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After a period of falling asthma treatment illness rates, the recent spread of ventolin nebulizer pediatric dose the delta variant of asthma was a major disappointment and necessitated a reexamination of some previous assumptions http://keim-farben.de/online-cialis-prescription. This reconsideration may, at least in part, be a correction to overly optimistic views of what highly effective asthma treatments could accomplish. Some observers had hoped the treatments could eliminate transmission of the ventolin, the ultimate goal ventolin nebulizer pediatric dose of reaching herd immunity.1 A more likely picture of our future with this ventolin comes into focus if we examine the well-known patterns of another respiratory ventolin, influenza, both in and outside ventolins. That experience can help us reset expectations and modify goals for dealing with asthma as it further adapts in global spread.Early results from the clinical trials and observational studies of mRNA treatments against asthma indicated that not only were they highly effective at preventing symptomatic , but they were also effective in preventing asymptomatic and therefore transmission.2 The basic criterion used for emergency use authorization by the Food and Drug Administration was a standard one.
Prevention of laboratory-confirmed clinical meeting a case definition. The effect on ventolin nebulizer pediatric dose asymptomatic s was a welcome surprise, because it has been thought that most treatments for respiratory illnesses, including influenza, are âleakyâ â that is, they allow some degree of asymptomatic and are better at preventing symptomatic .The initial data on inapparent asthma strengthened the hope that, at a certain level of vaccination, transmission would cease completely. To many of us, this hope appeared overly optimistic, and it seems even more so now. The highly transmissible delta variant causes asymptomatic s and sometimes illnesses (albeit usually mild) in vaccinated people, probably because of increased growth potential, as well as because of waning immunity, which also involves ventolin nebulizer pediatric dose decreasing IgA antibody levels.
Elimination of an illness by means of herd immunity works best when the agent has low transmissibility, and it requires the absence of pockets of susceptible people. Eliminating asthma treatment seemed theoretically possible, because the original 2002 SARS ventolin ultimately disappeared. That ventolin, ventolin nebulizer pediatric dose however, did not transmit as well as even the initial strain of asthma. It occurred in limited regions and was characterized by focal spread, including superspreading events.
Such a pattern, which was also seen in the early ventolin nebulizer pediatric dose days of asthma, is called âoverdispersionâ â 10% of cases, for example, may be responsible for 80% of transmission.3 These dynamics explain why there were great differences in antibody prevalence within a given city and spotty global spread early in the ventolin. Overdispersion was thought to be an unstable trait that would disappear, with transmission becoming more uniform and higher overall. That transition appears to have occurred as newer variants take over.Given the parade of variants, their varying transmissibility, and continuing concern about antigenic changes affecting treatment protection, I believe it should now be clear that it is not possible to eliminate this ventolin from the population and that we should develop long-term plans for dealing with it after the unsupportable surges are fully controlled. ventolin and ventolin nebulizer pediatric dose seasonal influenza provide the most appropriate models to aid in developing strategies going forward.As with asthma, when a novel ventolin influenza strain appears, its spread can overwhelm the health care system.
Waves of go through a city in weeks and a country in months, but there is scant evidence that superspreading events occur. Thereafter, the ventolin ventolin persists as a new seasonal strain, and antigenic changes occur â albeit probably not as quickly as we are seeing with asthma. The new strain joins the other seasonal ventolin nebulizer pediatric dose influenza types and subtypes that reappear each year. The goal of vaccination becomes managing the inevitable outbreaks and reducing the rates of moderate-to-severe illness and death.
Preventing mild disease, though important, is less critical.Summary of World Health Organization (WHO) Process of ventolin Selection for Annual Influenza ventolin nebulizer pediatric dose treatments. Readministration of influenza treatment has become an annual event for much of the population, in response to both waning immunity and the appearance of variants, termed antigenic drift, necessitating updated treatments. Even when there is no substantial drift, revaccination is recommended because of waning immunity. But antigenic drift is a constant issue and is monitored globally, with treatment composition updated globally twice a year on the basis of recommendations ventolin nebulizer pediatric dose from a World Health Organization consultation.4 As outlined in the table, various criteria are considered in decisions about which strains to include in treatments.
treatment effectiveness against laboratory-confirmed symptomatic is never higher than 50 to 60%, and in some years it is much lower. Thus, the value of influenza treatments, now given to as many as 70% of people in some age groups, lies not in eliminating outbreaks but ventolin nebulizer pediatric dose in reducing them and preventing severe complications.Though there may be similarities between asthma and influenza, there are also meaningful differences. The most obvious difference is the efficacy of asthma treatments, which is currently much higher than we can achieve with influenza treatments. Whether that degree of efficacy will continue is one of the many open questions that can only be answered over time.
It is clear, however, that revaccination will be ventolin nebulizer pediatric dose necessary, for the same reasons that influenza revaccination is necessary. Antigenic variation and waning immunity. Data on the frequency of re with seasonal asthmaes may not be relevant, but they suggest that protection is relatively short term even after natural .5 Revaccination frequency and consequences will need to be determined.Let us hope that certain problems with the influenza treatment â such as the failure of vaccination, in some years, to produce the desired increase in protection in previously vaccinated people â do not occur with the asthma treatments. Other issues, ventolin nebulizer pediatric dose such as the variant to be targeted by treatments, will need to be addressed.
The successful publicâprivate collaboration in selecting influenza strains offers a model for dealing with such issues. asthma treatments will be used ventolin nebulizer pediatric dose globally, and the strain or strains contained in future treatments will need to be chosen globally, in consultation with the manufacturers.Most predictions about the shape of the postâasthma treatment world have been inaccurate â a reflection of rapid changes in knowledge. But we can now see a picture emerging in which use of effective treatments will continue to be critical over the long term. Increases in asymptomatic s and mild illnesses in vaccinated people will nonetheless continue to be possible, as variants continue to emerge.
Counts of hospitalizations and deaths may be more important in monitoring the overall impact than numbers of cases, as long as the treatments continue to be largely effective at preventing severe ventolin nebulizer pediatric dose illness. The possibility of severe illnesses in a small proportion of vaccinated people does emphasize one of the greatest unmet needs we currently face. Continued emphasis on better therapeutics and antiviral agents, which will not be affected by molecular changes in the ventolin as much ventolin nebulizer pediatric dose as treatments are.The future timing and composition of booster treatment doses will need to be determined on the basis of observational studies. We currently have few data on non-mRNA treatments, particularly protein-based treatments, which may have characteristics different from those of mRNA treatments, especially in terms of duration of immunity.Overall, the situation will be fluid, but we will require the continuing use of treatments to avert severe consequences, even if milder illnesses still occur at a low frequency.
