Wednesday, May 17, 2023

Tickborne virus Powassan

Virus
An adult from Sagadahoc County has died after becoming infected with Powassan, a tickborne virus, the Maine Center for Disease Control and Prevention said Wednesday in a news release.

Robert Weymouth, 58, of Topsham spent more than two weeks at Maine Medical Center before he died Sunday, his wife Annemarie told NEWS CENTER, Maine.

His wife said he was an avid racer across Maine, including the Wiscassett speedway, and he would have turned 59 on Saturday.

Weymouth developed neurologic symptoms and is believed to have been infected in Maine by a deer tick or woodchuck tick, according to the health agency.

The Maine CDC said this was the first confirmed case in the state in 2023, and it marks the third death from the virus in Maine since 2015.

According to the agency, Powassan cases are infrequent, with approximately 25 reported annually in the United States since 2015. In Maine, there have been only 15 confirmed cases since 2015. Moreover, the disease has a relatively low fatality rate, with around 10 percent of infected individuals succumbing to it.

The Maine Center for Disease Control and Prevention (Maine CDC) has highlighted that individuals infected with Powassan virus may not exhibit any symptoms. However, if symptoms do occur, they can include fever, headache, vomiting, weakness, confusion, seizures, and memory loss. The CDC also warns that severe neurological symptoms are possible, such as inflammation of the brain or spinal cord. It is important to be aware of these potential symptoms and seek medical attention if necessary.

The health agency provided several "Tick Free ME" tips to help people stay tick free:
  • Know tick habitat and take precautions in areas where ticks may live.
  • Wear light-colored clothing that covers the arms and legs; tuck pants into socks.
  • Use an EPA-approved repellent like DEET, picaridin, IR3535, or oil of lemon eucalyptus on skin; use permethrin on clothing.
  • Check for ticks daily and after any outdoor activity. Check family members and pets too.
  • Ask a veterinarian about tick bite prevention for cats and dogs.
  • Remove your clothing when you get home and put it in the dryer before washing. Use high heat for 10-15 minutes to kill any crawling ticks that have not attached to you.
More information about tick bites and prevention is available on the Maine CDC website.

Friday, May 12, 2023

Degenerative Disc Disease

Disc Disease

Degenerative disc disease (DDD) is a chronic condition in which the intervertebral discs that separate the vertebrae of the spine begin to deteriorate. These discs function to provide cushioning between the vertebrae, absorb shock, and allow for flexibility of the spine. The degeneration of these discs can lead to back pain and a range of other symptoms that may interfere with daily life.

DDD can develop in any part of the spine, although it is frequently observed in the top (cervical) and bottom (lumbar) areas. The indications you encounter may differ depending on the area of your spine where the degeneration is taking place.

DDD is a condition where the discs between the vertebrae in the spine begin to break down and degenerate. This can cause back pain and other symptoms, which may vary depending on where the breakdown is occurring in the spine. In some cases, DDD can be severe enough to cause disability and significantly impact daily life. However, there are several treatment methods available that have been shown to improve symptoms. It is important to consult with a healthcare professional to determine the best course of treatment for your specific case of DDD.

Degenerative Disc Disease Symptoms:

Degenerative disc disease (DDD) is commonly associated with pain, which can vary in intensity and duration. The pain may be chronic or intermittent and may be felt in the neck or back, particularly when bending, twisting, lifting, or sitting. Other symptoms may include numbness, tingling, or weakness in the affected area. It is important to seek medical attention if you experience any of these symptoms to determine the best course of treatment for your specific situation.

DDD can lead to a herniated disc, which is when the degenerated disc slips out of place and presses against the nerves in your spine. This can cause pain, weakness, or numbness in your back, arms, or legs. The herniated disc can also cause sciatica, which is pain that travels from your lower back down your leg. It is important to note that not all cases of DDD will result in a herniated disc, and not all herniated discs cause symptoms. Treatment options are available for those who experience symptoms from a herniated disc.

DDD may lead to more severe symptoms, including:
  • Difficulty walking or rising from a sitting position
  • Bladder and bowel control problems
  • Impaired movement
  • Nerve damage
Each part of your spine may be at different stages of degeneration at once, which can impact your symptoms. For example, if the degeneration is happening in the lumbar section of your spine, you may only feel pain in your lower back.

