US doctors urge public to quit vaping as deaths, illnesses rise

The American Medical Association has urged Americans to stop using electronic cigarettes of any sort until scientists have a better handle on the cause of 450 lung illnesses and at least five deaths related to the use of the products.

The AMA, one of the nation’s most influential physician groups, also called on doctors to inform patients about the dangers of e-cigarettes, including toxins and carcinogens, and swiftly report any suspected cases of lung illness associated with e-cigarette use to their state or local health department.

The recommendation followed advice from the United States Centers for Disease Control and Prevention on Friday for people to consider not using e-cigarette products while it investigates the cause of the spate of severe lung illnesses associated with vaping.

Many, but not all, of the cases, have involved those who used the devices to vaporise oils containing tetrahydrocannabinol (THC), the psychoactive component of cannabis.

CDC officials said some laboratories have identified vitamin E acetate in product samples and are investigating that as a possible cause of the illnesses.

Public health experts have not found any evidence of infectious diseases and believe the lung illnesses are probably associated with chemical exposure.

Megan Constantino, 36, from St. Petersburg, Florida, quit vaping six days ago after hearing reports of the illnesses and deaths related to vaping.

“It scared me into quitting,” she said.

Like many users of vaping pens, Constantino picked up the device after quitting cigarette smoking three years ago, and said, “It’s the hardest thing I’ve ever done.”

She added, “I threw the last cartridge away. I took a picture of it and I literally cried.”

Constantino said many people who vape have been “on pins and needles” for the investigation results, and she is concerned that the reports of a link to vaping THC may give people an excuse to ignore the warnings.

E-cigarettes are generally thought to be safer than traditional cigarettes, which kill up to half of all lifetime users, the World Health Organization says. But the long-term health effects of vaping are largely unknown.

The US Food and Drug Administration has faced mounting pressure to curb a huge spike in teenage use of e-cigarettes, a trend that coincided with the rising popularity of Juul e-cigarettes.

“We must not stand by while e-cigarettes continue to go unregulated. We urge the FDA to speed up the regulation of e-cigarettes and remove all unregulated products from the market,” AMA president Dr Patrice Harris, said in a statement.

Gregory Conley, president of the American Vaping Association, which advocates for cigarette smokers to switch to nicotine-based vaping devices, said the AMA should be “ashamed of themselves for playing politics with people’s health and protecting the profits of drug dealers.”

He criticised the AMA for “fearmongering about nicotine-vaping products” while not mentioning “the very real risks of vaping illicit THC products.”

Juul Labs declined to comment. Altria Group Inc owns a 35 percent stake in Juul.

https://www.aljazeera.com/ajimpact/doctors-urge-public-quit-vaping-deaths-illnesses-rise-190910015919760.html

Purdue Pharma in talks over multibillion-dollar deal to settle more than 2,000 opioid lawsuits

Drugmaker Purdue Pharma is negotiating a multibillion-dollar settlement with lawyers for local and state governments that would resolve about 2,000 lawsuits against the company, which would declare bankruptcy as part of the deal.

The Sackler family, which owns the company, would relinquish control and contribute at least $3 billion in personal funds to the settlement, which could total as much as $12 billion, according to three people familiar with the talks, who spoke on the condition of anonymity because they were not authorized to discuss the negotiations.

Leaders of the 2,000 plaintiffs in a consolidated lawsuit pending in federal court are seriously considering the offer, according to one person with knowledge of the negotiations. Another person familiar with the discussions said: “I think this is a last effort. If they don’t take this deal, [Purdue is] going to bankruptcy very quickly.”

The proposed deal, first reported Tuesday by NBC News, has been in the works for months, according to one person familiar with it, and was discussed at a meeting in Cleveland last week called by U.S. District Judge Dan Aaron Polster, who oversees the sprawling federal lawsuit scheduled to get underway in mid-October.

Polster, who has encouraged the parties to settle rather than go to trial, told the parties to report back to him Friday, the person said.

