Tag: 15/11/21

Categories : Diet and NutritionTags :

Intermittent Fasting Triggers an Anti-inflammatory Response

On By ModernMedia
Credit: Intermountain Healthcare

Intermittent fasting may not only be a hot dieting trend, but it also has broader health benefits, including helping to fight inflammation, according to a new study. The new research shows that intermittent fasting raises the levels of galectin-3, a protein tied to inflammatory response.

Intermittent fasting has previously been shown to possibly improve health markers not related to weight. 

“Inflammation is associated with higher risk of developing multiple chronic diseases, including diabetes and heart disease. We’re encouraged to see evidence that intermittent fasting is prompting the body to fight inflammation and lowering those risks,” said Benjamin Horne, PhD, principal investigator of the study and director of cardiovascular and genetic epidemiology at the Intermountain Healthcare Heart Institute.

The findings of the study were presented at the American Heart Association’s Scientific Sessions 2021.

These results form part of Intermountain’s WONDERFUL Trial which is studying intermittent fasting. It found that intermittent fasting causes drops in metabolic syndrome score (MSS) and insulin resistance.  

This particular study followed 67 patients aged 21 to 70 who all had at least one metabolic syndrome feature or type 2 diabetes, and were also not taking anti-diabetic or statin medication, and had raised LDL cholesterol levels.

Of the 67 patients studied, 36 were prescribed an intermittent fasting schedule: twice a week water-only 24-hour fasting for four weeks, then once a week water-only 24 hour-fasting for 22 weeks. Fasts could not be done on consecutive days. The remaining 31 participants continued their routines.

After 26 weeks, participants’ galectin-3 was measured, and found to be higher in the intermittent fasting group. Lower rates of HOMA-IR (insulin resistance) and MSS (metabolic syndrome) were found, which researchers believe may be similar to the reported effects of SGLT-2 inhibitors.

“In finding higher levels of galectin-3 in patients who fasted, these results provide an interesting mechanism potentially involved in helping reduce the risk of heart failure and diabetes,” said Dr Horne, who added that a few members of the trial team completed the same regime before the study started to make sure that it was doable and not overly onerous for participants.

“Unlike some IF diet plans that are incredibly restrictive and promise magic weight loss, this isn’t a drastic form of fasting. The best routine is one that patients can stick to over the long term, and this study shows that even occasional fasting can have positive health effects,” he added.

Source: EurekAlert!

Categories : Metabolic DisordersTags :

DIY Artificial Pancreas Gets Expert Nod of Approval

On By ModernMedia
Photo by Nataliya Vaitkevich from Pexels

More than 40 healthcare professionals and legal experts have issued the first guidance of its kind to support people with type 1 diabetes using Do-it-Yourself (DIY) technology driven systems to manage their condition.

The paper sets out recommendations that allow health-care professionals to support DIY artificial pancreas systems as a safe and effective treatment option for type 1 diabetes.

Published in The Lancet Diabetes & Endocrinology and endorsed by nine professional diabetes organisations including the International Diabetes Federation. Patients say using the technology has been a “revolution and a revelation” which has had positive impacts on their wider health.

Study co-lead Dr Sufyan Hussain, a consultant diabetologist and honorary senior lecturer from King’s College London, who has lived with type 1 diabetes for over 30 years says: “The medical and legal position of do-it-yourself and citizen science approaches have been subject to a lot of debate and uncertainty. This paper not only clarifies the position for do-it-yourself artificial pancreas systems in diabetes as a safe and effective treatment but sets a precedent for achieving an international professional consensus for other treatments based on user-driven do-it-yourself technologies and innovations.”

Traditional monitoring of type 1 diabetes involves taking blood samples from the fingertips several times a day and calculating precise injections of insulin to maintain blood sugar levels. This can be a time-consuming and stressful method, but over 10 000 people worldwide are using DIY systems, also known as open-source Automated Insulin Delivery (AID) systems. These automatically adjust insulin dosing in response to continuous sensor glucose, insulin pump data and additional information using community generated algorithms. It means that the algorithm can calculate the dosage and administer the dose automatically through conventional insulin pumps.

The authors note that such systems aim to reduce both hypo- and hyperglycaemia, but can also improve glycaemic and long-term health outcomes, reducing diabetes distress and burden, and improving sleep quality.

