Year: 2020

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A Bad Rap? Statins Have “Nocebo” Effect

On By ModernMedia

According to an article by the BBC, new research funded by the Imperial Heart Foundation indicates that a significant portion of statins’ adverse side effects are attributable to the “nocebo” effect. 

Statins are one of the most prescribed tablets in the UK, used to lower low-density lipoprotein (LDL) cholesterol and triglycerides levels, and raise high-density lipoprotein (HDL) cholesterol. The effects help prevent heart attacks and stroke, but nearly a fifth of patients stop taking them due to side effects such as joint pain, muscle ache, fatigue and nausea. In 60 patients were recruited, who had all stopped taking statins due to their adverse effects. On a scale of 0 to 100, those taking placebo tablets reported a similarly high score (15.4) to those taking statins (16.3), compared to a group receiving no tablets (8).  The effect was so strong that many patients discontinued the dummy pills. 

The nocebo effect is the inverse of the placebo effect, where patients experience adverse effects even when they are taking a placebo. This is thought to explain why there is such a high prevalence of penicillin allergies when testing proves otherwise. 

Once the patients were talked through the nocebo effect, most were able to resume statins. It is not known as to why statins have such a powerful nocebo effect, although some attribute this to media creating a “self-fulfilling destiny”.

“If you stopped a man in the street and asked how do you feel about an aspirin or a statin a day, I think people would be much more positive about the aspirin,” said one of the researchers, Dr James Howard.

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Elon Musk Says He May Have COVID

On By ModernMedia

Elon Musk, CEO of SpaceX and Tesla tweeted that he may have COVID, according to Bloomberg.

The 49 year old tech entrepreneur said that so far his symptoms resemble those of a cold. He took four rapid antigen tests, which are cheaper and faster but two of them came back as negative and two came back as positive. He commented that these results were “extremely bogus”.

No stranger to courting controversy, Musk has in the past cast doubts about COVID, even claiming in March that there would be “zero” cases in the United States by April (which currently has recorded 153 496 new daily cases as of writing this article). He then appeared to cast further doubts, saying that the number of cases would “explode” due to the number of false positives.

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Vaping May Increase Respiratory Disease Risk

On By ModernMedia

Research has increasingly been focused on the health effects of vaping, usually touted as a way to quit combustible smoking, and evidence is accumulating for their risks.

Research by Boston University School of Public Health and School of Medicine has revealed that, far from being harmless, vaping may in fact raise the risk for a number of respiratory diseases by 21% for former e-cigarette users and 43% for current users.

Corresponding author Dr Andrew Stokes, assistant professor of global health at Boston University said, “This provides some of the very first longitudinal evidence on the harms associated with e-cigarette products.

“In recent years we have seen dramatic increase in e-cigarette use among youth and young adults which threatens to reverse decades of hard-fought gains,” Stokes said. “This new evidence also suggests that we may see an increase in respiratory disease as youth and young adults age into midlife, including asthma, COPD, and other respiratory conditions.”

Previous research has largely focused on in vitro studies, or short-term studies with human participants. The study used data from 21 618 participants from the nationally representative Population Assessment of Tobacco and Health (PATH) survey. To isolate the effect of e-cigarettes, the researchers adjusted for any form of combustible smoking use, including second-hand smoking.

“With a longitudinal study design and extensive sensitivity analyses, the study adds to a growing body of evidence indicating long-term health risks of e-cigarette use to the respiratory system,” said study lead author Wubin Xie, a postdoctoral associate at Boston University.

Source: Medical Xpress

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Spike Protein Mutation May Be COVID’s Achilles Heel

On By ModernMedia

New research suggests that the very spike protein that makes SARS-CoV-2 so infective may also make it more vulnerable to vaccines. The characteristic “crown” of spikes on the virus gives rise to its “coronavirus” name.

