Children with obesity are more likely to be diagnosed with depression, anxiety, or attention-deficit hyperactivity disorder (ADHD). But the nature of the relationship between obesity and these mental health conditions is not clear. Obesity might contribute to mental health symptoms, or vice versa.
According to a new study, childhood BMI is unlikely to have a significant impact on children’s mood or behavioural disorders.
The results suggest that some previous studies, which have shown a strong link between childhood obesity and mental health, may not have fully accounted for family genetics and environmental factors.
Children with obesity are more likely to be diagnosed with depression, anxiety, or attention-deficit hyperactivity disorder (ADHD). But the nature of the relationship between obesity and these mental health conditions is not clear. Obesity might contribute to mental health symptoms, or vice versa. Alternatively, a child’s environment might contribute to both obesity and mood and behavioural disorders.
“We need to better understand the relationship between childhood obesity and mental health,” says lead author Amanda Hughes, Senior Research Associate in Epidemiology at Bristol Medical School, University of Bristol, UK. “This requires teasing apart the contributions of child and parent genetics and the environmental factors affecting the whole family.”
Hughes and colleagues examined genetic and mental health data from 41,000 eight-year-old children and their parents from the Norwegian Mother, Father, and Child Cohort Study and Medical Birth Registry of Norway. They assessed the relationship between children’s body mass index (BMI) — a ratio of weight and height — and symptoms of depression, anxiety and ADHD. To help separate the effects of the children’s genetics from the influence of other factors that affect the whole family, they also accounted for parental genetics and BMI.
The analysis found a minimal effect of a child’s own BMI on their anxiety symptoms. There was also conflicting evidence about whether a child’s BMI influenced their depressive or ADHD symptoms. This suggests that policies aiming to reduce childhood obesity are unlikely to have a big impact on the prevalence of these conditions. “At least for this age group, the impact of a child’s own BMI appears small. For older children and adolescents, it could be more important,” says Neil Davies, Professor at University College London, UK.
When they looked at the effect of the parents’ BMI on the children’s mental health, the team found little evidence that the parents’ BMI affected children’s ADHD or anxiety symptoms. The data suggested that having a mother with a higher BMI might be linked with depressive symptoms in children, but there was little evidence of any link between the child’s mental health and the father’s BMI.
“Overall, the influence of a parent’s BMI on a child’s mental health seems to be limited. As a result, interventions to reduce parents’ BMIs are unlikely to have widespread benefits to children’s mental health,” says Alexandra Havdahl, Research Professor at the Norwegian Institute of Public Health, Norway. Havdahl is a co-senior author of the study alongside Neil Davies and Laura Howe, Professor of Epidemiology and Medical Statistics at Bristol Medical School.
“Our results suggest that interventions designed to reduce child obesity are unlikely to make big improvements in child mental health. On the other hand, policies which target social and environmental factors linked to higher body weights, and which target poor child mental health directly, may be more beneficial,” Hughes concludes.
The results suggest that critical period plasticity in the amygdala is increased and may be shifted to earlier developmental time-points. This could cause a ‘maladaptive’ form of plasticity and yet one that can be treated with therapeutic intervention at key developmental time points.
A new study suggests that therapeutic interventions to treat neurodevelopmental disorders may be more effective if done during the early stages of brain development.
“In order to stop the progression of neurodevelopmental disorders, it is important to identify how and when brain circuits are changing during development. Our study identifies when circuits are altered in addition to how brain circuits are corrected,” said the study’s senior author Molly Huntsman, PhD, associate professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences located on the University of Colorado Anschutz Medical Campus.
“Currently, there are no approved or effective therapies targeting specific pathophysiology underlying the clinical manifestations of FXS,” Huntsman said, adding, “We’re hoping to provide answers for when and how to treat FXS to help with therapeutic options eventually.”
The CU Skaggs School of Pharmacy researchers identified potential causal circuit-level changes during a critical period of brain development susceptible to therapeutic intervention. They focused on the amygdala — the brain region where fear and anxiety are processed.
Using a mouse model of FXS, they identified a critical period of increased circuit plasticity occurring in early brain development. They showed that fear-learning emerges in the brain during these periods of increased plasticity. At the same time, they demonstrated that early intervention ameliorates it.
The results suggest that critical period plasticity in the amygdala is increased and may be shifted to earlier developmental time-points. This could cause a ‘maladaptive’ form of plasticity and yet one that can be treated with therapeutic intervention at key developmental time points.
Age at the time of treatment, the study said, is important because early pharmacological intervention was shown as effective in reducing fear-learning in the mouse model.
“This is highly significant and addresses a critical barrier for understanding how circuits develop in a mouse model of autism and intellectual disability and even more important, for therapeutic intervention-directed treatment options,” Huntsman said.
