Two major warning signs you’re lacking the vitamin found on your face

PMQs: Boris Johnson urged to introduce vitamin D treatment

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Vitamin B12 is a crucial ingredient for the healthy running of one’s body, as it’s needed to make red blood cells. Signs of a deficiency can develop very slowly but there are two major warning signs found on your face including facial neuralgia and jaundice.

Pain on the face or facial neuralgia is one warning sign of low levels of B12 to look out for in the face, according to The Thyroid Patient Advocacy.

It continued: “The pain is usually felt on only one side of the face at a time.

“This pain varies so much that it would be difficult to describe all the possibilities.

“It can be a dull pain in the cheek bone right underneath an eye.

“It can also be a sharp shooting pain across the forehead, sometimes coming downward from the scalp to the edge of the nose by the eye.

“This can be excruciating but is usually fleeting.”

A study published in MD Edge Neurology found that vitamin B12 deficiency may cause isolated facial neuralgia with sensations of a decrease in touch and pain, as well as numbness on the affected side.

“It was somewhat unexpected that vitamin B12 deficiency can cause isolated facial neuralgia,” said Dr Jitendra Baruah, a neurologist.

He continued: “Treatment for facial neuralgia is sometimes very difficult, and patients may often go into multimodalities treatment without much success.”

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Those lacking B12 may also notice the colour of their face is more yellow. 

The whites of the eyes may also appear less white and more yellow.

The reason for this colour change in the face is due to the body’s red blood cell production being affected.

When the body lacks B12, it is not able to make red blood cells as easy.

People with a B12 deficiency often look pale or have a slight yellow tinge to the skin and whites of the eyes, a condition known as jaundice.

This happens when a lack of B12 causes problems with your body’s red blood cell production.

Due to the low levels of healthy red blood cells, leading to a type of anaemia called pernicious anaemia.

Symptoms of pernicious anaemia may include diarrhoea, loss of appetite, and jaundice.

How should I respond to these symptoms?

You should see a GP if you’re experiencing symptoms of vitamin B12 deficiency, the NHS says.

“These conditions can often be diagnosed based on your symptoms and the results of a blood test,” explains the health body.

It’s doubly important for vitamin B12 deficiency to be diagnosed and treated as soon as possible.

“Although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible if left untreated,” warns the NHS.

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How Watching Too Much TV Really Affects Your Health

There’s really nothing like an unfettered Netflix binge when you need to unwind, and doing this once in a while is probably more cathartic than harmful. But what happens to your body when most of your days entail answering “yes” to the dreaded pop-up question “Are you still watching?” 

Experts classify binge-watching as watching more than three hours of TV in a single sitting (via Everyday Health). And if you’re from the United States, you’re more likely than almost anyone else to be guilty of doing this. In fact, a third of Americans between 18 and 35 years old do this regularly, and Netflix metrics show that Americans tend to finish an entire television series in less than a week.

Studies have shown that there are different types of binge watchers, ranging from occasional to habitual, meaning that while some will only engage in three or more hours of TV watching once in a while, others do it regularly. As you might expect, like most things that are better in moderation, it is those who are classified as “habitual bingers” that tend to suffer the most consequences.

How too much TV hurts your body

The first way bingeing TV can be harmful is due to the sedentary nature of the activity. For the most part, while we are viewing hours of TV, we are sitting on our couches or lounging in bed. Further, we are less engaged mentally and physically while lounging and consuming entertainment than we are while sitting at a desk, working. This is the difference between active and non-active sitting.

Non-active sitting, which is what most of us do while watching TV, has been linked to 25 percent higher body mass index (BMI) and also higher body fat in young adults. It even contributes to the occurrence of metabolic syndrome according to the Journal of Behavioral Medicine. Another issue that crops up with TV bingeing is that while we watch, we often snack, and not always on healthy foods. We are all guilty of having vegged out watching TV with a bag of chips in our lap.

The issue is, if we eat chips while paying attention to what we are eating, we are likely to eat less of them. However, when we eat while watching TV, it is usually “distraction eating,” which means we aren’t paying attention to our actual level of hunger or the portions we are consuming. So, we just keep eating. Distraction eating is directly associated with consuming more food and being overweight, per the American Journal of Clinical Nutrition.

Need to sleep? Shut off the TV

Watching TV right before bed can actually have a negative impact on both quantity and quality of your sleep (via Reverie). Once again, Americans are the worst about this; a whopping 90 percent of us admit to watching something on a screen in the hour before bed. Interestingly, 60 percent of us also report some type of sleep issue. Are the two related? Maybe.

