Month: March 2021

Categories : Mental Health PaediatricsTags :

Playing with Ultra-thin Dolls Skews Girls’ Ideal Body Size

On By ModernMedia

A small-scale study led by Durham University in the UK, has shown that play with ultra-thin dolls may negatively affect body image in girls as young as five years old.

The researchers warn that the dolls, combined with exposure to ‘thin ideals’ in the media, could lead to body dissatisfaction in young girls, which has been shown to be a factor in the development of eating disorders. A Dutch study showed that girls randomised to receive an ultra-thin doll to play with ate less than those who received a realistic adult doll.

The study had 30 girls aged between 5-9 years old play with an ultra-thin doll, a realistic childlike doll or a car. Before and after each play session, the girls were asked about their perceived own body size and ideal body size via an interactive computer test using pictures.

Playing with the ultra-thin dolls reduced girls’ ideal body size immediately after play. There was no improvement even when they subsequently played with the childlike dolls or cars afterwards, demonstrating that playing with other toys cannot quickly counteract the effects. The realistic children’s dolls had a neutral effect on body ideals.

Lead author Professor Lynda Boothroyd, from Durham University’s Department of Psychology, said: “Body dissatisfaction is a huge problem, particularly amongst young girls. It can have serious consequences for girls’ wellbeing and lead to eating disorders and depression.

“The results from our study indicate that playing with ultra-thin dolls, which are sold in the millions each year, could have a real negative impact on girls’ body image. This is on top of all the images of unrealistic body sizes they see on TV, in films and on social media. This is something that needs to be addressed in order to reduce the pressure on girls and women to aspire to a ‘thin ideal body’.”

The psychologists had found in previous research that the more TV we watch, the more we prefer thinner female bodies. Of the girls who took part in the study, 80% said they had ultra-thin dolls at home or with their friends, and nearly all watched films which tend to portray very thin female bodies. Dolls available in shops tend to have a projected BMI of 10 to 16 (underweight). The study used realistically proportioned dolls resembling healthy children of 7 and 9.

Dr Elizabeth Evans, from Newcastle University’s School of Psychology, said: “This study isn’t intended to make parents feel guilty about what’s in their child’s toy box, and it certainly isn’t trying to suggest that ultra-thin dolls are ‘bad’.

“What our study provides is useful information that parents can take into account when making decisions about toys. Ultra-thin dolls are part of a bigger picture of body pressures that young children experience, and awareness of these pressures is really important to help support and encourage positive body image in our children.”

The study, though small, tested the children before and after doll play, an unusual approach which nevertheless adds to growing evidence that doll play affects young girls’ beauty ideals.

Professor Martin Tovee, from Northumbria University’s Department of Psychology, said: “Our study shows how perception of ideal body size and shape is moulded from our earliest years to expect unrealistic ideals. This creates an inevitable body image dissatisfaction which is already known to lead towards disordered eating.”

Source: Medical Xpress

Journal information: Can realistic dolls protect body satisfaction in young girls?, Boothroyd et al, Body Image, 11 March 2021.

Categories : General Interest TransplantsTags :

Teen Embraces Chance to ‘Live Well’ With Kidney Disease

On By ModernMedia

Thanks to a young organ donor, Bronwen Fredericks has a new kidney that she and her mother Bridget are deeply thankful for.
The 15-year-old was one of two patients at Red Cross War Memorial Children’s Hospital who received their new kidneys last month. With a new chance at their childhoods, they have a chance to embrace the spirit of “Living Well with Kidney Disease”, the 2021 theme for World Kidney Day tomorrow. 

Bronwen said: “I’m really grateful to my donor and excited for my new life. I’m really looking forward to being able to dance again.”

According to her mother, a blood pressure test had alerted them to the problem.

“I would like to encourage everyone, especially parents, to do a regular general check-up with their children at a clinic or GP. A simple blood pressure test could show us that there was a serious problem and we were able to take action that saved my daughter,” she said.

“Irrespective of age, being diagnosed with kidney disease can pose a huge challenge for the patient and their family. It remains draining on those involved, be it emotional, financial, physical or a combination of these – but imagine the impact on a young child,” the Red Cross War Memorial Children’s Hospital said in a statement on Wednesday.  The hospital conducts around 10 to 12 kidney transplants a year.