Ischemic cardiac diseases reduces the heart’s ability to pump blood which might lead to heart attacks, or irregular heart rhythm and heart failure as well. Here’s all you need to know about its causes, risk factors, different symptoms in men and women, diagnosis and treatment.
A partial or total blockage of the arteries pumping the heart muscle with blood results in ischemic heart disease, a health condition that is sometimes also referred to as coronary heart disease. If the coronary arteries were thought of as a network of tubes, then as they progressively become blocked, the blood that is flowing through them, in this situation, is prevented from properly reaching its destination, the heart.
The prevalence of ischemic heart disease is currently decreasing in developed countries due to improved treatments and healthier lifestyles; but the same is increasing in developing countries. In either case, ischemic heart disease remains the leading cause of death among adults in both developing and developed countries.
Causes:
A significant population in both developed and developing nations are affected by ischemic heart disease, which is a prevalent condition. In an interview with HT Lifestyle, Dr Yogendra Singh, Associate Director at Max Super Speciality Hospital’s Department of Cardiology in Dehradun, explained, “Ischemic heart diseases occur when blood flow to the heart decreases, which prevents the heart which is a muscle from receiving enough oxygen. Ischemic cardiac diseases reduces the heart’s ability to pump blood which might lead to heart attacks, or irregular heart rhythm and heart failure as well. The decrease in blood flow is a result of blockage in the heart’s arteries. Under this condition, the treatment usually is to improve the blood flow in arteries by simultaneously reducing the blockage.”
Dr MM Yusuf, Consultant Cardiac Surgeon at Apollo Hospital in Chennai’s Greams Road, elaborated, “Ischemic Heart Disease (IHD) denotes, narrowing or blockage in the blood vessels over the heart, (Coronary arteries). These vessels supply blood to the heart muscles and enable good function. There are 3 blood vessels, 2 on the left and 1 on the right side of the heart. Triple vessel or multivessel coronary artery disease indicates disease in all these 3 vessels. These narrowing or blockages are caused by fat deposits within the blood vessel, which reduces blood supply to the heart muscle. This can lead to angina (chest pain), breathing difficulty or heart attack which can lead to death.”
Risk factors and symptoms:
Dr Yugal Kishore Mishra, Head of Cardiac Sciences and Chief Cardiovascular Surgeon at Manipal Hospital in Delhi’s Dwarka, revealed, “The risk of this condition rises with age and is common in the elderly. In terms of men and women, men are more likely to have ischemic heart disease as compared to women. According to various studies, men and women who are 65 to 94 years old are twice as likely to have coronary heart disease than those who are 35 to 64 years old. The most common symptom of ischemic heart disease in men is myocardial infarction (heart attack), while the most common symptom in women is angina pectoris.”
Talking about the common risk factors for ischemic heart disease, Dr MM Yusuf blamed diabetes, high blood pressure, high cholesterol, smoking and family history of IHD.
Diagnosis:
According to Dr Yogendra Singh, it is advised to consult a doctor for advice if one experiences persistent or severe chest pain. He said, “An ischemic cardiac condition can be diagnosed with the help of an ECG, stress test, echocardiogram, coronary angiography, and cardiac CT scan, which will show which artery or arteries are afflicted. Your doctor might advise drugs, surgery, or a combination of the two depending on the seriousness of your disease. Consume a balanced diet low in saturated fat, cholesterol and sodium to help treat coronary artery disease and reduce your risk of problems. Additionally, you’ll receive advice on how to exercise safely given your condition. Don’t think of lifestyle adjustments as temporary remedies. Instead, resolve to create lasting healthy behaviours.”
Treatment for Ischemic Heart Disease
Dr Yugal Kishore Mishra shared, “Increasing blood flow to the heart muscle is part of the treatment for ischemia heart disease. Treatment options include prescription drugs, an angioplasty procedure to unblock clogged arteries, or bypass surgery. The treatment of ischemic heart disease, there are a number of treatments in each class. To control any ischemic episodes, using medication is sometimes the best course of action. In other circumstances, when dealing with a more serious issue or if medication is not enough, it is recommended to unblock the artery.”
He added, “Sometimes, there can be numerous lesions or blocked coronary arteries that make angioplasty a challenge so in such cases a heart bypass surgery can be the best option to open up the blocked arteries of the heart. A robotic assisted bypass surgery of heart is considered to be the best option for heart disease. Robotic heart surgery is performed through very small chest incisions. Surgeons can perform open-heart surgery without as much trauma as they can with minimally invasive procedures using robot-controlled tools and microscopic instruments. In order to prevent a recurrence of angina or an infarction, this can be supported by long-term treatment (heart attack). To lower the risk of heart disease, a mix of lifestyle modifications and medication therapy is prescribed.”