Details about the talks come a day after an Oklahoma judge found health-care giant Johnson & Johnson responsible for fueling the state’s opioid epidemic and ordered it to pay $572 million to help abate the crisis.

In addition to Oklahoma, more than 40 other states have filed lawsuits in their own courts against Purdue and other companies in the pharmaceutical industry. The deal under discussion would cover the federal and state lawsuits, according to the people familiar with the proposal.

Purdue settled separately with Oklahoma for $270 million in March. In May, a North Dakota judge threw out that state’s lawsuit against the company.

Purdue is widely blamed for sparking the prescription opioid crisis in the United States with the introduction of OxyContin in 1996, followed by an aggressive marketing effort that persuaded doctors to prescribe it more widely and at higher doses.

In 2007, the company and three executives pleaded guilty to federal charges of misleading doctors and the public about the drugs. Purdue paid a $635 million fine.

Asked for comment Tuesday, Purdue said in a statement: “While Purdue Pharma is prepared to defend itself vigorously in the opioid litigation, the company has made clear that it sees little good coming from years of wasteful litigation and appeals.

“The people and communities affected by the opioid crisis need help now. Purdue believes a constructive global resolution is the best path forward, and the company is actively working with the state attorneys general and other plaintiffs to achieve this outcome.”

The company has made clear for months that it was considering bankruptcy in light of the liabilities it faced from hundreds of lawsuits. Another signal came in an Aug. 19 letter to former sales representatives, warning that “there exists the possibility that Purdue may not, or may not be able to, contribute enough to fully fund all of the retirement benefits that will become payable in the future under the Plan.”

The federal case is set to begin with two Ohio counties proceeding to trial as test cases. Polster has encouraged the plaintiffs to settle with some two dozen drug companies named in the lawsuits, and negotiations have occurred even as both sides readied for trial. State attorneys general were present, along with lawyers for the federal plaintiffs, at last week’s meeting, according to people familiar with it.

They said the company’s $7 billion in payments toward the settlement would come from a combination of sources, including insurance policies, cash, assets and Purdue’s remaining product inventory.

The company would declare Chapter 11 bankruptcy and restructure as a for-profit “public benefit trust,” with the Sacklers, who have owned Purdue since 1952, no longer in control, two people said. That trust would contribute to the settlement over a number of years by selling drugs such as OxyContin and non-opioids.A bankruptcy judge would choose the trustees.

The company also would provide anti-addiction medications such as buprenorphine, naloxone and nalmefene, a medication that has not been approved but has been fast-tracked by the FDA.

The Sacklers also would contribute $3 billion in personal funds to the settlement. That could grow by $1.5 billion if the family sells Mundipharma, an international drug company that it also owns. The Sackler family paid itself nearly $4.3 billion from the sale of its drugs between 2008 and 2016, a Massachusetts lawsuit against the company claims.

Hostility toward the Sacklers has grown as emails and other documents released by Massachusetts Attorney General Maura Healey and others portray a company that pushed sales representatives to persuade doctors to prescribe more drugs to a wider group of people at higher doses, seemingly with little regard for patient safety. The company was led at the time by Richard Sackler.

The company has denied the allegations against it, and the Sackler family has said the Massachusetts lawsuit contains “misleading and inflammatory allegations” that took internal emails out of context.

But public protests against the Sacklers have been staged outside a number of cultural institutions bearing their name. The Louvre Museum in Paris said in mid-July that it had removed the Sackler name from its Sackler Wing of Oriental Antiquities as a result of outrage. Earlier, the Metropolitan Museum of Art and the Solomon R. Guggenheim Museum, both in New York, and the Tate Modern in London announced they would no longer accept gifts from the family.

https://beta.washingtonpost.com/health/purdue-pharma-in-talks-over-multibillion-dollar-deal-to-settle-more-than-2000-opioid-lawsuits/2019/08/27/7cf50ed4-c914-11e9-be05-f76ac4ec618c_story.html

Fancy a 20-hour non-stop flight? Qantas tests passengers’ limits

Qantas Airways Ltd. will run marathon ghost flights from New York and London to Sydney carrying just a few staff to see how the human body holds up before commercial services start.

