Tag: 23/11/22

Categories : HIVTags :

Infection by HIV Leaves a ‘Memory’ in Cells

On By ModernMedia
HIV Infecting a T9 Cell. Credit: NIH

Despite the benefits of antiretroviral therapy, people living with HIV often suffer from chronic inflammation, increasing the risk of developing comorbidities such as cardiovascular disease and neurocognitive dysfunction. Now, a new study in Cell Reports explains why chronic inflammation may be happening and how suppression or even eradication of HIV in the body may not resolve it.

In the study, researchers from the George Washington University show how an HIV protein permanently alters immune cells in a way that causes them to overreact to other pathogens. When the protein is introduced to immune cells, genes in those cells associated with inflammation turn on, or become expressed, the study showed. These pro-inflammatory genes remain expressed, even when the HIV protein is no longer in the cells. According to the researchers, this “immunologic memory” of the original HIV infection is why people living with HIV are susceptible to prolonged inflammation, putting them at greater risk for developing cardiovascular disease and other comorbidities.

“This research highlights the importance of physicians and patients recognizing that suppressing or even eliminating HIV does not eliminate the risk of these dangerous comorbidities,” Michael Bukrinsky,professor of microbiology, immunology, and tropical medicine at GW’s School of Medicine and Health Science and lead author on the study, said. “Patients and their doctors should still discuss ways to reduce inflammation and researchers should continue pursuing potential therapeutic targets that can reduce inflammation and co-morbidities in HIV-infected patients.”

For the study, the research team isolated human immune cells in vitro and exposed them to the HIV protein Nef. The amount of Nef introduced to the cells is similar to the amount found in about half of HIV-infected people taking antiretrovirals whose HIV load is undetectable. After a period of time, the researchers introduced a bacterial toxin to generate an immune response from the Nef-exposed cells. Compared to cells that were not exposed to the HIV protein, the Nef-exposed cells produced an elevated level of inflammatory proteins, called cytokines. When the team compared the genes of the Nef-exposed cells with the genes of the cells not exposed to Nef, they identified pro-inflammatory genes that were in a ready-to-be-expressed status as a result of the Nef exposure.

According to Bukrinsky, the findings in this study could help explain why certain comorbidities persist following other viral infections, including COVID-19.

“We’ve seen this pro-inflammatory immunologic memory reported with other pathogenic agents and often referred to as ‘trained immunity,'” Bukrinsky explains. “While this ‘trained immunity’ evolved as a beneficial immune process to protect against new infections, in certain cases it may lead to pathological outcomes. The ultimate effect depends on the length of this memory, and extended memory may underlie long-lived inflammatory conditions like we see in HIV infection or long COVID.”

Source: George Washington University

Categories : General Interest Healthcare Politics and RegulationsTags :

Healthcare Workers Strike over Salaries and Poor Working Conditions

On By ModernMedia

On Tuesday 22 November, healthcare workers were among the public sector employees who engaged in a strike action to protest a lack of pay increase. A number of hospitals and clinics across South Africa and particularly Gauteng were affected, the Daily Maverick reports.

Unions had been offered a 3% increase plus an additional R1000, which the negotiating unions refused. Union leaders rejected this, demanding a 10% increase. Inflation is running at 6%, and food prices have risen by 12% from the start of the year to September – largely driven up by the war in Ukraine.

Union leaders say the strikes and protests are driven by wages staying the same over the past few years. Healthcare workers had already been suffering high rates of burnout battling COVID waves. In addition, workers complained of being understaffed, and enduring dire working conditions from lack of equipment, medication and food.

On Tuesday morning, burning tires were placed on Chris Hani Road in Soweto. Striking workers wearing union colours were preventing many vehicles, including ambulances, from entering Chris Hani Baragwanath Hospital. Patients inside were being left unattended.

Sebokeng Hospital in Sedibeng meanwhile was running on a skeleton staff, with doctors and nurses prevented from entering. Emergency services were being diverted to nearby facilities.

Meanwhile, GroundUp reported that patients were being turned away from Mabandla Clinic in the Eastern Cape. In Gqeberha, Motherwell NU8 clinic and the Motherwell Healthcare Centre were both reported to be closed. 

On Tuesday afternoon, the Gauteng Department of Health received an interdict against the strikes, preventing striking workers from interfering with access to hospitals, EWN reports. The public healthcare systems in Gauteng and other provinces have already been strained, with recent high-profile protests and resignations over inadequate funding and allegations of corruption.