As per Dr Yogendra Singh, treatment options include:
Medications
Angioplasty
Bypass Surgery
Explaining the process, he said, “A long, thin tube (catheter) is placed into the blocked area of your artery during coronary angioplasty. The artery is widened by inserting a wire carrying a tiny balloon there and inflating it. To keep the artery open, a tiny coil of wire mesh called a stent is typically employed. Drug eluting stents are safe and effective. This procedure can be performed radially from the groin to the thigh or from the wrist. As a result of it being easier, more accurate and less painful than the femoral technique, radial angioplasty is gaining more popularity.”
He added, “Contrarily, a coronary artery bypass surgery involves the creation of a graft that allows blood to move around a blocked or constricting coronary artery using a vascular from another region of your body. This kind of open-heart surgery is typically only performed on patients with several narrowed coronary arteries.”
Dr MM Yusuf suggested, “Sensible eating, regular exercise and good lifestyle would prevent IHD. Ischemic Heart Disease is widely prevalent in India. Patients with risk factors should have regular health checks and follow preventive measures, while patients with IHD should seek medical help early and take appropriate treatment. The outcomes of treatment are extremely good with minimally invasive treatment procedures hence, patients need not be worried and keep away from getting appropriate treatment.”
He recommended, “Patients affected with IHD can be treated depending on the severity of the coronary artery stenosis (narrowing / blockage). Minimal stenosis can be managed with medications and lifestyle modifications. Significant stenosis in 1 or 2 vessels can be treated with angioplasty and stent insertion. Much more severe and multiple blockages especially in diabetics or patients with reduced heart function is best treated by Coronary Artery Bypass Graft (CABG) surgery. Use of Internal Mammary Artery in CABG has the best long-term outcome.”
Traditionally, CABG was performed by splitting open the chest bone and patients would take 3 to 6 months to recover depending on their age and other co-morbid conditions. Dr MM Yusuf revealed, “Over the past decade minimally invasive cardiac surgery with the use of surgical robot (Robotic assist CABG) has significantly reduced the trauma and recovery in treating patients requiring CABG surgery. Patients undergoing robotic assisted CABG stay in hospital for 2 to 4 days and recover to full normal activity within 2 to 3 weeks. Over the years, CABG had been performed with the use of cardiopulmonary bypass (CPB) and cardioplegic arrest. With the advent of self-retaining coronary stabilizers and intracoronary shunts, CABG is being performed in many centers without the use of CPB-Off Pump CABG (OPCABG).”
He added, “However, conventional CABG has its own limitations in terms of being invasive and associated with morbidity. Stroke, bleeding, wound infections, arrhythmias, prolonged ICU stay and hospital stay has been the known common complications of conventional CABG. Minimally Invasive Direct Coronary Artery Bypass Surgery (MIDCAB) is gaining increasing popularity in recent years owing to its technique and lesser incidence of complications associated with conventional CABG and OPCABG surgery.”
He explained, “Conventional CABG uses median sternotomy. In contrast, MIDCAB is performed using anterolateral thoracotomy in the 4th or 5th intercostal space using a 5-7 cm incision. Thorax is entered through this incision. LIMA is harvested either under direct vision or using Robotic assistance or thoracoscope camera. Bypass Grafting is then performed under direct vision with the aid of MICS instruments – MICS retractor system, MICS stabilizer (Octopus Nuvo) and Heart positioner (Starfish NS). Intracoronary shunts and mister blower are used to keep the field bloodless. The notable advantages of MIDCAB surgery are decrease in incidence of post operative complications such as stroke, decrease in ICU stay & hospital stay, lesser blood product transfusion, lesser wound infection, quick recovery and better cosmoses. The disadvantages being longer learning curve and limited working space.”
Talking about Minimally Invasive Hybrid Coronary Artery Revascularization (MIHCR), he said, “Minimally Invasive Hybrid Coronary artery Revascularization (MIHCR) combines the benefits of PCI and OPCABG surgery. This involves IMA grafting to one or two major coronary arteries, usually the left coronaries through a left mini thoracotomy, followed by the stenting of the non-LAD vessels. MIHCR provides the advantages of reduced incidence of MACCE in the immediate post operative period with best long term outcome. This less invasive procedure minimizes the incidence of known complications of off pump coronary artery bypass surgery and hastens the recovery. Another added advantage with MIHCR is that the patency of IMA can be assessed while undergoing PCI to non- bypassed vessel. This provides an opportunity for the graft to be revised in case of need while the patient is still in hospital.”
He concluded, “Due to these advantages it is emerging as the method of choice among the younger population as it enables faster return to routine activities and also among the older group as it is less invasive and reduces post-operative complications.