Causes of Degenerative Disc Disease:

DDD is a medical condition that arises when the intervertebral discs, which act as cushions between the vertebrae in the spine, begin to deteriorate. The natural aging process is the most common cause of DDD, as the discs tend to lose water content and become less flexible and more brittle over time. This degeneration can result in a range of symptoms, including chronic back or neck pain, stiffness, and limited mobility.

As you age, your discs can dry out and begin to break down. Most people over the age of 40 experience some degeneration. However, not all people who have degeneration experience pain.

You can also experience DDD due to injury from sports or daily activities. When a disc tears, it can’t repair itself, so it may be more likely to break down.

Risk Factors:

Research shows variations in certain genes, such as genes that control collagen production and the immune response, may make some people more likely to develop DDD than others.

Collagen strengthens connective tissues including skin, bone, cartilage, tendons, and ligaments. It contributes to the structure of discs in the spine and helps make them more stable. A lower production of collagen could make the discs more likely to slip or breakdown.

How Is Degenerative Disc Disease Diagnosed?

A healthcare provider can use several tests to diagnose DDD, many of which help rule out similar conditions that might be causing your symptoms.

Your healthcare provider may prescribe one or a combination of the following tests:
  • X-rays: The imaging tests are often used to rule out other diagnoses, including scoliosis (curved spine), spondylolisthesis (slipped vertebra), fractures, or gross instability. X-rays allow a view of the structure and alignment of the bones in the spine, but they can’t show discs or soft tissues, meaning they can’t necessarily identify DDD.
  • Computed tomography (CT) scans: Used for similar purposes as x-rays, this test is particularly helpful for identifying pars defects (stress fractures in the lower vertebrae) or spondylolisthesis.
  • Magnetic resonance imaging (MRI) scans: These can provide similar results as x-rays and CT scans, but can also give a view of neural (nerve) structures and discs. If an MRI shows a dark disc, it may signal dehydration or loss of hydrogen ions inside the disc, which can be a sign of DDD.
Treatments for DDD:

Treatment for DDD may consist of a range of methods, including:
  • Physical therapy, particularly with core strengthening and stretching exercises.
  • Lifestyle changes, including modifying or avoiding activities that make the pain worse.
  • Medications, including non-steroidal anti-inflammatory medications (NSAIDs), steroids, and muscle relaxants. Certain medications that influence mood may also be used, such as GABA drugs, serotonin uptake inhibitors, and tricyclic depressants.
  • Epidural injections, which inject anti-inflammatory steroids into the area around the sac of fluid encasing your spinal cord (this is different from numbing epidurals given before childbirth).
  • Heat or cold therapy (cryotherapy) and massage for the management of pain, inflammation, and muscle spasms.
  • Surgery, which is usually reserved for people whose symptoms severely impact their daily life and aren’t responsive to other treatment.
If you have DDD, your treatment plan may include care from several healthcare professionals, including but not limited to:
  • Your primary care provider
  • Physical therapists
  • Physiatrists (specializing in physical medicine and rehabilitation)
  • Neurologists (specializing in the brain and nervous system)
  • Orthopedists (specializing in the bones, muscles, and joints)
  • Neurosurgeons (performs surgery for conditions of the brain and nervous system)
Since DDD can cause disability and impact daily life, you may find seeking mental health care is beneficial to your overall well-being. Specifically, therapists trained in cognitive behavioral therapy (CBT) can help you cope and adjust to life changes.

How to Prevent DDD Flares:

Many causes of degenerative disc disease cannot be prevented. However, making certain lifestyle changes may help reduce symptoms and prevent flares.
  • Your healthcare provider may recommend:
  • Getting regular physical activity
  • Eating a nutritious diet
  • Managing your weight
  • Avoiding smoking or drinking alcohol
These changes have been shown to provide additional improvements in quality of life for people with DDD when used in combination with treatment methods above.

Related Conditions:

There are several conditions associated with DDD, some of which may make it more likely for you develop DDD. These include, but are not limited to:
  • Type 2 diabetes
  • Metabolic syndrome
  • Hypertension (high blood pressure)
  • Hypothyroidism (under-active thyroid)
Many of the lifestyle changes for preventing flares of DDD overlap with lifestyle changes for managing and preventing these related conditions.

