Adults with type 2 diabetes (T2D) have a greater risk of developing cardiovascular disease (CVD) compared with the general population, even when risk factors associated with CVD are optimally controlled, according to research published in the American Heart Association's journal 

.

First author Alison Wright, PhD, a research associate at the Centre for Pharmacoepidemiology and Drug Safety at the University of Manchester in the United Kingdom, explained in a press release that previous studies investigating the association between T2D and CVD risk factors had demonstrated that people with T2D had little or no increased risk of CVD events or death when all risk factors are optimally controlled.

"Our team sought to determine how the degree of risk factor control in people with Type 2 diabetes impacted CVD risk and mortality compared to people with type 2 diabetes who had all risk factors optimally controlled and to people who do not have type 2 diabetes," Wright said in the press release.

The researchers analyzed data between 2006 and 2015 from the Clinical Practice Research Datalink (CPRD) and the Scottish Care Information-Diabetes (SCI-Diabetes) dataset. After collecting the data, the researchers identified more than 101,000 people with T2D and matched them with approximately 379,000 people without diabetes in CPRD and nearly 331,000 with T2D in SCI-Diabetes.

When conducting the analysis, the researchers focused on 5 risk factors for CVD, including blood pressure, smoking, cholesterol, triglycerides, and blood glucose. They then assessed the association between future CVD events and death with these risk factors when the risk factors are optimally controlled. They also investigated whether the presence of cardiorenal (heart and kidney) disease had any impact on these connections as well.

The results demonstrated that only 6% of participants included in the analysis with T2D had all 5 risk factors within target range. Among patients with these 5 risk factors who had them optimally controlled, those patients with T2D were demonstrated to still have a 21% higher risk for CVD and 31% higher risk for hospitalization from heart failure than people without diabetes.

Additionally, the association between the number of increased risk factors and CVD event risk was greater in people with T2D who did not also have cardiorenal disease.

"People with type 2 diabetes should be treated for cardiovascular risk factors as early as possible, regardless of whether they have cardiovascular disease or not," Wright said in the press release. "There is real potential here to reduce the overall impact of type 2 diabetes on future cardiovascular events, especially for patients with type 2 diabetes who have not yet been diagnosed with CVD."

The researchers noted that although this research showed the importance of controlling all risk factors in patients, future research will investigate the individual risk factors that may have a greater impact on CVD risk and require targeted interventions.




Preventing heart disease should be a priority for people with Type 2 diabetes. Dallas, TX: American Heart Association; November 16, 2020. eurekalert.org/pub_releases/2020-11/aha-phd111620.php. Accessed November 17, 2020.

Articles

Adults with type 2 diabetes have a greater risk of developing cardiovascular disease (CVD) compared with the general population, even when risk factors associated with CVD are optimally controlled.

People With Type 2 Diabetes Have a Greater Risk of Cardiovascular Disease Even With Risk Factors Optimally Controlled

Randall A. Oyer, MD, president of the Association of Community Cancer Centers, and medical director at Penn Medicine’s Ann B. Barshinger Cancer Institute in Lancaster, Pennsylvania talks to 

® on the necessity of cancer screenings in the effort to reduce cancer mortality. The coronavirus disease 2019 (COVID-19) pandemic is projected to cause a spike in cancer deaths, which, according to Oyer, is due to the decline in screening since the pandemic began.

Videos

Cancer deaths are expected to spike due to COVID-19. 

Cancer Screenings Crucial for Mortality Reduction

Contemporary Clinic spoke with Daniel R. Wilson, MD, PhD, President of Western University of Health Sciences, about what to recommend to those who are struggling cognitively through the COVID-19 pandemic.

Wilson reminded those who may be stressed since the start of the pandemic to continue to take care of both your body and mind, such as eating well, sleeping well, and socializing when possible.

Wilson also shared his thoughts on what he hopes to see for the future of COVID-19 and the focus of future studies on it. 

The Future of Neurological Studies During COVID-19

According to 2 editorials in the journal 

, research in the nursing field has been critically influential to understanding evidence-based health care practice, care delivery, and policy during the coronavirus disease 2019 (COVID-19) pandemic. In order to investigate this influence further, researchers at the University of Pennsylvania School of Nursing assessed what the role of nursing research has been in supporting patients during the pandemic.