The Red Cross Hospital said it is aiming to reduce stress factors through education, empowerment and by building a partnership with patients and their families.

“The diagnosis and management, particularly in the advanced stages of kidney disease, impacts severely upon the lives of our young patients by reducing their ability to participate in everyday activities like attending school, participating in extra-curricular activities and socialising, whilst the whole family’s ability to travel and parents ability to work is also affected,” said Dr Deveshni Reddy, ‎paediatric nephrologist at the hospital.

Current management includes dialysis to take the strain off of kidneys, and in more extreme cases, donor transplants.
Professor Mignon McCulloch, the hospital’s head of paediatric nephrology and solid organ transplantation, said: “While we always try our best to treat chronic kidney disease and other kidney disorders through medical intervention, sometimes a surgical intervention, or dialysis and resultant kidney transplant, is the only option.

“The Red Cross War Memorial Children’s Hospital conducts around 10-12 kidney transplants per year, making it one of the most active paediatric transplant services in South Africa, which is only possible due to the close collaboration with the multi-disciplinary role-players from Groote Schuur Hospital and Red Cross.”

Source: IOL News

Categories : COVID HospitalsTags :

Brazil’s Hospitals Are on The Brink of Collapse

On By ModernMedia

Health systems in most of Brazil’s largest cities are close to collapse because of COVID cases, its leading health institute Fiocruz warns.

More than 80% of intensive care unit beds are occupied in the capitals of 25 of Brazil’s 27 states, Fiocruz said.  The highly contagious variant that emerged in Brazil may have serious knock-on effects for the rest of the world, health experts have warned.

In a stark warning, Fiocruz epidemiologist Jesem Orellana told AFP news agency that  “Brazil is a threat to humanity.”

Brazil’s President Jair Bolsonaro had already provoked outrage among his citizens and rebukes from local leaders by telling people to “stop whining” about COVID. The country recorded 1972 COVID deaths on Tuesday, along with a surge to 70 000 cases — a 38% increase on last week’s figure. ICUs at 15 state capitals are at 90% capacity, said Fiocruz, and in two cities, Porto Alegre and Campo Grande, they had exceeded capacity.

“The fight against COVID was lost in 2020 and there is not the slightest chance of reversing this tragic circumstance in the first half of 2021,” Fiocruz’s Jesem Orellana said, as quoted by AFP.

“The best we can do is hope for the miracle of mass vaccination or a radical change in the management of the pandemic. Impunity in management seems to be the rule.”

Of the currently available vaccines, so far Pfizer’s has been confirmed to be effective in lab tests against a specially engineered version of the virus made to mimic the variant.

Source: BBC News

Categories : CancerTags :

No Survival Benefit Seen for PD-1 Inhibitor in Triple-negative Breast Cancer

On By ModernMedia

Results of a large randomised trial showed no survival improvement in previously treated metastatic triple-negative breast cancer (TNBC) with single-agent pembrolizumab versus chemotherapy.

Eric Winer, MD, of Dana-Farber Cancer Institute in Boston, presented findings from his team’s randomised trial KEYNOTE-119, which compared pembrolizumab monotherapy versus single-agent chemotherapy as second or third-line therapy for metastatic TNBC. Investigators randomised 622 patients to the two treatment arms. The primary analysis in patients with a PD-L1 combined positive score (CPS) ≥10 showed a median overall survival (OS) of 12.7 months with pembrolizumab and 11.6 months with investigator’s choice of chemotherapy. No significant advantage for pembrolizumab was seen in analyses of patients with CPS ≥1 and the overall population. 

Pembrolizumab led to fewer grade 3/4 treatment-related adverse events (TRAEs). The most common grade 3/4 TRAEs all  more often with chemotherapy, with serious AEs occurring in 20% of each group.
After a median follow-up of 31 months, analysis of the CPS ≥10 subgroup showed the pembrolizumab arm had a non-significant 22% reduction in the survival hazard. The CPS ≥1 analysis yielded median OS values of 10.7 months for the pembrolizumab arm and 10.2 months for the chemotherapy arm. Analysis of the overall population showed a median OS of 9.9 months with pembrolizumab and 10.8 months with chemotherapy. There was some evidence from a post hoc exploratory analysis that pembrolizumab activity might increase with higher CPS values.

