Nicotine exposure alone leads to pulmonary hypertension, study suggests

Posted on 01/05/2020 by Boris Clair

A study conducted by a team of researchers at LSU Health New Orleans has shown for the first time that chronic exposure to inhaled nicotine alone increases blood pressure (hypertension), in both the body’s general circulation and in the lungs that can lead to pulmonary hypertension. The study also found that nicotine-induced pulmonary hypertension is accompanied by changes in the size, shape and function (remodeling) of the blood vessels in the lung and the right lower chamber of the heart. Results are published in the May 2020 issue of Hypertension.

Although cigarette smoking is the single most important risk factor for developing cardiovascular and lung diseases, the role of nicotine in the development of disease has not been well understood. The researchers used a novel nicotine inhalation model in mice that closely mimics human smokers/e-cigarette users to examine the effects of chronic nicotine inhalation on the development of cardiovascular and pulmonary disease with a focus on blood pressure and cardiac remodeling.

The researchers documented that nicotine inhalation increased systemic systolic and diastolic blood pressure as early as the first week of exposure.

“The increase was transient, but was sufficiently long to pose potential health risks in individuals with preexisting cardiopulmonary conditions,” notes Eric Lazartigues, PhD, Professor of Pharmacology at LSU Health New Orleans School of Medicine.

Pulmonary hypertension is also often associated with remodeling of the blood vessels of the lung. The study findings suggest that chronic nicotine inhalation leads to muscularization of previously non-muscular pulmonary arterioles (small branches of arteries leading to capillaries) consistent with increased right ventricular systolic pressure and pulmonary vascular resistance.

Right ventricle failure is a major cause of death in pulmonary hypertension. The researchers found an eight-week exposure to nicotine resulted in significantly higher right ventricular systolic pressure, as well as thickening of the walls and enlargement of the right ventricle.

“Interestingly, the adverse effects of inhaled nicotine are largely isolated to the right heart, as we found no significant changes in left heart remodeling or protein expression,” adds Xinping Yue, MD, PhD, Assistant Professor of Physiology at LSU Health New Orleans School of Medicine.

According to the Centers for Disease Control and Prevention, tobacco use is the leading cause of preventable disease, disability, and death in the United States. Based on 2018 data, about 34 million US adults smoke cigarettes. Every day, about 2,000 young people under age 18 years smoke their first cigarette, and more than 300 begin smoking cigarettes daily. Over 16 million people live with at least one disease caused by smoking, and 58 million nonsmoking Americans are exposed to secondhand smoke. In 2017, 25.2% of Louisiana high school youth reported currently using any tobacco product, including e-cigarettes. Among Louisiana high school youth, 12.3% reported currently smoking cigarettes.

“There is a frightening trend of increasing usage of e-cig and vape products in youths and young adults,” says Jason Gardner, PhD, Associate Professor of Physiology at LSU Health New Orleans School of Medicine. “Recent high-profile cases of hospitalization and death following e-cig usage necessitate a greater understanding regarding the health impact of inhaled nicotine delivery systems. The current study clearly demonstrates the adverse effects of nicotine on both systemic and pulmonary blood pressure and cardiac remodeling. This study should help raise the awareness of the adverse effects of nicotine inhalation on the cardiopulmonary system and help formulate public health policies on e-cigarettes.”

The LSU Health New Orleans research team also included Joshua Oakes, PhD, Postdoctoral Fellow; Jiaxi Xu, PhD, Postdoctoral Fellow; Tamara Morris, BS, Research Associate; Nicholas Fried, BS, MD/PhD student; Charlotte Pearson, undergraduate student; Thomas Lobell, MS, Research Associate; and Nicholas Gilpin, PhD, Professor of Physiology.

This study was supported in part by research grants from the National Institute of Health and the Department of Veterans Affairs.

Natural fires help native bees, improve food security

Posted on 01/05/2020 by Boris Clair

Native bees that boost food crops are in decline but changing fire management policies could help them.

Most flowering plant farms employ honeybees, a non-native species originally imported from Europe and managed by beekeepers. However, research shows that farms surrounded by natural bee habitat have higher crop yields.

UC Riverside entomologist Lauren Ponisio explains that native bees are increasingly important to food growers. They pollinate crops on the fringes of a farm and could potentially also be used for agricultural purposes.

“The non-native honeybees currently used for crops are having problems, and we’re in trouble if native bees can’t replace or supplement them on our farms,” Ponisio said. “Relying on one species of bee to pollinate all our crops is unsustainable.”

Ponisio led a study to be published this month in the journal Ecology and Evolution that examined environmental factors affecting the health of native bees. There are thousands of bee species that live in the wild, many of which are found in California.

Ponisio found that these native bees are better able to survive harsh climate events, like drought, in areas where naturally occurring fires are allowed to burn.

