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A Child’s Blood Sodium Ranges Had been Dangerously Excessive. What Was the Trigger?

A Baby’s Blood Sodium Levels Were Dangerously High. What Was the Cause?

The couple sat in silence as they drove home from Blank Children’s Hospital in Des Moines. Her 5-month-old appeared to be dwarfed by the baby carrier strapped to the back seat. He was tiny. He hadn’t grown since he was 2 months old. He weighed just 10 pounds – barely three pounds more than when he was born.

The baby was breastfed from birth, but his mother immediately noticed that he struggled with it more than his three older brothers. She tried putting her breast milk in a bottle to see if that would be easier for her baby to handle. When that didn’t help, she tried adding baby food. He often spat; sometimes it seemed as if more was coming out than was going in. His pediatrician prescribed him an acid-reducing medication. It didn’t seem to do much either.

Despite his size, he looked healthy. He was active. He was able to achieve all of his milestones. He could hold his head up. He could turn around. His fontanelle, the soft spot on his head, was flat—as it should be. His pediatrician advised patience, but when the boy still hadn’t gained any weight at his 4-month visit, she sent blood samples to the lab.

In the late afternoon, the parents received a call with the results. The baby had worrisome abnormalities in his blood chemistry. The salt level in his blood was very high, so high that he could trigger a seizure. In fact, it was so high that he could die if not addressed. Parents rushed the little boy to Blank Children’s Hospital.

Samples taken in the hospital’s emergency room quickly confirmed the anomaly. The child’s sodium level was 159, more than 10 points above normal. The high number not only told his doctors that he had too much sodium, but also that he didn’t have enough water in his body, that he was very dehydrated.

Normally, when there is too much sodium in the body, the brain triggers the urge to drink in order to absorb more water. The brain also tells the kidneys to retain as much water as possible.

The brain communicates all of this with a hormone called vasopressin. Problems with vasopressin can cause a condition first described in the 1700s as diabetes insipidus (DI) — a disease that produces copious and watery (rotten) urine.

The combination of the child’s high sodium levels and watery, dilute urine immediately led doctors to suspect he had DI. His high sodium levels should have caused his brain to send a vasopressin message to his kidneys to hold on to as much water as possible. And yet his urine consisted almost entirely of water. Why? Wasn’t the pituitary gland in his brain able to make the hormone? Or was there a problem on the news-receiving side in his kidneys?

No matter where the problem started, there were medications that could help. Doctors give the baby two drugs that are normally used to control high blood pressure and that cause the kidneys to excrete sodium. Almost immediately, the baby’s sodium began to drop. This indicated that the baby had DI. If so, was the problem in the brain, where the hormone is made, or in the kidneys? How the problem was handled depended on where it originated.

An MRI was done to look for signs of a problem in the pituitary gland. It looked normal. The problem, his doctors thought, was probably in his kidneys. They sent samples to look for a genetic reason for his abnormality, but those results would not be available for weeks.

In the meantime, they continued to give the baby the medicines that helped him get rid of the salt. And slowly the levels dropped. After a few days on these drugs, the baby’s chemistry was perfectly normal. His parents were told he should start gaining weight now. But he did not do it. By the day the doctors decided the baby was well enough to go home, it still hadn’t gained an ounce.

Parents were instructed to feed the child every three hours 24/7 to help him get the maximum number of calories. They should contact their pediatrician and see a genetics specialist. Then they were sent home. They had a strong feeling that their baby was not ready to leave the hospital. He was brought in with a diagnosis of failure to thrive and he’s still not doing well. He was in the zero percentile on the growth chart. Zero. They brought this argument to the boy’s doctors. He will gain weight now that his chemistry is normal they were told. Just give him time.

The child’s parents felt that he did not have time, that his life was still in danger. So early the next morning, parents and baby were back in the car. They had talked their way through to an appointment with the genetics specialists at the University of Iowa Stead Family Children’s Hospital in Iowa City, two hours away. When they got there, the parents shared their concerns. Was the baby’s inability to gain weight because of his DI? Or was there something else going on?

The child had been tested for cystic fibrosis at Blank Hospital. The test was inconclusive. Dozens of other medical conditions can affect a baby’s growth. Parents and baby were sent to the lab to have blood drawn to check for other genetic abnormalities and to the cardiology department to make sure his heart was normal.

