Published in IJCP October 2021
News and Views
October 25, 2021 | ijcp

Surgical Approach Influences Early Initiation of Post-Surgery Adjuvant Therapy in Colon Cancer

Patients who undergo minimally invasive surgery for stage III colon cancer recover faster and begin their intended adjuvant therapy earlier when compared to patients who undergo open surgery, suggests a new study. The findings were presented at the virtual Society of American Gastrointestinal and Endoscopic Surgeons meeting.

The study analyzed 34,736 patients with third stage colon adenocarcinoma, who had undergone surgical resection and initiated adjuvant chemotherapy. Of these, 16,977 patients underwent open resection of the tumor, while 17,759 underwent minimally invasive surgery (MIS). The study compared the time for return to intended oncological treatment (RIOT) between the two groups.

Results showed that patients in the MIS group started the adjuvant treatment earlier than those in the open surgery group; 6 vs. 7 weeks, respectively. The duration of hospitalization was longer in the open surgery group (6 vs. 5 days, respectively) as was the rate of re-hospitalization at 30 days (4.7% vs. 4.2% days, respectively). In the MIS group, the short-term outcomes and RIOT were comparable between patients who underwent a laparoscopic resection and those who underwent robotic surgery. However, patients who required conversion to open surgery during the minimally invasive procedure showed similar results as those in the open surgery group.

The line of management for locally advanced colonic cancers often involves surgery and adjuvant therapy. Patients are often anxious about any post-surgical delay in starting adjuvant treatment due to prolonged recovery. Recovery is faster after MIS, as demonstrated in this study. These findings may allay their concerns about timing of the adjuvant therapy.

(Source: Medpage Today)

Disruptions Due to COVID-19 Causing Several Deaths from TB, AIDS in Poorest Countries

Thousands of people will die due to tuberculosis (TB) left untreated caused by disruptions to healthcare systems in poor nations as a result of the coronavirus disease 2019 (COVID-19) pandemic, stated a global aid fund.

In some of the world’s poorest countries, excess deaths from acquired immunodeficiency syndrome (AIDS) and TB might even surpass those from COVID-19 itself, stated the head of the Global Fund. The Fund’s annual report for the year 2020 has revealed that the number of individuals treated for drug-resistant TB in the nations where it is operational dropped by 19%. Additionally, there has been a drop of 11% in human immunodeficiency virus (HIV) prevention programs and services. Executive Director Peter Sands stated that around a million fewer people were treated for TB in 2020 compared to 2019 and this would mean that thousands of people will die… (Source: Reuters)

New Tool may Accurately Predict Risk of Aneurysm Rupture after Growth

A new prediction model may be able to accurately predict aneurysm rupture within a year after growth is identified on imaging, suggests research published online in JAMA Neurology.  

Investigators noted that the “triple-S” prediction model evaluates aneurysm size, site and shape, and can serve as a “starting point” to guide treatment and management. Investigators evaluated 312 adult patients with 329 aneurysms that had shown growth of at least 1 mm or more in one direction at follow-up imaging. About 7.6% of the aneurysms ruptured over 864 aneurysm-years of follow-up. The absolute risk for rupture following growth was estimated as 2.9%, 4.3% and 6% at 6 months, 1 year and 2 years, respectively. Multivariable analyses suggested that the predictors of rupture included size >7 mm (hazard ratio [HR], 3.1), irregular shape (HR, 2.9), and being located in the middle cerebral artery (HR, 3.6) and the anterior cerebral artery, posterior communicating artery or posterior circulation (HR, 2.8)… (Source: Medscape)

Fatigue Most Common Feature of Long COVID

Studies have confirmed that fatigue is the most common feature of long COVID-19, and in a considerable proportion of patients, it is the most stubborn.