Qantas said Thursday it will simulate the world’s longest direct flights with Boeing Co. Dreamliners as soon as October. The payload of 40 passengers and crew, most of them employees, will undergo a host of medical checks and assessments.

The Australian airline wants to start direct flights connecting Sydney to New York and London as soon as 2022. Chief Executive Officer Alan Joyce describes the services as aviation’s final frontier.

The services, which take about 20 hours, aren’t yet a sure thing. Qantas still hasn’t decided on a Boeing or Airbus SE plane that can fly the route fully laden and without a break. And it’s not clear how passengers will tolerate living in the cabin for the best part of a day and night.

“The things we learn on these flights will be invaluable,” Joyce said on a call Thursday.

Joyce has previously said he plans to choose either Boeing’s 777-8X or Airbus’s ultra-long-range A350-900ULR and -1000ULR for the flights. Competition for the contract gives Qantas more leverage over price.

In an interview with Bloomberg Television on Thursday, Joyce said the delay to Boeing’s 777X program hasn’t excluded the U.S. manufacturer from the deal. He said Boeing had offered Qantas a “transitional” solution to accommodate for any delay. He didn’t elaborate.

“This is still a very competitive race,” he said.

https://www.aljazeera.com/ajimpact/fancy-20-hour-stop-flight-qantas-tests-passengers-limits-190822033007678.html

Nigeria Marks a Major Milestone – 3 Years Without Polio

Cape Town — Nigeria has made remarkable progress against polio.

The World Health Organization has certified Nigeria polio-free. It’s been three years since any cases of polio have been detected since August 21, 2016.

Dr Faisal Shuaib, Executive Director of the National Primary Healthcare Development Agency, said “there is no doubt that three years without a case of Wild Polio Virus is a historic milestone for the Polio eradication programme in Nigeria and the global community”.

He said: “This achievement would certainly not have been possible without the novel strategies adopted in the consistent fight against polio and other vaccine preventable diseases. We commend the strong domestic and global financing and the commitment of government at all levels. We appreciate the leadership and support from our traditional leaders especially the Northern Traditional Leaders Committee on Primary Health Care, donors, development and local partners. We give kudos to the efforts of all the health workers and the care givers for their patience and understanding.”

Shuaib also acknowledged the “humbly and sincerely appreciate the support of His Excellency, President Muhammadu Buhari who ensured that he walked his talk”.

This is not the first time Nigeria has been declared polio-free.

In 2015, WHO declared that polio had been eliminated, but a 2016 outbreak wiped out the designation.

The government confirmed three new cases of polio in Borno State, a development that dealt a blow to Nigeria’s hope of being certified polio-free. Nigeria was the last country on the continent where polio was endemic.

The presence of militant group Boko Haram had made some areas of the conflict-driven Borno State hard to access. This left some health workers unable to get out and vaccinate children against the disease, leaving nearly 66,000 children in remote villages without the vaccine.

To achieve this feat, the Nigerian government, Global Polio Eradication Initiative partners, Dangote group, the Bill & Melinda Gates Foundation, volunteer community members and health workers worked hard in trying to end polio within its borders.

Over the past few years, hundreds of thousands of volunteers have repeatedly vaccinated roughly 50 million Nigerian children under the age of five. The effort was driven by the Nigerian government, via the Global Polio Eradication Initiative, a joint effort between the WHO, Rotary International, the U.S. government, Unicef and the Bill & Melinda Gates Foundation. The programme also received funding from the foundation of Aliko Dangote, Africa’s richest man.