According to the authors of the guest editorial “Nursing Research Is Coronavirus Research

,” nursing practice has not only saved lives throughout the pandemic, but it has also played a critical role in understanding the nature of care for patients with COVID-19. The research conducted to understand this role further has helped to progress knowledge regarding the necessary elements of more supportive work environments that save patient lives and promote recovery in both hospitals and nursing homes.

Additionally, research in the field of nursing has helped to advance knowledge regarding how individuals sheltering at home with in-home nursing care are managing diets to support their health in light of chronic conditions, as well as how in-home nursing care has been able to stabilize chronic conditions during the pandemic.

The research in the field has also been able to bring to light lessons from the past around areas of concern for patients in order to positively impact policy around patient care during the pandemic.

"We know that nursing practice is saving lives in this pandemic. Nursing research also plays a critical role," write the authors of the guest editorial. “We support the move in universities to concentrate research on innovations directly related to the coronavirus crisis. But so much of nursing's research is coronavirus research. We applaud the search for reliable epidemiological data, effective treatments, and vaccines. We, though, must articulate nursing research's fundamental frame. We focus on the lived experiences of clinicians, patients, families, and communities.”

The author of the second editorial “How Effective Response to COVID-19 Relies on Nursing Research

,” Eileen T. Lake, PhD, the associate director of the Center for Health Outcomes and Policy Research and editor in chief of 

, explained further that throughout the pandemic, several clear challenges to an effective response to the public health crisis became evident. These challenges included the country’s restricted access to health care, the present surging demand for health care personnel, and the moral distress that many health care providers face during the pandemic.

Lake also noted that in order to better help institutions meet the demands that the COVID-19 pandemic posed to the health care system, nursing research was critical to effectively inform crucial elements of policy response and institutional preparedness.

"Nursing research provides answers during crises," writes Lake in the editorial. “In a time of profound upheaval, risk, and strain, it is reassuring to have evidence-based solutions to the challenges confronting our health care system and its clinicians.”

Nursing research informs response to COVID-19 pandemic. Philadelphia, PA: University of Pennsylvania School of Nursing; April 27, 2020. eurekalert.org/pub_releases/2020-04/uops-nri042720.php. November 30, 2020.

D’Antonio P, Naylor M, Aiken L. Nursing research is coronavirus research. 

Lake ET. How effective response to COVID‐19 relies on nursing research. 

2020;43(3):213-214. doi: 10.1002/nur.22025.

According to 2 editorials, research in the nursing field has been critically influential to understanding evidence-based health care practice, care delivery, and policy during the COVID-19 pandemic.

Nursing Research Has Been Critical to Improving the COVID-19 Pandemic Response

Favipiravir may be a beneficial treatment for mild-to-moderate coronavirus disease 2019 (COVID-19), according to a study published in the 

International Journal of Infectious Diseases

The COVID-19 pandemic has caused over 1.39 million deaths and there have been more than 59.2 million confirmed cases worldwide, according to the World Health Organization.

 Favipiravir is an RNA-dependent RNA polymerase (RdRp) inhibitor that is approved in Japan and China for the treatment of novel influenza virus.

Currently, 2 other trials have demonstrated that favipiravir has an advantage over other antivirals in treating COVID-19. Additionally, it is estimated that over 80% of patients with COVID-19 experience mild-to-moderate illness. However, very little antiviral research has investigated therapeutic interventions in this patient group.

The randomized, open-label phase 3 study took place across 7 sites in India. Study participation had a maximum treatment period of 28 days. Care was provided past the 14-day mark based on investigator judgement. The control arm received standard of care alone while the study group received standard of care plus favipiravir. Drugs with suspected antiviral activity against SARS CoV-2, including hydroxychloroquine, were prohibited.

Patients treated with favipiravir met the primary end point of median time to RT-PCR negativity 28.7% sooner than those treated with standard of care alone. However, according to the study, the median time to viral clearance was shorter in the control group (7 days) than in the study group (11 days). The statistically significant endpoint was not achieved.

“Faster viral clearance would be expected to reduce the duration of infectivity during the early course of disease, which would yield critical reductions in the secondary attack rate, duration of quarantine, and burden on health care providers and facilities,” study authors write.