Among 239 people from online support groups for long COVID, 85% reported having severe fatigue when a survey was done 11 weeks after symptom onset, reported Maarten Van Herck, a PhD student at the University of Hasselt in the Netherlands, at the European Respiratory Society’s virtual annual meeting. At Week 24, around 79% reported that they had severe fatigue, with 15 of the 35 individuals who reported having mild or no fatigue at Week 11 now indicating that their fatigue was severe. A total of 31 out of 178 individuals reporting severe fatigue initially stated that it had become milder or had disappeared… (Source: Medpage Today)

Prioritize Pregnant, Breastfeeding Women for COVID-19 Vaccines: PAHO

The Pan American Health Organization (PAHO) has stated that countries in the Americas should prioritize COVID-19 vaccination for pregnant and lactating women, acknowledging the potential of the vaccines to protect women and their babies.

PAHO Director, Dr Carissa Etienne, said that the agency recommends that all pregnant women after the first trimester, and all breastfeeding women be administered the COVID-19 vaccine. Over 2,70,000 pregnant women have suffered from COVID-19 in the Americas and nearly 1% have died, stated Etienne. She also stated that in Mexico and Colombia, the disease has been the major cause of maternal deaths this year. (Source: Reuters)

COVID may not Impair Lung Function in Young Adults: Studies

A study presented at the virtual European Respiratory Society International Congress has suggested that COVID-19 infection may not impair the lung function of children and adolescents.

Researchers also noted that even patients with asthma did not have a statistically significant decline in lung function. However, these patients did show slightly lower measurements for forced expiratory volume in 1 second (FEV1). Another study presented at the conference revealed that the lung function in children and adolescents appeared not to be impaired after COVID-19 infection, except for those who developed a severe infection. Of the 661 young individuals with an average age of 22 years included in the first study, 178 had antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), suggesting that they had been infected. Investigators assessed the changes in lung function between the period before and during the pandemic and compared the percentage change with participants who had not been infected. The lung function was found to be similar regardless of COVID-19 history. On including the 123 participants with asthma in the analysis, 24% of the patients who had had COVID-19 were found to have a slightly lower lung function, though statistically nonsignificant.

The second study assessed the long-term effects of COVID-19 infection from August 2020 through March 21 in 73 children and adolescents aged 5 to 18 years. It also included 45 children who had not contracted COVID-19 but may have had some other infection. On comparing the COVID-19 patients with the control group, there seemed to be no statistically significant differences in the frequency of abnormal lung function… (Source: ET Healthworld – PTI)

Severe Breakthrough COVID-19 Risk Higher for Older Adults and those with Underlying Conditions

For people who are fully vaccinated, the risk of being hospitalized or death due to COVID-19 is low, and way lower than the risk for unvaccinated people. However, in rare cases of a fully vaccinated individual getting infected, older adults and those with several underlying conditions have the highest risk of serious illness, suggest data.

As of August 30, 12,908 severe breakthrough cases of COVID-19 have been reported to the US Centers for Disease Control and Prevention (CDC) among fully vaccinated individuals that led to hospitalization or death. The data suggests a less than a 1 in 13,000 chance of having a severe breakthrough case of COVID-19. The data also suggest that nearly 70% of breakthrough cases resulting in hospitalization were seen in those aged 65 years and older and about 87% of breakthrough cases culminating in death were observed among those 65 years of age and older… (Source: CNN)

Gender Gap not Seen in Prevalence of Ankylosing Spondylitis

A study published in Arthritis Care & Research refutes the conventional wisdom regarding ankylosing spondylitis (AS) and suggests that there appears to be no gender gap in the prevalence of the disease.

Researchers noted that there was no statistically significant difference in the rates between men and women according to an analysis of military medical records. Researchers retrospectively tracked 7,28,556 members of the US military who had been subjected to guideline-directed screening for back pain during 2014 to 2017. About 85% of the study population was male. The subjects were assessed for a mean of 2.21 years, and 0.06% were diagnosed with AS at least once during this period. The rates of AS among males vs. females were found to be similar (incidence rate ratio, 1.16; adjusted odds ratio [OR], 0.79; 95% confidence interval [CI], 0.61-1.02; p = 0.072)… (Source: Medscape)

FDA Safety Alert for JAK Inhibitors

The US Food and Drug Administration (FDA) has cautioned about the increased risk of serious cardiovascular events such as myocardial infarction or stroke, including a higher risk of cancer, blood clots and death with tofacitinib and other Janus kinase (JAK) inhibitors like baricitinib and upadacitinib.

