Day: May 27, 2024

Categories : COVID Immune SystemTags :

An Entirely New COVID-related Syndrome

On By ModernMedia
SARS-CoV-2 infecting a human cell. Credit: NIH

A rare autoimmune disease has been newly described as a COVID-related syndrome, following an investigation by the University of California San Diego School of Medicine and Leeds University.

It started when Pradipta Ghosh, MD, a professor in the Departments of Medicine and Cellular and Molecular Medicine at UC San Diego School of Medicine, received an email from Dennis McGonagle, PhD, professor of investigative rheumatology at the University of Leeds in the UK. This was the beginning of an international collaboration, one that uncovered a previously overlooked COVID-related syndrome and resulted in a paper in eBioMedicine, a journal published by The Lancet.

McGonagle asked if she was interested in collaborating on a COVID-related mystery. “He told me they were seeing mild COVID cases,” Ghosh said. “They had vaccinated around 90 percent of the Yorkshire population, but now they were seeing this very rare autoimmune disease called MDA5 – autoantibody associated dermatomyositis (DM) in patients who may or may not have contracted COVID, or even remember if they were exposed to it.”

McGonagle told of patients with severe lung scarring, some of whom presented rheumatologic symptoms – rashes, arthritis, muscle pain – that often accompany interstitial lung disease. He was curious to know if there was a connection between MDA5-positive dermatomyositis and COVID.

“DM is more common in individuals of Asian descent, particularly Japanese and Chinese,” Ghosh said. “However, Dr McGonagle was noting this explosive trend of cases in Caucasians.”

“But that’s the least of the problem,” Ghosh said. “Because he said, ‘Oh, and by the way, some of these patients are progressing rapidly to death.'”

Ghosh is the founding director of the Institute for Network Medicine at UC San Diego School of Medicine, home to the Center for Precision Computational Systems Network (PreCSN – the computational pillar within the Institute for Network Medicine). PreCSN’s signature asset is BoNE – the Boolean Network Explorer, a powerful computational framework for extracting actionable insights from any form of big-data.

“BoNE is designed to ignore factors that differentiate patients in a group while selectively identifying what is common (shared) across everybody in the group,” Ghosh explained. Previous applications of BoNE allowed Ghosh and her team to identify other COVID-related lung and heart-afflicting syndromes in adults and children, respectively.

As a rheumatologist, McGonagle specialises in inflammatory and autoimmune conditions. Ghosh said that McGonagle’s roster of patients, all within the UK’s National Health System (NHS), helped to facilitate the investigation.

“The NHS has a centralised health care database with comprehensive medical records for a large population, making it easier to access and analyse health data for research purposes,” Ghosh explained.

Ghosh and McGonagle put together a team to probe what they found was indeed an entirely new syndrome.

The study began with McGonagle lab’s detection of autoantibodies to MDA5 – an RNA-sensing enzyme whose functions include detecting COVID and other RNA viruses. A total of 25 patients from the group of 60 developed lung scarring, also known as interstitial lung disease. Ghosh noted that the lung scarring was bad enough to cause eight people in the group to die due to progressive fibrosis. She said that there are established clinical profiles of MDA5 autoimmune diseases.

“But this was different,” Ghosh said. “It was different in behaviour and rate of progression – and in the number of deaths.”

Ghosh and the UC San Diego team explored McGonagle’s data with BoNE. They found that the patients who showed the highest level of MDA5 response also showed high levels of interleukin-15.

“Interleukin-15 is a cytokine that can cause two major immune cell types,” she explained. “These can push cells to the brink of exhaustion and create an immunologic phenotype that is very, very often seen as a hallmark of progressive interstitial lung disease, or fibrosis of the lung.”

BoNE allowed the team to establish the cause of the Yorkshire syndrome – and pinpoint a specific single nucleotide polymorphism that is protective. By right of discovery, the group was able to give the condition a name: MDA5-autoimmunity and Interstitial Pneumonitis Contemporaneous with COVID. It’s MIP-C for short, “Pronounced ‘mipsy,'” Ghosh said, adding that the name was coined to make a connection with MIS-C, a separate COVID-related condition of children.

Ghosh said that it’s extremely unlikely that MIP-C is confined to the United Kingdom. Reports of MIP-C symptoms are coming from all over the world. She said she hopes the team’s identification of interleukin-15 as a causative link will jump start research into treatment.

Source: University of California – San Diego

Categories : Mental HealthTags :

Mental Disorders can Spread within Young People’s Social Networks

On By ModernMedia
Photo by Inzmam Khan

Using population-wide registry data, researchers investigated whether mental disorders can be transmitted within social networks formed by school classes.

