Mystery Condition Can Spur Sudden Paralysis – Possible Link to microRNA

 Researchers believe they may have discovered a possible cause of a mystery condition that can leave sufferers suddenly unable to walk, talk, or see.

It’s hoped the study — led by the University of York and Hull York Medical School and supported by Tees, Esk and Wear Valley NHS Trust — will pave the way for new treatments for Conversion disorder which affects around 800,000 people in the UK alone.

The condition, also known as functional neurological disorder (FND), causes physical symptoms that would appear neurological but doctors can’t find an injury or physical condition to explain them.

Professor Christina van der Feltz-Cornelis from the Department of Health Sciences is leading the Conversion And Neuro-inflammation Disorder Observational (CANDO) study. This pilot study is the first in a program of research to explore how conversion disorder/FND can be caused, and to develop and evaluate new treatments.

The first findings suggest that conversion disorder could be caused by a low grade inflammation process that influences gene expression, which is the process by which the instructions in our DNA are converted into a functional product, such as a protein. Protein does most of the work in cells and is required for the structure, function, and regulation of the body’s tissues and organs.

Professor van der Feltz-Cornelis said: “This is a very difficult condition for people to live with and one which is often overlooked because the medical profession doesn’t have the answers.”

“People living with the condition can become very distressed and isolated, often losing jobs and social networks through being unable to communicate or being unwell. Patients can also suffer from memory and concentration problems.”

“We made the discovery by examining levels of inflammation in blood samples from patients with FND that mimicked stroke-like symptoms. They were found to be higher than normal. Also, microRNA levels in the blood seemed to play a role and this influences the expression of genes in the cell.”

“These preliminary results deserve further exploration and replication in larger samples before we can draw firm conclusions.”

The CANDO researchers hope the new study will help in the development of new treatments, as treatments previously given to people with conversion disorder have often not helped ease the symptoms.

Annie, a patient involved in the CANDO study, says: “It is a relief to suddenly find that there may be a reason for this condition. I can’t wait for treatments that may be developed as a result of this work.”

“Assessment of Cytokines, microRNA and patient related outcome measures in Conversion Disorder/Functional Neurological Disorder (CD/FND): the CANDO clinical feasibility study” by Christina van der Feltz-Cornelis, Sally Brabyn, Jonathan Ratcliff, Danielle Varley, Victoria Allgar, Simon Gilbody, Chris Clarke and Dimitris Lagos, 24 February 2021, Brain, Behavior, & Immunity – Health.
DOI: 10.1016/j.bbih.2021.100228

https://scitechdaily.com/mystery-condition-can-leave-people-suddenly-paralyzed-possible-link-to-microrna-discovered/

Viagra May Prolong Life for Men With Coronary Artery Disease

 Men with stable coronary artery disease who are on Viagra due to impotence seem to live longer and have a lower risk of experiencing a new heart attack, a study from Karolinska Institutet in Sweden published in the Journal of the American College of Cardiology reports.

Impotence can be an early warning sign of cardiovascular disease in healthy men and is treated either locally with alprostadil, which dilates the blood vessels so that the penis stiffens, or with so-called PDE5 inhibitors, such as Viagra or Cialis, which are taken in tablet form orally before sex, inhibiting the enzyme phosphodiesterase5 (PDE5) in the penis to increase the blood flow.

Since PDE5 inhibitors decrease blood pressure, they were previously not recommended for men with coronary artery disease due to the risk of heart attack.

However, in 2017 Martin Holzmann and colleagues showed that men who have had a heart attack tolerate the drug well and that it even prolongs life expectancy and protects against new infarctions and heart failure.

In their new study, the researchers sought to compare the effect of alprostadil and PDE5 inhibitors in men with stable coronary artery disease. The patients were to have had either an infarction, balloon dilation or a coronary artery bypass surgery at least six months before the onset of treatment for erectile dysfunction.

“The risk of a new heart attack is greatest during the first six months, after which we consider the coronary artery disease to be stable,” says lead author Martin Holzmann, adjunct professor at the Department of Medicine, Solna, Karolinska Institutet.

The registry study comprised 16,500 men treated with PDE5 inhibitors and just under 2,000 who received alprostadil. The data was collected from the patient, drug, and cause of death registries.

The study shows that the men who received PDE5 inhibitors lived longer and had a lower risk of new heart attack, heart failure, balloon dilation, and bypass surgery than those who received alprostadil. The protection was dose-dependent, so that the more frequent the dose of PDE5 inhibitor, the lower the risk.

“This suggests that there’s a causal relationship, but a registry study can’t answer that question,” Holzmann says. “It is possible that those who received PDE5 inhibitors were healthier than those on alprostadil and therefore had a lower risk. To ascertain whether it is the drug that reduces the risk, we would need to randomly assign patients to two groups, one that takes PDE5 and one that doesn’t. The results we have now give us very good reason to embark on such a study.”

As PDE5 inhibitors are available by prescription only in Sweden, they cannot be bought over the counter, but Holzmann hopes that men with coronary artery disease do not shy away from addressing the matter with their doctor.

“Potency problems are common in older men and now our study also shows that PDE5 inhibitors may protect against heart attack and prolong life,” he says.

