Blood thinners may improve survival among hospitalized COVID-19 patients

Posted on 08/05/2020 by Boris Clair

Treating hospitalized COVID-19 patients with anticoagulants — blood thinners that slow down clotting — may improve their chances of survival, researchers from the Mount Sinai COVID Informatics Center report. The study, published in the May 6 issue of the Journal of the American College of Cardiology, could provide new insight on how to treat and manage coronavirus patients once they are admitted to the hospital.

The study found that hospitalized COVID-19 patients treated with anticoagulants had improved outcomes both in and out of the intensive care unit setting. The research also showed that the difference in bleeding events among patients treated with and without anticoagulants was not significant. The Mount Sinai researchers say their work outlines an important therapeutic pathway for COVID-19 patients.

“This research demonstrates anticoagulants taken orally, subcutaneously, or intravenously may play a major role in caring for COVID-19 patients, and these may prevent possible deadly events associated with coronavirus, including heart attack, stroke, and pulmonary embolism,” says senior corresponding author Valentin Fuster, MD, PhD, Director of Mount Sinai Heart (the nation’s number six ranked hospital in Cardiology/Heart Surgery) and Physician-in-Chief of The Mount Sinai Hospital. “Using anticoagulants should be considered when patients get admitted to the ER and have tested positive for COVID-19 to possibly improve outcomes. However, each case should be evaluated an individualized basis to account for potential bleeding risk.”

The publication of this study follows recent research out of the Icahn School of Medicine at Mount Sinai that shows a large number of patients hospitalized with COVID-19 have developed high levels of life-threatening blood clots, leading to potentially deadly thromboembolic events.

A team of investigators evaluated records of 2,773 confirmed COVID-19-positive patients admitted to five hospitals in the Mount Sinai Health System in New York City (The Mount Sinai Hospital, Mount Sinai West, Mount Sinai Morningside, Mount Sinai Queens, and Mount Sinai Brooklyn) between March 14 and April 11, 2020. They specifically looked at survival rates for patients placed on blood thinners versus those not placed on blood thinners. The researchers took certain risk factors into account before evaluating the effectiveness of anticoagulation, including age, ethnicity, pre-existing conditions, and those already on blood thinners.

Of the COVID-19 patients analyzed, 786 (28 percent) received a full-treatment dose of anticoagulants — a higher dose than what is typically given for blood clot prevention, and one that is usually given to those who already have clots or are suspected to have clots. Treatment with anticoagulants was associated with improved hospital survival among COVID-19 patients both in and out of the intensive care unit setting. Of the patients who did not survive, those on anticoagulants died after spending an average of 21 days in the hospital, compared to the non- anticoagulant patients who died after an average of 14 days in the hospital. The effect of anticoagulation had a more pronounced effect on ventilated patients — 62.7 percent of intubated patients who were not treated with anticoagulants died, compared to 29.1 percent for intubated patients treated with anticoagulants. Of the intubated patients who did not survive, those with no anticoagulants died after 9 days, while those on anticoagulants died after 21 days.

All patients in the study had blood work done when they arrived at the hospital, which included measuring various inflammatory markers. The analysis of their records showed patients who received anticoagulants had higher inflammatory markers compared to patients not treated with anticoagulants. This may suggest patients with more severe illness may benefit from anticoagulants early on.

The observational study also explored the association of systemic anticoagulant treatment with bleeding events. Major bleeding was defined as 1) hemoglobin <7 g/dL and any red blood cell transfusion; 2) at least 2 units of red blood cell transfusion within 48 hours; or 3) a diagnosis code for major bleeding including intracranial hemorrhage; hematemesis; melena; peptic ulcer with hemorrhage; colon, rectal, or anal hemorrhage; hematuria; ocular hemorrhage; and acute hemorrhagic gastritis. Among those who did not receive anticoagulants, 38 (1.9 percent) patients had bleeding events, compared to 24 (3 percent) among those who received anticoagulants, p=0.2).

“We are hopeful that this report of the association of anticoagulation therapy with improved survival will be confirmed in future investigations. The astute scientists at Mount Sinai continue to analyze our data on COVID-19 patients in order to contribute to worldwide efforts to find effective treatments,” says David Reich, MD, President and Chief Operating Officer of The Mount Sinai Hospital.

