StemCell Therapy

As the facts surrounding the global coronavirus pandemic continue to change at a moments notice, its important to stay informed on the latest news. Doing so can help us make informed decisions to better protect our health. However, as important as it is to stay up to date with the latest news, could we also be harming our mental health?

Its understandable that we all want to spend our free time reading everything about the coronavirus as it helps to provide us with a sense of control, which is what we need during these uncertain times. However, its clear that absorbing too much bad news can be harmful to both our mental and physical health.

According to a survey from the American Psychological Association, most adults admitted to following the news regularly, but 56 % shared that doing so causes them stress. Now with that said, why do we still find ourselves glued to our screens, enamored with every sensational headline?

The fact is being informed allows us to develop tools that we can use to better protect ourselves. Unfortunately, being informed can often come as a cost to our mental health. For instance, research published in the British Journal of Psychology found that after just 14 minutes of watching bad news, participants began to experience negative effects on their mental health. Whats more, heightened stress levels can weaken your immune system, which is the last thing you need especially now.

However, this doesnt mean that you should give up on staying informed and engaged. In fact, there are ways for you to stay informed without compromising your mental health.

Similar to how you establish screen time limits for your kids, you should also set your own time limits when it comes to reading the news. Clicking on a link with a sensational headline can catapult you down a rabbit hole of never-ending information. However, by setting an alarm, you can pull yourself out before you get in too deep and compromise your mental health.

Try to figure out how much time youll need to read the news, and set an actual timer on your phone, be it for 5, 15, or 30 minutes or even an hour. You should then decide how many times a day youll do it for say reading the news for 15 minutes three times per day. Once the time is up, close all your apps or tabs related to the news, and dont open it up again until the next time, or day.

In addition to timing yourself when it comes to reading the news, you should also remember to allocate time to other activities that are good for your mental health. This includes exercising, reading, or any other healthy hobbies.

Different news sources help to provide you with more perspective when it comes to current affairs. However, the constant and multiple news alerts and notifications on your phone can get overwhelming, raising your stress levels.

As such, it would be advisable to limit your notifications and only allow news alerts from sites that you deem necessary. In fact, more information is not necessarily the best way to stay informed. Instead of allowing a barrage of notifications to fill up your phone, rather choose just two or three of the most credible sources and ignore the rest. Sites such as the CDC and the WHO organization are the best sources as they provide the latest, and the most credible information surrounding the coronavirus.

When a news story breaks, were all glued to CNN or refreshing our Twitter timelines in an effort to get the latest updates. While normal, this action can affect your mental health. This is because when a news story breaks, it takes a while to get all the facts straight and oftener than not, the information we see online is more so based on half-truths, speculations, and even conspiracy theories. As a result, these stories may serve to get our attention, but they also serve to increase anxiety and stress levels.

As it takes some time for journalists to collect all the facts, it would be advisable to wait for them to provide a more accurate and well-rounded report.

The last thing you want is to be going to bed with news anxiety, as this will disrupt your sleep, and this is the last thing you need. In addition to weakening your immune system, lack of quality sleep can also affect your mental health by increasing the risk of depression.

Its important to never check the news before bed. This is because you want enough time during the day to process the information. During the day, if you read something that raises your stress levels, youll be able to engage in stress-relieving techniques such as yoga or meditation. Its also advisable to not sleep with your phone too close to you as you may be tempted to read the news as soon as you wake up.

With the constant influx of infection rates and death tolls, the news can get quite depressing. However, its important to remember that there are good things happening in the world. The bad news does not provide a full picture of the days events.

Reading good news can help to relieve some stress accumulated by bad news. So, try to read up on some human interest stories or you can also follow sites like the Good News Network, Positive News, and Optimist Daily.

In addition to getting some good news, you should also try focusing on issues that you can help solve. As the coronavirus pandemic has affected various people in different ways, why dont you go out of your way to research how you can help them? For ways to get involved, or help make a change, check out Global Givings Coronavirus Relief Fund.

Starting your day reading bad news can affect your mood. So, its important to start your day on a more positive note.

Try starting your day by listening to a relaxing podcast that boosts your mood, exercising, meditating, or by even enjoying a cup of coffee on your porch, enjoying the tranquil silence.

If youve been consuming the news, and youre feeling overwhelmed, its important not to suppress your feelings. Doing so can make things worse.

Instead, try reaching out to a friend or family member and talk about your feelings. Additionally, your area may be on lockdown, but psychologists and counselors are still operating online. Therefore, dont shy away from contacting your nearest mental health counseling group.

Yes, you should reach out if you are feeling overwhelmed with crippling coronavirus anxiety. However, you can also make the conscious decision not to discuss the coronavirus if you believe that doing so affects your mental health.

When it comes to the coronavirus, everyone has an opinion, and theyre each looking to share it. As a result, we often feel forced into a conversation. However, youre allowed to not engage if you feel that doing so can bring your mood down. Feel free to change the subject to something more positive.

If all else fails, feel free to simply step back and unplug.

Youre allowed to protect your mental health. If you feel that you need to disconnect from time to time, feel free to do so. Uninstall all your social media apps and disconnect from all news outlets for a period of time. Ask a close friend or family member to only alert you if something is going on that you need to know about.

Yes, its important to stay up to date with the news as this can help us to make more informed decisions. Unfortunately, too much news can affect our health, and thats the last thing we need right now.

Thankfully, there are ways to protect our health and stay informed.

Johnston, W.M. and Davey, G.C.L. (1997), The psychological impact of negative TV news bulletins: The catastrophizing of personal worries. British Journal of Psychology, 88: 85-91. DOI:10.1111/j.2044-8295.1997.tb02622.x

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Here Are 9 Ways To Stay Informed and Protect Your Mental Health - Longevity LIVE

Andrea Bocelli, 61, is the Italian opera singer who will give a special performance at the Duomo of Milan on Easter Sunday,sending a message of love to the world during the coronavirus pandemic. The Italian tenor said of his upcoming performance that it will not be a concert but instead a prayer for the world during one of the most difficult times in our lives. The singer will be accompanied by organist Emanuele Vianelli and will be singing at the historic cathedral. Many believe Bocelli was born blind but in fact he had lost his sight at 12 years old after a football accident.

To say Bocelli has a good voice is an understatement.

Celine Dion described his voice and said: If God would have a singing voice, he must sound a lot like Andrea Bocelli.

Bocelli has soldmore than90 million records worldwide and has brought classical music back into the mainstream.

Bocelli was born with poor eyesight, however, became fully blind after a football accident.

The singer was hit in the eye playing goalkeeper during a match and suffered a brain haemorrhage.

Doctors tried in vain to help restore Bocellis sight, even resorting to using leeches in a last-ditch effort, buttheywere sadly unsuccessful and he remained blind.

Despite his traumatic accident, Bocelli has gone on to become one of the worlds best-selling artists of all time and never allowed his loss of sight to be a hindrance in his career.

The NHS said: A subarachnoid haemorrhage is most often caused by a burst blood vessel in the brain.

A brain aneurysm is a bulge in a blood vessel caused by weakness in the blood vessel wall, usually at a point where the vessel branches off.

As blood passes through the weakened vessel, the pressure causes a small area to bulge outwards like a balloon.

Occasionally, this bulge can burst, causing bleeding around the brain.

Around eight out of every 10 subarachnoid haemorrhages happen in this way.

A brain aneurysm doesnt usually cause any symptoms unless it ruptures.

But some people with unruptured aneurysms experience symptoms such as sight problems, pain on one side of the face or around the eye and persistent headaches.

The BMJ said: Blindness may occur simultaneously with the haemorrhage, it occurs just as frequently after an interval of several days and even weeks.

It would seem to be important to separate these two varieties of blindness in view of their different prognosis, and also in view of the fact that the former recovers with no therapy, whereas the latter variety has a uniformly bad prognosis in spite of treatment.

These cases are not, however, clearly separated in the literature.

It would seem that the former variety is associated with a rapid reduction in the blood-volume and afall in blood-pressure.

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Andrea Bocelli health: How did the singer become blind - symptoms - Express.co.uk

This article is inThe Spectators April 2020 US edition.Subscribe here to get yours.

Before the COVID-19 scare I never thought that one particular Spanish proverb would come in useful. It goes: Los ojos con los codos. This hardly seems to make sense, Eyes with the elbows, but the great 19th-century traveler Richard Ford explains in his Gatherings from Spain that the suns glare on the dusty land may inflame the eyes, which must never be rubbed with the hand, only with the elbow, lest ophthalmia and blindness set in. He also recommends blue gauze spectacles, which I must out.