We need to learn to live with these illnesses, just as we have learned to live with influenza.Data Source Data on all residents of Israel who had been fully vaccinated before June 1, 2021, and who had not been infected before the study period were extracted from the Israeli Ministry of Health database on September 2, 2021. We defined fully vaccinated persons as those for whom 7 days or ventolin nebulizer pediatric dose more had passed since receipt of the second dose of the BNT162b2 treatment. We used the Ministry of Health official database that contains all information regarding asthma treatment (see Supplementary Methods 1 in the Supplementary Appendix, available with the full text of this article at NEJM.org). We extracted from the database information on all documented asthma s (i.e., positive result on PCR assay) and on the severity of the disease after .
We focused on s that had been documented in the period from July 11 through ventolin nebulizer pediatric dose 31, 2021 (study period), removing from the data all confirmed cases that had been documented before that period. The start date was selected as a time when the ventolin had already spread throughout the entire country and across population sectors. The end date was just after Israel had ventolin nebulizer pediatric dose initiated a campaign regarding the use of a booster treatment (third dose). The study period happened to coincide with the school summer vacation.
We omitted from all the analyses children and adolescents younger than 16 years of age (most of whom were unvaccinated or had been recently vaccinated). Only persons 40 years of age or older were included in the ventolin nebulizer pediatric dose analysis of severe disease because severe disease was rare in the younger population. Severe disease was defined as a resting respiratory rate of more than 30 breaths per minute, oxygen saturation of less than 94% while the person was breathing ambient air, or a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen of less than 300.14 Persons who died from asthma treatment during the follow-up period were included in the study and categorized as having had severe disease. During the study period, approximately ventolin nebulizer pediatric dose 10% of the detected s were in residents of Israel returning from abroad.
Most residents who traveled abroad had been vaccinated and were exposed to different populations, so their risk of differed from that in the rest of the study population. We therefore removed from the analysis all residents who had returned from abroad in July. Vaccination Schedule The official vaccination regimen in Israel involved the administration of the second dose ventolin nebulizer pediatric dose 3 weeks after the first dose. All residents 60 years of age or older were eligible for vaccination starting on December 20, 2020, thus becoming fully vaccinated starting in mid-January 2021.
At that time, younger persons were eligible for vaccination only if they belonged to designated groups (e.g., health care workers and severely immunocompromised adults). The eligibility age was reduced to 55 years on January 12, 2021, and ventolin nebulizer pediatric dose to 40 years on January 19, 2021. On February 4, 2021, all persons 16 years of age or older became eligible for vaccination. Thus, if they did not belong to a designated group, persons 40 to 59 years of age ventolin nebulizer pediatric dose received the second dose starting in mid-February, and those 16 to 39 years of age received the second dose starting in the beginning of March.
On the basis of these dates, we defined our periods of interest in half months starting from January 16. Vaccination periods for individual persons were determined according to the time that they had become fully vaccinated (i.e., 1 week after receipt of the second dose). All the analyses were stratified according to vaccination period and ventolin nebulizer pediatric dose to age group (16 to 39 years, 40 to 59 years, and â¥60 years). Statistical Analysis The association between the rate of confirmed s and the period of vaccination provides a measure of waning immunity.
Without waning of immunity, one would expect to see no differences in rates among ventolin nebulizer pediatric dose persons vaccinated at different times. To examine the effect of waning immunity during the period when the delta variant was predominant, we compared the rate of confirmed s (per 1000 persons) during the study period (July 11 to 31, 2021) among persons who became fully vaccinated during various periods. The 95% confidence intervals for the rates were calculated by multiplying the standard confidence intervals for proportions by 1000. A similar analysis was performed to compare the association between the rate of severe asthma treatment and the vaccination period, but for this outcome we used periods of entire months because there were ventolin nebulizer pediatric dose fewer cases of severe disease.
To account for possible confounders, we fitted Poisson regressions. The outcome variable was the number ventolin nebulizer pediatric dose of documented asthma s or cases of severe asthma treatment during the study period. The period of vaccination, which was defined as 7 days after receipt of the second dose of the asthma treatment, was the primary exposure of interest. The models compared the rates per 1000 persons between different vaccination periods, in which the reference period for each age group was set according to the time at which all persons in that group first became eligible for vaccination.
A differential effect of the vaccination period for each age group ventolin nebulizer pediatric dose was allowed by the inclusion of an interaction term between age and vaccination period. Additional potential confounders were added as covariates, as described below, and the natural logarithm of the number of persons was added as an offset. For each vaccination period and age group, an adjusted rate was calculated as the expected number of weekly events per 100,000 persons if all the persons in that age group had been vaccinated in that period. All the analyses were performed with the use of the glm function in the R statistical software package.17 In addition to age and sex, the regression analysis ventolin nebulizer pediatric dose included as covariates the following confounders.
First, because the event rates were rising rapidly during the study period (Figure 1), we included the week in which the event was recorded. Second, although PCR testing is free in Israel for all residents, compliance with PCR-testing recommendations is variable and is a possible source of ventolin nebulizer pediatric dose detection bias. To partially account for this, we stratified persons according to the number of PCR tests that had been performed during the period of March 1 to November 31, 2020, which was before the initiation of the vaccination campaign. We defined three levels of use.
Zero, one, and two or more ventolin nebulizer pediatric dose PCR tests. Finally, the three major population groups in Israel (general Jewish, Arab, and ua-Orthodox Jewish) have varying risk factors for . The proportion of vaccinated persons, as well as the level of exposure to the ventolin nebulizer pediatric dose ventolin, differed among these groups.18 Although we restricted the study to dates when the ventolin was found throughout the country, we included population sector as a covariate to control for any residual confounding effect. We conducted several secondary analyses to test the robustness of the results, including calculation of the rate of confirmed in a finer, 10-year age grouping and an analysis restricted to the general Jewish population (in which the delta outbreak began), which comprises the majority of persons in Israel.
In addition, a model including a measure of socioeconomic status as a covariate was fitted to the data, because this was an important risk factor in a previous study.18 Since socioeconomic status was unknown for 5% of the persons in our study and the missingness of the data seemed to be informative, and also owing to concern regarding nondifferential misclassification (persons with unknown socioeconomic status may have had different rates of vaccination, , and severe disease), we did not include socioeconomic status in the main analysis. Finally, we compared the association between the number of PCR tests that had been conducted before the vaccination campaign (i.e., before December 2020) ventolin nebulizer pediatric dose with the number that were conducted during the study period in order to evaluate the possible magnitude of detection bias in our analysis. A good correlation between past behavior regarding PCR testing and behavior during the study period would provide reassurance that the inclusion of past behavior as a covariate in the model would control, at least in part, for detection bias.Participants Figure 1. Figure 1.