The approved indications have now been limited to patients who have not responded or cannot tolerate one or more tumor necrosis factor (TNF) blockers.

According to the FDA, safety of baricitinib and upadacitinib has not been evaluated in large-scale trials, but as they share their mechanisms of action with tofacitinib, they may also have similar risks as seen in the tofacitinib safety trial.

All the aforementioned JAK inhibitors are approved to treat patients with rheumatoid arthritis. Tofacitinib is also indicated for use in psoriatic arthritis, ulcerative colitis and polyarticular course juvenile idiopathic arthritis.

However, the FDA has said that these required updates to the prescribing information do not apply to ruxolitinib and fedratinib, which are used to treat blood disorders like myelofibrosis.

(Source: US FDA Drug Safety Communication & MedPage Today)

Two Doses of COVID-19 Vaccine 97.5% Effective in Preventing COVID Mortality: ICMR

The COVID-19 vaccines available in India are nearly 97% effective in preventing mortality due to the illness, while vaccination also decreases hospitalization significantly, suggests the assessment of real time vaccination data from the COVID vaccine tracker.

Analysis of the data indicates that one dose of COVID-19 vaccine is 96.6% effective in preventing death, while two doses are 97.5% effective, stated Director General of the Indian Council of Medical Research (ICMR), Dr Balram Bhargava.

The data has been evaluated for the period from April to August and does not differentiate between the different COVID vaccines being administered in the country, stated Dr Bhargava. This tracker also provides data to monitor re-infections and breakthrough infections and combines data from Co-WIN, the national COVID-19 testing database and the COVID-19 India portal of the Health Ministry… (Source: ET Healthworld – TNN)

GBS Listed as Very Rare Side Effect of AstraZeneca COVID-19 Vaccine

The European Medicines Agency (EMA) has listed Guillain-Barré syndrome (GBS), a neurological disorder known to cause temporary paralysis, as a very rare side effect of AstraZeneca COVID-19 vaccine.

With 833 cases of GBS reported worldwide as of July 31, from around 592 million doses of the AstraZeneca “Vaxzevria” vaccine administered, the EMA stated that a causal relationship was “considered at least a reasonable possibility”.

The EMA said that GBS should be added to the product information as a side effect of the vaccine, and stated that the syndrome was a very rare side effect, noted in less than one in 10,000 individuals… (Source: NDTV – AFP)

Ivermectin does not Reduce Viral Load in COVID-19 Patients: AIIMS Study

A randomized controlled trial conducted among 157 patients admitted with mild-to-moderate COVID-19 at the All India Institute of Medical Sciences (AIIMS) revealed that ivermectin did not reduce the viral load or duration of symptoms in the patients, even at higher doses.

The trial was conducted during the first surge between July and September, 2020, and has been published in the Journal of Infection and Chemotherapy. The study participants were divided into three groups – one received 12 mg ivermectin (dosage usually prescribed by doctors), the second group was given 24 mg of ivermectin and the third group received a placebo. The proportion of patients testing reverse transcription-polymerase chain reaction (RT-PCR) negative on Day 5 was found to be higher among the patients in the high-dose ivermectin arm as compared to those who received lower dose of the drug or placebo; however, it was not significantly high (47.5% vs. 35% among those who were given lower dose of ivermectin vs. 31.1% in the placebo group)… (Source: HT)

New ESC/EACTS Valvular Heart Disease Guidelines Issued

New guidelines for the management of valvular heart disease introduce over 45 revised or new recommendations to the previous version published in 2017, revealed members of the writing committee presenting the updated guidelines during the annual congress of the European Society of Cardiology (ESC).