Now, with the coming of the coronavirus, the public-spirited sneezer will use a pad of paper tissues in her hand, or sneeze into the crook of her elbow, rather than into her hand, which might then infect door handles, transportation-carriage poles or escalator handrails.

It is impossible to use the point of the elbow on the eyes; you cant reach. I mentioned the crook of the elbow, but the Oxford English Dictionary seems to limit the reference of elbow to the pointed, angular part. The elbow is literally the bend (bow) of the ell (which gives us the obsolete measurement), though the Old English word had an n in it: eln. That word is related to Latin ulna (which we use technically for the bone beside the radius). What the inside angle of the elbow is called, who can say? My husband was useless when I asked him, going on about the antecubital fossa. Some call it the elbow-pit, but the OED is ignorant of this term.

Someone who hasnt a clue is often said not to know his ass from his elbow. Richard Ford doesnt give the acknowledged Spanish equivalent, but it is confundir el culo con las tmporas cant tell his ass from his ember days. Ember days are more recondite than elbows, being quarterly fast days, to wit: the Wednesday, Friday, and Saturday following the first Sunday in Lent, Whitsunday, Holy Cross Day (September 14) and St Lucys day (December 13). The origin of ember is most straightforwardly found in the Old English ymbren, meaning revolution of time. But scholars tell us that ember might after all be a corruption of Latin tempora.

Digging up reliable etymologies takes a lot of elbow grease.

This article is inThe Spectators April 2020 US edition.Subscribe here to get yours.

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What do elbows have to do with fighting coronavirus? - The Spectator USA

Regeneron's (NASDAQ:REGN) stock has increased by 34% in 2020 as the company and its partner Sanofi (NASDAQ:SNY) initiated two large scale phase 2/3 clinical trials in March where it is providing an existing drug, Kevzara, to treat patients with severe COVID-19, the disease caused by the novel coronavirus. This development has investors optimistic about its prospects. But Regeneron's financial performance for the full year will be driven by the company's core business of treating eye diseases, asthma, eczema, and cancer.

Let's take a closer look at the biotech stock's main revenue drivers to decide if it's a buy today.

IMAGE SOURCE: GETTY IMAGES

As of April 9, there have been over 1.4 million worldwide confirmed COVID-19 cases and almost 90,000 virus-related deaths. While there are no approved drugs to effectively treat COVID-19 patients, many companies, including Regeneron, have commenced clinical trials to determine whether existing compounds used for other diseases can help these patients recover.

In March, Regeneron and Sanofi announced that they initiated two large phase 2/3 trials to assess whether Kevzara can prevent lung damage and respiratory distress in patients with severe COVID-19. Regeneron and Sanofi currently market Kevzara as a treatment for adult patients with rheumatoid arthritis (RA). Kevzara blocks the interleukin-6 (IL-6) protein, which may cause a patient's immune system to overreact and damage the lungs.

Recently, a preliminary study performed at a Munich Hospital found patients who have a minimal amount of IL-6 protein have significantly lower rates of respiratory failure and may not need mechanical ventilation. Earlier, a small Chinese study showed that patients who received Actemra, Roche Holdings' (OTC:RHHBY) IL-6 receptor antagonist and competing RA drug, were able to be discharged from the hospital and return home.

Eylea, an injectable drug that prevents blindness, grew by 14% in the U.S. to over $4.6 billion in 2019 (about 60% of Regeneron's sales). Eylea's revenues should continue to increase as it the company fully launches a pre-filled syringe delivery option for physicians and continues to market to the drug to adults with age-related macular degeneration (AMD), a disease that affects almost 11 million people in the U.S and is the leading cause of vision loss in Americans 60 and older. Eylea prevents the disease from progressing to an advanced stage and results in rapid, large sustained improvement for patients with mild to moderate AMD.

Regeneron will also benefit from growth in its diabetic eye business as it has established a dedicated salesforce to specifically contact specialists that see these types of patients. The company is devoting a significant amount of resources to improve on the low current rates of diagnosis and treatment of diabetic retinopathy (DR). DR is a complication of diabetes that causes damage to the retina and can lead to severe vision loss. Early treatment with Eylea, however, can halt the progress of DR, reducing the risk of blindness. This is a welcome development for the almost 8 million people who have DR.

Dupixent sales reported by Sanofi grew by almost 151% to over $2.3 billion in 2019 as physicians prescribed the drug to other adult patients with eczema and treated patients in three new sub-segments (asthma, children with eczema, and adults with chronic long-term sinus inflammation linked to nasal polyps). While Sanofi records all of global Dupixent sales on its income statement, it paid Regeneron over $1.4 billion in contribution revenue in 2019, up 40%, relating to royalties and profits from Dupixent (and two other drugs).

Dupixent should continue to grow as it is used for other patients in these three markets and it will enjoy further growth if it obtains approval from the Food and Drug Administration (FDA) for using the drug for asthma in pediatrics, chronic obstructive pulmonary disease, eczema in pediatrics, and several other indications.

Regeneron generated $176 million in revenue from Libatyo in 2019, up from almost $15 million in 2018. Libtayo treats advanced Cutaneous Squamous Cell Carcinoma (CSCC), a form of skin cancer that accounts for an estimated 7,000 deaths each year in the U.S. As of November 2019, its share of U.S. patients with CSCC was 43%, up from 3% when it was launched in October 2018.

Regeneron is currently testing Libtayo in Non-Small Cell Lung Cancer (NSCLC) patients, cervical cancer, and Basal Cell Carcinoma (BCC; the most common form of skin cancer). Libtayo's revenues should increase in the near-term as physicians continue to prescribe the drug for their CSCC patients and the drug is eventually used in other types of cancers.

I consider to be Regeneron a buy right now because it has ample opportunity to increase the revenue and profits it currently generates from its three key drugs, Eylea, Dupixent, and Libtayo. While investors will be waiting for further updates on Kevzara, they should focus and monitor Regeneron's progress in expanding its the diabetic eye segment, further penetrating the three emerging areas for Dupixent, gaining market share in CSCC, and obtaining FDA approval for treating other indications with these drugs.

While it's easy to be enthralled by its progress in the COVID-19 space, investors thinking about buying Regeneron would do well to consider the stock from a more holistic stance. And it looks good from here.

Originally posted here:
Here's Why Regeneron's Stock Is Worth More Than Its Coronavirus Work - Citybizlist Real Estate

A BRAVE boy who won the nation's heart in his battle against leukaemia gave his millions of fans a thumbs up after being discharged from hospital and declared cancer free.

Oscar Saxelby-Lee, 6, was diagnosed with an aggressive blood cancer in December 2018 after his parents noticed unusual bruising on his legs.

Doctors gave Oscar, from Worcester, just months to find a stem cell match to save his life which led parents Olivia Saxelby, 25, and Jamie Lee, 28, to launch a UK-wide appeal for donors.

Last March, a record-breaking 4,855 volunteers queued in the freezing rain after Oscar's Pitmaston Primary School in Worcester opened as a testing centre.

A suitable donor was finally found after a staggering 10,000 people were tested across the UK.

Just months later, Oscar's family faced further anguish when his rare T-cell acute lymphoblastic leukaemia returned.

But after a crowdfunding campaign raised 600,000, his family flew him to Singapore to undergo CAR-T therapy - a pioneering treatment not available on the NHS.

Oscar became only the second child in the world to have the treatment before having a second bone marrow transplant.

Now the boy's thrilled mum Olivia has confirmed he is out of hospital and cancer free.

In a touching picture, brave Oscar, nicknamed Ozzy Bear by his parents, posed in his car seat wearing a protective mask and giving a massive thumbs up.

Writing on the 'Hand in Hand for Oscar' Facebook page, followed by millions worldwide, she said: "He's only gone and done it!!!!!!!

"Thank you from the bottom of our hearts to our AMAZING team at National University Hospital - NUH, you have made miracles happen!

Delighted Olivia added: "We love you all!

"HOME SWEET HOME, WHEREVER IT WILL BE!"

Jen Kelly, director of the Grace Kelly Childhood Cancer Trust, who has kept in touch with the family, said:"They have now been in Singapore for six months and it is incredible that he is still cancer free and that his bone marrow transplant has gone well to date.

"We would like to say a big thank you to the people of Worcestershire for helping us give this lifesaving chance to Oscar and his family."

While Oscar is now out of hospital, he is still returning frequently to Singapore for treatment so will remain there for several more months before returning home to Worcester.

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Throughout his treatment, Oscar has kept in touch with his classmates and teachers from his hospital bed via an innovative robot - nicknamed "Ozzybot".

