Diabetes has been one disease that may not show immediate symptoms or even a cure but scares the best of us nonetheless and although it cannot be cured, high blood sugar is a rather prevalent lifestyle condition that can be managed. The pancreas insulin is in charge of keeping the blood’s glucose levels stable but Diabetes results from abnormally high blood sugar levels due to a lack of insulin, its ineffective manufacture or its improper use.
In an interview with HT Lifestyle, Dr Kriti Soni, Head- R&D at Kapiva, insisted, “There is no single cure for diabetes; instead, a number of lifestyle adjustments must be made on a regular basis. Sustainable prevention strategies must be put in place in addition to these lifestyle changes to help not just manage but also prevent diabetes.”
According to a study, one of the most effective methods for treating the underlying causes of diabetes is Ayurveda. Dr Kriti Soni shared, “Ayurvedic remedies, which use natural medicines, can help manage the debilitating symptoms of diabetes based on the idea that prevention is better than cure. By bringing blood sugar levels down to non-diabetic ranges, these medicines can effectively cure the disease at its source.”
Ahead of World Diabetes Day, which is marked annually on November 14, she suggested some cutting-edge approaches to controlling diabetes should be planned as part of these preventative actions and lifestyle modifications:
1. Ayurveda-approved juices
Natural diabetes management is made possible by ayurvedic drinks and their superior blend of pure herbs. The greatest natural method of regulating blood sugar levels is thought to be juices made from a combination of amla, jamun seeds, and karela. Both type 1 and 2 diabetics can benefit from karela juice, which can be consumed early in the morning. These juices assist general digestion, increase energy levels, and control carbohydrate metabolism in addition to controlling blood sugar levels. For best results, make sure you take these supplements after speaking with an Ayurvedic physician.
2. Managing stress
A major contributor to heart disease is now stress. Nowadays, people are continually exposed to high amounts of stress at work and at home, so it’s crucial to maintain low-stress levels. Ayurveda claims that meditation can aid in stress management and reduction. Chanting and breathing exercises can both support maintaining a healthy blood sugar level.
3. Maintaining a healthy diet
Adopting a healthy food routine is one of the fundamental steps in managing diabetes and may positively impact a person’s health. Changing one’s diet would entail choosing foods with a lower glycemic index. This would entail consuming entire grains and healthy fats while limiting red meat and processed sugar-based liquids.
4. Regular physical activity
Regular exercise or engaging in physical activity, even for an hour, could prevent the early onset of diabetes in our hectic and busy lives. Breaking the cycle of your hectic routine becomes crucial if you want to prevent subsequent medical traumas like hypertension, excessive cholesterol, etc.
These are a few modern practices that are based on an in-depth study on healthy ways to not only manage diabetes but also prevent it by utilizing preventative measures.
Two omicron subvariants that are resistant to key antibody treatments are on the rise in the U.S., according to data from the Centers for Disease Control and Prevention.
The subvariants BQ.1 and BQ.1.1 now represent 27% of infections in the U.S., a significant jump from the week prior when they made up about 16% of new cases, according to CDC data published Friday.
Omicron BA.5, though still the dominant variant, is diminishing every week. It now represents about 50% of infections in the U.S., down from 60% the week prior, according to the data.
President Joe Biden this week warned people with compromised immune systems that they were particularly at risk this winter because antibody treatments are not effective against emerging subvariants.
BQ.1 and BQ.1.1 are likely resistant to Evusheld and bebtelovimab, according to the National Institutes of Health.
Evusheld is an antibody cocktail administered as two injections that people ages 12 and older with moderately or severely compromised immune systems take to prevent Covid-19. Bebtelovimab is a monoclonal antibody taken to treat Covid after an infection.
Biden urged people with weak immune systems to consult their physicians on what precautions to take. Dr. Ashish Jha, head of the White House Covid task force, said the U.S. is running out of options to treat the vulnerable because Congress failed to pass more money for the nation’s Covid response.
“We had hoped that over time as the pandemic went along, as our fight against this virus went along, we would be expanding our medicine cabinet,” Jha told reporters this week. “Because of lack of congressional funding that medicine cabinet has actually shrunk and that does put vulnerable people at risk.”
It’s unclear how well the new boosters will protect against variants such as BQ.1 and BQ.1.1. Jha has said the boosters should offer better protection than the old shots because these subvariants are descended from BA.5, which is contained in the updated vaccines.
Two independent studies from Columbia and Harvard this week found that the omicron boosters did not perform much better than the old shots against BA.5. The Food and Drug Administration said the studies were too small to draw any definitive conclusions.
The CDC, the FDA and the White House Covid taskforce believe the new shots will prove more effective because they are better matched to the circulating variants than the first generation vaccines.
“It is reasonable to expect based on what we know about immunology and the science of this virus that these new vaccines will provide better protection against infection, better protection against transmission and ongoing and better protection against serious illness,” Jha told reporters in September.
Jha called for all eligible Americans to get the omicron booster and their flu shot by Halloween so that they are protected when families start gathering for the holidays.