Reference: “Association of Phosphodiesterase-5 Inhibitors vs. Alprostadil with Survival in Men with Coronary Artery Disease” by Daniel P Andersson, Laura Landucci, Ylva Trolle Lagerros, Alessandra Grotta, Rino Bellocco, Mikael Lehtihet and Martin J Holzmann, 22 March 2021, Journal of the American College of Cardiology.
DOI: 10.1016/j.jacc.2021.01.045

The study was conducted in collaboration with the Obesity Centre in Stockholm and the University of Milano-Bicocca. Martin Holzmann receives funding from the Swedish Heart and Lung Foundation and Region Stockholm. Daniel Andersson has received a grant through a collaboration between Region Stockholm and Karolinska Institutet. Martin Holzmann has previously received consultancy fees from the pharmaceutical company Idorsia. No other potential conflicts of interest have been reported.

https://scitechdaily.com/viagra-may-prolong-life-for-men-with-coronary-artery-disease-lower-risk-of-experiencing-a-new-heart-attack/

France sees biggest jump in COVID-19 intensive care patients in months

 France reported on Friday that 5,254 people were in intensive care units with COVID-19, an increase of 145 people in one day and the highest daily increase in five months.

The risk of emergency wards being unable to cope was one of the main reasons for President Emmanuel Macron to order a third nationwide lockdown this week, after unsuccessfully trying for months to contain the epidemic with a curfew and regional lockdowns.

From next week, France starts a third lockdown, with schools and non-essential businesses closed nationwide for four weeks.

Announcing the lockdown on Wednesday, Macron said the number of ICU beds will be raised from 7,000 to over 10,000.

At the peak of the first lockdown in spring 2020, France saw a high of 7,148 COVID-19 patients in ICUs, but that fell back to a few hundred in August following the strict first lockdown.

During November’s less restrictive lockdown, ICU numbers peaked at just under 5,000, but since then they have only briefly dipped below 3,000 in December.

With new infections rising sharply, doctors expect the third wave of the virus will peak in the coming two weeks, with a further increase in ICU numbers.

On Friday, new confirmed cases jumped by the highest week-on-week rate since the end of November, when France was in its second nationwide lockdown.

The ministry reported 46,677 new cases, 6.2% more than a week ago, taking the total to 4.74 million cases.

France on Friday also reported 332 new deaths from COVID-19, taking the toll to 96,280, but the new death tally included only 32 deaths in retirement care homes over three days.

Death rates in retirement homes, which were several hundreds per week at the end of 2021, have fallen sharply as the government focused its vaccination campaign on the elderly.

The health ministry said 12.13 million people had received a vaccine so far, including just over three million second doses.

https://www.reuters.com/article/us-health-coronavirus-france/france-sees-biggest-jump-in-covid-19-intensive-care-patients-in-months-idUSKBN2BP1EN

India's daily coronavirus infections hit six-month high

 India’s daily coronavirus infections hit another record on Saturday for the highest tally since September, while daily deaths reached a five-month high, a Reuters count based on data from the health ministry showed.

The south Asian nation recorded 89,129 new infections and 714 deaths, the ministry said. That was the biggest single-day rise since September 20 last year and the most deaths since October 21, according to a Reuters tally.

Infections have surged in India since the beginning of March, with its richest state of Maharashtra, home to the financial capital of Mumbai, the worst hit.

Late on Friday, the state’s chief minister warned of a full lockdown to curb infections if people did not limit their movements.

https://www.reuters.com/article/us-health-coronavirus-india-cases/indias-daily-coronavirus-infections-hit-six-month-high-idUSKBN2BQ04D

B of A Acquires Healthcare Payment System Axia Technologies

 Acquisition Enhances the Bank’s Ability to Serve Healthcare Clients with a Comprehensive Range of Payment Solutions

Bank of America today announced that it has acquired Axia Technologies, Inc. ("AxiaMed"), an industry-leading health care payment and technology company focused on facilitating secure patient payments.

The acquisition will deepen and expand Bank of America’s payment offerings for healthcare clients and will further accelerate the bank’s ability to serve this key vertical. It is part of a broader initiative to integrate merchant services onto its proprietary platform following the dissolution of its merchant services joint venture last year. Terms of the acquisition were not disclosed.

"We are adding a talented team that brings great domain expertise and technology, and we’re excited to have them join Bank of America," said Mark Monaco, head of enterprise payments at Bank of America. "We have a shared vision of providing clients with the best technology to meet their payment needs. Working together, we can leverage our joint expertise and capabilities to deliver a comprehensive range of payment and settlement solutions to our healthcare clients and their patients."

Established in 2015, AxiaMed provides a gateway and terminal software solution, powering many healthcare providers to offer end-to-end, omni-channel patient payment solutions. Its integrated offerings help the financial performance of healthcare providers by expanding the payment options available to patients and streamlining administrative workflows.