The geneticist also wanted the baby to be evaluated by a pediatric gastroenterologist. It was clear he was having trouble feeding and seemed to spit out much of what he was able to eat. The geneticist turned to Dr. Eyad Hanna, who saw the child later that day. It was only minutes before the gastroenterologist decided the child was too small to send home. Like the child’s parents, he feared that if the baby couldn’t gain weight in the hospital, he might not be able to make it at home either. The baby was taken into Hanna’s care and fed around the clock to try to help him get back on the growth curve. Hanna also turned to a pediatric kidney specialist, Dr. Pat Brophy, who recommended adding plain water to make up for the water the boy lost with his urine. Doctors usually advise mothers not to give their babies water because breast milk contains enough water. But this clearly wasn’t a normal baby. And because of the reflux and difficulty breastfeeding the baby, Brophy also recommended placing a tube in the baby’s stomach — a gastrostomy, or G-tube — to ensure it could get enough calories, medication, and much-needed extra water.

The baby continued to spit up copious amounts of the milk and water he was given. Usually, this type of spitting goes away as an infant’s esophagus lengthens and stomach enlarges. But this baby would not grow at all without more food. Hanna recommended adding baby food and dry food to the milk. He had her enlarge the hole in the bottle’s nipple so the thickened liquid could flow through easily.

And then they waited. Test results trickled in. He didn’t have cystic fibrosis. His heart was perfectly normal. But even as the negative results began to roll in, the baby’s parents could see that he was doing better just because he was getting the calories and most importantly, the water he needed. Every night he got the equivalent of an 8-ounce glass of water through his G-tube. Every day he was fed every three hours to get a total of 1,300 calories. And slowly he started gaining weight – 30-40 grams per day. He stayed in the hospital for almost two weeks, and by the time he and his parents were able to go home he had gained over a pound. He needed a few more months to get back on the growth curve. Only then did they get the results of the genetic test, which confirmed what they already knew: the baby had DI

This baby is now 7 years old. He’s learning to live with his DI. He continues to take the medications that help him get rid of his sodium. He often has to go to the toilet. And he has to drink lots and lots of water to replace whatever he loses in his urine. He’s not as big as his brothers – not yet and maybe never. But he’s still growing and thriving, and that’s more than enough for his parents.

Lisa Sanders, MD, is a contributing writer for the magazine. Her latest book is Diagnosis: Solving the Most Baffling Medical Mysteries. If you have a solved case you want to share, write to her at Lisa.Sandersmdnyt@gmail.com.

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Entertainment

‘Candyman’ Evaluation: Who Can Take a Dawn, Sprinkle It With Blood?

‘Candyman’ Review: Who Can Take a Sunrise, Sprinkle It With Blood?

The first time Candyman the hook-wielding ghoul appeared on the big screen was in 1992, and he was making mince out of the people in Cabrini-Green, the troubled housing estate in Chicago. Since then, residents have moved (or moved out) and more than a dozen buildings have been razed to the ground. Forgotten sequels have come and gone, but Candyman remains, because cult film characters are a more durable and certainly more valuable commodity than affordable housing.

The original “Candyman”, written and directed by Bernard Rose, is more gross than scary, but it has a real bite to it. The focus is on the son of a formerly enslaved man – Tony Todd plays the title demon – who was once punished by racists for loving a white woman. Now he wanders around cutting and rolling those who call him. Just look in a mirror and say his name five times (oh, go ahead) and wait for the blood to splatter. Among those who did it back then was a white graduate student who becomes an ardent victim. The pain wasn’t exquisite as Candyman had promised, but it had its moments.

Candyman seems to pause in the sharp, trembling repeat directed by Nia DaCosta. The time is the present and the place is the bougie community that arose around Cabrini-Green. There, in slim towers with designer kitchens and window walls, the rising avant-garde sips wine and enjoys the view. Beyond that, the city sparkles pretty and its evils are a safe distance (if not for long). The troubled camera oversees the scene, and Sammy Davis Jr. – a black civil rights touchstone who became a supporter of Richard M. Nixon – belts out his sticky ’70s hit “The Candy Man” dive”). ) It is a smart reminder and warning that the past always troubles the present.

Sometimes the past bites the present exactly where it hurts, and soon the initial calm is violently reversed. As the blood begins to gush and the number of corpses increases, the story takes shape, as does the somewhat tense domestic life of a painter, Anthony (a very good Yahya Abdul-Mateen II) and a curator, the pointed Brianna (Teyonah Paris ). You soon learn that Candyman never left (well, he’s a valuable franchise item). Enter the horrors and screams and frightened laughs and the dependably indispensable Colman Domingo who shows up with a grin of a Cheshire Cat. There are also flashing police lights that are not as inviting as elsewhere.