Categories : Cardiovascular Disease Diet and NutritionTags :

A Cup of Tea a Day Keeps the Doctor Away

On By ModernMedia
Photo by Joanna Kosinska on Unsplash

Tea has long been known to have many health benefits, but now a study of 881 elderly women found they were far less likely to have extensive build-up of abdominal aortic calcification (AAC) if they consumed a high level of flavonoids in their diet – found in black and green tea, apples, nuts, citrus fruit, berries.

AAC is the calcification of the abdominal aorta and is a predictor of cardiovascular risk such as heart attack and stroke. It has also been found to be a reliable predictor for late-life dementia.

Edith Cowan University researcher and study lead Ben Parmenter said while there were many dietary sources of flavonoids, some had particularly high amounts.

“In most populations, a small group of foods and beverages – uniquely high in flavonoids – contribute the bulk of total dietary flavonoid intake,” he said.

“The main contributors are usually black or green tea, blueberries, strawberries, oranges, red wine, apples, raisins/grapes and dark chocolate.”

The flavonoid family

There are many different types of flavonoids, such as flavan-3-ols and flavonols, which the study indicated appear to also have a relationship with AAC.

Study participants who had a higher intake of total flavonoids, flavan-3-ols and flavonols were 36–39% less likely to have extensive AAC.

Black tea was the study cohort’s main source of total flavonoids and was also associated with significantly lower odds of extensive AAC.

Compared with respondents who didn’t drink tea, participants who had two-to-six cups per day had 16–42% less chance of having extensive AAC.

However, some other dietary sources of flavonoids such as fruit juice, red wine and chocolate, did not show a significant beneficial association with AAC.

Not just tea

Though black tea was the main source of flavonoids in the study – likely due to the age of the participants – Mr Parmenter said people could still benefit from flavonoids without putting the kettle on.

“Out of the women who don’t drink black tea, higher total non-tea flavonoid intake also appears to protect against extensive calcification of the arteries,” he said.

“This implies flavonoids from sources other than black tea may be protective against AAC when tea is not consumed.”

Mr Parmenter said this was important as it allows non-tea drinkers to still benefit from flavonoids in their diet.

“In other populations or groups of people, such as young men or people from other countries, black tea might not be the main source of flavonoids,” he said.

“AAC is a major predictor of vascular disease events, and this study shows intake of flavonoids, that could protect against AAC, are easily achievable in most people’s diets.”

Source: Edith Cowan University

Categories : General InterestTags :

Very Few South Africans can Swim, Says the NSRI. It Aims to Change this

On By ModernMedia

With summer and the holidays approaching, soon thousands of adults and children will flock to the country’s shorelines and public pools. But many who live inland and in poor communities do not have access to safe water bodies and have not learned how to swim. Children play unsupervised in rivers and farm dams.

In Riebeek Kasteel last year, a grade six learner found his way into a dam within walking distance of his school, Meiring Primary. Just 12 years old, he drowned.

Now a bright red container stands at the school. It is one of the National Sea Rescue Institute’s (NSRI) “survival swimming centres”.

Andrew Ingram, NSRI drowning prevention manager, says swimming is an “essential skill”.

The first of its kind, the 12-metre shipping container contains a six-metre heated swimming pool, a changing room, an office and a camera monitored by the NSRI. The water is one metre deep, making it possible for the learners’ feet to touch the ground. The facility can also be locked up to avoid children accessing it unsupervised.

The design is inspired by previous work done with lifeguard containers. Almost everything is donated – the container, the pool’s fibreglass and resin, pumps and the filtration systems. The cost would otherwise be about R650 000.

After the Riebeek Kasteel installation in March, a second centre was set up in Tombo Village, Eastern Cape. Two more are expected next year – in KZN and the Northern Cape.

“We don’t teach the children how to swim, we teach them how to survive,” says Petro Meyer, an NSRI Instructor in Riebeek Kasteel. She said the valley gets very hot in summer and parents are away working. Children then “go to the dams and to the rivers and they swim alone without supervision”.

Meyer says they teach students four things: breath control, orientation, floating and moving through water. Children should be able to swim at least five metres once training is complete. Since the survival school opened, she says that they’ve given about 1,400 lessons.

A 2021 study on drowning prevention by the World Health Organisation found drowning to be the third most common accidental death in the world.

