals receiving Wegovy lost an average of 12.4% of their initial body weight compared to individuals who received placebo. Another trial enrolled adults with type 2 diabetes. The average age was 55 years and 51% were female, with an average body weight of 100 kg and average BMI of 36 kg/m2. In this trial, individuals receiving Wegovy lost 6.2% of their initial body weight compared to the placebo group.

“The approval of Wegovy in the US brings great promise to people with obesity. Despite the best efforts to lose weight, many people with obesity struggle to achieve and maintain weight loss due to physiological responses that favour weight regain,” said Martin Holst Lange, executive vice president, Development at Novo Nordisk. “The unprecedented weight loss for an anti-obesity medication marks a new era in the treatment of obesity, and we now look forward to making Wegovy available to people living with obesity in the US”.

Unfortunately, the drug may be out of the reach of many people in need of it, with indications being that the medication may be charged at around US$1,300 a month.

Source: Food and Drug Administration

Categories : Diet and NutritionTags :

Scientists Search for Ways to Make Plant-based Protein Tastier and Healthier

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As the demand for meat continues to increase around the world, a paper in the new Nature journal, Science of Food, that explores the topic of ways to create healthier, better-tasting and more sustainable plant-based protein products that mimic animal-based foods. 

It’s no simple task, said lead author of the article, renowned food scientist David Julian McClements, University of Massachusetts Amherst Distinguished Professor.

“With Beyond Meat and Impossible Foods and other products coming on the market, there’s a huge interest in plant-based foods for improved sustainability, health and ethical reasons,” said  McClements, a leading expert in food design and nanotechnology, and author of Future Foods: How Modern Science Is Transforming the Way We Eat.

It’s a growing industry: in 2019, the US plant-based food market was valued at nearly $5 billion, with 40.5% of sales in the milk category and 18.9% in plant-based meat products. That reflects a growth in market value of 29% from 2017.

“A lot of academics are starting to work in this area and are not familiar with the complexity of animal products and the physicochemical principles you need in order to assemble plant-based ingredients into these products, each with their own physical, functional, nutritional and sensory attributes,” McClements said.

With funding from the USDA’s National Institute of Food and Agriculture and the Good Food Institute, McClements is leading a multidisciplinary team at UMass Amherst that is discovering how to design better plant-based protein. Co-author Lutz Grossmann, who recently joined the UMass Amherst food science team as an assistant professor, has expertise in alternative protein sources, McClements noted.

“Our research has pivoted toward this topic,” McClements said. “There’s a huge amount of innovation and investment in this area, and I get contacted frequently by different startup companies who are trying to make plant-based fish or eggs or cheese, but who often don’t have a background in the science of foods.”

While the plant-based food sector is growing to meet consumer demand, Prof McClements noted in the paper that “a plant-based diet is not necessarily better than an omnivore diet from a nutritional perspective.”

In order to provide the micronutrients that are naturally present in animal meat, milk and eggs, plant-based products have to be fortified with vitamin D, calcium, zinc and others. Adequate amounts of micronutrients are needed for, among other things, the proper functioning of the immune system. Meat-free diets presently increase risks for fractures and other conditions, although they have other considerable health benefits.

Plant-based foods also need to be digestible and provide the full complement of essential amino acids.

McClements said that many of the current generation of highly processed, plant-based meat products are unhealthy because they contain large amounts of of saturated fat, salt and sugar. But, he added, ultra-processed foods do not necessarily have to be unhealthy.

“We’re trying to make processed food healthier,” McClements explained. “We aim to design them to have all the vitamins and minerals you need and have health-promoting components like dietary fiber and phytochemicals so that they taste good and they’re convenient and they’re cheap and you can easily incorporate them into your life. That’s the goal in the future, but we’re not there yet for most products.”

To tackle these challenges, McClements said, the UMass Amherst team of scientists is taking a holistic, multidisciplinary approach.

Source: University of Massachusetts Amherst

Journal information: McClements, D. J & Grossmann, L., (2021) A brief review of the science behind the design of healthy and sustainable plant-based foods. npj Science of Food. doi.org/10.1038/s41538-021-00099-y

Categories : New Compounds and TreatmentsTags :

Olaparib Excels in Breast Cancer Trial

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A clinical trial of olaparib has been shown to help keep certain early-stage, hard-to-treat breast cancers at bay after initial treatment in promising early findings.

The results were so promising they were published early, ahead of the American Society of Clinical Oncology’s annual meeting and published in the New England Journal of Medicine. 

Olaparib, sold under the name Lynparza, was found to help breast cancer patients with harmful mutations have a longer disease-free survival after their cancers had been treated with standard surgery and chemotherapy.

It was studied in patients with BRCA1 and BRCA2 gene mutations, which can not only predispose people to breast cancer if they don’t work properly, but who did not have a gene flaw that can be targeted by the drug Herceptin.

Most patients in the study also had tumours not fuelled by oestrogen or progesterone. Triple negative breast cancers are not fuelled by these two hormones nor by the gene Herceptin targets.