Small fires consume dry brush that would otherwise fuel megafires, like 2018’s deadly Camp Fire, which occur with increasing frequency in California. In addition to eliminating fuel for megafires, smaller mixed-severity burns also trigger positive changes in the environment. They remove unhealthy and dead trees, allow sunlight to reach a forest floor, and create a better environment for native plants and their pollinators to thrive.

To compare bees from areas where fires are allowed to burn with bees from areas where they aren’t, Ponisio and her team headed to Yosemite National Park. Near park buildings and tourist hotspots, fires are fought immediately. In other areas of the park, like the Illilouette Basin, fires are allowed to burn naturally as they have for centuries.

The team sampled bees in 2013 and 2014, a two-year period of severe drought in California. In 2014, there was no summer rainfall, there was little snowpack in the Sierra Nevada mountains, and flowers were not blooming.

A majority of the 164 bee and 71 flowering plant species Ponisio sampled during the study period declined. However, where natural fires had created a diversity of habitats, bees were able to find alternative flower species to visit, and therefore their populations did not decline as much as when the same species were in areas without a diversity of natural fires. There was only a single species of bee that not only survived but increased as a result of the drought — the European honeybee.

“The honeybee is a hyper generalist,” said Ponisio. “There’s not a plant they won’t try out, which is why they’re great for agriculture, and are so successful when they invade wild ecosystems.”

Boosting native plants would provide ample food resources both for native and the non-native European honeybees that spread into wild environments. This way, all of them could feed and not compete for pollen resources. One of the best and most immediate ways to encourage this scenario would be to reconsider fire management policies.

“Smokey the Bear was wrong,” Ponisio said. “We actually don’t need to prevent forest fires when they are not endangering people.”

Story Source:

Materials provided by University of California – Riverside. Original written by Jules Bernstein. Note: Content may be edited for style and length.

Health24.com | The lowdown on Covid-19 treatments

Posted on 01/05/2020 by Boris Clair

There’s a lot of confusion about medications and Covid-19, so experts offer some answers.

There are no proven drug treatments for the illness caused by the new coronavirus, so doctors sometimes use drugs approved for other conditions to treat seriously ill Covid-19 patients. This is called off-label use.

One drug being investigated as a possible Covid-19 treatment is hydroxychloroquine, which is approved by the US Food and Drug Administration to treat malaria, but widely used to treat autoimmune diseases such as rheumatoid arthritis and lupus.

Hydroxychloroquine, often combined with the antibiotic azithromycin, has been touted as a potential treatment for Covid-19. Neither of the medications are antivirals, and the combination has been shown to cause heart problems in some patients.

Limited data for effectiveness

Some people wonder if they should take hydroxychloroquine to prevent Covid-19. The answer is definitely no, said Chris Bland and Tim Brown, from the University of Georgia’s College of Pharmacy.

“I don’t believe at this time that anybody outside of the hospital setting should be a candidate for these two medications used together for Covid-19,” Bland said in a university news release.

“In the hospital, we can perform cardiac monitoring of these patients to ensure safety. There are very limited data for effectiveness with definite risk of cardiac toxicity,” Bland said. “That’s why we don’t recommend it to outpatients.”

The experimental antiviral drug remdesivir shows promise against Covid-19, but doesn’t yet have FDA approval for treating any condition. More research is needed to assess the drug’s effects on Covid-19, and several trials are underway around the world.

Higher risk of exposure

There are also claims that ibuprofen makes people more susceptible to the coronavirus and that ACE inhibitor drugs, used to treat high blood pressure and heart failure, increase the risk of poor outcomes in Covid-19 patients.

There’s no proof for either claim, Bland and Brown said.

They also warned that people who suddenly stop taking ACE inhibitors put themselves at risk for drastic blood pressure increases and worsening heart problems.

“One of the last places you want to be is admitted to the hospital where they could be potentially taking care of Covid-19 patients, and have a higher risk of exposure,” Bland said. “You never want to start or stop anything that is a chronic medication without talking to a health care provider, such as a pharmacist or your physician.”

READ | SA expert cautions on coronavirus treatment

READ | Will remdesivir help Covid-19 patients? Two reports provide different answers

READ | Lopinavir-ritonavir not effective against Covid-19, says Department of Health

^{Image credit: Dimitri Karastelev, Unsplash}

Defects in the ‘Swiss-army knife’ of gene expression may contribute to neuronal diseases like Alzheimer’s

Posted on 01/05/2020 by Boris Clair

The growth, death, and diseases of complex organisms rely on the flow of information — from genes in DNA, through their transcription into RNA, and then translation of that transcript into proteins, which in turn build much of the living organism.

