Day: May 19, 2021

Categories : COVIDTags :

School Closures in NC and All School Contact Sports Suspended

On By ModernMedia

As South Africa awaits an impending third wave, twenty-eight schools in the Northern Cape have had to close as a result of COVID cases this month, while all school contact sports are being suspended.

While infections are on the rise in most provinces, Northern Cape has 314 patients in hospital with COVID, according to information from the National Institute for Communicable diseases.

“Since 1 May we can report that 28 schools in the Province have been directly affected due to COVID-19 cases,” the department said in a statement on Wednesday.

The department said that those schools were closed for disinfecting and those who were infected with COVID were isolated.

“To date, 13 schools still remain closed and will reopen once it is safe to do so. The department also recorded from 1 May to date, 124 positive cases that were reported at schools thus impacting on valuable learning and teaching time being lost.”

Four schools in the small town of Calvinia were also closed earlier this year to contain rapidly spreading COVID infections.

The provincial education department’s Geoffrey van der Merwe called on communities to be even more vigilant and follow COVID safety protocols.

“District offices developed recovery plans for these schools to ensure that the academic performance of learners are not negatively affected,” he said.

Since the second phase of the programme kicked off this week, a mere 329 people in the province have so far received a COVID vaccine shot. So far approximately 9500 healthcare workers in the Northern Cape have been vaccinated.

No more rugby

Meanwhile, all contact sport at South African schools has been suspended with immediate effect.

This was decided on by the Council of Education Ministers  in a virtual meeting held on Wednesday morning .

However, the Department of Basic Education said non-contact sport training in schools could continue, on the condition that all social distancing, hygiene and safety measures would be adhered to and that there was no physical contact between participants during training.

Source: Eyewitness News

Categories : Diseases, Syndromes and ConditionsTags :

SA Study Finds That Influenza is Widely Spread by Asymptomatic Cases

On By ModernMedia
Image by Arek Socha from Pixabay

A new study investigated the prevalence and transmission of influenza in rural and urban South Africa communities.

The study was conducted by the National Institute for Communicable Diseases (NICD), Perinatal HIV Research Unit (PHRU), WITS Agincourt HDSS in partnership with the US Centers for Disease Control and Prevention (CDC), who also funded the study. 

Influenza, a communicable viral disease caused by a spectrum of influenza viruses, affects the upper respiratory tract, including upper and lower respiratory passages. The virus can be transmitted in droplets from coughing, talking or sneezing, and through touching contaminated surfaces.

Researchers enrolled 100 rural and urban households in South Africaeach year and observed them for 10 months. Systematic twice-weekly nasopharyngeal sampling of all household members were conducted, with samples tested by polymerase chain reaction (PCR) for influenza. A total of 81 430 samples were collected from 1116 participants in 225 households, out of which 917 (1%) tested positive for influenza and 79% of households (178/225) had ≥1 influenza-positive individual.

The burden of was high in a rural and an urban African setting, the study revealed, with over three-quarters of households and more than one in three individuals experiencing at least one flu infection each year. It is important to note that the flu incidence risk was similar between the rural and urban areas who participated in the study. The study also showed that recurring flu infections in the same annual flu epidemic, particularly in children, were a common occurrence, accounting for 15% of those infected. Young children also experienced the highest burden of flu infection and symptomatic illness — and compared to other age groups, they were more likely to spread the flu to others in their household.

In addition, the study also revealed that slightly over half of the flu infections were symptomatic. Asymptomatic individuals were also able to spread flu, transmitting the flu to approximately 6% of household contacts. For this reason, authors of the study believe asymptomatic infections to be an important driver of flu transmission.

Medically attended influenza-associated influenza like illness (ILI), defined as a fever and cough as captured by the World Health Organization-recommended flu surveillance programs, suggests the prevalence of flu within communities may be much higher than observed at healthcare facilities. Understanding the community burden and transmission of seasonal influenza is crucial for vaccination programmes and non-pharmaceutical interventions, as well as pandemic preparedness.