Favipiravir was found to be well tolerated, and no adverse events led to drug discontinuation. One patient in the control group died of acute respiratory distress syndrome.

1. Udwadia, Zarir, et al. Efficacy and Safety of Favipiravir, an Oral RNA-Dependent RNA Polymerase Inhibitor, in Mild-to-Moderate COVID-19: A Randomized, Comparative, Open-Label, Multicenter, Phase 3 Clinical Trial. November 8, 2020. 

https://doi.org/10.1016/j.ijid.2020.11.142

2. WHO Coronavirus Disease (COVID-19) Dashboard

. The World Health Organization. Accessed November 25, 2020. 

The drug, which is approved for use in Japan and China, may help those with mild-to-moderate COVID-19. 

Favipiravir May be an Effective COVID-19 Treatment

Among women with breast cancer, colorectal cancer, or melanoma, those who were taking cholesterol-lowering medications were less likely to die from cancer, according to an analysis published in the 

The researchers tested the hypothesis that adherence to lipid-lowering medications (LLMs) is associated with reduced cancer-specific mortality in a homogeneous population who had used these drugs before cancer diagnosis. The Australian Cancer Database was linked to the Pharmaceutical Benefits Scheme database and to the National Death Index up to the year 2015, according to the study.

Further, the medication adherence was calculated by proportion of days covered. Cox regression models with time-varying covariates were used to derive multivariable-adjusted cause-specific hazard ratio and 95% confidence interval for the associations between adherence to LLMs, statins, lipophilic, and hydrophilic statins, and cancer-specific mortality.

From 2003 to 2013, 3 separate cohorts of 20,046, 11,719, and 6430 female patients with newly diagnosed breast, colorectal cancer, and melanoma were identified, respectively. The 1-year adherence was similar at 1-year pre-diagnosis in the 3 cohorts, at an average of 82%.

Additionally, each 10% increase in 1-year adherence to LLMs was inversely associated with cancer-specific mortality among women with breast cancer, colorectal cancer, or melanoma. The reductions in cancer-specific mortality were more pronounced for women who adhered to lipophilic rather than hydrophilic statins in all 3 cancers, although it was not statistically significant for melanoma, according to the study.

The researchers found that among LLM users, adherence to the drug is associated with a decrease in cancer-specific mortality. If confirmed, LLMs could be considered as an adjuvant cancer therapy to improve prognosis in cancer survivors, according to the study.

Cholesterol medications linked to lower cancer-related deaths in women. EurekAlert! 

https://www.eurekalert.org/pub_releases/2020-10/w-cml101920.php

. Published October 21, 2020. Accessed October 28, 2020.

Feng JL, Qin X. Does adherence to lipid-lowering medications improve cancer survival? A nationwide study of breast and colorectal cancer, and melanoma. 

Among women with breast cancer, colorectal cancer, or melanoma, those who were taking cholesterol-lowering medications were less likely to die from cancer, according to a recent analysis.

Cholesterol Medications Linked to Fewer Cancer-Related Deaths in Women 

Universal mask wearing is critical to prevent the spread of coronavirus disease 2019 (COVID-19) as the pandemic persists throughout the United States.

Evidence consistently demonstrates that mask wearing is one of the best measures to prevent the spread of COVID-19 in a community, and it is recommended by the CDC and other health experts as the best method available to do so.

 Person to person spread of COVID-19 has been known as the primary method of transmission.

However, the CDC recently updated their guidance based on evidence that COVID-19 can sometimes spread by airborne transmission from small droplets and particles that linger in the air for minutes to hours.

 Without federal mask mandates in place, inconsistencies exist across the country as many states have eased restrictions. According to Johns Hopkins University, there have been over 225,000 deaths from COVID-19 in the United States as of October 26, 2020.

An epidemiological study analyzed data across the country from the first recorded case through September 21, 2020 to determine different scenarios for the future trajectory of COVID-19.

The study found different patterns of COVID-19 across the United States, including data that demonstrated that sixth of the deaths (16.6%) occurred in New York alone. Between February and September 2020, the highest levels of daily deaths occurred in New York (998), New Jersey (311), and Texas (220). On September 21, 2020, the highest level of daily deaths occurred in Florida at 101 deaths per day.