His headteacher Kate Wilcock, who organised the huge donor registration event and Ozzybot lessons, said: "Incredible news his last results are MRD negative, no disease.

"We are absolutely blown away - the dream has become a reality.

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Brave boy, 6, who won the nations heart as he battled leukaemia gives a thumbs up after being discharged f - The Sun

The Autologous Stem Cell and Non-Stem Cell Based Therapies market research encompasses an exhaustive analysis of the market outlook, framework, and socio-economic impacts. The report covers the accurate investigation of the market size, share, product footprint, revenue, and progress rate. Driven by primary and secondary researches, the Autologous Stem Cell and Non-Stem Cell Based Therapies market study offers reliable and authentic projections regarding the technical jargon.

All the players running in the global Autologous Stem Cell and Non-Stem Cell Based Therapies market are elaborated thoroughly in the Autologous Stem Cell and Non-Stem Cell Based Therapies market report on the basis of proprietary technologies, distribution channels, industrial penetration, manufacturing processes, and revenue. In addition, the report examines R&D developments, legal policies, and strategies defining the competitiveness of the Autologous Stem Cell and Non-Stem Cell Based Therapies market players.

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The major players profiled in this report include:U.S. STEM CELL, INC.Brainstorm Cell TherapeuticsCytoriDendreon CorporationFibrocellLion BiotechnologiesCaladrius BiosciencesOpexa TherapeuticsOrgenesisRegenexxGenzymeAntriaRegeneusMesoblastPluristem Therapeutics IncTigenixMed cell EuropeHolostemMiltenyi Biotec

The end users/applications and product categories analysis:On the basis of product, this report displays the sales volume, revenue (Million USD), product price, market share and growth rate of each type, primarily split into-Embryonic Stem CellResident Cardiac Stem CellsAdult Bone MarrowDerived Stem CellsUmbilical Cord Blood Stem Cells

On the basis on the end users/applications, this report focuses on the status and outlook for major applications/end users, sales volume, market share and growth rate of Autologous Stem Cell and Non-Stem Cell Based Therapies for each application, including-Neurodegenerative DisordersAutoimmune Diseases Cancer and TumorsCardiovascular Diseases

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Objectives of the Autologous Stem Cell and Non-Stem Cell Based Therapies Market Study:

The Autologous Stem Cell and Non-Stem Cell Based Therapies market research focuses on the market structure and various factors (positive and negative) affecting the growth of the market. The study encloses a precise evaluation of the Autologous Stem Cell and Non-Stem Cell Based Therapies market, including growth rate, current scenario, and volume inflation prospects, on the basis of DROT and Porters Five Forces analyses. In addition, the Autologous Stem Cell and Non-Stem Cell Based Therapies market study provides reliable and authentic projections regarding the technical jargon.

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After reading the Autologous Stem Cell and Non-Stem Cell Based Therapies market report, readers can:

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Autologous Stem Cell and Non-Stem Cell Based Therapies Market: Incredible Possibilities, Growth With Industry Study, Detailed Analysis And Forecast To...

SINGAPORE: It was a moment of pure elation for the family of Oscar Saxelby-Lee the six-year-old has finally been discharged from hospital after staying cancer-free for nearly three months.

The British boy has been battling acute lymphoblastic leukaemia since December 2018, and arrived in Singapore forexperimental treatment at the National University Hospital (NUH) that only one other child in the world has received.

Doctors in the UK said that they had exhausted all conventional treatment and that there was only palliative care left for Oscar. Thefamily was told to prepare for the worst.

But after arriving in Singapore in November and starting treatment on Christmas Eve, Oscar has remained MRD (minimal residue disease) negative which means no cancer cells are detected for nearly three months.

He was discharged from hospital on Thursday (Apr 9) and will go back for check-ups every few days.

His mum Olivia told CNA it is the longest period her only son has remained cancer-free since he was diagnosed.

Oscar is defeating the odds. After being told end-of-life care was the only option left for Oscar about eight months ago, he has shown that miracles really do happen, she said.

He is the best he has been in a very long time full of life, living life and enjoying life again.

It has been a huge learning curve, and no doubt will continue to be, but we are grateful. Grateful for this chance, grateful for the team saving Oscars life and also grateful for the experience.

It still feels a little like a dream. We just cant believe it. NUH has saved Oscars life!

NUH TREATMENT WAS OSCARS LAST HOPE

The treatment in Singapore was Oscars last hope. All other treatments had failed to rid him of the cancer - he was still MRD positive after a stem cell transplant and rounds of chemotherapy.

The little boy from Worcester, England flew to Singapore after the family crowdfunded 500,000 (S$885,000) for a new form of treatment, in which immune cells from a patients blood is drawn and equipped with a Chimeric Antigen Receptor (CAR-T).

The receptor binds itself to a specific protein on the cancer cell and activates the CAR-T cells to kill the cancer cells.

This particular form of CAR-T treatment is different and more difficult because the leukaemia cells resemble Oscars immunity system, Associate Professor Allen Yeoh, head of paediatric oncology at NUH, explained previously.

This is compassionate treatment,which means it is not even in the medical trial stage yet.

By the time he arrived in Singapore, Oscar wasweak from the months in hospital isolation and from battling the rare blood cancer.

He got stronger and doctors started treatment on Christmas Eve. On Jan 15, his parents were told he was MRD negative but that was just the first major step towards a full recovery.

Over the last three months, Oscar has battled several conditions as a result of complications and undergone more surgeries and transplants.

He was diagnosed with both Graft versus host disease (GvHD) and Thrombotic microangiopathy(TMA) that caused him shaking spells, pain and weakness.

"WE NEEDED MUM HERE"

Over the last five months, Oscars family has remained in Singapore far from their loved ones in the UK.

Shortly before the COVID-19 pandemic broke out, Oscars grandmother Oomar travelled to Singapore to be with her grandson.

We needed her with us after such a long haul of trauma. She flew knowing of the risks (of contracting COVID-19) and was very worried, Olivia said.

Oomar completed her 14-day stay-home notice and was allowed to see Oscar just as he was overcoming the worst of the TMA.

This was the moment Oscar saw his grandmother for the first time in months:

Oscars life instantly became better, he was ecstatic, said Olivia.

She has been a huge lift for us all, for me especially as well. We all need our mums at times. An extra pair of hands, loving support and someone else to talk to.

The family will remain in Singapore and keep Oscar isolated at the apartmentwhere they've been staying as his immunity system is still recovering, and he will make frequent trips to outpatient clinics in hospital, his mum said.

He isnt out of the woods yet. Being post-transplant puts him even more at risk, and very vulnerable to not just COVID-19, but any cold or illness, she explained.

Thats nearly a year and a half of complete isolation and even in the future, we will have to be very vigilant.

"SINGAPORE IS AN AMAZING COUNTRY"

With the COVID-19 outbreak affecting countries around the world, including the UK and Singapore, the family will stay in Singapore until Oscar has been given the all-clear to fly home.

We all miss home. We miss our friends, our family, our society, our community, Olivia said.

We are really homesick, but we are safe, and we believe we are in the safest place. Singapore is an amazing country, and we feel privileged to be here, even at this difficult time.

We have met so many wonderful people here, from friends, to medics ... each has been an incredible support for us as a family.

Our lives have changed greatly.

The support has been so heartwarming. The well wishes and prayers truly mean so much to us. We are touched by peoples generosity, care and compassion for us as a family and cannot thank everyone both here and back home enough.

Its been one heck of a journey, and Im sure will continue to be, but the support makes it all that little easier.

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British boy fighting rare cancer is discharged after coming to Singapore for experimental treatment - CNA

ISLAMABAD, (UrduPoint / Pakistan Point News - 12th Apr, 2020 ) :Chairman Task Force of Pakistan Science and Technology, Dr Ata ur Rehman on Sunday said that combination of two drugs would have better results in treating coronavirus patients.

The clinical trials of patients had been carried out in Karachi and Lahore for checking the results of Anti-malarial and Erythromycin drugs, he stated in a ptv programe.

The Americans had tested "Hydroxychloroquine in treatment of patients infected with coronavirus but the result was appearing negative. We hope that in Pakistan, Hydroxychloroquine" plus "Erthromycine" would produce results after treating patients of this spreading virus, he added.

The university of health sciences (UHS), was undergoing testing with some 1100 patients to check the effectiveness of the combination of two drugs, he said. "These are different approaches, where our scientists, experts and pathologists were working, " he said. The Chairman hoped that combination of two drugs would be helpful for patients of coronavirus. To a question about threshold of virus, he said intensity of COVID-19, here was less pernicious as compared to European regions.

