Drug cocktail reduces aging-associated disc degeneration

 Chronic back pain affects upwards of 15 million adults in the US, racking up billions in healthcare costs and lost work days. Degeneration of the discs that cushion and support vertebrae, a common occurrence of aging, is a major contributor to low back pain. Although a widespread condition, few treatments are available. Now Jefferson's Makarand Risbud, PhD, James J. Maguire Jr. Professor of Spine Research in orthopedic surgery, division director of orthopedic research and co-director of the cell biology and regenerative medicine graduate program, and colleagues have shown that treating mice with a drug cocktail that removes aging cells reduces disc degeneration. The findings, reported in Nature Communications on September 3rd, show how a novel approach to preventing age-related disc degeneration may pave the way for treating chronic back pain.

"Once intervertebral discs start to degenerate, there is very little regeneration that happens," says Dr. Risbud. "But our results show that it is possible to mitigate the disc degeneration that happens with aging."

Surgery or steroid injections are options to treat low back pain from disc degeneration, but the vast majority of patients do not meet criteria for surgery and epidural steroid injections do not work well most of the time. Prolonged use of strong painkillers prescribed for back pain, such as opioids, carry the risk of addiction.

In collaboration with Brian Diekman, PhD, an assistant professor of biomedical engineering at the University of North Carolina in Chapel Hill, Dr. Risbud and his team were looking for an effective and noninvasive way to treat back pain from disc degeneration that did not involve painkillers like opioids. Instead, they turned to a class of small molecules known as senolytics. These drugs target cells in the body that are in a process of age-related deterioration called senescence.

With age, every tissue in the body accumulates senescent cells. Senescent cells secrete destructive enzymes and inflammatory proteins that affect nearby healthy cells. Senolytic drugs remove these deteriorating cells, leaving room for new cells to replace them. The idea is that removing senescent cells from a tissue will improve the tissue's function.

Recent research has shown that to be the case. Two senolytic drugs, dasatinib and quercetin, have shown enough promise to treat scarring in lung tissue that they are now in clinical trials. But the lungs are very different than discs in the spine.

"Just because the drugs work in one tissue doesn't mean they will also work in another," Dr. Risbud says. "Every tissue is different."

To find out whether senolytics could improve aging-related disc degeneration, Emanuele Novais, an MD, PhD student in Dr. Risbud's lab and first-author of the new work, and colleagues gave young, middle-aged and elderly mice a cocktail of the senolytic drugs, dasatinib and quercetin, every week.

The weekly injections mitigated disc generation, but not in the way that Dr. Risbud and his team had expected. They expected to see the largest effect in the oldest animals because these animals would have accumulated more senescent cells than younger mice. Instead, Dr. Risbud and colleagues found that treatment in younger animals had more benefit and actually had a protective effect.

Young and middle-aged mice given the senolytic cocktail showed less disc degeneration and fewer senescent cells by the time they reached an advanced age compared to mice given a placebo.

"We anticipated that in tissues with a lot of senescence, removing the senescent cells would make a big difference, but it didn't," Dr. Risbud said. "The therapy was most effective when we started treating the mice when those senescent cells were just beginning to emerge. Our findings show that if given early, senolytic drugs can actually slow disc degeneration," says Dr. Risbud. "This is a novel preventive approach

But the mice needed a weekly injection from a relatively young age until they reached old age, a much longer time period than senolytic drugs have been given in other uses. The researchers however did not see any deleterious effects of long-term treatment.

"It is possible that people will have to take this for a long time for treatment to be effective, and our data show that the drugs were well-tolerated, at least in mice," Dr. Risbud says.

Altogether, the findings show that senolytic drugs -- ones already approved for use in clinical trials -- can mitigate disc degeneration that occurs with aging.

"This research paves the way for translating these studies first to a preclinical animal model and then to a clinical trial in humans," says Dr. Risbud said.

This work was supported by grants and fellowships from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Fundac?a?o para a Cie?ncia e a Tecnologia, Thurston Arthritis Research Center and Biomedical Engineering, and the National Institute on Aging supported this research.

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Story Source:

Materials provided by Thomas Jefferson University. Note: Content may be edited for style and length.