The study projected that if states continue to ease restrictions, the total death rate in the United States could reach over 1 million by February 28, 2021.

 In addition, the study predicted that if states begin to shut down social interaction and the economy when daily deaths reach a threshold of 8 deaths per million, the projected death toll is predicted to decrease to 511,373 deaths by February 28, 2021. The implementation of universal mask use, or 95% mask use by the general public, is predicted to result in better outcomes as the pandemic surges in many states and is estimated to save an additional 129,574 lives from September 22, 2020 through the end of February 2021.

This study provides important evidence about what the future could hold for the United States in terms of COVID-19 deaths and the critical nature of universal mask use to save lives. Limitations of the study include that it involved estimations of real-world scenarios and the rapidly evolving nature of the COVID-19 pandemic, which may not be accounted for in the analysis.

, Anthony Fauci, MD, National Institute of Allergy and Infectious Diseases director, calls for universal mask adherence, keeping distance from others, and frequent handwashing measures, especially as the winter months approach.

“They sound very simple. But we’re not uniformly doing that and that’s one of the reasons we’re seeing these surges,” said Fauci in the interview.

Health care professionals can play a critical role in educating the public about the importance of correct mask use (covering mouth and nose) to prevent the spread of COVID-19.

 It is important to emphasize that masks work along with social distancing (staying at least 6 feet away from others) and frequent handwashing.

 As the holiday season approaches, it is vital to continue these measures to prevent serious COVID-19 illness and death.

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html

. Updated October 5, 2020. Accessed October 26, 2020.

Johns Hopkins University & Medicine. Coronavirus resource center.

Reiner RC, Barber RM, Collins JK, et al. IHME COVID-19 Forecasting Team.Modeling COVID-19 scenarios for the United States. 

. Published online October 23, 2020. doi: 10.1038/s41591-020-1132-9.

. Fauci says it might be time to mandate masks as COVID-19 surges across US. 

https://www.cnn.com/2020/10/23/health/fauci-covid-mask-mandate-bn/index.html

. Published October 23, 2020. Accessed October 26, 2020.

To prevent the spread of COVID-19 throughout the United States, universal mask wearing is critical.

Study: Universal Mask Wearing Could Save Nearly 130,000 US Lives from COVID-19 

A diet rich in flavan-3-ols, more commonly referred to as flavanols, includes food and beverages such as tea, apples, and berries. According to the European Prospective Investigation into Cancer (EPIC) Norfolk study published in 

, this type of diet may lower blood pressure, indicating its ability to support the maintenance of cardiovascular (CVD) health on a population scale.

Flavanols are a group of bioactive compounds that have demonstrated an ability to help vascular function in prior intervention studies. For this reason, the researchers were interested in investigating flavanols as dietary support in the prevention of CVD diseases due to a lack of reliable data from observational studies on the subject. They noted that such a lack may be in part because of the high variability in the flavanol content of food, making estimates of actual intake difficult without nutritional biomarkers.

The researchers assessed the biomarker-estimated flavanol intake of 25,618 citizens of Norfolk in the United Kingdom in relation to their blood pressure and other CVD risk markers, as well as longitudinal associations with CVD risk. However, the researchers strayed from common practice in studies of this kind by not relying on the reported diets of participants, and instead measured flavanol intake through nutritional biomarkers, such as indicators of dietary intake, metabolism, or nutritional status present in the blood.

"Previous studies of large populations have always relied on self-reported data to draw conclusions, but this is the first epidemiological study of this scale to objectively investigate the association between a specific bioactive compound and health,” said lead author Gunter Kuhnle, PhD, a professor of nutrition at the University of Reading, in a press release.

The results demonstrated that participants with the lowest 10% of flavanol intake and participants with the highest 10% of intake had a difference in blood pressure between 2 and 4 mmHg. Such significant changes in blood pressure are comparable to those with a Mediterranean diet or moderate salt reduction.

"What this study gives us is an objective finding about the association between flavanols—found in tea and some fruits—and blood pressure. This research confirms the results from previous dietary intervention studies and shows that the same results can be achieved with a habitual diet rich in flavanols. In the British diet, the main sources are tea, cocoa, apples and berries,” Kuhnle said.