Proteins that control this whole process are themselves subject to this overarching information flow for survival. Researchers have now discovered a previously unknown function of a group of proteins, called the Ccr4-Not complex, that may shed light on the development of diseases like Alzheimer’s.

The findings were published in Science on 17-Apr-2020.

“The Ccr4-Not complex is involved in so many aspects of gene expression that we might as well call it the ‘Swiss Army Knife’ of protein production,” says Toshifumi Inada, a professor from the Graduate School of Pharmaceutical Sciences at Tohoku University, who led the research.

The best understood aspect of Ccr4-Not’s role is its involvement in the destruction of the messenger RNA (mRNA). The mRNA molecules are like instruction manuals that tell the ribosomes, the cell’s protein-making machinery, how to construct proteins.

The amount of proteins produced by the ribosomes is crucial, and so is the speed of that production. You don’t want too many or too few, too fast or too slow. In turn, these protein levels depend on the amount of mRNA. Thus control of mRNA destruction — especially when these instruction manuals have mistakes in them — is critical in controlling protein production.

“But until now, how Ccr4-Not did this has remained elusive,” Inada adds.

The mRNA instruction manuals are composed of multiple three-unit codes called ‘codons’ that tell the ribosomes which amino acids to use. Amino acids are the building blocks of proteins.

But even with this error-tolerant redundancy, there can still be a preference, or to use the formal term, bias, toward a particular synonym codon, because it speeds up the process. If an instruction manual for some reason doesn’t have this codon bias, the system is not working at the speed it should.

The researchers found that the Ccr4-Not complex is always on the hunt for slow-poke mRNA that don’t have this codon bias. They discovered that when the complex spots one, a part of it attaches itself to the ribosome, in turn triggering a degradation of the faulty mRNA.

But if the Ccr4-Not complex itself is faulty, missing the part that would attach to the ribosome reading the faulty mRNA, then the complex loses this crucial ability to sense and destroy these mRNA that are manufacturing proteins at the wrong speed.

Protein production that happens at the wrong speed can result in incorrect protein concentration, location or shape, all of which have been associated with a wide variety of diseases including Huntington’s and Alzheimer’s. The research offers insight into how Ccr4-Not abnormalities contribute to such illnesses via insufficient control of the rate of protein synthesis.

The researchers now want to investigate whether a normally functioning Ccr4-Not complex’s management of this rate also enables it to control protein folding and transport of proteins to their appropriate destination in the body.

Story Source:

Materials provided by Tohoku University. Note: Content may be edited for style and length.

New study examines which galaxies are best for intelligent life

Posted on 01/05/2020 by Boris Clair

Giant elliptical galaxies are not as likely as previously thought to be cradles of technological civilizations such as our own, according to a recent paper by a University of Arkansas astrophysicist.

The paper, published May 1 in the journal Monthly Notices of the Royal Astronomical Society, contradicts a 2015 study that theorized giant elliptical galaxies would be 10,000 times more likely than spiral disk galaxies such as the Milky Way to harbor planets that could nurture advanced, technological civilizations.

The increased likelihood, the authors of the 2015 study argued, would be because giant elliptical galaxies hold many more stars and have low rates of potentially lethal supernovae.

But Daniel Whitmire, a retired professor of astrophysics who is an instructor in the U of A mathematics department, believes that the 2015 study contradicts a statistical rule called the principle of mediocrity, also known as the Copernican Principle, which states that in the absence of evidence to the contrary, an object or some property of an object should be considered typical of its class rather than atypical.

Historically, the principle has been employed several times to predict new physical phenomena, such as when Sir Isaac Newton calculated the approximate distance to the star Sirius by assuming that the sun is a typical star and then comparing the relative brightness of the two.

“The 2015 paper had a serious problem with the principle of mediocrity,” said Whitmire. “In other words, why don’t we find ourselves living in a large elliptical galaxy? To me this raised a red flag. Any time you find yourself as an outlier, i.e. atypical, then that is a problem for the principle of mediocrity.”

He also had to show that most stars and therefore planets reside in large elliptical galaxies in order to nail down his argument that the earlier paper violated the principle of mediocrity.

According to the principle of mediocrity, Earth and its resident technological society should be typical, not atypical, of planets with technological civilizations elsewhere in the universe. That means that its location in a spiral-shaped disk galaxy should also be typical. But the 2015 paper suggests the opposite, that most habitable planets would not be located in galaxies similar to ours, but rather in large, spherical-shaped elliptical galaxies.

In his paper, Whitmire suggests a reason why large elliptical galaxies may not be cradles of life: They were awash in lethal radiation when they were younger and smaller, and they went through a series of quasar and star-burst supernovae events at that time.

“The evolution of elliptical galaxies is totally different than the Milky Way,” said Whitmire. “These galaxies went through an early phase in which there is so much radiation that it would just completely have nuked any habitable planets in the galaxy and subsequently the star formation rate, and thus any new planets, went to essentially zero. There are no new stars forming and all the old stars have been irradiated and sterilized.”