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Journal Reference:

1. Emanuel J. Novais, Victoria A. Tran, Shira N. Johnston, Kayla R. Darris, Alex J. Roupas, Garrett A. Sessions, Irving M. Shapiro, Brian O. Diekman, Makarand V. Risbud. Long-term treatment with senolytic drugs Dasatinib and Quercetin ameliorates age-dependent intervertebral disc degeneration in mice. Nature Communications, 2021; 12 (1) DOI: 10.1038/s41467-021-25453-2

https://www.sciencedaily.com/releases/2021/09/210903085903.htm

Conn. Gov order to give nursing homes temporary staffing help

 Connecticut nursing homes will once again be allowed to hire temporary nursing aides as they deal with staffing shortages during the pandemic.

Gov. Ned Lamont on Friday signed an executive order that revives the state’s nurses aides program that was used last year.

Under the program, the temporary workers will be allowed to provide nursing-related services, but nothing that requires a license.

The governor’s office said the idea is to use those aides to help serve residents who do not have COVID-19, allowing permanent staff to focus on patients who have tested positive for the coronavirus.

The measure also will assure adequate staffing at long-term care facilities, which have struggled with hiring and retaining workers, the governor’s office said.

Connecticut recorded 111 cases of COVID-19 among nursing home patients and 94 cases among staff between Aug. 18 and Aug. 31, according the state Department of Health. There were 16 patient deaths related to the coronavirus during that time and none among staff.

The governor on Friday also extended the deadline for nursing home workers to be vaccinated against COVID-19. He has previously ordered that workers in nursing homes, assisted living centers, residential care homes, chronic disease hospitals, intermediate care facilities and managed residential communities be at least partially immunized by Sept. 7.

Under Friday’s revised order, workers must have their first shot by Sept. 27.

The orders came as the state reported a daily increase of 665 COVID-19 cases and eight more hospitalizations, being the total to 365.

The seven-day rolling average of daily new cases in Connecticut has risen over the past two weeks from 574.29 per day on Aug. 19 to 632.43 on Sept. 2, according to Johns Hopkins University.

https://apnews.com/article/business-health-coronavirus-pandemic-nursing-homes-a39cf0d558ede199b3d2d929feb93f98

MCKESSON, AMERISOURCEBERGEN, CARDINAL, J&J: ‘ENOUGH’ STATES JOINED $26B OPIOID SETTLEMENT TO MOVE FORWARD

https://www.marketscreener.com/quote/stock/CARDINAL-HEALTH-INC-11969/news/MCKESSON-AMERISOURCEBERGEN-CARDINAL-HEALTH-JOHNSON-JOHNSON-SAY-ENOUGH-STATES-JOINED-26-BILLI-36339708/

Texas law opens door for other states to pursue abortion restrictions

 The Supreme Court’s refusal to block the Texas “fetal heartbeat” law, the most restrictive abortion legislation in the U.S. to date, is expected to inspire more Republican-led states to follow in the Lone Star State’s footsteps.

Politicians in Arkansas, South Dakota and Florida, including Florida Gov. Ron DeSantis (R), have already committed to at least looking into implementing a version of the Texas six-week abortion ban in their states.

The court’s 5-4 decision not to intervene in the Texas law that went into effect Wednesday did not determine whether the law is constitutional, while courts have ruled previous six-week bans unconstitutional.

“What they did in Texas was interesting, but I haven't really been able to look at enough about it,” DeSantis told reporters on Thursday. “They've basically done this through private right of action. So, it's a little bit different than how a lot of these debates have gone. So we'll have to look, I'm gonna look more significantly at it.”

Similarly, Florida Senate President Wilton Simpson (R) said the state’s lawmakers will consider mimicking Texas’s law, saying in a statement to The Hill that the legislation “represents a new approach,” and the Supreme Court’s decision not to intervene is “encouraging.”

“As an adoptive child myself, it’s important to me that we do everything we can to promote adoption and prevent abortion; therefore, I think it’s worthwhile to take a look at the Texas law and see if there is more we can do here in Florida,” he said.

The court officially declined to block Texas’s “fetal heartbeat” bill in a late Wednesday decision, with Chief Justice John Roberts dissenting along with the three liberal justices. But the majority emphasized that it was not ruling on the constitutionality of the law, meaning the Supreme Court can still strike it down later in the legal process. 