Five years ago, Lady Gaga revealed that she had fibromyalgia, a chronic illness so intense that it led to “severe pain” and tour cancellations during her music career.
Fibromyalgia is a long-lasting disorder that “causes pain and tenderness throughout the body,” according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. But while its effects can have severe impacts on those with the disease, some people don’t view it as an actual medical condition — because it cannot currently be diagnosed through medical testing. People are often diagnosed with fibromyalgia because it’s the only explanation left, after doctors have ruled out everything else.
Gaga, whose given name is Stefani Germanotta, expressed her frustration with people who don’t view the condition as a real disease in an interview with Vogue.
“I get so irritated with people who don’t believe fibromyalgia is real,” the singer-actress said. “People need to be more compassionate. Chronic pain is no joke. And it’s every day waking up not knowing how you’re going to feel.”
She’s not alone: Fibromyalgia affects about 4 million adults in the U.S., or 2% of the country’s adult population, according to the Centers for Disease Control and Prevention.
To get a better understanding of the condition and its effects on people living with it each day, CNBC Make It spoke with Benjamin Natelson, an expert on fibromyalgia and chronic fatigue syndrome and professor of neurology at the Icahn School of Medicine at Mount Sinai in New York.
Fibromyalgia symptoms, causes and treatments
The CDC defines fibromyalgia as “pain all over the body,” or widespread pain. You might also have fibromyalgia if you’re experiencing tenderness in different parts of your body, when probed, with no medical explanation after several tests, Natelson says.
“For years, primary care doctors were just telling the patient there was nothing wrong with them or it was all in their head,” he says.
There’s currently no test to detect the illness: Fibromyalgia is diagnosed based on what the patient feels and expresses to their doctor, according to the American College of Rheumatology. Lab tests and X-rays can be used to rule out other conditions, the organization adds.
For some people, that raises doubt about whether fibromyalgia is a real condition, or simply a catch-all for unexplained chronic pain symptoms. And as doctors have learned more about the condition, its case definition has repeatedly changed.
Right now, its most commonly observed symptoms overlap with those of chronic fatigue syndrome, says Natelson. Chronic fatigue syndrome is an illness with long-term effects like severe fatigue, trouble sleeping and difficulty with concentration, according to the CDC.
“Whether those two illnesses are the same or different has been a focus of my research for the past decade,” he says. “And there are a lot of bits of data that suggest they’re different, but there are also similarities between the two.”
Symptoms
Fibromyalgia’s main symptom is achiness all over the body that can’t be linked to any other disease through medical testing, Natelson says. Living with the condition can also lead to symptoms like:
Difficulty sleeping
Fatigue
Pain that leads to disability
The chronic nature of the illness can also cause “mental and emotional distress,” Natelson adds. For someone who hasn’t experienced discomfort and fatigue at this level prior to developing fibromyalgia, chronic pain subsiding and reappearing can be emotionally draining, he says.
Causes
What causes fibromyalgia? It’s a tricky question: The condition’s causes are unclear, Natelson says. The condition does have a couple known risk factors, according to the CDC:
Most people with the condition are diagnosed when they’re middle-aged or older. However, fibromyalgia can impact anyone regardless of age, including kids.
You are more likely to develop fibromyalgia if you have lupus or rheumatoid arthritis.
The CDC also notes several more possible links to the development of fibromyalgia, but emphasizes that more research is needed to confirm or understand any connections:
Sex, as women are twice as likely to develop the condition than men.
Stressful or traumatic events like car accidents
Repetitive injuries or injury from repetitive stress on certain joints
Illness, like viral infections
Family history
Obesity
Treatments
Fibromyalgia can be treated in several ways, according to Natelson and the CDC:
Medications including prescriptions drugs — the U.S. Food and Drug Administration has approved three drugs for the condition — and over-the-counter pain relievers
Cardio and muscle-strengthening exercises
Patient education courses
Stress management practices like yoga, meditation and massages
Improved sleep habits for better rest
Therapy for the condition’s potential mental health impacts
“The best self-help thing that a patient with body-wide pain can do is to walk for 30 minutes every other day,” Natelson says. “Gentle physical conditioning, and I focus on the word ‘gentle’ if the person has really severe fibromyalgia, is best to relieve the discomfort and feel better.”
Just be careful: If you’re experiencing any of these symptoms, don’t self-diagnose or self-medicate. Contact your doctor to test for any possible conditions or health issues — whether fibromyalgia, chronic fatigue syndrome or otherwise.
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The pandemic might be over in the minds of some. But like it or not, COVID is ramping up for a fall wave—one likely to be fueled by multiple variants, experts say, as the virus mutates and spreads exponentially.
The Institute for Health Metrics and Evaluation at the University of Washington and other experts, including Dr. Anthony Fauci, the nation’s top infectious disease expert, foresee a wave beginning to swell in late October, and peaking in late December or January.
It could kill another 20,500 Americans, according to the IHME.
While the coming wave may be caused by multiple variants, they may start to look increasingly similar as they mutate to become more efficient—and take the same path to achieve it.