Screening, Randomization, ventolin nebulizer pediatric dose and Follow-up. The diagram represents all enrolled participants 16 years of age or older through the data cutoff date (March 13, 2021). The diagram includes two deaths that occurred after the second dose in human immunodeficiency ventolin (HIV)âinfected participants (one in the BNT162b2 group and one ventolin nebulizer pediatric dose in the placebo group. These deaths were not reported in the Results section of this article because the analysis of HIV-infected participants is being conducted separately).
Information on the screening, randomization, and follow-up of the participants 12 to 15 years of age has been reported previously.11Table 1. Table 1 ventolin nebulizer pediatric dose. Demographic Characteristics of the Participants at Baseline. Between July 27, 2020, and October 29, 2020, a total of 45,441 participants 16 years ventolin nebulizer pediatric dose of age or older underwent screening, and 44,165 underwent randomization at 152 sites (130 sites in the United States, 1 site in Argentina, 2 sites in Brazil, 4 sites in South Africa, 6 sites in Germany, and 9 sites in Turkey) in the phase 2â3 portion of the trial.
Of these participants, 44,060 received at least one dose of BNT162b2 (22,030 participants) or placebo (22,030), and 98% (21,759 in the BNT162b2 group and 21,650 in the placebo group) received the second dose (Figure 1). During the blinded period of the trial, 51% of the participants in each group had 4 to less than 6 months of follow-up after the second dose. 8% of the participants in the BNT162b2 ventolin nebulizer pediatric dose group and 6% of those in the placebo group had 6 months of follow-up or more after the second dose. During the combined blinded and open-label periods, 55% of the participants in the BNT162b2 group had 6 months of follow-up or more after the second dose.
A total of 49% of the participants were female, 82% were White, 10% were Black, and 26% were Hispanic or Latinx. The median age was 51 years ventolin nebulizer pediatric dose. A total of 34% of the participants had a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30.0 or more, 21% had at least one underlying medical condition, and 3% had baseline evidence of a previous or current asthma (Table 1 and Table S2). Between October 15, 2020, and January 12, 2021, a total of ventolin nebulizer pediatric dose 2306 participants 12 to 15 years of age underwent screening, and 2264 underwent randomization at 29 U.S.
Sites. Of these participants, 2260 received at least one dose of BNT162b2 (1131 participants) or placebo (1129), and 99% (1124 in the BNT162b2 group and 1117 in the placebo group) received the second dose.11 Among participants who received at least one dose of BNT162b2 or placebo, 58% had at least 2 months of follow-up after the second dose, 49% were female, 86% were White, 5% were Black, and 12% were Hispanic or Latinx. Full details of the demographic characteristics of the participants have been reported previously.11 Safety Reactogenicity ventolin nebulizer pediatric dose The subgroup that was evaluated for reactogenicity in the current report, in which reactions were reported in an electronic diary, included 9839 participants 16 years of age or older. In this subgroup, 8183 participants had been included in the previous analysis, and 1656 were enrolled after the data cutoff for that analysis.9 The reactogenicity profile of BNT162b2 in this expanded subgroup did not differ substantially from that described previously.9 This subgroup included 364 participants who had evidence of previous asthma , 9426 who did not have evidence, and 49 who lacked the data needed to determine previous status.
More participants in the BNT162b2 group than in the placebo group reported local reactions, the most common of which was mild-to-moderate pain at the injection site ventolin nebulizer pediatric dose (Fig. S1A). Local reactions were reported with similar frequency among the participants with or without evidence of previous asthma , and the reactions were of similar severity. No local reactions of grade 4 (according to the guidelines of the Center for Biologics Evaluation ventolin nebulizer pediatric dose and Research12) were reported.
More participants in the BNT162b2 group than in the placebo group reported systemic events, the most common of which was fatigue (Fig. S1B). Systemic events were mostly mild to ventolin nebulizer pediatric dose moderate in severity, but there were occasional severe events. Systemic reactogenicity was similar among those with or without evidence of previous asthma , although BNT162b2 recipients with evidence of previous reported systemic events more often after receipt of the first dose, and those without evidence reported systemic events more often after receipt of the second dose.
For example, 12% of recipients with evidence of previous asthma and 3% of those without evidence reported fever after receipt of ventolin nebulizer pediatric dose the first dose. 8% of those with evidence of previous and 15% of those without evidence reported fever after the second dose. The highest temperature reported was a transient fever of higher than 40.0°C on day 2 after the second dose in a BNT162b2 recipient without evidence of previous . Adverse Events Analyses of adverse events ventolin nebulizer pediatric dose during the blinded period included 43,847 participants 16 years of age or older (Table S3).
Reactogenicity events among the participants who were not in the reactogenicity subgroup were reported as adverse events, which resulted in imbalances between the BNT162b2 group and the placebo group with respect to adverse events (30% vs. 14%), related adverse events (24% ventolin nebulizer pediatric dose vs. 6%), and severe adverse events (1.2% vs. 0.7%).
New adverse events attributable to BNT162b2 that were ventolin nebulizer pediatric dose not previously identified in earlier reports included decreased appetite, lethargy, asthenia, malaise, night sweats, and hyperhidrosis. Few participants had serious adverse events or adverse events that led to trial withdrawal. No new serious adverse events were considered by the investigators to be related to BNT162b2 after the data cutoff date of the previous report.9 During the combined blinded and open-label periods, cumulative safety data during follow-up ventolin nebulizer pediatric dose were available through 6 months after the second dose for 12,006 participants who were originally randomly assigned to the BNT162b2 group. No new safety signals relative to the previous report were observed during the longer follow-up period in the current report, which included open-label observation of the original BNT162b2 recipients and placebo recipients who received BNT162b2 after unblinding.9 During the blinded, placebo-controlled period, 15 participants in the BNT162b2 group and 14 in the placebo group died.
During the open-label period, 3 participants in the BNT162b2 group and 2 in the original placebo group who received BNT162b2 after unblinding died. None of these deaths were ventolin nebulizer pediatric dose considered to be related to BNT162b2 by the investigators. Causes of death were balanced between BNT162b2 and placebo groups (Table S4). Safety monitoring will continue according to the protocol for 2 years after the second dose for participants who originally received BNT162b2 and for 18 months after the second BNT162b2 dose for placebo recipients who received BNT162b2 after unblinding.
