Tag: 21/4/23

Gastric Surgery for Weight Loss Harms Adolescents’ Bone Development

In sleeve gastrectomy (SG), about 80% of the stomach is removed to reduce obesity and its complications. It has been observed to be associated with bone loss in adolescents, prompting a prospective study published in the Journal of Bone and Mineral Research, that revealed through imaging tests that SG decreases strength and bone mineral density of the lumbar spine in adolescents and young adults.

The researchers followed 29 adolescents and young adults with obesity underwent SG and 30 were without surgery over 12 months. At baseline and 12 months, participants underwent computed tomography of the lumbar spine for bone assessments and magnetic resonance imaging of the abdomen and thigh for body composition assessments.

Participants in the SG group lost an average of 34.3 kg 12 months after surgery, whereas weight was unchanged in controls. There were significant reductions in abdominal fat tissue and thigh muscle in the SG group compared with controls. Also, bone strength and bone mineral density decreased in the SG group compared with controls. Reductions in bone strength and bone mineral density were associated with reductions in body mass index, abdominal fat tissue, and muscle.

“Weight loss surgery is very effective in treating obesity and obesity-associated comorbidities in adolescents and young adults with obesity; however, it can cause loss of bone density and strength. We hope that our study raises awareness of the importance of bone health after weight loss surgery, so physicians can make sure that children eat a healthy diet with enough calcium and vitamin D and engage in weight-bearing activity to build up muscle mass, which is good for bones,” said corresponding author Miriam A. Bredella, MD, of Massachusetts General Hospital. 

Source: Wiley

Western Diet Increases Prostate Cancer Risk

A study published in BJU International found that while adherence to healthy diets seems to have no effect on prostate cancer risk, following an unhealthy ‘Western’ diet may increase the risk of developing aggressive prostate cancer.

The study assessed the diets of 15 296 men recruited in Spain in from 1992–1996. Among these men, 609 prostate cancer cases were identified during a median follow-up of 17 years. Diets were categorised as Western, Prudent, or Mediterranean. The Western dietary pattern consisted of a high intake of high-fat dairy products, processed meat, refined grains, sweets, caloric drinks, convenience food, and sauces, and a low intake of low-fat dairy products and whole grains. The Prudent dietary pattern was characterised by a high intake of low-fat dairy products, vegetables, fruits, whole grains, and juices. The Mediterranean dietary pattern represented a high intake of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable oil, and a low intake of juices.

No effect over prostate cancer risk was detected for the Prudent and Mediterranean dietary patterns, but detrimental effect was observed with the Western dietary pattern. This effect was only observed for aggressive tumors.

“Our results indicate that avoiding unhealthy dietary habits could be the best nutritional strategy to prevent aggressive prostate cancer,” said lead author Adela Castelló-Pastor, PhD, of the Carlos III Institute of Health and CIBERESP, in Spain. “Substituting the intake of Western-type diet products by products characteristic of the Mediterranean diet could also decrease the risk of other chronic diseases,” added co–senior author Marina Pollán, PhD, of the Carlos III Institute of Health and CIBERESP, in Spain.

“The information provided by the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition – or EPIC – has contributed to improving scientific knowledge of the relationship between diet and cancer and other chronic diseases,” added co–senior author Maria-José Sánchez, MD, PhD, lecturer at the Andalusian School of Public Health, scientific director at ibs.GRANADA and researcher at CIBERESP, in Spain.

Source: Wiley

Better Transplant Outcomes from Slightly Warmer Donor Lungs

Photo by Robina Weermeijer on Unsplash

Storing donor lungs for transplant at 10°C markedly increases the length of time the organ can live outside the body, according to results of a trial were published in the New England​ Journal of Medicine Evidence. These findings will help reduce the strain on hospitals, reduce waitlists and possibly eliminate the need to bump other surgeries for a lung transplant.