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Blood clots linked to AstraZeneca shot have 22% mortality charge: research

Blood clots linked to AstraZeneca shot have 22% mortality rate: study

A paramedic prepares doses of the AstraZeneca vaccine for patients at a walk-in COVID-19 clinic at a Buddhist temple in the Smithfield suburb of Sydney on Aug. 4, 2021.

Saeed Khan | AFP | Getty Images

A new study has provided further details on the “rare but devastating” blood clotting complications associated with the Oxford-AstraZeneca Covid-19 vaccine.

In a peer-reviewed article published Wednesday in the New England Journal of Medicine, Massachusetts Medical Society scientists analyzed the first 220 cases of the disease reported in the UK.

The Oxford-AstraZeneca vaccine – now one of the most widely used Covid vaccines in the world – was launched in the UK in January, making it the first country to give the vaccine.

A very small number of people who were vaccinated with the AstraZeneca vaccine have developed blood clots. Described by health officials as “extremely rare”, it is characterized by blood clots accompanied by low platelet counts.

The Massachusetts Medical Society study uses data identified from 294 patients who presented to UK hospitals between March 22nd and June 6th.

All of these patients had received their first dose of the Oxford-AstraZeneca shot and were hospitalized with symptoms between five and 48 days after their vaccination. The average time between vaccination and hospitalization was 14 days, the results showed.

The overall mortality rate for VITT in the study was 22%.

The researchers also found that 41% of patients who presented with VITT were not diagnosed with any underlying health problems. Of those reporting a past or current illness, the study found that no illnesses or medications that were “unexpected in the general population” were prevalent.

“Against the background of a successful vaccination program in the UK, VITT has emerged as a rare but devastating complication,” the study’s authors said in their report. “We found that it often affects young, otherwise healthy vaccine recipients and is associated with high mortality.”

“In our cohort, 85% of the patients were younger than 60 years, although the (Oxford / AstraZeneca) vaccination was predominant in older adults,” the scientists found.

As a precaution, Great Britain has been offering people under 40 an alternative to the Oxford AstraZeneca vaccine since May.

People diagnosed with VITT ranged from 18 to 79 years old, with the mean age being 48, the study showed.

As of July 28, inclusive, an estimated 24.8 million first doses of the Oxford-AstraZeneca Covid vaccine had been administered in the UK, with an estimated 23.6 million second doses received.

On July 28, government figures show that for every million first or unknown doses of the Oxford AstraZeneca shot, 14.9 people developed a rare blood clot with low platelet counts. After a second dose of the vaccine, the number dropped to 1.8 cases per million.

The overall death rate for that period was 18%, the government data showed, with 73 deaths. Six of these occurred after the second dose.

Late last month, AstraZeneca published a study that found the VITT rate was 8.1 per million after the first dose of its vaccine, which dropped to 2.3 per million after a second dose.

According to official information, 411 suspected cases of VITT had been reported in Great Britain by July 28.

Benefits vs. Risks

In a statement Thursday, AstraZeneca said the research published in the New England Journal of Medicine was drawn from “a small sample size.”

“Recent practical evidence from millions of people shows that AstraZeneca’s vaccine has a similar safety profile to other vaccines and that thrombosis with thrombocytopenia is extremely rare and treatable,” said a spokesman.

The spokesman added that the infection with Covid-19 “poses a far greater risk” for rare blood clotting events.

“Vaccines remain the most effective protection against Covid-19 and the best way out of this pandemic,” they said.

Both the UK and EU drug regulators have identified possible links between the Oxford AstraZeneca vaccine and rare blood clots.

In April, the company announced it would comply with government requests in the UK and Europe to update its Covid vaccine labels. However, it stressed that the WHO had said “a causal relationship is considered plausible but not confirmed”.

The UK Joint Vaccination and Immunization Committee has stated time and time again that for the vast majority of people, the benefits of the Oxford-AstraZeneca vaccine continue to outweigh the risks.

Several health authorities, including the WHO, the European Medicines Agency and the International Society on Thrombosis and Hemostasis, agree that the benefits of giving the vaccine outweigh the risks.

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Health

He Was Coughing Up Blood. However His Lungs Regarded O.Ok.

He Was Coughing Up Blood. But His Lungs Looked O.K.

It was the EKG in the emergency room that gave Wallach the last clue he needed to make a diagnosis. An EKG measures the electricity generated by the heart to effectively contract the muscles. A thick, muscular heart will produce an EKG recording that is larger and more exaggerated than normal. The more muscles there are, the greater the signal. But this man’s heart was producing a signal that was smaller than normal. Less current could indicate fewer muscles. Was this man’s heart enlarged by anything other than muscle?