The Chairman Task Force said the research was underway in different labs of Pakistan for identifying the stages of mutation. Expressing his view as an eminent scientist, he said some nine mutation were being observed in the virus that had entered into this part of the region from outside.

He said intensity of the virus was not as much higher as in the European countries. To another question, he said that Dr Tahir Shamsi, and his team was working on a project of plasma for treating coronavirus patients.

While Dr S.Shah Nawaz with her team was working on stem cell. The third approach, he said that a pharmaceutical company had acquired a shrub from China and for approval, the summery has been sent to Drugs Regulatory Authority of Pakistan (DRAP). About the families of virus, Dr Ata ur Rehman said that we simply called it a third family virus appeared before the world namely COVID-19. He said in the recent history, there was a middle Eastern Respiratory Syndrome (MERS), and Severe Acute Respiratory Syndrome (SARS).

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Combination of two drugs better results in treating coronavirus patients: Dr Ata - UrduPoint News

VANCOUVER, Washington, April 06, 2020 (GLOBE NEWSWIRE) -- CytoDyn Inc. (OTC.QB: CYDY), (CytoDyn or the Company), a late-stage biotechnology company developing leronlimab (PRO 140), a CCR5 antagonist with the potential for multiple therapeutic indications, announced today that the first two COVID-19 patients have been treated with leronlimab under the Companys Phase 2 randomized clinical trial, which is for patients with mild-to-moderate indications. The Company anticipates that enrollment of more patients will accelerate this week at multiple clinical sites.

In addition, the Companys investigational new drug, leronlimab, has now been administered to 15 severely ill COVID-19 patients at four hospitals, 10 patients treated at a leading medical center in the New York City area and five patients at three other hospitals, all under an emergency investigational new drug (EIND), which were granted by the U.S. Food and Drug Administration (FDA) for each individual patient.

CytoDyn also anticipates initiating its other COVID-19 trial this week. This trial is a Phase 2b/3 for severely ill COVID-19 patients and is for 342 patients, double-blinded with a 2:1 ratio (drug to placebo ratio). Patients enrolled in this trial are expected to be administered leronlimab for two weeks, with the primary endpoint being the mortality rate at 14 days. The Company will perform an interim analysis on the data from 50 patients following two weeks of leronlimab therapy.

Bruce Patterson, M.D., Chief Executive Officer and founder of IncellDx, a diagnostic partner and advisor to CytoDyn, commented, We are encouraged by the positive results demonstrated with leronlimab in the New York patients. Our team is working hard to distribute leronlimab to multiple clinical sites to initiate therapy in patients with severe COVID-19 disease. While every patient is experiencing different comorbidities, we are seeing similar clinical responses, which we believe is a reflection of leronlimabs mechanism of action.

Nader Pourhassan, Ph.D., President and Chief Executive Officer of CytoDyn, said, Our partnership with the New York medical team and now other hospitals has been exemplary. We are collaborating in every aspect to deliver leronlimab to patients in order to provide proof of concept as soon as possible. The outstanding coordination among the physicians, the hospital administrators, the FDA, and our team, will hopefully help mitigate the deleterious effects from this pandemic should we prove leronlimab as a solution. The lead physician in New York is a true medical hero, who deserves to be recognized for his contribution to humanity in the pandemic of COVID-19. We are very hopeful of sending the day three and day seven results of the first ten EIND patients to the FDA by the end of this week.

About Coronavirus Disease 2019SARS-CoV-2 was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. The origin of SARS-CoV-2 causing the COVID-19 disease is uncertain, and the virus is highly contagious. COVID-19 typically transmits person to person through respiratory droplets, commonly resulting from coughing, sneezing, and close personal contact. Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals. For confirmed COVID-19 infections, symptoms have included fever, cough, and shortness of breath. The symptoms of COVID-19 may appear in as few as two days or as long as 14 days after exposure. Clinical manifestations in patients have ranged from non-existent to severe and fatal. At this time, there are minimal treatment options for COVID-19.

About Leronlimab (PRO 140) The FDA has granted a Fast Track designation to CytoDyn for two potential indications of leronlimab for deadly diseases. The first as a combination therapy with HAART for HIV-infected patients and the second is for metastatic triple-negative breast cancer. Leronlimab is an investigational humanized IgG4 mAb that blocks CCR5, a cellular receptor that is important in HIV infection, tumor metastases, and other diseases, including NASH. Leronlimab has completed nine clinical trials in over 800 people, including meeting its primary endpoints in a pivotal Phase 3 trial (leronlimab in combination with standard antiretroviral therapies in HIV-infected treatment-experienced patients).

In the setting of HIV/AIDS, leronlimab is a viral-entry inhibitor; it masks CCR5, thus protecting healthy T cells from viral infection by blocking the predominant HIV (R5) subtype from entering those cells. Leronlimab has been the subject of nine clinical trials, each of which demonstrated that leronlimab could significantly reduce or control HIV viral load in humans. The leronlimab antibody appears to be a powerful antiviral agent leading to potentially fewer side effects and less frequent dosing requirements compared with daily drug therapies currently in use.

In the setting of cancer, research has shown that CCR5 may play a role in tumor invasion, metastases, and tumor microenvironment control. Increased CCR5 expression is an indicator of disease status in several cancers. Published studies have shown that blocking CCR5 can reduce tumor metastases in laboratory and animal models of aggressive breast and prostate cancer. Leronlimab reduced human breast cancer metastasis by more than 98% in a murine xenograft model. CytoDyn is, therefore, conducting a Phase 1b/2 human clinical trial in metastatic triple-negative breast cancer and was granted Fast Track designation in May 2019.

The CCR5 receptor appears to play a central role in modulating immune cell trafficking to sites of inflammation. It may be crucial in the development of acute graft-versus-host disease (GvHD) and other inflammatory conditions. Clinical studies by others further support the concept that blocking CCR5 using a chemical inhibitor can reduce the clinical impact of acute GvHD without significantly affecting the engraftment of transplanted bone marrow stem cells. CytoDyn is currently conducting a Phase 2 clinical study with leronlimab to support further the concept that the CCR5 receptor on engrafted cells is critical for the development of acute GvHD, blocking the CCR5 receptor from recognizing specific immune signaling molecules is a viable approach to mitigating acute GvHD. The FDA has granted orphan drug designation to leronlimab for the prevention of GvHD.

About CytoDyn CytoDyn is a late-stage biotechnology company developing innovative treatments for multiple therapeutic indications based on leronlimab, a novel humanized monoclonal antibody targeting the CCR5 receptor. CCR5 appears to play a critical role in the ability of HIV to enter and infect healthy T-cells. The CCR5 receptor also appears to be implicated in tumor metastasis and immune-mediated illnesses, such as GvHD and NASH. CytoDyn has successfully completed a Phase 3 pivotal trial with leronlimab in combination with standard antiretroviral therapies in HIV-infected treatment-experienced patients. CytoDyn plans to seek FDA approval for leronlimab in combination therapy and plans to complete the filing of a Biologics License Application (BLA) in April of 2020 for that indication. CytoDyn is also conducting a Phase 3 investigative trial with leronlimab as a once-weekly monotherapy for HIV-infected patients. CytoDyn plans to initiate a registration-directed study of leronlimab monotherapy indication. If successful, it could support a label extension. Clinical results to date from multiple trials have shown that leronlimab can significantly reduce viral burden in people infected with HIV with no reported drug-related serious adverse events (SAEs). Moreover, a Phase 2b clinical trial demonstrated that leronlimab monotherapy can prevent viral escape in HIV-infected patients; some patients on leronlimab monotherapy have remained virally suppressed for more than five years. CytoDyn is also conducting a Phase 2 trial to evaluate leronlimab for the prevention of GvHD and a Phase 1b/2 clinical trial with leronlimab in metastatic triple-negative breast cancer. More information is at http://www.cytodyn.com.

