Tag: 25/5/21

Categories : Neurodegenerative DiseasesTags :

Nasal Spray Maximises Parkinson’s Drug Delivery

On By ModernMedia
Image source: Pixabay

Scientists at the University of York have been developing a nasal spray treatment for patients with Parkinson’s disease, which helps to maximise delivery of the drug in high enough dosages to be effective.

To do so, the researchers have developed an innovative new gel that can adhere to tissue inside the nose alongside the drug levodopa, helping deliver treatment directly to the brain.

Levodopa is a dopamine precursor which is converted to dopamine in the brain, where it makes up for the deficit of dopamine-producing cells in Parkinson’s patients. Generally administered when other anti-Parkinson’s medication is no longer useful, levodopa helps treat the symptoms of the disease, particularly bradykinesia, which is the impairment of voluntary motor control and slow movements or freezing. However, in the long term levodopa becomes less effective, requiring increased doses for the same effect.

Higher dosages neededProfessor David Smith, from the University of York’s Department of Chemistry, explained: “The current drug used for Parkinson’s Disease is effective to a point, but after a long period of use the body starts to break down the drug before it gets to the brain where it is most needed.

“This means increased dosage is necessary, and in later stages, sometimes, instead of tablets, the drug has to be injected.  Investigations into nasal sprays have long been of interest as a more effective delivery because of its direct route to the brain via the nerves that service the nose, but the challenge here is to find a way of making it adhere to the nasal tissue long enough to release a good dosage of the drug.”

The researchers created a levodopa-loaded gel that could flow into the nose in a liquid form and then rapidly change to a thin layer of gel inside the nose.  The method was tested in animal models by a team at King’s College London, where levodopa was successfully released from the gel into the blood and directly to the brain.

Improved uptake

Professor Smith said: “The results indicated that the gel gave the drug better adhesion inside the nose, which allowed for better levels of uptake into both the blood and brain.”

The team is now working on incorporating these materials in nasal spray devices, to progress clinical trials in humans.  The treatment of neurodegenerative diseases such as Alzheimer’s may also benefit from this approach.

Khuloud Al-Jamal, Professor of Drug Delivery and Nanomedicine from King’s College London, said: “Not only did the gel perform better than a simple solution, but the brain uptake was better than that achieved using intravenous injection of the drug. This suggests that nasal delivery of Parkinson’s drugs using this type of gel may have clinical relevance.” 

Source: University of York

Journal information: Wang, J. T-W., et al. (2021) Enhanced Delivery of Neuroactive Drugs via Nasal Delivery with a Self-Healing Supramolecular Gel. Advanced Science. doi.org/10.1002/advs.202101058.

Categories : COVIDTags :

Risk of COVID Infection Tripled in Healthcare Workers

On By ModernMedia
Photo by Alex Mecl on Unsplash

A study of healthcare workers has shown their likelihood of being infected with COVID during the pandemic was three times higher compared to the general population, with about one in five of those infected workers being asymptomatic and unaware they had COVID.

The study also shows that it was not only frontline staff who faced the higher risk, suggesting that there was transmission between staff and within the wider community. The results are published in ERJ Open Research.

However, health care workers who had been infected were very unlikely to contract COVID a second time in the following six months.

The research was led by Professor James Chalmers, a consultant respiratory physician from the University of Dundee.

“We have always believed that front line health workers face a high risk of contracting COVID and that’s why we’ve tried to ensure they have the PPE needed to protect themselves,” said Prof Chalmers. “But many questions remain about the level of this risk and what other measures we can take to protect staff and reduce transmission of the disease.”

The study recruited 2063 staff working in a wide variety of healthcare roles in the East of Scotland. Between May and September 2020, the participants had blood tests for COVID antibodies, a very accurate indication of prior COVID infection. The researchers also recorded whether any participants developed an infection in subsequent months.

The health care workers results were compared with a randomly selected control group of blood samples taken by local GPs during the same time period.