“As a cardiologist who has been on service caring for COVID-19 patients for the last three weeks, I have observed an increased amount of blood clot cases among hospitalized patients, so it is critical to look at whether anticoagulants provide benefits for them,” says co-researcher Anu Lala, MD, Assistant Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai. “It’s important to note that further analysis and prospective studies are required to determine the effectiveness for widespread use of anticoagulants in hospitalized COVID-19 patients.”

“This study is opening the door for a more extensive study that will be carried out with 5,000 COVID-19-positive patients, where we will evaluate the effectiveness of three types of antithrombotic therapy — oral antithrombotic, subcutaneous heparin, and intravenous heparin — and then perhaps engage our data for prospective clinical trials,” says senior author Girish Nadkarni, MD, Co-Director of the Mount Sinai COVID Informatics Center. “We are excited about these preliminary results that may have a positive impact on COVID-19 patients and potentially give them a greater chance of survival, although more studies are needed.”

Prediction tool shows how forest thinning may increase Sierra Nevada snowpack

Posted on 07/05/2020 by Boris Clair

The forest of the Sierra Nevada mountains is an important resource for the surrounding communities in Nevada and California. Thinning the forest by removing trees by hand or using heavy machinery is one of the few tools available to manage forests. However, finding the best way to thin forests by removing select trees to maximize the forest’s benefits for water quantity, water quality, wildfire risk and wildlife habitat remains a challenge for resource managers. The U.S. Forest Service is leading an effort to balance all these challenges in landscape-scale forest restoration planning as part of the Lake Tahoe West Restoration Partnership.

As part of this effort, University of Nevada, Reno’s Adrian Harpold recently led a team in developing a modeling tool to focus on the issue of water quantity. The tool predicts how different approaches to thinning the forest impact snowpack accumulation in Lake Tahoe, which controls how much water is available for downstream communities such as Reno.

“The snowpack we’ve relied upon is under pressure from years of fire suppression that increased tree density, combined with the effects of climate change and warming temperatures,” Harpold, natural resources & environmental science assistant professor with the College of Agriculture, Biotechnology & Natural Resources, said.

He explained that too many trees means less snow reaches the ground. In addition, when many trees are clumped together, they warm up and release heat, which can melt the snow on the ground. However, too few trees means the snowpack is less protected from the sun and wind, which also melt snow.

The tool, developed with funding from the College’s Experiment Station and the U.S. Forest Service, was built to specifically model the west shore of Lake Tahoe, which the team felt was a good sample of the Sierra Nevada forest. The team initially created a small-scale high-resolution model using data collected with 3D laser scanners, called “LiDAR.”

“The LiDAR data lets us see individual trees, which we use to ‘virtually thin’ the forest by taking trees out of the model,” he said. “As such, it lets us create a thinning experiment that’s realistic. We can then represent different management actions, such as removing trees below certain heights.”

His team, including the post-doctoral scholar Sebastian Krogh, graduate student Devon Eckberg, undergraduate students Makenzie Kohler and Gary Sterle, the College’s Associate Professor of Remote Sensing Jonathan Greenberg and University of Arizona’s Patrick Broxton, tested the model’s accuracy by conducting thinning experiments and comparing the predictions to measurements in the real forest. Results were discussed in a recently published article on the proof-of-concept for using high-resolution modeling to predict the effect of forest thinning for snow, for which Harpold was the lead author.

Once the team determined the model was working correctly, they increased the model size to represent Lake Tahoe’s western shore. Results are discussed in another recently published article on using the model to predict the effects of forest thinning on the northern Sierra Nevada snowpack, led by Krogh with Harpold, Broxton and the Forest Service’s Patricia Manley as co-authors. Their experiments showed that overall, more trees removed means more snow maintained. However, there are beneficial ways and detrimental ways to remove trees. The method that appeared to be most effective was removing dense trees that had many leaves and branches and were shorter than about 50 feet, leaving behind taller trees. There were also differences in effectiveness depending on the elevation, the slope and the direction the slope was facing.

Harpold plans to continue expanding the model, testing to see if it will work for Lake Tahoe’s eastern shore and in the American River Basin, with the ultimate goal of providing a tool for Forest Service decision-makers and others to inform their forest-thinning plans.

The water-quantity tool is one of many different modeling tools being developed with funding from the Forest Service as part of the Tahoe-Central Sierra Initiative, which aims to quickly restore the forest to improve the health and resilience of Sierra Nevada mountains and maximize the benefits that the forest provides.

“My decision-support tool for water quantity would be a smaller piece in a larger toolkit to help determine how and where to thin the forests,” Harpold said.