A limited number of commercial versions of these systems have recently been approved by regulators, but they can be expensive and are accessible only in certain countries. Instead, DIY systems are a product of citizen science that have been co-created by people living with diabetes. These systems are not regulated. However, today’s landmark paper provides professional validation and clear recommendations for their use.

At least 20% of DIY system users are children or adolescents, although use in pregnancy and the elderly is also widely noted. For many families and users, use of an AID system improved quality of life for caregivers, allowing carers to remotely monitor their condition.

However, in common with other insulin-based treatments, these systems are not risk-free, the authors warn. Historically, people living with diabetes had to do their own research on how to build and set up these systems. The paper recommends that clinicians work with individuals living with diabetes or their caregivers to ensure safe and effective use of these systems, and provide guidance on how to achieve this.

At age 15, Dominic Nutt was diagnosed with type 1 diabetes. Now 54, he has a personalised algorithm that automatically controls his glucose monitor and insulin pump. He manages the process through a smartphone, putting in when he eats carbohydrates or exercises, as this affects his blood sugar.
“I’m not a techie at all,” he said, “but since I was diagnosed, I’ve always been excited to try the latest developments as soon as they’re available. A friend put me in touch with someone who could help me to personalise the algorithm to my diabetes and my insulin pump. I then worked with Dr Hussain who helped me to make it work for my diabetes and the technology I was already using.

“It’s been a revolution and a revelation. The swings in my blood sugar have gone. I used to have severe hypos needing emergency care about once every six months – my kids got used to having to talk to the paramedics. Now that never happens, my blood sugar is under control, which has wider health benefits as well, plus I’m feeling fitter and stronger, and I don’t have to eat as much sugar to control my blood sugar.

“The emotional weight that has been lifted is huge. I still have to think about my diabetes sometimes, but it’s not the daily grind it used to be. It’s exciting that now there’s more of an opportunity for others with diabetes to get the kind of personalised advice that I’ve had.”

Source: King’s College London

Categories : DentistryTags :

Obesity Found to Fuel Periodontal Disease

On By ModernMedia
Source: Unsplash

Chronic inflammation resulting from obesity may trigger osteoclast production and bone tissue breakdown, including the alveolar bone that holds teeth in place, according to a new animal model study.

The study, reported in the Journal of Dental Research, found that excessive inflammation caused by obesity raises the number of myeloid-derived suppressor cells (MDSC), a group of immune cells that increase during illness to regulate immune function. MDSCs, which originate in the bone marrow, develop into a range of different cell types, including osteoclasts.

Bone loss is a major symptom of periodontal disease which may ultimately lead to tooth loss. Periodontal disease affects more than 47% of adults 30 years and older, according to the Centers for Disease Control and Prevention.

“Although there is a clear relationship between the degree of obesity and periodontal disease, the mechanisms that underpin the links between these conditions were not completely understood,” said Keith Kirkwood, DDS, PhD, professor of oral biology in the UB School of Dental Medicine.

“This research promotes the concept that MDSC expansion during obesity to become osteoclasts during periodontitis is tied to increased alveolar bone destruction. Taken together, this data supports the view that obesity raises the risk of periodontal bone loss,” said Kyuhwan Kwack, PhD, postdoctoral associate in the UB Department of Oral Biology.

In the study, two groups of mice were fed different diets over the course of 16 weeks: one group a low-fat diet that derived 10% of energy from fat, the other group a high-fat diet getting 45% of energy from fat.

The high-fat diet group developed obesity, had more inflammation and a greater increase of MDSCs in the bone marrow and spleen compared to the low-fat diet group. The high-fat diet group also developed a significantly larger number of osteoclasts and lost more alveolar bone, which holds teeth in place.

Additionally, in the group fed a high-fat diet, the expression was significantly elevated for 27 genes tied to osteoclast formation.
The findings may help reveal the mechanisms behind other chronic inflammatory, bone-related diseases that develop concurrently with obesity, such as arthritis and osteoporosis, Prof Kirkwood said.

Source: University at Buffalo

Categories : Cardiovascular Disease PaediatricsTags :

Penicillin Reduces Rheumatic Heart Disease Progression in Kids

On By ModernMedia
Photo by Roman Nguyen on Unsplash

In a new study, penicillin significantly reduces the risk of underlying rheumatic heart disease progression in children and adolescents.  