Forward-Looking Statements This press release contains certain forward-looking statements that involve risks, uncertainties and assumptions that are difficult to predict. Words and expressions reflecting optimism, satisfaction or disappointment with current prospects, as well as words such as believes, hopes, intends, estimates, expects, projects, plans, anticipates and variations thereof, or the use of future tense, identify forward-looking statements, but their absence does not mean that a statement is not forward-looking. The Companys forward-looking statements are not guarantees of performance, and actual results could vary materially from those contained in or expressed by such statements due to risks and uncertainties including: (i) the sufficiency of the Companys cash position, (ii) the Companys ability to raise additional capital to fund its operations, (iii) the Companys ability to meet its debt obligations, if any, (iv) the Companys ability to enter into partnership or licensing arrangements with third parties, (v) the Companys ability to identify patients to enroll in its clinical trials in a timely fashion, (vi) the Companys ability to achieve approval of a marketable product, (vii) the design, implementation and conduct of the Companys clinical trials, (viii) the results of the Companys clinical trials, including the possibility of unfavorable clinical trial results, (ix) the market for, and marketability of, any product that is approved, (x) the existence or development of vaccines, drugs, or other treatments that are viewed by medical professionals or patients as superior to the Companys products, (xi) regulatory initiatives, compliance with governmental regulations and the regulatory approval process, (xii) general economic and business conditions, (xiii) changes in foreign, political, and social conditions, and (xiv) various other matters, many of which are beyond the Companys control. The Company urges investors to consider specifically the various risk factors identified in its most recent Form 10-K, and any risk factors or cautionary statements included in any subsequent Form 10-Q or Form 8-K, filed with the Securities and Exchange Commission. Except as required by law, the Company does not undertake any responsibility to update any forward-looking statements to take into account events or circumstances that occur after the date of this press release.

CYTODYN CONTACTSInvestors: Dave Gentry, CEO RedChip Companies Office: 1.800.RED.CHIP (733.2447) Cell: 407.491.4498 dave@redchip.com

More:
First Two Patients Enrolled in Randomized Phase 2, COVID-19 Trial with Leronlimab; Five More Severely Ill COVID-19 Patients Treated Under Emergency...

Type 2 diabetes affects insulin in the body. Symptoms of type 2 diabetes include increased thirst, increased hunger, headaches and tiredness. Everybody needs insulin to live and has an essential job to help keep the body healthy. Insulin allows the glucose in the blood to enter the cells and fuel the body. When a person has type 2 diabetes, the body still breaks down carbohydrate from the food and drink and turns it into glucose.

The pancreas responds to this by releasing insulin, however, this insulin cant work properly, and blood sugar levels keep rising and more insulin is released.

This plays havoc on the body with various warning signs that the blood sugar levels are too high.

Left untreated, high blood sugar levels could cause strokes or heart attacks.

There is another side effect to ones health caused by high blood sugars and is knowns as neuropathy.

What is it?

For people with type 2 diabetes, foot complications such as neuropathy and circulation problems can make it difficult for wounds to heal.

Serious problems could arise and other foot issues such as calluses are also common in people with type 2 diabetes.

While calluses may not seem a big problem, left untrimmed they can turn into ulcers or open sores.

People with diabetes are also at risk for Charcot joint, a condition in which a weight-bearing joint progressively degenerates, and this could lead to bone loss or deformity in the feet.

The NHS said: Peripheral neuropathy develops when nerves in the bodys extremities, such as the feet, are damaged.

The symptoms depend on which nerves are affected. In the UK its estimated almost one in 10 people aged 55 or over are affected by peripheral neuropathy.

The main symptoms of neuropathy can include a numbness and tingling in the feet or hands, burning, stabbing or shooting pain in affected areas, loss of balance and co-ordination and muscle weakness, especially in the feet.

These symptoms are usually constant but may come and go.

Read the original here:
Type 2 diabetes: The major warning in your feet due to blood sugar levels being too high - Express

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Physicians in China are reporting what they believe is the first case of COVID-19 initially presenting as acute Guillain-Barre syndrome (GBS). The patient was a 61-year-old woman returning home from Wuhan during the pandemic.

"GBS is an autoimmune neuropathy, which could be triggered by various infections," corresponding author Sheng Chen, MD, PhD, Shanghai Jiao Tong University School of Medicine, China, told Medscape Medical News.

However, "Our single case report only suggests a possible association between GBS and SARS-CoV-2 infection. It may or may not have a causal relationship," Chen noted.

The case study was published online April 1 in Lancet Neurology.

The female patient returned from Wuhan on January 19 but denied having any fever, cough, chest pain, or diarrhea. She presented on January 23 with acute weakness in both legs and severe fatigue that progressed.

At presentation, temperature was normal, oxygen saturation was 99% on room air, and the patient's respiratory rate was 16 breaths per minute. She was not tested for SARS-CoV-2 at that point.

A neurologic examination revealed symmetric weakness (Medical Research Council grade 4/5) and areflexia in both legs and feet. The patient's symptoms had progressed 3 days after admission, and testing revealed decreased sensation to light touch and pinprick.

Admission laboratory test results indicated a low lymphocyte count and thrombocytopenia. Results of nerve conduction studies performed on day 5 of hospitalization were consistent with demyelinating neuropathy.

She was diagnosed with GBS and given intravenous immunoglobulin. On day 8, she developed a dry cough and fever, and a chest CT showed ground-glass opacities in both lungs. At this point, she was tested for SARS-CoV-2, and the results were positive.

The patient was immediately transferred to an isolation room and received supportive care and antiviral drugs. Her condition improved gradually, and her lymphocyte and thrombocyte counts were normalon day 20.

At discharge on day 30, she had normal muscle strength in both arms and legs, and tendon reflexes in both legs and feet had returned. Her respiratory symptoms had resolved as well. A second SARS-CoV-2 test was negative.

Two relatives of the patient who had been with her during her hospital stay also tested positive for SARS-CoV-2 and were isolated and treated.

All of the hospital staff that cared for the patient, including two neurologists and six nurses, tested negative for SARS-CoV-2.

Given the temporal association, SARS-CoV-2 infection could be responsible for the development of GBS in this patient, the investigators note. They add that the onset of GBS symptoms overlapped with the period of SARS-CoV-2 infection.

"Hence Guillain-Barre syndrome associated with SARS-CoV-2 might follow the pattern of a parainfectious profile, instead of the classic postinfectious profile, as reported in Guillain-Barre syndrome associated with Zika virus," the researchers write.

"More cases with epidemiological data are necessary to support a causal relationship" between SARS-CoV-2 infection and GBS, said Chen.

"However, we still suggest physicians who encounter an acute GBS patient from a pandemic area protect themselves carefully and test [for the] virus on admission. If the result is positive, the patient needs to be isolated," Chen said.

Lancet Neurol. Published online April 1, 2020. Full text

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First Case of COVID-19 Presenting as Guillain-Barr Reported - Medscape

The Southern Railway has asked the Divisional Railway Hospital at Tiruchi to recruit doctors, nurses, pharmacists, lab assistants, radiographers, hospital attendants and housekeeping assistants on contract basis for a period of three months in view of COVID-19 pandemic.

Based on a communication from the Principal Chief Medical Director, Southern Railway, the Tiruchi divisional railway authorities have issued a notification for the recruitment of doctors and para-medical staff at the divisional railway hospital here. The interview for these posts would be held online on different dates this month with monthly remuneration fixed for each category.

Senior railway officials told The Hindu on Friday that the plan was to recruit 36 doctors of which 27 would be general duty medical officers; three anaesthetists; three general medicine and three chest physicians. Thirty-six nurses and and an equal number of hospital attendants are proposed to be recruited. A total number of 72 housekeeping assistant would be recruited and 12 each for the posts of pharmacist, lab assistant and radiographer.

As per the notification, the online interview for the contract medical practitioners (doctors) was scheduled on April 16, while it was April 17 for the posts of nurses and pharmacist. The online interview for lab assistant, radiographer, hospital attendant and housekeeping assistant was slated on April 18. The doctors and para-medical staff were expected to be recruited before this month-end and posted in shifts, a senior official attached to the Medical Department said.

The recruitment would be done in consultation with the Divisional Railway Manager in accordance with the Standard Operating Procedure on medical matters. The existing strength of doctors at the divisional railway hospital at Tiruchi was 19. They belonged to different specialities such as Ortho, Opthalmology, Gynaecology, Anaesthesia, General Surgery, General Medicine and Paediatrics.

In the wake of the spread of COVID-19, the railway hospital here has been designated as hospital for COVID-19. An isolation ward was created at the hospital early last month. The Southern Railway administration has also stated that 110 out of the 197 beds at the divisional railway hospital here could be spared for the State government for COVID-19.

The railway administration has also made it clear that accommodation and food for the contract medical practitioners and contract paramedical staff should be taken care as they would not be permitted to go to their homes during the duty period in view of the high infectivity of COVID-19. Food could be arranged through the IRCTC or through the Commercial Department, the administration further said.

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Railway hospital to recruit doctors - The Hindu

Arthritis is a common condition that can affect people of all ages, according to the NHS. But you could lower your risk of developing painful arthritis symptoms by simply eating more limes, it's been claimed.