The wave may be carried by one variant, Dr. Raj Rajnarayanan, assistant dean of research and associate professor at the New York Institute of Technology campus in Jonesboro, Ark., told Fortune this week.
“But if you look closer, they may all have the same set of mutations.”
And they may all end up with the same disastrous effect: rendering current COVID countermeasures like drugs and vaccines powerless.
The spawn of Centaurus
Omicron spawn BA.2.75, dubbed “Centaurus,” seemed like the COVID variant to watch this summer—one with the potential to wreak havoc later in the year.
But Centaurus is no longer a worry, according to Rajnarayanan. Instead, one of its children, BA.2.75.2, has outcompeted it, eliminating it as a threat—but replacing it with a more formidable one.
Fauci this week called the BA.2.75.2 variant “suspicious,” in that it has the potential to develop into a variant of concern for the fall.
In Rajnarayanan’s book, it’s the most formidable of up-and-coming strains because of its spike protein—a feature that allows it to enter cells—binds more tightly to human cells than that of any other variant. By doing so, it makes it more difficult for antibodies to successfully attack.
The variant is picking up mutations that make it more similar to globally dominant BA.5 and the deadly Delta variant of late 2021. And it’s just “a couple of mutations away from picking up increased transmission speed,” Rajnarayanan said.
To make matters worse, the new variant shows “extensive escape” ability, according to a new preprint paper released this week by researchers at the Imperial College in London and the Karolinska Institute in Sweden.
The paper, which is not yet peer reviewed but has been widely cited by experts, called the variant “the most neutralization-resistant variant evaluated to date,” and said it may effectively evade antibody immunity, built by vaccination and prior infection.
A spin-off of a heavyweight champ
Another major contender: Omicron spawn BF.7. It’s a spin-off of globally dominant strain BA.5, three generations removed.
The new subvariant has a change in the spike protein seen in other Omicron strains making headway. It also has a change in the nucleotide sequence—sometimes referred to as the blueprint of an organism—that could cause it to behave differently than other subvariants, Dr. Stuart Ray, vice chair of medicine for data integrity and analytics at Johns Hopkins Department of Medicine, told Fortune this week.
Scientists are taking note of BF.7 because it’s making headway in an increasingly crowded field of Omicron subvariants.
“The same growth advantage in multiple countries makes it reasonable to think that BF.7 is gaining a foothold,” and that it’s potentially more transmissible than parent BA.5, Ray said.
Convergent evolution & ‘frankenviruses’
There are more contenders, including BQ.1.1. The variant is jockeying with BA.2.75.2 to lead the wave this fall, Rajnarayanan said.
Major players are beginning to pick up identical advantageous mutations as they try to gain supremacy over their rivals, according to Rajnarayanan. Some mutations offer advantages like increased transmissibility, while others make it more difficult for the human immune system—as well as treatments and vaccines—to fight them off.
It’s common for variants to garner multiple mutations—and increasingly, variants of potential concern are acquiring many of the same ones.
“Eventually all variants may look the same at the spike level,” Rajnarayana said.
Variant hunters are also keeping their eye on recombinants—combinations of multiple variants that form “frankenviruses” of sorts.
One Rajnarayanan and others are watching: XBB, a combination of two different Omicron spawns. It’s not currently a concern in terms of spread, but “it’s probably the most immune evasive yet”—even more so than the rising BA.2.75.2, which is more immune evasive than globally dominant BA.5, the most immune evasive until recently.
It’s a concerning pattern that has the ability to reduce the effectiveness of COVID treatments, as acknowledged by World Health Organization officials this week—and perhaps even vaccines. In a worst-case scenario, increasingly immune-evasive variants could render them ineffective entirely.
BA.2.75.2 is being watched for its potential to escape theimmunity provided by the last antibody drug that is effective on all variants, Bebtelovimab, according to Rajnarayanan and other experts. It’s administered to those at high risk of serious outcomes from COVID.
According to a preprint updated Friday by Yulong Richard Cao, an assistant Professor at Peking University’s Biomedical Pioneering Innovation Center in China, and others, BQ.1.1 beat it to the punch. The variant escapes immunity from Bebtelovimab, as well as another antibody drug that only works against some variants.
“Such rapid and simultaneous emergence of variants with enormous advantages is unprecedented,” Cao and others wrote in the paper.
It’s unknown how well new Omicron boosters will hold up against coming variants. But Cao’s paper notes that herd immunity and boosters may not protect against new strains. It urges the rapid development of broader COVID vaccines and new antibody drugs, and encourages researchers to test them against recombinants they construct in the lab, in an effort to gauge their effectiveness ahead of time.
Rajnarayanan worries for the future of COVID countermeasures and, like WHO officials, calls on countries to keep up testing and the genetic sequencing of samples. It’s the only way to know what’s coming, they contend. Ideally, such knowledge will allow researchers to scramble to create new countermeasures, or update old ones, as necessary.
“We used to say we have the tools,” he said. “The tools are getting picked off.”
Summary: Patients with major depressive disorder who experienced trauma during childhood see symptom improvement following psychopharmacological intervention, psychotherapy, or a combination of both.
