You might assume that all great medical discoveries are the result of deliberate action on the part of scientists. But you’d be wrong. Many great discoveries are the result of accidents, mistakes and chance. Here are five of the best, starting with the most recent.

1. Oxford vaccine dose

If the Oxford-AstraZeneca vaccine had been given at the specified dose, the effectiveness of the vaccine at stopping Covid-19 would have been a slightly disappointing 62%. (And I say “slightly disappointing” guardedly because it’s a good result, but next to Pfizer and Moderna’s 95% efficacy, it doesn’t look champagne-poppingly brilliant.)

In Brazil and South Africa, the Oxford vaccine was given at the correct initial dose, and the second dose a month later. But in the UK, the trial participants were incorrectly given half a dose in the first round and a full dose later. And, serendipitously, this resulted in 90% efficacy. Not only that, but the “wrong” dose also resulted in milder side-effects.

2. Penicillin

Perhaps the most famous serendipitous discovery in medicine is Alexander Fleming’s chance discovery of penicillin in 1928. Growing Staphylococcus bacteria that had been left on a bench, he noted on returning from holiday, that one of the plates he was culturing had no bacterial growth around a fungal colony that had started in the plate.

Fleming made his cultures of this fungus – penicillin – available far and wide. It would be one of his former students who first used it to treat a bacterial infection in 1930.

And it would be more than ten years later that penicillin was being produced in mass quantities to test its clinical effectiveness on patients, following groundbreaking work from Oxford University.

3. Culturing bacteria

The discovery and study of bacteriology by Robert Koch was a significant scientific advance. Before his work, bacteria were notoriously difficult to isolate from each other and were often grown in a nutrient broth that supports many species.

In 1872, Koch noted the growth of distinct colonies on a potato slice and this would be the catalyst for the use of agar, which is now the standard substance used to grow bacteria in a petri dish.

This discovery would allow scientists to isolate which bacteria were making a patient ill.

Koch’s work led to him discover the first causative bacteria of a named disease: Bacillus anthracis, which causes anthrax.

4. X-rays

The application of X-rays revolutionised medicine in the late 19th and early 20th century. Wilhelm Röntgen became aware of these new rays, which he called “X” because of their unknown origin, while studying cathode rays (streams of electrodes in vacuum tubes).

He noticed that the X-rays could penetrate cardboard, and he quickly used them to show they penetrated human tissues, too, using his wife’s hand to do so.

The application of these rays for looking inside the human body soon became widespread. There was little understanding of the damage they were doing. Many cases of symptoms typical of radiation sickness and exposure were documented, including famous scientists such as Thomas Edison.

5. Stomach ulcers

Over 4 billion people are estimated to be infected with H pylori, a bacterium that lives in the stomach and can cause ulcers. It was the tireless efforts of two researchers – Barry Marshall and J. Robin Warren – and a longer than usual growing period, that led to the discovery of the bacteria.

Before this, stress and certain foods were thought to cause stomach ulcers. While these factors can make ulcers worse, they don’t cause them.

In 1982, Marshall and Warren were studying the stomach lining and contents of several patients with varying gastric symptoms. The fortuitous positioning of the Easter weekend meant that cultures from patients were left alone in the lab longer than usual. This resulted in the identification of a slow-growing novel bacteria that was causing these symptoms.

Sadly, the reluctance of the scientific community to accept the findings of the scientists led to Marshall infecting himself with H pylori by consuming a live culture of bacteria, becoming symptomatic and then treating himself with antibiotics.

Adam Taylor, Professor and Director of the Clinical Anatomy Learning Centre, Lancaster University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

“I knew, as I clutched my firstborn child, that I was losing my second,” Meghan writes in an article.

• Prostate cancer treatment can affect some physiological functions
• The effect of exercise during prostate cancer treatment has not been widely studied 
• However, a new study has found that exercise during treatment has no adverse effects on prostate cancer patients

It has been established that treatment for prostate cancer may affect a number of bodily functions, yet the effect of exercise on the immune response in such patients has not been thoroughly investigated.

Previous exercise guidelines for cancer patients were based on physiological responses in healthy patients, but it has recently been found that cancer patients have a different response to exercise.

A recent study published in Experimental Physiology set out to describe the nature of the natural killer (NK) cell response after acute exercise (a single bout of exercise) in prostate cancer survivors. 

Natural killer cells

Natural killer (NK) cells are of the same family as T cells and B cells and are categorised as lymphocytes (a type of white blood cell).