There are diseases that can invade the heart muscles to make them look bigger but weaker. Such a disease could be responsible for all of the man’s symptoms – the thick-looking walls, the overflow into the lungs, the strange EKG, the shortness of breath, even the hemoptysis. “I think you have something serious,” Wallach told the patient. A heart MRI could give you the answer. The patient got this test a few days later. He hadn’t been out of the scanner for more than 20 minutes when his phone rang. It was Wallach. The pictures told the story: The man had a disease called amyloidosis.

Amyloidosis is the end result of many disease processes that ultimately cause zigzag fibers to accumulate in different parts of the body. Cardiac amyloidosis can be the result of a cancer known as multiple myeloma. In this cancer, a type of white blood cell called a plasma cell creates abnormal fibers that can break down and form the sawtooth fibers characteristic of amyloidosis. These jagged fibers can also be age-related. In this version of the disease, carrier proteins known as transthyretins are broken down and take on the abnormal but characteristic irregular folds of amyloidosis. In both diseases, these jagged fibers migrate through the body, penetrate the muscle and collect there – often in the heart muscle.

Blood and urine tests quickly showed that his disease was not due to myeloma. That was a relief; The prognosis for patients with cardiac amyloidosis from multiple myeloma is poor. They often die within a year of being diagnosed. A heart muscle biopsy showed it was age-related amyloidosis. This form of amyloidosis is also progressive, but much more slowly. The patient was referred to a Columbia University cardiovascular surgeon. Sooner or later he would need a heart transplant.

Three years passed before Wallach heard from the patient again. He wrote to tell Wallach that he had received his heart transplant and was fine. He wrote to say thank you, “You saved my life.”

I asked Wallach how he could make this diagnosis if other doctors hadn’t. He called it the Aunt Tilly Sign. “If I were to describe Aunt Tilly to you and send you out into a crowd to find her, you would likely fail. But if you’ve ever seen Aunt Tilly “- he snapped his fingers -” no problem. You would find her in a second. It’s about recognition. “

Lisa Sanders, MD is a contributing writer for the magazine. Her latest book is Diagnosis: Solving the Most Baffling Medical Mysteries. If you have a resolved case with Dr. Sanders, drop her a line at Lisa .Sandersmd @ gmail.com.

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Health

There’s a ‘Extreme Blood Scarcity’ within the U.S., Purple Cross Says

There’s a ‘Severe Blood Shortage’ in the U.S., Red Cross Says

As many Americans return to prepandemic lifestyles, hospitals are facing a new issue: a desperate need for blood.

Over the past few months, hospitals have seen a rise in trauma cases, organ transplants and elective surgeries, prompting a national blood shortage, the American Red Cross said last week.

The lack of blood is so great that some hospitals are pumping the brakes on the pace of elective surgeries and “delaying crucial patient care,” until blood supply levels rebound, Chris Hrouda, president of Red Cross Biomedical Services, said in a statement.

“The Red Cross is currently experiencing a severe blood shortage,” Mr. Hrouda said, adding that the organization was working to distribute more blood than expected over the past three months. “But we can’t do it without donors. Every two seconds, someone in the U.S. needs blood.”

The demand for blood is not new. There was also a shortage last year when blood donation centers were forced to close because of the coronavirus pandemic.

But in some ways, it seems more dire than before. During last year’s shortage, for example, Brian Gannon, chief executive of the Gulf Coast Regional Blood Center in Texas, said his organization had one or two days’ worth of Type O red blood cells, down from a normal supply of three to four days’ worth.

In recent weeks, Type O blood supply has been down to half a day’s worth, according to the Red Cross, which said there was also an “emergency need” for the donation of platelets, half of which go to patients undergoing cancer treatments.

Dr. Merlyn Sayers, president and chief executive of Carter BloodCare, based in Texas, called the need for blood a “national crisis.”

“Carter BloodCare dreads reaching the point, with blood inventories so jeopardized, that patients needing transfusion cannot be confident that the blood is there for them,” Dr. Sayers said.

The blood shortage is a result of two challenges caused by the pandemic — closing and reopening, Dr. Sayers said.

“In the first place, the pandemic, for more than a year, imposed conditions, such as social distancing, that were inimical to blood donation,” Dr. Sayers said, adding that many businesses that typically supported blood donation campaigns at workplaces had closed. “And now, with the gradual emergence from restrictions, hospital demands for blood have increased dramatically as patients who understandably avoided hospitalization for fear of Covid are presenting for treatment.”