Our bodies and brains just weren’t built for this screen-related behavior. All screens are backlit, and so when we engage with them in the hour before bed, we confuse our brains into thinking it’s daytime. Studies have shown that looking at screens in the hour before bed reduces the secretion of the hormone melatonin by over 20 percent (via Applied Ergonomics). Melatonin is the hormone that helps to make us sleepy. Also, watching TV engages our minds in a way that makes us want to stay up and watch the rest of the episode or just one more. In this way, watching TV before bed encourages us to stay up later than we otherwise might (via Health).

Further, according to Buffer, doing anything in bed other than winding down to sleep (like doing work, answering texts, eating, or watching TV) over time sends the message to our minds and bodies that bed isn’t necessarily for sleep, and so we might find it harder to fall asleep than if we automatically associate crawling into bed with dozing off by reserving our bedrooms for that purpose.

Too much TV can affect your mental health, too

And let’s not forget our mental health. According to Everyday Health, binge-watching TV can become a substitute for social interaction and can lead to social isolation. This can happen in a cycle; people who are stuck inside may turn to the TV for company and entertainment, and at first it helps to alleviate the loneliness. But eventually, the desire to actually interact meaningfully with other actual people can decrease, because they start to feel that the TV is sufficient company and that their needs are being met. 

This also relates to another mental health issue that can come of too much TV bingeing: addiction. In the same way that some people can experience potentially addicting things but only use them occasionally (like alcohol, gambling, etc.) while others become dependent, habitual TV bingers can become addicted to the behavior. The pleasure centers of the brain are stimulated in a way that is calming and joy-inducing when we watch a show we enjoy. While most of us can enjoy that feeling and then go about the rest of our lives, others become dependent on TV to help them feel happy and relaxed, and this addiction can interfere with their ability to live a normal and healthy life. 

So, at the end of the day, no one is telling you to give up your favorite shows! We are just reminding you that like all good things, moderation is key to enjoying all the wonders Netflix has to offer without damaging your health or well-being.

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Canada records second case of rare blood clot after AstraZeneca shot

blood clot

Canadian health authorities said Saturday the country has recorded a second case of rare but serious blood clotting linked to AstraZeneca’s COVID-19 vaccine, but still recommend the shot for use.

The patient, who lives in the western province of Alberta and received a version of the AstraZeneca vaccine supplied by the Serum Institute of India, “has received treatment and is recovering,” Canadian health authorities wrote on Twitter.

Canada reported its first case of blood clotting associated with low platelets on Tuesday in a Quebec woman who received the same shot.

Blood clot formations linked to the AstraZeneca vaccine “remain very rare” and Canada still believes that the vaccine’s benefits “outweigh the potential risks,” Health Canada and the Public Health Agency of Canada said.

Canada’s health authorities added that they would “continue to monitor the use of all #COVID19 vaccines closely and examine and assess any new safety concerns.”

At the end of March Canada’s National Advisory Committee on Immunization (NACI) recommended suspending the use of the AstraZeneca vaccine in people under the age of 55 while it evaluated the risks.

However Health Canada said Wednesday that according to its analysis, limiting the use of the vaccine to certain populations was not necessary for the moment.

After a slow start, Canada’s vaccine campaign is gaining momentum. To date, 23.3 percent of the Canadian population has received at least one vaccine dose according to the COVID-19 Tracker Canada website.

The country is facing a third coronavirus wave, however, that has recently forced provinces to tighten restrictions.

Ontario, which has the highest number of cases, announced Friday it would strengthen and extend lockdown measures until May 19, and also close its borders with the provinces of Quebec and Manitoba beginning Monday.

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Novel PET tracer is safe and can clearly identify early stages of rheumatoid arthritis

New research shows that a novel positron emission tomography (PET) tracer that targets inflammation is safe and can clearly identify early stages of rheumatoid arthritis. The promising PET tracer, 68Ga-DOTA-Siglec-9, rapidly clears from blood circulation, has a low radiation dose, and can be easily produced. This first-in-human study was published in the April issue of the Journal of Nuclear Medicine.

Inflammation is a significant part of several chronic diseases, including rheumatoid arthritis and its related issues. While PET imaging with 18F-FDG is a valuable tool for the diagnosis and monitoring of the effects of treatments, it is not specific enough to assess inflammation.