The guidelines emphasize on early diagnosis and expansion of indications, the significance of clinical examination as well as the best strategies for diagnosis and treatment. The highest number of revisions and new additions involve perioperative antithrombotic therapy. A total of 11 new recommendations on the use of anticoagulants or antiplatelet treatment have been included. The next major focus of the guidelines involves when to consider surgical aortic valve repair (SAVR) relative to transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis… (Source: Medscape)

People not Vaccinated against COVID 11 Times More Likely to Die from the Disease

According to a study published by the US CDC, unvaccinated individuals were found to be 11 times more likely to die due to COVID-19 and were 10 times more likely to require hospital admission. Researchers assessed 6,00,000 COVID-19 cases across 13 states between April and mid-July. CDC Director, Dr Rochelle Walensky, said that people who were not vaccinated against COVID-19 had about four and a half times higher likelihood of getting the infection. Dr Walensky added that vaccination works and can protect people from the severe complications of COVID-19.

Meanwhile, US President, Joe Biden outlined a plan to impose strict new vaccine rules on federal workers, large employers and healthcare staff… (Source: CNN)

No Trace of Coronavirus in Ganga Water: Study

No traces of coronavirus have been detected in the Ganga water after bodies of COVID-19 victims were recovered in Buxar, Katihar and certain districts in Uttar Pradesh, reported a recent study by the National Mission for Clean Ganga under the Union Jal Shakti Ministry, conducted in association with the Indian Institute of Toxicology Research (IITR), Lucknow, the Central Pollution Control Board (CPCB) and the Bihar State Pollution Control Board (BSPCB).

Ashok Ghosh, Chairman of BSPCB, stated that the samples of water were collected after the bodies of COVID-19 victims were found floating in the Ganga river during the second COVID wave peak in May and June. None of the samples tested were found to have any traces of SARS-CoV-2 virus, thus suggesting that the water was not contaminated by the bodies of COVID victims… (Source: TOI – TNN)

COVID-19 Associated with Increase in Suicide-related ED Visits among Young Individuals

Following a drop in the initial months of the COVID-19 pandemic, the number of young individuals with suicidal thoughts and behaviors visiting an emergency department (ED) showed resurgence, stated a cross-sectional study conducted at Kaiser Permanente Northern California. The results are in line with CDC data published a few months back in the Morbidity and Mortality Weekly Report that evaluated these trends in young people aged between 12 and 25 years prior to and during the pandemic. The new data, published in JAMA Psychiatry, suggest that efforts aimed at prevention might help these young people and their families.

Investigators assessed suicide-related ED visits among children, 5 to 17 years of age, presenting to EDs in the Kaiser Permanente Northern California system and compared four periods in 2020 with the same periods in 2019. From March to May 2020, the incidence rate ratio (IRR) of suicide-related ED visits among children and adolescents was found to drop by over 40% (IRR, 0.53) compared to the same months in 2019. From June through August and September to December 15, suicide-related ED visits escalated, reaching prepandemic levels, though there were differences between genders. Among girls, an increase in the first period was significant (IRR, 1.19) and rose even higher in the second period (HR, 1.22)… (Source: Medscape)

COVID-19 Vaccines Offer Strong Protection against Delta Variant; Protection may Wane in Older Adults

Three studies in the United States have suggested that COVID-19 vaccines offer strong protection against hospitalization and death, even amid the spread of the highly transmissible Delta variant. However, the protection extended by the vaccines seems to be waning among older individuals, particularly among those aged 75 years and older.

Data on hospital admissions from nine states during the period when the Delta variant was dominating also indicated that the Moderna vaccine was comparatively more effective at preventing hospitalizations among individuals of all ages compared to the Pfizer/BioNTech or Johnson & Johnson (J&J) COVID-19 vaccines. In that study involving over 32,000 visits to urgent care centers, emergency rooms and hospitals, the Moderna vaccine was found to be 95% effective at preventing hospitalization, while the Pfizer vaccine was 80% effective and the J&J vaccine was 60% effective… (Source: Reuters)

Peanuts may Reduce Cardiovascular Disease Risk: Study

A new study, published in the journal Stroke, has suggested that Asian men and women living in Japan who consumed an average of 4-5 peanuts/day had a lower risk of having an ischemic stroke or a cardiovascular disease event in comparison with those who did not consume peanuts.