The Red Cross said patients who did not seek care during the height of the pandemic in the United States were showing up in hospitals with “more advanced disease progression,” which in some cases requires more blood transfusions.

In addition to patients who delayed seeking treatment for fear of the virus, another possible reason for the increased demand for blood is that as cities reopen, more people are exposed to potential dangers leaving their homes.

The Red Cross said hospitals across the country had been responding to an “atypically high” rise in trauma cases and emergency room visits. The organization said it had seen demand from hospitals with trauma centers increase by 10 percent this year, compared with 2019.

“Where there’s more people on the road, there’s probably more accidents. We did quarantine for a long time,” said Cameron Palmer, a community development coordinator with the Gulf Coast Regional Blood Center in Houston. “Having more people on the road can cause more accidents, which can cause people to need more transfusions.”

The Gulf Coast Regional Blood Center is still making its collection calls, but hospitals have had a greater need for blood, Mr. Palmer said.

“It’s not really a shortage. It’s more of a usage,” he said. “It’s just that our hospitals are now asking for more than expected.”

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Theranos is historical past, however massive blood testing breakthroughs are coming

Theranos is history, but big blood testing breakthroughs are coming

Medical researchers say within a few years major breakthroughs in blood testing technology that use immune system response and genetic analysis to identify disease quickly and cost-effectively will be on the market.

picture alliance | picture alliance | Getty Images

One morning last May, Tayah Fernandes’s mother Shannon realized her four-year-old daughter was seriously unwell, and rushed her to the nearest ER in the English city of Manchester. The coronavirus had crashed onto Britain’s shores weeks earlier, and emergency doctors were initially uncertain how best to treat Tayah’s constellation of symptoms, which included stomach pains and a bright red rash.

They gave her antibiotics for a suspected bacterial infection, but her condition only worsened, her fever spiking. For her parents, for any parents, this was the ultimate medical nightmare; doctors in the dark for days over the cause of their daughter’s illness.

Eventually, after further blood tests, physicians decided Tayah was suffering from an unusual inflammatory syndrome that pediatric infectious disease specialists had only just started to see, but suspected had links to Sars-COV-2.

Young patients across the U.K. and U.S. were arriving in intensive care units with symptoms similar to another disease doctors already recognized, called Kawasaki. But they had no guarantee that the same course of treatment — injecting a solution of donors’ antibodies into the bloodstream — would prove successful.

In Tayah’s case the antibodies solution, known as immunoglobulin, worked, to her parents’ relief. But at around that same time last May a team of researchers at Imperial College, London confirmed through complex analyses of blood samples, taken from patients like Tayah, that this was indeed a new disease, distinct from Kawasaki.

Hunting inside immune system response to bacteria, virus

A related breakthrough in that same laboratory, focused specifically on the way individual genes behave, could have seismic implications for a multi-billion dollar diagnostics sector that has received unprecedented attention from patients, regulators and the business world over the course of this pandemic.

A new method for identifying a specific illness from blood samples relies on the correlation between the activity in small set of genes, which represents the immune response, and specific pathogens that cause a specific disease — just as the poliovirus causes polio, the coronavirus (SARS-COV-2, a pathogen) causes Covid-19. Scientists believe that by studying a small number of genes, they can quickly discern which pathogen is in a patient’s system, what disease they have, and so how best to treat them. 

Companies from small research university spin-offs to industry giants like Abbott Laboratories and Danaher’s Cepheid are looking to build on two decades of research into the way our own immune systems naturally respond to foreign substances in our bodies, including pathogens like bacteria or viruses. A current technology like Cepheid’s GeneXpert technology is able to distinguish between the different RNA of various viruses, such as SARS-COV-2, or a particular influenza strain, but experts say it’s become increasingly clear that our body’s immune systems can be faster, more accurate detection systems. 

Historically, doctors have had to rely on a patient’s case history and symptoms to narrow down the cause of an illness and develop a treatment plan. More recently, laboratory inspections at the molecular level such as the Cepheid technology have allowed clinicians to identify specific pathogens in nasal mucus, throat swabs or blood samples that might have caused an illness. But hunting for bacteria or a virus in this way can be time-consuming, costly and sometimes simply ineffective. The specific RNA signature of a virus can be hard to detect.

Abbott and Cepheid did not respond to requests for comment.

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The team at Imperial College, London, working separately but at the same time as several counterparts around the world, are now convinced that future diagnoses can soon be conducted using table-top tests that will take just a matter of minutes.