Brenton Cupido, principal at Meiring Primary, said there are no other public pools. The closest public one is 20 minutes by bus to Malmesbury and costs R30.

Riebeek Kasteel has many poor families and many parents at his school are farm workers and the majority depend on social grants.

“The farmers try to stop the learners [from using the farm dams] but they can’t be everywhere,” he says.

Cupido said the government should see that “there is a need for swimming pools in the rural areas with proper supervision”, and this would “prevent further tragedy”. “I don’t want to go through another … drowning again,” said Cupido.

“We have that peace of mind, that if our children … fall in the water, they know how to survive,” he said.

Another NSRI project is the over 1300 pink buoys across South Africa used as assisted floating devices in case of emergencies. These can be found in dams, rivers and the seaside. The NSRI also runs free swimming lessons at various municipal pools in the Western Cape.

According to the NSRI, only 15% of South Africans can swim (we cannot verify this statistic but it is highly likely that most South Africans cannot swim – editor). “If your parents can’t swim, it’s very likely that you won’t learn to swim,” said Ingram. “It’s expensive to learn to swim”.

With the survival centres, the NSRI hopes to “instil a culture of swimming in poor communities where it wouldn’t have been possible previously”.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Cardiovascular DiseaseTags :

‘Good Cholesterol’ may not be Such a Good Cardiovascular Risk Indicator

On By ModernMedia
Source: Wikimedia CC0

A study published in the Journal of the American College of Cardiology found that high-density lipoprotein (HDL) cholesterol, often called ‘good cholesterol’, may not be as effective as scientists once believed in uniformly predicting cardiovascular disease risk among adults of different racial and ethnic backgrounds.

The research found that while low levels of HDL cholesterol predicted an increased risk of heart attacks or related deaths for White adults – a long-accepted association – the same was not true for Black adults. Additionally, higher HDL cholesterol levels were not associated with reduced cardiovascular disease risk for either group.

“The goal was to understand this long-established link that labels HDL as the beneficial cholesterol, and if that’s true for all ethnicities,” said senior author Nathalie Pamir, PhD, an associate professor at Oregon Health & Science University, Portland. “It’s been well accepted that low HDL cholesterol levels are detrimental, regardless of race. Our research tested those assumptions.”

Pamir and colleagues reviewed data from 23 901 participants from the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS). Previous studies that shaped perceptions about ‘good’ cholesterol levels and heart health were conducted in the 1970s through research with a majority of white adult study participants. For the current study, researchers were able to look at how cholesterol levels from Black and White middle-aged adults without heart disease who lived throughout the country overlapped with future cardiovascular events.

Study participants enrolled in REGARDS between 2003–2007 and researchers analysed information collected throughout a 10- to 11-year period. Black and white study participants shared similar characteristics, such as age, cholesterol levels, and underlying risk factors for heart disease, including having diabetes, high blood pressure, or smoking. During this time, 664 Black adults and 951 White adults experienced a heart attack or heart attack-related death. Adults with increased levels of LDL cholesterol and triglycerides had modestly increased risks for cardiovascular disease, which aligned with findings from previous research.

However, the study was the first to find that lower HDL cholesterol levels only predicted increased cardiovascular disease risk for white adults. It also expands on findings from other studies showing that high HDL cholesterol levels are not always associated with reduced cardiovascular events. The REGARDS analysis was the largest US study to show that this was true for both Black and White adults, suggesting that higher than optimal amounts of ‘good’ cholesterol may not provide cardiovascular benefits for either group.

“What I hope this type of research establishes is the need to revisit the risk-predicting algorithm for cardiovascular disease,” Pamir said. “It could mean that in the future we don’t get a pat on the back by our doctors for having higher HDL cholesterol levels.”

Pamir explained that as researchers study HDL cholesterol’s role in supporting heart health, they are exploring different theories. One is quality over quantity. That is, instead of having more HDL, the quality of HDL’s function – in picking up and transporting excess cholesterol from the body – may be more important for supporting cardiovascular health.

The authors conclude that in addition to supporting ongoing and future research with diverse populations to explore these connections, the findings suggest that cardiovascular disease risk calculators using HDL cholesterol could lead to inaccurate predictions for Black adults.

“When it comes to risk factors for heart disease, they cannot be limited to one race or ethnicity,” said Pamir. “They need to apply to everyone.”

Source: NIH/National Heart, Lung and Blood Institute