NK cells are known for cell-mediated, cytotoxic innate immunity – meaning that they act as the first line of defence when it comes to detecting and controlling the first stages of cancer.

Previous studies have shown that, in animal models, exercise triggered the immune system to send NK cells to areas where infection and tumours are present and in cancer patients, NK cells would invade the tumours, potentially slowing down growth. 

Mobilising the immune system

Researchers at the Victory University in Melbourne had 33 participants complete a cycling task in order to assess their maximal fitness. Eleven of the participants were cancer survivors, 14 were men with prostate cancer, and the other eight were healthy individuals acting as controls. 

The researchers then opted to use an exercise session of moderate intensity, and standardised the exercise according to each participant’s maximal fitness. This was done to ensure that each individual’s immune system was equally stimulated.

Blood samples were collected before exercise, immediately after and two hours later in order to assess immune function. Immune function was assessed again one day (24 hours) after the exercise.

Exercise gets thumbs up for prostate cancer patients

After 24 hours, it was found that NK cell levels had returned to resting levels. This means that exercise is, in fact, safe for prostate cancer survivors and patients and that it does not interfere with treatment. 

The researchers stated: “Consecutive training sessions can likely be used without adverse effects on the immune system during prostate cancer treatment.”

“Inadequate” stockpiles meant the government had to boost supplies quickly, the spending watchdog says.

• The Covid-19 pandemic has made previously routine vaccinations against other infectious diseases, such as measles, a challenge
• This is because many vaccination campaigns were paused for months in 2020
• These factors may result in severe measles outbreaks in 2021, and governments need to urgently address the situation

Measles, a highly contagious respiratory disease, claimed over 207 500 lives in 2019, according to the World Health Organization – a 50% increase from 2016.

While vaccination efforts may have reduced the number of deaths from 2000 to 2018, the Covid-19 pandemic is impacting efforts to control and treat other diseases, including measles.

The disease, caused by a virus in the paramyxovirus family, affects mainly unvaccinated young children and unvaccinated pregnant women. However, any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected, notes the WHO.

A recently-published article in The Lancet has therefore called for urgent international action to prevent potentially devastating measles epidemics in the years to come.

As a result of resources and attention shifting to the pandemic, many children have missed out on measles vaccination this year, making future measles outbreaks inevitable, said lead author Professor Kim Mulholland, from the Murdoch Children’s Research Institute and Chair of the WHO’s SAGE Working Group on measles and rubella vaccines.

Economic impact of lockdown, malnutrition, and measles

The year 2020 has been a quiet year for measles, thanks to travel reductions and national Covid-19 control measures implemented globally. However, the resulting economic impact could have a direct effect on the proliferation of the disease, especially against the background of childhood malnutrition.

The severity of measles can be worsened through malnutrition, the authors wrote, leading to poorer outcomes and more deaths, especially in low- and middle-income countries. (Measles is particularly common in parts of Africa and Asia, where the majority – more than 95% – of measles deaths occur in countries with low per capita incomes and weak health infrastructures.)

“Children who die from measles are often malnourished, but acute measles pushes many surviving children into malnutrition,” Mulholland said.

“Malnutrition, along with measles-associated immune suppression, leads to delayed mortality, while co-existing vitamin A deficiency can also lead to measles-associated blindness.

“The coming months are likely to see increasing numbers of unimmunised children who are susceptible to measles. Many live in poor, remote communities where health systems are less resilient, and malnutrition and vitamin A deficiency are already increasing.”

Vaccination campaigns also halted during pandemic

Mulholland also expressed concern about the negative effect the Covid-19 pandemic has had on the control of vaccine-preventable diseases, as a result of vaccination campaigns being paused during some months in 2020, and routine immunisation services disrupted in many countries.

By the end of October 2020, the WHO estimated that delayed vaccination campaigns in 26 countries led to 94 million children missing scheduled measles vaccine doses.

“All these factors create the environment for severe measles outbreaks in 2021, accompanied by increased death rates and the serious consequences of measles that were common decades ago,” Mulholland said.

“This is despite the fact that we have a highly cost-effective way to prevent this disease through measles vaccination.”

The return of measles in 2019

Before Covid-19 swept the globe, there was already a dramatic return of measles – more than at any time in the past 20 years, the researchers stated.

According to WHO data, there were 9.8 million measles cases and 207 000 deaths in 2019, a staggering 50% more than in 2016.

Where have most cases occurred?