A common mutation in the D614G protein makes a flap open in the spike. This spike makes it easier for the virus to latch onto cells, but this same flap opens a pathway directly into the virus’ core. This makes it easier for antibodies, such as those in the vaccines presently undergoing testing, to infiltrate into the virus, and disable it.

Yoshihiro Kawaoka, a virologist at the University of Wisconsin-Madison, explains: “The original spike protein had a ‘D’ at this position, and it was replaced by a ‘G,’ Several papers had already described that this mutation makes the protein more functional and more efficient at getting into cells.”

This mutation, they found, makes the virus replicate 10 times faster and also makes it more infectious.

When hamsters were exposed to the mutated and unmutated coronavirus strains, the ones infected with the mutated strain were found to transmit the virus much faster than those infected with the unmutated strain. Neither strain seemed to make the hamsters sicker, suggesting that the mutation does not make the virus more lethal. Researchers caution that the animal test results may not hold true for humans, and that constant vigilance in observing and documenting mutations in the SARS-CoV-2 virus is necessary. 

Source: Medical Xpress

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Assisted Hyperventilation: A New Way to Treat Alcohol Intoxication

On By ModernMedia

Alcohol impacts just about every bodily function, from brain function and circulation to nail growth. At high levels, alcohol intoxication can damage organs and lead to death.

According to the World Health Organization, approximately three million people around the world die due to alcohol intoxication each year. 

About 90% of alcohol is processed through the liver at a constant rate, and the only way to speed this up is dialysis. Thus, the only treatment for alcohol intoxication thus far has been to supply oxygen and intravenous fluids, and medications for cardiac support as needed.

The new approach simply adds the lungs to the process: simply by hyperventilating, three times more alcohol could be excreted via the lungs than the liver. 

“But you can’t just hyperventilate, because in a minute or two you would become light-headed and pass out,” explained Dr Fisher, anaesthesiologist and senior scientist at the Toronto General Hospital Research Institute (TGHRI). The decrease in CO2 in the bloodstream is what causes the sensation of light-headedness, as well as tingling in the extremities.

To get around this, the researchers created a simple device which returns the same amount of carbon dioxide to the lungs as was exhaled, no matter the volume of air.

“It’s [a] very basic, low-tech device that could be made anywhere in the world: no electronics, no computers or filters are required. It’s almost inexplicable why we didn’t try this decades ago,” said Dr. Fisher.

Source: Medical Xpress

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Hydroxychloroquine Confirmed Ineffective in the Prevention of COVID

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An article published in The Lancet examines the evidence for the drug hydroxychloroquine’s controversial application as a treatment for COVID, which was initially very encouraging based on the drug in vitro inhibition of the SARS-CoV-2 virus. However, the evidence now definitively shows that hydroxychloroquine is ineffective for COVID.

This would have been very useful if hydroxychloroquine, regularly used to treat rheumatic diseases, could have been used as an easily available treatment.

However, numerous studies since the beginning of the COVID pandemic have reiterated the same findings: that hydroxychloroquine does not reduce mortality risk for people hospitalised with COVID, nor does it shorten recovery times. Nevertheless, interest persisted in the possible preventative effects of hydroxychloroquine against COVID.    

Using electronic health records for 30 569 patients, a study comparing hydroxychloroquine use by rheumatoid arthritis or systemic lupus erythematosus sufferers to non-users with the same maladies reported no significant difference in standardised cumulative COVID mortality associated with hydroxychloroquine use (0.23% among hydroxychloroquine users and 0.22% among non-users) with an adjusted hazard ratio of 1.03 (95% CI 0·80–1·33).

These results reflect those of two studies where hydroxychloroquine was administered as prophylaxis to frontline and health care workers, which also showed no effect.

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‘Flight or Flight’ Brain Region Linked to Heart Disease

On By ModernMedia

Research on marmosets as reported in The Conversation has revealed the role that a region of the brain called sgACC plays in emotional arousal. Over-activity of sgACC was already associated with the dampening of pleasure and reward stimulus, seen in depression. 