These tests would not explicitly screen for a specific pathogen, but instead, allow scientists and medical professionals to simply watch how specific genes in the body are behaving as an indication of how an immune system is already responding to a pathogen that may not be easily otherwise detectable. 

Imperial College professor Mike Levin currently leads an ongoing European Union-funded study focused on this potential, called “Diamonds.” In recent years he and other scientists have shown how the observed activity in a small number of our genes can work as a kind of shorthand for our body’s immune response to a pathogen. If a handful of specific genes out of thousands in a blood sample are seen to be activated — or the opposite, inhibited — it can indicate that a person is preparing to fight off a specific pathogen.

We think this is a completely revolutionary way of doing medical diagnosis.

Imperial College professor Mike Levin

Levin and colleagues already have a proof of concept for this diagnostic approach after studies involving thousands of patients with fever caused by tuberculosis, and hundreds of Kawasaki patients. And his Imperial College team’s work with the “Diamonds” study are starting to bear fruit and could help identify the distinct immunological markers of illnesses like the coronavirus-linked multi-system inflammatory syndrome in children like Tayah Fernandes, now commonly known as MIS-C. 

When Covid-19 turned up in multiple locations, with MIS-C in its wake, it presented Levin and his researchers with an unprecedented opportunity to test this technique on an entirely new disease.

In the future, these tests — by relying on huge amounts of data and machine learning — should be able to produce multi-class rather than just binary results. This means they could confirm not only if a pathogen is bacterial or viral, or whether someone has a specific disease or not, but could distinguish which one of a multitude of illnesses is afflicting their patient.

In short, Levin expects that by examining the behavior of a relatively small number of genes, clinicians will be able to assign patients to all the major disease classes within an hour.

“We think this is a completely revolutionary way of doing medical diagnosis,” Levin said. He expects the research will provide the basis for new technology, but has no financial interest in any business related to it. 

Rather than what he calls the “stepwise process” of first eliminating bacterial infections, treating for the most common conditions, and then doing more investigation, “this idea is the very first blood test can tell you, has the patient got an infection or not an infection, and what group of infection that is, right down to the individual pathogens.”

Purvesh Khatri, an associate professor at the Stanford Institute for Immunity, Transplantation and Infection and Department of Medicine, says our immune systems have been evolving for millennia to combat pathogens, and so it may prove more effective, and efficient, to examine the response of our bodies.

“We didn’t have a technology, until now, that could measure a set of genes in a rapid point of care way,” he said. “But in the last couple of years, there have been enough technologies available that now allow us to measure a few genes in a rapid multiplex point of care assay way.”

While neither the FDA nor any European regulators have approved these kinds of gene-based pathogen detection systems, Khatri, who is helping launch a related commercial venture, says they’re coming soon. “In the next year or two, there will be several that will be available on the market.”

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CDC says 28 blood clot instances, three deaths could also be linked to J&J Covid vaccine

CDC says 28 blood clot cases, 3 deaths may be linked to J&J Covid vaccine

The Johnson & Johnson Janssen vaccine

Stephen Zenner | LightRocket | Getty Images

CDC scientists say their investigation into a rare blood clotting problem related to the Johnson & Johnson Covid-19 vaccine identified 28 people who may have developed life-threatening blockages – three of whom have died.

The Food and Drug Administration and Centers for Disease Control and Prevention urged states on April 13 to temporarily cease use of J & J’s vaccine “out of caution” while examining six women ages 18 to 48 who developed cerebral venous sinus thrombosis, or CVST combined with low platelets within about two weeks of receiving the shot.

They recommended resuming use of the shot 10 days later after the CDC found the benefits of the vaccinations outweighed their risks.

CVST is a form of thrombosis with thrombocytopenia, or TTS, which are blood clots with a low platelet count that make patients at risk of stroke. Platelets actually help the blood to clot.

CDC official Dr. Tom Shimabukuro said Wednesday that four of the 28 people with TTS were hospitalized on May 7, one of whom was in intensive care, and two were being discharged to a post-acute care facility. The remaining 19 patients have all been discharged, he said during a presentation to the CDC Advisory Committee on Immunization Practices. The panel voted earlier in the day to recommend the Pfizer BioNTech vaccine for 12 to 15 year olds.

The mean age of the patients with TTS was 40 years and ranged from 18 to 59 years. Women aged 30 to 39 were the greatest risk group. All patients received the J&J shot before the April 13 break. Of the 28 TTS cases, 19 involved the brain, with 10 of those patients suffering from cerebral haemorrhage, Shimabukuro said.

The other clots formed in the lower extremities, pulmonary arteries, or other areas of the body.

