Month: January 2022

Categories : AgeingTags :

Muscles may Stay Younger at an Epigenetic Level through Exercise

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Photo by Kanasi on Unsplash

While the benefits of exercise in ageing have been well established, such as lowering risk of cardiovascular disease, a new study that used mice demonstrated that exercise in aged individuals could help muscles stay younger at an epigenetic level.

Despite generating a wealth of data, the study, which was published in Aging Cell, made use of a relatively straightforward experiment. Lab mice nearing the end of their natural lifespan, at 22 months, were allowed access to a weighted exercise wheel. Mice generally run voluntarily, without any coercion. Older mice will run anywhere from six to eight kilometres a day, mostly in spurts, while younger mice may run up to 10 to 12 kilometres. The weighted wheel ensured they built muscle. While there isn’t a direct analogue to most human exercise routines, first author Kevin Murach, assistant professor at the University of Arkansas, likened it to “a soldier carrying a heavy backpack many miles.”

When the mice were examined after two months of progressive weighted wheel running, it was determined that they were the epigenetic age of mice eight weeks younger than sedentary mice of the same age – 24 months. Murach noted that while the specific strain of mice and their housing conditions can impact lifespans, “historically, they start dropping off after 24 months at a significant rate.” Needless to say, when your lifespan is measured in months, an extra eight weeks – roughly 10 percent of that lifespan – is a noteworthy gain.

The science behind this hinges largely on DNA methylation, where methyl groups attach to DNA, altering their function. As the body ages, there tends to be increased DNA methylation, or even hypermethylation, at promoter sites on genes in muscle. “DNA methylation changes in a lifespan tend to happen in a somewhat systematic fashion,” Murach explained, “to the point you can look at someone’s DNA from a given tissue sample and with a fair degree of accuracy predict their chronological age.” Due to this, researchers can use one of a number of “methylation clocks” to determine the age of a DNA sample.

While the paper strengthens the case for exercise, much work remains to be done. Though there is a clear connection between methylation and ageing, the relationship between methylation and muscle function is less clear. Murach is not yet prepared to say that the reversal of methylation with exercise causes improved muscle health. “That’s not what the study was set up to do,” he explained. However, he intends to pursue future studies to determine if “changes in methylation result in altered muscle function.”

Source: University of Arkansas

Categories : Diseases, Syndromes and ConditionsTags :

A New Method to Block Listeria Infections

On By ModernMedia
Photo by Drew Hays on Unsplash

University of Queensland researchers have unlocked a way of fighting Listeria infections, which can cause severe and potentially illness in pregnant women and immunocompromised individuals.

Listeria infection does not cause disease in most people, but can be deadly for the immunocompromised and is also a major health concern during pregnancy and can lead to miscarriage, stillbirth and premature birth.

From 2017 to 2018, South Africa suffered the world’s largest listeriosis outbreak, in which there were 216 deaths out of 1060 recorded cases.

During the study, published in the journal PLOS Pathogens, researchers discovered a way to block Listeria from making the proteins that allow bacteria to survive and multiply in immune cells. University of Queensland’s Professor Antje Blumenthal said using a small, drug-like inhibitor has improved their understanding of Listeria’s weak spot.

“Listeria is found in the soil and sometimes in raw foods. Once ingested it can hide from the immune system and multiply inside immune cells,” Prof Blumenthal said.

“Instead of killing the bacteria, the immune cells are used by the bacteria to multiply and are often killed by Listeria growing inside them.

“Our study showed the bacteria could be cleared with a small drug-like inhibitor that targets the ‘master regulator’ of the proteins that help Listeria grow in immune cells. The inhibitor helped the immune cells survive infection and kill the bacteria.”

Previously, studies into Listeria’s ‘master regulator’, which controls critical proteins that make the bacteria virulent, have mostly been based on engineered bacteria, or mutated versions of these proteins.

“By using a drug-like inhibitor, we were able to use molecular imaging and infections studies to better understand what happens to Listeria when the bacteria cannot effectively grow inside immune cells and hide from immune defence mechanisms,” Prof Blumenthal said.

“We hope that our discovery, together with recent research into the master proteins’ molecular structure and functions, could guide the development of inhibitors and new drugs to treat Listeria infection.”

“Our findings could also inform design of inhibitors against related proteins that are found in different bacteria,” Prof Blumenthal said.