Kuhnle explained that the methodology of the study was also of importance in their research.

“This is one of the largest ever studies to use nutritional biomarkers to investigate bioactive compounds. Using nutritional biomarkers to estimate intake of bioactive food compounds has long been seen as the gold standard for research, as it allows intake to be measured objectively. The development, validation and application of the biomarker was only possible because of the long-term commitment of all collaborators. In contrast to self-reported dietary data, nutritional biomarkers can address the huge variability in food composition. We can therefore confidently attribute the associations we observed to flavanol intake," Kuhnle said.

Following this study, researchers from the University of Reading; Cambridge University; University of California, Davis; and Mars, Incorporated assessed the data of the participants from the EPIC Norfolk study and observed that the greatest change in blood pressure due to diet was observed in participants with the highest blood pressure.

The researchers noted this finding suggests that an increase in flavanol intake among the general public could result in an overall reduction in CVD disease incidence.

"This study adds key insights to a growing body of evidence supporting the benefits of dietary flavanols in health and nutrition,” said Hagen Schroeter, PhD, chief science officer at Mars Edge, in a press release. “But, perhaps even more exciting was the opportunity to apply objective biomarkers of flavanol intake at a large scale. This enabled the team to avoid the significant limitations that come with past approaches which rely on estimating intake based on self-reported food consumption data and the shortcomings of current food composition databases."

Ottaviani JI, Britten A, Lucarelli D, et al. Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk. 

. 10,17964(2020). doi: 10.1038/s41598-020-74863-7.

High flavanol diet may lead to lower blood pressure. Reading, UK: University of Reading; October 21, 2020. eurekalert.org/pub_releases/2020-10/uor-hfd101620.php. Accessed October 28, 2020.

According to a recent study, a flavanol-rich diet may lower blood pressure, indicating its ability to support the maintenance of cardiovascular (CVD) health on a population scale.

Flavanol-rich Diet May Lower Blood Pressure

The FDA has approved invermectin 0.5% (Sklice, Sanofi Pasteur Inc), a lotion for the treatment of head lice, for OTC use.

Invermectin 0.5% was initially approved for prescription use in patients 6 months of age and older in February 2012. Every year, an estimated 6 to 12 million cases of head lice infestation occurs in children 3 to 11 years of age, according to an FDA press release. Lice are most common among children in preschool, elementary school, and among members of a household in which children have lice.

The nonprescription designation was changed in a process known as prescription (RX)-to-OTC switch. This process is usually initiated by the manufacturer, which must prove that the drug is safe and effective when used as directed in the proposed labeling in order to be successful.

Invermectin 0.5% is a lotion for external use only and should be used on the scalp or dry hair in accordance with label instructions only. The lotion is not approved for any other use, according to the FDA.

“The Rx-to-OTC switch process aims to promote public health by increasing consumer access to drugs that would otherwise only be available by prescription,” Theresa Michele, MD, acting director of the Office of Nonprescription Drugs in the FDA’s Center for Drug Evaluation and Research, said in a press release. “Today’s approval expands access to another effective topical treatment for the thousands of people with head lice.”

The lotion will be marketed as a nonprescription drug and will no longer require a prescription drug. Those who are currently using a prescription version of the product should consult their health care professional, according to the FDA.

FDA Approves Lotion for Nonprescription Use to Treat Head Lice [News Release] October 27, 2020; White Oak, MD. 

https://www.fda.gov/news-events/press-announcements/fda-approves-lotion-nonprescription-use-treat-head-lice?utm_medium=email&utm_source=govdelivery

Invermectin 0.5% is a topical lotion available OTC to treat head lice. 

FDA Approves Invermectin Lotion for Head Lice 

A new study from researchers at the University of Maryland School of Medicine (UMSOM) found that hospitalized patients with coronavirus disease 2019 (COVID-19) who were taking a daily low-dose aspirin to protect against cardiovascular disease had a significantly lower risk of complications and death compared with those who were not taking aspirin.

Further, aspirin takers were less likely to be placed in the ICU or hooked up to a mechanical ventilator and were more likely to survive the infection compared with hospitalized patients who were not taking aspirin.