These blood tests showed that 300 (14.5%) of the healthcare workers had been infected, a rate more than triple the proportion of people infected in the local population. The highest rates of infections among the workers were found in dentistry (26%), health care assistants (23.3%) and hospital porters (22.2%). The rate among admin staff was the same as that of doctors (21.1%).

Rates among people working in areas of the hospital where COVID patients were being treated were somewhat higher than those working in non-COVID areas (17.4% vs 13.5%). However, the majority of infections were in staff who were not working directly with COVID patients, suggesting there was transmission between staff or infections acquired in the community.

Out of the 300 healthcare workers testing positive, 56 (18.7%) did not think that they had ever caught COVID and were totally asymptomatic. This is an important finding, according to the researchers, since people without symptoms are likely to go to work, potentially infecting others.

In the months following their blood tests, 39 workers developed a symptomatic COVID infection, but only one of these was a worker who had previously tested positive. This equates to an 85% risk reduction, similar to the level of protection provided by COVID vaccines.

Prof Chalmers said: “A lot of attention during the pandemic has been around PPE for doctors and nurses but we found that dentists, healthcare assistants and porters were the staff most likely to test positive.

“We continued to monitor staff for up to seven months and found that having a positive antibody test gave 85% protection against a future infection. This is really good news for people who have already had COVID-19, as it means the chances of a second infection are very low.”

The team hopes to continue the research to see how long immunity persists and how vaccination affects infections among healthcare workers.

Professor Anita Simonds, President of the European Respiratory Society and Consultant in Respiratory and Sleep Medicine at Royal Brompton Hospital, UK, was not involved in the research, offered comments.

She said: “This research shows the high levels of COVID infection among all healthcare workers, with the highest evidence of infection in dentists, healthcare assistants and porters. Staff working in critical care, who are likely to have been protected by using personal protective equipment at all times, were not disproportionately affected.

“It should be noted that among administrative staff, 21.1% were found to have been infected with COVID, indicating that all those working directly with patients, and those working in other hospital roles are at risk, and vaccination and risk assessment for appropriate levels of PPE in all these frontline groups are crucial.”

Source: European Respiratory Society

Categories : Injury & Trauma NeurologyTags :

White Matter Changes Uncovered in Repeated Brain Injury

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A new study has uncovered insights into white matter changes that occur during chronic traumatic encephalopathy (CTE), a progressive brain disease associated with repetitive head impacts. This discovery may help in identifying new targets for therapies.

CTE been diagnosed after death in the brains of American football players and other contact sport athletes as well as members of the armed services. The disease has been identified as causing impulsivity, explosivity, depression, memory impairment and executive dysfunction.

Though much prior research focused on repetitive head trauma leading to the development of abnormal tau, this study focused on white matter changes, particularly the oligodendrocytes which myelinate nerve sheaths. The results have been published online [PDF] in the journal Acta Neuropathologica.

“Research to date has focused on the deposition of abnormal tau in the gray matter in CTE. This study shows that the white matter undergoes important alterations as well.  There is loss of oligodendrocytes and alteration of oligodendrocyte subtypes in CTE that might provide new targets for prevention and therapies,” explained corresponding author Ann McKee, MD, chief of neuropathology at VA Boston Healthcare, director of the BU CTE Center.

Dr McKee and her team isolated cellular nuclei from the postmortem dorsolateral frontal white matter in eight cases of CTE and eight matched controls. They conducted single-nucleus RNA-seq (snRNA-seq) with these nuclei, revealing transcriptomic, cell-type-specific differences between the CTE and control cases. In doing so, they discovered that the white matter in CTE had fewer oligodendrocytes and the oligodendroglial subtypes were altered compared to control tissue.

Since previous studies have largely focused on the CTE-specific tau lesion located in the cortex in the brain, these findings are particularly informative as they explain a number of features of the disease. “In comparison, the cellular death process occurring in white matter oligodendrocytes in CTE appears to be separate from the accumulation of hyperphosphorylated tau,” she said. “We know that the behavioural and mood changes that occur in CTE are not explained by tau deposition. This study suggests that white matter alterations are also important features of the disease, and future studies will determine whether these white matter changes play a role in the production of behavioral or mood symptoms in CTE, such as explosivity, violence, impulsivity, and depression.”