Source: The Lancet
Adults with major depressive disorder who have a history of childhood trauma experience symptom improvement after pharmacotherapy, psychotherapy, or combination treatment.
The results of a new study, published in The Lancet Psychiatry, suggest that contrary to current theory, these common treatments for major depressive disorder are effective for patients with childhood trauma.
Childhood trauma (defined as emotional/physical neglect or emotional/physical/sexual abuse before the age of 18) is known to be a risk factor for the development of major depressive disorder in adulthood, often producing symptoms that are earlier onset, longer lasting/more frequently recurring, and with increased risk of morbidity.
Previous studies have suggested that adults and adolescents with depression and childhood trauma were around 1.5 times more likely to not respond or remit after pharmacotherapy, psychotherapy, or combination treatment, than those without childhood trauma.
“This study is the largest of its kind to look at the effectiveness of depression treatments for adults with childhood trauma and is also the first to compare the effect of active treatment with control condition (waitlist, placebo, or care-as-usual) for this population.
“Around 46% of adults with depression have a history of childhood trauma, and for chronic depression sufferers the prevalence is even higher. It is therefore important to determine whether current treatments offered for major depressive disorder are effective for patients with childhood trauma,” says Ph.D. Candidate and first author of the study, Erika Kuzminskaite.
The researchers used data from 29 clinical trials of pharmacotherapy and psychotherapy treatments for major depressive disorder in adults, covering a maximum of 6,830 patients. Of the participants, 4,268 or 62.5% reported a history of childhood trauma. Most of the clinical trials (15, 51.7%) were conducted in Europe, followed by North America (9, 31%). Depression severity measures were determined using the Beck Depression Inventory (BDI) or Hamilton Rating Scale for Depression (HRSD).
The three research questions tested were: whether childhood trauma patients were more severely depressed prior to treatment, whether there were more unfavorable outcomes following active treatments for patients with childhood trauma, and whether childhood trauma patients were less likely to benefit from active treatment than control condition.
In line with the results of previous studies, patients with childhood trauma showed greater symptom severity at the start of treatment than patients without childhood trauma, highlighting the importance of taking symptom severity into account when calculating treatment effects.
Although childhood trauma patients reported more depressive symptoms at both the start and end of the treatment, they experienced similar symptom improvement compared to patients without childhood trauma history.
Treatment dropout rates were also similar for patients with and without childhood trauma. The measured treatment efficacy did not vary by childhood trauma type, depression diagnosis, assessment method of childhood trauma, study quality, year, treatment type or length.
“Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma. Nevertheless, residual symptoms following treatment in patients with childhood trauma warrant more clinical attention as additional interventions may still be needed.
“To provide further meaningful progress and improve outcomes for individuals with childhood trauma, future research is necessary to examine long-term treatment outcomes and mechanisms through which childhood trauma exerts its long-lasting effects,” says Erika Kuzminskaite.
Previous studies have suggested that adults and adolescents with depression and childhood trauma were around 1.5 times more likely to not respond or remit after pharmacotherapy, psychotherapy, or combination treatment, than those without childhood trauma. Image is in the public domain
The authors acknowledge some limitations with this study, including a high variety of results among the studies included in the meta-analysis, and all cases of childhood trauma being reported retrospectively.
The meta-analysis focused on symptom decline during acute treatment phase, but people with depression and childhood trauma often show post-treatment residual symptoms and are characterized by a high risk of relapse, thus they may benefit from treatment significantly less than patients without childhood trauma in the long run. The study design also did not account for differences between genders.
Writing in a linked Comment, Antoine Yrondi, University of Toulouse, France (who was not involved in the research) said, “This meta-analysis could allow to deliver a hopeful message to patients with childhood trauma that evidence-based psychotherapy and pharmacotherapy could improve depressive symptoms.
“However, physicians should keep in mind that childhood trauma could be associated with clinical features which may make it more difficult to reach complete symptomatic remission, and therefore, have an impact on the daily functioning.”
See also
About this depression and child abuse research news
Author: Press Office Source: The Lancet Contact: Press Office – The Lancet Image: The image is in the public domain
Original Research: Closed access. “Treatment efficacy and effectiveness in adults with major depressive disorder and childhood trauma history: a systematic review and meta-analysis” by Erika Kuzminskaite et al. Lancet Psychiatry
Abstract
Treatment efficacy and effectiveness in adults with major depressive disorder and childhood trauma history: a systematic review and meta-analysis
Background
Childhood trauma is a common and potent risk factor for developing major depressive disorder in adulthood, associated with earlier onset, more chronic or recurrent symptoms, and greater probability of having comorbidities. Some studies indicate that evidence-based pharmacotherapies and psychotherapies for adult depression might be less efficacious in patients with a history of childhood trauma than patients without childhood trauma, but findings are inconsistent. Therefore, we examined whether individuals with major depressive disorder, including chronic forms of depression, and a reported history of childhood trauma, had more severe depressive symptoms before treatment, had more unfavourable treatment outcomes following active treatments, and were less likely to benefit from active treatments relative to a control condition, compared with individuals with depression without childhood trauma.