"This is a critical finding that needs to be confirmed through a randomized clinical trial," said study leader Jonathan Chow, MD, assistant professor of Anesthesiology at UMSOM in a press release. "If our finding is confirmed, it would make aspirin the first widely available, over-the-counter medication to reduce mortality in COVID-19 patients."

Chow and his colleagues went through medical records of 412 COVID-19 patients with an average age of 55 years who were hospitalized over the past few months due to complications of their infection. The patients were treated at the University of Maryland Medical Center in Baltimore and 3 other hospitals along the East Coast. Approximately one-quarter of the patients taking a daily low-dose aspirin before they were admitted or right after admission to manage their cardiovascular disease.

The researchers found aspirin use was associated with a 44% reduction in the risk of being put on a mechanical ventilator, a 43% decrease in the risk of ICU admission, and a 47% decrease in the risk of dying in the hospital compared with those who were not taking aspirin. The patients in the aspirin group did not experience a significant increase in adverse events, such as major bleeding while hospitalized, according to the study.

Several factors may have contributed to the patients’ prognosis, including age, gender, body mass index, race, hypertension, and diabetes, also accounting for heart disease, kidney disease, liver disease, and the use of beta blockers to control blood pressure.

Although physicians often recommend a daily low-dose aspirin for patients who have previously had a heart attack or stroke caused by a blood clot to prevent future blood clots, daily use can increase the risk of major bleeding or peptic ulcer disease, according to the study.

"We believe that the blood thinning effects of aspirin provides benefits for COVID-19 patients by preventing microclot formation," said study co-author Michael A. Mazzeffi, MD, associate professor of anesthesiology at UMSOM, in a press release. "Patients diagnosed with COVID-19 may want to consider taking a daily aspirin as long as they check with their doctor first.”

Further studies are needed to prove that aspirin use leads to better outcomes in COVID-19, but the evidence from this study suggests that patients may want to discuss with their physician whether it is safe for them to take aspirin to manage potentially prevent serious complications, according to the study authors.

New study: aspirin use reduces risk of death in hospitalized patients. EurekAlert! Published October 22, 2020. Accessed October 23, 2020.

Aspirin takers were less likely to be placed in the ICU or hooked up to a mechanical ventilator and were more likely to survive the infection compared with hospitalized patients who were not taking aspirin.

Study: Aspirin Use Reduces Risk of Death in Hospitalized COVID-19 Patients 

New research suggests that CBD can reduce inflammation and reduce the cytokine storm that causes lung damage and death in many patients with coronavirus disease 2019 (COVID-19).

Investigators at the Dental College of Georgia and Medical College of Georgia had previously found that CBD improves oxygen levels and reduces inflammation and physical lung damage in their model of adult respiratory distress syndrome (ARDS). In their new study, the team found that apelin levels significantly decrease during COVID-19, but that CBD quickly helps normalize those levels.

“CBD almost brought [apelin] back to a normal level,” said co-author Jack Yu, MD, in a press release.

COVID-19 enters human cells via the angiotensin-converting enzyme 2 (ACE2) receptor, which typically works with apelin to control blood pressure. The authors hypothesized that an upregulation of both ACE2 and apelin may be helpful in cardiovascular disease by decreasing blood pressure and increasing the heart’s ability to pump.

Similar to other diseases, however, the investigators said COVID-19 appears to upset the partnership between apelin and ACE2. The binding of the virus to ACE2 has been shown to decrease the receptor’s levels and increase levels of angiotensin II, because angiotensin II is degraded and fewer vasodilators are produced.

In the researchers’ ARDS models, blood levels of apelin dropped close to zero but quickly increased 20 times over with CBD, according to the study published in the 

Journal of Cellular and Molecular Medicine.

 Apelin—a pervasive peptide created by cells in the heart, lungs, brain, fat tissue, and blood—is essential in regulating both blood pressure and inflammation.

When blood pressure increases, the investigators said apelin levels should grow in the correct place to help bring it down. It should also increase in order to normalize significant spikes in lung inflammation and related breathing difficulties associated with ARDS.

“Ideally, with ARDS it would increase in areas of the lungs where it’s needed to improve blood and oxygen flow to compensate and to protect,” said Babak Baban, PhD, the study’s corresponding author.

However, Baban added that this did not prove to be true in their ARDS model, with apelin decreasing in both the lung tissue itself and the general circulation.