If habitable planets hosting intelligent life are unlikely in large elliptical galaxies, where most stars and planets reside, then by default galaxies such as the Milky Way will be the primary sites of these civilizations, as expected by the principle of mediocrity, Whitmire said.

Story Source:

Materials provided by University of Arkansas. Original written by Bob Whitby. Note: Content may be edited for style and length.

For people with diabetes and COVID-19, blood sugar control is key

Posted on 01/05/2020 by Boris Clair

A study reported in the journal Cell Metabolism on April 30 adds to the evidence that people with type 2 diabetes (T2D) are at greater risk of a poor outcome should they become infected with the virus that causes COVID-19. But there is some encouraging news: people with T2D whose blood sugar is well controlled fare much better than those with more poorly controlled blood sugar.

“We were surprised to see such favourable outcomes in well-controlled blood glucose group among patients with COVID-19 and pre-existing type 2 diabetes,” says senior author Hongliang Li of Renmin Hospital of Wuhan University. “Considering that people with diabetes had much higher risk for death and various complications, and there are no specific drugs for COVID-19, our findings indicate that controlling blood glucose well may act as an effective auxiliary approach to improve the prognosis of patients with COVID-19 and pre-existing diabetes.”

More than 500 million people around the world have T2D. While it was clear that people with this condition fare worse with COVID-19, Li and colleagues wondered what role a person’s blood glucose control might have on those outcomes.

To find out, they conducted a retrospective longitudinal multi-centered study including 7,337 confirmed COVID-19 cases enrolled among 19 hospitals in Hubei Province, China. Of those, 952 people had T2D and the other 6,385 did not. Among those with diabetes, 282 had well-controlled blood glucose; the other 528 did not.

The data showed that people admitted to the hospital with COVID-19 and T2D required more medical interventions. Despite those interventions, they also had significantly higher mortality (7.8% vs. 2.7%) as well as a greater incidence of multiple organ injury.

However, those with well-controlled blood sugar and COVID-19 were less likely to die than those whose blood glucose was poorly controlled. Meanwhile, those with well-managed T2D also received less of other medical interventions including supplemental oxygen and/or ventilation, and had fewer health complications.

The researchers say the new findings offer three main messages for people with diabetes:

People with diabetes have a higher risk to die from COVID-19 and develop more severe complications after infection. Therefore, they should take extra precautions to avoid becoming infected.
People with diabetes should take extra care to keep their blood sugar under good control during the pandemic.
Once infected, patients with diabetes should have their blood glucose level controlled to maintain it in the right range, in addition to any other needed treatments.

The researchers say they will continue to study the relationship between T2D and COVID-19 outcomes. The hope is to learn more about the underlying biology that is leading to poorer outcomes for people with T2D and high blood sugar.

This work was supported by grants from the National Key R&D Program of China, the National Science Foundation of China, the Major Research Plan of the National Natural Science Foundation of China, the Hubei Science and Technology Support Project, and Medical Flight Plan of Wuhan University.

Story Source:

Materials provided by Cell Press. Note: Content may be edited for style and length.

Health24.com | Coronavirus pandemic: why a flu jab is a good idea in countries heading into winter

Posted on 01/05/2020 by Boris Clair

As the southern hemisphere moves closer to winter, virologists are concerned about the upcoming influenza season. This may result in more people needing medical care for flu – including hospitalisation – while the health system is still battling the coronavirus. This may swing the pendulum in favour of SARS-CoV-2 by making it harder to control the pandemic, especially in Africa, which has recorded the lowest number of cases thus far.

There are many other respiratory viruses that circulate throughout the year. But the influenza virus can be deadly. Influenza epidemics occur in late autumn and winter – between May and August – in the southern hemisphere and during the rainy season, which may be year round in the tropics.

Most people who get influenza only have a mild illness: a fever, cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), sore throat and a runny nose. But influenza can also cause more severe illness. This includes lower respiratory tract diseases that cause difficulty breathing, such as bronchitis or pneumonia. These conditions may require hospitalisation or even be fatal.

These signs are very similar to those caused by Covid-19. It may create additional anxiety for patients and stress on the healthcare system this year. This is why it’s advisable that everybody get the influenza vaccine. It will not protect people from Covid-19, but it will reduce influenza-related illness and in effect ease stress on health services during this pandemic.

Covid-19 and influenza

People older than 65 are most at risk and could die of either flu or Cpvid-19. Influenza also causes severe disease in young children. This is different to Covid-19, which has so far caused very few fatalities in children under nine. Pregnant women and people with HIV or other immune suppressive conditions are at high risk for severe disease and even death due to influenza. People with underlying health conditions may also experience Covid-19 more severely.