Arthritis pain can lead to a number of debilitating symptoms that patients will want to try and avoid.

The condition can make life more difficult when carrying out simply, every day tasks.

But, just some simple lifestyle changes could go a long way in helping to prevent arthritis symptoms from flaring up.

One of the easiest ways to lower your chances of developing symptoms is to regularly eat limes, it's been claimed.

READ MORE: Arthritis causes - does cracking your fingers cause arthritis?

"While theres no miracle diet for arthritis, fortunately, many foods can help fight inflammation and improve joint symptoms," said the Arthritis Foundation.

"For starters, a diet rich in fruits, vegetables, fish, nuts and beans but low processed foods and saturated fat, is not only great for overall health, but can also help manage disease activity.

"If this advice sounds familiar, its because these are the principles of the Mediterranean diet, which is frequently touted for its anti-aging and disease-fighting powers.

"Citrus fruits like oranges, grapefruits and limes are rich in vitamin C. Research shows getting the right amount of that vitamin aids in preventing inflammatory arthritis and maintaining healthy joints."

Read the rest here:
Arthritis - the exotic fruit you should add to your breakfast routine to prevent symptoms - Express

Massachusetts General Hospital, Brigham and Womens Hospital, Tufts Medical Center, and Beth Israel Deaconess Medical Center are among 64 hospitals at 51 US sites where the drug is being tested. All told, about 1,000 patients are participating in the study. Sibold couldnt specify how many of them are in Massachusetts.

Patients began receiving doses the week of March 16. Sibold said its way too soon to discuss whether the drug is helping them.

We have to see the data," he said. Im hopeful in the sense that we need more solutions for COVID-19, and if this can have a positive effect on patients, thats a wonderful thing.

The primary goal of the clinical trial is to determine if Kevzara lowers fever and then curbs the need for supplemental oxygen to help patients breathe, according to a Sanofi spokeswoman.

Scientists around the world are studying at least 95 potential treatments for the coronavirus in laboratories and hospitals, according to an online tracker by the Milken Institute, a nonprofit think tank in Santa Monica, Calif. The possible treatments include several decades-old medicines approved for diseases ranging from HIV to influenza.

Kevzara was developed by Sanofi and Regeneron and approved in 2017 to treat rheumatoid arthritis, an autoimmune disorder that causes the bodys immune system to mistakenly attack tissues. Researchers believe it might be useful because many patients who become critically ill with COVID-19 experience a cytokine storm, a runaway response in which the immune system attacks the bodys organs. Some researchers believe drugs that suppress the immune system, including monoclonal antibodies such as Kevzara, might counter that.

Its a really promising approach, said Dr. Kathryn Stephenson, an assistant professor of medicine at Harvard Medical School and co-investigator in the study of Kevzara at Beth Israel. We know that theres a really prominent piece of this disease process that has to do with a huge rise in inflammation. At the point where patients are getting really sick, it looks like were going to need some intervention to turn down the immune response.

A recent study in China of 21 COVID-19 patients with acute respiratory distress found that Actemra, a similar rheumatoid arthritis medicine made by Swiss drug giant Roche, helped suppress that overreaction. The study, which wasnt peer-reviewed, found that fevers in patients who received Actemra fell rapidly and that within a matter of days, most didnt need supplemental oxygen. Roche is now running a clinical trial of that medicine in coronavirus patients, with research sites that include Boston.

Regeneron is overseeing the clinical trial of Kevzara in the United States. Sanofi, whose roughly 4,800 employees at Sanofi Genzyme make up one of the largest workforces of any drug maker in Massachusetts, is overseeing testing of Kevzara on patients in Italy, Spain, Germany, France, Canada, and Russia.

Sanofi is also launching two clinical trials of hydroxychloroquine, an old malaria drug that it sells outside the United States under the brand name Plaquenil. The medicine has been in use since the 1950s. Sanofi began making as much of it as it could in February after Chinese data indicated the medicine could help some patients with coronavirus.

One of the trials including about 210 patients will take place in the United States, France, and the Netherlands and will test the malaria drug on coronavirus outpatients during the early stage of the disease.

The second hydroxychloroquine trial will take place in France, Germany, the United Kingdom, Denmark, and the Czech Republic. It will focus on people hospitalized with moderate and severe cases of the disease, and will include about 300 patients.

President Trump has aggressively promoted the malaria drug as a treatment for COVID-19, although experts have warned that it has yet to be proved safe or effective for coronavirus.

Sanofi is also working on two potential vaccines to prevent coronavirus. One is a collaboration with Lexington-based Translate Bio and seeks to develop a new messenger RNA vaccine. The other is a collaboration with the Biomedical Advanced Research and Development Authority, part of the US Department of Health and Human Services, and relies on recombinant DNA.

The World Health Organization lists more than 40 potential vaccines in development globally.

Jonathan Saltzman can be reached at jonathan.saltzman@globe.com

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Sanofis rheumatoid arthritis drug will be tested on coronavirus patients at four Mass. hospitals - The Boston Globe

In a cohort of women with rheumatoid arthritis (RA) and psoriatic arthritis (PsA), the effect of their conditions considerably varied before, during, and after pregnancy, thereby emphasizing the importance of patients and clinicians working together for informed decision making at all stages, according to findings published in Scientific Reports.

Given the concerns faced by childbearing women with RA or PsA, the study investigators had the following objectives: (1) to better understand fertility within this population; (2) to describe their peripartum periods in terms of preconception counseling, time to pregnancy, requirement for infertility treatment, unplanned/planned pregnancy, number of pregnancies prior to and after inflammatory arthritis (IA) diagnosis, pregnancy outcomes, disease activity during and after pregnancy, type of delivery and breastfeeding; (3) to better understand choices made regarding RA/PsA medications; and (4) to better understand fetal and maternal outcomes in terms of neonatal, labor, and delivery complications. To this end, investigators conducted a retrospective survey-based evaluation of the peripartum period in patients with RA/PsA participating in the Rheumatoid Arthritis Pharmacovigilance Program and Outcomes Research in Therapeutics prospective cohort in northern Alberta, Canada, which is a prospective inception cohort of IA patients on biologics, ongoing since 2004.

Of the 162 patients completing the survey, 234 pregnancies occurred among 103 patients, with 164 pregnancies occurring before RA/PsA diagnosis and 70 occurring after diagnosis. Outcomes included 1.9% stillbirths, 15% therapeutic abortions, 23% miscarriages, and 96% live births. Some 33% of the participants had fewer children than desired due to RA/PsA disease activity (14/34), RA/PsA medications (15/34), social reasons (5/34), infertility (5/34), and other comorbidities (5/34).

Among the 63 pregnancies occurring after diagnosis (and excluding those ending in therapeutic abortion), 49% obtained preconception counseling. In terms of disease control, discontinuing medication, and complications including gestational diabetes, preeclampsia/eclampsia, pregnancy-induced hypertension, placental abruption, multiple pregnancies, intrauterine growth restriction, disease flares, and hospitalizations no statistically significant differences were found between those receiving preconception counseling (31/63) vs those who did not (32/63).

Although 65% (41/63) of pregnancies occurring after diagnosis described good disease control during pregnancy, 73.7% (28/38) experienced disease flares in the first 3 months postpartum (19/28, 67.9%). IA medications were discontinued in 79% of pregnancies, and 35% (22/63) of pregnancies occurred while patients were on biologics at or prior to conception. Five patients continued biologic therapy for all or part of their pregnancies (3/5 with complications: ectopic pregnancy, flare, intrauterine growth restriction, multiple birth).

Gestational age at time of delivery was 37 to 40 weeks in 66% (83/126) of prearthritis vs 58% (33/57) of postarthritis pregnancies. Comparing pregnancies before RA/PsA diagnosis with those after diagnosis, no statistically significant differences were found for fertility treatment, pregnancy planning, neonatal complications, birth defect frequency, or pregnancy and labor/delivery complications. Neonatal ICU admissions were significantly lower in prearthritis pregnancies compared with postarthritis pregnancies. No pregnancy complications were seen in 24 of 54 pregnancies in women on medications compared with 6 of 9 pregnancies in women not on medications.

Study investigators concluded that these findings show peri-partum complications in RA/PsA patients do not significantly increase in patients with good disease control; however, neonatal ICU admissions are increased in women with RA/PsA revealing the importance of decision-making before, during and after pregnancy. Most patients discontinued RA/PsA medication during pregnancy andonly a minority of patients continued biologics during pregnancy. Therefore, providing patients with medication and disease information is essential to ensure that patients make informed and educated reproductive decisions.