In conclusion, the study provides important data on the community burden of flu and transmission thereof in an African setting, a topic that hasn’t been adequately explored. It also contributes important findings relating to symptomatic and asymptomatic flu transmissions, and has implications for the use of non-pharmaceutical interventions and vaccination strategies that target children.

A similar study to examine the burden and transmission of SARS-CoV-2 in the same communities including the role of asymptomatic infections in the spread of SARS-CoV-2 was initiated in July 2020 and results of this study are expected in the coming months.

Source: National Institute for Communicable Diseases

Categories : Cardiovascular Disease PaediatricsTags :

New Model for Blood Clot Prediction in Children

On By ModernMedia

Monroe Carell Jr Children’s Hospital at Vanderbilt has launched a study to test out a predictive model for identifying paediatric patients at risk for developing blood clots or venous thromboembolisms.

The study examined the use of advanced predictive analytics to predict the development of blood clots in paediatric patients at risk for them.

“Hospital-associated blood clots are an increasing cause of morbidity in paediatrics,” said the study’s principal investigator, Shannon Walker, MD, clinical fellow of Paediatric Haematology-Oncology at Children’s Hospital.

Though they are rarer events in children than in adults, morbidity and mortality is higher and Dr Walker nevertheless noticed that blood clot development in children was on the rise.

“The reason children get blood clots is very different from adults,” said Dr Walker.
“There was no standardised protocol for preventing clots in paediatric patients. As we noticed that the rate of blood clots was going up and recognised that the adult strategy wasn’t going to work for our patients, we wanted to look at each patient’s individual risk factors and see how we could focus our attention on targeted blood clot prevention.”

The study, which will be published in Pediatrics, describes how the team built and validated a predictive model that can be automated to run within the electronic health record of each patient admitted to the hospital.

The model includes 11 risk factors and was based on an analysis of more than 110 000 admissions to Children’s Hospital and has been validated on more than 44 000 separate admissions.

Currently the team is studying using this model along with targeted intervention in the clinical setting in a trial called “Children’s Likelihood of Thrombosis,” or CLOT.

The prediction model follows this procedure: every child admitted to the hospital has a risk score calculated. The patients are randomised, so in half of the patients, elevated scores are reviewed by a hematologist, and then discussed with each patient’s medical team and family to determine a personalised prevention plan. All patients, regardless of their assigned group, continue to receive the current standard of care.

“We are not utilising a one-size-fits-all plan,” said Walker. “This is an extra level of review allowing for a very personalized recommendation for each patient with an elevated score. Each day the score is updated, so as risk factors change, the scores change accordingly.

“We are, in real-time, assessing the use of this model as a clinical support tool. We saw a clinical opportunity of something we could improve and have moved forward with building the model—to identify high-risk patients and are currently performing the CLOT trial, which will run through the end of the year.”

The Advanced Vanderbilt Artificial Intelligence Laboratory (AVAIL) was instrumental in Walker’s study. Only in its second year, the programme is leading the way in supporting artificial intelligence tools at Vanderbilt University through project incubation and curation, including facilitating clinical trials to assess their effectiveness.

“AVAIL served as a catalyst, in this instance by bringing experts in a complex trial development into proximity so that a great synthesis could happen,” said Warren Sandberg, MD, PhD, who is executive sponsor of AVAIL, along with Kevin Johnson, MD.

“What is unique about this particular project is that we were not only able to predict complications but also able to test the model in a rigorous, pragmatic, randomized, controlled trial to see if it benefits patients,” said Dan Byrne, senior biostatistician for the project and director of artificial intelligence research for AVAIL.

“The future of this kind of work is unlimited,” he said. “We can hopefully use this approach to predict and prevent pressure injuries, sepsis, falls, readmissions or most any complication before they happen. At Vanderbilt, we are raising the bar when it comes to the science of personalised medicine and application of artificial intelligence in medicine in a way that is both ethical and safe.”

Source: Medical Xpress

Categories : Gender Neurodegenerative DiseasesTags :

High Blood Pressure Dementia Risk Found for Women

On By ModernMedia
Image by Steve Buissinne from Pixabay

Differences in blood pressure’s influence on dementia risk in men and women may provide clues to help slow the rapid progress of the disease, according to new research.