There is a growing interest in MIHCR, although conventional open techniques remain more popular, a study to assess the early outcomes of MIHCR in our population is opted here.
The most recent study explains how Pfizer and Moderna mRNA boosters affect our Covid-19 antibodies’ ability to remain over time. The researchers found that all patients, including those who had recovered from a Covid-19 infection, developed more robust antibodies in response to a booster.
Recent research from the University of Virginia School of Medicine discussed the benefits of a Covid-19 booster vaccine dose. The most recent study clarifies how Pfizer and Moderna mRNA boosters influence the persistence of our Covid-19 antibodies. According to the researchers, a booster produced more durable antibodies in all individuals, including those who had recovered from a Covid-19 infection.
The researchers have published their latest findings in the scientific journal Annals of Allergy, Asthma & Immunology. “These results fit with other recent reports and indicate that booster shots enhance the durability of vaccine-elicited antibodies,” said senior researcher Jeffrey Wilson, MD, PhD, of UVA Health’s Division of Asthma, Allergy and Immunology.
Tracking Covid-19 antibodies: Wilson and his collaborators looked at antibody levels following a booster in 117 UVA employee volunteers and compared those results with the levels seen in 228 volunteers after their primary vaccination series. Antibody levels one week to 31 days after the primary series and booster were similar, but the boosted antibodies stuck around longer regardless of whether the person had had Covid-19.
“Our initial thought was that that booster would lead to higher antibody levels than the primary vaccine series, but that was not what we found,” said researcher Samuel Ailsworth, the first author of a new scientific paper outlining the findings. “Instead, we found that the booster led to longer-lasting antibodies.”
Antibody levels naturally decline over time after an infection or after vaccination, but higher levels are thought to be more protective. Thus, longer-lasting antibodies would be expected to provide more sustained immunity against severe Covid-19.
The researchers found that the antibodies generated by the Moderna booster proved longer lasting than those generated by the Pfizer booster. Moderna’s antibody levels exceeded Pfizer’s out to five months, the end of the study period. Although the findings were statistically significant, Wilson notes that both mRNA vaccine boosters provide enhanced and fairly similar levels of protection against Covid-19 in recently published large epidemiologic studies. Because the frequency of Covid-19 infections in the community was relatively high when the boosters were being given, the authors also studied the effect of COVID-19 infection on antibody levels. The findings suggest that the “enhanced antibody durability observed after booster vaccination was not explained by hybrid immunity,” the researchers report in their paper.
The new results are the latest from Wilson’s team tracking the antibody response to the Covid-19 vaccines over time. The researchers previously found that after the primary vaccination series the antibodies generated by Pfizer’s Covid-19 vaccine rose more slowly and declined more quickly than those generated by the Moderna vaccine. That study also found that older recipients of the Pfizer vaccine generated fewer antibodies than did younger recipients – but this wasn’t the case for Moderna, where age did not appear to be a factor.
In the latest results, younger booster recipients initially generated more antibodies than did older recipients, but this difference disappeared with time. Wilson notes that this study adds to the accumulating evidence that boosters are important in protecting the community from Covid-19. “Although only about half of the U.S. population that is eligible for a booster has received one, it is increasingly clear that boosters enhance the protection that is conferred by the primary series mRNA vaccines alone,” he said.
Researchers from the University of Colorado School of Medicine and the Linda Crnic Institute for Down Syndrome have discovered that the harmful effects of cholesterol on the brain and blood vessels may be caused by a single mechanism.
Researchers at the Linda Crnic Institute for Down Syndrome and the University of Colorado School of Medicine have found that a single mechanism may underlie the damaging effect of cholesterol on the brain and on blood vessels. High levels of blood cholesterol increase the risk of both Alzheimer’s disease and heart disease, but it has been unclear exactly how cholesterol damages the brain to promote Alzheimer’s disease and blood vessels to promote atherosclerosis.
Using insights gained from studying two much rarer disorders, Down Syndrome and Niemann Pick-C disease, researchers at the Linda Crnic Institute for Down Syndrome and the Department of Neurology of the University of Colorado School of Medicine found that cholesterol wreaks havoc on the orderly process of cell division, leading to defective daughter cells throughout the body.
In the new study published this week in the on-line journal PLOS ONE, Antoneta Granic, PhD, and Huntington Potter, PhD, show that cholesterol, particularly in the LDL form, called ‘bad cholesterol’, causes cells in both humans and mice to divide incorrectly and distribute their already-duplicated chromosomes unequally to the next generation. The result is an accumulation of defective daughter cells with the wrong number of chromosomes and therefore the wrong number of genes. Instead of the correct two copies of each chromosome, and thus two copies of each gene, some cells acquired three copies and some only one.