Although the investigators did not attribute all of CBD’s benefits to apelin levels, they said the peptide does play an important role. More research is needed in order to understand whether COVID-19 or CBD have a direct impact on apelin or if these are downstream consequences.

“It is an association; we don’t know yet about causative, but it is a very good indicator of the disease,” Baban said.

CBD helps reduce lung damage from COVID by increasing levels of protective peptide [news release]. EurekAlert!; October 19, 2020. 

https://www.eurekalert.org/pub_releases/2020-10/mcog-chr101620.php

Although the investigators did not attribute all of CBD’s benefits to apelin levels, they said the peptide does play an important role.

Study: CBD Increases Levels of Protective Peptide, Reducing COVID-19 Lung Damage

Investigators at MIT and the Ragon Institute of MIT, MGH, and Harvard have designed a vaccine that triggers an immune response against an influenza protein segment that rarely mutates, but is not normally targeted by the immune system, according to a study published in 

 According to the authors, this vaccine marks one step closer towards the development of a universal flu vaccine.

The flu vaccine has to be redesigned annually in order to account for mutations that the virus accumulates. However, even with the yearly redesign, the vaccine often does not fully protect everyone.

The vaccine candidate offers nanoparticles coated with flu proteins that teach the immune system to create desired antibodies. In testing with mice, the vaccine elicited an antibody response targeted the protein segment. This means that the vaccine could potentially be effective against any flu strain.

According to the study, the immune system targets the head of the HA Protein and not the stem. The head of the protein tends to mutate rapidly, but the HA stem very rarely mutates. This makes the stem a prime target for a universal flu vaccine.

"We don't understand the complete picture yet, but for many reasons, the immune system is intrinsically not good at seeing the conserved parts of these proteins, which if effectively targeted would elicit an antibody response that would neutralize multiple influenza types," said Daniel Lingwood, PhD of Harvard Medical School, in a prepared statement.

According to study authors, developing a universal flu vaccine can help minimize pandemic threats. Refocusing immunity can help in its development.

"When there's a refocusing event, that means we can swing the antibody response against that target, which under other conditions is simply not seen. We have shown in previous studies that when you're able to elicit this kind of response, it's protective against flu strains that mimic pandemic threats,” Lingwood said.

Trafton A. A step toward a universal flu vaccine. MIT News. Published October 7, 2002. Accessed October 23, 2020. https://news.mit.edu/2020/universal-flu-vaccine-1007

Targeting the virus’s stem, not the head, could be the answer. 

Steps Made Towards Universal Flu Vaccine

The National Association of Pediatric Nurse Practitioners (NAPNAP) has revised its position statement on the integration of mental health care in primary care settings. The change was made because of the rise of mental health in the public health realm, according to the organization.

The revised position statement confirms that the holistic, family-centered, longitudinal approach of care delivered at the pediatric primary care level can lead to early identification of mental health issues and behavioral factors contributing to mental health issues of children. Further, pediatric-focused advanced practice registered nurses have the education and skills to meet the increasing demand for pediatric mental health care integration in primary care settings.

“There is a stigma associated with mental health that leads to a reluctance by families to talk to primary care providers about these concerns,” said NAPNAP president Jessica Peck, DNP, APRN, CPNP-PC, CNE, CNL, FAANP, in a prepared statement. “Nurse practitioners in pediatric primary care need to treat every visit as an opportunity to screen a child’s mental health and provide families with the information and resources they need.”

In order to provide comprehensive mental and behavioral health services to all children and adolescents, pediatric-focused nurse practitioners should be guided by the position statement, according to NAPNAP, which recommends practices as follows:

Using a lifespan approach to provide mental and behavioral health promotion

Integrating research findings that optimize physical and mental health in childhood and adolescence, laying the foundation for physical and mental well-being in adulthood

Educating children and families about the early signs and symptoms of mental and behavioral health problems in primary care

Advocating for reimbursement policies that support parity for mental health services provided to children in primary care settings

Educating the public about pediatric mental health conditions and support legislative and other interdisciplinary efforts that aim to bolster children’s mental and behavioral health needs at the local, state, and federal levels

NAPNAP revises position statement on integration of mental health care in primary care settings. NAPNAP [email]. Sent October 21, 2020. Accessed October 21, 2020.