Source: University of Queensland

Categories : Metabolic DisordersTags :

Simple Dietary Supplement in Type 1 Diabetes Calms Immune System

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Gut microbiome. Credit: Darryl Leja, NIH

A clinical trial performed by Australian scientists showed that a simple dietary supplement that targeted gut microbiota could improve gut health and strengthen the immune system in individuals with type 1 diabetes.

The supplement is a type 2–resistant starch consisting of a high-amylose (70%) maize starch that has been modified by bonding the acetate and butyrate. The supplement is resistant to digestion in the upper gastrointestinal tract and delivers a very high yield of short-chain fatty acids (SCFAs) in the colon. This makes it a useful tool to measure the effect of SCFAs on intestinal biology.

According to senior author and lead investigator Dr Eliana Marino, the study tested 21 adults with type 1 diabetes who incorporated the supplement into their daily diet for six weeks. Increased production of metabolites by the gut microbiota was observed, specifically SCFAs. This has an important role in preventing type 1 diabetes.

“People with 1 diabetes have shown altered gut microbiota and reduced production of short-chain fatty acids in stools and blood. We previously have demonstrated that the supplement used in this human study protected mice from diabetes,” said Dr Marino.

Published in Microbiome, the clinical trial showed that participants’ blood immune cells developed a more regulatory phenotype post-intervention.

“We were very excited to find that blood immune cells had become more regulated. Because type 1 diabetes is caused when the immune system becomes too activated and attacks the insulin-producing cells in the pancreas,” said co-lead researcher Associate Professor Hamilton-Williams.

“Type 1 diabetes is a lifelong autoimmune disease that is on the rise with no cure. Individuals living with type 1 diabetes depend on insulin treatment. As a consequence, they can develop late life-threatening inflammatory complications, such as kidney failure, neurological and cardiovascular diseases,” said co-lead researcher Associate Professor Sonia Saad

“While glucose control and insulin requirements didn’t change overall, the participants with the highest short-chain fatty acid concentrations showed the best glucose control after the supplementation,” said co-lead researcher Dr Kirstine Bell.

“Using this supplement for longer and starting it earlier in the disease could potentially stop the immune attack, preserving insulin-producing cells and improving glucose regulation,” said Dr Marino.

“This dietary supplementation represents a safe and accessible alternative therapy for many children with type 1 diabetes or other autoimmune diseases. Also, it could decrease the risk of subsequent inflammatory complications such as cardiovascular disease as clinical trials are underway,” said Dr Marino.

Source: Monash University

Categories : Lab Tests and ImagingTags :

A New Test to Diagnose Dizziness without Deafening

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Source: Miika Luotio on Unsplash

Swedish researchers have developed a new way to diagnose dizziness problems in a simpler and less painful way than the old method. A bone conduction speaker, easily attached behind the ear, can make the diagnosis more efficient and safer – especially for patients with pre-existing hearing problems.

For patients with dizziness, the relationship of dizziness and hearing is used for diagnosis. Typically, a ‘VEMP’ test (Vestibular Evoked Myogenic Potentials) is performed. With loud sounds, the test evokes a muscle reflex contraction in the neck and eye muscles, triggered by the vestibular system. In their new approach, reported in Communications Medicine, researchers at Chalmers University instead made use of bone-conducted sounds to achieve better results.

“We have developed a new type of vibrating device called B250 that is placed behind the ear of the patient during the test,” said Bo Håkansson, a professor at Chalmers University. “The vibrating device is small and compact in size and optimised to provide an adequate sound level for triggering the reflex at frequencies as low as 250 Hz, which we have found to be optimal for VEMP stimulation. Previously, no vibrating device has been available that was directly adapted for this type of test of the balance system.”

In bone conduction transmission, sound waves are transformed into vibrations through the skull, stimulating the cochlea within the ear, in the same way as when sound waves normally go through the ear canal, the eardrum and the middle ear. This can be used in various technologies such as in hearing aids.

Half of over-65s suffer from dizziness, but the causes can be difficult to diagnose for several reasons. Dizziness in 50% of those cases results from vestibular system problems. But current VEMP methods have major shortcomings and can cause hearing loss and discomfort for patients. The VEMP test uses very high sound levels which can cause permanent hearing damage. Additionally, if certain types of hearing loss are already present, the test can be inconclusive.