Efficacy Table ventolin nebulizer pediatric dose 2. Table 2. treatment Efficacy against asthma treatment from 7 Days ventolin nebulizer pediatric dose after Receipt of the Second Dose during the Blinded, Placebo-Controlled Follow-up Period. Among 42,094 participants 12 years of age or older who could be evaluated and had no evidence of previous asthma , asthma treatment with an onset of 7 days or more after the second dose was observed in 77 treatment recipients and in 850 placebo recipients up to the data cutoff date (March 13, 2021), corresponding to a treatment efficacy of 91.3% (95% confidence interval [CI], 89.0 to 93.2) (Table 2).
Among 44,486 participants with or without evidence of previous who could be evaluated, cases of asthma treatment were observed in 81 treatment recipients and in 873 placebo recipients, corresponding to a treatment efficacy of 91.1% (95% CI, 88.8 to 93.0). Among the participants with evidence of previous asthma based on a positive baseline N-binding antibody test, asthma treatment was observed in 2 treatment recipients after the first dose and in 7 placebo ventolin nebulizer pediatric dose recipients. Among the participants with evidence of previous asthma based on a positive nucleic acid amplification test at baseline, cases of asthma treatment were observed in 10 treatment recipients and in 9 placebo recipients (Table S5). asthma treatment was less common among the placebo recipients with positive N-binding antibodies at trial entry (7 of 542 participants, for an incidence of 1.3%) than among those without evidence of at trial entry (1015 of 21,521, for an incidence of 4.7%) ventolin nebulizer pediatric dose.
These findings indicate that previous conferred approximately 72.6% protection. Figure 2. Figure 2 ventolin nebulizer pediatric dose. Efficacy of BNT162b2 against asthma treatment after Receipt of the First Dose (Blinded Follow-up Period).
The top of the figure shows the cumulative incidence curves for the first occurrence of asthma disease 2019 (asthma treatment) after receipt of the first dose (efficacy analysis population of participants â¥12 years of age who could be evaluated). Each symbol represents asthma treatment cases starting on a given day, and ventolin nebulizer pediatric dose filled symbols represent severe asthma treatment cases. Because of overlapping dates, some symbols represent more than one case. The inset shows the same data on an enlarged y axis through ventolin nebulizer pediatric dose 21 days.
The bottom of the figure shows the time intervals for the first occurrence of asthma treatment in the efficacy analysis population, as well as the surveillance time, which is given as the total time (in 1000 person-years) at risk for the given end point across all participants within each group. The time period for the accrual of asthma treatment cases was from after receipt of the first dose to the end of the surveillance period for the overall row and from the start to the end of the range stated for each time interval. treatment efficacy was calculated as 100Ã(1âIRR), where IRR (incidence rate ratio) is the ratio of the rate (number per 1000 person-years of follow-up) of confirmed cases of asthma treatment in the BNT162b2 group to the corresponding rate in the placebo group ventolin nebulizer pediatric dose. The 95% confidence interval for treatment efficacy was derived with the use of the ClopperâPearson method, with adjustment for surveillance time.Among the participants with or without evidence of previous , cases of asthma treatment were observed in 46 treatment recipients and in 110 placebo recipients from receipt of the first dose up to receipt of the second dose, corresponding to a treatment efficacy of 58.4% (95% CI, 40.8 to 71.2) (Figure 2).
During the interval ventolin nebulizer pediatric dose from the approximate start of observed protection at 11 days after receipt of the first dose up to receipt of the second dose, treatment efficacy increased to 91.7% (95% CI, 79.6 to 97.4). From its peak after the second dose, observed treatment efficacy declined. From 7 days to less than 2 months after the second dose, treatment efficacy was 96.2% (95% CI, 93.3 to 98.1). From 2 months to less than 4 months after the second dose, treatment efficacy ventolin nebulizer pediatric dose was 90.1% (95% CI, 86.6 to 92.9).
And from 4 months after the second dose to the data cutoff date, treatment efficacy was 83.7% (95% CI, 74.7 to 89.9). Table 3. Table 3 ventolin nebulizer pediatric dose. treatment Efficacy against asthma treatment up to 7 Days after Receipt of the Second Dose among Participants without Evidence of .
Severe asthma treatment, as defined by the Food and Drug Administration,13 with an onset after receipt of the first dose occurred in ventolin nebulizer pediatric dose 31 participants, of whom 30 were placebo recipients. This finding corresponds with a treatment efficacy of 96.7% (95% CI, 80.3 to 99.9) against severe asthma treatment (Figure 2 and Table S6). Although the trial was not powered to definitively assess efficacy according to subgroup, supplemental analyses indicated that treatment efficacy after the second dose in subgroups defined according to age, sex, race, ethnic group, presence or absence of coexisting medical conditions, and country was generally consistent with that observed in the overall population (Table 3 and Table S7). Given the concern about the asthma B.1.351 (or beta) variant, which appears to be neutralized less efficiently by BNT162b2-immune sera than many other lineages,14 whole-viral-genome sequencing was performed on midturbinate samples from asthma treatment cases observed in South Africa, where this ventolin nebulizer pediatric dose lineage was prevalent.
Nine cases of asthma treatment were observed in South African participants without evidence of previous asthma , all of whom were placebo recipients. This finding corresponds with a treatment efficacy ventolin nebulizer pediatric dose of 100% (95% CI, 53.5 to 100) (Table 3). Midturbinate specimens from 8 of 9 cases contained sufficient viral RNA for whole-genome sequencing. All viral genomes were the beta variant (Global Initiative on Sharing All Influenza Data accession codes are provided in the Supplementary Appendix).Participants Figure 1.
Figure 1 ventolin nebulizer pediatric dose. Enrollment and Randomization. The diagram represents all enrolled participants through November 14, 2020. The safety subset (those with a median of 2 months of follow-up, in accordance with application requirements for Emergency Use Authorization) is based on ventolin nebulizer pediatric dose an October 9, 2020, data cut-off date.
The further procedures that one participant in the placebo group declined after dose 2 (lower right corner of the diagram) were those involving collection of blood and nasal swab samples.Table 1. Table 1 ventolin nebulizer pediatric dose. Demographic Characteristics of the Participants in the Main Safety Population. Between July 27, 2020, and November 14, 2020, a total of 44,820 persons were screened, and 43,548 persons 16 years of age or older underwent randomization at 152 sites worldwide (United States, 130 sites.
Argentina, 1 ventolin nebulizer pediatric dose. Brazil, 2. South Africa, 4 ventolin nebulizer pediatric dose. Germany, 6.