Dr. Margaret Chan, WHO Director-General, has said that “the outstanding commitment and efforts that got Nigeria off the endemic list must continue, to keep Africa polio-free. We must now support the efforts in Pakistan and Afghanistan so they soon join the polio-free world, she added.”

Polio, or poliomyelitis, is transmitted person-to-person through the fecal-oral route or contaminated food. It mainly affects children under the age of five. It can cause fevers, vomiting, headaches, back pain and sometimes paralysis. It was once widespread in the continent, but there has not been a case in Africa for more than two years.

Nevertheless, Nigeria has undoubtedly come a long way.

https://allafrica.com/stories/201908210643.html

Ebola in Burundi: EU funding to prevent spread of disease

The European Commission has released aid funding to prevent the spread of Ebola in Burundi as the disease continues to spread through the neighbouring Democratic Republic of Congo.

The Commission will provide €465,000 to strengthen preparedness for and protection against a potential outbreak of Ebola in Burundi. While to date the epidemic is almost entirely confined to the North Eastern provinces of the Democratic Republic of Congo, concerns have grown over potential spread to the neighbouring countries of Burundi, Rwanda, South Sudan and Uganda due to porous borders and high levels of trade; and the EU has to date committed more than €4m in humanitarian aid for disease prevention and rapid detection measures in these regions to guard against ‘spill-over’. €47m has been deployed for Ebola treatment and additional humanitarian support in the Democratic Republic of Congo, which currently sees an average of 81 cases of Ebola per week, since 2018.

The new funding, to be delivered through the World Health Organization, will be deployed to support measures aimed at preventing and potentially addressing future cases of Ebola in Burundi; shoring up surveillance and response facilities and co-ordinating efforts between humanitarian actors on the ground. It will complement EU funding for awareness raising and surveillance of Ebola already distributed around the region through United Nations bodies and NGOs.

Christos Stylianides, Commissioner for Humanitarian Aid and Crisis Management and the EU’s Ebola Coordinator, said: “To effectively fight the Ebola virus we do not only have to address the affected cases in the Democratic Republic of Congo but also increase our efforts to prevent the disease from spreading to neighbouring countries like Burundi. The European Union is therefore supporting ongoing Ebola preparedness measures in the country, including infection prevention and control. Everything possible must be done to avoid a further spread of the deadly virus.”

https://www.governmenteuropa.eu/ebola-in-burundi/94373/

Israel seeks to beat PTSD with ‘ecstasy’ therapy

Nachum Pachenick says he lived a nightmare for nearly two decades after being sexually abused
and developing post-traumatic stress disorder — until MDMA therapy came to his rescue.

“It’s a life full of stress, pressure, nerves, anxiety, fatigue,” the 46-year-old Israeli said from his home in Sde Boaz, south of Jerusalem.

“You can’t live like that.”

Pachenick said relief came in 2014, when he took part in a clinical trial that included the use of MDMA, the active component in the drug known to nightclubbers as ecstasy.

The treatment’s success on him and dozens of others has led Israel’s health ministry to approve its own pilot for MDMA-assisted therapy for people with treatment-resistant PTSD.

Encouraged by trials so far, therapists involved hold out hope for its future treatment possibilities, though there have also been warnings that further investigation is needed.

Last year, a research team reported in the journal The Lancet Psychiatry that a trial in the United States showed positive results, but stressed such treatment should only be done hand-in-hand with psychotherapy under professional supervision.

During that trial, 85 “adverse events” — including anxiety, headaches, fatigue and insomnia — were reported by 20 participants. It was not clear however whether the MDMA or something else was responsible.

Pachenick had been part of the second phase of three trials conducted in a number of countries under the auspices of the Multidisciplinary Association for Psychedelic Studies (MAPS).

MAPS hopes to receive approval from the US Food and Drug Administration for the process by 2021.

The results of the trial’s first two phases were “extraordinary,” said Dr Keren Tzarfaty, a psychologist in charge of training therapists for MAPS in Israel.