Methods
We did a comprehensive meta-analysis (PROSPERO CRD42020220139). Study selection combined the search of bibliographical databases (PubMed, PsycINFO, and Embase) from Nov 21, 2013, to March 16, 2020, and full-text randomised clinical trials (RCTs) identified from several sources (1966 up to 2016–19) to identify articles in English. RCTs and open trials comparing the efficacy or effectiveness of evidence-based pharmacotherapy, psychotherapy, or combination intervention for adult patients with depressive disorders and the presence or absence of childhood trauma were included. Two independent researchers extracted study characteristics. Group data for effect-size calculations were requested from study authors. The primary outcome was depression severity change from baseline to the end of the acute treatment phase, expressed as standardised effect size (Hedges’ g). Meta-analyses were done using random-effects models.
Findings
From 10 505 publications, 54 trials met the inclusion criteria, of which 29 (20 RCTs and nine open trials) contributed data of a maximum of 6830 participants (age range 18–85 years, male and female individuals and specific ethnicity data unavailable). More than half (4268 [62%] of 6830) of patients with major depressive disorder reported a history of childhood trauma. Despite having more severe depression at baseline (g=0·202, 95% CI 0·145 to 0·258, I2=0%), patients with childhood trauma benefitted from active treatment similarly to patients without childhood trauma history (treatment effect difference between groups g=0·016, –0·094 to 0·125, I2=44·3%), with no significant difference in active treatment effects (vs control condition) between individuals with and without childhood trauma (childhood trauma g=0·605, 0·294 to 0·916, I2=58·0%; no childhood trauma g=0·178, –0·195 to 0·552, I2=67·5%; between-group difference p=0·051), and similar dropout rates (risk ratio 1·063, 0·945 to 1·195, I2=0%). Findings did not significantly differ by childhood trauma type, study design, depression diagnosis, assessment method of childhood trauma, study quality, year, or treatment type or length, but differed by country (North American studies showed larger treatment effects for patients with childhood trauma; false discovery rate corrected p=0·0080). Most studies had a moderate to high risk of bias (21 [72%] of 29), but the sensitivity analysis in low-bias studies yielded similar findings to when all studies were included.
Interpretation
Contrary to previous studies, we found evidence that the symptoms of patients with major depressive disorder and childhood trauma significantly improve after pharmacological and psychotherapeutic treatments, notwithstanding their higher severity of depressive symptoms. Evidence-based psychotherapy and pharmacotherapy should be offered to patients with major depressive disorder regardless of childhood trauma status.
Stem cells are unspecialized cells that can be manipulated into becoming mature cells with special functions.
“Our mouse embryo model not only develops a brain, but also a beating heart, all the components that go on to make up the body,” said lead study author Magdalena Zernicka-Goetz, professor of mammalian development and stem cell biology at the University of Cambridge in the United Kingdom.
“It’s just unbelievable that we’ve got this far. This has been the dream of our community for years, and a major focus of our work for a decade, and finally we’ve done it.”
The paper is an exciting advance and tackles a challenge scientists face studying mammal embryos in utero, said Marianne Bronner, a professor of biology at the California Institute of Technology in Pasadena (Caltech). Bronner was not involved in the study.
“These develop outside of the mother and therefore can be easily visualized through critical developmental stages that were previously difficult to access,” Bronner added.
The researchers hope to move from mouse embryos to creating models of natural human pregnancies — many of which fail in the early stages, Zernicka-Goetz said.
By watching the embryos in a lab instead of a uterus, scientists got a better view into the process to learn why some pregnancies might fail and how to prevent it, she added.
For now, researchers have only been able to track about eight days of development in the mouse synthetic embryos, but the process is improving, and they are already learning a lot, said study author Gianluca Amadei, a postdoctoral researcher at the University of Cambridge.
“It reveals the fundamental requirements that have to be fulfilled to make the right structure of the embryo with its organs,” Zernicka-Goetz said.
Where it stands, the research doesn’t apply to humans and “there needs to be a high degree of improvement for this to be truly useful,” said Benoit Bruneau, the director of the Gladstone Institute of Cardiovascular Disease and a senior investigator at Gladstone Institutes. Bruneau was not involved in the study.
But researchers see important uses for the future. The process can be used immediately to test new drugs, Zernicka-Goetz said. But in the longer term, as scientists move from mouse synthetic embryos to a human embryo model, it also could help build synthetic organs for people who need transplants, Zernicka-Goetz added.
“I see this work as being the first example of work of this kind,” said study author David Glover, research professor of biology and biological engineering at Caltech.
How they did it
In utero, an embryo needs three types of stem cells to form: One becomes the body tissue, another the sac where the embryo develops, and the third the placenta connecting parent and fetus, according to the study.
In Zernicka-Goetz’s lab, researchers isolated the three types of stem cells from embryos and cultured them in a container angled to bring the cells together and encourage crosstalk between them.
Day by day, they were able to see the group of cells form into a more and more complex structure, she said.