This leaves state legislatures to decide whether to act sooner based on the Lone Star State’s legislation or wait for the court to rule on a Mississippi law that directly challenges the 1973 Roe v. Wade decision and bans abortion after 15 weeks.

Arkansas Sen. Jason Rapert (R), who sponsored the first “fetal heartbeat” bill passed in the country, tweeted that he ordered a law that mirrors Texas’s ban to be filed in his state.

“I look forward to working with my fellow legislators adding cosponsors and [Arkansas Gov. Asa Hutchinson] to pass this important legislation before we adjourn the legislative session,” Rapert, who is running for lieutenant governor, said.

In South Dakota, Gov. Kristi Noem (R) — who, like DeSantis, is a possible 2024 White House candidate — declared on social media that she instructed her office's so-called unborn child advocate to “immediately review the new TX law and current South Dakota laws to make sure we have the strongest pro life laws on the books.”

Noem spokesperson Ian Fury told The Hill in a statement that the governor’s unborn child advocate has begun his review but “it’s too soon in the process to comment on it.”

South Dakota has already passed a trigger law that would outlaw abortion if Roe v. Wade is overturned, but until then, "Governor Noem and her Unborn Child Advocate will continue working to implement the strongest pro-life laws possible in South Dakota," Fury said.

The momentum for red states to pursue abortion restrictions picked up this year after the Supreme Court officially reached a 6-3 conservative majority with Justice Amy Coney Barrett’s confirmation late last year. 

The conservative advantage in the highest court motivated state legislatures to enact more than 90 abortion restrictions, prompting the Guttmacher Insittue to name this 2021 as “the worst legislative year ever” for abortion rights in the country.

Elizabeth Nash, a state policy analyst at the Guttmacher Institute, said she expects states in the South, the Plains and the Midwest, where the “lion’s share of abortion restrictions” are, to try to pass laws similar to Texas's.

“If the door is opened around weakening abortion rights, whether it's a Texas-style ban or another kind of restriction, then yes, states will pursue many types of restrictions to limit access to abortion,” she said. “I think they're hoping the courts are at their back and that they will just move ahead with some of these bans now."

Still, many state legislatures are not in session at this point in the year, leaving these legislators to wait until next year to try to pass a Texas-style law; however, a few states are still in legislative session, like Ohio, which has a Republican supermajority that may make it easier for such a law to pass. 

The Pro-Life Action League’s Executive Director Eric Scheidler said state legislators might take a more cautious approach and wait to see what comes out of the Mississippi Supreme Court case.

“That's the case that is either going to open up the door to a whole host of new types of regulations akin to the 15 week ban and accident in Mississippi, rather than trying to move on this very sort of unusual Texas law,” he said.

Texas Gov. Greg Abbott signed the “fetal heartbeat” bill into law in May, which prohibits abortions after fetal cardiac activity is detected, which can happen as early as six weeks, before some people know they’re pregnant.

However, the legislation is considered unique because it’s intended to be enforced by private citizens instead of state authorities. Private residents who successfully sue anyone who provides or aids and abets in an abortion can earn at least $10,000.

Scheidler said he wouldn’t be surprised if the Supreme Court “ultimately” strikes down the Texas law. But he expects some “particularly zealous state legislators … in very red states,” such as Oklahoma and Alabama, to move forward with a Texas-style law to halt abortions in their states. 

Several states have expressed interest, with Rebecca Parma, the senior legislative associate at Texas Right to Life, saying her advocacy group has seen an uptick in curiosity about the legislation after it went into effect this week. 

When asked whether her group would recommend taking immediate action or waiting for the ruling in the Mississippi Dobbs v Jackson case, she said, “We would recommend [to] go ahead just like we did.”

“Certainly what happened with our law … that's an encouragement that indicates positively about how the Supreme Court might rule in the Dobbs case, but we can't know for sure,” she added. “And so in the meantime, it's great to pass legislation that can start saving lives immediately.”

The Supreme Court is slated to review the Mississippi case next term, with a decision expected by next summer, just months before the midterm elections.

Rose Mimms, the executive director of Arkansas Right to Life, said the Texas law “certainly gives us a new angle in trying to save the lives of unborn babies.”