“When we look at these people a year after the end of their treatment, we see that 68 percent of the people who received MDMA-combined therapy don’t have (PTSD) anymore or are not defined as having PTSD,” she said.

Recovery rates are especially impressive when taking into account the fact that “the people who reach us have tried everything,” Tzarfaty said from her spacious clinic in the Israeli town of Hod Hasharon.

“Their trauma is resistant to medication, to psychotherapy; they come to us as a last resort.”

The third and final phase of the trials began in the second half of 2019, and demand far exceeded the mere 14 spots allotted for Israeli participants.

As a result, the Israeli medical establishment has decided to operate its own pilot program and allow dozens more to receive the treatment, which is done in a controlled setting.

“The Israeli health ministry decided to take the humane and responsible measure to start a pilot of 50 people suffering from PTSD who are resistant to other forms of treatment,” said Dr Bella Ben Gershon, in charge of trauma for the Israeli health ministry.

Tzarfaty has facilitated the training of 30 Israeli therapists to work with MDMA.

PTSD is triggered by experiencing an event so traumatic it cannot be fully processed, leaving parts of the brain in a state of hyperarousal and harming its elasticity.

What MDMA has been found to do is “remove all the defenses, but also create lots of compassion to others and oneself,” Ben Gershon said.

The drug can afford the joy and empathy those suffering from PTSD need to begin processing their trauma in the therapy sessions, Tzarfaty said.

The treatment includes 12-15 therapy sessions, all attended by both a male and female mental health professional.

Two or three of the sessions are under the influence of MDMA, administered in the form of a small pill.

While the PTSD of most Israelis taking part in the trial was caused by sexual assault, the country has also fought a series of conflicts, resulting in relatively high rates of the disorder, Ben Gershon said.

Tzarfaty said because of that, she believed the government had a moral duty to do what it could to help those suffering from it.

Most Jewish Israelis must perform mandatory military service.

The current trials with MDMA, a substance created in a laboratory in 1912, are part of the “renaissance” in the research of psychedelic substances and their application in psychiatry over the past decade, Tzarfaty said.

Pachenick said the effects of the treatment on him were dramatic.

“The process put me back on track, but in a more profound way brought me home, to myself,” he said.’

“I’m a much calmer person today. I have a family that’s very dear to me — all these things were very unstable beforehand.”

http://www.israelnationalnews.com/News/News.aspx/267692

CERF allocates $10 million to the Ebola response in DR Congo

United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock today announced a US$10 million contribution from the Central Emergency Response Fund (CERF) to provide life-saving assistance to people affected by Ebola in the Democratic Republic of the Congo (DRC).

The Ebola outbreak in DRC has continued in eastern Ituri and North Kivu provinces for more than a year and is now the second worst outbreak in history. The 2,787 recorded cases have resulted in 1,868 deaths as of 7 August. “Despite the scale-up of the Government-led response and the heroic efforts of frontline health workers, community members and other partners, the disease is not under control. The risk of further spread – including to neighboring countries – is very high,” said Lowcock.

The CERF funds will be used to strengthen early detection of the disease, reinforce prevention and infection control measures, provide psychosocial and nutritional support to affected people, and bolster engagement with communities, which helps ensure they are receptive to the life-saving response. “The CERF funds will help us to detect more new cases faster, reduce the risk of further spread, and support people who have lost loved ones,” said Lowcock. “But we urgently need donors to provide sustained funding for the response at this critical juncture.” The public health tools to respond to Ebola virus disease are better than ever before, including effective vaccinations. But insecurity, community mistrust, and political instability have constrained their effectiveness in this 10th outbreak in the DRC. The United Nations and partners continue to work with the Government to ensure an enabling environment for the public health response, including appropriate security, logistics, political and community engagement, and action to address the concerns of affected communities.