“These findings might inform future research of pembrolizumab monotherapy for selected subpopulations of patients, especially those with PD-L1-enriched tumours, and inform a combinatorial approach for the treatment of patients with metastatic triple-negative breast cancer,” the researchers concluded.

The findings are consistent with the history of single-arm anti-PD-1/L1 therapy for breast cancer, said Eitan Amir, MD, and David W Cescon, MD, PhD, both of Princess Margaret Cancer Center in Toronto. In all types of breast cancer, checkpoint inhibitors have produced low response rates, but this has been consistent.

“Given the low response rates observed in the overall population with pretreated triple-negative breast cancer in previous studies of anti-PD-1 or anti-PD-L1 monotherapy, the primary results of KEYNOTE-119 are unsurprising,” they wrote. “Since KEYNOTE-119 was launched, clinical development has focused principally on combinations of chemotherapy and immunotherapy in the first-line setting.”

Drs Amir and Ceson cautioned that the results of the post hoc analysis are intriguing but must be treated with caution.

“The finding that this higher PD-L1 expression threshold might be a predictor of pembrolizumab monotherapy benefit adds to previously observed associations with single-drug immunotherapy benefit, including de novo metastatic disease, absence of previous chemotherapy, normal lactate dehydrogenase, lung or nodal involvement, and absence of liver metastases […] . It would be intriguing to see if similar results can be validated in triple-negative breast cancer,” Amir and Cescon added.

Source: MedPage Today

Categories : HIVTags :

Home Deliveries of Antiretrovirals Worked Better for SA HIV Patients

On By ModernMedia

A study investigating the feasibility of home delivery of antiretroviral therapy (ART) was well received and had significantly more participants achieving viral suppression.

In South Africa, 27% of the population is HIV positive, with viral suppression achieved only in 64% of the population. Post-apartheid healthcare reforms have done little to improve access to healthcare for most South Africans. HIV positive pregnant women, for example, have difficulty achieving viral suppression for a number of reasons including crowded clinics that are often at a great distance.

To investigate the feasibility of home delivery of ART recruited 162 people living with HIV, 88% of those randomised to home delivery experienced viral suppression (defined as viral loads less than 100 copies/ml) compared to 74% of those randomised to clinic visits, reported Ruanne Barnabas, MBChB, DPhil, of the University of Washington. The participants were followed for a median of 47 weeks, even during COVID restrictions.

Dr Barnabas reported that the difference was even more pronounced in men (64% in clinic group vs 84% in delivery group). This is important as there are gaps in viral suppression with standard, clinic-based ART, especially among men and priority populations. Home ART delivery and monitoring can increase access and the intention to treat.

“If a client pays for the service, and the benefits are sufficient, this could become a scalable strategy,” Dr Barnabas said. This could help achieve UNAIDS viral suppression targets for South Africa of 86%, she added.

Dr Barnabas described the home delivery as an Amazon Prime-type service, where clients paid an income-scaled one-time fee, for ART delivery and monitoring.

Viral load testing was a secondary objective while testing of the ability to pay the fee and the acceptability of the service was the primary objective. The participants were from a lower income group, with 19% being labourers or semi-skilled workers, and 60% unemployed.

The participants responded well to the home delivery, with 98% of participants paying the fee, and 100% saying they thought the fee was reasonable, that it reminded them to take their medications, and that they would continue to pay it if delivery was available. The next step would be to see if the service could be financially viable if scaled up. 

Source: MedPage Today

Presentation information: Barnabas R, et al “Fee for home delivery and monitoring of ART raises viral suppression in South Africa” CROI 2021; Abstract 111LB.

Categories : COVIDTags :

How The COVID Variant Was Discovered in South Africa

On By ModernMedia

The so-called South African variant was identified by an international team of researchers, including biomedical scientists from the University of California, Riverside. They explain the process behind discovering the variants, why they are so concerning, and what the future holds.

“The new COVID variants are the next new frontier,” said Adam Godzik, a professor of biomedical sciences in the UC Riverside School of Medicine. “Of these, the SA and Brazil strains are most worrying. They have mutations that make them resistant to antibodies we generate with existing vaccines. It is commonly believed we are in a tight race: Unless we vaccinate people quickly and squash the pandemic, new variants would dominate to the point that all our COVID vaccines would be ineffective.”

