Day: April 19, 2021

Categories : Cardiovascular DiseaseTags :

Aspirin Plus Blood Thinners Isn’t Always Better

On By ModernMedia
Collection of pills. Photo by Myriam Zilles on Unsplash

A new study has confirmed that combining two different blood thinners doesn’t necessarily improve outcomes. 

The new publication examined the minimal pros and the serious cons of combining a daily aspirin with a drug from the newer class of direct oral anticoagulants (DOACs) which include apixaban, dabigatran, edoxaban and rivaroxaban.

Patients were taking DOACs to prevent strokes from non-valvular atrial fibrillation or for the treatment of venous thromboembolic disease (deep vein thrombosis or pulmonary embolism). The included patients lacked another reason to take aspirin, such as a recent history of a heart attack or having had a heart valve replacement. One-third of those taking DOACs

“The patients on combination therapy were more likely to have bleeding events but they weren’t less likely to have a blood clot,” said lead author Jordan Schaefer, MD, an assistant professor of internal medicine and a haematologist at the University of Michigan. “Therefore, it’s important that patients ask their doctors if they should be taking aspirin when they are prescribed a direct oral anticoagulant.”

Combination therapy with an anticoagulant and an antiplatelet may be appropriate for people who have had a recent heart attack, recent coronary stent placement or bypass surgery, prior mechanical valve surgery or known peripheral artery disease, among other conditions, according to co-author Geoffrey Barnes, MD, MSc, an assistant professor of internal medicine and a vascular cardiologist at the Michigan Medicine Frankel Cardiovascular Center.

For the others, “combination therapy may not be happening intentionally; rather, the addition of aspirin might get overlooked because it’s not in any one specialist or general care provider’s territory,” Prof Barnes said.

There are many situations where an aspirin and DOAC combination has been insufficiently studied, and Prof Schaefer added that they are planning a larger, lengthier study since there were insufficient blood clots during the study to assess aspirin’s potential benefit.

Profs Schaefer and Barnes had also previously reported increased adverse outcomes for patients receiving both aspirin and warfarin, which is not a DOAC.

Source: Medical Xpress

Journal information: “Adverse Events Associated with the Addition of Aspirin to DOAC Therapy Without a Clear Indication,” JAMA Internal Medicine. DOI: 10.1001/jamainternmed.2021.1197

Categories : Injury & Trauma PaediatricsTags :

Safety Commission Warns on Peloton Treadmill Hazard to Children

On By ModernMedia

The US Consumer Product Safety Commission (CPSC) has put out a warning for owners of the popular Peloton Tread+ exercise machine following “multiple incidents of small children and a pet being injured beneath the machines.”

The warning comes weeks after Peloton CEO John Foley said a child died in an accident related to the machine. “While we are aware of only a small handful of incidents involving the Tread+ where children have been hurt, each one is devastating to all of us at Peloton, and our hearts go out to the families involved,” he said in a statement.

As a result, the CPSC launched an investigation into the treadmill, one that the commission says remains ongoing. The commission reported that it is aware of 38 other non-fatal safety incidents involving the device.
In the commission’s view, the Peloton Tread+ “poses serious risks to children for abrasions, fractures, and death” resulting from “children becoming entrapped, pinned, and pulled under the rear roller of the product.”

The announcement included a video of a child seemingly pulled underneath the treadmill while playing behind the machine.

The CPSC is advising those with children at home to stop using the Peloton Tread+ treadmill immediately and says that the hazard the machine imposes “cannot be avoided simply by locking the device when not in use.”

“Peloton has not yet agreed to do a recall or a stop sale,” Consumer Product Safety Commission spokesperson Joe Martyak told NPR. He continued, “We hope that will change.”

Generally, product recalls are done on a voluntary basis by companies, in concert with government.

Peloton responded to the CPSC, saying the warning was “inaccurate and misleading.”

“Like all motorized exercise equipment, the Tread+ can pose hazards if the warnings and safety instructions are not followed,” the company said. In response to further questions from NPR about a possible recall, a spokesperson for the company said “a recall has never been warranted.”

The spokesman added that, “The Peloton Tread+ is safe when operated as directed and in accordance with the warnings and safety instructions.”.

Source: NPR

Categories : Diet and Nutrition PaediatricsTags :

Junk Food Impacts Bone Growth in Kids

On By ModernMedia
Burger and chips. Photo by Jonathan Borba on Unsplash

A new study has found that ultra-processed foods (aka junk food) impacts bone quality, showing how damaging these can be especially in younger children.

The Hebrew University study provides the first comprehensive analysis showing the manner in which such foods impact skeletal development.  

Junk foods go through many processing stages, and contain non-dietary ingredients. They are easily accessible, can be eaten without preparation and fairly cheap, and their increasing presence in diets is contributing to worldwide obesity with its associated metabolic impacts.

Children tend to like junk food. As much as 70% percent of their caloric consumption are estimated to come from ultra-processed foods. While numerous studies have reflected on the overall negative impact of junk food, few have focused on its direct developmental effects on children, particularly young children.

