Tag: 27/5/22

Categories : Cardiovascular Disease Diet and NutritionTags :

An Egg a Day Keeps the Cardiologist Away

On By ModernMedia
Photo by Annie Spratt on Unsplash

Research published in eLife has shown how moderate egg consumption can increase the amount of heart-healthy metabolites in the blood. The findings suggest that eating up to one egg per day may help lower the risk of developing cardiovascular disease.

A rich source of dietary cholesterol, eggs also contain a variety of essential nutrients. Eggs have long had a bad rap when it comes to cardiovascular health, with conflicting evidence as to whether egg consumption is beneficial or harmful to heart health. A large study in China showed that those who ate one egg a day had a lower cardiovascular disease risk than those who ate eggs occasionally. To explore this, researchers carried out a population-based study exploring how egg consumption affects markers of cardiovascular health in the blood.

“Few studies have looked at the role that plasma cholesterol metabolism plays in the association between egg consumption and the risk of cardiovascular diseases, so we wanted to help address this gap,” explained first author Lang Pan, MSc at the Department of Epidemiology and Biostatistics, Peking University, Beijing, China.

Pan and the team selected 4778 participants from the China Kadoorie Biobank, 3401 of whom had a cardiovascular disease and 1377 did not. Measuring 225 metabolites in plasma samples taken from the participants’ blood, they identified 24 that were associated with self-reported levels of egg consumption.

Their analyses showed that individuals who ate a moderate amount of eggs had higher levels of a protein in their blood called apolipoprotein A1- a building-block of high-density lipoprotein (HDL). These individuals especially had more large, protective HDL molecules in their blood.

The researchers further identified 14 metabolites linked to heart disease, and participants who ate fewer eggs had lower levels of beneficial metabolites and higher levels of harmful ones in their blood, compared to regular egg eaters.

“Together, our results provide a potential explanation for how eating a moderate amount of eggs can help protect against heart disease,” says author Canqing Yu, Associate Professor at the Department of Epidemiology and Biostatistics, Peking University. “More studies are needed to verify the causal roles that lipid metabolites play in the association between egg consumption and the risk of cardiovascular disease.”

“This study may also have implications for Chinese national dietary guidelines,” adds senior author Liming Li, Boya Distinguished Professor at the Department of Epidemiology and Biostatistics, Peking University. “Current health guidelines in China suggest eating one egg a day, but data indicate that the average consumption is lower than this. Our work highlights the need for more strategies to encourage moderate egg consumption among the population, to help lower the overall risk of cardiovascular disease.”

Source: eLife

Categories : COVIDTags :

Loss of Smell Went Unnoticed as Delta Wave Symptom

On By ModernMedia
Woman smelling jasmine
Photo by Elly Johnson on Unsplash

The loss of smell and taste with a COVID infection during the delta wave was a prevalent symptom and wasn’t prevented by vaccination, suggests a new study is published in the journal Med.

The small Ohio State University study also found that some people with the earliest COVID infections were continuing to experience loss of these senses months later without realising it.

In participants with active infections during the delta surge, a majority (22 of 25) had been vaccinated. Objective screenings found that 100% were experiencing a diminished or lost sense of smell – but only 54.5% self-reported any problem with odour detection.

“We’re getting this quick communication out as an early warning. We need to continue to take a closer look at COVID infection’s impact on smell and taste,” said Dr Kai Zhao, associate professor of otolaryngology in Ohio State’s College of Medicine and senior author of the study. “Even if COVID doesn’t cause death or hospitalisation, it can have long-lasting effects on some of our sensory functions.

“A lot of people are potentially suffering, which is probably not appreciated by society.”

Data for this study emerged from an earlier project the researchers started to test the use of hard candy as a screening tool for the loss of taste and smell in populations at risk for exposure to the SARS-CoV-2 virus.

As part of that work, the team used an existing objective screening tool to collect sensory function data from 123 never-infected control participants and 65 people who had previous or active COVID infections. During the delta surge, the researchers became alarmed by what they found.

“At that time, there were a lot of speculations about whether smell loss is associated with the delta variant and whether the vaccine could protect against these symptoms. So we decided to do this interim data analysis,” Dr Zhao said.

In addition, about three-fourths of participants whose mostly mild COVID infections had occurred before delta’s dominance reported no ongoing smell and taste losses – however, over half of those participants were found by the objective screening, conducted between 102 and 785 days after their infection diagnosis, to have a loss of smell. 

“Many people who had COVID in the past, probably with the original variants of the virus,  underwent some degree of smell loss, even if they didn’t think they did,” said co-author Susan Travers, professor of biosciences in Ohio State’s College of Dentistry. “This suggests the long-term impact on sensory function isn’t captured by self-reporting.”