Researchers assessed the association between peanut consumption and the incidence of different types of stroke - ischemic and hemorrhagic - as well as cardiovascular disease events (such as stroke and ischemic heart disease) among Japanese people. Compared to a diet without peanuts, intake of about 4-5 unshelled peanuts/day was found to be tied to 20% lower risk of ischemic stroke, 16% lower risk of total stroke and 13% lower risk of cardiovascular disease (both stroke and ischemic heart disease)… (Source: ET Healthworld – ANI)

Regular Exercise may Decrease Risk of Developing Anxiety

According to a new study, individuals who engage in regular physical activity may have around 60% lower risk of developing anxiety.

Researchers in Sweden demonstrated that people who participated in the world’s largest long-distance cross-country ski race between 1989 and 2010 were found to have a significantly lower risk of developing anxiety, when compared with those who did not ski during the same period.

The study includes data from around 4,00,000 individuals in one of the largest epidemiological studies. Among individuals with a more physically active lifestyle, the risk of developing anxiety disorders was lower by around 60% over a follow-up period of up to 21 years, stated researchers. The findings are published in Frontiers in Psychiatry… (Source: HT – ANI)

New-onset Bladder Symptoms in COVID-19 Patients Discharged from Hospital

A case series presented at the American Urological Association (AUA) 2021 Annual Meeting indicated that new-onset bladder symptoms can impact men and women who have been admitted to a hospital for COVID-19.

Investigators compared 53 patients who were discharged in recent weeks after a COVID-19 hospital admission and had reported new-onset urinary symptoms (average age of 65 years), with 12 asymptomatic subjects (controls). A large proportion of subjects reporting bladder symptoms had no evidence of SARS-CoV-2 in their urine. Luminex assays revealed that the levels of inflammatory cytokines, such as growth-regulated oncogene-alpha, interleukin-6, interferon-gamma-inducible protein 10 and C-reactive protein, were significantly increased in urine samples from COVID-19 patients, particularly those with COVID-19 associate cystitis, compared to control subjects… (Source: Medscape)

Cancer Patients with COVID-19 have Long-term Effects: Study

A study in Europe has noted that nearly 15% of cancer patients who developed COVID-19 reported having long-term effects from the infection that had an adverse impact on their cancer outcomes.

At a median follow-up of 128 days, these patients had persistent respiratory symptoms, chronic fatigue, weight loss and neurocognitive issues. A multivariable analysis adjusted for sex, age, comorbidities, tumor characteristics, anti-cancer therapy and COVID-19 severity, revealed that the long-term sequelae were tied to a heightened risk of death (HR 1.76, 95% CI 1.16-2.66). In the study, around 15% of the patients reported at least one sequelae, which included respiratory symptoms in about 49.6% of patients, followed by fatigue in 41%, neurocognitive dysfunction in 7.3% and weight loss in around 5.5%. It was more likely for these patients to be male, above 65 years of age, to have at least two comorbidities or a history of smoking and to have COVID-19 that needed treatment or hospitalization… (Source: Medpage Today)

School Closures During Pandemic Associated with Mental Health Inequities

A new study published in JAMA Network Open has suggested that virtual schooling during 2020 was tied to worse mental health outcomes for students, particularly those who are older, and youth from Black, Hispanic or lower-income families were the most affected as they witnessed the most closures.

A cross-sectional population-based survey involving 2,324 parents of school-age children in the United States was conducted from December 2 to 21, 2020. Investigators employed the parent-report version of the Strengths and Difficulties Questionnaire (SDQ) to evaluate mental health difficulties of one child per family in terms of emotional problems, peer problems, conduct and hyperactivity. During the 2020 school year, 58% of children attended school remotely, 24% attended the school fully in person, while 18% attended in a hybrid manner. Older children who underwent remote schooling were found to have more difficulties, compared to those who attended the school in person. Among younger children, remote learning appeared to be comparable or slightly better with regard to mental health… (Source: Medscape)

Plant-based Diet and Urological Health in Men

Studies presented at the American Urological Society (AUA) virtual meeting have suggested that plant-based diets are tied to a decreased risk of erectile dysfunction (ED), lower prostate-specific antigen (PSA) rates, and probably a reduced rate of total and fatal prostate cancer among younger men.