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C.D.C Confirms Extra Instances of Uncommon Blood Clot Dysfunction Linked to J.&J. Vaccine

C.D.C Confirms More Cases of Rare Blood Clot Disorder Linked to J.&J. Vaccine

Federal health officials have now confirmed 28 cases, including six in men, of a rare bleeding disorder in adults who have received the Johnson & Johnson Covid-19 vaccine.

Dr. Tom Shimabukuro, deputy director of the vaccination safety bureau at the Centers for Disease Control and Prevention, presented the new cases on Wednesday at a CDC advisory board meeting

The number is an increase from the 15 confirmed cases that were all women reported at the meeting last month.

Although officials have now identified a handful of cases in men, women – particularly between the ages of 30 and 49 – appear to be at increased risk. “The trend is that women in all age groups have higher reporting rates than men,” said Dr. Shimabukuro at the meeting.

Patients with the rare but serious disorder develop blood clots, often in the brain, as well as low levels of platelets, components of the blood that promote clotting. The disorder is a “rare, clinically serious, and potentially life-threatening condition,” said Dr. Shimabukuro.

Last month, after reports first emerged that six women who had received the vaccine had developed the disorder, federal health officials recommended discontinuing use of the vaccine during the investigation. They lifted the suspension 10 days later and warned the vaccine label of possible risks that suggest that there is a “plausible” link between the vaccine and the disease.

22 of the confirmed cases so far involved women and six men. All were adults between the ages of 18 and 59 who received the vaccine before the national break. (Another case was also recorded in a 25-year-old male who participated in the clinical trial.)

Three people have died and four remain in the hospital, including one in intensive care. No new deaths have been documented since last month’s meeting, said Dr. Shimabukuro.

The overall risk remains extremely low. More than 9 million doses of the Johnson & Johnson vaccine have now been administered in the United States.

There were 12.4 cases per million doses in women between 30 and 39 years of age and 9.4 cases per million doses in women between 40 and 49 years of age, the two demographics that appear to be at greatest risk. There were fewer than 3 cases per million doses in older women and men of all ages.

Of the 28 confirmed cases, 12 people who developed the disorder had obesity, 7 had high blood pressure, 3 had diabetes, and 3 were taking estrogen, although it is not yet clear whether any of these factors could significantly increase the risk of the disorder.

Officials will continue to look for cases of the coagulation disorder in vaccinated people, said Dr. Shimabukuro.

There were no confirmed cases of coagulation disorder after the Pfizer BioNTech or Moderna vaccines, which use a different technology, said Dr. Shimabukuro.

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Theranos blood take a look at accuracy at coronary heart of Elizabeth Holmes legal case

Theranos blood test accuracy at heart of Elizabeth Holmes criminal case

Former Theranos CEO Elizabeth Holmes will attend the US government fraud court hearing against her on May 5, 2021.

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Former Theranos CEO Elizabeth Holmes promised a technological breakthrough, but it really was a house of cards, prosecutors said during a trial Wednesday.

“Miss Holmes went out, told the world, and told investors, we have tests with the highest accuracy rate,” said US assistant attorney Robert Leach, adding that her expert’s testimony “lies.”

The argument was in response to efforts by the defense, Dr. Stephen Master, an associate professor of pathology and laboratory in the University of Pennsylvania Medical School, from taking a stand. In 2013, after interviewing Holmes at a conference, Master said that her claims about Theranos’ miniLab technology “fell far short of previous claims”.

Holmes’ defenders argued that the master was used as a “parrot” by the government and that his conclusions about certain Theranos blood tests were “based on emails and customer complaints,” not practical experience.

Wednesday’s hearing was the second day of the argument about what evidence can be admitted and excluded from Holmes’ criminal fraud trial, which begins August 31st.

Prosecutors, among other things, alleged that Holmes was presenting an inappropriate defense in good faith.

“Efforts to return money to victims cannot undo the fraud once it is committed,” said John Bostick, another US assistant attorney.

The judge is expected to rule on critical motions, including whether to provide evidence of Holmes’ assets and expenses, private text exchanges and regulatory reports by the end of the week.

The hearing came when a former Theranos executive who had been close to Holmes in the company’s final days told CNBC that management was discussing Holmes’ resignation as CEO on several occasions. For Holmes, however, “that was a non-runner”.

“If she had resigned, I think she would have saved herself a lot of legal danger,” said the former Theranos manager, who asked not to be named. “Everyone who knows Elizabeth knows that she saw herself as a company, and I don’t think she can see the company going on without her.”