Beyond these silent smell and taste losses, there were also people who reported that they hadn’t regained taste or smell function for longer than six months, said first author Kym Man, a graduate student in food science and technology. 

“We’re still collecting data on these long haulers, some of whom have been experiencing smell and taste loss for over a year,” she said. 

Effects on the senses include diminished or complete loss of smell and/or taste, disordered smell and/or taste and, least common, smelling odors that are not present at all. 

The sensory function screenings were conducted with a National Institutes of Health tool consisting of a 9-item scratch-and-sniff odour identifier and an intensity rating of bitterness in a sip of quinine. The odour-detection results were adjusted for age – in general, smell sensitivity declines with age, Dr Zhao said. 

Beyond affecting the quality of life, the loss of smell and taste has health ramifications that include negative effects on nutrition intake and a reduced ability to detect danger – such as a fire or spoiled food.

“The disease’s impact on smell and taste is underreported. This is a public health concern that there may potentially be some broader impacts of COVID that we don’t realise are there,” Dr Zhao said. 

Source: Ohio State University

Categories : Hospitals Obstetrics & GynaecologyTags :

Doctors Stand Behind Scathing Indictment of Rahima Moosa Hospital Conditions

On By ModernMedia
Source: CC0

Doctors have come out in support of criticism of the conditions at Rahima Moosa Mother and Child Hospital (RMMCH) in Johannesburg. The dire situation at the hospital, which has reportedly resulted in numerous patient deaths, has been highlighted on a number of occasions.

A year ago, Daily Maverick visited RMMCH after concerns being voiced by doctors and patients, and found a number of problems there. This year, a viral video clip showed pregnant women sleeping on the floor at the Gauteng hospital, and Daily Maverick returned to found the situation had worsened, yet the hospital’s CEO Dr Nozuko Mkabayi emphatically denied anything was amiss.

Dr Mkabayi said that although the hospital experiences periodic drug stockouts and equipment shortages, “Patients’ lives are not in danger and there is enough essential equipment. The hospital equipment committee is functional in ensuring adequate equipment needs for patient care.”

Then paediatrician Dr Tim de Maayer wrote an open letter to the Department of Health which sent further shockwaves through the media.

He said that his patients were dying due to a simple lack of basic resources. Drugs were in short supply; staff were massively overloaded; the hospital’s generators were ill-equipped to handle load shedding; and even water supply was threatened, causing hospital-acquired infections to spread “like wildfire”. These issues, Dr Maayer noted, had been raised with management before.

Gift of the Givers had stepped in and sunk a borehole to assist with the water supply situation – although a charity having to come to the rescue of a public hospital is an embarrassment.

Department of Health spokesperson Kwara Kekana acknowledged that the infrastructure was lacking:

“The hospital has over the past decade seen an increase in patient load with no increase in infrastructure development,” she said. “It has steadily increased intake from 10 000 deliveries to 16 000 deliveries per year, which is the second highest in the country.”

“To add more capacity, the hospital has repurposed 22 beds to accommodate more antenatal patients in the last two years making a total of 56 antenatal beds, which is still insufficient.”

RMMCH had requested exemption from the load shedding schedule, she noted.

In an interview with eNCA, Professor Haroon Saloojee, head of community paediatrics at Wits Universiy, said that he “wholeheartedly” agreed with Dr Mayeer, saying that, “what I think he is describing is the ‘complete storm'” and it “contributes to a reduction in quality care.

“[…]it’s the issue of inadequate staff, just not enough doctors but particularly nurses for the patient load – and certainly for the situation at Rahima Moosa has been far worsened that Charlotte Maxeke has been closed for so long and they’ve had to take the load. So a very busy hospital with a greatly increased number of deliveries as the load has become more. Added to that a problem with getting adequate equipment, he makes that point. And to add to that we’ve had both the crises with water availability and to top that all the regular loadshedding which means the generators weren’t coping.

“So you end up with a major storm and shouldn’t surprise then that children’s lives get affected.”

Regarding procurement issues such as running out of bread he remarked, “I’m sure there’s a lot of bureaucracy, but a lot of it is the simple management of the day-to-day running of a hospital, including how it places accounts, and the truth is that many hospitals are forfeiting at that.”

Since his letter went out, Dr Maayer has said there has been some reaction from the government, with President Ramaphosa reportedly wanting to see a response from RMMCH’s CEO. Deputy Health Minister, Sibongiseni Dhlomo has said that the letter is worrying and will be looked into.