It would appear that Covid-19 has a higher fatality rate (1%-5%) than influenza (less than 0.5%). But during winter influenza can infect up to a third of the population. Every year seasonal influenza kills between 100 000 and 600 000 people worldwide. There are around 11,500 deaths in South Africa alone.

So why should the annual influenza season concern us at a time when Covid-19 appears to be much worse than flu?

Well, firstly we want to avoid visits to doctors if possible during the pandemic. This will reduce the stress on the healthcare system and help patients to avoid exposure to Covid-19 infected patients, so as to avoid the risk of having influenza and Covid-19 co-infections. Little information is available on the severity of Covid-19 and other viral co-infections. But a recent report suggests that influenza and Covid-19 co-infections may result in more severe disease in high-risk patients and complicate the diagnoses.

This further emphasises the importance of getting the influenza vaccine. The pneumococcus vaccine can also reduce the number of bacterial secondary infections that can compound disease, especially in children and the elderly.

So who should get the vaccine?

The World Health Organization (WHO) recommends annual vaccination for high risk population groups. These include pregnant women, children aged between 6 months and 5 years, people older than 65 years, those with chronic medical conditions such as HIV, heart or lung problems, and healthcare workers.

Most countries provide vaccines for free to these high risk groups. But people of all ages will benefit from getting the flu vaccine. High-risk people should however be prioritised if the vaccine stocks run low.

There are, however, myths and questions about the flu vaccine that influence people’s decisions about whether to get the vaccine. These must be addressed.

How do I know the influenza vaccine matches the strains circulating during our season? There are three influenza subtypes that circulate globally at the same time that are included in the flu vaccine. Every year the WHO’s global network of National Influenza Centres collaborate to identify the most common strains that are circulating in the northern and southern hemispheres. These strains are then used to produce specific vaccines for each hemisphere that are ready in time for the following year’s influenza season. Influenza strains may mutate or drift genetically from year to year. But most of the time the strains in the vaccine are a very close match to the current circulating strains and provide protection against most if not all the strains in the vaccine.
Can the influenza vaccine make you sick? No, the influenza vaccine only contains dead flu virus so it cannot give you flu. The flu vaccine is produced in eggs and killed to make the vaccine. Some people who are allergic to eggs may have a reaction to the egg proteins and shouldn’t get the vaccine, but this is rare.
Is it true that there is mercury in the vaccine that could be toxic? In the past, a preservative called Thimerosal was used in vaccines that contained trace amounts of ethyl-mercury. Etyl-mercury is not the same as methyl-mercury, which is found in certain fish and can be toxic if consumed at high levels. Nevertheless, due to public concerns Thimerosal was removed from all vaccines in 1999.
I still got sick in the past after getting the flu vaccine. Other viruses such as rhinovirus or respiratory syncytial virus circulating at the same time as flu can also cause an infection with the same symptoms. The vaccine is about 50%-70% effective in preventing the flu. But if you do still get sick or if you get a co-infection with another virus, the flu vaccine will still reduce the severity of disease.

The flu vaccine will not protect you from getting Covid-19. But by being protected from influenza, people could avoid unnecessary doctors’ visits and protect vulnerable groups from potentially more severe disease.

^{Marietjie Venter}^{, Head: Zoonotic arbo and Respiratory virus Program, Professor, Department Medical Virology,} ^{University of Pretoria}

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

^{Image credit: Getty Images}

Marietjie Venter, University of Pretoria

Coronavirus: Government ‘likely’ to get close to or hit 100,000 tests target – Shapps

Posted on 01/05/2020 by Boris Clair

Grant Shapps says he is optimistic over the target, as the PM declares the UK is past the peak of the virus.

Health24.com | Coronavirus morning update: Schools proposal, no Nando’s yet, and new rule on prescriptions

Posted on 01/05/2020 by Boris Clair

WHAT’S HAPPENING IN SA

Cases update:

The latest number of confirmed cases is 5 647.

According to the latest update, no new deaths were recorded. The total of number of deaths so far is 103.

So far, 207 530 tests have been conducted, with more than 10 400 new tests.

Latest news:

The Department of Basic Education may only be able to start phasing in Grade 7 and 12 pupils from 1 June, according to Minister Angie Motshekga.

Motshekga and her higher education counterpart, Blade Nzimande, briefed the nation on Thursday, outlining the plans to ensure teaching and learning resume as the country fights the coronavirus pandemic.

But the return to school for Grades 7 and 12 from June depends on the department’s plans to ensure that schools are safe and Covid-19 compliant.

The department plans to have personal protective equipment (PPE) delivered to all schools in the country.

It will have schools deep cleaned, and also make sure that all necessary support is provided for teachers, non-teaching staff and pupils.

