The American Academy of Sleep Medicine has published an update in the Journal of Clinical Sleep Medicine stating that, during the pandemic, telemedicine has been an effective tool for the diagnosis and management of sleep disorders. Since the academy’s last update in 2015, the use of telemedicine services has increased exponentially as a result of the COVID-19 pandemic. The academy’s latest update adds that the COVID-19 pandemic has highlighted telemedicine’s ‘importance in improving access to sleep care and advocating for sleep health.’ Furthermore, a growing body of published research has found telemedicine to be effective in the management of patients with sleep disorders, such as apnea, and for the delivery of cognitive behavioral therapy for the treatment of insomnia. The update authors also outlined how a shortage of trained behavioral sleep therapists has led to the development of online application-based CBT-I programs and a recent systematic review and meta-analysis found that internet-delivered CBT-I is effective in improving sleep. Telemedicine, the academy says, is also effective for helping to treat sleep disorders among children: ‘Telehealth follow-up visits, primarily via telephone, have been used for chronic management of obstructive sleep apnea and internet delivered CBT-I has been shown to be effective in adolescents with insomnia.’ *Image by Claudio_Scott from Pixabay
A pill that contains four different medicines and is designed to be taken daily could dramatically reduce the number of heart attacks and strokes, a new study has found. The polypill – which is the generic term used to describe a medication that contains multiple active pharmaceutical ingredients – contains aspirin, a cholesterol-lowering statin and two drugs to reduce blood pressure. For the study, researchers from Iran and the UK studied around 6,800 people from more than 100 villages in Iran. Half were given the polypill and advice on how to improve their health through lifestyle changes and the other half were just given the lifestyle changes advice. After five years, the group taking the polypill had experienced 202 cardiovascular events, while the group that had just been given the advice had experienced 301 cardiovascular events. In other words, the group taking the polypill had experienced around a third less cardiovascular events. The researchers say the pill costs just pennies a day, but could have a huge impact, especially in poorer countries where doctors have fewer options available to them. Stroke and coronary heart disease are the top two causes of death worldwide, killing more than 15 million people each year. Obesity, smoking and doing little exercise are all risk factors associated with an unhealthy heart. Based on the findings of the study, if 35 people were all given the polypill daily, it would prevent one of them developing a major heart problem within 5 years. “Given the polypill's affordability, there is considerable potential to improve cardiovascular health and to prevent the world's leading cause of death,” said Dr Nizal Sarrafzadegan, of Isfahan University of Medical Sciences, Iran. The findings of the research are published in The Lancet.
Previous claims that one or two alcoholic drinks a day doesn’t do any harm and could actually be protective are now in significant jeopardy following the publication of a large genetic study in The Lancet. According to the UK and Chinese researchers who followed 500,000 Chinese people over a 10-year period, the findings of the study are the best evidence yet on the direct effects of alcohol. While the negative health implications of heavy drinking are understood, the impact of consuming small amounts of alcohol on a regular basis has remained unclear. The researchers, from the University of Oxford, Peking University and the Chinese Academy of Medical Sciences, found that: drinking one to two alcoholic drinks every day increased stroke risk by 10-15% drinking four alcoholic drinks every day increased stroke risk by 35% For the purposes of the study, one drink was defined as either: a small glass of wine a bottle of beer a single measure of spirits In other words, even light-to-moderate drinking can increase blood pressure and a person’s chances of having a stroke. Prof David Spiegelhalter, from the University of Cambridge, said drinking alcohol on a daily basis gives the “opposite effect of taking a statin” (drugs that are used to lower cholesterol levels). The bottom line, according to Prof Richard Peto, professor of medical statistics and epidemiology at the University of Oxford, is the “claims that wine and beer have magical protective effects is not borne out”.