It's important to detect inflammation early so that patients can receive the best treatment. Our institution has worked for several years to develop an imaging agent that targets areas of inflammation, and in this study, tested its effectiveness in humans for the first time."

Anne Roivainen, PhD, Professor of Preclinical Imaging and Drug Research, Turku PET Centre, University of Turku and Turku University Hospital in Finland

To evaluate the radiotracer's safety and biodistribution characteristics, six healthy study participants underwent whole body 68Ga-DOTA-Siglec-9 PET/computed tomography scans. 68Ga-DOTA-Siglec-9 was well-tolerated and cleared quickly from the blood, and its radiation dose was similar to other 68Ga tracers. In one additional study participant with rheumatoid arthritis, the tracer was able to clearly detect joints with arthritis.

"We have proven that the characteristics of 68Ga-DOTA-Siglec-9 are favorable for use in patient imaging studies," remarked Roivainen. "Future studies will clarify whether 68Ga-DOTA-Siglec-9 PET imaging has the potential to detect other inflammatory diseases early. It could also help to evaluate the effectiveness of treatments and promptly identify patients who are unlikely respond to therapy."

Source:

Society of Nuclear Medicine and Molecular Imaging

Journal reference:

Viitanen, R., et al. (2021) First-in-Humans Study of 68Ga-DOTA-Siglec-9, a PET Ligand Targeting Vascular Adhesion Protein 1. Journal of Nuclear Medicine. doi.org/10.2967/jnumed.120.250696.

Posted in: Medical Science News | Medical Research News | Medical Condition News

Tags: Arthritis, Blood, Chronic, Computed Tomography, CT, Heart, Hospital, Imaging, Immunology, Inflammation, Laboratory, Ligand, Medicine, Molecular Imaging, Nuclear Medicine, Oncology, Positron Emission Tomography, Preclinical, Preclinical Imaging, Protein, Radiology, Radiotherapy, Research, Rheumatoid Arthritis, Rheumatology, Theranostics, Tomography, Vascular

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DR MICHAEL MOSLEY: Should doctors prescribe dummy pills to ease pain?

DR MICHAEL MOSLEY: Should doctors now prescribe dummy pills to ease pain? (…and tell you they’re fake)

How would you feel if you went to see your GP with severe pain caused by a bad back or irritable bowel syndrome (IBS), and you were told they had just the thing to help — a placebo; a pill containing nothing but rice flour or sugar.

That possibility has come closer, thanks to a new study showing that giving patients an ‘honest’ placebo, one where they know they are getting a dummy pill, can be extremely effective at reducing pain.

And with a recent report from the Office of National Statistics showing that deaths from taking high-strength painkillers, such as tramadol and codeine, have doubled over the past ten years, there is clearly a need for safe and effective alternatives.

I’ve been involved in studies of the placebo effect, including one where we recruited more than 100 patients with chronic back pain and told them they were either getting a powerful new painkiller or a placebo. In fact, they were all given a placebo

But if the placebo effect is so effective, why don’t doctors make more use of it?

I’m a huge fan of the placebo effect. I think it’s remarkable that you can give someone a bright-coloured pill, which contains no active ingredient, and this will reduce their pain.

But it is also misunderstood. The assumption is that people who respond either weren’t ill in the first place or are credulous. Neither is true.

I’ve been involved in studies of the placebo effect, including one where we recruited more than 100 patients with chronic back pain and told them they were either getting a powerful new painkiller or a placebo. In fact, they were all given a placebo.

In this study, which was published last July in the European Journal for Person Centred Healthcare, nearly half the patients reported significant pain relief, despite swallowing dummy pills.

As I was told by Dr Jeremy Howick, an expert from Oxford University who designed our study, people who respond best to a placebo are not gullible; they are simply more open minded, especially when it comes to new experiences.

So how does it work? Well, a couple of years ago I watched an intriguing experiment carried out by Manchester University’s Human Pain Research Group. They started by attaching electrodes to a volunteer, Jack, so they could measure his brainwave activity. Then he was given two identical-looking creams and told one was a normal moisturiser, and the other may or may not contain an anaesthetic.

In reality, they were both just moisturisers. He was asked to rub cream from one tub into his left arm, the other into his right.

Next, they heated Jack’s arms with a laser, which he had to rate for painfulness on a scale from one to ten. What they didn’t tell him was that while his left arm got a full blast, his right arm had a weaker zap. They did this several times until Jack was convinced the cream he’d rubbed on his right arm contained an anaesthetic.