Categories : CancerTags :

Abiraterone and Enzalutamide Less Safe for Prostate Cancer than Thought

On By ModernMedia
Credit: Darryl Leja, National Human Genome Research Institute, National Institutes of Health

Men taking abiraterone or enzalutamide, two common oral medications for advanced prostate cancer in combination with hormone therapy, were at greater risk of serious metabolic or cardiovascular issues than patients receiving hormone therapy alone.

Patients taking abiraterone, an androgen biosynthesis inhibitor, had 1.77 greater risk of emergency room or the hospital admission due to diabetes, hypertension or heart disease compared to those who were only on hormone therapy. The risk was 1.22 for those receiving enzalutamide.

Compared to patients not receiving abiraterone, those taking abiraterone were also more likely to need an outpatient visit with their physician related to at least one of these health conditions. That was not the case if the man was taking enzalutamide.

Abiraterone and enzalutamide were both found to be relatively safe in clinical trials, but concerns that the population of patients who participated in the trials was different than those in real-life settings prompted the researchers to take another look at the effects of the drugs.

For instance, this research exclusively analysed patients with Medicare health insurance, and the majority of men studied were significantly older than those in the drugs’ clinical trials.

“Patients enrolled in clinical trials tend to be highly selected and often times do not reflect the patient population in day-to-day practice,” said first author Lillian Y. Lai, MD, MS, at Michigan Medicine. “Trial participants also undergo stringent safety evaluations that some of our patients do not have access to. By studying adverse events in real-life settings, we can better understand the risks of these life-prolonging cancer treatments and help clinicians and patients make informed decisions regarding treatment.”

Since metabolic and cardiovascular conditions tend to be under the purview of primary care providers, Dr Lai and her fellow authors recommend team-based care that involves PCPs for patients with advanced prostate cancer as a way to manage these higher risks.

“With continued expansion of the indications for abiraterone and enzalutamide to earlier stages of the disease, increasing numbers of men will be receiving these therapies for longer periods of time,” Dr Lai said. “This will potentially amplify the scope of men affected and increase the magnitude of the risks of adverse events, making careful attention to management of these issues crucial.”

Source: University of Michigan

Categories : Antibiotics Cardiovascular DiseaseTags :

Gut Bacteria can Reduce Effectiveness of Antihypertensive Drugs

On By ModernMedia

A new study published this month in the journal Hypertension has shown gut bacteria can reduce the effectiveness of certain antihypertensive drugs. The research provides the first clues into why some people not respond well to medication.

Among those with hypertension, an estimated 20% have resistant hypertension, where their blood pressure remains high despite aggressive treatment.

“The only thing doctors can really do in these patients is adding or switching medications and increasing the dose with the hope they can find something that works,” said Dr Tao Yang, an assistant professor at University of Toledo and the study’s first and lead author. “Until now, we haven’t had any clear indication what the mechanism is for resistant hypertension. Our research could provide a first step toward identifying new ways to effectively overcome treatment-resistant hypertension.”

Recent research has focused on the link between blood pressure and the gut microbiome. That work has helped to unravel potential causes of hypertension beyond diet and exercise. However, Dr Yang’s research is the first to examine the impact of gut bacteria on blood pressure medication itself.

In the study, UToledo scientists compared the effectiveness of the antihypertensive drug quinapril in rats with normal gut bacteria against those with gut microbiota depleted by high doses of antibiotics.

Researchers found a clear difference between the two, with animals that were given antibiotics first responding much better to quinapril.

Analysis of the gut bacteria composition in the animals identified the bacteria Coprococcus as the culprit. Laboratory experiments proved that Coprococcus comes, a dominant bacteria species in this genus, can break down quinapril and ramipril, resulting in the compromised blood pressure-lowering effects.

While the study was confined to animal models and lab experiments, researchers did find at least one intriguing case study that seems to support the notion that this could be applicable to humans.

That 2015 report, published in the International Journal of Cardiology, described a woman with a long history of treatment-resistant hypertension whose blood pressure was controlled without any antihypertensive medication for the two weeks she was taking antibiotics for a post-surgical infection. Her blood pressure was able to be controlled with only one medication for six months after stopping antibiotics, before again becoming treatment-resistant.

“This is just one report and more research is needed. However, this suggests that gut bacteria can play a very real and very important role in regulating the efficacy of blood pressure medication,” Dr Yang said.

The research group intends to further explore the interaction between additional blood pressure medications and other common types of gut bacteria.

Though long-term use of antibiotics isn’t a realistic strategy for addressing treatment-resistant hypertension, Dr Yang said it should be possible for someone to alter their microbiota through probiotics, prebiotics and changes in diet.

“The ultimate goal of my research is to identify ways we can specifically target the bacteria in an individual’s gut to improve drug efficacy,” he said. “This has the potential to benefit a lot of people.”

Source: University of Toledo