“The previous test was like a machine gun going off next to the ear – with this bone-conduction method it will be much more comfortable. The sound levels to which patients are exposed can be minimised. The test can be performed at 40 decibels lower than today’s method, which uses air-conducted sounds through headphones. This eliminates the risk that the test itself could cause hearing damage,” said researcher Karl-Johan Fredén Jansson, who made all the measurements in the project.

“The benefits also include safer testing for children, and that patients with impaired hearing function due to chronic ear infections or congenital malformations in the ear canal and middle ear can still be diagnosed for the origin of their dizziness,” said Prof Håkansson.

The device has now been tested and developed in several patient studies that have been published internationally, both with healthy individuals to obtain normal data, and in patients suffering from various types of dizziness. The device is compatible with standardised equipment for balance diagnostics in healthcare, which makes it easy to use. In addition to the benefits for patients, the cost of the new technology is also judged to be lower than the corresponding equipment used today.

Source: News-Medical.Net

Categories : Ethics and LawTags :

Medical Bodies Push Back against Commission for Gender Equality’s Statement

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Image source: NCI on Unsplash

The South African Medical Research Council (SAMRC), along with other professional medical and scientific institutions released a statement  distancing themselves from the Commission for Gender Equality’s (CGE) press release of 16 January, 2022, titled “Warning Against Imposing Mandatory Covid-19 Vaccination on Employees and Students”. [PDF]

The CGE cited an article published in Obstetrics and Gynaecology which found that women receiving Pfizer-BioNTech, Moderna or J&J COVID vaccines, vaccine administration was associated with less than a one-day change in cycle length for both vaccine-dose cycles compared with pre-vaccine cycles. The article concluded that clinically meaningful change in menstrual cycle duration associated with COVID vaccination was found. 

The CGE used this study as justification, cautioning businesses and institutions against mandatory vaccination and recommended against sanctions for employees who chose to remain vaccinated.

The signatories expressed their concern at the contents of the statement which is at odds with the scientific understanding of COVID vaccinations, a concern which is compounded by the “enormous influence” of the GCE.

They accept that the vaccine mandates are subject to legal scrutiny, but take issue with the commission “trying to bolster its argument by wrongly insinuating that COVID vaccination has the potential to harm women’s health.”

They also point out that the commission seems to disregard the much greater risks to women and their unborn babies of COVID infection, while misinterpreting evidence on minor menstrual cycle lengthening. This creates fear and confusion in vaccinated women, and may increase vaccine hesitancy.

“It fails to appreciate that one in six unvaccinated pregnant women admitted to hospital in South Africa with COVID infection requires mechanical ventilation, and one in 16 has a fatal outcome,” the signatories stated.

They noted that COVID vaccination provides upwards of 80% protection against severe disease, hospitalisation and death.

They endorse the view of the College of Obstetricians and Gynaecologists of South Africa, which draws on research of the highest quality, that the menstrual effects are minor.

The evidence is “indisputable” that COVID vaccination is safe, does not negatively affect women’s bodies and saves the lives of women, they stress. Statements to the contrary are strongly repudiated.

“We are of the view that the CGE, like all state institutions, medical and scientific bodies, social partners and civil society formations working in the fields of women’s rights, empowerment and equality, should urge women to get vaccinated and advance and defend their rights to all relevant information about and access to vaccination.”

The signatories call on the CGE to withdraw its 16 January statement and to share with it scientific facts on COVID vaccination and women’s health.

Source: South African Medical Research Council

Categories : Ageing Neurodegenerative DiseasesTags :

How Many Intervention Sessions to Prevent Cognitive Decline?

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Image by Mar Lezhava on Unsplash

Physical activity, diet and cognitive stimulation are all known to be good interventions for the prevention of Alzheimer’s disease and dementia. Now an international team of researchers has determined that only about a dozen intervention sessions are all that were needed to observe an improvement in cognition.

Until now, the number of sessions or “doses” needed for optimal effect has been unknown. Published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, the study led by Université de Montréal psychology professor Sylvie Belleville showed that between 12 and 14 sessions were all that were needed to boost cognitive ability, though the gain observed levelled off with more sessions.

“In pharmacological studies, every effort is made to define an optimal treatment dose needed to observe the expected effects, “ said Prof Belleville,  a neuropsychologist and researcher at the research centre of the UdeM-affiliated Institut universitaire de gériatrie de Montréal. “This is rarely done in non-pharmacological studies, especially those on the prevention of cognitive decline, where little information is available to identify this dose.