There are ethical and legal considerations to address before moving to human synthetic embryos, Zernicka-Goetz said. And with the difference in complexity between mouse and human embryos, it could be decades before researchers are able to do a similar process for human models, Bronner said.
But in the meantime, the information learned from the mouse models could help “correct failing tissues and organs,” Zernicka-Goetz said.
The mystery of human life
The early weeks after fertilization are made up of these three different stem cells communicating with one another chemically and mechanically so the embryo can grow properly, the study said.
“So many pregnancies fail around this time, before most women (realize) they are pregnant,” said Zernicka-Goetz, who is also professor of biology and biological engineering at Caltech. “This period is the foundation for everything else that follows in pregnancy. If it goes wrong, the pregnancy will fail.”
But by this stage, an embryo created through in vitro fertilization is already implanted in the parent, so scientists have limited visibility into the processes it is going through, Zernicka-Goetz said.
They were able to develop foundations of a brain — a first for models such as these and a “holy grail for the field,” Glover said.
“This period of human life is so mysterious, so to be able to see how it happens in a dish — to have access to these individual stem cells, to understand why so many pregnancies fail and how we might be able to prevent that from happening — is quite special,” Zernicka-Goetz said in a press release. “We looked at the dialogue that has to happen between the different types of stem cell at that time — we’ve shown how it occurs and how it can go wrong.”
Thousands of people with long Covid are travelling abroad to spend huge sums of money on unproven treatments such as “blood washing”, prompting warnings from experts and doctors.
Patients are attending private clinics in Cyprus, Germany and Switzerland for procedures such as a blood filtering treatment and anti-clotting therapy, according to an investigation by the British Medical Journal and ITV News.
However, experts have raised concerns over whether such invasive and expensive therapies should be offered without sufficient evidence.
“I am worried these patients have been offered therapies which have not been assessed by modern scientific methods – well-designed clinical trials,” said Beverley Hunt, medical director of the charity Thrombosis UK. “In this situation, the treatment may or may not benefit them but, worryingly, also has the risk of harm.”
The World Health Organization (WHO) estimates between 10% and 20% of people experience symptoms for at least two months after an acute Covid infection.
In the UK, long Covid is defined by the National Institute for Health and Care Excellence (Nice) guidelines as having new or ongoing symptoms four weeks or more after the start of the disease.
The Office for National Statistics estimates the number of people with long Covid increased from 1.3 million in January this year to 2 million in May.
Symptoms can include fatigue, shortness of breath, loss of concentration and joint pain. As well as affecting day-to-day activities, the condition can be severely limiting for some people.
Researchers, health experts and clinicians are scrambling to investigate possible treatments for long Covid, but because the condition is still novel, there is no internationally-agreed treatment pathway.
Apheresis, a blood filtering treatment normally used for lipid disorders, involves needles being put into each arm and the blood passing over a filter, separating red blood cells from the plasma. The plasma is then recombined with red blood cells and returned to the body via a different vein.
Gitte Boumeester, a trainee psychiatrist in Almelo, the Netherlands, tried it after developing severe long Covid symptoms.
After undergoing treatment at The Long Covid Center in Cyprus at a cost of more than €50,000 (£42,376), she returned home with no improvement to her symptoms. She received six rounds of apheresis, as well as nine rounds of hyperbaric oxygen therapy and an intravenous vitamin drip at the Poseidonia clinic next door to the clinic.
Boumeester was also advised to buy hydroxychloroquine as an early treatment package in case she was reinfected with Covid, despite a Cochrane review concluding that it is “unlikely” the drug has any benefit in the prevention of the disease.
Dr Beate Jaeger, an internal medicine doctor, began treating long Covid patients with apheresis in February last year at her clinic in Mülheim, Germany, after reading reports that Covid causes issues with blood clotting. She told the BMJ she has now treated thousands in her clinic after patients shared their stories on social media and via word of mouth.
Jaeger accepts that the treatment is experimental for long Covid, but said trials are taking too long when the pandemic has left millions of patients with the condition worldwide.
Chris Witham, a 45-year-old long Covid patient from Bournemouth, England, spent about £7,000 on apheresis treatment (including travel and accommodation costs) in Kempten, Germany, last year. “I’d have sold my house and given it away to get better, without a second thought,” he said. The treatment did not improve his long Covid symptoms, the BMJ reported.
While some doctors and researchers believe apheresis and anticoagulation drugs may be promising treatments for long Covid, others worry patients becoming increasingly desperate are spending life-changing sums on invasive, unproven treatments.
Shamil Haroon, clinical lecturer in primary care at the University of Birmingham and a researcher on the Therapies for Long Covid in non-hospitalised patients (TLC) trial, believes such “experimental” treatment should only be done in the context of a clinical trial.
“It’s unsurprising that people who were previously highly functioning, who are now debilitated, can’t work, can’t financially support themselves, would seek treatments elsewhere,” he said.
“It’s a completely rational response to a situation like this. But people could potentially go bankrupt accessing these treatments, for which there is limited to no evidence of effectiveness.”