The $10 million allocation is in addition to $4.8 million allocated by CERF to UN agencies to respond to the outbreaks in Equateur and North Kivu provinces last year and a separate $10 million contribution for Ebola response readiness in Burundi, Rwanda, South Sudan, and Uganda.
CERF pools contributions from donors around the world into a single fund allowing humanitarian responders to deliver life-saving assistance whenever and wherever crises hit. On average, more than half of CERF-funded humanitarian action addresses the needs of women and girls.

https://reliefweb.int/report/democratic-republic-congo/cerf-allocates-10-million-ebola-response-dr-congo

Western Cape health services paint bloody picture of gun violence

A massive increase in gun violence in the Western Cape is putting critical health services under pressure. This emerged at a press conference in Cape Town on Thursday.

Professor Andy Nicol, head of the Groote Schuur Hospital trauma centre, said the centre attended to 37 gunshot victims per month on average in 2012. This number has increased to 73. About a quarter of gunshot victims which are seen at the hospital are return patients.

Nicol showed a video of how they stabilise patients to save lives. They put in plastic shunts, staples and tubes to stop massive bleeding, cover the wounds up with “plastic” and admit patients to the intensive care unit for 24 hours. Thereafter they are taken to theatre for surgery to repair injuries.

Some patients are admitted with multiple gunshot wounds. “All this trauma does damage to interns, nursing staff and even doctors who have been here for years … They are exposed to massive levels of trauma,” he said.

According to the Western Cape Department of Health the average number of gunshot victims per month at Tygerberg Hospital is 107.

In the 2018/19 financial year, 81% of violence-related deaths occurred in the Metro Health District, with Tygerberg Hospital receiving 318 cases from Khayelitsha, 242 from Parow and 239 from Delft.

The ripple effect of this is that people booked for other surgery – such as a hip replacement, tumour removal or eye surgery – are bumped off the operating theatre list and their surgery gets repeatedly postponed.

Dr Beth Engelbrecht, Head of Department of Health in the Western Cape, said 65% of homicides in the province occur between 5pm on Fridays and 4am on Mondays. Some 80% of the gunshot victims are male, according to the department.

Engelbrecht said the high caseload due to violence forces the department to shift funds away from other areas. She said violence therefore affects all sectors of society.

The Forensic Pathology Services (FPS) are also under pressure. They can’t “save time on cases, because they have to testify in court. This leads to other bodies not being released and families have to wait longer.”

In 2018 the FPS recorded 11,930 bodies of which 4,170 were unnatural deaths; of these, 2,029 died from gunshot wounds. Since January this year there were 5,840 bodies admitted and 1,100 were deaths due to gunshots and 893 to stabbings.

Engelbrecht added that due to the violence in some areas the response time of the Emergency Medical Services has dropped from being at a scene within 15 minutes 60% of the time to 12%. This is because ambulance crews first have to wait for a police escort before they enter high risk areas.

Dr Nomafrench Mbombo, Western Cape Minister of Health, said: “Our budget now goes to crime. We are doing battleground medicine.” The province’s health budget was cut three years in succession and she said it looks worse ahead.

She said people complain that they have “to sleep on the floor as they wait for a bed” but “they will wait longer, because of this [high incidence of gun violence] … We run out of beds and have to put patients in the passage, that is how it is.”

Mary Bruce, from Hanover Park, spoke about how she was shot on the 7 July while she was hanging washing in her backyard. “I heard the first shot. The second bullet hit me while I was running away. He just kept shooting … I don’t know who he is.”

Bruce was shot in the knee. “I lay there for 10 minutes, hiding, before anyone found me. I thank the Lord. I could have been dead. I could have lost my leg if it was not for the people from Groote Schuur.”

Bruce works with about 50 children to help them escape gang life. “I tell them, you have to get out, because either you die or you go to prison.”