“Defining an optimal number of treatment sessions is therefore crucial.,” she continued. “Indeed, proposing too few sessions will produce no noticeable improvement effects, but too many sessions is also undesirable as these interventions are costly. They are costly both for the individual who follows the treatments, in terms of time and involvement, and for the organisation offering these treatments.”

The study is based on a secondary analysis of data from the three-year Multidomain Alzheimer Preventive Trial (MAPT) and examined 749 participants who received a range of interventions aimed at preventing cognitive decline. These interventions included dietary advice, physical activity and cognitive stimulation.

In their research, Prof Belleville’s team noted that people’s individuality should be considered when determining the optimal treatment dose.

In their study, the researchers gauged the effects of the sessions in terms of each participant’s age, gender, education level, and cognitive and physical condition. The relationship between the “dose” each received and their cognitive improvement was then analysed.

The findings revealed an increase with dose followed by a plateau effect after 12 to 14 sessions. However, participants with lower levels of education or more risk factors for frailty did benefit from more sessions.

The researchers concluded that it’s important to pinpoint an optimal dose and to customise the treatment for each individual. Not only is “dosage” an important component of behavioural interventions, it can also provide valuable information in resource-constrained settings, helping public-health agencies develop effective prevention programs and offer guidance to older adults and clinicians.

Source: University of Montreal

Categories : Medical IndustryTags :

SA Healthcare Bolstered With Vaccine Lab Investment and Loans

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Photo by Louise Reed on Unsplash

Last week, South African healthcare received a double shot in the arm with the opening of a local vaccine manufacturing facility and the approval of a World Bank loan to bolster social safety nets and health systems.

On Wednesday, President Cyril Ramaphosa and health technology billionaire Dr Patrick Soon-Shiong officially opened a new vaccine manufacturing facility in Brackenfell, Western Cape.

The South African-born entrepreneur has been strongly supporting local healthcare, with R3 billion invested to help SA share vaccine technology with the rest of Africa. His company, ImmunityBio, is developing a T-cell based universal COVID vaccine, currently in Phase III trials in SA. The same adenovirus vector technology it uses is also being tested in cancer vaccines.

“It has been a dream of mine, since I left the country as a young physician, to bring state-of-the-art, 21st century medical care to SA and to enable the country to serve as a scientific hub for the continent,” Dr Shoon-Siong had previously said. The technology transfer will help “establish much-needed capacity and self-sufficiency.”

The hub will transfer technology, know-how and materials for DNA, RNA, adjuvant vaccine platforms and cell therapies to SA.

“There is no reason we couldn’t make 500 million doses a year,” said Dr Soon-Shiong, who is also a Wits alumnus. “Subject to the raw material being available.”

He said he wants to tap the country’s expertise on prevalent diseases such as HIV and cervical cancer. “There are fantastic scientists with deep knowledge about these diseases,” he said. “More so than in America because they see these patients every day.”

President Ramaphosa and Dr Soon-Shiong also launched the Coalition to Accelerate Africa’s Access to Advanced Healthcare, which aims to drive the development of innovative therapeutics and ensure the continent is prepared for future pandemics.

The coalition aims to manufacture a billion doses of the COVID vaccine by 2025 and to develop treatments for conditions including cancer, COVID, tuberculosis and HIV.

South Africa also received approval from the World Bank for a US$750 million COVID relief loan aimed at reducing the worst of the pandemic’s impact on the poor.

“The World Bank budget support is coming at a critical time for us and will contribute towards addressing the financing gap stemming from additional spending in response to the COVID crisis,” said Dondo Mogajane, Director General of the National Treasury. “It will assist in addressing the immediate challenge of financing critical health and social safety net programs whilst also continuing to develop our economic reform agenda to build back better.”

Meanwhile, Health Minister Dr Joe Phaahla warned that South Africa will likely enter a fifth wave when cold temperatures in May, though what COVID variants may drive it remain to be seen.

Categories : Injury & TraumaTags :

K-Wires for Wrist Fractures on Par with Cast

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Photo by Cottonbro on Pexels


Using metal K-wires (aka ‘pins’) to hold broken wrist bones in place while they heal are no better than a traditional moulded plaster cast, finds a study published by The BMJ.