Finally, they gave his right arm a full blast with the laser. Amazingly, when that happened, part of Jack’s brain, the frontal cortex, began producing large amounts of brainwaves called alpha waves and this immediately moderated the pain signals reaching the brain.

This, and other research they’ve done, suggests the placebo effect works by ‘persuading’ your brain to express more alpha waves, thereby dialling down the pain, although no one knows why the waves work in this way.

But if the placebo effect is so effective, why don’t doctors make more use of it?

My sister, Susie Stead, has just published a book, Stephen From The Inside Out, about a friend who, when young, was labelled ‘schizophrenic’ and spent more than 25 years in psychiatric wards. Stephen wasn’t diagnosed with autism until his late 40s 

Well, there is a belief among doctors that a placebo treatment works only if patients think they are getting a ‘real’ pill. And that would mean lying to patients, which is unethical. A new study, however, involving people with IBS suggests the placebo effect can work even when you know you are taking a placebo. IBS affects around 20 per cent of adults in the UK and can cause crippling stomach cramps, as well as bloating, diarrhoea and constipation.

There is no known cure, though lifestyle changes can help.

To see whether giving patients an ‘honest’ placebo can help, researchers from the Beth Israel Deaconess Medical Centre in the U.S. recruited 262 people with IBS.

The patients were randomly allocated to three different groups. One group was told it would be getting placebo pills, containing no active ingredient, though the patients were also told that taking the pills could improve their symptoms. The second group was told it would get either a placebo or a pill containing peppermint oil (which can help with IBS), but didn’t know which.

A third group acted as a control and received nothing.

Those given a pill were asked to take it three times a day, 30 minutes before meals, for six weeks. At the end of the study, the patients in both of the pill groups reported a much bigger improvement in their symptoms than the control group.

Seventy per cent of those swallowing pills reported at least a 50-point improvement in their symptom score, while 30 per cent reported their score had increased by at least 150 points, which was considered a ‘very strong’ response.

I wasn’t surprised. In our back- pain study, most of the patients who got relief from taking our placebo pills said they wanted to continue taking them, despite knowing that they were swallowing nothing but ground up rice.

It seems you don’t have to deceive people to tap into the power of the placebo, at least for certain conditions. If you trust the doctor prescribing them, then simply taking pills which you have been told might do you good, really can help.

There’s a powerful connection between the microbes living in your gut, known as the microbiome, and your brain. Not only does your microbiome influence your mood, but there is evidence that children with severe autism can be helped by changing their gut bacteria. More on that in a moment.

The popular image of autism is either of a child rocking to and fro, barely able to speak, or someone who is brilliant at science but bad at human relationships. The truth is more complicated. Autistic spectrum disorder (ASD), can range from those who are severely affected to those who simply find it hard to communicate and interact with other people.

A recent study by the University of Cambridge suggests that around 1.76 per cent of children in England are on the autism spectrum, a higher figure than previously thought.

What’s tragic is that so many people with ASD have been misunderstood or misdiagnosed. My sister, Susie Stead, has just published a book, Stephen From The Inside Out, about a friend who, when young, was labelled ‘schizophrenic’ and spent more than 25 years in psychiatric wards. Stephen wasn’t diagnosed with autism until his late 40s, and none of his talents, including his extraordinary memory and aptitude for poetry, was celebrated in his lifetime.

While autism can’t be ‘cured’, speech and social therapy can help. There is also research that suggests changing the gut microbiome with a faecal transplant (using a treated sample from a donor) can improve some of the symptoms and behavioural problems associated with severe autism.

Evidence for this comes from a small study by researchers at Arizona State University in the U.S. At the start of the study, 83 per cent of the children were rated as having ‘severe’ autism, but two years after the transplant, only 17 per cent were rated ‘severe’. The parents also reported significant improvements in their language, interactions and behaviour.

The researchers are now carrying out a bigger, placebo-controlled trial in adults.

Sleeping well? This is not a rhetorical question, I really want to know. So much so that I recently launched, with the help of researchers from Oxford University, what we are hoping will be the UK’s largest ever sleep study.

If you fill in our questionnaire — find it by googling ‘BBC2 Horizon Sleep Census’ — you will get your own personalised sleep score and discover where you are on the owl-lark spectrum, i.e. the extent to which you’re better suited to late nights or early mornings. We’ll be using the anonymous data to build a detailed picture of what we all do to get a good night’s sleep, as well as the impact that sleep has on how we think and feel.

