Year: 2020

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HIV Prophylactic Injection 9 Times More Effective than Oral Administration

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According to The Citizen, researchers have reported that pre-exposure prophylaxis (PrEP) in the form of an injection once every eight weeks was 9 times more effective than a daily oral pill in preventing HIV contraction. The daily pill is currently the standard PrEP available to the public.

Dr Sinead Delany-Moretlwe, director of research at the Wits Reproductive Health and HIV Institute (Wits RHI), said, “We know that adherence to a daily pill continues to be challenging, and an effective injectable product such as a long-acting CAB [cabotegravir injection] is a very important additional HIV prevention option for them. We are grateful to the women who volunteered for this study and the research staff, as this study would not have been possible without their commitment to HIV prevention.”

The HIV Prevention Trials Network (HPTN) took place over several years, measuring the effectiveness of PrEP in preventing the contraction of HIV.  3223 cisgendered women with an average age of 26 were enrolled in the study in South Africa, Botswana, Eswatini, Kenya, Malawi, Uganda and Zimbabwe. The trial found that of 38 women who contracted HIV, four were receiving the injection while the remainder were using the oral pill.

Executive director of Wits RHI, Professor Helen Rees, said, “These results are a milestone for prevention of HIV among women at risk worldwide and especially for women in sub-Saharan Africa. If we are to turn the tide on the HIV epidemic, we will need prevention options that work for women in sub-Saharan Africa. These findings provide great hope and motivation for additional studies to show safety and acceptability in adolescents, pregnant and breastfeeding women.”

The game-changing medication will not be available to the public until further testing is completed. 

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Benefits of Cutting Cholesterol for Elderly Increase with Age

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A pair of new studies in The Lancet found that the effects of low-density lipoprotein (LDL) lowering agents reduced the number of serious cardiovascular events in geriatric patients.

Taking data on over 90 000 individuals in Denmark, an observational study followed patients for 7.7 years, with LDL cholesterol levels as well as first heart attacks or strokes recorded.

The researchers found that people aged 70-100 without a previous cardiovascular event benefited more from taking cholesterol-lowering medications in terms of preventable cardiovascular events.

People aged 80-100 had the highest incidence of heart attacks, at 8.5 per 1000 person-years.

Børge Nordestgaard, joint author of the first study, of the Copenhagen University Hospital, said, “Our study provides further evidence for the cumulative burden of LDL cholesterol over a person’s lifetime and the progressive increase in risk for heart attack and cardiovascular disease with age. With the proportion of people living beyond 70 years of age worldwide rapidly increasing, these data point to the huge potential for primary prevention strategies aimed at lowering LDL cholesterol levels to reduce the population burden of heart disease. The findings should guide decision making about whether older individuals will benefit from statin therapy.”

A separate review and meta-analysis revealed that cholesterol-lowering therapies are as effective as preventing heart attacks in older patients as they are in younger ones. Analysing data from 29 randomised controlled trials, they found that for every reduction of 1mmol/L of HDL cholesterol, the relative risk of major cardiovascular events in patients over 75 years was reduced by 26%. For patients under 75 years, the reduction was 15% per 1mmol/L of HDL-cholesterol.

Source: HCP Live

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Exoskeleton Technology Evaluated for Nursing Care

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A new article from the journal Ergonomics in Design reported on research by Tampere University into how exoskeleton technology can help reduce the physical burden of nurses.

Postdoctoral Research Fellow Tuuli Turja said, “This message from the field led us to investigate what conditions exoskeletons would need to meet in order to reform nursing. Currently, exoskeletons are mainly used in manufacturing and logistics. Isn’t it high time to introduce exoskeletons in female-dominated sectors, where musculoskeletal disorders are rampant?” she continues. “However, in our study, a very different type of mobile and light exoskeleton was worn by nurses in patient care.”

Two studies evaluated the Laevo Exoskeleton, which is a “passive” device designed to distribute loads across the body via interconnected pads on the back, chest and thighs. According to the manufacturer, it is designed to reduce lower back strain by 40 to 50%. For the first study, pairs of nurses helped elderly patients to wheelchairs from their hospital beds, with and without use of the exoskeleton. In the second study, seven nurses wore the exoskeleton in a real care environment.

The results show that although the nurses were amenable to their use, exoskeletons need specific designs when it comes to the challenges of patient care, such as comfort, interactive features and safety to help them through hectic workloads.

Source: Science Daily

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New Plasma Jet Sterilises Surfaces but Doesn’t Get Hot

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Researchers at University of California, Los Angeles (UCLA) have developed a novel way to sterilise surfaces – using a jet of glowing plasma.

The team created a tool which emits plasma, generated from an electric arc and a supply of harmless argon, but only at room temperature. However, their study, testing the plasma jet on a series of different materials, has shown that it can sterilise surfaces of the COVID virus within 30 seconds

Unlike other sterilisation solutions, such as chemicals or UV light, the plasma is completely harmless, with the only inputs being electricity and air – argon makes up 1% of the air we breathe. It was even able to sterilise surfaces such as cardboard, which would be difficult to sterilise with traditional chemicals without slightly damaging it.  

A relatively new technology, “cold” plasma has been used in a variety of medical applications, including cancer surgery, dentistry and wound healing.

Author Richard E. Wirz said the results show that plasma has a great role to play in potentially breaking the transmission of COVID/

“This is only the beginning. We are very confident and have very high expectations for plasma in future work. In the future, a lot of answers for the scientific community will come from plasma,” said Wirz.

Source: Phys.org

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COVID Vaccines May Lose Potency as Virus Evolves

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Looking to a time beyond the development of COVID vaccines, researchers are attempting to determine how long the SARS-CoV-2 virus will take to develop resistance to those vaccines.

David Kennedy, assistant professor of biology at Pennsylvania State University said, “A COVID-19 vaccine is urgently needed to save lives and help society return to its pre-pandemic normal,” said David Kennedy, assistant professor of biology. “As we have seen with other diseases, such as pneumonia, the evolution of resistance can quickly render vaccines ineffective. By learning from these previous challenges and by implementing this knowledge during vaccine design, we may be able to maximise the long-term impact of COVID-19 vaccines.”

The researchers recommend that vaccines be designed to create multiple immune responses, making it harder for the vaccine to survive the immune system’s attack, much the way multiple antibiotics are used to suppress bacterial infections, by forcing the virus to have multiple mutations to survive.

Strongly suppressing virus transmission through the host is key to minimising the amount of mutation and thereby the lifespan of the vaccine’s  effectiveness.

“According to the World Health Organization, at least 198 COVID-19 vaccines are in the development pipeline, with 44 currently undergoing clinical evaluation,” said Kennedy. “We suggest that the risk of resistance be used to prioritise investment among otherwise similarly promising vaccine candidates.”

Source: SciTech Daily

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Melatonin: Possible New Drug in COVID Fight

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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

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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

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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

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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

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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.