A new cholesterol-lowering drug could offer hope for both people who are unable to take statins due to the side effects and for people who statins are ineffective. An international study suggests the drug, called bempedoic acid, helps lower cholesterol in people who continue to have high levels despite taking statins. It is thought that it can also be used for people who are unable to take statins because of the associated side-effects. Publishing their research in the New England Journal of Medicine, the researchers say they have asked UK and US drug regulators to consider approving the pill for widespread use. Bempedoic acid works by blocking an enzyme in the body that is used to produce cholesterol. For the study, over 1,000 people with cardiovascular disease or a genetic cholesterol condition were given bempedoic acid in addition to their usual cholesterol-lowering medication. About 700 other study participants were given a placebo. After just three months, the group taking bempedoic acid had 17% less bad cholesterol than the group receiving the dummy medication. Speaking about the findings of the research, Prof Kausik Ray, from Imperial College London, said: “Bempedoic acid could be another addition to the arsenal of cholesterol lowering treatments available to patients. “What we have is a new class of drug that could be given to patients who are already taking statins and could help them further reduce their cholesterol levels and thus potentially cut their risk of heart attacks and strokes.” Bad cholesterol remains one of the main risk factors for heart attacks and strokes across the world.
One in five men and one in six women will develop cancer in their lifetime. That’s one of the stark predictions revealed in a new report from the WHO’s International Agency for Research on Cancer (IARC), which is based in Lyon, France. This year alone, there will be 18.1 million new cases of cancer and 9.6 million people will die with the disease worldwide. This represents a significant increase from 14.1 million cases and 8.2 million deaths in 2012. The report also predicts that by the end of the century, cancer will be the number one killer globally and the single biggest barrier to people living long lives. Looking closely at data from 185 countries, the researchers focussed on 36 different types of cancer. Lung cancer, colorectal (bowel) cancer and female breast cancer are thought to be responsible for a third of all cancer cases worldwide. Researchers have attributed the rise to the world’s growing and ageing population. That’s because more people equals more cancer, and as people get older their cancer risks grow. Moreover, as countries become wealthier, more of the people living in them develop lifestyle-related cancers. Speaking about the report, Dr. Christopher Wild, director of the International Agency for Research on Cancer, said: “These new figures highlight that much remains to be done to address the alarming rise in the cancer burden globally and that prevention has a key role to play.” “Efficient prevention and early detection policies must be implemented urgently to complement treatments in order to control this devastating disease across the world.”
A study conducted in Yorkshire, Derbyshire and Nottinghamshire in the UK has found that offering new mothers financial incentives in the form of shopping vouchers boosts breastfeeding rates. For the study, more than 10,000 mothers were offered up to £200 in shopping vouchers as an incentive to breastfeed. The vouchers could be used to buy food, household items, toys, clothes, books or DVDs in supermarkets and other shops. Breastfeeding levels are among the lowest in the world, with just 12% of new mothers in some areas feeding their six to eight week-old babies this way. However, with the voucher incentive scheme, breastfeeding rates in the areas involved rose by 6%. The women were given vouchers worth £120 if they signed declaration forms stating their babies had been breastfeed for the first six weeks of their lives. The mothers received a further £80 of vouchers if they were still breastfeeding after six months. Principal investigator Dr Clare Relton, from the University of Sheffield’s School of Health and Related Research (ScHARR), said: “Our scheme offered vouchers to mothers as a way of acknowledging the value of breastfeeding to babies and mothers and the work involved in breastfeeding. “The trial found a significant increase in breastfeeding rates in areas where the scheme was offered. “It seems that the voucher scheme helped mothers to breastfeed for longer. Mothers reported they felt rewarded for breastfeeding.” NHS guidelines say that babies should be exclusively breastfeed for at least the first six months of their lives. Babies that are breastfed have fewer health problems in their younger years and are less likely to develop conditions such as diabetes when they are older. The five-year trial was funded by research councils, medical charities and Public Health England.
A pioneering breakthrough in the treatment of Huntington’s disease has seen the defect that causes it corrected for the first time. According to the research team from University College London, there is a real possibility that the deadly neurodegenerative disease could be stopped going forward. The team of scientists injected an experimental drug into spinal fluid which reduced the levels of toxic proteins in the brain. Experts are hailing the groundbreaking procedure as the potentially the biggest breakthrough in neurodegenerative diseases for 50 years. Huntington’s disease is a particularly devastating illness that is passed down through families. Some sufferers have likened it to having Parkinson's, Alzheimer's and motor neurone disease all at the same time. A genetic error causes the protein huntingtin – which is vital for brain development – to instead kill brain cells. The unstoppable degradation of brain cells in Huntington's patients leaves them in permanent decline and affects their movement, behaviour, memory and ability to think clearly. Huntington’s blights families and generally hits people while they are in their prime – 30s and 40s. Patients tend to die around 10-20 years after symptoms first appear. The revolutionary drug therapy works by effectively silencing the effects of the mutant huntingtin gene and preventing the harmful protein from ever being built. Professor Sarah Tabrizi, the lead researcher and director of University College London’s Huntington’s Disease Centre, said: “For the first time a drug has lowered the level of the toxic disease-causing protein in the nervous system, and the drug was safe and well-tolerated. This is probably the most significant moment in the history of Huntington’s since the gene [was isolated].”