The research also showed that early screening was critical for preventing serious rheumatic heart disease progression and death in young children. Rheumatic heart disease affects 40.5 million people globally, causing 306 000 or more deaths every year. The chronic disease results from damage to the valves of the heart after a case of Strep throat. It’s considered a disease of poverty and disadvantage.

Associate Professor Andrea Beaton of Cincinnati Children’s Hospital Medical Center said that prior to this study, it was unknown if antibiotics were effective at preventing the progression of latent rheumatic heart disease.

“The trial is the first contemporary randomised controlled trial in rheumatic heart disease. The results are incredibly important on their own, but also demonstrate that high-quality clinical trials are feasible to address this neglected cardiovascular disease,” she said.

The trial involved 818 Ugandan children aged 5 to 17 years with latent rheumatic heart disease, who received either four-weekly injections of penicillin for two years or no treatment. All underwent echocardiography screening at the beginning and end of the trial.

The findings from the screenings, published in the New England Journal of Medicine, reported just three (0.8%) participants who received penicillin experienced latent rheumatic heart disease progression, compared to 33 (8.3%) who didn’t receive the treatment.

Dr Daniel Engelman of Murdoch Children’s Research Institute (MCRI) said the results showed a significant and greater than expected reduction in disease development.  

MCRI Professor Andrew Steer said screening for latent rheumatic heart disease was critical to stop progression because heart valve damage was largely untreatable.

“Children with latent rheumatic heart disease have no symptoms and we cannot detect the mild heart valve changes clinically,” he said.

“Currently, most patients are diagnosed when the disease is advanced, and complications have already developed. This late diagnosis is associated with a high death rate at a young age, in part due to the missed opportunity to benefit from preventative antibiotic treatment. If patients can be identified early, there is an opportunity for intervention and improved health outcomes.”

Uganda Heart Institute Dr Emmy Okello said the Ugandan government should strengthen programs that promote screening of rheumatic heart disease and the availability of penicillin.

“Our study found a cheap and easily available penicillin can prevent progression of latent rheumatic heart disease into more severe, irreversible valve damage that is commonly seen in our hospitals with little or no access to valve surgery,” Dr Okello said.

Source: Murdoch Childrens Research Institute

Categories : COVIDTags :

Heparin’s Beneficial Impact on COVID Outcomes

On By ModernMedia
Source: Fusion Medical Animation on Unsplash

Researchers at the Medical University of Vienna have now shown that the anticoagulant heparin not only has a beneficial effect on survival of COVID patients, but also influences the duration of active infection with the SARS-CoV-2 coronavirus. The results were published in the journal Cardiovascular Research.

COVID is now known to be a multifaceted infectious disease, which affects several functional systems in the human body following infection with the pathogen SARS-CoV-2. One of these functional systems is blood clotting. COVID patients are at greater risk of thromboses and embolisms, such as strokes, pulmonary or myocardial infarctions, and even deep vein thromboses. The use of drugs that inhibit blood clotting has been part of the treatment guidelines for COVID since July 2020. “These complications during hospitalisation have a direct impact on the well-being of patients and increased the risk of dying from COVID,” said first author David Pereyra from MedUni Vienna’s Department of General Surgery. The underlying coagulopathy is still not fully understood.

“The coagulopathy observed in COVID patients is novel and differs in many respects from previously known coagulation problems,” said senior author Alice Assinger, group leader at the Institute of Vascular Biology and Thrombosis Research at the Medical University of Vienna. “COVID-associated coagulopathy displays characteristics that, although partially comparable with other coagulation diseases, cannot be fully explained by them.” Alice Assinger’s group therefore started to look for an explanation for this sub-condition of COVID in the spring of 2020, in an early phase of the pandemic.

In a multi-centre analysis of COVID patients, the group saw that COVID-associated coagulopathy occurs almost exclusively in patients requiring intensive care or in patients who die as a result of COVID. While anticoagulant drugs improve the survival of COVID patients, they show no effect on immunological processes related to blood coagulation (immunothrombosis).