Living With Degenerative Disc Disease:

People with DDD can experience pain and limited mobility that can make it difficult to accomplish daily tasks. The condition may worsen with age, although the rate at which disc degeneration progresses can be unpredictable.

However, with a comprehensive treatment plan, people with DDD can lead a healthy life. Treatments like physical therapy and medications can help maintain mobility and manage pain. Getting mental health care and implementing lifestyle changes can help you cope and improve your quality of life.

In addition, new research on biological therapies shows promise. Researchers are looking for improved ways of treating the pain associated with DDD to offer more treatment options in the future.

Thursday, May 11, 2023

Toddlers who have a mild peanut allergy

Toddlers who have a mild peanut allergy

Results from a late-stage clinical trial conducted by an international team of researchers suggest that a peanut patch may help alleviate allergic reactions in children with nut allergies.

Wearing a peanut patch for 12 months has been shown to desensitize toddlers with mild allergies to peanuts, allowing them to safely consume a small number of peanuts without allergic symptoms.

An international clinical trial led by pediatric allergy specialist Matthew Greenhawt from the Children's Hospital Colorado conducted on toddlers aged 1 to 3 years in eight countries across the US, Australia, Canada, and Europe showed that wearing a peanut patch for 12 months effectively desensitized toddlers with mild allergies to peanuts, allowing them to eat a small number of peanuts without experiencing allergic symptoms.

Alkis Togias, an allergist-immunologist at the US National Institute of Health, who was not involved in the trial, writes that the trial results "are very good news for toddlers and their families as the next step toward a future with more treatments for food allergies.

Toddlers were deemed desensitized if they could tolerate approximately one to four peanuts following treatment, which was sufficient to safeguard them from inadvertent exposure.

The desensitization offered by the peanut patch in the clinical trial could provide significant relief to families of children with peanut allergies, who often experience significant anxiety and stress from the constant vigilance required to avoid exposure to allergens.

The team of researchers note that families have expressed the need for treatments that can safeguard their children from unintentional peanut exposure, as it would enhance the socialization and quality of life of both the children and their families.

The patches are intended to expose children with peanut allergies to controlled, small doses of peanut protein through the skin, in order to desensitize them. While it may seem risky, emerging evidence suggests that this approach could be effective in treating food allergies.

Research on children's food allergies is rapidly advancing, particularly in Australia, where studies have revealed that one in ten infants suffer from a food allergy, making it the food allergy capital of the world.

Food allergy rates are increasing in countries like Australia, with one in ten infants affected, and while the reason is not yet known, theories include environmental factors such as low vitamin D levels, and changes in the gut microbiome due to fewer childhood infections, according to researchers.

Children with eczema have a higher likelihood of developing food allergies, as studies suggest they may have been exposed to allergens through their skin before ingesting them, which can trigger the immune system to react negatively to food.

Allergy specialists have recognized the importance of early intervention to prevent food allergies, and parents in Australia and the US are now advised to introduce known allergens into their infants' diets instead of avoiding them to prevent allergies from developing.

There is currently no cure or approved therapies for kids under four years old with food allergies, and research shows that about two-thirds of young children don't outgrow their peanut allergy by age six, highlighting the need for developing a therapy.

"The lovely thing about [a skin patch] is it is much, much, much safer than taking something orally," Murdoch Children's Institute pediatric allergist and co-author Kirsten Perrett said when speaking at a conference last year about new therapies in the works for food allergies.
The doses of allergens applied in a skin patch are far lower than doses used for oral immunotherapies (essentially crushed-up peanuts taken in a tablet form). And although children may still develop some skin irritation or adverse reactions, patches are a much simpler – and potentially safer – alternative to oral immunotherapy, which involves arduous treatment schedules.

Results from trials testing oral immunotherapies have been mighty encouraging. One kind of oral immunotherapy for peanut allergy has been approved in the US, but it's only for kids older than four, and oral immunotherapy remains controversial because it carries a high risk of serious allergic reactions.

The safety of peanut patches is also under close watch. Four toddlers in the patch trial experienced an anaphylactic reaction related to the patch; one child pulled out of the trial while the other three resumed treatment without reacting again.