And Turkey, 9) in the phase 2/3 portion of the trial. A total of 43,448 participants ventolin nebulizer pediatric dose received injections. 21,720 received BNT162b2 and 21,728 received placebo (Figure 1). At the data cut-off date of October 9, a total of 37,706 participants had a median of at least 2 months of safety data available after the second ventolin nebulizer pediatric dose dose and contributed to the main safety data set.
Among these 37,706 participants, 49% were female, 83% were White, 9% were Black or African American, 28% were Hispanic or Latinx, 35% were obese (body mass index [the weight in kilograms divided by the square of the height in meters] of at least 30.0), and 21% had at least one coexisting condition. The median age was 52 years, and 42% of participants were older than 55 years of age (Table 1 and Table S2). Safety Local ventolin nebulizer pediatric dose Reactogenicity Figure 2. Figure 2.
Local and Systemic Reactions Reported within 7 Days after Injection of BNT162b2 or Placebo, According to Age Group. Data on local and systemic reactions and use of medication were collected with electronic diaries from participants in ventolin nebulizer pediatric dose the reactogenicity subset (8,183 participants) for 7 days after each vaccination. Solicited injection-site (local) reactions are shown in Panel A. Pain at the injection site was assessed ventolin nebulizer pediatric dose according to the following scale.
Mild, does not interfere with activity. Moderate, interferes with activity. Severe, prevents daily ventolin nebulizer pediatric dose activity. And grade 4, emergency department visit or hospitalization.
Redness and swelling were measured ventolin nebulizer pediatric dose according to the following scale. Mild, 2.0 to 5.0 cm in diameter. Moderate, >5.0 to 10.0 cm in diameter. Severe, >10.0 cm in diameter ventolin nebulizer pediatric dose.
And grade 4, necrosis or exfoliative dermatitis (for redness) and necrosis (for swelling). Systemic events and medication use are shown in Panel B. Fever categories are designated ventolin nebulizer pediatric dose in the key. Medication use was not graded.
Additional scales were as ventolin nebulizer pediatric dose follows. Fatigue, headache, chills, new or worsened muscle pain, new or worsened joint pain (mild. Does not interfere with activity. Moderate.
Some interference with activity. Or severe. Prevents daily activity), vomiting (mild. 1 to 2 times in 24 hours.
Moderate. >2 times in 24 hours. Or severe. Requires intravenous hydration), and diarrhea (mild.
2 to 3 loose stools in 24 hours. Moderate. 4 to 5 loose stools in 24 hours. Or severe.
6 or more loose stools in 24 hours). Grade 4 for all events indicated an emergency department visit or hospitalization. и bars represent 95% confidence intervals, and numbers above the ð¸ bars are the percentage of participants who reported the specified reaction.The reactogenicity subset included 8183 participants. Overall, BNT162b2 recipients reported more local reactions than placebo recipients.
Among BNT162b2 recipients, mild-to-moderate pain at the injection site within 7 days after an injection was the most commonly reported local reaction, with less than 1% of participants across all age groups reporting severe pain (Figure 2). Pain was reported less frequently among participants older than 55 years of age (71% reported pain after the first dose. 66% after the second dose) than among younger participants (83% after the first dose. 78% after the second dose).
A noticeably lower percentage of participants reported injection-site redness or swelling. The proportion of participants reporting local reactions did not increase after the second dose (Figure 2A), and no participant reported a grade 4 local reaction. In general, local reactions were mostly mild-to-moderate in severity and resolved within 1 to 2 days. Systemic Reactogenicity Systemic events were reported more often by younger treatment recipients (16 to 55 years of age) than by older treatment recipients (more than 55 years of age) in the reactogenicity subset and more often after dose 2 than dose 1 (Figure 2B).
The most commonly reported systemic events were fatigue and headache (59% and 52%, respectively, after the second dose, among younger treatment recipients. 51% and 39% among older recipients), although fatigue and headache were also reported by many placebo recipients (23% and 24%, respectively, after the second dose, among younger treatment recipients. 17% and 14% among older recipients). The frequency of any severe systemic event after the first dose was 0.9% or less.
Severe systemic events were reported in less than 2% of treatment recipients after either dose, except for fatigue (in 3.8%) and headache (in 2.0%) after the second dose. Fever (temperature, â¥38°C) was reported after the second dose by 16% of younger treatment recipients and by 11% of older recipients. Only 0.2% of treatment recipients and 0.1% of placebo recipients reported fever (temperature, 38.9 to 40°C) after the first dose, as compared with 0.8% and 0.1%, respectively, after the second dose. Two participants each in the treatment and placebo groups reported temperatures above 40.0°C.
Younger treatment recipients were more likely to use antipyretic or pain medication (28% after dose 1. 45% after dose 2) than older treatment recipients (20% after dose 1. 38% after dose 2), and placebo recipients were less likely (10 to 14%) than treatment recipients to use the medications, regardless of age or dose. Systemic events including fever and chills were observed within the first 1 to 2 days after vaccination and resolved shortly thereafter.
Daily use of the electronic diary ranged from 90 to 93% for each day after the first dose and from 75 to 83% for each day after the second dose. No difference was noted between the BNT162b2 group and the placebo group. Adverse Events Adverse event analyses are provided for all enrolled 43,252 participants, with variable follow-up time after dose 1 (Table S3). More BNT162b2 recipients than placebo recipients reported any adverse event (27% and 12%, respectively) or a related adverse event (21% and 5%).
This distribution largely reflects the inclusion of transient reactogenicity events, which were reported as adverse events more commonly by treatment recipients than by placebo recipients. Sixty-four treatment recipients (0.3%) and 6 placebo recipients (<0.1%) reported lymphadenopathy. Few participants in either group had severe adverse events, serious adverse events, or adverse events leading to withdrawal from the trial. Four related serious adverse events were reported among BNT162b2 recipients (shoulder injury related to treatment administration, right axillary lymphadenopathy, paroxysmal ventricular arrhythmia, and right leg paresthesia).
Two BNT162b2 recipients died (one from arteriosclerosis, one from cardiac arrest), as did four placebo recipients (two from unknown causes, one from hemorrhagic stroke, and one from myocardial infarction). No deaths were considered by the investigators to be related to the treatment or placebo. No asthma treatmentâassociated deaths were observed. No stopping rules were met during the reporting period.
Safety monitoring will continue for 2 years after administration of the second dose of treatment. Efficacy Table 2. Table 2. treatment Efficacy against asthma treatment at Least 7 days after the Second Dose.
Table 3. Table 3. treatment Efficacy Overall and by Subgroup in Participants without Evidence of before 7 Days after Dose 2. Figure 3.