Motshekga said parents had been concerned that pupils would be returning to schools from May, but that it would not be the case.

She said the department had decided to postpone the May/June National Senior Certificate rewrite examinations and it would now merge with the November/December exams.

The Department of Higher Education and Training has decided not to resume campus-based activity when Level 4 of the lockdown commences on Friday.

“We have decided not to resume with campus-based academic activity throughout the sector, including all universities and TVET (technical vocational education and training) colleges, both public and private, during the Level 4 lockdown period,” Higher Education and Training Minister Blade Nzimande said at a briefing on Thursday afternoon.

President Cyril Ramaphosa introduced a risk-adjusted strategy, composed of five levels of lockdown, in order to allow for the reopening of the economy while at the same time managing the spread of Covid-19 in the country.

As a result, South Africa will be shifting from Level 5 to Level 4 on Friday, which will see a slight easing of the lockdown restrictions.

A number of South Africa’s beloved fast-food restaurants, including Chicken Licken, Debonairs and Steers, are open again for fast food deliveries from 1 May.

However, Nando’s will remain closed for now.

According to new regulations, gazetted on Wednesday, the sale of hot, prepared food will be permitted for delivery only. Customers cannot visit restaurants to get the takeaways. Restaurants may open for food delivery services only, between 09:00 to 19:00.

The major fast-food outlets and restaurants confirmed to open from Friday include:

Chicken Licken (limited number of stores)Wimpy KFC (only from Saturday, at a limited number of stores)Debonairs Pizza SteersAndiccio24 PizzaHut Fishaways Roman’s PizzaMcDonald’s (only from Saturday, limited number of stores) Spur (limited number of franchise stores) Burger King (limited number of stores)

People with expiring prescriptions, in the midst of the Covid-19 crisis, are set for some relief.

In what appears to be a bid to further restrict movement and lessen the burden on the healthcare system, if you have an expiring six-month prescription, under certain circumstances, you will not have to visit the doctor for a while longer.

In an amendment to the Medicines and Related Substances Act, schedule 2, 3 and 4 drugs will be subject to extensions by dispensing pharmacists for a further six months.

The act previously limited the dispensing of the scheduled, prescribed drugs to six months whereafter a new prescription from the prescribing doctor would be required.

But the amendment to the act, section 22A(6)(f), allows for schedule 2, 3 and 4 drugs to be excluded from that requirement.

On the topic of whether South Africa’s focus on resources against the Covid-19 fight is coming at the cost of tackling other diseases in the country, Health Minister Dr Zweli Mkhize said it is a matter the health sector battles with every day, but they are striving to keep a balance.

Speaking at the WHO Media Briefing on Covid-19 in Africa on Thursday, Mkhize explained that the reality is that the health sector has to mount an immediate response to the Covid-19 challenge, but at the same time, there is an understanding that unless the country’s health services are able to balance this in the management of other comorbidities, it may bring about a new challenge.

“We grapple with that matter every day. A huge number of our people who have diabetes, hypertension, chest infections, tuberculosis (TB), HIV and AIDS, and cancers – all of these need to be managed as well, while we are dealing with this [Covid-19 crisis].

“That is the reason there has been an additional allocation of resources – to actually help the department get additional human resources and additional structures, in terms of hospital beds and field hospitals, so that we don’t actually have the Covid-19 patients displacing other patients who need it,” Mkhize said.

Chronic conditions are particularly in the spotlight at the moment, as many Covid-19-related deaths in the country have seen victims also suffering from underlying chronic illnesses.

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.

Early on Friday morning, positive cases worldwide were close to 3.25 million, while deaths were almost 233 000.

The United States had the most cases in the world – more than 1 067 000, as well as the most deaths – close to 63 000.

Latest news:

According to a new report from the United Nations Population Fund (UNFPA), the United Nations’ sexual and reproductive health agency, the coronavirus will have a devastating impact on women worldwide.

As the Covid-19 pandemic ravages nations across the globe, health systems continue to be overloaded – facilities remain closed down or continue to limit the services they offer, including services to women and girls.

The UNFPA report suggests Covid-19 is already having a profound impact on women across the globe, with many women choosing to skip crucial medical checkups through fear of contracting the virus.

However, the outcomes for women and their respective communities don’t stop there.

Speaking with Business Insider, UNFPA’s deputy executive director, Dr. Ramiz Alakbarov said: “Globally, roughly 70% of the health workforce is comprised of women. At the moment, there’s more risk of women being exposed [to the coronavirus] as a frontline worker.”

“These issues aren’t exclusive to the developing world. Inequality is less pronounced in the developed world but it’s still there. It’s a catastrophe,” said Alakbarov. “Women are the first to lose their jobs during these crises, they’re the first to stand up for the family, they take most of the brunt economically. But this report is a catastrophe within a catastrophe.”