Other tools being designed to predict forest-thinning impacts include a tool to predict impact on wildfire spread, a tool to predict impact on smoke, a tool to predict impact on endangered and threatened species, a tool to predict sediment flow into Lake Tahoe and a tool to predict economic impact.

Olanzapine may help control nausea, vomiting in patients with advanced cancer

Posted on 07/05/2020 by Boris Clair

Olanzapine, a generic drug used to treat nervous, emotional and mental conditions, also may help patients with advanced cancer successfully manage nausea and vomiting unrelated to chemotherapy. These are the findings of a study published Thursday, May 7 in JAMA Oncology.

Charles Loprinzi, M.D., a Mayo Clinic medical oncologist, played a leadership role in this work in conjunction with Rudolph Navari, M.D., of The University of Alabama at Birmingham.

“It’s well-appreciated by most people that patients receiving cancer chemotherapy suffer from nausea and vomiting,” explains Dr. Loprinzi. “However, it’s less well-appreciated that patients with advanced cancer also have significant problems with nausea and vomiting that are unrelated to chemotherapy.”

Drs. Loprinzi and Navari found limited research regarding nausea and vomiting in patients with advanced cancer unrelated to chemotherapy, so they decided to conduct a clinical trial.

The colleagues, along with other collaborators, conducted a randomized, placebo-controlled trial in 30 patients with advanced cancer who had not recently received chemotherapy or radiation therapy but did have substantial trouble with nausea and vomiting. Researchers randomly assigned patients to receive a low-dose of olanzapine or a placebo daily. Neither the trial participants nor their clinicians knew whether participants were receiving olanzapine or a placebo.

Prior to starting their medications on the first day of the study, participants rated their nausea over the previous 24 hours on a scale of 0-10, with 0 being none and 10 being as bad as it could be. Participants continued to rate their nausea every day at about the same time of day for the duration of the study.

When the study was unblinded, the research team learned that all 30 participants recorded nausea scores of 8-10 on the first day of the study. After one day and one week, nausea scores in the 15 patients who received a placebo were all still 8-10 out of 10. In contrast, the 15 patients who received olanzapine had scores of 2-3 out of 10 after one day and 0-3 out of 10 after one week. Correspondingly, these patients reported less vomiting, better appetite and better well-being. No patient-reported adverse events were observed among trial participants receiving olanzapine.

“Olanzapine given at 5 milligrams per day for seven days markedly improved patient quality of life with no side effects,” says Dr. Navari. “And as a generic drug, it’s also relatively affordable, with a one-month supply often costing anywhere from $10 to $15.”

“Current guidelines for the management of nausea and vomiting in patients with advanced cancer have not specifically indicated that one drug looks substantially better than a variety of other drugs,” says Dr. Loprinzi. “However, we believe the present results may be viewed as a best practice for treating nausea and vomiting in patients with advanced cancer-associated nausea and vomiting.”

Story Source:

Materials provided by Mayo Clinic. Original written by Kevin Punsky. Note: Content may be edited for style and length.

Coronavirus: Black Britons face ‘twice the risk’ of death, says ONS

Posted on 07/05/2020 by Boris Clair

Location and wealth do not fully explain the risk compared with white people, new analysis suggests.

Coronavirus PPE: Gowns ordered from Turkey fail to meet safety standards

Posted on 07/05/2020 by Boris Clair

Up to 400,000 gowns ordered by the UK do not meet British safety standards, the government confirms.

Health24.com | Coronavirus morning update: Concerns over schools plan, top companies get UIF money, and ‘Covid toes’

Posted on 07/05/2020 by Boris Clair

WHAT’S HAPPENING IN SA

Cases update:

The latest number of confirmed cases is 7 808.

According to the latest update, 153 deaths have been recorded in the country.

So far, 279 379 tests have been conducted – with more than 11 300 new tests conducted.

Latest news:

Equal Education (EE) high school members and teachers have raised concerns about the impact the national Covid-19 lockdown has had on them and their fears around the phased re-opening of schools.

The movement said while it was relieved schools would be re-opening at a later stage, it believed plans by the Department of Basic Education were a cause for concern and had caused more confusion.

Basic Education Minister Angie Motshekga has outlined the department’s plans about recovering the academic year after schools closed on 18 March following President Cyril Ramaphosa’s declaration of a national state of disaster.