Studying lab rodents with skeletons in post embryonic growth stages, they found that those exposed to ultra-processed foods suffered from stunted growth and compromised bone strength. With histological examination, high levels of cartilage were found in the epiphyseal plates at the end of bones. The RNA genetic profiles of cartilage cells exposed to ultra-processed food also showed signs of impaired boned development.

In order to understand how eating habits might impact bone development, the researchers replicated this kind of food intake for the rodents. “We divided the rodents’ weekly nutritional intake—30% came from a ‘controlled’ diet, 70% from ultra-processed foods,” said Monsonego-Ornan. They found that the rodents experienced bone density moderate damage though there were fewer signs of cartilage buildup in their growth plates. “Our conclusion was that even in reduced amounts, the ultra-processed foods can have a definite negative impact on skeletal growth.”

Children and adolescents eat junk foods in great quantities, with half of American minors eating junk food daily. Monsonego-Ornan added. “When Carlos Monteiro, one of the world’s leading experts on nutrition, said that there is no such thing as a healthy ultra-processed food, he was clearly right. Even if we reduce fats, carbs nitrates and other known harmful substances, these foods still possess their damaging attributes. Every part of the body is prone to this damage and certainly those systems that remain in the critical stages of development.”

Source: Medical Xpress

Journal information: Janna Zaretsky et al. Ultra-processed food targets bone quality via endochondral ossification, Bone Research (2021). DOI: 10.1038/s41413-020-00127-9

Categories : AntibioticsTags :

WHO Says New Antibiotic Treatments are Falling Behind

On By ModernMedia

The development projects of new antibiotic treatments are falling behind, despite increasing awareness of the antibiotic resistance threat, according to a recently released report by the World Health Organization. 

The WHO revealed that none of the 43 antibiotics that are currently in clinical development sufficiently address the problem of drug resistance in the world’s most dangerous bacteria.

Dr Hanan Balkhy ,Assistant Director General on AMR, WHO said that, “The persistent failure to develop, manufacture, and distribute effective new antibiotics is further fueling the impact of antimicrobial resistance (AMR) and threatens our ability to successfully treat bacterial infections.”

All of the new antibiotics released onto the market in the past few decades have been variations of those developed in the 1980s.

The impact of AMR is most severely felt in resource-constrained settings and in vulnerable populations such young children. Bacterial pneumonia and bloodstream infections are some of the major causes of childhood mortality under age 5, and about 30% of neonates with sepsis die due to bacterial infections resistant to multiple first-line antibiotics.

WHO puts out its Antibacterial Pipeline Report every year, reviewing antibiotics under development. The report evaluates the potential of the candidates to address the most threatening drug-resistant bacteria outlined in the WHO Bacterial Priority Pathogens List (WHO PPL). Since it began in 2017, this list, which includes 13 priority drug-resistant bacteria, has informed and guided priority areas for research and development.

The 2020 report paints a picture of an almost stalled pipeline with only few antibiotics in recent years receiving regulatory approval. Most of these agents in development have little extra clinical benefit over current ones, with 82% of recently approved antibiotics being derivatives of previous  ones with well-established drug-resistance, and drug resistance to these new ones is expected to emerge rapidly.

The review concludes that “overall, the clinical pipeline and recently approved antibiotics are insufficient to tackle the challenge of increasing emergence and spread of antimicrobial resistance”.

Speeding up development requires innovative approaches. For the first time. the 2020 WHO pipeline report includes a comprehensive overview of non-traditional antibacterial medicines, detailing 27 antibacterial agents in the pipeline. These range from antibodies to bacteriophages and therapies that boost the immune response and weaken bacterial effects.

The report notes that there are some promising products in different stages of development. However, only a fraction of these will ever make it to the market due to the economic and inherent scientific challenges in the drug development process. This, along with the small return on investment from successful antibiotic products, has limited the interest of major private investors and most large pharmaceutical companies.

Only a fraction of the promising products in the pipeline will make it to market because of financial and scientific obstacles in the development process. 

The preclinical and clinical pipelines continue to be driven by small- and medium-sized companies, which often struggle to finance their products through clinical trials and approval.

The COVID pandemic has deepened the global understanding of the health and economic implications of uncontrolled disease, as well as funding gaps, including investments in R&D of antimicrobial medicines and vaccines, while also demonstrating that much can be achieved with political will and sufficient funding.

“Opportunities emerging from the COVID-19 pandemic must be seized to bring to the forefront the needs for sustainable investments in R&D of new and effective antibiotics,” said Haileyesus Getahun, Director of AMR Global Coordination at WHO. “Antibiotics present the Achilles heel for universal health coverage and our global health security. We need a global sustained effort including mechanisms for pooled funding and new and additional investments to meet the magnitude of the AMR threat.”

To address funding challenges in antibiotics development, WHO partnered with the Drugs for Neglected Diseases intitive (DNDi) to set up the Global Antibiotic R&D Partnership (GARDP) to develop promising treatments.

In addition, the WHO has been working closely with other non-profit funding partners such as the CARB-X to “push” and accelerate antibacterial research. Another important new initiative is the AMR Action Fund, a partnership by the European Investment Bank. pharmaceutical companies and philanthropies.