The new study tested Lynparza in 1836 women and men with early-stage disease who were given the drug or placebo pills for one year after surgery and chemotherapy. About 82% of participants had triple-negative breast cancer.

Independent monitors advised releasing the results after observing clear benefit from Lynparza. After three years, 86% of patients on it were alive without cancer recurrence compared to 77% in the placebo group.

The results suggest more patients should get their tumours tested for BRCA mutations to help guide treatment decisions, said ASCO president Dr Lori Pierce, a cancer radiation specialist at the University of Michigan.

Serious side effects were rare, and other less serious side effects included anaemia, fatigue and blood cell count abnormalities.

Lynparza, which is marketed by AstraZeneca and Merck, is already sold in the United States and elsewhere for treating metastatic breast cancers and for treating certain cancers of the ovaries, prostate and pancreas. It costs roughly US$14 000 per month, though what patients pay out of pocket varies depending on income, insurance and other factors.

Source: Medical Xpress

Categories : COVID Medical Research & TechnologyTags :

A COVID Vaccine Without the Jab

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Photo by Webstacks on Unsplash

University of Queensland scientists used a ‘patch’ to deliver a US-developed COVID vaccine without the jab, and successfully protected mice from the virus.

The vaccine candidate from University of Texas Hexapro was delivered via the high-density microarray patch (HD-MAP) and provided protection against COVID disease with a single, painless ‘click’ from a handheld applicator.

Dr David Muller, from UQ’s School of Chemistry and Molecular Biosciences, said the vaccine patch produced strong immune responses that were shown to be effective when the mice were exposed to SARS-CoV-2.

“When the Hexapro vaccine is delivered via HD-MAP applicator – rather than a needle – it produces better and faster immune responses,” Dr Muller said.

“It also neutralises multiple variants, including the UK and South Africa variants.

“And it’s much more user-friendly than a needle – you simply ‘click’ an applicator on the skin, and 5000 microscopic projections almost-imperceptibly deliver vaccine into the skin.

“The UQ team, together with Vaxxas, hope to take the technology to the world and are looking for funding opportunities to accelerate to clinical trials as soon as possible.”
Dr Muller said that Hexapro, delivered by the high-density microarray patch, could dramatically assist global vaccine rollout effort, particularly for billions of vulnerable people in low- and middle-income countries.

“We’ve shown this vaccine, when dry-coated on a patch, is stable for at least 30 days at 25 degrees Celsius and one week at 40 degrees, so it doesn’t have the cold chain requirements of some of the current options.”

High-density microarray patch (HD-MAP)

Vaxxas was founded in 2011 with the help of University of Queensland. The company’s president and CEO, David L Hoey, said he was extremely excited about the findings.

“These results are extremely clear – vaccination by HD-MAP produces much stronger and more protective immune responses against COVID-19 in model systems than via needle or syringe,” he said.

“We thank and recognise our incredible research collaborators at UQ for these important findings.

“The prospect of having a single-dose vaccine, that could be easily distributed and self-administered, would greatly improve global pandemic vaccination capabilities,” said Hoey

The research is currently undergoing peer review and has been published in BioRxiv (DOI: 10.1101/2021.05.30.446357).

Source: The University of Queensland

Categories : Medical IndustryTags :

Financial Feasibility of NHI Challenged

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Health groups are seeking detailed information on the workings of South Africa’s new National Health Insurance (NHI) scheme, particularly on its financial feasibility.

The Khayelitsha and Klipfonetin health forums said in a presentation to parliament that a proper analysis is necessary to see if South Africa can even afford to fund the NHI. This is a concern that has been echoed by experts. The analysis should also find out if the public trusts the government to be able to deliver an NHI that is fully inclusive of community participation, the forums said.

“There is a view that perhaps we need to be building our public healthcare system as a priority to ensure a successful transition to an NHI Fund,” it said.

The forums also raised concerns around what the NHI will mean for existing healthcare systems – including the future of the country’s medical aids.

“Clarity is needed with respect to how the NHI Bill will address the transition between private medical aids and a universal healthcare system for all.

“The gap between private and public healthcare needs to be bridged and how this is done is important.”

Other critics have also pointed out that the scheme does nothing to address the serious gaps and flaws in South Africa’s healthcare system.

The fate of medical aids

The NHI Bill currently states that when the system is “fully implemented”, services that are paid for by the NHI will not be covered by medical aids.

Discovery Health has said that while it is in general supportive of the structural changes being introduced through the NHI, medical aids should not be limited.

“Our strong view is that limiting the role of medical schemes would be counterproductive to the NHI because there are simply insufficient resources to meet the needs of all South Africans.

“Limiting people from purchasing the medical scheme coverage they seek will seriously curtail the healthcare they expect and demand. It poses the risks of eroding sentiment, and of denuding the country of critically needed skills, and is impacting negatively on local and international investor sentiment and business confidence.”