The multicentre, non-randomised clinical trial study of 70 patients demonstrated that donor lungs remained healthy and viable for transplant up to four times longer compared to storage at the current standard of ice cooler preservation of around 4°C. The study was led by a team of scientists at the Toronto Lung Transplant Program in UHN’s Ajmera Transplant Centre.

“The clinical impact of this study is huge,” says lead author Dr Marcelo Cypel, Surgical Director of the Ajmera Transplant Centre and a surgeon within UHN’s Sprott Department of Surgery.

“It’s a paradigm shift for the practice of lung transplant.​ I have no doubt that this will become the gold standard practice of lung preservation for the foreseeable future.”

Lungs available for transplant are currently limited by the length of time a donor organ can be kept viable. Increasing storage time allows for viable donor lungs to come from greater distances, increasing the potential for greater numbers of lungs becoming available for transplant and overcoming many of the hurdles around transplant logistics.

“In transplant, we still see a critical shortage of organs and people dying on the waitlist because there are not enough lungs to be transplanted,” says Dr Cypel, who is also a professor in the Division of Thoracic Surgery, Department of Surgery at the University of Toronto.

“It’s a great accomplishment to see that our research is now having an impact, and that we can actually have more cases done at our centre, with continued outstanding clinical results.

“Better organ preservation also means better outcomes for patients.”

Transplant surgeries could become planned procedures

The trial took place over 18 months at UHN’s Toronto General Hospital, the Medical University of Vienna, and Hospital Universitario Puerta de Hierro-Majadahonda in Madrid.

“The ability to extend the lifespan of the donor organ poses several advantages,” says study first author Dr Aadil Ali, adjunct scientist at the Toronto General Hospital Research Institute.

“Ultimately, these advantages will allow for more lungs to be utilised across farther geographies and the ability to improve recipient outcomes by converting lung transplantation into a planned rather than urgent procedure.”

Some advantages of this new 10°C standard for lung storage include the potential to reduce or eliminate the 24/7 schedule and urgency of lung transplant procedures. By increasing the length of time donor lungs are viable, transplant surgeries could become planned procedures, which avoids bumping scheduled surgeries and overnight transplantation.

The study also suggests the new preservation temperature will allow more time to optimise immunologic matching between donor and recipients, and the possibility of performing lung transplantation in a semi-elective rather than urgent fashion.

For more on the study, watch Dr Marcelo Cypel’s presentation of findings at a recent American Association for Thoracic Surgery event.

Also, watch a video with Drs Cypel and Ali discussing the foundational work leading to this breakthrough.

Source: University Health Network

The Era of Pandemics: Abbott Partnership to Address Emerging Viral Threats in Africa

Prof Tulio de Oliveira and Dr Mary Rogers
  • Scientists predict that we are entering the era of pandemics.
  • A sustainable global commitment to pandemic preparedness is instrumental to maintaining the upper hand and winning the battle.
  • In collaboration with the Abbott Pandemic Defense Coalition, CERI unveiled a new genomics facility to help identify, analyse and test infectious diseases in Africa to enable early detection and rapid responses to potential viral threats.  

With the increasing rates of urbanisation, global travel and climate change, infectious disease experts predict the world is entering a new era of pandemics. In response to this, Abbott founded the Abbott Pandemic Defense Coalition which comprises of 20 scientific and public health organisations from across the globe who are committed to detecting and responding to emerging viral threats.

Since its launch in 2021, the global Coalition has partnered with organisations in Africa to build up the network and capabilities in the region. The Centre for Epidemic Response and Innovation (CERI) at Stellenbosch University is one of the recent partners, who recently unveiled a new genomics facility that will enable early detection and the rapid response to emerging threats in Africa in collaboration with the Abbott Pandemic Defense Coalition.