Reference

Dissanayake TD, Maksymowych WP, Keeling SO. Peripartum issues in the inflammatory arthritis patient: A survey of the RAPPORT registry. Sci Rep. 2020;10(1):3733.

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Outcomes Associated With Inflammatory Arthritis Diagnosis Before, During, and After Pregnancy - Rheumatology Advisor

A link between homocitrullination and the development of interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA) may exist, according to the results of a cross-sectional study published in the Annals of the Rheumatic Diseases.

RA-associated ILD (RA-ILD) is associated with high mortality, therefore early detection is necessary for establishing an individualized treatment strategy in these patients. Anti-carbamylated protein antibodies (Anti-CarP) are associated with poor disease outcomes in patients with RA and have been detected in various chronic lung diseases regardless of RA history. Thus, researchers analyzed the association between Anti-CarP and ILD in RA patients.

A total 179 patients were enrolled in the study; 37 (21%) of whom were diagnosed with RA-ILD. The researchers found that Anti-CarP specificities were more frequent in patients with RA-ILD. Anti-CarP specificities showed a robust effect towards increasing the odds of ILD in a multivariate analysis. In addition, serum titers of Anti-CarP were significantly higher in patients with RA-ILD and The researchers also observed similar findings in the replication sample.

This is the first time that an association between RA-ILD and Anti-CarP was demonstrated, independent of smoking, sex, age, RA disease duration, anticitrullinated protein antibody, and rheumatoid factor.

It is important to note that this study had several limitations: a relatively small proportion of patients with RA-ILD was included and treatment and disease activity were not included. Additionally, most patients were of Mediterranean Caucasian origin, which has been associated with a less aggressive RA course and a lower prevalence of extra-articular disease.

In conclusion, a robust association between different Anti-CarP and RA-ILD was found after adjusting for multiple confounders, the researchers stated. These findings pose the debate whether a link between homocitrullination and the development of this devastating extra-articular manifestation exists. However, these results should be interpreted with caution and further studies are needed.

Reference

Castellanos-Moreira R, Rodrguez-Garca SC, Gomara MJ, et al. Anti-carbamylated proteins antibody repertoire in rheumatoid arthritis: evidence of a new autoantibody linked to interstitial lung disease [published online March 10, 2020]. Ann Rheum Dis. doi:10.1136/annrheumdis-2019-216709

Read more:
Homocitrullination May Be Linked to Interstitial Lung Disease in Rheumatoid Arthritis - Pulmonology Advisor

Compared with patients without access restrictions to biologic or targeted synthetic disease-modifying antirheumatic drugs (DMARDs) or with psoriatic arthritis (PsA) only, patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) whose insurance plans restrict access to these DMARDs have lower odds of treatment effectiveness, according to study results published in PharmacoEconomics Open.

According to the researchers, novel DMARDs can slow disease progression in RA and PsA; however, many health insurance plans require prior authorization or step therapy for access to these treatments. The objective of this study was to compare treatment effectiveness in patients with RA or PsA with and without plan-level access restrictions to biologic or targeted synthetic DMARDs, and also to compare medication adherence between each group.

Researchers used the IBM MarketScan Commercial Claims and Encounters Database to analyze data from patients aged 18 to 64 years with RA or PsA with 1 claims for subcutaneous biologic DMARDs between January 2014 and December 2015. Patients included in the study were stratified into 1 of 2 cohorts: RA with or without PsA, and PsA only. The primary outcome was treatment effectiveness during the 12 months after the first DMARD claim; the secondary outcome was adherence to the index medication. Multivariate analysis was used to examine differences in the primary outcome of treatment effectiveness between patients with and without DMARD access restrictions.

Researchers revealed that among patients with RA (n=3993) and PsA (n=1713), 34.2% and 35.1%, respectively, had plan-level access restrictions. Among patients with access restrictions, 70.5% and 78.9% of patients with RA and PsA, respectively, had plans that required step therapy. The odds of treatment effectiveness during the 12-month follow-up were 19% lower among patients with RA (odds ratio [OR], 0.81; 95% CI, 0.67-0.98; P =.033) and 27% lower among patients with PsA whose plans included step therapy (OR, 0.73; 95% CI, 0.5-0.98; P =.037) compared with patients whose plans did not include step therapy. The odds of medication adherence among patients enrolled in plans with vs without step therapy were 19% lower among patients with RA (OR, 0.81; 95% CI, 0.68-0.96; P =.014) and 29% lower among patients with PsA (OR, 0.71; 95% CI, 0.54-0.94; P =.017).

Study limitations included possible miscoding or undercoding of the datasets used, lack of control for several baseline characteristics and medication use behaviors in patients, and the inability to generalize data for patients who were uninsured or had other types of insurance plans.

Researchers concluded, Compared with patients in plans without access restrictions or with PsA only, patients [with] RA and PsA in insurance plans with step therapy had lower odds of treatment effectiveness, mainly [because of] lower odds of adhering to treatment, during the 12 months [after] subcutaneous [biologic] DMARD initiation.

Disclosure: This clinical trial was supported by Elli Lilly and Company. Please see the original reference for a full list of authors disclosures.

Reference

Boytsov N, Zhang X, Evans KA, Johnson BH. Impact of plan-level access restrictions on effectiveness of biologics among patients with rheumatoid or psoriatic arthritis. Pharmacoecon Open. 2020;4(1):105-117.

Originally posted here:
Lower Treatment Effectiveness in Patients With RA and PsA With Insurance Restrictions for DMARDs - Rheumatology Advisor

Magician Dynamo has told of how his pre-exisiting health conditions made his experience of coronavirus "severe."

Dynamo - real name Stephen Frayne - suffers from Crohn's disease and arthritis.

This morning he told Chris Evans' Virgin Radio Breakfast Show that he's been healing up after sticking to the guidelines by self-isolating and resting.

"I was obviously struck down by COVID," he told Chris, "My case was possibly a mild case, but it got quite severe because of my existing condition."

He added: "Last couple of weeks, I've spent a lot of time in bed.

"I've been self-isolating and following all of the rules. Now I'm definitely feeling in much better spirits."

The drugs he takes for Crohn's disease can hamper the immune system, making him high risk.

Dynamo offered a message of hope for the future, continuing: "If anything, it just in some ways shows that we shouldn't take things for granted and we should just make the most of the moments that we go through.

"I hope everyone's taking this time as well to take care of themselves, and trying to be positive and use this time wisely."

He's been open about his experience with coronavirus, even telling the Mirror that he feels he'd been helped in his fight against the big by adversity early on in his life.

"Some of my greatest triumphs have come from dark places," he revealed, "My whole outlook on life came from not having a father figure - someone to guide me.

"I had to make my own path."

Dynamo went on to compare himself to rapper Eminem, and late singer Amy Winehouse.

"If you look at Amy Winehouse," he said, "A lot of her greatness came from the negative things she'd been through.

"Eminem's best work came because he was an angry young man who hated the world and the cards he'd been dealt.

"But he took it, and made something phenomenal."

More:
Dynamo says his coronavirus became 'severe' because of his Crohn's disease and arthritis - Mirror Online

Updated with new information on April 7 at 4 p.m. ET.

The world is now desperate to find ways to slow the spread of the novel coronavirus and to find effective treatments. As of April 6, more than 200 clinical trials of COVID-19 treatments or vaccines that are either ongoing or recruiting patients. New ones are being added every day, as the case count in the U.S. (and globally) skyrockets. The drugs being tested range from repurposed flu treatments to failed ebola drugs, to malaria treatments that were first developed decades ago. Here, we take a look at several of the treatments that doctors hope will help fight COVID-19.

An oral drug called EIDD-2801 has shown promise in test-tube experiments with human lung and airway cells, scientists reported online April 6 in the journal Science Translational Medicine. The drug might even be more efficient at blocking the novel coronavirus, SARS-CoV-2, than remdesivir, a drug being tested against COVID-19 in clinical trials that began in March. While remdesivir stops the novel coronavirus from replicating entirely, EIDD-2801 introduces genetic mutations into the viruss RNA. As the RNA makes its copies, so many damaging mutations accumulate that the virus is no longer able to infect cells, Scientific American reported. The drug also seems to work against several RNA viruses, and as such, the researchers said it could be a multipurpose antiviral.

And unlike remdesivir, which needs to be given intravenously, this drug could be swallowed as a pill. "EIDD-2801 is an oral drug that could be administered at home, early after diagnosis," lead study author Timothy Sheahan, of the Department of Epidemiology at the University of North Carolina at Chapel Hill, said in a statement from the journal. "This has the potential to be as ubiquitous as Tamiflu in the future, as long as it proves to be safe and effective in people."