Crucially, by preventing those who can afford it from using their medical scheme cover, and forcing them into the NHI system, this approach will also have the effect of increasing the burden on the NHI and will drain the very resources that must be used for people in most need, the scheme said. Significantly, there is no indication by government as to how the NHI will be paid for, or whether it can even be afforded, with only mention made to payroll taxes and other revenue streams being tapped.

Source: BusinessTech

Categories : CancerTags :

Diet Affects both Breast Microbiome and Breast Cancer Tumours

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Breast cancer cells. Image source: National Cancer Institute on Unsplash

The breast has its own microbiome of bacteria, and new research has shown it can be influenced by diet, as can breast cancer tumours.

In 2018, scientists at Wake Forest School of Medicine, part of Wake Forest Baptist Health, showed that diet, just like the gut microbiome, can influence the breast microbiome.

Now, new research shows that diet, including fish oil supplements, can alter not only the breast microbiome, but also breast cancer tumours. The findings were published online in Cancer Research.

To untangle the relationship between microbiome, diet and cancer risk, researchers undertook a multi-pronged approach to study both animal models and breast cancer patients.

“Obesity, typically associated with a high-fat diet consumption, is a well-known risk factor in postmenopausal breast cancer,” said Katherine L. Cook, PhD, assistant professor in the surgery – hypertension and cancer biology departments at Wake Forest School of Medicine. “But there’s still a lot we don’t know about the obesity link to microbiomes and the impact on breast cancer and patient outcomes.”

In the first part of the study, mice susceptible to breast cancer were fed either a high-fat or a low-fat diet. Mice consuming the high-fat diet had more tumours, which were also larger and more aggressive than the tumours in the low-fat diet group.

Next, to study the microbiome, researchers performed faecal transplants. Mice consuming the low-fat diet received the high-fat diet microbiome transplant, and mice consuming the high-fat diet received the low-fat diet microbiome transplant. Unexpectedly, mice that consumed the low-fat diet and received a high-fat diet microbiome had just as many breast tumours as mice on the high-fat diet.

“Simply replacing the low-fat diet gut microbiome to the microbiome of high-fat diet consuming animals was enough to increase breast cancer risk in our models,” Cook said. “These results highlight the link between the microbiome and breast health.”

Researchers also conducted a double-blind placebo-controlled clinical trial with breast cancer patients, with patients either receiving placebo or fish oil supplements for two to four weeks before lumpectomy or mastectomy.

Results showed that fish oil supplementation significantly modified the breast microbiome in both non-cancerous and malignant breast tissue. For example, scientists found longer-term administration of fish oil supplements (four weeks) increased the proportional abundance of Lactobacillus in the breast tissue near the tumour. Lactobacillus is a genus of bacteria shown to decrease breast cancer tumour growth, suggesting potential anti-cancer properties of this intervention. Researchers also found decreased proportional abundance of Bacteroidales and Ruminococcus microbes in the breast tumours of patients taking the supplements, though the significance of this is not understood.

“This study provides additional evidence that diet plays a critical role in shaping the gut and breast microbiomes,” concluded Dr Cook. “Ultimately, our study highlights that potential dietary interventions might reduce breast cancer risk.”

Dr Cook’s team is also conducting further studies to see if probiotic supplements can affect microbiome populations in mammary glands and in breast tumours.

Source: Wake Forest Baptist Medical Center

Categories : Cardiovascular Disease Implants and ProsthesesTags :

Ventricular Assist Device Pulled from Market due to Failures

On By ModernMedia
Photo from Olivier Collett on Unsplash
Photo from Olivier Collett on Unsplash

The HeartWare system, a left ventricular assist device (LVAD) for advanced heart failure patients, is being discontinued immediately, according to the Food and Drug Administration.

The manufacturer, Medtronic, is halting global distribution and sale of its HeartWare system in the wake of observational evidence of increased neurological adverse events and mortality for its LVAD compared with similar mechanical circulatory support (MCS) devices.

Last December, some HeartWare LVADs were recalled because of complaints that the pump may delay or fail to start. So far 100 of these complaints have been received, including 14 patient deaths and 13 cases where an explant was necessary, the FDA noted.

“We have been carefully monitoring the adverse events associated with this device and support its removal from the marketplace,” said Bram Zuckerman, MD, director of the Office of Cardiovascular Devices at the FDA’s Center for Devices and Radiological Health, in a statement.

Medtronic now advises physicians to immediately stop new implants of the HeartWare device, but does not recommend explants.

The company is working on a plan for ongoing support of the some 4000 patients around the world who currently have this LVAD. It received commercial approval for use in the US in November 2012.

The FDA named Abbott’s HeartMate 3 as one alternative LVAD for patients with end-stage heart failure. This device features a magnetic levitation system that keeps the rotor separate without mechanical contact.

“The FDA is working closely with both Medtronic and Abbott to ensure patient care is optimised during this transition period and that there is an adequate supply of devices available to provide this patient population with options for end-stage heart failure treatment,” said Dr Zuckerman.

In a separate press release, Abbott reassured the public that it has the ability to meet increased demand for MCS devices as a result of HeartWare withdrawal from clinical use.

Source: MedPage Today