The study is the largest and most comprehensive so far on the spread of mental disorders in social networks, with more than 700 000 ninth-grade pupils from 860 Finnish schools participating. The adolescents were followed from the end of ninth grade for a median of 11 years.

The researchers, from the University of Helsinki, the Finnish Institute for Health and Welfare, the University of Jyväskylä and the University of Manchester, demonstrated that the number of classmates diagnosed with a mental disorder was associated with a higher risk of receiving a mental disorder diagnosis later in life.

“The observed link was the strongest during the first year of follow-up in the study. This was not explained by a number of factors related to parents, school and residential area. The link was most pronounced in the case of mood, anxiety and eating disorders,” says Associate Professor Christian Hakulinen of the University of Helsinki.

Schools well-suited to social network research

According to Hakulinen, prior studies have yielded similar results: for example, American researchers have observed indications of depressive symptoms potentially being transmitted from one individual to another in social networks.

In prior research, however, social networks have typically been chosen independently by the research subjects, which may result in bias in the data. Hakulinen points out that school classes are social networks well suited to research, as people are usually not able to choose their classmates.

“Defining the social networks and following adolescents were made possible by extensive Finnish registers. The findings significantly deepen our understanding of how mental health problems develop and affect other people in our social networks,” he says.

Hakulinen nevertheless notes that the connection observed in the study is not necessarily causal. Furthermore, the study did not investigate how mental disorders can potentially be transmitted between individuals.

“It may be possible, for instance, that the threshold for seeking help for mental health issues is lowered when there are one or more people in your social network who have already sought help for their problems. In fact, this kind of normalisation of diagnosis and treatment can be considered beneficial contagion of mental disorders,” Hakulinen says.

The study involved a total of 713 809 Finnish citizens born between 1985 and 1997. The adolescents were investigated from the end of comprehensive school until they received their first mental disorder diagnosis, relocated from the country or died. At the latest, the follow-up was discontinued at the end of 2019, resulting in a median follow-up period of 11.4 years.

More preventive measures?

Mental disorders are a significant global challenge, adversely affecting individuals, society and the economy. According to Hakulinen, anxiety and mood symptoms in particular have in recent years increased among young people.

Previous studies have shown that, in roughly half of all cases, the onset of mental disorders in adulthood occurs when people are under 18. In fact, Hakulinen emphasises the importance of preventive measures and early intervention.

“When taking preventive measures, it’s worthwhile considering that mental disorders can spread from one adolescent to another,” Hakulinen says.

Source: University of Helsinki

Categories : Cancer Obstetrics & GynaecologyTags :

Most Young Breast Cancer Survivors can Still Have Children

On By ModernMedia
Photo by SHVETS production

A new study by Dana-Farber Cancer Institute investigators, which tracked nearly 200 young women treated for breast cancer, found that the majority of those who tried to conceive during a median of 11 years after treatment were able to become pregnant and give birth to a child.

The findings, to be presented at the 2024 Annual Meeting of the American Society of Clinical Oncology (ASCO), are particularly noteworthy because they answer several questions left open by previous studies of pregnancy and live-birth rates among breast cancer survivors, the study authors say.

“Earlier studies were limited because they included select subgroups of patients, followed patients for a relatively short period of time, and didn’t ask participants, during the study period, if they had attempted pregnancy,” says the study’s senior author, Ann Partridge, MD, MPH, the founder and director of the Program for Young Adults with Breast Cancer at Dana-Farber. “This study was designed to address those gaps by tracking pregnancy and live birth rates among a group of breast cancer survivors and patients who indicated they’d attempted to conceive following their cancer diagnosis.”

The patients in the study were participants in the Young Women’s Breast Cancer Study, which is tracking the health of a group of women diagnosed with breast cancer at or under age 40. Of 1213 eligible participants, 197 reported an attempt of pregnancy over a median follow-up period of 11 years. Within this latter group, the median age at the time of diagnosis was 32 years, and most were diagnosed with hormone receptor-positive breast cancer. Participants were periodically surveyed about whether they had tried to become pregnant and whether they had conceived and given birth.

Over the course of the study, 73% of women attempting to conceive achieved a pregnancy and 65% had a live birth, researchers found. Those who opted for fertility preservation by egg/embryo freezing before cancer treatment tended to have a higher live birth rate, while older participants tended to have lower pregnancy and live birth rates

Participants in the study had breast cancers ranging from stage 0, which are non-invasive and confined to the inside of the milk duct, to stage III, in which the cancer has spread to the lymph nodes. There was no statistically significant association with stage of the disease at diagnosis and achieving a pregnancy or live birth.