In a study involving half a million people, researchers found that although the link between several mid-life cardiovascular risk factors and dementia was similar for both sexes, for blood pressure it was not. Low and high blood pressure were both shown to be associated with a greater risk of dementia in men, but for women the risk of dementia increased as blood pressure went up.

Lead author Jessica Gong said that while more research was needed to verify these findings, they may point to better ways of managing risk.

“Our results suggest a more tailored approach to treating high blood pressure could be more effective at preventing future cases of dementia,” she said.

Dementia is fast becoming a global epidemic, currently affecting an estimated 50 million people worldwide. This is projected to triple by 2050 – mainly driven by aging populations. Rates of dementia and associated deaths are both known to be higher in women than men.

In 2016 it overtook heart disease as the leading cause of death in Australian women and it is the second leading cause of death for all Australians.

With no treatment breakthroughs of any significance, the focus has therefore been on cutting the risk of developing the disease. Cardiovascular risk factors are increasingly recognised as contributors to different types of dementia.

To explore differences in major cardiovascular risk factors for dementia between the sexes, George Institute researchers accessed data from the UK Biobank, a large-scale biomedical database that recruited 502 489 dementia-free Britons 40-69 years old between 2006 and 2010.

They found that, to a similar degree in women and men, smoking , diabetes, high body fat levels, prior stroke history, and low socio-economic status were all linked to a greater risk of dementia.

But when it came to blood pressure, the relationship with dementia risk between the sexes was different. Although the reason for this wasn’t clear, the authors proposed some possible explanations.

“Biological differences between women and men may account for the sex differences we saw in the relationship between blood pressure and the risk of dementia,” said Ms Gong.

“But there may also be differences in medical treatment for hypertension. For example, women are less likely to take medication as prescribed by their healthcare provider than men and may be taking more medications and experiencing more side effects.”

While there are no effective treatments for dementia, trying to reduce the burden of the disease by encouraging healthier lifestyles is the priority, and the strongest evidence points to blood pressure management.

“Our study suggests that a more individualised approach to treating blood pressure in men compared to women may result in even greater protection against the development of dementia,” said study co-author Professor Mark Woodward.

“It also shows the importance of ensuring sufficient numbers of women and men are recruited into studies and that the data for women and men should be analysed separately,” he added.

Source: George Institute

Categories : Genetics NeurologyTags :

Researchers Close in on Genetic Cure for Congenital Deafness

On By ModernMedia

Researchers are a step closer in the quest to use gene therapy to enable people born deaf to hear, having uncovered a new role for a key protein.

The study, published in Molecular Biology of the Cell, focused on a large gene responsible for an inner-ear protein called otoferlin. Otoferlin mutations are linked to severe congenital hearing loss, a common type of deafness in which patients can hear almost nothing.

“For a long time otoferlin seemed to be a one-trick pony of a protein,” explained Colin Johnson, associate professor of biochemistry and biophysics in the Oregon State UniversityCollege of Science. “A lot of genes will find various things to do, but the otoferlin gene had appeared only to have one purpose and that was to encode sound in the sensory hair cells in the inner ear. Small mutations in otoferlin render people profoundly deaf.”

Because the otoferlin gene is too big as it normally is to package into a delivery vehicle for molecular therapy, Prof Johnson’s team explored the use of a shortened version.

Research led by graduate student Aayushi Manchanda showed the shortened version needed to have part of the gene known as the transmembrane domain, for a surprising reason: without it, the sensory cells matured slowly.

“That was surprising since otoferlin was known to help encode hearing information but had not been thought to be involved in sensory cell development,” Johnson said.

For years, scientists in Prof Johnson’s lab have been working with the otoferlin molecule and in 2017 they identified a shortened form of the gene that can function in the encoding of sound.

To find out if the transmembrane domain of otoferlin needed to be part of the shortened version of the gene, Manchanda shortened the transmembrane domain in zebrafish.