Motshekga said the department would use the month of May to ensure schools were safe and compliant with Covid-19 regulations before allowing for the return of teachers and pupils

This week, government gazetted new regulations for vehicle owners and public transport during the latest phase of the national lockdown.

The regulations, released on Monday, specified that no vehicles – either private or public transport – were allowed on the roads outside of 05:00 to 20:00, with a grace period of an hour, “to complete a journey”, to 21:00.

But on Wednesday, transport minister Fikile Mbalula gazetted a change to that regulation. Now, public transport – which includes minibus taxis – can operate from 05:00 to 19:00 only, with no mention of a grace period. Instead “the driver must ensure that the drop off is completed by 19:00.”

The section governing the permitted times of private vehicles on the road – a curious inclusion in regulations about public transport in the first place – has been deleted by the same amendment. This presumably means that private car owners can be on the road only till 20:00, when the national curfew starts.

Public transport will only be allowed outside of these hours if it is a chartered service for Level 4 workers, which has been arranged by an employer. The transport owners will have to present documentation to confirm this.

The Unemployment Insurance Fund (UIF) has released an online list of all the employers which have received a special grant to pay their staff.

Prominent companies have already received money, including Sasol, Mr Price Group, Damelin, a number of Bidvest businesses, some Protea hotels and Engen service stations, as well as individual Spur, Wimpy and McDonald’s restaurants.

Hundreds of bottle stores and churches have also received payouts, while gyms, golf clubs and funeral parlours feature prominently on the list. More than two dozen taxidermy businesses have also benefited

As part of the Covid-19 Temporary Relief scheme (TERS), workers who are put on leave, have been laid off temporarily or whose employers can’t afford to pay their full salaries are entitled to a special payout from the UIF. The maximum a worker will get is R6 730 a month (if you earn more than R17 700) – while the minimum amount is R3 500.

SA Breweries (SAB) – owner of Castle Lager, Hansa, and Black Label – says it may be forced to destroy more than 130 million litres of beer if it is not allowed to transport the brew to its depots.

The transport of alcohol – apart from alcohol for export – is currently illegal under South Africa’s lockdown regulations. All sale of alcohol is also prohibited.

SAB has not been brewing since March 23rd, nor has it or transported beer since the start of the hard Covid-19 lockdown on March 27th.

But as part of “the orderly wind down” of its business during lockdown, a small group of staff have been fermenting and bottling alcohol. SAB is not legally allowed to store brewed beer at its brewery facilities above a certain capacity, which it has now reached.

Currently, SAB has around 132 million litres of beer – roughly the equivalent of 400 million bottles of beer – sitting in its tanks, which it can’t bottle due to the restrictions on alcohol capacity at its breweries.

WHAT’S HAPPENING IN THE REST OF THE WORLD

Cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Late on Wednesday night, positive cases worldwide were more than 3.7 million, while deaths were more than 261 000.

The United States had the most cases in the world – more than 1.2 million, as well as the most deaths – more than 72 500.

Latest news:

A top scientist who advised British leaders on coronavirus lockdown measures said on Tuesday he had resigned from a key government panel after admitting to breaking the country’s rules on social distancing.

Professor Neil Ferguson, an epidemiologist on the advisory team helping the UK coordinate its pandemic response, stepped down following media reports that he had allowed a woman to visit him at home.

“I accept I made an error of judgement and took the wrong course of action,” he said.

“I deeply regret any undermining of the clear messages around the continued need for social distancing to control this devastating epidemic.”

LATEST RESEARCH

When South Africa moved to Level 4 restrictions on 1 May 2020, masses of people gathered outside to enjoy a bit of exercise and fresh air – as we are now allowed to exercise outdoors between 06:00 and 09:00.

Soon, however, running and neighbourhood community groups on social media expressed the same concern: too many people too close to each other, with many of them not covering their mouths and noses with buffs or masks.

Criticism of the regulation to cover one’s mouth and nose came fast – as many people experience discomfort and laboured breathing when running with a mask.

However, even though it might be uncomfortable at first, it is vitally important that we stick to this rule and keep our distance from fellow runners. It’s for our own protection.

The virus that causes Covid-19 typically strikes the lungs with full force, but new research shows it can also cause frostbite-like patches on the hands and toes, and rashes on the body.

The condition has recently been dubbed “Covid toes”. Fortunately, it isn’t serious and the lesions usually disappear on their own, said Dr Esther Freeman, director of Global Health Dermatology at Massachusetts General Hospital in Boston.