How long a child would have to wear a patch to ensure lasting benefit is also a big unknown that other trials are exploring.

If future trials can replicate the study findings, and show that peanut patches are a safe option that fairly balances the risks of a reaction in a few children with the benefits of many more kids being able to tolerate peanuts in small doses, then we might be onto a good thing.

Thursday, May 4, 2023

World's first RSV vaccine approves


The Food and Drug Administration has approved the first-ever respiratory syncytial virus (RSV) vaccine, Arexvy, developed by GSK. The single-dose shot is designed to protect people aged 60 and older from lower respiratory tract disease caused by RSV, a highly contagious virus that can be severe in older people and young children. The vaccine has been shown to reduce the risk of severe RSV-associated LRTD by 94% and RSV-associated LRTD by 83%, according to data from a clinical trial. The vaccine is expected to be available to eligible seniors in the US before the RSV season, which begins in the autumn.

About Arexvy (respiratory syncytial virus vaccine, adjuvanted)

Respiratory syncytial virus (RSV) vaccine, adjuvanted, which is developed by GlaxoSmithKline (GSK), contains a recombinant subunit prefusion RSV F glycoprotein antigen (RSVPreF3) combined with GSK's proprietary AS01E adjuvant. It is indicated for the prevention of RSV-LRTD in individuals 60 years of age and older in the US, and is not yet approved anywhere else in the world. The proposed trade name is subject to regulatory approval outside the US. Clinical trials are ongoing to expand the population who may benefit from RSV vaccination into adults aged 50-59, with results expected in 2023. The GSK proprietary AS01 adjuvant system contains QS-21 STIMULON adjuvant licensed from Antigenics Inc.

Click for full US Prescribing Information 

RSV in adults:

Respiratory syncytial virus (RSV) is a contagious virus that affects the lungs and respiratory system. Older adults are at high risk of severe disease due to age-related decline in immunity, particularly those with underlying conditions like chronic obstructive pulmonary disease (COPD), asthma, and chronic heart failure. RSV can worsen these conditions and result in severe outcomes, including pneumonia, hospitalization, and death. In the US, approximately 177,000 adults aged 65 and older are hospitalized each year due to RSV, with an estimated 14,000 cases resulting in death. Data suggest that adults 60 and older are at increased risk for severe RSV infection leading to hospitalization, especially those with underlying conditions.

Wednesday, May 3, 2023

Semantic Decoder: An AI System that Converts Brain Activity into Text

AI brain activity decoder

Researchers at The University of Texas at Austin have developed a new AI system, called a semantic decoder, which is capable of translating a person's brain activity into a stream of text while listening to or imagining a story. The system could potentially aid individuals who are mentally conscious but physically unable to speak, such as stroke victims, to communicate effectively again. The researchers published their work in the journal Nature Neuroscience, relying on a transformer model similar to those used in Open AI's ChatGPT and Google's Bard. Brain activity is measured using a functional MRI scanner following extensive training of the decoder, during which the individual listens to hours of podcasts in the scanner.


Artificial Intelligence Aiding in Early Detection of Breast Cancer in Certain US Hospitals:

Participants open to having their thoughts decoded later listened to a new story or imagined telling a story, allowing the machine to generate corresponding text from brain activity alone.

While the result is not a word-for-word transcript, it captures the gist of what is being said or thought.

About half the time, when the decoder has been trained to monitor a participant’s brain activity, the machine produces text that closely – and sometimes precisely – matches the intended meanings of the original words.

A participant who listened to a speaker say that they do not have their driver's license yet had their thoughts translated as, "She has not even started to learn to drive yet."

The researchers said they were getting the model to decode continuous language for extended periods of time with complicated ideas.

AI Chatbot's "Bedside Manner" prefferred over conventional Doctors by Shocking margin, according to blind study

The researchers conducted a study where the participants were required to watch four short, silent videos while inside a scanner. The semantic decoder was able to accurately describe certain events from the videos using their brain activity. In addition to listening or thinking about stories, this approach was used to test the system's performance. However, it was observed that when the system was tested on people who had not been trained, the results were unintelligible.