Britain is “past the peak” of its coronavirus outbreak, Prime Minister Boris Johnson said on Thursday, despite recording another 674 deaths in the last 24 hours, taking the toll to 26 711.

The country is now the third-most affected in the world behind the United States and Italy on cumulative deaths, after changing its reporting to include community as well as hospital deaths on Wednesday.

But Johnson, making his first appearance at a daily government briefing since his own battle with Covid-19, said there were reasons for optimism.

“For the first time, we are past the peak of this disease… and we are on the downward slope,” he told reporters.

Criminal gangs are using fast-food couriers to deliver recreational drugs to people confined at home because of coronavirus lockdowns, policing agency Interpol said on Thursday.

Cocaine, marijuana, ketamine and ecstasy are among the drugs being moved in pizza boxes or other takeaway containers in countries including Ireland, Malaysia, Spain and Britain, Interpol said in a statement.

The agency issued a “purple notice” to warn its 194 member agencies of “this new modus operandi” involving couriers using bikes, motorcycles or cars.

With drug buyers and their dealers under lockdown along with the rest of society in many countries, some drivers are using this time to make a quick buck, while in some cases dealers simply posed as couriers.

LATEST RESEARCH

As the Covid-19 pandemic escalates, many governments worldwide are advocating for the mandatory use of face masks in public.

When President Cyril Ramaphosa addressed the nation on 23 April, he indicated that the use of face masks in public – during all lockdown levels – would be mandatory.

And if you can’t find one, you can certainly make one, but be sure to take the advice of scientists in a recent study.

Six researchers from the Argonne National Laboratory and the University of Chicago recently conducted a study and found that two simple but important features can help to stop the spread of the new coronavirus, officially named SARS-CoV-2.

Experts are scrambling to buy time in the Covid-19 vaccine race by testing the potential of existing drugs like chloroquine and its milder cousin hydroxychloroquine. These drugs have been featuring in the news, especially since their optimistic endorsement by President Donald Trump.

While optimism is what we are looking for as the pandemic sweeps the globe, false hope based on one medication might keep people from the next best thing, an article in Nature suggests.

Not only will false and premature claims of chloroquine as an effective treatment against Covid-19 cause a surge in demand, depleting stock for those who truly need the medication for its designed purpose, but it may also keep people from conducting more promising clinical trials and considering other treatments.

It’s basically a case of placing all your eggs in one basket. Doctors who endorse clinical trials are saying that patients tend to ignore other trials and treatments, stated neurologist Sergio Iván Valdés-Ferrer from the Salvador Zubirán National Institute of Medical Sciences and Nutrition in Mexico City.

New research adds to a growing body of evidence that suggests men are far more vulnerable to severe Covid-19 than women are.

Although both genders fall ill in the same numbers, men are 2.5 times more likely to get severe disease and die, the study from China showed.

The finding comes as scientists in New York and California are starting to test a novel hypothesis that sex hormones might play a part in disease severity.

Last week, doctors on Long Island started treating Covid-19 patients with oestrogen to boost their immune systems, The New York Times reported. And beginning next week, physicians in Los Angeles will start treating male patients with progesterone, a hormone that is predominantly found in women. Progesterone has anti-inflammatory properties and might prevent the immune system from overreacting, the researchers explained.

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 | Will remdesivir help Covid-19 patients? Two reports provide different answers

Posted on 01/05/2020 by Boris Clair

Two new reports have produced conflicting results on the potential effectiveness of remdesivir, an experimental antiviral drug considered to be one of the leading hopes in the fight against Covid-19.

Disappointing results emerged from the first gold-standard clinical trial for remdesivir, which found that the drug did not help patients in China with severe Covid-19. Those findings were published in The Lancet medical journal.

On the same day, drugmaker Gilead Sciences announced positive early findings from a US-designed clinical trial being conducted at 180 sites around the world.

Gilead announced that the US trial will show that Covid-19 patients treated earlier with remdesivir had better outcomes than those who received the drug later in the course of their illness.

‘Not a very encouraging result’

The trial also will show that people who take remdesivir for five days do as well as patients who take a 10-day course, Gilead said.

Infectious disease experts said they are more encouraged by the US clinical trial – which is being run by the US National Institute for Allergy and Infectious Disease (NIAID) – than they are discouraged by the Chinese trial.

That’s because the Chinese team “only enroled half the patients you would need to have a powerful study result” from such a clinical trial, said Dr Aaron Glatt, chairman of medicine and hospital epidemiologist with Mount Sinai South Nassau in Oceanside, New York.

“It would have been great if they had seen evidence it worked, even in the small number of patients they studied,” Glatt said. “It’s not a very encouraging result, but it’s inadequate to say the drug doesn’t work.”