Source: News-Medical.Net

Categories : COVIDTags :

Brazil P.1 Variant May Be Twice as Transmissible

On By ModernMedia

Researchers have found evidence suggesting that the P.1 COVID variant could be twice as transmissible as prior strains. The findings were published in the Journal Science.

The P.1 SARS-CoV-2 variant was first detected in four travellers from Brazil during a routine screening at Haneda airport, Tokyo. Manaus, the capital of the state of Amazonas in Brazil was the origin of the variant. According to preliminary investigations, the virus emerged late in 2020, beginning to spread in November and then quickly became the dominant strain. This prompted many to believe that it could reinfect those infected with the initial strain.

Some 70% of the residents in the city were believed to have been infected during the initial infection period. After variant infections rose in Manaus, the P.1 variant soon spread throughout Brazil, and then to other countries—thus far, it has been detected in at least 37 countries.

The researchers used molecular clock analysis to determine that the virus had 17 identifiable mutations and that three spike protein mutations (N501Y, E484K and K417T) allowed the virus to bind more effectively to host cells. These also may help in evading antibodies, and the researchers also found that P.1 can evade immunity granted by prior strains.

In simulations, P.1 was 1.7 to 2.4 times more transmissible than the prior virus baseline, but whether this was due to longer persistence in the body or increased viral load could not be determined. Additionally, it could not be established if it increased disease severity or raised mortality rates. Though people inffected with the variant were 1.2 to 1.9 times as likely to die, this could have been a result of the severe strain the overburdened healthcare systems were experiencing in the city.

More work is needed to find out whether the P.1 strain can infect those infected with prior strains or have been vaccinated, the researchers said.

Source: Medical Xpress

Journal information: Nuno R. Faria et al. Genomics and epidemiology of the P.1 SARS-CoV-2 lineage in Manaus, Brazil, Science (2021). DOI: 10.1126/science.abh2644

Categories : COVIDTags :

Human to Pet Transmission of COVID Virus Common

On By ModernMedia
Girl in a park, wearing mask with two pet dogs. Photo by Helena Lopes from Pexels


A US study uploaded onto the bioRxiv preprint server showed that pets with SARS-CoV-2 likely acquired the virus from humans. 

This suggests that human-animal infection may actually occur much more frequently than previously thought – implying that infected individuals should limit their contact with animals. The paper is currently available on the bioRxiv* preprint server.

Both natural and experimental infections with SARS-CoV-2 have been demonstrated in various species of pets, which includes dogs, cats, hamsters, rabbits, and ferrets. Hamsters, cats and ferrets have been shown to transmit the virus to each other, and dogs are still weakly susceptible to the virus. However, natural infections of pets have almost always resulted from contact with a COVID-infected person.

Since pets share so much space with humans, this is a good use of the One Health approach, a transdisciplinary collaboration aiming for health outcomes through awareness of the interconnectedness between people, animals, plants and their mutual environment.

As part of a COVID household transmission investigation, researchers in the US conducted a One Health appraisal of SARS-CoV-2 infection in pet cohabitants as one of the earliest research endeavours in assessing risk and behavioral factors shared between people and pets.

The study was conducted between April and May of 2020, and mammalian pets from households with at least one individual with confirmed COVID were eligible for inclusion. Detailed descriptions of each animal’s residence were made.

Demographic and exposure information was obtained from all household members. At the same time, the pets were tested with the use of real-time reverse transcription-polymerase chain reaction (rRT-PCR) and neutralisation assays from oropharyngeal, nasal, rectal, fur, faecal, and blood samples.

The small sample size of this study made it difficult to analyse prevention measures in the home, so additional investigations are needed in order to determine the best methods to prevent human-pet COVID transmission.

All oropharyngeal, nasal, and rectal swabs from the tested animals tested negative when rRT-PCR was conducted; however, fur swabs from the one dog tested positive with the use of this molecular method at the first animal sampling. This is actually the first study to detect RNA of a virus from an animal’s fur.

Furthermore, in households where owners withs COVID lived with their pets, 20% had pets with serological evidence of prior SARS-CoV-2 infection, implying some secondary viral transmission. Four dogs and four cats from six households were found to have detectable neutralising antibodies against the virus.

In households with higher rates of human COVID infections, SARS-CoV-2 was more likely to be seen in pets, while much less common when owners limited interactions with their pets after they had developed COVID symptoms.

The authors stressed that it is still important for decision-makers to understand the role of animals in the epidemiology of the pandemic

“Our findings add to the growing body of evidence demonstrating SARS-CoV-2 transmission can occur between people and pets – most often from people to pets – and suggest this transmission may occur more frequently than previously recognized”, wrote the authors of the bioRxiv paper.

Source: News-Medical.Net

Journal information: Goryoka, G.W. et al. (2021). One Health Investigation of SARS-CoV-2 Infection and Seropositivity among Pets in Households with Confirmed Human COVID-19 Cases — Utah and Wisconsin, 2020. bioRxiv. https://doi.org/10.1101/2021.04.11.439379, https://www.biorxiv.org/content/10.1101/2021.04.11.439379v1