“One of the more surprising findings in this epidemic has been the lesions that we’re seeing on people’s toes and hands,” she said.

Freeman noted that Covid toes aren’t caused by exposure to cold, as is frostbite or chilblains. Rather it seems to be an inflammation of the circulatory system that shows up as a skin rash.

Like many other countries, South Africa is struggling to access adequate testing materials to scale up Covid-19 testing.

A key challenge faced by laboratories in South Africa and elsewhere is that most of our diagnostic infrastructure requires the use of proprietary test materials – including reagents, consumables and cartridges. This largely prevents laboratories from making their own test materials or procuring test materials from sources other than the diagnostic machine’s manufacturer.

South Africa’s National Health Laboratory Service (NHLS) is currently using diagnostic machines produced by several companies to diagnose Covid-19. But the country is facing challenges in securing an adequate supply of reagents and consumables for running these tests. The NHLS has also indicated that it will increase its use of the company Cepheid’s GeneXpert machines for testing as test cartridges become available.

Yet, despite being the first country to broadly roll out GeneXpert diagnostic machines, and having been a crucial location for the trialling of the machines, South Africa is struggling to access adequate Covid-19 test cartridges from Cepheid.

The global lockdown caused by Covid-19 risks a “devastating” surge in tuberculosis cases, with nearly 1.4 million additional deaths from the world’s biggest infectious killer by 2025, new research showed on Wednesday.

TB, a bacterial infection that normally attacks patients’ lungs, is largely treatable yet still infects an estimated 10 million people every year.

In 2018, it killed around 1.5 million people, according to the World Health Organization (WHO), including more than 200 000 children.

Since effective medication exists, the world’s TB response is centred on testing and treating as many patients as possible.

People all over the globe who’ve recovered from the new coronavirus want to know the same thing: Am I immune, at least for a while? A new study of common coronaviruses is not exactly reassuring.

Researchers found it was “not uncommon” for people with run-of-the-mill coronaviruses (not the one that causes Covid-19) to have a repeat infection within a year. Of 86 New York City residents infected with those coronaviruses, 12 tested positive for the same bug again.

A big caveat is, the study looked only at the four coronaviruses that are endemic in humans – the kinds that cause nothing worse than cold symptoms.

“They’re kind of wimpy,” said researcher Jeffrey Shaman, a professor of environmental health sciences at Columbia University Mailman School of Public Health. “People rarely have to go to the doctor for these infections.”

Because people who receive a donor kidney are often on immune-suppressing medications, they’re at extremely high risk of dying if Covid-19 strikes, a new report warns.

The study, from doctors at Montefiore Medical Center in hard-hit New York City, looked at outcomes for 36 kidney transplant patients diagnosed with Covid-19 between 16 March and 1 April.

Nearly a third of these patients died from their infection with the new coronavirus, and in most cases, Covid-19 worsened rapidly, according to a team of Montefiore physicians led by Dr Enver Akalin.

Thirty-nine percent of patients needed to be put on a mechanical ventilator, and nearly two-thirds (64%) of those ventilated patients died.

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

Health24.com | Blood pressure medications do not increase Covid-19 risk

Posted on 07/05/2020 by Boris Clair

Many people with high blood pressure, medically known as hypertension, have been wondering whether their blood pressure medications could increase their risk of developing Covid-19, the disease caused by the new coronavirus. However, a new study, led by researchers from NYU Grossman School of Medicine, found that common high blood pressure drugs did not increase the risk of contracting Covid-19, or of developing severe disease.

This came after the American Heart Association, the American College of Cardiology and the Heart Failure Society of America issued a joint statement on 17 March, wherein they called for urgent research into whether high blood pressure medications worsen Covid-19 patient outcomes, a news release by EurekAlert reports.

The study was recently published in the New England Journal of Medicine.

Why the cause for concern?

The topic became popular recently when some experts questioned the relationship between common blood pressure medications and their ability to increase the risk of Covid-19. Among them was a letter published in the Lancet. The author recommended stopping ACE Inhibitors and ARBs – which relaxes the veins and arteries to lower blood pressure – in Covid-19 patients, based on seemingly legitimate theoretical concerns. For people with hypertension, this led to a wave of panic, causing them to stop taking their medication.

The NYU study specifically looked at medications that act on the renin-angiotensin-aldosterone hormonal system (RAAS), which regulates blood pressure. The researchers identified 12 594 patients in the NYU Langone Health electronic health record who had tested positive for Covid-19. They then analysed their medical history to compare treated and untreated patients.