“For many young women with breast cancer, the ability to have children following treatment is a major concern,” says the study’s first author, Kimia Sorouri, MD, MPH, of Dana-Farber. “The findings of our study can be helpful when counselling patients about fertility issues. The finding that egg/embryo freezing before treatment was associated with a higher live birth rate underscores the need for accessibility to fertility preservation services for this population.”

Source: Dana-Farber Cancer Institute

Categories : Environmental EffectsTags :

Study Tallies Heatwave Deaths over Recent Decades

On By ModernMedia
Photo by Fandy Much

Between 1990 and 2019, more than 150 000 deaths around the globe were associated with heatwaves each year, according to a new study published May 14 in PLOS Medicine by Yuming Guo of Monash University, Australia, and colleagues.

Heatwaves, periods of extremely high ambient temperature that last for a few days, can impose overwhelming thermal stress on the human body.

Studies have previously quantified the effect of individual heatwaves on excess deaths in local areas, but have not compared these statistics around the globe over such a prolonged period.

In the new study, researchers used data from the Multi-Country Multi-City (MCC) Collaborative Research Network that included daily deaths and temperatures from 750 locations across 43 countries.

With the MCC data, the researchers estimated excess heatwave deaths around the world spanning 1990 to 2019 and mapped the variance in these deaths across continents.

During the warm seasons from 1990 to 2019, heatwave-related excess deaths accounted for 153 078 deaths per year, a total of 236 deaths per 10 million residents or 1% of global deaths.

While Asia had the highest number of estimated deaths, Europe had the highest population-adjusted rate, at 655 deaths per 10 million residents.

A substantial burden of estimated deaths was seen in southern and eastern Europe as well as the area between Northern Africa, the Arabian Peninsula and Southern Asia.

At the national level, Greece, Malta, and Italy had the highest excess death ratios.

Overall, the largest estimated rates of heatwaves deaths were seen in areas with dry climates and lower-middle incomes.

Understanding the regional disparity of heatwave-related mortality is key to planning local adaptation and risk management towards climate change.

“Heatwaves are associated with substantial mortality burden that varies spatiotemporally over the globe in the past 30 years,” the authors say.

“These findings indicate the potential benefit of government actions to enhance health sector adaptation and resilience, accounting for inequalities across communities.”

The authors add, “In the context of climate change, it is crucial to address the unequal impacts of heatwaves on human health. This necessitates a comprehensive approach that not only tackles immediate health risks during heatwaves but also implements long-term strategies to minimize vulnerability and inequality. The strategies include: climate change mitigation policy, heat action plans (e.g., heat early warning system), urban planning and green structure, social support program, healthcare and public health services, education awareness, and community engagement and participation.”

Provided by PLOS

Categories : General InterestTags :

Prominent Cardiologist’s Passing a Loss to KZN Healthcare

On By ModernMedia

Colleagues pay tribute to highly respected Dr Singh  

Dr Surendra Singh. Photo: supplied

Monday, 27 May 2024. The passing of esteemed cardiologist Dr Surendra Singh (11 April 1955 – 16 May 2024) at the age of 69 after a short illness is a tremendous loss to healthcare in KwaZulu-Natal, the communities he served and everyone who knew him.

“We wish to express our sincere condolences to Dr Singh’s wife, Professor Shanta, and his children Rajiv, Ameet and Rhea,” said Netcare uMhlanga Hospital general manager Wendy Beato.

“We mourn the passing of an exceptional healthcare professional and a man of stature. Dr Singh was highly respected and much loved by his colleagues, patients and the staff and management of Netcare uMhlanga Hospital, where he has practised for several years.

“Dr Singh will be deeply missed by all who had the privilege to know him,” she says.

After qualifying as a cardiologist in 1990, Dr Singh embarked on a journey during which he harnessed the power of his knowledge to heal others. Known for this brilliance both as a man and a doctor, he possessed a rare combination of exceptional expertise, humility and deep caring.

“Dr Singh’s dedication to his patients was evident throughout his career, and he continued to provide much valued service at Netcare uMhlanga Hospital until he became ill. His passing leaves a deep void for all who knew him and the countless patients whose lives he touched throughout his career.

“Dr Singh’s legacy as a caring healthcare provider and respected cardiologist will endure. Through his considerable dedication and expertise, he improved and saved lives while inspiring a new generation of healthcare professionals. His passion for healing and deep commitment to his patients will be forever remembered. Although his time with us was cut short, the impact of his life’s work will continue to be felt for many years to come,” Beato concluded.