“I am scared every day of my life. The bullets are like rain there [on the Cape Flats],” she said.

https://www.groundup.org.za/article/health-services-paint-bloody-picture-gun-violence-western-cape/

A healthy lifestyle also preserves the brain

This is good news for public health. While Alzheimer’s disease and other dementia affect 50 million people worldwide, and that figure could triple by 2030, a new study shows that adopting a healthy lifestyle, which protects against cardio Vascular, also helps preserve the health of the brain.

The work coordinated by the EpiAgeing team of the epidemiology and statistics research center of the National Institute of Health and Medical Research (Inserm) is published Thursday, August 8 in the British Medical Journal . They conclude that 50-year-olds who adhere to Life’s Simple 7 recommendations (a cardiovascular health score built from seven parameters) subsequently develop fewer dementias. For each point gained on this score from 0 to 14, the risk of brain damage decreases by 11%. Clearly, even small improvements in lifestyle are paying off.

Adopted by the American Heart Association (AHA) in 2010, Life’s Simple 7 has four behavioral parameters (smoking, diet, physical activity and body mass index) and three biological parameters (fasting blood glucose, total cholesterol and blood pressure), identified as the most important for the health of the heart and arteries.

Each being rated 0 (level at risk), 1 (intermediate level) or 2 (optimal level), the tool allows to calculate a score from 0 to 14, reflecting the level of protection against cardiovascular diseases – mainly myocardial infarction and cerebrovascular accidents. The Life’s Simple 7 is available free on the AHA website, about 100 000 people have created a profile.

Neuroprotective effect

According to these criteria, optimal cardiovascular health (maximum score) corresponds to an individual who has never smoked or stopped for more than one year, with a normal weight (body mass index less than 25 kg / m ² ), a varied and healthy diet, and physical activity in line with World Health Organization recommendations (more than 150 minutes per week of moderate intensity activity or 75 minutes of sustained intensity).

Biologically, total cholesterol is less than 200 milligrams per deciliter (mg / dl), fasting glucose level is below 100 mg / dl and normal blood pressure – less than 120/80 mm mercury (mmHg).

To evaluate whether this score is as predictive of the risk of Alzheimer’s disease and other dementias, Séverine Sabia, researcher at Inserm and the University College of London, and her colleagues have calculated – with slightly modified for the purpose of the study – at nearly 7,900 British officials in the Whitehall cohort at the age of 50. With an average follow-up of twenty-five years, 347 cases of dementia were recorded.Read also Alzheimer’s: 1 million patients, 2 million caregivers, 20 billion euros in costs … and 0 treatment

Compared to the group with a low level of cardiovascular health (score from 0 to 6), individuals with an intermediate level (score of 7 to 11) and those with an optimal level (12 to 14) had a level of risk decreased by 39% and 43%, respectively.

This neuroprotective effect was found in people who developed cardiovascular disease, but also in those who remained free from cardiovascular events. “Our results suggest that at age 50, the seven Life’s Simple 7 parameters synergistically contribute to the protection against Alzheimer’s disease and other dementias. The risk reduction is evident from an intermediate level of the score, “ says Séverine Sabia.

“Never too late to get started”

In August 2018, Cécilia Samieri’s team (Inserm, Bordeaux Population Health Research Center) published in the Journal of the American Medical Association a similar study based on the French cohort of the Three Cities, launched in 2000, which includes 10,000 people aged 65 and over. The Life’s Simple 7 score was measured at the age of 65, and was predictive of dementia risk with a follow-up of 15 years. “We had obtained the same amplitude of results with a risk reduction of 10% per additional point to the score, but the strength of this new study is to have applied these parameters earlier, at 50 years,” said Cecilia Samieri.

For the researcher from Bordeaux, these results are in line with current conceptions of Alzheimer’s disease, with risk factors that accumulate throughout life and are particularly important from the forties.