“No one organisation, network or country is strong enough to effectively fight against viral pathogens,” says Mary Rodgers, principal scientist at Abbott’s diagnostics business. “We therefore must have an ongoing global commitment to pandemic preparedness – and key to that is collaboration across the private and public sectors to detect and have a rapid response to emerging threats. Our partnership with CERI will expand testing capacity to continue research in understanding how known viruses are spreading in order to identify new viral outbreaks, so that we can stop them from becoming the next pandemic.”

New Technology to Detect Viral Threats in Africa

The state-of-the-art genomics facility is equipped with new technology such as the Metagenomics Next Generation Sequencing which is revolutionising how viruses are discovered – creating a genome that once took years to complete can now be sequenced and analysed in a day or two. The genomics center will also have access to Abbott’s diagnostics molecular lab testing capabilities to provide fast and scalable molecular testing, as well as provide researchers the ability to create molecular tests for new and emerging viral threats.

Professor Tulio de Oliveira, director of CERI concludes, “The partnership with the Abbott Pandemic Defense Coalition will help train Africa’s next generation of virus hunters and public health experts in cutting-edge sequencing, bioinformatics, and other technologies so that they can track and identify viruses faster and smarter. The launch of this new genomics facility is a testament to our shared commitment to advancing scientific knowledge and protecting public health in Africa.”

SAHPRA Reports 3rd Fatal Case of Guillain-Barré Syndrome Following Janssen Vaccination

Gloved hand holding vial of Janssen COVID vaccine
Photo by Spencer Davis on Unsplash

The South African Health Products Regulatory Authority (SAHPRA) issued media statements on 4 August 2022 and 12 September 2022, relating to two fatal cases of Guillain-Barré syndrome (GBS) following vaccination with COVID-19 Vaccine Janssen. SAHPRA has been informed of a third fatal case of GBS following vaccination with the same vaccine.

A causality assessment of the reported case was conducted by the National Immunisation Safety Expert Committee (NISEC) using the World Health Organization’s (WHO) methodology. Following investigations, the case was classified as a vaccine product-related event. The events reported in the vaccine recipient were consistent with the case definition of GBS and no other likely cause of GBS was identified at the time of illness.

As previously communicated, GBS is a very rare but potentially severe neurological adverse event that is associated with the administration of various vaccines and other medicines and can also be triggered by some bacterial or viral infections, including SARS-CoV-2. Symptoms of GBS range from mild to severe, and may include muscle weakness, muscle pain, numbness, and tingling. In many cases, GBS resolves with no serious after-effects, but in some cases GBS can cause serious or life-threatening problems.

Regulatory authorities have previously investigated reports of GBS associated with COVID-19 vaccines. They concluded that COVID-19 Vaccine Janssen may increase the risk of GBS. GBS is therefore listed as a rare adverse event in the professional information (PI) for COVID-19 Vaccine Janssen.

Investigations and causality assessment of all reported severe adverse events following immunisation (AEFI) with all COVID-19 vaccines are ongoing. The outcomes of these investigations and causality assessments will be shared with the public as soon as they are completed.

Important points to note

  • COVID-19 vaccines have consistently been shown to prevent severe forms of disease, hospitalisation and death. Based on the currently available evidence, SAHPRA has determined that the benefits of COVID- 19 vaccination far outweigh the very low risk of severe adverse events, including GBS. The public are strongly advised not to delay COVID-19 vaccination if eligible in terms of the national vaccination programme.
  • SAHPRA urges the public to report any suspected adverse events following the use of all medicines and vaccines. Reporting can be done at a health facility or by downloading the Med Safety App (https://medsafety.sahpra.org.za/), which is available for Android and iOS phones, or by calling the COVID-19 hotline at 0800 029 999. More information regarding AEFIs reported for the COVID-19 vaccines and how to report an AEFI is available from the SAHPRA website: https://aefi-reporting.sahpra.org.za/.
  • More information regarding AEFIs reported for the COVID-19 vaccines and how to report an AEFI is available from the SAHPRA website: https://aefi-reporting.sahpra.org.za/.

Source: SAHPRA