Figure 3. Efficacy of BNT162b2 against asthma treatment after the First Dose. Shown is the cumulative incidence of asthma treatment after the first dose (modified intention-to-treat population). Each symbol represents asthma treatment cases starting on a given day.
Filled symbols represent severe asthma treatment cases. Some symbols represent more than one case, owing to overlapping dates. The inset shows the same data on an enlarged y axis, through 21 days. Surveillance time is the total time in 1000 person-years for the given end point across all participants within each group at risk for the end point.
The time period for asthma treatment case accrual is from the first dose to the end of the surveillance period. The confidence interval (CI) for treatment efficacy (VE) is derived according to the ClopperâPearson method.Among 36,523 participants who had no evidence of existing or prior asthma , 8 cases of asthma treatment with onset at least 7 days after the second dose were observed among treatment recipients and 162 among placebo recipients. This case split corresponds to 95.0% treatment efficacy (95% confidence interval [CI], 90.3 to 97.6. Table 2).
Among participants with and those without evidence of prior SARS CoV-2 , 9 cases of asthma treatment at least 7 days after the second dose were observed among treatment recipients and 169 among placebo recipients, corresponding to 94.6% treatment efficacy (95% CI, 89.9 to 97.3). Supplemental analyses indicated that treatment efficacy among subgroups defined by age, sex, race, ethnicity, obesity, and presence of a coexisting condition was generally consistent with that observed in the overall population (Table 3 and Table S4). treatment efficacy among participants with hypertension was analyzed separately but was consistent with the other subgroup analyses (treatment efficacy, 94.6%. 95% CI, 68.7 to 99.9.
Case split. BNT162b2, 2 cases. Placebo, 44 cases). Figure 3 shows cases of asthma treatment or severe asthma treatment with onset at any time after the first dose (mITT population) (additional data on severe asthma treatment are available in Table S5).
Between the first dose and the second dose, 39 cases in the BNT162b2 group and 82 cases in the placebo group were observed, resulting in a treatment efficacy of 52% (95% CI, 29.5 to 68.4) during this interval and indicating early protection by the treatment, starting as soon as 12 days after the first dose..
After a period of falling asthma treatment illness rates, the recent spread costco ventolin price of the delta variant of asthma was a major disappointment and necessitated a reexamination of some previous advice assumptions. This reconsideration may, at least in part, be a correction to overly optimistic views of what highly effective asthma treatments could accomplish. Some observers had hoped the treatments could eliminate transmission of the ventolin, the ultimate goal of reaching herd immunity.1 A more likely picture of our future with this ventolin comes into focus if we examine the well-known patterns of another respiratory ventolin, influenza, both costco ventolin price in and outside ventolins.
That experience can help us reset expectations and modify goals for dealing with asthma as it further adapts in global spread.Early results from the clinical trials and observational studies of mRNA treatments against asthma indicated that not only were they highly effective at preventing symptomatic , but they were also effective in preventing asymptomatic and therefore transmission.2 The basic criterion used for emergency use authorization by the Food and Drug Administration was a standard one. Prevention of laboratory-confirmed clinical meeting a case definition. The effect on asymptomatic s was a welcome surprise, because it has been thought that most treatments for respiratory illnesses, including influenza, are âleakyâ â that is, they allow some degree of asymptomatic and are better at preventing symptomatic .The initial data on inapparent asthma strengthened the hope that, at costco ventolin price a certain level of vaccination, transmission would cease completely.
To many of us, this hope appeared overly optimistic, and it seems even more so now. The highly costco ventolin price transmissible delta variant causes asymptomatic s and sometimes illnesses (albeit usually mild) in vaccinated people, probably because of increased growth potential, as well as because of waning immunity, which also involves decreasing IgA antibody levels. Elimination of an illness by means of herd immunity works best when the agent has low transmissibility, and it requires the absence of pockets of susceptible people.
Eliminating asthma treatment seemed theoretically possible, because the original 2002 SARS ventolin ultimately disappeared. That ventolin, however, did not transmit as well as even the costco ventolin price initial strain of asthma. It occurred in limited regions and was characterized by focal spread, including superspreading events.
Such a pattern, which was also seen in the early costco ventolin price days of asthma, is called âoverdispersionâ â 10% of cases, for example, may be responsible for 80% of transmission.3 These dynamics explain why there were great differences in antibody prevalence within a given city and spotty global spread early in the ventolin. Overdispersion was thought to be an unstable trait that would disappear, with transmission becoming more uniform and higher overall. That transition appears to have occurred as newer variants take over.Given the parade of variants, their varying transmissibility, and continuing concern about antigenic changes affecting treatment protection, I believe it should now be clear that it is not possible to eliminate this ventolin from the population and that we should develop long-term plans for dealing with it after the unsupportable surges are fully controlled.
ventolin and seasonal influenza provide the most appropriate models to aid in developing costco ventolin price strategies going forward.As with asthma, when a novel ventolin influenza strain appears, its spread can overwhelm the health care system. Waves of go through a city in weeks and a country in months, but there is scant evidence that superspreading events occur. Thereafter, the ventolin ventolin persists as a new seasonal strain, and antigenic changes occur â albeit probably not as quickly as we are seeing with asthma.
The new strain joins the costco ventolin price other seasonal influenza types and subtypes that reappear each year. The goal of vaccination becomes managing the inevitable outbreaks and reducing the rates of moderate-to-severe illness and death. Preventing mild disease, though important, is less critical.Summary of World Health Organization (WHO) Process of ventolin Selection for Annual Influenza costco ventolin price treatments.
Readministration of influenza treatment has become an annual event for much of the population, in response to both waning immunity and the appearance of variants, termed antigenic drift, necessitating updated treatments. Even when there is no substantial drift, revaccination is recommended because of waning immunity. But antigenic drift is a constant issue and is monitored globally, with treatment composition costco ventolin price updated globally twice a year on the basis of recommendations from a World Health Organization consultation.4 As outlined in the table, various criteria are considered in decisions about which strains to include in treatments.
treatment effectiveness against laboratory-confirmed symptomatic is never higher than 50 to 60%, and in some years it is much lower. Thus, the value costco ventolin price of influenza treatments, now given to as many as 70% of people in some age groups, lies not in eliminating outbreaks but in reducing them and preventing severe complications.Though there may be similarities between asthma and influenza, there are also meaningful differences. The most obvious difference is the efficacy of asthma treatments, which is currently much higher than we can achieve with influenza treatments.