A threat was presented to the marmosets in the form of a rubber snake and the marmosets were conditioned with a tone to create an association. The tone was later made without the snake to de-associate it from threat. The experimental group had over-activity induced in sgACC, the control group did not.

They found that marmosets who had not had sgACC over-stimulated responding normally to the de-association, calming down more quickly, but the over-activity group displayed fear and elevated blood pressure for much longer.

The over-activity of sgACC was also linked to abnormal heart function – increased heart rate and reduced variability in heart rate even at rest, without the presence of a threat.

Such changes reflect the presence of anxiety. The abnormal heart rates suggests that sgACC promotes the “flight or fight” response.
Brain imaging showed, with over-activity in sgACC, concurrent increased activity in the amygdala and hypothalamus, and reduced activity in the lateral prefrontal cortex, which is also seen in depression. Ketamine, a drug being investigated to treat depression, was shown to treat the depression aspects of sgACC over-activity, but in this case not anxiety – the marmosets remained fearful to stimulus.

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COVID Cough Droplets Can Travel up to 6.6m

On By ModernMedia

Researchers in Singapore have employed fluid physics to add to the growing body of research surrounding the airborne transmission of the SARS-CoV-2 virus. 

“In addition to wearing a mask, we found social distancing to be generally effective, as droplet deposition is shown to be reduced on a person who is at least one metre from the cough,” said study author Fong Yew Leong.

The researchers found that the results were highly dependent on ambient air characteristics, such as temperature and humidity, as well as assumptions about the viability of the virus

“An evaporating droplet retains the non-volatile viral content, so the viral loading is effectively increased,” said author Hongying Li.

Source: IOL

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Air Pollution May Increase COVID Mortality Risk by 11%

On By ModernMedia

Air pollution, a persistent problem around the world, is known to cause lung diseases, and existing lung diseases are known to exacerbate COVID. According to new research reported on by The Guardian, air pollution has been shown to be a significant factor for dying from COVID – increasing the risk of death by 11%.

The gold standard for assessing an association between COVID and air pollution would be getting a large enough sample of participants and acquiring personal details so that their age, smoking history and other details can be taken into account. However, such levels of individual details are not yet available, so researchers are looking to group studies to provide the data, albeit at reduced quality. Hundreds of group studies are awaiting review, but the evidence so far appears compelling.

Prof Francesca Dominici at Harvard University, the research leader says that there is definitely enough evidence to act on already. “We already have an overwhelming amount of evidence of the adverse health effects of fine particle pollution, so even without Covid, we should implement more stringent regulation. But the amount of [Covid-related] evidence is also big enough now that there is absolutely nothing to lose, and only benefits, to prioritise some of the more vulnerable areas.”

Efforts to help mitigate the effect of air pollution on potential COVID patients could include air pollution reduction measures and distributing PPE in priority areas.

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Eradication of Polio in Africa Boosted Public Health

On By ModernMedia

A story in Medical Xpress discusses the eradication of polio in Africa – officially declared polio-free on August 2020 – and how the campaign for its elimination reaped many other side benefits for public healthcare on the continent.

Polio, alongside smallpox which has now been eradicated worldwide, is one of the great success stories of vaccination: 350 000 people were paralysed by polio in 1988, and in 2019 only 175 people were.

The current effort started in 1996, when African heads of state resolved to eliminate polio on the African continent, and Nelson Mandela launched the “Kick Polio out of Africa” campaign. Collaborations between all sectors of civil society came together to achieve the goal. Vaccination is followed up with surveillance – 3 consecutive disease-free years are needed to certify eradication in an area. Polio was close to eradication 20 years ago, but vaccine hesitancy – a key concern for future COVID vaccination – was spread by misinformation and undermined the efforts.

Africa now has stronger public health systems thanks to the investments made, and developments such as new innovations to deliver vaccines and a renewed demand for vaccine services.