Africa has seen the large majority of measles-related deaths, with major outbreaks happening in Madagascar and the Democratic Republic of Congo. The disease also re-emerged in South America, especially among indigenous communities.

Mulholland explained that the inadequate vaccination that led to the 2019 measles outbreaks has still not been adequately addressed, adding that the situation has been exacerbated by service disruptions during the Covid-19 pandemic where high-risk, unimmunised children were clustered together in unreached communities.

The way forward: Proposed solutions

The authors proposed three pillars for immediate action:

• Help countries reach unimmunised children through catch-up immunisation and campaigns.
• Better prepare countries for expected outbreaks – the WHO and partners have developed a Strategic Response Plan to assist with measles outbreak prevention, preparedness and response.
• Maintain measles and rubella elimination targets. WHO’s new Measles Rubella Strategic Framework 2021–2030, aligned with the Immunization Agenda 2030 provides a plan for strengthening routine immunisation and surveillance.

“Without concerted efforts now, it is likely that the coming years will see an increase in measles and its severe, frequently fatal, complications,” Mulholland said, commenting that the proposed solutions might help end the outbreaks of the past decade.

READ | How measles complications can affect every organ

READ | Measles leaves people more vulnerable to future infections

READ | Vaccinations halted in several poor countries due to coronavirus fears

^{Image: Katja Fuhlert from Pixabay} 

South Africa has a long tradition of using plants for medicinal purposes. Some of these, such as Aloe ferox, Sutherlandia frutescens and Kiggelaria africana, have been studied as sources of useful compounds. But most still need to be scientifically validated as treatments for particular diseases.

Medicinal plants are gradually gaining prominence in scientists’ search for potential treatment agents for Covid-19. Currently there is no specific antiviral drug to treat this new respiratory disease. Most treatment strategies focus on managing symptoms and supportive therapy such as supplementary oxygen and mechanical ventilation.

My colleagues and I from the Durban University of Technology and the University of KwaZulu-Natal in South Africa are among the researchers looking for potential Covid-19 treatments from plants. We recently completed the first phase of our project, which ultimately seeks to develop a novel SARS-CoV-2 therapeutic.

Our aim in the first phase was to identify bioactive compounds in plants that are indigenous to South Africa which could be effective against SARS-CoV-2, the virus that causes Covid-19. We looked for potential Covid-19 therapeutic agents from a list of 29 bioactive compounds.

The species chosen were based on their use for the common cold, flu, other respiratory conditions, antimalarial, antiviral and antioxidant activity.

Our initial findings show that some compounds had the potential to inhibit SARS-CoV-2. We are now in the second phase of our study, which will test the compounds rigorously in the laboratory. This is a starting point in the search for a novel SARS-CoV-2 therapeutic.

From plant extract to therapeutic

In the initial stage of this project we worked with collaborators from the University of KwaZulu-Natal, Bio-computational and drug design laboratory. The team screened potential bioactive compounds isolated from commonly used South African medicinal plants using molecular docking.

Molecular docking is the study of how two or more molecular structures (for example, a drug and an enzyme or protein) fit together. Protein-binding may affect drug activity in one of two ways: either by changing the effective concentration of the drug at its site of action or by changing the rate at which the drug is eliminated, thus affecting the length of time for which effective concentrations are maintained.

We performed molecular docking of the plant compounds against SARS-CoV-2, using biocomputational analysis.

Some of the plant compounds showed potential. These were from Acacia senegal, Sutherlandia frutescens, Hypoxis hemerocallidea, Xysmalobium undulatum and Aspalathus linearis (commonly known as rooibos).

They exhibited favourable binding orientations and were identified as potential inhibitors of the SARS-CoV-2 receptor binding domain and SARS-CoV-2 RNA-dependent polymerase.

Four compounds exhibited extremely good binding to the virus, meaning that these compounds may prevent the virus from replicating.

These compounds could serve as a starting point for the discovery of a novel SARS-CoV-2 therapeutic.

Next steps

For the next stage we will infect animal cells with the virus. Then we’ll administer the compounds (cytotoxicity screening) to see what effect they have. If this in vitro study shows promising results, further analysis will be conducted using an animal model. The effects of the compounds on infected rats will be monitored.

Our end goal is to finally have a successful treatment for this virus. Infections can still occur even when a safe and effective vaccine is available. This is why it’s important to ensure effective treatments are also part of the efforts to end Covid-19.

No traditional African medicine has been scientifically validated yet as a treatment for SARS-CoV-2.