Marcus Klotz, co-founder of the Long Covid Center, told The BMJ: “We as a clinic do neither advertise, nor promote. We accept patients that have microcirculation issues and want to be treated with HELP apheresis … If a patient needs a prescription, it is individually assessed by our doctor or the patient is referred to other specialised doctors where needed.”
A spokesperson for the Poseidonia clinic said all treatments offered are “always based on medical and clinical evaluation by our doctors and clinical nutritionist, diagnosis via blood tests with lab follow-ups as per good medical practice.”
Summary: Recent antibiotic use impacts the way in which people pay attention to negative facial expressions. Findings shed light on how antibiotic use can increase the risks of depression.
Source: Lieden University
People who have taken antibiotics in the past three months pay more attention to negative facial expressions, according to research by postdoc Katerina Johnson and assistant professor Laura Steenbergen. This may explain how antibiotics increase the risk of developing depression.
The use of antibiotics negatively affects the microbial community in the gut, previous research has shown. That can then have knock-on effects on the rest of our health, Johnson explains. “We know that the gut microbiome in animals and humans not only affects physical health, but also interacts with the brain, influencing emotions and cognition.”
Johnson and Steenbergen investigated whether there are differences in the way people process emotional stimuli depending on whether they have recently taken a course of antibiotics or not.
The participants were young, otherwise healthy college students who had been treated for relatively minor ailments. The participants had recovered from their infection when they were recruited for the study.
The study found that those who had taken antibiotics paid more attention to negative facial expressions. They paid more attention to sad facial expressions in particular.
Steenbergen: “It is a commonly used method in psychology to measure how much attention people pay to different emotional expressions.
The use of antibiotics negatively affects the microbial community in the gut, previous research has shown. Image is in the public domain
“This allows us to detect subtle changes in the way people process emotional stimuli. We know that people who pay more attention to negative emotions have a higher risk of developing mental illnesses such as depression and anxiety.”
Increased risk of depression
Previous studies have found that even one course of antibiotics can increase the risk of depression and anxiety. Steenbergen adds: “As well as the disruption to the microbiome caused by antibiotics, we also know that inflammation from an infection can itself affect the brain.
“However, studies have shown that people who have an infection treated with antifungal or antiviral drugs do not have such an increased risk of depression. This suggests that antibiotics may be a causal factor in the relationship with negative mood.
“In addition, we also know from animal studies that antibiotics can cause symptoms of depression.”
Johnson concluded: “This association between antibiotic treatment and increased negative bias demonstrates the strong relationship between physical and mental health. Antibiotics are commonly prescribed and are important for treating bacterial infections.
“Therefore, our findings emphasize the need to further investigate their potential psychological effects, especially in light of their known impact on the microbiome.”
About this pharmacology and mood research news
Author: Press Office Source: Leiden University Contact: Press Office – Leiden University Image: The image is in the public domain
Original Research: Open access. “Do common antibiotic treatments influence emotional processing?” by Katerina V.-A. Johnson et al. Physiology & Behavior
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Abstract
Do common antibiotic treatments influence emotional processing?
Antibiotics are among the most commonly prescribed medications worldwide, yet research in recent years has revealed the detrimental effect they can have on the human microbiome, with implications for health. The community of microorganisms inhabiting the gut has been shown to regulate physiological and neural processes.
Since studies in both humans and animal models have revealed that the gut microbiome can affect the brain, influencing emotion and cognition, here we investigate whether antibiotic treatment is associated with changes in emotional processing and mood with a between-subject design in 105 young healthy adult volunteers, using both psychological tests and questionnaires.
As both the immune system and vagal signalling can mediate the microbiome–gut–brain axis, we also assess whether there is any evidence of such changes in participant physiology.
We find that individuals who have taken antibiotics in the past three months show a stronger emotional bias towards sadness and at a physiological level they have a higher heart rate (though this does not mediate the relationship with negative bias).
While we cannot rule out a possible role of prior infection, our findings are in any case highly relevant in light of research revealing that antibiotics are linked to increased susceptibility to depression and anxiety.
Our results also have implications for listing antibiotic use as an exclusion criterion in studies on emotional processing and psychophysiology.
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Over the last few months, the Monkeypox disease has spread across the world prompting government health agencies and hospitals to fear the worse as the world emerges from the Covid-19 pandemic.
Monkeypox is a rare infectious disease in the same virus family as smallpox and can be transmitted to humans and animals. The disease was first discovered in 1958 when two African colony monkeys began to develop pox-like symptoms. Despite its namesake, the exact source of this disease is not known, and various non-human primates may infect people with the virus.
The virus is typically found in tropical environments in central and West Africa where the animals who carry the disease live. The 2022 global outbreak has been linked to the resurgence of international travel to countries where the disease is present.
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What are the symptoms?
Monkeypox symptoms in humans include fever, swollen lymph nodes, and a blister rash that typically dries out the skin, according to the World Health Organization. Individuals may experience mild symptoms but the ability to carry the virus without symptoms is not known at this time. These symptoms typically last between 2 and 4 weeks from the initial exposure.