“Dementia and cardiovascular diseases are environmental pathologies with common determinants. With a perfect lifestyle, 80% would be preventable, but this study shows that it’s never too late to get started , “said Professor Claire Mounier-Vehier (Heart Institute Lung, CHU Lille), who did not participate in this work. The cardiologist, outgoing president of the French Federation of Cardiology, also notes that “even a moderate observance is effective, which can reconcile the concept of prevention and pleasure . “

Should we already translate Life’s Simple 7 and offer it to the population, to encourage the French to improve their lifestyle and thus lower their risk of heart disease or dementia?

Prevention strategy

“One of the strengths of this tool is to deliver a positive message, encouraging the accumulation of good attitudes rather than scare the risks ,” continues Cecilia Samieri. But for now, it’s more for research than for mainstream use. “ With regard to food and physical activity, the criteria are difficult to evaluate themselves objectively, she said, and would probably fit. “In cardiology, doctors are working on different tools to stratify risks as finely as possible, but we must also model scores accessible to the general public,” said Claire Mounier-Vehier.

“The Life’s Simple 7 test is part of the current movement, which seeks to take into account the overall health risks, even if it is less precise on certain items, the quantification of LDL cholesterol [” bad cholesterol “] for example “ Says Thierry Couffinhal, professor of cardiology and director of a research unit Inserm (Bordeaux), who will soon test this score among patients in his department.

Beyond primary prevention, the aim of which is to prevent illnesses by reducing existing risk factors, and secondarily, to prevent recurrence of accidents, a prevention strategy, which is more fundamental and upstream, is emerging. “It’s a population-based approach, which aims to prevent the appearance of risk factors, for example by promoting physical activity, banning smoking in public places, reducing the salt content food, “ says Claire Mounier-Vehier. A more behavioral, less medicated conception of health. A whole revolution.

https://www.lemonde.fr/societe/article/2019/08/08/un-mode-vie-sain-preserve-aussi-le-cerveau_5497521_3224.html

Africa: Uganda, Rwanda, DR Congo Must Fight Ebola Together

Ebola has exacted a heavy death toll on Uganda, Rwanda and the Democratic Republic of the Congo (DRC) for a long time.

The viral disease has killed hundreds of people and overwhelmed facilities and health workers. And every time this epidemic crosses the common borders of the three countries, the response has been slow and reactionary.

That is, the emphasis is put on isolation of the sick and educating relatives and health workers on how to handle the affected persons. Efforts to prevent the viral disease’s resurgence have not been very successful in the past. This is partly blamed on the lifestyle of residents in the most vulnerable areas.

It is said monkeys are the natural habitat of this virus; therefore, people who eat monkey meat help the contraction and spread of this disease.

Also there were no preventive vaccines to combat this deadly disease in the past. But there is good news now that Uganda has embarked on an experimental vaccination of people in the vulnerable border areas. This effort should be embraced by all concerned countries. The attention given to the Ebola vaccine should exceed that given to political terrorists.

The experimental Johnson & Johnson vaccine will be administered to health care professionals, as well as ambulance drivers, burial teams and cleaners. The trial is expected to last two years and cover 800 people in the western Mbarara district.

Once in 2013 and 2016, DRC tried using vaccines manufactured by Merck. Though the vaccines seemed effective, the campaign did not cover the entire country and the neighboring countries.

It is said that over 180,000 people have received this vaccine. Again typically, this effort was frustrated by the unsteady supply of the vaccines.

The Merck vaccine is administered through one shot and takes 10 days to be effective, the Johnson & Johnson vaccine requires two shots, two months apart.

Uganda, Rwanda and DRC need to take an aggressive vaccination campaign against Ebola just like they have done against hepatitis. They also need to take a holistic approach to the promotion of this vaccination.

The medical personnel need to dispel the lurking anti-vaccine fear of the unknown side effects. The regional governments need to stabilize and control the movement of persons and animals across the borders.

There is violence in northeastern DRC, which could curtail disease-control efforts. If the government resolve against Ebola is as firm as that directed against terrorists or political opponents, it is conceivable that the Ebola epidemic will become a disease of the past.

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