Prof Godzik and Arghavan Alisoltani-Dehkordi, a postdoctoral researcher who joined his lab two years ago, helped characterise the new SA variant by providing its spike protein structure using computer simulations.  

Dr Alisoltani-Dehkordi, who was a postdoctoral fellow at the University of Cape Town before she joined UCR, mentioned that research teams at the University of KwaZulu-Natal  and UCT discovered the new SARS-CoV-2 variant from samples collected between October 15 and November 25, 2020, in three provinces. By early November, this variant rapidly became the dominant variant in samples from two provinces. The researchers suggested that this may be due to increased transmissibility or immune escape.

“Each SARS-CoV-2 variant has specific mutations defining it,” Dr Alisoltani-Dehkordi said. “Professor Godzik and I used computer modeling to suggest possible structural and functional consequences of spike protein mutations in the SA lineage. Our analysis, confirmed also by several other research groups, shows that some of the mutations potentially result in a higher transmissibility of the virus and a weaker immune response.”

The SA variant has been detected in 40 countries, and is quite likely present in more still.

“This variant is probably spreading in areas where it has not been sequenced and is, therefore, not identifiable,” Prof Godzik said. “In the US, sequencing is still a slow process. In many parts of the country, including Riverside, we have no information whatsoever about variants.”

The SA variant prompted concern among scientists because its mutations allowed it to evade antibody protection, and potentially, vaccines. Indeed, the AstraZeneca vaccine rollout was halted in South Africa due to the low level of protection against this new variant.

“That’s when it received a high level of interest,” Prof Godzik said. “Subsequent research confirmed it is resistant to vaccines and is spreading. South Africa is doing a good job, however, at controlling the variant through quarantining and other measures.”

Common mutational signatures can be seen in each of the newly emerged SARS-CoV-2 variants of concern in the UK, SA, Brazil, and California. But each of these variants also has a unique set of mutations; for example, the SA and Brazil variants have two unique mutations on spike proteins K417N and E484K, respectively. But, as Prof Godzik explains, there is no single “SA variant”, rather a branch on an evolutionary tree. And viruses can acquire mutations and escape at any time.

Prof Godzik thinks COVID will become a permanent feature of our lives. “It takes six months to develop a flu vaccine,” he said. “Models predict the evolution of the flu virus and vaccines are produced before the variants show up. If the predictions are good, the vaccines work. If they miss, a heavy flu season follows. This is how COVID will likely behave. A lot of effort will be invested in predicting what will happen the following year, vaccines would then be updated, and people will need to get a booster shot.”

Source: University of Riverdale, California

Categories : Immune System New Compounds and TreatmentsTags :

New Compound Can Reduce Inflammation Without Dampening Immune Response

On By ModernMedia

Researchers from Nanyang Technological University (NTU), Singapore, have discovered a compound that is capable of dampening immune overactivity without the cost of reducing the immune response.

The new compound, ASO-1, targets tyrosine kinase 2 (TYK2), a member from the Janus kinase (JAK) family of enzymes involved in immune response regulation. These enzymes have received attention in recent years as targets for drugs to treat immune system overactivity, and TYK2 is a possible therapeutic target for cancer treatment. A recent study found that high levels of TYK2 have been associated with severe COVID.

“Human genetic studies have suggested that deactivating TYK2 could provide protection against a broad range of autoimmune conditions such as rheumatoid arthritis, psoriasis, lupus, and type 1 diabetes,” said Phan Anh, Professor and Interim Director, Institute of Structural Biology, NTU.

Co-lead author Dr Lim Kah Wai, NTU senior researcher, added: “With the UK-led study of critically ill COVID patients published in Nature linking high TYK2 expression to severe COVID, ASO-1 could be a therapeutic agent worth investigating further. We are planning to conduct further pre-clinical work to validate its therapeutic potential.”

The ASO-1 compound designed by the researchers is an antisense oligonucleotide (ASO), which targets messenger RNA (mRNA).  ASO-1 was identified from over 200 potentially effective ASOs designed by the team.  ASO-1 is designed to bind to TYK2 mRNA and prevent the cells from making the TYK2 protein. ASO-1 has to be highly selective for TYK in order to prevent side effects involving other JAK enzymes.