“We're going to be looking at this law to see if we can pass it in Arkansas,” she said. “I don't think there's any problem. We have a pro-life general assembly. We have a pro-life governor. We have pro-life attorney general, and we have millions of pro-life citizens that ... want to save lives.”

https://thehill.com/policy/healthcare/570801-texas-law-opens-door-for-other-states-to-pursue-abortion-restrictions

Nursing homes warn vaccine mandate could lead to staff shortages

 The Biden administration's vaccination requirement is putting a squeeze on nursing homes as they try to balance protecting residents and retaining low-wage staff that have been reluctant to get the shot.

Later this month, the administration will outline a policy that requires all staff working at nursing homes to be vaccinated or risk the facilities losing federal funding.

The specifics of the policy are sparse so far, but it would effectively be a mandate for an industry that relies heavily on Medicare and Medicaid funding.

Only about 62 percent of nursing home and long term care facility staff are fully or partially vaccinated nationally, according to federal data compiled by the Centers for Medicare and Medicaid Services (CMS).

More than 602,000 staff members have contracted COVID-19 and more than 2,000 have died from it.

The numbers vary by state, but reflect the nationwide rate for fully vaccinated adults. However, the figures are significantly lower than the nationwide average vaccination rate — nearly 84 percent — for nursing home residents. 

Nursing home residents are among the most vulnerable to infection, and despite high levels of vaccination, outbreaks still occur, driven in large part by unvaccinated staff. 

Health experts say a vaccine requirement could go a long way towards protecting residents and stopping preventable outbreaks. 

The rule "has the potential to really change the narrative that's been ongoing in nursing homes where we've seen staff quite hesitant to get vaccinated. This is an opportunity to really press reset, and actually see high rates of vaccination," said David Grabowski, a professor of health policy at Harvard Medical School.

Some states have already moved forward with mandating vaccines for all health workers. Some nursing homes and health systems have also imposed mandates on their staff, but it's far from an industry standard.

Jewish Home Family, a nonprofit nursing home operator in Rockleigh, N.J., was the first long-term care organization in the state to mandate vaccinations. 

Carol Silver-Elliott, the company's President and CEO, said they only lost five out of their 530 employees as a result of the policy.

"It was a small price to pay to keep our elders safe. I think we did well," Silver-Elliott said.

"Do I think everyone can do as well? I think sometimes geography makes a difference ... We're in a part of New Jersey that was hit very hard by the pandemic. It doesn't take much to invoke those images of what horrible experiences we all went through, and all of them suffered losses of friends and colleagues and family members and elders."

Yet industry groups fear the policy will exacerbate what is already a severe staffing crisis, as workers will quit rather than get vaccinated, leaving facilities understaffed and putting residents at risk.

Mark Parkinson, the CEO of the American Health Care Association and National Center for Assisted Living, a nursing home lobby, sent a letter to Health and Human Services Secretary Xavier Becerra warning about the impact of the requirement on the workforce.

"If a significant portion of the approximately 38 percent of unvaccinated nursing home staff leave, the net impact will be worse care for the residents. While the loss of just half of the unvaccinated staff would be devastating to care, the loss of even one or two staff in a nursing home impacts care on certain shifts and units," Parkinson wrote. 

Among other issues, AHCA is pressing the administration to broaden the vaccine requirement to all workers in Medicare and Medicaid certified health facilities.

"This is the only way to prevent nursing facility employees from leaving to work in other settings such as hospitals or home health," Parkinson wrote.

Grabowski said the fear about staff loss is reasonable, and while he is in favor of putting a sector-wide mandate in place, he doesn't think that would solve the staffing shortage. 

"The biggest group of unvaccinated staff are certified nurse aides. They're making close to minimum wage. They can make that, maybe even more, plus maybe even better benefits out in retail jobs, restaurant jobs. The vast majority of those employers are not imposing mandates," Grabowski said.

"So, yes, the federal government could have done a better job of doing this across the board for health care providers ... But you also still would have this kind of back door where staff might leave for other jobs that are not in healthcare," Grabowski said.

CMS has historically been reluctant to remove nursing home providers from the Medicare program, and it's still unclear what kind of penalties the policy will entail. The details are expected to be released in an emergency rule later this month, though there is no formal deadline. 

The agency did not return The Hill’s request for comment. 