Bank of America has been developing its proprietary merchant services solutions over the past year that will better serve the payment needs of clients across all business lines. The platform leverages innovations such as real-time payments and best-in-class digital capabilities to provide essential functions such as merchant acquiring, payments processing and settlement, along with value-added services such as analytics and security solutions.

https://finance.yahoo.com/news/bank-america-acquires-axia-technologies-130000677.html

FDA extends review of Abbvie's sNDA for Rinvoq in atopic dermatitis

 

• The FDA is extending the PDUFA data for Abbvie's (NYSE:ABBV) sNDA for the JAK inhibitor Rinvoq (upadacitinib) in moderate to severe atopic dermatitis by three months to Q3 2021.
• AbbVie previously disclosed it received an information request from the FDA for an updated assessment of the benefit-risk profile for the drug in this indication and it responded.
• Last month, Abbvie said the FDA was extending the PDUFA data for another Rinvoq sNDA in psoriatic arthritis to late Q2.

https://seekingalpha.com/news/3678991-fda-extends-review-of-abbvie-snda-for-rinvoq-in--atopic-dermatitis

Personalized Care Act Empowers Individuals Instead of Bureaucrats

 Every time I take my children to the doctor, I’m reminded of the ridiculous restrictions around health savings accounts (HSAs). With four kids, I quickly run out of money in my HSA if any of them need non-routine care. It doesn’t need to be this way.

Created in 2003, HSAs allow people to save money on a pre-tax basis to use for medical expenses. Unlike flexible spending accounts (FSAs), which expire at the end of the year, funds in HSAs rollover year to year. In theory, this would allow families to save money in low-expense years to use in high-expense years. HSAs could have revolutionized health care financing in the U.S., but the current restrictions stifle the impact of the accounts.

Sen. Ted Cruz (R-TX) and Rep. Chip Roy (R-TX) have introduced the Personalized Care Act of 2021, which would remedy many of these limitations and help HSAs live up to their promise.

To start with, only people covered by specific high deductible insurance plans are currently eligible for HSAs. So, while I get frustrated by a lack of money in my HSA, I have friends who can’t even use one at all. That’s much worse. And there is no rational reason for this limitation.

Rather than trying to micromanage our health care from Washington, D.C., lawmakers need to empower people to manage their own affairs. The Personalized Care Act would be a step in the right direction as it would expand HSA eligibility to include individuals covered under any health plan or health insurance. Moreover, allowable expenses would be expanded to include the fees for coverage under these plans, such as insurance premiums.

Expanded HSAs would drive cost-containment and innovation—the one-two punch we need to improve health care affordability. For example, recent years have seen a growth of health care plans like direct primary care (DPC) practices that don’t rely on typical health insurance. With DPC, patients pay a flat monthly or yearly membership fee that covers primary care needs and preventative services. This makes health care costs more predictable and transparent. It also improves efficiency by removing the middleman (insurance companies). By allowing HSA funds to pay DPC membership fees, more people will be able to take advantage of these options.

Consolidation in the healthcare industry has accelerated in recent years. By 2018, around half of all physicians and 72 percent of hospitals were affiliated with hospital systems. This trend, driven in large part by government policies, is likely to continue—especially in the wake of COVID. Direct primary care can reduce the power of regional health care monopolies by giving consumers more alternatives.

Of course, expanded uses aren’t very useful if contribution limits are unreasonably low. Current limits are $3,600 for individuals and $7,200 for families. With four kids, these limits pretty much guarantee there will be eligible expenses I won’t be able to cover with my HSA. Sometimes this means paying more out of pocket, other times it means delaying care. And it typically means no rolling over funds for future expenses.

Fortunately, the Personalized Care Act recognizes these limits are too low. The legislation would increase contribution limits to $10,800 for individuals and $29,500 for families. While I’d recommend an allowance for additional dependents, these contribution limit increases would be a tremendous improvement.

Expanding HSA access could have another important impact: reduced reliance on employer-sponsored health insurance. Current tax rules give preferential treatment to employer-based plans, which has led to nearly 90 percent of Americans with private health insurance receiving it through their employers. With people changing jobs more often than in the past and with technology fueling the growth of independent contractors, employment-based health insurance is becoming less attractive. As HSA usage expands, more insurance options will become available outside of the workplace. This will provide the flexibility modern life demands.

With some sensible reforms like the ones proposed in the Personalized Care Act, HSAs could bring an entirely new patient-centered focus to health care financing. This would give individuals greater autonomy over their health care spending and lessen the control of insurance and government bureaucrats. The ability to rollover funds for future expenses would give people the incentive to shop around for non-emergency care. Over time, this would force providers to be more transparent in their pricing. Bit by bit, expanded HSAs would bring market forces to bear in the health care sector.

For families like mine, the bill would give us peace of mind knowing we’re building a cushion to help deal with unexpected medical expenses. This cushion will enable more people to make healthcare decisions based on medical—not just financial—concerns.

The Personalized Care Act won’t solve every problem we face when it comes to health care access. But it would go a long way toward putting individuals in the driver’s seat when it comes to their health care. And that’s a change that’s long overdue.

Colleen Hroncich is a visiting fellow with the Independent Women’s Forum.

https://www.realclearhealth.com/articles/2021/04/01/personalized_care_act_empowers_individuals_instead_of_bureaucrats_111184.html