Source: Boston University School of Medicine

Journal information: Chancellor, K. B., et al. (2021) Altered oligodendroglia and astroglia in chronic traumatic Encephalopathy. Acta Neuropathologica. doi.org/10.1007/s00401-021-02322-2.

Categories : Ageing PaediatricsTags :

Telomere Length May Be Set Early in Life

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Image source: Pixabay

Telomeres, the protective nucleotide end caps of chromosomes which shorten with every cell division, have been found by a new study to undergo great changes in length during the first years of life.

The length of telomeres is important in a number of age-related diseases and is also an important marker of biological age. When telomeres are completely shortened, cells become senescent and unable to divide any further to repair damage.

This study, one of the first to examine telomere length (TL) in childhood, found that the initial setting of TL during prenatal development and in the first years of life may determine one’s TL throughout childhood and potentially even into adulthood or older age. The study also finds that TL decreases most rapidly from birth to age 3, then remaining unchanged into the pre-puberty period, although on some occasions it was seen to lengthen.

Researchers at the Columbia Center for Children’s Environmental Health at Columbia University Mailman School of Public Health led the study, which followed 224 children from birth to age 9. Their findings were published in the journal Psychoneuroendocrinology.

The researchers discovered that a mother’s TL is predictive of newborn TL and tracks with her child’s TL through pre-adolescence. The reasons why some children have telomeres that shorten faster are unknown, though one explanation may be that telomeres are susceptible to environmental pollutants. It is also unknown why some children had telomeres that lengthened across the study period, a phenomenon seen in other studies.

“Given the importance of telomere length in cellular health and aging, it is critical to understand the dynamics of telomeres in childhood,” said senior author Julie Herbstman, PhD, director of CCCEH and associate professor of environmental health science at Columbia Mailman School. “The rapid rate of telomere attrition between birth and age 3 years may render telomeres particularly susceptible to environmental influences during this developmental window, potentially influencing life-long health and longevity.”

Researchers used polymerase chain reaction to measure TL in white blood cells isolated from cord blood and blood collected at ages 3, 5, 7, and 9, from 224 children. In a small group of mothers they also measured maternal TL at delivery.

The researchers said that further research is needed to understand the biological mechanisms behind the variance of TL shortening or lengthening rates in the first years of life, as well as modifiable environmental factors contributing to the shortening speed.

Source: Columbia Mailman School of Health

Categories : COVIDTags : 1 Comment

Case Positivity Rate in SA Breaches The Crucial 10% Mark

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Although new COVID cases have not yet shown an upward surge, the fact that the test positivity rate had climbed past 10% is cause for concern.

According to health minister Dr Zweli Mkhize, the 2383 new infections recorded in the past 24 hours came from 23 352 tests at a positivity rate of 10.2%. Yesterday the positivity rate stood at 9.86%, and in the days beforehand had been gradually creeping upward.

The government has previously expressed concern when the positivity rate (the percentage of COVID tests that return positive) reaches the 10% and 12% marks. In late November, ahead of the second wave, the case positivity rate was 14.5%. Some provinces of South Africa are reporting rates well in excess of this, particularly the Northern Cape which last week had a reported positivity rate of 24.1%.

Dr Mkhize also reported that there were 72 Covid-19 related deaths in the past 24 hours. The health minister also reported that across SA there were now 171 860 people who had received their first shot of the two-dose Pfizer vaccine.

With these latest figures, there are now 1 637 848 cumulative cases and 55 874 cumulative fatalities since the outbreak of the coronavirus in SA in March last year. However, the true toll may be much higher, as South Africa’s ‘excess deaths’, those which are above the average rate of deaths from all causes, were up to 2.67 times higher than the official toll. A report from a team at the SA Medical Research Council and University of Cape Town believed that around 85% of those excess deaths were due to COVID.