In a cohort of 1,399 men, investigators noted that those with a higher consumption of healthy plant-based diet (high PDI scores) had reduced odds of having raised PSA (OR 0.47, 95% CI 0.24-0.95). In another study that evaluated 2,549 men from the NHANES database - 57.4% of them having some degree of ED - increasing the intake of plant-based foods was tied to a decreased risk of ED.

Another prospective study included 27,243 men, followed up to 28 years, in the Health Follow-up study, and noted that among men aged ≤65 years at diagnosis, higher intake of plant-based food was linked with a lower risk of advanced prostate cancer (HR 0.68, 95% CI 0.42-1.10). Additionally, among younger men, higher intake of a healthy plant-based diet was associated with lower risks of total prostate cancer (HR 0.81 95% CI 0.70-0.95), as well as fatal disease (HR 0.53, 95% CI 0.32-0.90)… (Source: Medpage Today)

Revolutionizing Cancer Diagnosis: The NHS-Galleri Trial Launched

The National Health Service (NHS) has launched the NHS-Galleri trial of a new blood test “Galleri test” that can detect several types of cancers, especially those of the head and neck, throat, bowel, lung and pancreas, before they become symptomatic. In addition, it can detect deadly cancers and predict the location of the cancer in the body with high accuracy and has a very low false positivity rate. The chemical changes in fragments of genetic code-cell-free DNA (cfDNA) of the tumors are picked up by the test.

The randomized-controlled NHS-Galleri trial will recruit 1,40,000 participants, aged between 50 and 77 years, in eight areas of England. Their blood samples would be collected at baseline, at 12 months and at 2 years. Participants who have been diagnosed with cancer in the last 3 years will be excluded from the trial.

Detection of potential signals of cancer in the blood sample of a participant would merit referral to NHS hospital for further investigation. The participants would be required to consult their GP if they develop any new or unusual symptoms and also comply with the NHS screening schedules. Preliminary results are likely to be released by the year 2023. The trial would recruit 1 million more participants in 2024 and 2025, if the preliminary results are encouraging.

The Cancer Research UK and King’s College London Cancer Prevention Trials Unit have collaborated with the NHS and GRAIL, the healthcare company, which has developed this test.

(Source: NHS News & King’s College London, Sept. 13, 2021)

In a Review, Scientists State Boosters not Needed for Most People

In a review published in The Lancet by an international group of scientists, including from the FDA and the WHO, the scientists state that none of the data available on COVID-19 vaccines thus far provides reliable evidence to support booster doses for the general population.

The scientists stated that the advantage that the boosters provide would not outweigh the benefit of offering those doses to protect the people who are still unvaccinated globally. While boosters may be useful in some individuals who have weak immune systems, they are not required for the general population. Lead author Ana-Maria Henao-Restrepo, of the WHO, stated that studies do not provide any reliable evidence of a considerable decline in protection against severe disease, which is the main aim of vaccination, adding that if the vaccines are put to use where they would be most beneficial, then they could speed up the end of the pandemic by curbing the development of variants… (Source: ET Healthworld)

Antipsychotic Drugs Linked to Increased Risk of Breast Cancer

Antipsychotic drugs that increase prolactin levels have been shown to have a significant association with a heightened risk for breast cancer among women with schizophrenia in a new research. However, one expert states that currently, the clinical implications seem premature.

Data from Finnish nationwide registers on over 30,000 women with schizophrenia was compared. A total of 1,069 of these were diagnosed with breast cancer. Long-term exposure to the prolactin-increasing antipsychotic agents was tied to a 56% increase in the risk of developing breast cancer compared to short-term exposure. There appeared to be no significant association with cumulative exposure to prolactin-sparing antipsychotic drugs. The findings are published in The Lancet… (Source: Medscape)

Gluten-free Diet may Decrease Cancer Risk in Celiac Disease Patients

The overall risk for cancer is slightly increased among patients aged above 40 within their first year of a celiac disease diagnosis; however, the risk decline afterwards, suggests a study of around 47,000 individuals with celiac disease.