If vaccine mandates trigger worker shortages, nursing home operators should do more to retain their staff, said Charlene Harrington, professor emeritus at the UCSF School of Nursing. 

While some in the industry may plead poverty because of low federal reimbursement rates, Harrington said higher wages for staff are possible to make the job more worthwhile.

"They're entry level workers, and they're underpaid, and their benefits are terrible. The nursing homes have resisted increasing the wages and benefits, because most of the companies are for-profit," Harrington said. "They might have to raise the wages and benefits. They don't want to do it, but it really has to be done."

https://thehill.com/policy/healthcare/570807-nursing-homes-warn-vaccine-mandate-could-lead-to-staff-shortages

UK panel says it ‘would not recommend’ jabbing healthy teens

 THE UK government’s independent advisory body on vaccines has said that it would not recommend jabbing all 12- to 15-year-olds against coronavirus, arguing the benefits were “too small”.

  

360p geselecteerd als afspeelkwaliteit

The Joint Committee on Vaccination and Immunisation (JCVI), a panel of experts that advises ministers, has been weighing the issue after numerous other countries began giving the jabs to young teens.

It has previously recommended giving approved Covid-19 vaccines to all 16- and 17-year-olds but only to 12- to 15-year-olds who have underlying health conditions that make them more vulnerable to the virus.

On the advice of the JCVI, Britain’s four chief medical officers — in England, Scotland, Wales and Northern Ireland — will now provide further input ahead of a final government decision.

The committee, which focuses purely on health effects, wants them to consider the “wider societal impacts, including educational benefits” of whether to roll out vaccines to younger teens.

Schools have returned recently across Britain following the summer break, with fears that this could lead to a new surge in cases after weeks of moderate rises in infections.

In its recommendation, the JCVI argued the benefits from vaccination are “marginally greater than the potential known harms” of the inoculations, while acknowledging there was “considerable uncertainty” about those.

“The margin of benefit, based primarily on a health perspective, is considered too small to support advice on a universal programme of vaccination of otherwise healthy 12- to 15-year-old children at this time,” it said.

“As longer-term data on potential adverse reactions accrue, greater certainty may allow for a reconsideration of the benefits and harms.”

The recommendation contrasts with the US, which announced in May that younger teens would be vaccinated, and many European Union countries including France which have begun jabbing that age group.

All four health ministers in the UK wrote Friday (3) to their respective chief medical officers requesting they give a “broader perspective” on the issue.

“We will then consider the advice from the chief medical officers, building on the advice from the JCVI, before making a decision shortly,” England’s Health Secretary Sajid Javid said in a statement.

Britain began vaccinations in December last year and has jabbed nearly 89 per cent of all adults with a first dose, while more than 79 per cent have two shots.

The latest data from Public Health England and Cambridge University shows vaccines have saved more than 105,000 lives and prevented 143,600 hospitalisations and 24 million cases in England, according to the government.

https://www.easterneye.biz/uk-panel-says-it-would-not-recommend-jabbing-healthy-teens/

Brazil health regulator suspends use of 12 million Sinovac vaccine shots

 Brazil's federal health regulator Anvisa on Saturday suspended the use of over 12 million doses of a COVID-19 vaccine developed by China's Sinovac Biotech Ltd that were produced in an unauthorized plant, it said in a statement.

Anvisa said it was alerted on Friday by Sao Paulo's Butantan institute, a biomedical center that has partnered with Sinovac to locally fill and finish the vaccines, that 25 batches, or 12.1 million doses, sent to Brazil had been made in the plant.

"The manufacturing unit ... was not inspected and was not approved by Anvisa in the authorization of emergency use of the mentioned vaccine," the regulator said. The ban was "a precautionary measure to avoid exposing the population to possible imminent risk," it added.

Butantan also told Anvisa that another 17 batches, totaling 9 million doses, had been produced in the same plant, and were on their way to Brazil, the regulator said.

During the 90-day ban, Anvisa will seek to inspect the plant, and find out more about the security of the manufacturing process, it said.

During Brazil's vaccine rollout earlier this year, the vast majority of administered vaccines were from Sinovac. More shots from other manufacturers have since come online.

https://news.yahoo.com/brazil-health-regulator-suspends-12-214312060.html