I will report back on our findings later in the year.

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EMA Reviewing GSK’s Monoclonal Antibody to Treat COVID Patients

(Reuters) – The European Medicines Agency said on Thursday it is reviewing available data on the use of GlaxoSmithKline’s monoclonal antibody to treat COVID-19 patients.

The agency said its review of VIR-7831, which GSK is developing with Vir Biotechnology Inc, will include data from a study comparing its effect with that of a placebo in patients with mild to moderate COVID-19 who were at high risk of progressing to a more severe condition.

While a more comprehensive rolling review is expected to start at a later time, the agency said the current review will provide European Union-wide recommendations for national authorities who may take decisions on early use of the medicine.

The companies reported in March that VIR-7831 reduced the risk of hospitalisation and deaths among patients by 85%, based on interim data from a study.

VIR-7831 has not been granted a marketing authorisation anywhere in the world. The companies said in a statement on Thursday they planned to submit a full marketing authorisation application to the EMA, and talks with global regulators were on to make VIR-7831 available to patients with COVID-19.

In late March, the companies filed an application to U.S. regulators for emergency use authorization of VIR-7831 to treat early-stage COVID-19 infections.

The United States has already recommended similar therapies from Eli Lilly and Co and Regeneron Pharmaceuticals Inc.

European health regulators are reviewing treatments from this class of medicines called monoclonal antibodies, which are synthetically manufactured copies of the human body’s natural infection-fighting proteins and are already being used to treat some types of cancers.

GSK and Vir announced a partnership in 2020 to research COVID-19 treatments, and earlier this year said they will expand that partnership to develop monoclonal antibody treatments for influenza and other respiratory illnesses.

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Cerebral venous sinus thrombosis: What to know about rare blood clot condition

blood

Cerebral venous sinus thrombosis was reported in six American women after they were injected with the Johnson & Johnson COVID-19 vaccine, prompting federal officials to recommend a pause Tuesday in giving doses of the one-shot vaccine until an investigation can be completed.

But what is cerebral venous sinus thrombosis, and why are the U.S. Food & Drug Administration and the Centers for Disease Control and Prevention so concerned about it?

Dr. Geoffrey Barnes, a cardiologist and vascular medicine specialist at the Michigan Medicine Frankel Cardiovascular Center, told the Free Press Tuesday that the condition is an extremely rare form of stroke.

“This is a blood clot that forms in one of the veins that helps to drain blood from your head back down to your heart,” Barnes said. “It’s an uncommon place for blood clots to form, and when it forms up there, patients tend to have sort of a collection of symptoms.”

Those symptoms, he said, can include:

  • Severe headache
  • Vision changes
  • Severe nausea
  • Vomiting
  • Rarely, some people will have seizures

With these strokes, the blood clot forms in the cerebral spinal vein, he said.

“It is a pretty uncommon location,” Barnes said. “The two most common places in the body where people develop blood clots are either in the veins of the legs, or in the lungs; those are overwhelmingly where most blood clots form.”

Peter Marks, director of the Center for Biologics Evaluation and Research at the FDA, said in the general population, this occurs in between 2 and 14 people per million population.

What’s different about the six U.S. women who developed this condition within 6 and 13 days of getting a COVID-19 vaccine is that they also had a low platelet count, also known as thrombocytopenia.

“The combination here—the real thing that is so notable here—is not just the cerebral venous sinus thrombosis or the thrombocytopenia,” Marks said. “Those two things can occur. It’s their occurrence together that makes a pattern, and that pattern is very, very similar to what was seen in Europe with another vaccine.”

The vaccine Marks was referencing is AstraZeneca’s, which is similar to Johnson & Johnson’s in that it’s a recombinant vector vaccine using the adenovirus, which causes the common cold, that’s modified with the genetic spike protein found in SARS-CoV-2.

While Johnson & Johnson’s vaccine was developed using human adenovirus, there have been reports of blood clots in people in other countries who received AstraZeneca’s vaccine. It uses chimpanzee adenovirus.

“We don’t have a definitive cause,” Marks said. “But the probable cause that we believe may be involved here … is a similar mechanism that may be going on with other the other adeno-viral vector vaccine. That is that this is an immune response that occurs very, very rarely after some people receive the vaccine, and that immune response leads to activation of the platelets and these extremely rare blood clots.”