However, an analysis of the results showed that the length of active SARS-CoV-2 infection is shortened in patients treated with low-molecular-weight heparin, the most commonly used anticoagulant. “In patients who receive this drug, infection time is an average of four days shorter than in patients who are not treated with low-molecular-weight heparin. We were surprised to see that low-molecular-weight heparin may have a direct effect on coronavirus and its infectivity,” said David Pereyra. Experimental data show that heparin can inhibit the ability of SARS-CoV-2 to bind to cells, thereby preventing them from being infected.

These observations were made in the context of a close collaboration between the three hospitals involved – the Favoriten Hospital in Vienna, the Innsbruck Regional Hospital Innsbruck and the Johannes Kepler University Hospital in Linz – as well as through the active exchange between basic researchers and clinicians,” says Alice Assinger, underscoring the relevance of good cooperation during the COVID pandemic for a better understanding of the disease and its treatment.

Source: Medical University of Vienna

Categories : COVIDTags :

Stellenbosch Doctors Urge Patience on Ivermectin

On By ModernMedia

The South African public should be patient and wait for data on Ivermectin’s effectiveness against COVID, according to Stellenbosch doctors, who urge patience. The doctors wrote an article published in the South African Medical Journal explaining that further studies need to be completed before ivermectin can be authorised for use.

A veterinarian parasiticide that may have relevant antiviral and anti-inflammatory properties, ivermectin has gathered considerable attention for possible use in COVID prophylaxis and treatment since a number of small trials appeared to show effectiveness. However, close examination shows that they are very weak. Doubts have been raised over whether the necessary concentrations used in vitro can be achieved in vivo.

In their article, the doctors noted that several large randomised controlled trials are underway, and the results of these will allow the possible effectiveness of ivermectin to be gauged. “Data for Ivermectin from larger RCTs are expected in early 2021,” the doctors wrote. “These data are very promising, showing large treatment effects and acceptable adverse effect profiles for ivermectin against Covid-19, especially when combined in meta-analyses.”

They pointed out that the hoped-for effectiveness of other medications had not been borne out. “As a recent example, the widely proclaimed benefits of hydroxychloroquine and chloroquine from observational studies proved to be unfounded in larger RCTs,” they wrote.

Ivermectin use has been banned by the government, to considerable resistance. A number of organisations have already demanded that ivermectin be administered as a COVID treatment, including Black First Land First, the New Economic Rights Alliance and AfriForum. Afriforum is contemplating legal action to have ivermectin authorised. These calls have come despite the South African Health Products Regulatory Authority (SAHPRA) repeatedly counselled against the use of ivermectin.

The doctors cautioned that although the data trends indicated a possible efficacy for ivermectin, the optimal dosage if effective still needed to be determined: “Higher than standard Ivermectin doses appear to be safe in humans, but at the time of writing there is still much uncertainty regarding the human dose required to achieve antiviral activity and a favourable benefit-to-risk balance.”

Source: IOL

Categories : COVID Medical Industry VaccinesTags : 1 Comment

Johnson & Johnson is Behind on Vaccine Production

On By ModernMedia

Despite releasing promising data on its COVID vaccine, Johnson & Johnson may fall up to two months behind on its vaccine production schedule, Politico reported. The company is still committed to releasing the trial data on its 45 000 participants by the end of January to pave the way for approval.

If approved, as seems likely, the vaccine would be extremely beneficial for vaccination efforts as it would only require a single dose to confer protection and also would not require sub zero refrigeration, greatly simplifying vaccination efforts.

The company’s effort is part of the Operation Warp Speed initiative to vaccinate the US population as fast as possible, with a goal of vaccinating 80% of the country’s 330.7 million population by the end of June. The previous goal to distribute 20 million doses by the end of 2020 had already fallen short owing to insufficient production.

The co-director of Operation Warp Speed, Moncef Slaoui, hinted at a production slowdown, telling the media that the company was expecting to produce “single-digit million” doses by the second half of February. “We’re trying to make that number get as close to a double-digit number as possible, and then a larger number in March and a much larger number in April,” he added.

Johnson & Johnson had previously made a pledge to deliver 12 million doses by the end of February and as many as 100 million by June.

Despite the delay, there is good news in that initial data from 400 participants shows that the vaccine is safe and has a 90% efficacy in establishing antibodies, with immunity for most subjects established 29 days after the shot and lasting at least 57 days. Adverse reactions were reported to be be mild, and younger subjects were more likely to report them, with one subject experiencing a brief, mild fever.

Source: Politico