The revised position statement confirms that the holistic, family-centered, longitudinal approach of care delivered at the pediatric primary care level can lead to early identification of mental health issues and behavioral factors contributing to mental health issues of children. 

NAPNAP Revises Position Statement on Integration of Mental Health Care in Primary Care Settings

Columbia University School of Nursing has announced the establishment of the Center for Research on People of Color (CRPC). The center aims to provide multidisciplinary resources for research and educational programming designed to address injustices in health care that disproportionately affect communities of color, according to Columbia University.

The CRPC’s goals are to promote and expand the body of scholarly research related to people of color and to provide consultation and mentoring for researchers. In addition, the CRPC’s body of research will focus on conditions and diseases that disproportionately affect minority populations, such as hypertension, obesity, diabetes, maternal/child health and poor birth outcomes, LGBTQ health, and genomics of health and disease.

“For too long, people of color have not been sufficiently represented in health research, which has perpetuated injustice across the field and broader society,” said Jacquelyn Y. Taylor, PhD, founding director of the center in a prepared statement. “The CRPC seeks to promote health equity and justice through high-quality studies, mentorship for early career researchers, and learning opportunities open to all.”

The CRPC aims to support pilot investigators in conducting research and generating preliminary findings, and it will provide resources for research projects involving people of color, including project databases, access to biological samples located in the CRPC, data management consultation, and support for junior investigators on career development in health equity research.

With the emergence of the coronavirus disease 2019 (COVID-19), the CRPC will examine the interaction between the biological sciences and diverse social factors that contribute to health disparities, such as how COVID-19 is disproportionately affecting the nation’s most vulnerable populations.

“We are excited to launch this important interdisciplinary work and look forward to seeing the CRPC grow and thrive in the years to come” said Lorraine Frazier, PhD, dean of Columbia University School of Nursing and senior vice president, Columbia University Irving Medical Center in a prepared statement. “Under Dr. Taylor’s leadership, the center will be a focal point for important research and for supporting investigators in areas that have not been fully addressed before.”

Columbia University School of Nursing Launches Center for Research on People of Color (CRPC). Columbia School of Nursing. 

https://www.nursing.columbia.edu/news/columbia-university-school-nursing-launches-center-research-people-color-crpc

. Published October 15, 2020. Accessed October 20, 2020.

The CRPC’s goals are to promote and expand the body of scholarly research related to people of color and to provide consultation and mentoring for researchers.

Columbia University School of Nursing Launches Center for Research on People of Color

Telemedicine can help limit the time spent in the emergency department (ED) and help hospitals with demand surges, according to a new study published in 

The coronavirus disease 2019 (COVID-19) pandemic has limited doctors’ offices and hospital visits to help ensure patient and care provider safety. Telemedicine can help bridge the gap rather than diminish the quality of care, according to the study. Additionally, overcrowding in EDs are a common problem in general, which can be costly for hospitals and impact patient experience.

Investigators looked at ED visits in New York from 2010 to 2014, comparing visits that utilized telemedicine versus those that did not.

Investigators found that telemedicine significantly reduces average length of stay. According to the study, this finding is partially driven by flexible resource allocation. Using telemedicine during ED surges can also reduce hospital stays and reduce patient wait times.

The majority (76%), of United States hospitals are already using telemedicine technologies.

"The current pandemic has shown hospitals the great promise of telemedicine application and hopefully the unexpected enrollment of such policies, alongside this research, can help get the process underway to help more health care facilities utilize this technology in [Eds] and elsewhere," study author Susan Lu, PhD said in a prepared statement.

"Policymakers can play a role as well by reducing regulatory barriers that inhibit more expansive use of telemedicine and by creating incentives that encourage hospitals to more broadly adopt telemedicine in emergency rooms,” said Lu.

Adopting telemedicine during ED surges would not increase costs, study authors say, nor would it increase the expense of care quality.

Utilizing telemedicine in the ER can reduce wait times and patient length of stay [News Release] October 16, 2020; West Lafayette, Indiana. 

https://www.eurekalert.org/pub_releases/2020-10/ifor-uti101620.php

Investigators found that using telemedicine can improve patient experience. 

News

All Content