Through in vitro testing, the NTU scientists found that ASO-1 greatly reduced TYK2 levels over a sustained period and inhibited immune signalling pathways associated with autoimmune disorders. This points to the potential of the ASO-1 compound forming the basis for treatment of autoimmune conditions, There was also no effect against the other JAK proteins. Dr Lim noted that this high potency of ASO-1 rivals that of recent ASO drug candidates under development.

The team plans academic collaboration for further development of ASO-1 and animal model testing.

Source: News-Medical.Net

Categories : Diseases, Syndromes and Conditions GeneticsTags :

Diphtheria Resurfacing as a Threat As it Evolves Antibiotic Resistance

On By ModernMedia

Diphtheria is resurfacing as a threat worldwide as it evolves antibiotic resistance and could escape vaccine containment, scientists warn.

Diphtheria cases in recent years have doubled what they were in previous decades, to 16 651 cases in 2018. Although babies are vaccinated against it in high-income countries, there is less coverage in middle- and low-income countries.

Diphtheria is mainly caused by Corynebacterium diphtheriae, spread by coughs and sneezes or close contact with the infected. Usually, the bacteria cause acute infections, driven by the diphtheria toxin—the main target of the vaccine. However, non-toxigenic C. diphtheria can also cause disease.

A team of researchers from the UK and India used genomics to map infections, including a subset from India, where more than half of the globally reported cases occurred in 2018.

Analysing the genomes of 61 bacteria isolated from patients and combining these with 441 publicly available genomes, the researchers were then able to understand how they spread. They also used this information to assess the presence of antimicrobial resistance (AMR) genes and assess toxin variation.

The researchers found clusters to genetically-similar bacteria isolated from different continents, most commonly Asia and Europe. This indicates that C. diphtheriae has been travelling with humans as they spread across the planet.

The diphtheria toxin ch is encoded by the tox gene, for which the researchers found 18 different variations, of which several had the potential to change the structure of the toxin.

Professor Gordon Dougan from the Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID) said: “The diphtheria vaccine is designed to neutralise the toxin, so any genetic variants that change the toxin’s structure could have an impact on how effective the vaccine is. While our data doesn’t suggest the currently used vaccine will be ineffective, the fact that we are seeing an ever-increasing diversity of tox variants suggests that the vaccine, and treatments that target the toxin, need to be appraised on a regular basis.”

First author Robert Will, a PhD student at CITIID, said: “The C. diphtheriae genome is complex and incredibly diverse. It’s acquiring resistance to antibiotics that are not even clinically used in the treatment of diphtheria. There must be other factors at play, such as asymptomatic infection and exposure to a plethora of antibiotics meant for treating other diseases.”

Erythromycin and penicillin are commonly recommended to treat early-stage diphtheria, although there are other classes capable of it. Variants resistant to six of these classes in isolates from the 2010s were identified by the team.

Study leader Dr Ankur Mutreja from CITIID, said: “It’s more important than ever that we understand how diphtheria is evolving and spreading. Genome sequencing gives us a powerful tool for observing this in real time, allowing public health agencies to take action before it’s too late.
“We mustn’t take our eye off the ball with diphtheria, otherwise we risk it becoming a major global threat again, potentially in a modified, better adapted, form.”

Source: Medical Xpress

Journal information: Will, RC et al. Spatiotemporal persistence of multiple, diverse clades and toxins of Corynebacterium diphtheria. Nat Comms; 8 Mar 2021; DOI: 10.1038/s41467-021-21870-5

Categories : Ethics and Law General InterestTags :

Op-ed: Facebook Medical ‘Fact Checking’ Has No Room for Debate

On By ModernMedia

Fact-checking is increasingly important in an era of disinformation on social media, especially with the current COVID pandemic, but an article for MedPage Today calls into question the process for Facebook’s medical fact-checking.

After an op-ed in the Wall Street Journal by Marty Makary, MD, MPH, Johns Hopkins professor and editor-in-chief at MedPage Today, was labelled “misleading” by Facebook fact checkers, another op-ed in MedPage Today asks how the social media giant is choosing its medical fact-checkers. 

Mystified by why this would be labelled “misleading” by Facebook, and setting aside the ‘veracity’ of the article, Vinay Prasad, MD, MPH, a haematologist-oncologist and associate professor of medicine at the University of California San Francisco, investigated the website HealthFeedback.org that Facebook uses to fact-check some of its medical articles. 