For most people who are having a stroke or are treated for blood clots, the standard therapy in hospitals is to give them heparin, a blood thinner, Barnes said.

But for people who have a CVST following a COVID-19 vaccine, that’s not the recommendation.

“What we are learning about these blood clots and how they might be associated with the use of the AstraZeneca vaccine in Canada and Europe and now it sounds like potentially with the Johnson & Johnson Johnson vaccine here,” Barnes said, “is we actually need … to use a different form of a blood thinner. That’s sort of the critical piece for doctors to know about.

“Doctors need to be aware that if this very rare blood clot occurs within three weeks of somebody getting the J&J vaccine, then there’s some routine lab tests that they need to do, and they would want to start them on a non-heparin blood thinner.”

Two important studies were published Monday in the New England Journal of Medicine, Barnes said, that suggest that after getting one of these COVID-19 vaccines, the body can form an immune response that binds heparin with platelets, which is one of the things in the blood that helps people form blood clots.

“We see patients who get this sort of allergic reaction, you might call it, to heparin all the time,” Barnes said. “But what’s interesting here is it seems to have developed in people who never got heparin before. And so because we’re aware of this, now we know how to immediately jump in and use some non-heparin blood thinners.”

Barnes said people who’ve recently gotten a Johnson & Johnson vaccine shouldn’t be all that concerned.

“I want to reassure people that this is an exceedingly rare event,” he said. “We’re talking about six cases that have been reported from the CDC and the FDA despite millions and millions of doses of the J&J vaccine.

“We’re talking a fairly tiny percentage of people who have developed the rare blood clot. The second thing I would say is what we’ve learned from Europe and Canada, is that there does not seem to be any role for taking aspirin or a blood thinner, you know, shortly after getting your vaccine. Again, the risk of this blood clot is so exceedingly low. that we don’t want people to have other harms from taking medicines, things like that.

“The third thing I would say is that it’s really important to understand the time course. If you just got your vaccine yesterday or the day before, it’s pretty common that you might feel for muscle aches, maybe chills, fever, headache, flu-like symptoms. That’s a sign that your body’s reacting to the vaccine as we would expect—that’s not something to be concerned about.”

For anyone who got a Johnson & Johnson vaccine a month or two ago, “you’re also out of the window where we’re not concerned about any blood-clotting risk,” Barnes said.

“But if you fall in this window of about four to five days up to three weeks (post-vaccination), that’s where we’ve heard about these very rare blood clot events and so those are the people for whom we just want to keep our antenna up.

“We want to be aware of it in case they develop these new severe symptoms.”

Those people, he explained, should go to the hospital for an evaluation if they develop symptoms of CVST, such as severe headache, vision changes, severe nausea and vomiting or seizures.

“You can be reassured that every hospital in the region has the tools needed to do this evaluation,” Barnes said. “In the rare case where this is found, we have the tools necessary to treat it, but it’s pretty unlikely this is not going to be a common event that people will experience.”

He said it’s also not a reason to avoid getting a COVID-19 vaccine.

“We know that the COVID pandemic is the most important health risk out there right now, and especially here in Michigan,” Barnes said. “We are on the front lines of that, and anything we can do to get the COVID pandemic under control is going to be really important.

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Women seeking help for unmet needs often overdue for cervical cancer screenings

More than half of cervical cancer cases in the United States occur in women who have not had timely Pap smears and/or HPV tests — screenings that allow for detection of precancerous or cancerous cells on the cervix. Encouraging low-income women in particular to participate in such screenings likely would improve cancer detection and save lives, but health-care professionals have been uncertain of how best to improve patient adherence to screenings and follow-ups involving abnormal results.

Women with low incomes sometimes skip Pap smears and other cancer prevention screenings because they are focused on more pressing needs such as housing, food and other necessary expenses. So, researchers at Washington University School of Medicine in St. Louis evaluated efforts to help such women obtain cervical cancer screenings.

The scientists studied a group of female callers in Missouri seeking assistance from a free and confidential phone service that helps people find basic resources. The researchers determined that many female callers were due for cervical cancer screenings but most did not schedule one, even with the support of a health navigator, an individual trained to help people access medical care. Their findings indicate a new, more involved approach is needed to achieve such screenings and, ultimately, lower the number of women treated for advanced cancer.