The team looked at the link between treatment with four drug classes, and an increased risk of testing positive for Covid-19:

Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin receptor blockers (ARBs)
Beta blockers
Calcium channel blockers

Their study concluded: “We found no substantial increase in the likelihood of a positive test for Covid-19 or in the risk of severe Covid-19 [including intensive care, use of a ventilator, or death] among patients who tested positive in association with five common classes of antihypertensive medications.

“Before our study, there were no experimental or clinical data demonstrating the consequences of using these medications one way or the other in people at risk for Covid-19,” senior study researcher Judith Hochman, MD, the Harold Snyder Family Professor of Medicine and Senior Associate Dean for Clinical Sciences at NYU Langone Health said.

“In terms of next steps, our plan is to use similar approaches to investigate other medications and their relationship to Covid-19 illness.”

Lead author of the study Harmony Reynolds, MD, associate director of the Cardiovascular Clinical Research Center at NYU Langone Health, also said that considering nearly half of American adults live with high blood pressure, understanding the relationship between these common medications and Covid-19 was highly significant.

“Our findings should reassure the medical community and patients about the continued use of these commonly prescribed medications, which prevent potentially severe heart events in their own right,” Reynolds said.

Hypertension in SA

According to the Heart and Stroke Foundation South Africa, 225 South Africans are killed by heart diseases every day and 13% of global deaths are caused by hypertension. The World Health Organization (WHO) estimates that 1.13 billion adults worldwide are currently living with the condition. High blood pressure is the major risk factor for heart disease, stroke, and kidney disease.

In 2018, an estimated 42% to 54% of South Africans were suffering from hypertension, an article by Health-E News reported, and further explained that, according to a study by Wits University scientists, South Africa has the highest prevalence of the condition in southern Africa.

In response to the latest research, Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa, said:

“The findings of this study, published in a very reputable scientific journal, provide important evidence for the treatment of hypertensive patients during the Covid-19 pandemic. It is important for individuals who have hypertension to take their medication and follow related treatment protocols as prescribed by their doctor, whether they have Covid-19 or not, or in fact whether they are hospitalised or not.

“We need to always remember that health care professionals care deeply about their patients and follow evidence-based practice guidelines when they are treating their patients for hypertension, or any other medical condition.”

Mkhize urges South Africans with comorbidities to take extra precautions

In a media release on 2 May, South African Minister of Health, Dr Zweli Mkhize said:

“We have looked at the data for patients who have been hospitalised and found that, consistent with evidence emerging worldwide, hypertension, diabetes and cardiac disease are the three most common comorbidities associated with serious illness from Covid-19.

“I would, therefore, like to urge our millions of South Africans who are over 63 years of age and those who live with these conditions to take extra precaution as we ease the lockdown.”

Zakiyah Ebrahim

Coronavirus: Concerns for wellbeing of babies born in lockdown

Posted on 07/05/2020 by Boris Clair

New mothers are missing out on support for their babies amidst lockdown restrictions.

Coronavirus: UK becomes first country in Europe to pass 30,000 deaths

Posted on 06/05/2020 by Boris Clair

The UK records a further 649 deaths, taking the total number of coronavirus deaths to 30,076.

Focused ultrasound opening brain to previously impossible treatments

Posted on 06/05/2020 by Boris Clair

University of Virginia researchers are pioneering the use of focused ultrasound to defy the brain’s protective barrier so that doctors could, at last, deliver many treatments directly into the brain to battle neurological diseases. The approach, the researchers hope, could revolutionize treatment for conditions from Alzheimer’s to epilepsy to brain tumors — and even help repair the devastating damage caused by stroke.

Richard J. Price, PhD, of UVA’s School of Medicine and School of Engineering, is using focused soundwaves to overcome the natural “blood-brain barrier,” which protects the brain from harmful pathogens. His approach aims to breach the barrier only where needed, and only when needed, and then deliver treatments in exquisitely precise fashion.

“The blood-brain barrier is one of the greatest, if not the greatest, challenge to drug delivery for the central nervous system,” Price explained. “Evolution gave us this barrier because the central nervous system needs to be protected. The problem is now we want to deliver something to those cells and evolution has had millions and millions of years to optimize a solution to stop it. … So I’m attempting to circumvent biology with physics.”