We are now in the second phase of our study, which will test the compounds rigorously in the laboratory if funding can be found. This depends on a lot of different factors.

We will be working with collaborators from the University of KwaZulu-Natal’s Department of Virology, where the analysis will take place.

Depika Dwarka, Post doctoral Fellow, Durban University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

• High blood sugar levels in Covid-19 patients are a major red flag, even if they don’t have diabetes.
• A large Spanish study found this to be especially true when levels are high upon admission to hospital.
• Hyperglycaemia should be actively monitored and treated in Covid-19 patients to reduce mortality rates.

The deadly impact of Covid-19 on diabetic patients has been well-established during the coronavirus pandemic, but more research is showing that high blood sugar can be fatal, even if you don’t suffer from diabetes.

Earlier research in July first revealed this sinister complication in coronavirus patients, and the latest study from Spain is the largest to date, using data from more than 11 000 patients.

Published in Annals of Medicine, the study took a closer look at the blood sugar levels of Covid-19 patients at the time of their hospital admission, regardless of their diabetic status.

READ | High blood sugar in Covid-19 patients who have never had diabetes can cause death

Early warning sign

The researchers established that high blood sugar – also known as hyperglycaemia – upon non-critical admission is an early warning sign that a Covid-19 patient might need mechanical ventilation and have a higher risk of death. 

In those without diabetes, hyperglycaemia can be triggered by infection, trauma, medications and other chronic conditions.

“Although several studies and meta-analyses have shown that patients with diabetes have a significantly higher risk of severe Covid-19 and increased mortality rates,” write the researchers, “the impact of hyperglycaemia itself, rather than the presence of [diabetes], has not been sufficiently described in non-critical patients hospitalised with Covid-19”.

What is the link between blood sugar and Covid-19?

One theory suggests that the virus’s infection of endocrine pancreas cells can disrupt the body’s insulin management, while another highlights that the inflammation a body endures during an infection can increase insulin resistance.

“One question that remains to be answered is whether hyperglycaemia plays any role in the physiopathology of the disease or if it is just an inflammatory bystander,” the study speculates.

Using data from 11 312 Covid-19 patients from 109 hospitals in Spain, they looked at admission hyperglycaemia in non-critical patients and its link to the length of hospital stay, ICU admission, mechanical ventilation and death.

The study, however, didn’t include patients who developed hyperglycaemia while in the hospital due to treatments and medications.

READ MORE | More evidence shows why Covid mortality rate is higher in men

High glucose levels, higher death rate

The patients were assigned to three groups based on their blood sugar levels – less than 140mg/dL, between 140 and 180 mg/dL, and more than 180mg/dL. Only about 18.9% of the group was classified as diabetic, and those with high levels tended to be older, male and mostly had some history of diabetes, hypertension and other chronic conditions.

Just more than 20% of the patients died in the hospital and, out of the mortalities, 41.1% were in the high blood glucose group, 33% from the middle range and 15.7% below 140mg/dL.

“Indeed, there was a gradual increase in all-cause mortality as admission [blood glucose] levels increased, and there were no differences in mortality rates within each category of [blood glucose] levels between patients with or without a previous history of diabetes,” explain the researchers.

Early monitoring important 

Even compared to other factors like age, gender, hypertension, chronic obstructive pulmonary disease and anaemia, high blood sugar levels still stood out as a predictor for mortality from Covid-19.

Those with elevated levels also tended to stay in hospital for longer and were more likely to be admitted to ICU and go on a ventilator.

The results from the study highlight the importance of blood glucose monitoring in Covid-19 patients, even if they don’t have diabetes, especially in the early stages of infection and hospitalisation.

“Early correction of hyperglycaemia in the course of Covid-19 could result in a decrease in the release of inflammatory cytokines and a reduction in the virus’s ACE binding capacity, consequently resulting in better outcomes,” the researchers concluded.

READ | Covid-19: An extensive study of the outbreak in Spain found most people did not develop immunity

^{Image credit: Unsplash}

When you think of swimming, you probably imagine pushing through the water — creating backwards thrust that pushes you forward. New research at the Marine Biological Laboratory (MBL) suggests instead that many marine animals actually pull themselves through the water, a phenomenon dubbed “suction thrust.”

Anthraquinones are a class of naturally occurring compounds prized for their medicinal properties, as well as for other applications, including ecologically friendly dyes. Despite wide interest, the mechanism by which plants produce them has remained shrouded in mystery until now.