Whether that degree of efficacy will continue is one of the many open questions that can only be answered over time. It is clear, however, that revaccination will be necessary, for the same costco ventolin price reasons that influenza revaccination is necessary. Antigenic variation and waning immunity.
Data on the frequency of re with seasonal asthmaes may not be relevant, but they suggest that protection is relatively short term even after natural .5 Revaccination frequency and consequences will need to be determined.Let us hope that certain problems with the influenza treatment â such as the failure of vaccination, in some years, to produce the desired increase in protection in previously vaccinated people â do not occur with the asthma treatments. Other issues, such as the variant to be targeted by costco ventolin price treatments, will need to be addressed. The successful publicâprivate collaboration in selecting influenza strains offers a model for dealing with such issues.
asthma treatments will be used globally, and the strain or strains contained in future treatments will need to be chosen globally, in consultation costco ventolin price with the manufacturers.Most predictions about the shape of the postâasthma treatment world have been inaccurate â a reflection of rapid changes in knowledge. But we can now see a picture emerging in which use of effective treatments will continue to be critical over the long term. Increases in asymptomatic s and mild illnesses in vaccinated people will nonetheless continue to be possible, as variants continue to emerge.
Counts of hospitalizations and deaths may be more important in monitoring the overall impact than numbers of cases, as long as costco ventolin price the treatments continue to be largely effective at preventing severe illness. The possibility of severe illnesses in a small proportion of vaccinated people does emphasize one of the greatest unmet needs we currently face. Continued emphasis on better therapeutics and antiviral agents, which will not be affected by molecular changes in the ventolin as much as treatments are.The future timing and composition costco ventolin price of booster treatment doses will need to be determined on the basis of observational studies.
We currently have few data on non-mRNA treatments, particularly protein-based treatments, which may have characteristics different from those of mRNA treatments, especially in terms of duration of immunity.Overall, the situation will be fluid, but we will require the continuing use of treatments to avert severe consequences, even if milder illnesses still occur at a low frequency. We need to learn to live with these illnesses, just as we have learned to live with influenza.Data Source Data on all residents of Israel who had been fully vaccinated before June 1, 2021, and who had not been infected before the study period were extracted from the Israeli Ministry of Health database on September 2, 2021. We defined fully vaccinated persons costco ventolin price as those for whom 7 days or more had passed since receipt of the second dose of the BNT162b2 treatment.
We used the Ministry of Health official database that contains all information regarding asthma treatment (see Supplementary Methods 1 in the Supplementary Appendix, available with the full text of this article at NEJM.org). We extracted from the database information on all documented asthma s (i.e., positive result on PCR assay) and on the severity of the disease after . We focused on s that had been documented in the period from July 11 through 31, 2021 (study period), removing from the data all confirmed cases that had been documented costco ventolin price before that period.
The start date was selected as a time when the ventolin had already spread throughout the entire country and across population sectors. The end date was just after Israel had initiated a campaign costco ventolin price regarding the use of a booster treatment (third dose). The study period happened to coincide with the school summer vacation.
We omitted from all the analyses children and adolescents younger than 16 years of age (most of whom were unvaccinated or had been recently vaccinated). Only persons 40 years of age or older were included in the analysis of severe disease because severe disease was rare in the younger costco ventolin price population. Severe disease was defined as a resting respiratory rate of more than 30 breaths per minute, oxygen saturation of less than 94% while the person was breathing ambient air, or a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen of less than 300.14 Persons who died from asthma treatment during the follow-up period were included in the study and categorized as having had severe disease.
During the costco ventolin price study period, approximately 10% of the detected s were in residents of Israel returning from abroad. Most residents who traveled abroad had been vaccinated and were exposed to different populations, so their risk of differed from that in the rest of the study population. We therefore removed from the analysis all residents who had returned from abroad in July.
Vaccination Schedule The official vaccination regimen in Israel involved the administration costco ventolin price of the second dose 3 weeks after the first dose. All residents 60 years of age or older were eligible for vaccination starting on December 20, 2020, thus becoming fully vaccinated starting in mid-January 2021. At that time, younger persons were eligible for vaccination only if they belonged to designated groups (e.g., health care workers and severely immunocompromised adults).
The eligibility age was reduced to 55 years on January 12, 2021, and to 40 years costco ventolin price on January 19, 2021. On February 4, 2021, all persons 16 years of age or older became eligible for vaccination. Thus, if they did not belong to a designated group, persons 40 to 59 years of age received the second dose starting in mid-February, and those 16 to 39 years of age costco ventolin price received the second dose starting in the beginning of March.
On the basis of these dates, we defined our periods of interest in half months starting from January 16. Vaccination periods for individual persons were determined according to the time that they had become fully vaccinated (i.e., 1 week after receipt of the second dose). All the analyses were stratified according to vaccination period and to age group (16 to 39 years, 40 costco ventolin price to 59 years, and â¥60 years).
Statistical Analysis The association between the rate of confirmed s and the period of vaccination provides a measure of waning immunity. Without waning of immunity, one would expect to costco ventolin price see no differences in rates among persons vaccinated at different times. To examine the effect of waning immunity during the period when the delta variant was predominant, we compared the rate of confirmed s (per 1000 persons) during the study period (July 11 to 31, 2021) among persons who became fully vaccinated during various periods.
The 95% confidence intervals for the rates were calculated by multiplying the standard confidence intervals for proportions by 1000. A similar analysis was performed to compare the association between the rate of severe asthma treatment and the vaccination period, but for this outcome we used periods of entire months costco ventolin price because there were fewer cases of severe disease. To account for possible confounders, we fitted Poisson regressions.
The outcome costco ventolin price variable was the number of documented asthma s or cases of severe asthma treatment during the study period. The period of vaccination, which was defined as 7 days after receipt of the second dose of the asthma treatment, was the primary exposure of interest. The models compared the rates per 1000 persons between different vaccination periods, in which the reference period for each age group was set according to the time at which all persons in that group first became eligible for vaccination.
A differential effect of the vaccination period for each age group was allowed by costco ventolin price the inclusion of an interaction term between age and vaccination period. Additional potential confounders were added as covariates, as described below, and the natural logarithm of the number of persons was added as an offset. For each vaccination period and age group, an adjusted rate was calculated as the expected number of weekly events per 100,000 persons if all the persons in that age group had been vaccinated in that period.
All the costco ventolin price analyses were performed with the use of the glm function in the R statistical software package.17 In addition to age and sex, the regression analysis included as covariates the following confounders. First, because the event rates were rising rapidly during the study period (Figure 1), we included the week in which the event was recorded. Second, although PCR testing is free in Israel for all residents, compliance with PCR-testing recommendations is variable and costco ventolin price is a possible source of detection bias.