“Reasons for inadequate screening are many and often deeply rooted to social and structural determinants of health that drive health inequities,” said first author Lindsay Kuroki, MD, an assistant professor of obstetrics & gynecology. “We wanted to determine the need for cervical cancer screening among women seeking assistance with unmet basic needs and to assess different methods of encouraging callers to seek Pap screening. Connecting underserved women to cervical cancer-screening services and assisting them with barriers to access medical care can improve health equity and reduce cancer disparities.“

The findings are available online in the American Journal of Obstetrics & Gynecology.

Participants were recruited from June 2010 through June 2012 from among callers to United Way 2-1-1 Missouri, a telephone helpline for local health and social service resources. Most callers seek help with basic needs such as food, utility bills, shelter and unexpected expenses.

Of 932 callers, 211 were referred for cervical cancer screenings. Callers were randomized to one of three conditions: phone call only; phone call and a print reminder; or a phone call and a personal navigator. The researchers looked at how many women contacted a clinic to schedule a Pap test one month after receiving a referral.

Patients in need of Pap screening had multiple cervical cancer risk factors. These women had a mean age of 48.2 years, were predominantly non-white, poor and unemployed, not married, and actively smoking. Nearly all (94.7%) female callers, regardless of their need for Pap testing, had at least one unmet basic need, with callers reporting an average of two unmet needs.

Women in the group that was assigned health navigators reported higher rates of contacting Pap services (29.6%) than those given phone calls only (15.1%), or phone calls and tailored print reminders (13.4%). Health navigators tripled the likelihood that women made contact with Pap services, and this remained true even among women with multiple unmet needs. Nevertheless, only 41 of 211 (19.4%) women who were overdue for Pap testing and received a referral contacted the referred clinic to schedule cervical cancer screenings.

The scientists said future research is necessary to understand how unmet basic needs pose barriers to cervical screening and how effective interventions to meet basic needs may lead to improved access to cancer prevention services. Some of these interventions might include immediate help such as assisting women with transportation and childcare. Other interventions might focus on redesigning health systems and influencing social policy to provide women at risk for cervical cancer with secure homes free of hunger and tobacco.

“Women contacting 2-1-1 are likely to have health needs that greatly exceed those of the general population, in addition to lacking financial resources and social support required to seek cervical cancer screening,” said senior author Matthew Kreuter, PhD, the Kahn Family Professor of Public Health at the Brown School. “Continuing this line of research is critical to improving outcomes for low-income, medically underserved populations. No woman should die from a preventable cancer.”

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A neuromagnetic view through the skull

A neuromagnetic view through the skull

The brain processes information using both slow and fast currents. Until now, researchers had to use electrodes placed inside the brain in order to measure the latter. For the first time, researchers from Charité – Universitätsmedizin Berlin and the Physikalisch-Technische Bundesanstalt (PTB) have successfully visualized these fast brain signals from the outside—and found a surprising degree of variability. According to their article in PNAS, the researchers used a particularly sensitive magnetoencephalography device to accomplish this feat.

The processing of information inside the brain is one of the body’s most complex processes. Disruption of this processing often leads to severe neurological disorders. The study of signal transmission inside the brain is therefore key to understanding a myriad of diseases. From a methodological point of view, however, it creates major challenges for researchers. The desire to observe the brain’s nerve cells operating “at the speed of thought,” but without the need to place electrodes inside the brain, has led to the emergence of two techniques featuring high temporal resolution: electroencephalography (EEG) and magnetoencephalography (MEG). Both methods enable the visualization of brain activity from outside the skull. However, while results for slow currents are reliable, those for fast currents are not.

Slow currents—known as postsynaptic potentials—occur when signals created by one nerve cell are received by another. The subsequent firing of impulses (which transmit information to downstream neurons or muscles) produces fast currents which last for just a millisecond. These are known as action potentials. “Until now, we have only been able to observe nerve cells as they receive information, not as they transmit information in response to a single sensory stimulus,” explains Dr. Gunnar Waterstraat of Charité’s Department of Neurology with Experimental Neurology on Campus Benjamin Franklin. “One could say that we were effectively blind in one eye.” Working under the leadership of Dr. Waterstraat and Dr. Rainer Körber from the PTB, a team of researchers has now laid the foundations which are needed to change this. The interdisciplinary research group succeeded in rendering the MEG technology so sensitive as to enable it to detect even fast brain oscillations produced in response to a single sensory stimulus.