Focused Ultrasound’s Great Potential

Focused ultrasound focuses sound waves inside the brain much like a magnifying glass can focus light, letting doctors manipulate tissue without cutting into the skull. Magnetic resonance imaging (MRI), meanwhile, lets them watch what’s happening inside the brain in real time. While Price, a biomedical engineer, is developing his techniques in the lab, doctors are already using the technology to treat conditions such as Parkinson’s tremor.

Price marvels at the approach’s specificity. “With MRI, we can look at the target, whether it’s a brain tumor or maybe it’s a part of the brain we want to do gene therapy on, and we can select it — we can actually make a treatment plan and say, We only want to open the [blood-brain] barrier there. The other 95% of the brain, we don’t even touch,” said Price, the research director at UVA’s Focused Ultrasound Center. “Then, when we apply the focused ultrasound, it opens the barrier there for a few hours. It lets us get the gene therapy across, and then it closes naturally.”

Delivering Gene Therapy

Gene therapy introduced via focused ultrasound would essentially reprogram faulty cells.

For brain tumors, Price is exploring the potential of using focused ultrasound to deliver gene therapy via “deep-penetrating nanoparticles.” The nanoparticles, designed by Price’s collaborators at Johns Hopkins University, “are specifically engineered to penetrate the tissue extremely well,” he said. The problem has been transporting them where they’re needed, often deep inside the brain, and Price says focused ultrasound holds the answer.

His solution is to use the focused soundwaves to open spaces between cells in the tissue. “It doesn’t help us if you can’t get to the neuron that’s 50 microns away,” he said. “So that becomes an engineering transport problem.”

In addition to delivering the therapy, focused ultrasound can “precondition” targeted tissue to enhance the effectiveness of the gene delivery up to five-fold, Price has found. The preconditioning represents a “simple and effective strategy” to boost the benefits of the nanoparticles, he and his colleagues report in a scientific paper.

Improving Stroke Outcomes

For stroke, a condition that is often debilitating when it’s not deadly, Price aims to help the brain heal itself. He would do this by using focused ultrasound to put “homing molecules” inside damaged areas to recruit neural stem cells to do repairs. For this, his team has developed an innovative technique called “sonoselective transfection” that avoids opening the blood-brain barriers in brains that are already compromised.

“With stroke, there’s a lot of effort to try to salvage as much neural tissue as possible by doing things like gene therapy,” he said. “In our lab, we thought, well, maybe we can deliver treatment right to the cells that need it, without breaching the blood-brain barrier. And my students basically figured out how to do that.”

That notion of helping the body heal itself, of using focused ultrasound to activate an immune response, could be useful in cancer treatments as well. “We would love to be able to put something into those [tumor] cells that will then allow them to start recruiting immune cells into the tumor,” he said. “We have a lot of evidence that we can we can do some interesting things with focused ultrasound with respect to the internal landscape of those tumors.”

Price, of UVA’s Department of Biomedical Engineering, emphasizes that his work is still early, but he is excited to be creating new techniques that could change how many major diseases are treated in the not-too-distant future.

“We’ve had good results [with the research] so far. But what I, as an engineer, get excited about are all these tools we have made,” he said. “You can use these tools for all these different applications. We think there are a lot of really exciting possibilities.”

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Category Archives: Mind Building

Blood thinners may improve survival among hospitalized COVID-19 patients

Prediction tool shows how forest thinning may increase Sierra Nevada snowpack

Olanzapine may help control nausea, vomiting in patients with advanced cancer

Coronavirus: Black Britons face ‘twice the risk’ of death, says ONS

Coronavirus PPE: Gowns ordered from Turkey fail to meet safety standards

Health24.com | Coronavirus morning update: Concerns over schools plan, top companies get UIF money, and ‘Covid toes’

WHAT’S HAPPENING IN SA

Cases update:

Latest news:

WHAT’S HAPPENING IN THE REST OF THE WORLD

Cases update:

READ MORE | All the confirmed cases worldwide

Latest news:

LATEST RESEARCH

READ MORE: Coronavirus 101

^{Image credit: Getty Images}

Health24.com | Blood pressure medications do not increase Covid-19 risk

Why the cause for concern?

Hypertension in SA

Mkhize urges South Africans with comorbidities to take extra precautions

Coronavirus: Concerns for wellbeing of babies born in lockdown

Coronavirus: UK becomes first country in Europe to pass 30,000 deaths

Focused ultrasound opening brain to previously impossible treatments