Holmes left Stanford at 19 to start Theranos. By the time the company collapsed in 2018, she had a six-figure salary and a multi-billion dollar stake in the blood testing startup.

However, an investigation by the Wall Street Journal found that the technology didn’t work as Holmes claimed it did. Now she faces a dozen fraud charges for falsely claiming that Theranos technology can perform dozens of blood tests on a drop or two of blood. She pleaded not guilty.

Despite the chaos in the final months of her reign, Holmes believed Theranos could still be saved.

Holmes achieved a partial victory this week when the judge ruled that defenders can refer to Silicon Valley’s hype culture to explain why Holmes exaggerated the technology behind Theranos.

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Health

Public demand for AstraZeneca vaccine falls after blood clot scares

Ireland, Netherlands suspend AstraZeneca vaccine amid blood clot fears

A medical worker fills a syringe with AstraZeneca vaccine at Santa Caterina da Siena – Amendola secondary school in Salerno on March 13, 2021 in Salerno, Italy.

Francesco Pecoraro | Getty Images News | Getty Images

LONDON – Public preference for the coronavirus vaccine developed by AstraZeneca and the University of Oxford has fallen since reports surfaced suggesting it may be linked to some cases of unusual blood clotting events.

An April study of nearly 5,000 adults in the UK, with Covid vaccine uptake high and the vaccination program well established, found that public preference for the AstraZeneca Covid vaccine has declined since March and there is a belief that that he caused blood clots to have increased.

The UK academic study found that 17% of the public now say they would prefer the AstraZeneca vaccine if given a choice – up from 24% towards the end of March.

And 23% of people now believe the AstraZeneca vaccine causes blood clots – up from 13% in March. However, the public are still the most likely to say that this claim is false (39%) or that they don’t know if it is true (38%).

The study, conducted April 1–16 by the University of Bristol, King’s College London, and the NIHR Health Protection Unit for Emergency Preparedness and Relief, found a “big difference” in beliefs before and after MHRA ( the UK Medicines Agency) announced on April 7th that there is a possible link between the vaccine and extremely rare blood clots.

The study found that 17% of respondents in the first week of this month thought this claim was true, compared with 31% who were asked about it.

Why autumn

Since the first clinical data was published, the vaccine has shown an average effectiveness rate of 70% (subsequent studies in the US have shown an effectiveness rate of 79%, and other studies have shown that the effectiveness rate increases with a larger gap between the first and second doses ) The fate of the AstraZeneca vaccine is mixed to say the least.

Continue reading: Dates, Doubts, and Disputes: A Timeline for AstraZeneca’s Covid Vaccine Problems

One of the recent hurdles for the AstraZeneca vaccine was a small number of reports of unusual, sometimes fatal, blood coagulation events that occurred in post-vaccinating people in Europe in February, causing several countries to suspend use of the vaccine.

The UK and EU drug regulators (the UK Medicines and Health Products Regulatory Authority and the European Medicines Agency) examined the reports and said that while there is a possible link between the vaccine and low incidence of blood clotting, the benefits of the vaccine are significant outweighing them Risks.

The Anglo-Swedish vaccine maker, British government and experts largely defended the vaccine, saying it protected millions of people by reducing Covid cases, hospitalizations and deaths.

In addition, experts tried to correlate the risk, saying the number of reported rare blood clotting cases with low platelets was about one case in 250,000 people vaccinated and one death in one million.

Britain is fortunate that it has traditionally received high levels of public support for vaccination. The vaccine preference survey found that, despite the growing belief that it was associated with blood clots, the AstraZeneca vaccine did not affect general confidence in vaccines in general. 81% say vaccines are safe, compared to 73% who said so in late 2020.

Similarly, views on how well vaccines work have changed: 86% say they are effective, up from 79% in November and December 2020.

However, surveys have shown that the public perception of the AstraZeneca vaccine has deteriorated in mainland Europe, and there is scattered evidence that people in the EU are using the AstraZeneca vaccine (referred to as the “Aldi” vaccine after the low-cost food chain will) because in favor of the coronavirus vaccine from Pfizer-BioNTech, which also prevails when EU vaccinations are introduced.

Continue reading: “The damage is done”: Europe’s caution against the AstraZeneca vaccine could have far-reaching consequences

Moderna’s shot and Johnson & Johnson’s shot have also been approved for use in the EU and the UK, but have been less widely used, EU vaccination data show.

Hesitation to vaccinate can apparently work both ways. A British doctor reported in the Evening Standard newspaper in January that some of his patients had turned down the opportunity to receive the Pfizer vaccine, saying they would “wait for the English one.”