A leading UK-based cancer charity has warned that many people could be missing the symptoms associated with pancreatic cancer and not receiving treatment that could extend their lives as a result. Pancreatic Cancer UK says that as many as one in three adults could ignore the warning signs and symptoms of potential pancreatic cancer, simply because they don’t know what to look for. Indigestion, stomach ache, unexplained weight loss and faeces that float rather than sink in the toilet are all signs of the potentially deadly disease. At present, just one person in 10 survives longer than five years after being diagnosed with pancreatic cancer. Early detection and treatment are vital for saving lives. The charity’s survey of 4,000 people suggests many people take the symptoms for granted, with 35% of respondents saying they would not be anxious if they were suffering from a few of the signs of the disease. Speaking about the results of the survey, Pancreatic Cancer UK chief executive Alex Ford said: ““We must all be aware of the possible signs of pancreatic cancer, and of the devastating impact this disease can have, because 93% of people diagnosed will not live beyond five years”. Common symptoms of pancreatic cancer include: stomach and back ache unexplained weight loss indigestion changes to bowel habits, including floating faeces Other symptoms include: loss of appetite jaundice (yellow skin or eyes) itchy skin feeling and being sick difficulty swallowing recently diagnosed diabetes
The harmful Zika virus, which is spread by mosquitoes and causes devastating brain damage in babies, could be used to treat aggressive brain cancer in adults, according to US scientists. Up until now, Zika has only been seen as a major global health threat, but the new research could see it become a remedy. The scientists say the virus can be used to selectively infect and destroy hard-to-treat cancerous cells in adult brains. In mice studies, the Zika virus was seen to successfully shrink aggressive tumours, yet left other brain cells unscathed. While human trials are still quite a way off, laboratory tests show that the virus works on human cells, and experts believe the Zika virus holds a huge amount of potential. They say it could be injected into a human brain at the same time as surgery to remove life-threatening tumours. Some brain cancers are fast growing and spread quickly through the brain. This makes it very difficult to see where the tumour finishes and healthy tissue begins. As an extra precaution, the team from Washington University School of Medicine and the University of California San Diego School of Medicine have already begun modifying the Zika virus to make it less potent than the regular strain. Researcher Dr Michael Diamond said: "It looks like there's a silver lining to Zika. This virus that targets cells that are very important for brain growth in babies, we could use that now to target growing tumours."
A trial involving an anti-inflammatory drug could represent the biggest breakthrough in the treatment of heart attacks and strokes since statins were introduced to help lower cholesterol, its authors say. The study of 10,000 patients found that anti-inflammatory drug canakinumab reduced the risk of a patient who had already had a heart attack having another one in the future. The four-year trial saw patients receive high doses of statins as well as either canakinumab or a placebo. Those who received canakinumab were found to be 15% less likely to suffer from a cardiovascular event than their counterparts who received the placebo. Furthermore, cancer deaths were also halved in patients who received canakinumab. The results, which have been referred to as “exciting” by the British Heart Foundation, are thought to be down to the effect of the anti-inflammatory drug on unchecked inflammation within the heart’s arteries. Presenting their results at the European Society of Cardiology meeting, held in Barcelona, Spain, the research team from Brigham and Women's Hospital in Boston, led by the study's lead author Dr Paul Ridker, said the study represented "a milestone in a long journey". "For the first time, we've been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk. "This has far-reaching implications." It is thought the trial could now lead to new types of treatment for heart attacks and strokes being developed.