A Monkeypox lesion on a woman’s hand. (CDC/Getty Images)
The WHO notes that signs of a rash usually start within 24 to 72 hours after the start of the fever and lesions may have filled with clear or yellowish fluid. The rash typically is concentrated on the face, palms, and soles of the feet but may also spread to the genitals, eyes, and mouth.
Does a vaccine exist for Monkeypox?
Several vaccines used to treat smallpox add protection against Monkeypox and those who have been vaccinated against smallpox may have some protection as well, according to the WHO. Imvanaex is a vaccine developed for smallpox and was approved in 2019 to help prevent monkeypox, but the drug is not accessible to most of the public.
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The WHO notes that the vaccines used to treat smallpox in 1980 are not available because it became the first disease to be fully eradicated. Health agencies are working to make newer smallpox vaccines more widely available to the public.
What are the treatments?
Most symptoms of Monkeypox typically resolve by themselves without the need for extensive treatment or medical care. However, the WHO and CDC recommend you avoid scratching or touching sores on the mouth or eyes.
In severe cases, the WHO recommends the use of vaccinia immune globulin (VIG), an antiviral made to treat smallpox that was approved for the treatment of Monkeypox back in January. Patients should also stay hydrated and eat food to maintain their nutritional status.
Monkeypox cases may be more severe in children, pregnant or individuals who have compromised immune systems.
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How many cases?
Since the start of the outbreak in 2022, confirmed cases of Monkeypox across the world totals to 4,106 confirmed cases in 47 different countries as of June 23, according to data compiled by the CDC. Moreover, the number of cases in the US stands at 173 cases in more than 20 states.
After surgery, some cancer patients can safely avoid treatments such as radiation or chemotherapy, say two recent studies that explore shorter, gentler cancer care.
Researchers are looking for ways to predict which cancer patients can avoid unneeded treatment to cut down on costs and bad side effects.
One new study used a blood test to study which colon cancer patients could skip, or not have, chemotherapy after surgery. Another study suggests some low-risk breast cancer patients might not need radiation after the surgical removal of a mass or lump, a surgery known as a lumpectomy.
The research was discussed recently at the yearly meeting of the American Society of Clinical Oncology (ASCO). The colon cancer study, financed by the Australian and U.S. governments and nonprofit groups, was recently published by the New England Journal of Medicine.
The findings let doctors pay careful attention to “the patients we think would truly benefit from chemotherapy and avoid the side effects for patients for whom it’s likely unnecessary,” said Dr. Stacey Cohen of the Fred Hutchinson Cancer Center. Cohen reviewed the colon cancer findings and was not involved in the research.
Colon cancer study
Many colon cancer patients are given chemotherapy after surgery, even though they may be cured. The drugs can come with bad side effects such as nausea, anemia and memory problems.
But deciding which patients might not need further treatment has been difficult. So, the scientists studied whether a blood test could help doctors make the decision.
The study involved 455 patients who had surgery because cancer had spread into the colon wall. After surgery, one group received a blood test specially made for the tumor’s genetic information to find any remaining bits of cancer DNA.
Their care was guided by the blood test. If the test showed no signs of remaining cancer, the patients did not get chemotherapy. Meanwhile, doctors made chemotherapy decisions for the rest of the patients in the usual way, guided by careful study of the tumor and nearby tissue.
Fewer patients in the blood test group got chemotherapy — 15 percent in comparison to 28 percent. But about 93 percent of both groups were still free of cancer after two years. In other words, the blood test group did equally well with less chemotherapy.
Dr. Jeanne Tie of the Peter MacCallum Cancer Center in Melbourne, Australia, led the research. Tie described the findings in terms of cancer relapse – the return of a cancer after a period of improvement.
“In patients where cancer DNA is not detected after surgery, the chance of cancer relapse is very low, suggesting that chemotherapy is very unlikely to benefit these patients,” Tie said.
ASCO president Dr. Everett Vokes said that not having chemo makes “a big difference in a person’s quality of life if that can be done without having to put them” at risk of the disease coming back.
Breast cancer
The other study followed 500 older women with a common form of early-stage breast cancer and low levels of a protein known as Ki67, a marker for fast-growing cancer.
After surgery, the women took hormone-blocking pills, a common treatment for this type of cancer. But the women did not get radiation treatment.
After five years, 10 of the women saw cancer return in the same breast, and there was one breast cancer death. The study had no comparison group, but researchers said the results compare well to historical data for similar patients who had radiation.
Dr. Timothy Whelan of McMaster University in Hamilton, Ontario, led the study.
“We estimate the benefits of radiation would be very small in this population compared to the side effects,” Whelan said.
Radiation can cause skin problems, tiredness and, less commonly, long-term heart problems and second cancers.
Dr. Deborah Axelrod of NYU Langone Health was not involved in the research.
Axelrod described the study as a “feel-good” message for patients with low-risk tumors. Axelrod added that the data will help doctors understand which of their patients they “can comfortably, with confidence” not give radiation to.
I’m John Russell.
Carla K. Johnson reported on this story for the Associated Press. John Russell adapted it for VOA Learning English.
Studies: Some Cancer Patients May Not Need Treatments after Surgery