Granic and Potter’s study of the effects of cholesterol on cell division included a prominent finding of cells carrying three copies of the chromosome (#21 in humans and #16 in mice) that encodes the amyloid peptide that is the key component of the neurotoxic amyloid filaments that accumulate in the brains of Alzheimer patients.
Human trisomy 21 cells are significant because people with Down syndrome have trisomy 21 in all of their cells from the moment of conception, and they all develop the brain pathology and many develop the dementia of Alzheimer’s disease by age 50. Earlier studies by Granic, Potter and others have shown that as many as 10% of cells in an Alzheimer patient, including neurons in the brain, have three copies of chromosome 21 instead of the usual two. Thus, Alzheimer’s disease is, in some ways, a form of acquired Down syndrome. Furthermore, mutant genes that cause inherited Alzheimer’s disease cause the same defect in chromosome segregation as does cholesterol, thus indicating the presence of a common cell division problem in both familial and ‘sporadic’ (non-familial) Alzheimer’s disease.
The new research also found trisomy 21 neurons in the brains of children with what, until now, was thought to be an unrelated neurodegenerative disease (Niemann Pick type C), caused by a mutation affecting cholesterol physiology. This result suggests that neurodegeneration itself might be linked to chromosome missegregation. Such a model is supported by the finding of Thomas Arendt, MD, and colleagues at the University of Leipzig that 90% of the neuronal cell death observed at autopsy in Alzheimer patients is due to the creation and selective loss of neurons with the wrong number of chromosomes.
Identifying the specific problem caused by cholesterol will lead to completely new approaches to therapy for many human diseases, including Alzheimer’s disease, atherosclerosis and possibly cancer, all of which show signs of defective cell division. Granic and Potter already have found a potentially simple approach to preventing cholesterol from causing cells to distribute their chromosomes unequally into their new daughter cells. Specifically, when cells in culture were first treated with ethanol, the subsequent exposure to bad cholesterol was without effect on cell division: Each daughter cell received the correct number of chromosomes.
A small study shows promise in deploying mRNA technology against melanoma, but fighting tumors is vastly more complex than tackling Covid.
The long-awaited cancer vaccine revolution is getting a little closer to reality. New data from Moderna Inc. and Merck & Co. suggest that after decades of failures, researchers are finally figuring out the right way to design a vaccine that can teach immune cells how to recognize and combat tumors.
Earlier this month, the companies said that when used in concert with Merck’s cancer immunotherapy Keytruda, Moderna’s mRNA cancer vaccine reduced the risk of certain skin cancers from returning or patient deaths by 44% compared with Keytruda alone.
That number justly generated a lot of excitement. It’s the first time an mRNA-based cancer vaccine has proven itself in a randomized study, and with an unambiguously positive outcome. If that result holds up in larger trials, it would be a huge advance both for the mRNA technology behind Covid vaccines and for the field of cancer vaccines in general.
But there are a lot of steps between achieving early, positive data for a subset of melanoma patients and developing a widely accessible, cost-effective treatment. Among the more daunting challenges: The vaccine needs to be tailored to the genetic makeup of an individual patient’s tumors.
The study was small, enrolling just 157 people at high risk of their late-stage skin cancer returning. (Moderna and Merck have yet to make available the full dataset, though they plan to do so at an upcoming conference.) Still, even if the results are slightly less dramatic in a bigger study, the vaccine could make a difference for patients. “That would be a substantial change,” translating into long-term remissions, says Julie Bauman, director of the George Washington University Cancer Center. Bauman led an earlier study of Moderna’s cancer vaccine.
The study enrolled melanoma patients who had undergone surgery to remove any signs of their cancer. Unlike vaccines the public is used to taking — mass-produced shots that aim to prevent people from catching a contagious disease like the flu or polio, Moderna’s cancer vaccine instead is intended to keep the disease from returning. It does that by training immune cells to recognize as dangerous proteins found on a patient’s own tumor cells.
The hope was that the vaccine would amplify the already substantial benefit of Keytruda, which blocks a method that cancer cells use to hide from the immune system. Amazingly, the combination worked.
Moderna already demonstrated its capacity for developing and manufacturing mRNA vaccines. It had been working on vaccines for cancer and infectious diseases for more than a decade when the coronavirus pandemic hit, prompting the company to pivot to developing a Covid shot that, along with a similar one developed by Pfizer Inc. and BioNTech, became the first widespread commercial application of mRNA technology.
Building a successful cancer vaccine will be much more difficult. Moderna starts with a biopsy of a patient’s tumor, which it then sequences and uses artificial intelligence to pick out the mutations likely allowing the cancer to thrive. Then, mRNAs encoded for the most relevant cancer-driving proteins are packed inside a delivery system called a lipid nanoparticle, the same kind of delivery method used in Covid vaccines.