A new type of heart scan that analyses the fat and inflammation around the heart’s arteries could more accurately predict who will have a heart attack. The new way of scanning, developed by a team at the University of Oxford, identifies potential ticking time bomb arteries, allowing high-risk patients to receive intensive treatment and reduce their risk of suffering a heart attack or stroke. Most of us know inflammation as the red, swollen, sore feeling you experience after cutting your skin. However, the same occurs in all the tissues in the body, including inside the heart. Inflammation on the inside of blood vessels is linked to the build-up of unstable plaques, which can break apart and block a coronary artery, starving the heart of oxygen – resulting in a heart attack. "The holy grail in cardiology is the ability to pick up inflammation in coronary arteries, it's been a challenge for the past 50 years," said Prof Charalambos Antoniades, one of the Oxford researchers. Prof Metin Avkiran, associate medical director at the British Heart Foundation, said: "Discovering which plaques are likely to rupture, so people can be treated before such a devastating event strikes, is a major objective of current research. "If the technique lives up to its promise in larger trials in patients, it could lead to more effective treatment to avoid a potentially fatal heart attack or stroke."
Researchers from Oxford University have discovered a potential “goldmine” for new drugs in one of the unlikeliest places – ticks. They found that proteins contained in the parasites’ saliva are excellent at stopping inflammation of the heart, which can cause myocarditis and lead to heart failure. Ticks are remarkably good at biting and feeding without being detected. This allows them to stay attached to animals and humans for up to 10 days while they feed on their blood. The reason tick bites don’t cause any pain or inflammation is because proteins in their saliva neutralise chemicals called chemokines in the host. It’s now thought that ticks could be used to help treat other conditions, such as stroke and arthritis. Prof Shoumo Bhattacharya, BHF professor of cardiovascular medicine at the University of Oxford, who led the research, said: "Myocarditis is a devastating disease, for which there are currently very few treatments. "With this latest research, we hope to be able to take inspiration from the tick's anti-inflammatory strategy and design a life-saving therapy for this dangerous heart condition.” Traditionally, tick saliva was obtained by milking the tiny parasites using tubes. Nowadays, though, tick saliva proteins can be grown in yeast from synthetic genes, which allows large amounts to be produced. It should be noted that all of the current research has only been carried out in a laboratory, so it will be several years before any trials are conducted with humans.
Doctors say that an innovative new drug can cut bad cholesterol to unprecedented levels, reducing the risk of heart attacks and strokes for millions of people. Accounting for around 15 million deaths each year, heart attacks and strokes are the world's biggest killers. They are also the reason why people take drugs known as statins to reduce their levels of bad cholesterol, or LDL. Bad cholesterol causes blood vessels to fur up, which increases the chances of them blocking, leading to the heart or brain being starved of vital oxygen. The new drug, evolocumab, changes the way a person's liver works to help reduce bad cholesterol and is thought to be much more effective than statins. Evolocumab's potential was seen during a large international trial involving 27,000 patients who were already taking statins. "The end result was cholesterol levels came down and down and down and we've seen cholesterol levels lower than we have ever seen before in the practice of medicine," according to Prof Peter Sever, from Imperial College London. "They would have another 20% reduction in risk and that is a big effect. It is probably the most important trial result of a cholesterol lowering drug in over 20 years," he added. One heart attack or stroke was prevented for every 74 patients taking evolocumab in the two-year trial. The British Heart Foundation's medical director, Prof Sir Nilesh Samani, said: "This trial is a significant advance" in fighting one of the biggest killers in the world.
Swiss pharmaceutical company Roche has just agreed to purchase Trophos, a privately-held French biotechnology company situated in Marseille. The deal, which is reported to be worth 470 million euros ($545 million), will allow Roche to gain access to the French firm’s investigational medicine olesoxime – which is used to treat the debilitating genetic neuromuscular disease spinal muscular atrophy (SMA). Roche said that in a phase II study, the drug had a marked effect on individuals with SMA and helped to restore normal function and reduced related complications. The Swiss pharmaceutical giant is hoping that with its backing olesoxime will become the first approved drug for treating SMA - a disease that between one in 6,000 to one in 10,000 children around the world are affected by. "We will build on the work done by Trophos and the French Muscular Dystrophy Association to advance the development of olesoxime and to bring it to people who live with this devastating condition as quickly as possible”, said Roche’s Chief Medical Officer Sandra Horning in a statement. The deal will be welcome news for Trophos investors and highlights how much potential Roche believes olesoxime to hold for the treatment of SMA. You can read the full press release here, which contains more info about both companies, SMA and olesoxime.