Source: Times Live

Categories : COVID General InterestTags :

Indian Doctors Hit Back at Guru’s Inflammatory Remarks

On By ModernMedia
Image source: Naveed Ahmed on Unsplash

Doctors in India have hit out against yoga guru Baba Ramdev over his controversial statements against modern medicine and mocking of COVID patients.

Recently, the controversial guru said that tens of thousands died of COVID after taking modern medicines, and also mocked patients for trying to get oxygen cylinders. 

The guru subsequently withdrew his statement after being criticised by the country’s health minister. But on Monday he again took a swipe at modern medicine for not having a cure for some diseases.

Despite India’s modern allopathic healthcare system, alternative therapies like ayurveda and homoeopathy are hugely popular in India. This has helped many gurus to launch successful businesses with sales of herbal medicines and products. India also has a Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (Ayush) that promotes traditional medicine systems.

The Indian Medical Association (IMA), which represents allopathy doctors in India, has criticised the guru for his “insensitive” remarks in the middle of the pandemic. Such statements from a guru with millions of followers were “irresponsible and demoralising”, said doctors spoken to by the BBC.
The country has been grappling with a surge of infections caused by a ‘double mutant’ SARS-CoV-2 variant as well as prematurely relaxed social distancing rules.

The controversy
A video of Baba Ramdev mocking patients for trying to find oxygen went viral earlier this month, making references to oxygen shortages in several cities in April and May.

“God has given us free oxygen, why don’t we breathe that? How can there be a shortage when God has filled the atmosphere with oxygen? Fools are looking for oxygen cylinders. Just breathe the free oxygen. Why are you complaining about shortage of oxygen and beds and crematoriums?” he said.

The statement drew sharp criticism from doctors and families of COVID patients who demanded an apology.

Just two weeks later, another video surfaced in which he criticises doctors, blaming COVID deaths on them. Many doctors expressed their anger over Twitter, some went so far as to demand his arrest. In the face of mounting pressures, India’s Health Minister Dr Harsh Vardhan issued a statement asking the guru to withdraw his remarks.

“Allopathy and the doctors attached to it have given new lives to millions of people. It’s very unfortunate for you to say that people died from consuming allopathic medicines.

“We should not forget that this battle can only be won through united efforts. In this war, our doctors, nurses and other health workers are risking their lives to save people’s lives. Their dedication towards serving mankind in this crisis is unparalleled and exemplary,” Dr Vardhan said.

Baba Ramdev withdrew his controversial statement in a Sunday tweet — only to issue a letter the next day asking the IMA why modern medicine had no cure for 25 diseases, including diabetes and hypertension.

This has again infuriated doctors. Prominent pulmonologist Dr A Fathahudeen, who has treated thousands of COVID patients, told the BBC that such statements cause lasting damage.

“For more than a year, healthcare workers like me have been in a war-like situation. We have saved tens of thousand of lives. It’s really unfortunate, insulting and hurtful to read such statements,” he said.

Dr Fathahudeen added that modern medicine had evolved over the years with constant research and studies. “We follow evidence-based practice. At any given time, thousands of researchers are working to come up with cures. Look at the progress we have made in cancer treatment. We have to constantly evolve and learn. It’s hard to trust any branch of medicine that offers absolute cure for every disease.”

Dr Fathahudeen also said that such statements manifest doubts in the minds of people when trust in medicines and vaccines is most needed in the middle of a raging pandemic.

Baba Ramdev’s rise to fame
Televised yoga classes were Baba Ramdev’s ticket to fame; he had a following of millions and he received worldwide praise for promoting yoga and healthy living.

He successfully leveraged his fame to create a business empire. In 2006, he helped launch a company called Patanjali Ayurveda to sell herbal medicines and a few years later, the business expanded to sell almost any product. Since last year, the company has been selling a product called Coronil that it has made a number of false claims over, including that it was a WHO-approved COVID treatment.

Source: BBC News