First author Benjamin Lebwohl said that celiac disease is tied to a heightened risk of cancer, and this could be due to the long-term inflammation caused by gluten. The nationwide cohort study conducted in Sweden included 47,241 patients with celiac disease. Of these, 64% were diagnosed since 2000. Each patient was age- and sex-matched to up to five control subjects. There was a 1.11-times increased risk of cancer overall, after a median follow-up of 11.5 years, in patients with celiac disease, in comparison with controls. The incidences of cancer were 6.5 and 5.7, respectively, per 1,000 person-years. Most of the excess risk was attributed to gastrointestinal and hematologic cancer. The overall risk increased in the first year following the diagnosis of celiac disease (HR, 2.47; 95% CI, 2.22-2.74), but not after that (HR, 1.01; 95% CI, 0.97-1.05). According to Lebwohl, it seems that the increased risk of cancer in celiac disease patients decreased over time, and this might be tied to the beneficial effect of a gluten-free diet in the long run. The study is published in Clinical Gastroenterology and Hepatology… (Source: Medscape)

Britain to Test Mixed COVID-19 Vaccine Dose Schedules in kids

A British study is going to assess the immune responses to mixed COVID-19 vaccine dose schedules among children in a bid to ascertain the best approach to a second dose, considering a minor risk of heart inflammation.

Children in the age group of 12 to 15 years will start getting vaccinated in Britain from next week, while 16- and 17-year old have been eligible since August. The children will be offered a first dose of the Pfizer-BioNTech vaccine; however, the advice on the second doses will come later, as more data is accumulated.

The Com-COV3 study will evaluate different vaccine schedules in children aged between 12 and 16 years, and assess the immune responses as well as the milder side effects… (Source: Reuters)

Indian Women’s Healthy Life Expectancy Lowest in South East Asia

Women in India can expect to live just over 60 years of a healthy life, on average, not affected by disabling illness or injuries. This is the lowest healthy life expectancy among the 11 countries in the World Health Organization’s (WHO) South East Asia region, reveals a WHO report on progress in attaining universal health coverage and health-related sustainable development goals in the region. 

For men too, only two countries in the region, Timor-Leste and Myanmar, are worse in terms of healthy life expectancy. Countries with the best performance in the region include Sri Lanka, Thailand and Maldives. The health spending in these countries, as a share of total government expenditure, is one of the highest in the region. The estimated share of health expenditure in total government expenditure is the lowest in India, Bangladesh and Myanmar… (Source: ET Healthworld – TNN)

New Typhoid Vaccine Found Highly Effective

A major trial conducted in Africa’s Malawi has shown that a new vaccine against typhoid fever in young children was highly effective.

An intention-to-treat analysis demonstrated that the vaccine was 80.7% effective (95% CI 64.2-89.6%), with fewer adverse events compared to a standard meningococcal A (MenA) vaccine used as a control, reported researchers in the New England Journal of Medicine. Around 28,000 children, 9 months to 12 years of age, were included in the trial, and were assigned in almost equal numbers to the MenA vaccine or to the Vi-TCV typhoid vaccine (a conjugated product that combines tetanus toxoid and a Salmonella enterica Typhi polysaccharide). Of 14,069 children who received Ti-TCV, 12 developed typhoid infection, compared to 62 of those who were given MenA, during passive surveillance for 18 months or more. Infection rates were 46.9 per 1,00,000 person-years for Ti-TCV compared to 243.2 for MenA… (Source: Medpage Today)

Nonopioid Pain Medication Seems Promising for Neuropathic Pain

Findings from a phase 2, placebo-controlled, double-blind, randomized withdrawal study - CONVEY -suggest that vixotrigine, a nonopioid investigational oral pain medication, can decrease chronic neuropathic pain due to small fiber neuropathy (SFN). The drug is generally well-tolerated.