The process involves two to four reviewers chosen to examine an article. Prior to the COVID pandemic, medical fact checking appears to have been done by academics, but the flood of disinformation has resulted in the change of this process, Dr Prasad noted.  

In one instance, a reviewer for the article was selected because he had already written an article critical of Dr Markary’s op-ed: in other words, he was selected because he had already announced his bias.

The website’s picking and choosing of reviewers “felt like a high school clique”, Dr Prasad wrote. One that allowed them to confirm their previously held ideas about COVID and extinguish differing viewpoints. Labelling the alternative views as misleading “instantly usurps the reader of their ability to make up their own mind. It is antithetical to the spirit of the academy.”

He found that the fact-checkers typically had large Twitter followings, while the typical medical professor seems to have them in the hundreds. This makes sense, Dr Prasad wrote, as leading academics and authorities are likely too busy to be courting large numbers of followers on Twitter.
Other than a “vague explanation” of the feedback process, Dr Prasad could not find any information on how Facebook chooses its reviewers, which of the billions of posts and articles on Facebook to fact-check, whether anyone is paid and how appeals are made.

Source: MedPage Today

Categories : Obstetrics & GynaecologyTags :

New Study Finds Marijuana THC Persists in Breast Milk

On By ModernMedia


A new study has found that tetrahydrocannabinol (THC) from marijuana can linger in breast milk for up to six weeks after ceasing marijuana use.

Marijuana is the most commonly used dependent substance in pregnancy, with up to half of users continuing through pregnancy. The use of marijuana through pregnancy is likely due to its perceived safety as well as   THC readily crosses the placental barrier, and cannabinoid receptors have been identified in both the placenta and the foetus. However, most studies done on marijuana and pregnancy dates from the 1980s –  this study is the first of its kind to examine the levels of THC in breast milk since one in 1982.

“With the increasing utilisation of marijuana in society as a whole, we are seeing more mothers who use marijuana during pregnancy,” said primary investigator Erica Wymore, MD, MPH, Neonatologist, Children’s Colorado and Assistant Professor of Pediatrics, University of Colorado School of Medicine. “However, given the lack of scientific data regarding how long THC persists in breast milk, it was challenging to provide mothers with a definitive answer regarding the safety of using marijuana while breastfeeding and simply ‘pumping and dumping’ until THC was no longer detectable in their milk. With this study, we aimed to better understand this question by determining the amount and duration of THC excretion in breast milk among women with known prenatal marijuana use.”

The researchers screened women at the Children’s Colorado and UC Health’s University of Colorado Hospital for reported marijuana use or detected THC, who were willing to abstain from marijuana for the six week duration of the study. Of the 394 women screened, 25 enrolled in the study. Seven of these women were able to abstain from their marijuana use, while the others were not able to due depending on it for stress, sleep, and pain relief.

“This study provided invaluable insight into the length of time it takes a woman to metabolise the THC in her body after birth, but it also helped us understand why mothers use marijuana in the first place,” said Maya Bunik, MD, MPH, senior investigator, medical director of the Child Health Clinic and the Breastfeeding Management Clinic at Children’s Colorado and professor of pediatrics at the CU School of Medicine. “To limit the unknown THC effects on foetal brain development and promote safe breastfeeding, it is critical to emphasise marijuana abstention both early in pregnancy and postpartum. To help encourage successful abstention, we need to look at – and improve – the system of supports we offer new moms.”

While the study was not about the impact of maternal marijuana use on childhood development, longitudinal studies dating from the 1980s show that for children born to mothers who smoked marijuana during pregnancy, there are long-term issues with cognitive and executive functioning, including impulsivity, as well as deficits in learning, sustained attention and visual problem-solving skills. One recent retrospective study has also linked marijuana use in pregnancy to autism in children. Dr Wymore points out that this is cause for concern as currently available marijuana has a potency five to six times greater than what was available prior to legalisation.

Source: News-Medical.Net

Journal information: Wymore, E.M., et al. (2021) Persistence of Δ-9-Tetrahydrocannabinol in Human Breast Milk. JAMA Pediatrics. doi.org/10.1001/jamapediatrics.2020.6098.