Zebrafish are a small freshwater species that is very popular as a research organism. They grow rapidly, from a cell to a swimming fish in about five days, and share a remarkable similarity to humans at the molecular, genetic and cellular levels due to the conservation of mammalian genes early in their evolution. Embryonic zebrafish are transparent and easily maintained, and are amenable to genetic manipulation.

“The transmembrane domain tethers otoferlin to the cell membrane and intracellular vesicles but it was not clear if this was essential and had to be included in a shortened form of otoferlin,” Manchanda said. “We found that the loss of the transmembrane domain results in the sensory hair cells producing less otoferlin as well as deficits in hair cell activity. The mutation also caused a delay in the maturation of the sensory cells, which was a surprise. Overall the results argue that the transmembrane domain must be included in any gene therapy construct.”

At the molecular level, Manchanda found that a lack of transmembrane domain led to otoferlin not properly linking the neurotransmitter-filled synaptic vesicles to the cell membrane, resulting in less neurotransmitter being released.

“Our study suggests otoferlin’s ability to tether the vesicles to the cell membrane is a key mechanistic step for neurotransmitter release during the encoding of sound,” Manchanda said.

Source: EurekaAlert!

Categories : COVIDTags :

Indian States Turn to Ivermectin Amid COVID Crisis

On By ModernMedia
Image by Steve Buissinne from Pixabay

Two Indian states have decided to distribute the controversial anti-parasitic drug ivermectin as a preventative measure, MedPage Today reports.

Goa, on the west coast, and Uttarakhand, a northern state in the Himalayas, will give the anti-parasitic to wide swaths of their population as a preventative measure in hopes of preventing future outbreaks.

Leaders of both states insisted that their recommendations were evidence-based. “An expert medical panel has recommended this,” Om Prakash, chief secretary of Uttarakhand, told Reuters. Vishwajit Rane, health minister of Goa, also said an expert panel from Europe found the drug shortened recovery time and reduced the risk of death, the news agency reported.

Yet no large randomised controlled trial has proven the drug’s efficacy against COVID, and no prominent health group — the NIH and the WHO among them — has recommended the drug in treatment or prophylaxis.

The use of ivermectin for COVID has been the subject of bitter debate in South Africa, and human administration of ivermectin was approved for compassionate use with guidelines released in January. Following a court order, pharmacists and doctors in South Africa are allowed to make up small batches of medicines containing Ivermectin on prescription by a doctor and in small quantities, and can be used.

Madhu Pai, MD, PhD, professor of epidemiology and global health at McGill University in Montreal, tweeted a link to guidelines developed by collaborators in the UK and India, led by Cochrane and Christian Medical College Vellore in the southern state of Tamil Nadu.

On May 15, the group updated their guidance to state that it recommends “against using ivermectin for treatment of patients with any severity of COVID-19. Ivermectin should only be used in the context of a randomized controlled trial.”

Officials in Goa said the state will give ivermectin tablets to anyone aged 18 or over. Through most of the recent COVID surge, the popular tourist destination has remained open to holidaymakers, only imposing a 15-day lockdown last week.

Meanwhile, Uttarakhand plans to distribute the drug even more widely, giving it to anyone over age 2, with the exception of pregnant and lactating women, according. The state has been struggling with high caseloads, which rose from under 300 a day in early April to more than 7000 a day last week, Reuters reported.

The state recently hosted Kumbh Mela, a huge festival which drew millions of people from across the country for a two week long celebration including bathing in the river Ganges. Reports indicated many people did not wear masks and were closely packed. This became a massive superspreader event, with cases all over India being traced to it. Some districts of Madhya Pradesh reported that 20% of cases were festival returnees.

Goa and Uttarakhand’s moves have not gone unnoticed by ivermectin advocates. The Front Line COVID-19 Critical Care Alliance, a long time champion of the drug, paid scant attention to the difference between causation and correlation in a recent tweet on the issue: “Case counts and deaths are falling in India! A close look … shows that the declines occurred as the Health Ministry [sic] began its widespread distribution of #ivermectin.”

Source: MedPage Today