From tumor biopsy to first vaccine dose, the process can take between eight and 10 weeks, says Moderna Chief Medical Officer Paul Burton. Repeating this over and over for each patient enrolled in the clinical trial was a major undertaking, he adds.
Now imagine doing that for a commercial drug earmarked for thousands rather than for a few hundred people in a controlled study. There are nearly 100,000 cases of melanoma annually in the US, according to the American Cancer Society. While most cases are curable when detected early, more than 7,500 people die every year of the disease.
Bringing down the “needle-to-needle” time between biopsy and immunization will be critical to ensuring the treatment isn’t just promising, but practical and accessible to anyone who might benefit from it. One way to speed things up would be to establish regional hubs to quickly process biopsies.
Another measure that eventually could accelerate the development of the melanoma vaccine would be to simplify the vaccine’s components. Currently, the vaccine targets a laundry list of 34 mutated proteins to garner the full effect. It would be worth figuring out whether returns start to diminish after, say, 15 or 20 proteins.
Researchers also would like to understand whether certain types of tumors rely on common drivers that, if discovered, could be the foundation for a more broadly designed vaccine that could have some tailor-made components sprinkled in.
Burton says that Moderna so far hasn’t seen any common drivers that could help generalize components of the vaccine, but that data are limited — and the hope is that some clues might emerge as the vaccine is used over the long term and many more people are treated.
Scientists also still need to study the best way to use this vaccine for long-term suppression of cancer, considering, for example, whether people need to continue taking it every three weeks for life, or if they can get by with a periodic boost. And if someone’s disease progresses, does the vaccine itself need to be retooled to match new mutations that might have cropped up?
Perhaps the biggest question right now is whether the effect seen in melanoma can be extended to other types of cancer. Moderna Chief Executive Officer Stephane Bancel told CNBC recently that the company is moving aggressively into Phase 3 studies with the belief that “anywhere Keytruda works, this should work.”
Keytruda, meanwhile, is approved to treat a long list of cancers beyond melanoma—so many, in fact, that it’s expected to bring in more than $24 billion in sales in 2023. Bancel suggested that the vaccine might even make possible responses in tumors where Keytruda has failed, either on its own or by acting synergistically with Merck’s drug.
That’s an optimistic claim—worth studying, but a feat that has eluded other cancer immunotherapies. Melanoma is what’s known as a “hot” tumor, or one that features many mutations and has plenty of immune cells milling about, ready to be pushed into doing their cancer-killing job. It’s reasonable to be hopeful that Moderna’s vaccine could extend Keytruda’s benefits in other hot tumors, such as those found in lung cancer.
But “cold” tumors, or ones without that crowd of immune cells ready to be activated, are a much tougher proposition. In an earlier small study of the Moderna vaccine in solid tumors, for example, none of the patients with colon cancer — a notoriously “cold” tumor — responded, Bauman says.
Another immense challenge is the very high likely cost of a personalized therapy on top of Keytruda, which on its own carries a list price of around $185,000 per year. The only upside to that hefty price tag is that the companies will be motivated to answer these questions as quickly as possible. Indeed, Bancel has said that Moderna plans to aggressively invest in cancer.
All that money flowing into Moderna’s cancer vaccine will teach the field not just about that one product, but how to design, test and use other ones. Let’s hope that’s the catalyst for the true cancer vaccine revolution, one that could convert cancer from a potentially lethal illness into a chronic, stable disease.
Many post Covid patients who mistakenly believe their rapid heartbeat is due to anxiety could be suffering from POTS. Know all the symptoms of the disorder.
Do you experience dizziness, fatigue or rapid heart beat while getting up from the bed or a chair after prolonged sitting? You could be suffering from Postural orthostatic tachycardia syndrome (POTS), a condition that causes the heart to beat faster than usual. Our autonomic nervous system or the part of the nervous system that controls muscles of internal organs such as heart, blood vessels, lungs, stomach, and intestines is usually tasked with maintaining a healthy balance between heart rate and blood pressure to keep the blood flowing at a regular pace. In POTS, however, this function gets disrupted. Many post Covid patients who may mistakenly believe their rapid heartbeat is due to anxiety could be suffering from POTS.
WHAT IS POTS
“When you move from laying down or sitting to standing up, POTS, a disorder that causes your heart to beat more quickly than usual, can occur,” says Dr. Rajiv Dang, Senior Director and HOD – Internal Medicine and Medical Director, Max Hospital Gurugram.
SYMPTOMS OF POTS
– Dizziness or lightheadedness after prolonged standing or sitting
– Fainting
– heart palpitations
– fatigue or exhaustion
– Feeling anxious
– Excessive sweating
– Headache
– Shortness of breath
POTS symptoms can worsen on hot days, doing strenuous activities or during menstruation.