The study included 265 patients with pain due to confirmed idiopathic or diabetes-associated SFN. After a 4-week open-label run-in period, 123 subjects - responders to vixotrigine - were randomized to receive 200 mg or 350 mg vixotrigine or placebo twice a day for a duration of 12 weeks. At Week 12, the 200-mg dose met the primary endpoint of a statistically significant reduction in the mean average daily pain (ADP) score compared to placebo (p = 0.0501). In a subgroup analysis, a treatment effect was noted in participants with diabetes-associated SFN but not in those with idiopathic SFN. Additionally, there was a significant improvement in mean worst daily pain score at 12 weeks with the 200-mg dose, compared to placebo (p = 0.0455)… (Source: Medscape)

FDA Advisers Recommend COVID Booster Shots for People 65 and Older and those at High Risk

Advisers to the US FDA have voted to recommend COVID-19 vaccine boosters for people in the US aged 65 years and above as well as those who are at high risk of severe illness. The advisers rejected a broader approval.

They also recommended inclusion of healthcare workers and others at high risk due to occupational exposure to the virus, like teachers. So, in spite of the tapered scope of the authorization, the recommendation would still cover most Americans who received their vaccines in the initial stages of the vaccination drive. The FDA will likely take a decision on the booster shots soon. While the agency is not bound by the recommendation of the advisers, it will take it into consideration… (Source: Reuters)

Pfizer Vaccine Booster Dose can Reduce Severe Infections in Elderly, Says Study

A study done in Israel has shown that a booster dose of the Pfizer COVID-19 vaccine is able to prevent infections and severe illness in individuals aged above 60 years shortly after the jab.

The rates of confirmed COVID-19 and severe illness were found to be considerably lower among those who were administered a booster dose of the vaccine. Researchers accumulated data between July 30 and August 31 from the Ministry of Health database on 1,137,804 individuals aged 60 years or older who had been fully vaccinated at least 5 months earlier. At least 12 days following the booster dose, the rate of infection was found to be 11-times lower and the rate of severe disease was around 20-times lower in people who were given a booster shot, compared to those who had received only two vaccine doses. The findings are published in the New England Journal of Medicine… (Source: ET Healthworld – IANS)

Moderna COVID-19 Vaccine Protection vs. Pfizer and J&J: CDC Study

According to a case-control analysis which included data from 21 hospitals in the United States, the two-dose Pfizer and Moderna vaccines offered the best protection for preventing COVID-19–related hospital admissions.

Between March and August 2021, the vaccine effectiveness (VE) against hospitalizations was found to be 93% for the Moderna vaccine, 88% for the Pfizer jab and 71% for the Johnson & Johnson (J&J) shot, noted researchers. However, after 120 days, VE for Moderna jab against hospitalization dropped only to 92%, representing a nonsignificant decline, while Pfizer COVID-19 vaccine VE came down to 77%. There were no data for the J&J vaccine after 120 days as only a limited number of people received the vaccine, though the VE rate dropped to 68% for the vaccine after 28 days. The results are published in the Morbidity and Mortality Weekly Report… (Source: Medpage Today)

Endoscopic Surveillance and Management of Colorectal Dysplasia in IBD: AGA Expert Review and Clinical Practice Update

An expert review and clinical practice update has recently been published by the American Gastroenterological Association which addresses endoscopic surveillance and management of colorectal dysplasia in inflammatory bowel disease (IBD) patients.

Improvements in disease management and endoscopic technology and quality have modified the conceptualization and management of IBD-related dysplasia over the past 2 decades, wrote the authors in Gastroenterology. Fourteen best practice advice statements in the review cover an array of topics, including lesion terminology and characterization, timing of endoscopy, and indications for biopsies, resection, and colectomy.

The authors stated that all patients with chronic IBD must be subjected to colonoscopy screening for dysplasia 8 to 10 years following diagnosis. Further colonoscopies should be done every 1 to 5 years, based on the risk factors, like a family history of colorectal cancer and the quality of previous surveillance exams… (Source: Medscape)