They did this by significantly reducing the system noise produced by the MEG device itself. “The magnetic field sensors inside the MEG device are submerged in liquid helium, to cool them to -269 degrees C (4.2 K),” explains Dr. Körber. “To do this, the cooling system requires complex thermal insulation. This superinsulation consists of aluminum-coated foils which produce magnetic noise and will therefore mask small magnetic fields such as those associated with nerve cells. We have now changed the design of the superinsulation in such a way as to ensure this noise is no longer measurable. By doing this, we managed to increase the MEG technology’s sensitivity by a factor of ten.”

The researchers used the example of stimulating a nerve in the arm to demonstrate that the new device is indeed capable of recording fast brain waves. As part of their study on four healthy subjects, the researchers applied electrical stimulation to a specific nerve at the wrist whilst at the same time positioning the MEG sensor immediately above the area of the brain which is responsible for processing sensory stimuli applied to the hand. To eliminate outside sources of interference such as electric networks and electronic components, the measurements were conducted in one of the PTB’s shielded recording rooms. The researchers found that, by doing so, they were able to measure the action potentials produced by a small group of simultaneously activated neurons in the brain’s cortex in response to individual stimuli.

“For the first time, a noninvasive approach enabled us to observe nerve cells in the brain sending information in response to a single sensory stimulus,” says Dr. Waterstraat. “One interesting observation was the fact that these fast brain oscillations are not uniform in nature but change with each stimulus. These changes also occurred independently of the slow brain signals. There is enormous variability in how the brain processes information about the touch of a hand, despite all of the stimuli applied being identical.”

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India Covid variant: Two reasons why new variant found in UK raises major concerns

Coronavirus 'double mutation' variant found in UK

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Figures published by Public Health England (PHE) show there is a new coronavirus variant proliferating on UK shores. There have been 73 cases detected in England and another four in Scotland of the new Indian variant, also known as B.1.617. It is thought to be behind a tsunami of cases being recorded in India. 

The variant raises particular alarm bells because it has undergone a “double mutation”.

Mutations are part of the natural course of viruses, but this latest strain has undergone two mutations, which could make it more resistant to antibodies and more infectious.

One of the mutations – L452R – has been detected in a variant circulating in California.

The other variant – E484Q – shares some of the characteristics of the mutated spike protein seen in the South African variant, and some others.

But there are also differences in the genome and this uncertainty raises legitimate concerns over vaccine effectiveness.

The government said that an analysis of the samples collected from the western state of Maharashtra showed “an increase in the fraction of samples with the E484Q and L452R mutations” compared with December last year.

“Such [double] mutations confer immune escape and increased infectivity,” the health ministry said in a statement.

Lab tests show both mutations help the virus to infect human cells and evade some antibodies.

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Speaking to the BBC, Dr Jeremy Kamil, a virologist at Louisiana State University Health Sciences Center Shreveport, said the E484Q is similar to E484K – a mutation seen in the B.1.351 (South Africa) and P.1 (Brazil) variants, which have sprouted up independently several times.

If enough mutations happen in a viral family tree or a lineage, the virus can begin to function differently and the lineage can become a so-called “variant of concern”, Dr Jeremy Kamil said.

As far as the L452R mutation – also found in the “double mutation” in India – it first got attention as part of B.1.427/B.1.429 lineage in the US, which is sometimes called the “California variant”, he told the BBC.

Will the vaccines work agains the new Indian variant?

In short, it’s too early to say how effective the current crop of vaccines will prove against the new variant.

“Because COVID-19 vaccines train our immune system to respond to the spike proteins on the surface of the virus, there is concern that new variants with changes to the spike protein that help them evade immune responses may also render vaccines ineffective,” explains the COVID Symptom Study app.

Fortunately, research has shown that the Oxford AstraZeneca vaccine is working well against the B.1.1.7 variant first discovered in the UK.

However, because the trial mainly included young people who don’t tend to get seriously ill from COVID-19, it wasn’t possible to investigate the vaccine’s effect on rates of severe disease.

Laboratory studies suggest that the Pfizer and Oxford AstraZeneca vaccines offer some protection against the Brazil variant, but more work is needed to confirm this.

As COVID-19 continues to spread in many places, new variants will continue to emerge, especially in areas where rates of infection remain high.

According to the team behind the Symptom Study app, experts think future variants could help the virus avoid immune recognition, meaning that we will need new vaccines.

The CEO of Pfizer has signalled that the threat of new variants will not be going away anytime soon.

Albert Bourla said a potential booster shot of the Pfizer vaccine would be administered six to 12 months after being fully vaccinated.

The jab will then be offered annually, he suggested during a panel discussion.

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