If the bone fragments in wrist fractures have displaced, they often require manipulation followed either by surgery to insert metal wires or plates, or a moulded cast as a non-surgical alternative, to hold the bones in place while they heal.

Surgery is expensive and carries risk for the patient, whereas a moulded plaster cast is cheaper but may not provide the same functional outcome.

To see which option is superior, researchers tracked the progress of 500 adults, average age of 60 and 83% female. with a displaced wrist fracture. Patients were randomly allocated to receive a cast (255) or surgical fixation with K-wires (245) after manipulation of their fracture. The primary outcome measure was the Patient Rated Wrist Evaluation (PRWE) score at 12 months, which included questions about pain, function and disability, and gave an overall score from 0 (best) to 100 (worst).

Secondary outcomes were PRWE score at three and six months, quality of life, and complications, including the need for later surgery.

Of the 79% of patients who completed the follow-up, no statistically significant difference was seen in the PRWE score at three, six or 12 months (average score 21.2 in the cast group compared with 20.7 in the K-wire group). Quality of life was similar.

However, one in eight patients with cast needed later surgery for loss of fracture position in the first six weeks after their injury compared with only one patient in the K-wire group.

Other complications were rare, with no evidence of a difference between the two groups (28 in the cast group compared with 22 in the K-wire group).

Limitations included the fact that neither the treating clinicians nor the participants could be blind to the interventions. Still, the researchers noted this was a large trial involving adults of all ages and the results are based on validated patient reported outcomes, reflecting the care provided across a healthcare system.

As such, they conclude: “Surgical fixation with K-wires did not provide better wrist function at 12 months compared with a moulded cast, indicating that a cast is an acceptable first line treatment following manipulation of a dorsally displaced fracture of the distal radius.”

They added: “Cast treatment avoids the expense and risks of surgical fixation for seven out of eight patients. However, careful follow-up is needed as one in eight patients treated with a cast required subsequent surgical intervention as the fracture reduction could not be maintained.”

Source: The BMJ

Categories : Medical Research & Technology Metabolic DisordersTags :

New Diabetes Management Device Combines Testing and Injection

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Photo by Lisa Fotios from Pexels

By combining blood glucose measurement with insulin administration in a single device, the complicated process of blood sugar management could be made easier for people with diabetes.

Patients with diabetes often use two types of insulin to control their blood sugar levels: long-acting insulin, which helps control glucose levels over a 24-hour period, and short-acting insulin, which is injected at mealtimes. Patients first measure their blood glucose levels with a glucose meter with a finger prick. They must also estimate how many carbohydrates are in their meal and combine this information with their blood glucose levels to calculate and inject the proper insulin dose.

Existing technologies such as continuous blood glucose monitors and insulin pumps can help with some parts of this process. However, these devices are not widely available, so most patients must rely on finger pricks and syringes. To this end, MIT researchers have developed devices to simplify the process, which they describe in the Journal of Controlled Release.

“Every day, many patients need to do this complicated procedure at least three times,” explained MIT postdoc Hen-Wi Huang. “The main goal of this project is to try to facilitate all of these complex procedures and also to eliminate the requirement for multiple devices. We also used a smartphone camera and deep learning to create an app that identifies and quantifies food content, which can aid in carbohydrate counting.”

The researchers came up with two all-in-one devices, both of which incorporate the new smartphone app. Using a photo, the app estimates the volume of food and carbohydrate content.

The first device that consolidates many of the existing tools that patients use now, including a lancet for drawing blood and glucose test strips. The device conveys blood glucose information to the smartphone app via Bluetooth, and the app works out the correct insulin dose, delivered via a needle in the same device.

“What our device is doing is automating the procedures to prick the skin, collect the blood, calculate the glucose level, and do the computation and insulin injection,” Dr Huang says. “The patient no longer needs a separate lancing device, glucose meter, and insulin pen.”

Many of the components included in this device are already FDA-approved, but the device has not been tested in human patients yet. Tests in pigs showed that the system could accurately measure glucose levels and dispense insulin.

For their second device, the researchers wanted to come up with a system that would require just one needle prick. To achieve that, they designed a novel glucose sensor that could be incorporated into the same needle that is used for insulin injection.