The newly developed semantic decoder system, which has the ability to translate a person's brain activity into a continuous stream of text, is currently not suitable for use outside the laboratory due to its dependency on the time needed for an fMRI machine. Nevertheless, researchers have suggested that this technology could be adapted for use with other, more portable brain-imaging systems in the future. Despite concerns that such technology could be misused, study leader Jerry Tang, a doctoral student in computer science, emphasized that the team has taken steps to prevent this from happening and to ensure that the technology is only used when necessary and for beneficial purposes.

The frequency of chronic kidney disease is on the rise

Kidney disease is on the rise

Your kidneys are vital organs that, along with your brain and heart, help keep you alive. These two small organs located in your lower back act as filters, removing waste and excess fluids from your body and regulating blood pressure. While many people focus on monitoring their cholesterol and blood pressure, it's also important to pay attention to your kidney health and check for any signs of chronic kidney disease (CKD).

What causes chronic kidney disease?

Chronic kidney disease (CKD) can be caused by a variety of factors, including:
  1. Diabetes: High blood sugar levels can damage the blood vessels in the kidneys, leading to kidney damage and, over time, CKD.
  2. High blood pressure: High blood pressure can damage the blood vessels in the kidneys and cause CKD.
  3. Glomerulonephritis: An inflammation of the tiny filters in the kidneys that can damage them and cause CKD.
  4. Polycystic kidney disease: A genetic disorder that causes cysts to form in the kidneys and can lead to CKD.
  5. Kidney infections: Repeated or severe kidney infections can cause damage to the kidneys and lead to CKD.
  6. Certain medications: Long-term use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can cause kidney damage and lead to CKD.
  7. Other factors: Other factors that can contribute to CKD include autoimmune diseases, congenital kidney defects, and obstruction of the urinary tract.

Understanding the importance of kidney health

It is important to know about kidney health because the kidneys are vital organs that play a crucial role in maintaining overall health. They filter waste and excess fluids from the body, regulate blood pressure, and produce hormones. Chronic kidney disease is a serious health condition that can have significant consequences if left untreated. By understanding the importance of kidney health and taking steps to keep your kidneys functioning properly, you can help prevent kidney disease and maintain good health.

Two important markers to detect kidney disease

Dr. Kapoor suggests that the estimated Glomerular Filtration Rate (eGFR) and urine Albumin-Creatinine Ratio (uACR) are two crucial markers to detect kidney disease. eGFR is measured by a blood test and indicates how well the kidneys clean blood, while uACR is measured by a urine test and detects the presence of a protein called albumin. Both these tests are essential for detecting kidney damage and disease, especially in patients with diabetes. However, eGFR may not be reliable for patients with rapidly changing creatinine levels or altered diet patterns.

uACR

The uACR test measures the amount of albumin that passes into urine in a 24-hour period to diagnose and monitor kidney damage in patients with type 1 or type 2 diabetes. A result of 30 or above may indicate kidney disease. Additional lab and imaging tests, such as an ultrasound or CT scan, may be performed to evaluate the kidneys and urinary tract. Regular monitoring is necessary to confirm or rule out CKD, and to adjust treatment plans as needed.

Tuesday, May 2, 2023

Nigeria's NCDC Reports 897 Lassa Fever Cases and 154 Deaths

Nigeria's NCDC Lasa fever cases

The Nigeria Centre for Disease Control (NCDC) has announced a total of 897 cases of Lassa fever and 154 deaths in Nigeria between January and March of this year. In its latest report, the NCDC states that the number of cases and fatalities has increased compared to the same period last year, with the highest incidence occurring in Edo, Ondo, and Ebonyi states.

Lassa fever is an acute viral illness that is transmitted to humans through contact with the urine or faeces of infected rodents, commonly the multimammate rat. It can also be transmitted through contact with bodily fluids of an infected person.

The NCDC notes that the increase in cases and deaths is due to several factors, including inadequate disease surveillance, late presentation of cases, and poor case management in health facilities.

The NCDC also advises that Lassa fever can be prevented through improved sanitation and hygiene practices, avoiding contact with rats, and taking precautions when caring for infected patients.

Efforts to combat Lassa fever in Nigeria include increased surveillance and laboratory capacity, improved case management, and public health awareness campaigns. The NCDC urges the public to report suspected cases promptly to their nearest health facility and to follow recommended prevention measures.