Dr Amesh Adalja, a senior scholar with the Johns Hopkins Center for Health Security, said the Chinese trial is an “important milestone and allows us to better assess the impact of the drug in a rigorous manner”.

However, Adalja added that “the study, because it did not meet its enrolment goals, is underpowered so it is not a definitive result and will need to be supplemented with other trial data.

Broad-spectrum antiviral

“For example, the primary end point of the NIAID-designed trial was met and will provide more information on the benefit of the drug,” Adalja concluded.

Remdesivir is a broad-spectrum antiviral that has shown promise in fighting many different dangerous viruses, including the Covid-19 coronavirus, MERS and SARS, Gilead said. It is designed to interfere with viral replication.

In the study from China, 237 severely ill patients were randomly chosen to receive either remdesivir or a placebo between 6 February and 12 March at 10 hospitals in Hubei, the province that includes Wuhan. Researchers had aimed to recruit 453 patients, but a steep decline in Covid-19 cases prevented them from reaching that goal.

Those who received remdesivir did not receive any apparent benefit over the placebo, regardless of when treatment started, said the research team led by Dr Bin Cao from China-Japan Friendship Hospital and Capital Medical University in China.

“Our trial found that intravenous remdesivir did not significantly improve the time to clinical improvement, mortality, or time to clearance of virus in patients with serious Covid-19 compared with placebo,” the report concluded.

The early results reported Wednesday by Gilead are based on an initial phase of the US-led clinical trial involving 397 patients with severe Covid-19 assigned to receive either five or 10 days of remdesivir. There was no mention of a control or placebo group.

Underlying damage

At least half of patients treated with a five-day dose of the drug improved, and more than half were discharged from the hospital within two weeks, Gilead reported.

More than 64% of the patients who received the shorter treatment course were discharged, compared with 54% of the group treated for 10 days.

The trial also showed that people who got the drug soon after they developed symptoms did better than those who got it later.

This matches with what doctors on the front lines have learned regarding Covid-19 treatment, Glatt said – namely, delaying the use of antivirals gives the coronavirus more time to damage the body.

“If we only save antivirals for the patients who have already deteriorated so much, it may not be the virus we’re treating anymore. It’s the underlying damage, and I’m not sure that any viral treatment is going to make a difference if the lungs are damaged and the immune system cascade has reached a point where you’re seeing toxicity,” Glatt explained.

Gilead said it will share additional data from the trial in the near future, but did not provide a timeline. The company also expects data by the end of May from a second US trial evaluating the use of remdesivir in patients with moderate Covid-19.

The NIAID trials for remdesivir are expected to eventually enrol around 6 000 Covid-19 patients worldwide, Gilead said.

READ | Why remdesivir might be a good bet against Covid-19

READ | More good news on remdesivir’s power to treat Covid-19

READ | Covid-19: The pros and cons of high-speed science

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^{Image credit: Dimitri Karastelev, Unsplash}

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Health24.com | Coronavirus pandemic: why a flu jab is a good idea in countries heading into winter

Covid-19 and influenza

So who should get the vaccine?

^{Marietjie Venter}^{, Head: Zoonotic arbo and Respiratory virus Program, Professor, Department Medical Virology,} ^{University of Pretoria}

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

^{Image credit: Getty Images}

Coronavirus: Government ‘likely’ to get close to or hit 100,000 tests target – Shapps

Health24.com | Coronavirus morning update: Schools proposal, no Nando’s yet, and new rule on prescriptions

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^{Image credit: Getty Images}

Health24.com | Will remdesivir help Covid-19 patients? Two reports provide different answers

‘Not a very encouraging result’

Broad-spectrum antiviral

Underlying damage

^{Image credit:}^{Dimitri Karastelev, Unsplash}

Limited data for effectiveness

Higher risk of exposure

Image credit: Dimitri Karastelev, Unsplash

Covid-19 and influenza

So who should get the vaccine?

Marietjie Venter, Head: Zoonotic arbo and Respiratory virus Program, Professor, Department Medical Virology, University of Pretoria

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

Image credit: Getty Images

Latest news:

WHAT’S HAPPENING IN THE REST OF THE WORLD

Cases update:

Latest news:

LATEST RESEARCH

Image credit: Getty Images

‘Not a very encouraging result’

Broad-spectrum antiviral

Underlying damage

Image credit: Dimitri Karastelev, Unsplash

^{Image credit: Dimitri Karastelev, Unsplash}

^{Marietjie Venter}^{, Head: Zoonotic arbo and Respiratory virus Program, Professor, Department Medical Virology,} ^{University of Pretoria}

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

^{Image credit: Getty Images}

^{Image credit: Getty Images}

^{Image credit:}^{Dimitri Karastelev, Unsplash}