HOW POTS IS A LONG COVID MANIFESTATIOn
“We have what is basically one of the manifestations of long Covid syndrome, Postural Orthostatic Tachycardia Syndrome. People visit the doctor with mild palpitations and a lot of patients feel that it is anxiety but it may not be anxiety. It may be a symptom of the long Covid called POTS, the palpitations and so on, but it may remain for two months, six months or maybe more but it settles over a period of time. You may treat each patient differently according to their symptoms,” says Dr Vasant Nagvekar, co-director of infectious disease at Sir HN Reliance Foundation Hospital.
No matter what posture your body is in, your autonomic nervous system normally maintains a healthy balance between your heart rate and blood pressure to keep your blood flowing at a regular pace.
“If you have POTS, your body is unable to balance the reaction of your heart rate and blood vessel constriction (squeezing). This signifies that your body is unable to maintain a constant and stable blood pressure level,” says Dr Dang.
“There is no hard evidence of the connection between Covid and POTS but we have witnessed that post Covid patients come with this issue and it could be an effect of long Covid,” says Dr Nagvekar.
The unique and first of its kind Covid vaccine does not require an injection and is administered as nasal drops. All you want to know about nasal vaccines.
Bharat Biotech’s nasal vaccine, iNCOVACC, will soon be available as booster shot for eligible adults come fourth week of January. Nasal vaccines, which are sprayed into the nose directly, however, cannot be taken by those who have already taken their booster shots and is recommended as first booster shot. People who fear the jab can take a sigh of relief as the administration of these vaccines is quick and painless. This nasal vaccine will be administered to people twice with the gap of 28 days. Known as heterologous booster, any 18 + individual can take it who has already received covaxin or covishield vaccine earlier.
What is nasal vaccine
“In direction towards our efforts to prevent spread of covid 19, India had come up with a yet another novel nasal covid vaccine. It is a unique, first of its kind, covid vaccine as it does not require an injection instead it is administered as nasal drops. It has been cleared by DCGI, for administration, as heterologous booster, in 18+ individuals who have already received covaxin or covishield vaccine earlier,” says Dr. Gurmeet Singh Chabbra, Director Pulmonology Marengo QRG Hospital, Faridabad.
How is nasal vaccine given
It is an adeno virus vector based recombinant replication deficient stabilized spike protein vaccine. Heterologous booster vaccination means administration of vaccine other than the primary vaccination.
“It is given as 0.5ml dose (8 drops – 4 drops in each nostril) to be repeated after 4 weeks interval,” says Dr Chabbra.
How does it work
“Nasal vaccine stimulates immunity by development of neutralizing IgG, mucosal IgA and T cell response. It acts at the site of entry of covid virus – the nasal mucosa by local IgA antibody response and possibly preventing both infection to the individual and spread to others. It would help prevent spread from even asymptomatic and mild cases,” says Dr Chabbra.
Side effects of nasal vaccines
“Mild side effects may include headache, fever, running nose and sneezing. It is not to be given to those who are allergic to any of its component or had a severe allergic reaction to it in past and having acute infection or fever,” adds Dr Chabbra.
Early morning chill can play havoc with your heart health, especially if one exercises without a warm-up or does not wear appropriate clothing. Here are tips from cardiologists on how to prevent early morning heart attacks.
According to researchers most heart attacks happen during early hours of morning from 4am to 10am as there is an increase in secretion of certain hormones like epinephrine, norepinephrine, and cortisol, that may trigger increase in oxygen demand and blood pressure. Also decreased levels of endothelial progenitor cells can also increase chances of heart attack. Winter mornings can further aggravate the risk of heart attack as the morning chill can affect cardiac health of high-risk people meaning those who have hypertension, diabetes or lung issues. Experts say that these people should avoid morning workouts or walks in early hours and even if they go for walks in the morning, they should cover their ears, chest, legs and head well.
“We all know that heart attacks happen during early hours of waking and during winter season because of cold weather. It also further aggravates risk of heart attack. All those people who are high risk which means who have family history of heart disease, have high blood pressure, those who are diabetic and those who have some other lung problem, it is not advisable that they go for early morning winter walks (or workouts),” says Dr Udgeath Dhir, Director and Head of Cardiothoracic and Vascular Surgery (CTVS), Fortis Memorial Research Institute in a telephonic conversation with HT Digital.
WHY EARLY MORNING WALK IN WINTER CAN INCREASE RISK OF HEART ATTACK
“During winters the body is already trying to increase metabolism for conserving body heat, already the body is in hyperactive moment. If at all we have to go for early morning walks, we have to protect us from early morning cold. We need to cover our extremities which means the head, the ears, the hands, and our toes. Your chest area should be warm enough and never start exercise without a warm-up. Warm up is most important and it is more crucial during winter season. If we aren’t exercising without proper warm up and those who are at high risk can have heart attack and strokes in winter,” says Dr Dhir.