The researchers designed a flexible electronic sensor that can be attached to the needle and measure glucose levels in the interstitial fluid, just below the surface of the skin. Once the needle penetrates the skin, it takes between five and 10 seconds to measure the glucose levels. This information is transmitted to the smartphone app, which calculates the insulin dose and delivers it through the inserted needle.

In tests in the pigs, the researchers showed that they could accurately measure glucose levels with this system, and that glucose levels dropped after insulin injection.

Because this device uses a novel type of glucose sensor, the researchers expect that it will require further development to get to a point where it could be tested in patients.

Source: MIT

Categories : COVID HospitalsTags :

Omicron Not ‘Mild’ for US, Experts Say

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In stark contrast to South Africa’s approach to COVID and the country’s experts characterising Omicron as “mild”, US experts have said that calling it “mild” ignores the harsh situation their country faces: record hospitalisations, sick children, other conditions being worsened by COVID, and staff shortages.

While Omicron’s odds of causing a person’s hospitalisation or death are lower, US numbers suggest that Omicron is, in fact, serious on a population level.

“What’s mild about hospitals at or near the breaking point? What’s mild about hundreds of healthcare workers per hospital out ill with COVID? What’s mild about 1.3 million cases in the U.S. just yesterday? What’s mild about the rising titer of burnout? What’s mild about an unprecedented number of children now ill and hospitalised with COVID?” Clyde Yancy, MD, chief of cardiology at Northwestern University’s Feinberg School of Medicine in Chicago, wrote in an email to MedPage Today.

“I think prudence would suggest that we reframe ‘mild’ and think more about ‘self-limited,'” he added. “We are likely at or near a plateau but how long will it last and how much more agony awaits?”

Americans were hospitalised in record numbers last week. “When there are many more people sick in large numbers – in millions – even if it’s a smaller percentage that’s going to be severely sick, that is going to result in large numbers in the hospitals,” said Biykem Bozkurt, MD, PhD, a cardiologist at Baylor College of Medicine in Houston.

While Omicron is still a threat for those unvaccinated or without previous infection, its high breakthrough rate is a cause for concern, especially in vulnerable people.

“Individuals who have breakthroughs after being vaccinated, including the elderly who have comorbid heart disease, are now flooding our emergency departments with decompensated cardiovascular diagnoses and a positive coronavirus test,” said cardiologist Jim Januzzi, MD, of Massachusetts General Hospital and Harvard Medical School in Boston.

As well as buckling healthcare systems, vulnerable and overlooked populations are being affected by Omicron even more.

Paediatric hospitalisations in the US reached a new peak in mid-January, with 20% of the entire pandemic’s hospitalisations of children happening in just two weeks in January. Over 1000 children have died from COVID by the CDC’s numbers, including 359 under five.

Moreover, patients on immunosuppressive medications may be less protected by the vaccines. “The labelling of the Omicron infection as ‘mild’ overlooks the important features and the messaging to the public,” rheumatologist Vaidehi Chowdhary, MBBS, MD, DM, of Yale School of Medicine in New Haven, Connecticut, wrote in an email to MedPage Today.

“Some patients who are on strong immunosuppressive medications do not have adequate vaccine titers and remain vulnerable,” she said, pointing out that there’s a shortage of monoclonal antibodies and antivirals, which means that this group must take extra precautions to ensure they aren’t infected in the first place.

Omicron’s impact on those who are immunosuppressed or have long COVID is not yet known, Dr Chowdhary noted. “For immunosuppressed patients, to minimise infections, many in-person appointments have been converted to telehealth or elective procedures deferred. The impact of these practices and their impact on overall patient health are not known.”

People living with disabilities and chronic illnesses continue to be faced with worsened infections, delaying consultations and difficulty accessing healthcare.

Then there are those whose infection has exacerbated their condition, whatever it may be. Omicron could be the thing that tips them over the edge, or that keeps them in the hospital for longer, experts have said. Examples seen include patients with blood clots having those clots exacerbated by COVID, and COVID-positive trauma patients having complications and longer recovery times.

Healthcare workers falling ill due to Omicron has seriously stressed US healthcare, with staff shortages have been reported in almost 20% of the country’s hospitals, leaving their already overworked colleagues to work extra.

Dr Januzzi’s hospital has been “completely full, with a huge number of individuals with COVID. So, we’re really at a breaking point where staff are getting sick. Patients and physicians alike are exhausted … the hope would be that we can get through this time and get to the other side of this.”

Source: MedPage Today