The research was completed by scientists at Emory University, UNC Chapel Hill and Vanderbilt University Medical Center in Nashville. The Miami, Florida-based Ridgeback Biotherapeuticshas licensed the drug and was just granted permission by the Food and Drug Administration to start human trials of the drug over the next few months, the company said in a statement.

A drug developed by Fujifilm Toyama Chemical in Japan is showing promising outcomes in treating at least mild to moderate cases of COVID-19, Live Science previously reported.

The antiviral drug, called favipiravir or Avigan, has been used in Japan to treat influenza, and last month, the drug was approved as an experimental treatment for COVID-19 infections, Pharmaceutical Technology reported.

So far, reports suggest the drug has been tested in 340 individuals in Wuhan and Shenzhen. "It has a high degree of safety and is clearly effective in treatment," Zhang Xinmin, of China's science and technology ministry, said March 17, The Guardian reported.

The drug, which works by preventing certain viruses from replicating, seemed to shorten the duration of the virus as well as improve lung conditions (as seen in X-rays) in tested patients, though the research has yet to be published in a peer-reviewed science journal.

A separate study, published April 8 to the preprint database medrXiv, which has not yet been peer-reviewed, compared favipiravir to another flu drug, umifenovir (Arbidol). In the randomized, controlled study of 240 people, favipiravir did not help people recover faster compared to umifenovir. However, favipiravir did significantly shorten the time that people had fevers or coughs, the study found.

Chloroquine and hydroxychloroquine have been approved by the U.S. Food and Drug Administration for the treatment of malaria, lupus and rheumatoid arthritis, but preliminary research in human and primate cells suggests that the drugs could effectively treat COVID-19.

A 2005 study found that chloroquine could quell the spread of SARS-CoV when applied to infected human cells in culture. SARS-CoV is closely related to the novel coronavirus, SARS-CoV-2, and caused an outbreak of severe acute respiratory syndrome in 2002. Chloroquine disrupts the ability of the SARS-CoV virus to enter and replicate in human cells, Live Science previously reported. The cell culture studies of SARS-CoV-2 revealed that the drug and its derivative hydroxychloroquine undermine the novel virus' replication in a similar way.

Doctors in China, South Korea, France and the U.S. are now giving the drug to some patients with COVID-19 with promising, albeit anecdotal, results so far. The FDA is organizing a formal clinical trial of the drug.

As of Feb. 23, seven clinical trials had been registered in the Chinese Clinical Trial Registry to test whether COVID-19 infections could be treated with hydroxychloroquine. In addition, the University of Minnesota is studying whether taking hydroxychloroquine can protect people living with infected COVID-19 patients from catching the virus themselves.

In one heavily referenced study, conducted in France, a small number of patients with COVID-19 received either hydroxychloroquine alone or hydroxychloroquine in combination with an antibiotic called azithromycin. The authors reported that detectable concentrations of SARS-CoV-2 fell significantly faster in the study participants than coronavirus patients at other French hospitals who did not receive either drug. In six patients also given azithromycin, this promising effect appeared to be amplified.

However, the CDC noted that the small, non-randomized study "did not assess clinical benefit[s]" associated with the treatment; in other words, the study did not probe whether the treated patients were more likely to recover and survive their illness. Additionally, the agency advised that doctors should be cautious when giving either drug to patients with chronic disease, such as kidney failure, and especially those "who are receiving medications that might interact to cause arrhythmias."

A Gilead Sciences drug that was originally tested in people with Ebola, remdesivir, is being repurposed to see if it can effectively treat COVID-19.

The drug was found not to be effective in Ebola, but in lab studies, it has proven effective at inhibiting the growth of similar viruses, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). In a petri dish, remdesivir can prevent human cells from becoming infected with SARS-CoV-2, according to a letter published in the journal Nature in February.

The Food and Drug Administration has currently approved use of remdesivir for compassionate use, meaning only patients with severe COVID-19 disease can be approved for treatment. In other countries, requirements to receive remdesivir may be less stringent.

Five clinical trials in China and the U.S. are currently evaluating whether remdesevir can reduce complications or shorten the disease course in COVID-19 patients, the medical news site STAT reported.

Many doctors are excited about the drug's potential.

"There's only one drug right now that we think may have real efficacy," Bruce Aylward of the World Health Organization said last month, as reported by STAT. "And that's remdesivir."

George Thompson, an infectious disease specialist at UC Davis Medical Center who treated an early, severe case of COVID-19, told Science magazine that their patient got better after getting the drug, about 36 hours after diagnosis. The doctors initially thought the patient would die, Thompson said.

However, such anecdotal evidence can't demonstrate effectiveness, and the lab has yet to analyze blood samples to show that the patient's clinical improvement following the administration of remdesivir coincided with a drop in viral load (concentration of viral particles). On the flip side, a study posted to the preprint database medRXiv looked at three patients treated with remdesivir. The study, which was not peer-reviewed, found no clear time-dependent relationship between getting the drug and seeing improvements in symptoms. The patients also experienced rectal bleeding, elevated liver enzymes, vomiting and nausea, which could potentially be tied to the drug.

Another quandary is that antiviral drugs generally work better the earlier patients get them, but because remdesivir is not FDA-approved for general use, only patients with the most severe, and late-stage, disease, qualify for its use in clinical trials, Thompson told Science.

On Sunday (March 22), Gilead Sciences announced that they were temporarily halting compassionate use of remdesivir, due to "overwhelming demand." Instead, they are focusing on approving previously submitted requests and streamlining the process, while directing people to enroll in clinical trials, STAT reported.

The antiviral drug kaletra, a combination of lopinavir and ritonavir, generated early excitement. However, new data from China, published March 18 in the New England Journal of Medicine, could not detect a benefit when patients took the drug.

A total of 199 people with low oxygen levels were randomized to either receive kaletra or a placebo. While fewer people taking kaletra died, the difference was not statistically significant, meaning it could have been due to random chance. And both groups had similar levels of virus in their blood over time.

However, other studies are still ongoing, and there's still a possibility this combination could show some benefit. As with other antivirals, this drug would likely work better if given earlier in the disease course.

For some patients with COVID-19, the virus itself doesn't do the worst damage. Rather, in some people their immune system goes into overdrive and launches an all-out assault known as a cytokine storm. That immune overreaction can damage tissue and ultimately kill people.

To quiet such cytokine storms, doctors are now trying an immunosuppressant known as Actemra, or tocilizumab. The drug is approved to treat rheumatoid arthritis and juvenile rheumatoid arthritis. It blocks a cell receptor that binds something called interleukin 6 (IL-6). IL-6 is a cytokine, or a type of protein released by the immune system, that can trigger dangerous inflammatory cascades.

On March 19, pharmaceutical company Roche announced that it was launching a trial to see if tocilizumab could improve outcomes in patients with COVID-19 pneumonia. One group will receive the drug plus other standard treatments, while another group will receive a placebo, plus standard treatments.

Regeneron is enrolling patients in a clinical trial to test another IL-6 inhibitor, known as sarilumab (kevzara), for treating COVID-19 pneumonia. The logic behind using sarilumab is similar to that for tocilizumab.

Losartan is a generic blood-pressure medication that some scientists are hoping could help patients with COVID-19. The University of Minnesota has launched two clinical trials using the inexpensive, generic drug. The first would evaluate whether losartan can prevent multi-organ failure in those hospitalized with COVID-19 pneumonia. The second would evaluate if the drug can prevent hospitalizations in the first place, Reuters reported.

Losartan works by blocking a receptor, or doorway into cells that the chemical called angiotensin II uses to enter the cells and raise blood pressure. SARS-CoV-2 binds to the angiotensin-converting enzyme 2 (ACE2) receptor, and it's possible, the thinking goes, that because losartan might block those receptors, it may prevent the virus from infecting cells.

Complicating things, a paper published March 11 in the journal The Lancet has raised the possibility that common drugs for hypertension, such as ACE inhibitors and so-called angiotensin II receptor blockers (ARBs), which includes losartan, might actually spur the body to make more ACE2, thereby increasing the ability of the virus to infiltrate cells. A recent study of 355 COVID-19 patients in Italy (study in Italian) found that three-quarters of the patients who died had hypertension, and the authors propose this is one reason for their increased susceptibility.

Originally published on Live Science.

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Treatments for COVID-19: Drugs being tested against the coronavirus - Livescience.com

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