“Winter mornings increase the risk of cardiovascular conditions. Blood pressure is inversely proportional to winter. Chilly weather increases the pressure and as a result, our heart beats faster and even more blood is required to pump which is not favourable to someone with a weak heart. We cannot do anything about the climate, so taking precautions is the best way to tackle the problem,” says Dr. Manjinder Sandhu, Vice Chairman, Cardiology, Paras Hospitals, Gurugram.
POLLUTION AND COLD CAN BE A DEADLY COMBO
“In present scenario when there is pollution plus winter so there is smog. These are not good for lungs and heart. The air we breathe it is extra load on lungs and lungs are attached to heart, so it is extra load for heart. This can pose problem for patients who have lung issues like asthma, chronic bronchitis, smokers and certain sensitive people and in turn can lead to some heart dysfunction. These people can avoid early morning walks in winter,” says Dr Dhir.
IDEAL TIME FOR WALKS DURING WINTER
“Ideal time is not early morning and late evenings. Exercise is important for us. But we have to take the maximum benefit out of those exercise. Elderly and high-risk people should avoid early morning walk. Once there is a little sun outside, they can go for a walk or evening time. Warm-up, covering extremities, check your blood pressure, or blood sugar level are some of the points to be considered before venturing out. Try to be stress-free. That’s most important,” says Dr Dhir.
TIPS to AVOID HEART ATTACK IN EARLY WINTER MORNINGS
Below are the precautions listed by Dr Sandhu
– Regularly check your blood pressure and get in touch with the nearest healthcare provider as soon as any symptoms are witnessed.
– Stay warm and avoid stepping out in extremely low temperatures, especially early morning walks are a big no.
– Maintain regular indoor physical activities and a healthy diet that further helps you maintain your blood pressure or deal with any issues in winter.
– Do not exert yourself too much. It can result in heart attacks, heart failure, and fatal outcomes.
– Avoid fatty, fried, sweet foods with high cholesterol levels.
– If you have any existing medical conditions, keep a close watch and maintain any treatment or medication.
As a health minister, Mandaviya said he has spoken to many countries and WHO about what all precautions are needed to be taken and also understand in which direction the pandemic is moving.
In the wake of surge in COVID-19 cases in many countries, India has started 2 per cent random sampling of international travellers coming to the country and may consider making it mandatory for all if necessary, Health Minister Mansukh Mandaviya said on Thursday. He was responding to queries of some Opposition MPs after his suo moto statement in Rajya Sabha on the latest COVID-19 situation and India’s preparedness.
“We are constantly monitoring the situation. There are no direct flights between China and India but people come via other routes,” he said in response to a query by Raghav Chadha of AAP on whether the government would ban direct flights from China.
As a health minister, Mandaviya said he has spoken to many countries and WHO about what all precautions are needed to be taken and also understand in which direction the pandemic is moving.
“At a primary stage, we have already started doing 2 per cent random sampling of any traveller coming to India,” he said.
The minister further said “in the coming days the percentage could be increased and if necessary we will make it mandatory for everyone coming to India”.
Mandaviya also said the focus of the government is to ensure that no unknown variant of the virus enters India and at the same time there is now impediment on travelling.
The minister assured the Upper House that all the oxygen plants were running and a review has also been done about the availability of medicines.
“We are prepared and ready to provide the requirement of medicines and vaccines in the country,” he said.
Mandaviya also informed that an expert committee has given approval to nasal vaccine to combat the virus, doing away with the requirements of jabs.
“We are fully prepared to fight the virus,” he asserted.
Referring to the letter written to Rajasthan Chief Minister Ashok Gehlot and Congress leader Rahul Gandhi to follow appropriate covid protocol during the Bharat Jodo Yatra, he said it was his responsibility as a health minister to write after few MPs from the state had pointed out to him about people, including the Himachal Pradesh chief minister who took part in the event contracted the virus.
“We have never done politics on covid crisis and we don’t even want to do it,” Mandaviya asserted.
In his statement, he said in the recent days there have been reports of rise in COVID-19 cases in many countries such China, Japan, South Korea, the US, France, Greece and Italy.
The evolving nature of the virus poses threat to global health in a way that impacts virtually every country, he said adding the Centre has asked states to remain alert and create awareness about wearing face masks and using hand sanitisers, especially in view of upcoming festivals and new year celebrations.
He further said states have also been advised to focus on heightened surveillance within the community and to undertake requisite control and containment measures, increase the whole genome sequencing of all positive cases for timely detection of newer variants, if any.