To partially account for this, we stratified persons according to the number of PCR tests that had been performed during the period of March 1 to November 31, 2020, which was before the initiation of the vaccination campaign. We defined three levels of use. Zero, one, and two costco ventolin price or more PCR tests.
Finally, the three major population groups in Israel (general Jewish, Arab, and ua-Orthodox Jewish) have varying risk factors for . The proportion of vaccinated persons, as well as the level of exposure to the ventolin, costco ventolin price differed among these groups.18 Although we restricted the study to dates when the ventolin was found throughout the country, we included population sector as a covariate to control for any residual confounding effect. We conducted several secondary analyses to test the robustness of the results, including calculation of the rate of confirmed in a finer, 10-year age grouping and an analysis restricted to the general Jewish population (in which the delta outbreak began), which comprises the majority of persons in Israel.
In addition, a model including a measure of socioeconomic status as a covariate was fitted to the data, because this was an important risk factor in a previous study.18 Since socioeconomic status was unknown for 5% of the persons in our study and the missingness of the data seemed to be informative, and also owing to concern regarding nondifferential misclassification (persons with unknown socioeconomic status may have had different rates of vaccination, , and severe disease), we did not include socioeconomic status in the main analysis. Finally, we compared the association between the number of PCR tests that had been conducted before the vaccination campaign (i.e., before December 2020) with the number that were costco ventolin price conducted during the study period in order to evaluate the possible magnitude of detection bias in our analysis. A good correlation between past behavior regarding PCR testing and behavior during the study period would provide reassurance that the inclusion of past behavior as a covariate in the model would control, at least in part, for detection bias.Participants Figure 1.
Figure 1. Screening, Randomization, and costco ventolin price Follow-up. The diagram represents all enrolled participants 16 years of age or older through the data cutoff date (March 13, 2021).
The diagram includes two deaths that occurred after the second dose in human immunodeficiency ventolin (HIV)âinfected participants (one in the BNT162b2 group costco ventolin price and one in the placebo group. These deaths were not reported in the Results section of this article because the analysis of HIV-infected participants is being conducted separately). Information on the screening, randomization, and follow-up of the participants 12 to 15 years of age has been reported previously.11Table 1.
Table 1 costco ventolin price. Demographic Characteristics of the Participants at Baseline. Between July costco ventolin price 27, 2020, and October 29, 2020, a total of 45,441 participants 16 years of age or older underwent screening, and 44,165 underwent randomization at 152 sites (130 sites in the United States, 1 site in Argentina, 2 sites in Brazil, 4 sites in South Africa, 6 sites in Germany, and 9 sites in Turkey) in the phase 2â3 portion of the trial.
Of these participants, 44,060 received at least one dose of BNT162b2 (22,030 participants) or placebo (22,030), and 98% (21,759 in the BNT162b2 group and 21,650 in the placebo group) received the second dose (Figure 1). During the blinded period of the trial, 51% of the participants in each group had 4 to less than 6 months of follow-up after the second dose. 8% of the participants in the BNT162b2 group and 6% of those in the placebo group had 6 months of follow-up or more costco ventolin price after the second dose.
During the combined blinded and open-label periods, 55% of the participants in the BNT162b2 group had 6 months of follow-up or more after the second dose. A total of 49% of the participants were female, 82% were White, 10% were Black, and 26% were Hispanic or Latinx. The median costco ventolin price age was 51 years.
A total of 34% of the participants had a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30.0 or more, 21% had at least one underlying medical condition, and 3% had baseline evidence of a previous or current asthma (Table 1 and Table S2). Between October 15, 2020, and January 12, 2021, a total of 2306 participants 12 to 15 years of age underwent screening, and 2264 costco ventolin price underwent randomization at 29 U.S. Sites.
Of these participants, 2260 received at least one dose of BNT162b2 (1131 participants) or placebo (1129), and 99% (1124 in the BNT162b2 group and 1117 in the placebo group) received the second dose.11 Among participants who received at least one dose of BNT162b2 or placebo, 58% had at least 2 months of follow-up after the second dose, 49% were female, 86% were White, 5% were Black, and 12% were Hispanic or Latinx. Full details of the demographic characteristics of the participants have costco ventolin price been reported previously.11 Safety Reactogenicity The subgroup that was evaluated for reactogenicity in the current report, in which reactions were reported in an electronic diary, included 9839 participants 16 years of age or older. In this subgroup, 8183 participants had been included in the previous analysis, and 1656 were enrolled after the data cutoff for that analysis.9 The reactogenicity profile of BNT162b2 in this expanded subgroup did not differ substantially from that described previously.9 This subgroup included 364 participants who had evidence of previous asthma , 9426 who did not have evidence, and 49 who lacked the data needed to determine previous status.
More participants in the BNT162b2 group than in the placebo costco ventolin price group reported local reactions, the most common of which was mild-to-moderate pain at the injection site (Fig. S1A). Local reactions were reported with similar frequency among the participants with or without evidence of previous asthma , and the reactions were of similar severity.
No local reactions of grade 4 (according to the guidelines of the costco ventolin price Center for Biologics Evaluation and Research12) were reported. More participants in the BNT162b2 group than in the placebo group reported systemic events, the most common of which was fatigue (Fig. S1B).
Systemic events were mostly mild to moderate in severity, but there were occasional severe events costco ventolin price. Systemic reactogenicity was similar among those with or without evidence of previous asthma , although BNT162b2 recipients with evidence of previous reported systemic events more often after receipt of the first dose, and those without evidence reported systemic events more often after receipt of the second dose. For example, 12% of recipients with evidence of previous asthma and 3% of those without evidence costco ventolin price reported fever after receipt of the first dose.
8% of those with evidence of previous and 15% of those without evidence reported fever after the second dose. The highest temperature reported was a transient fever of higher than 40.0°C on day 2 after the second dose in a BNT162b2 recipient without evidence of previous . Adverse Events Analyses costco ventolin price of adverse events during the blinded period included 43,847 participants 16 years of age or older (Table S3).
Reactogenicity events among the participants who were not in the reactogenicity subgroup were reported as adverse events, which resulted in imbalances between the BNT162b2 group and the placebo group with respect to adverse events (30% vs. 14%), related costco ventolin price adverse events (24% vs. 6%), and severe adverse events (1.2% vs.
0.7%). New adverse events attributable to BNT162b2 costco ventolin price that were not previously identified in earlier reports included decreased appetite, lethargy, asthenia, malaise, night sweats, and hyperhidrosis. Few participants had serious adverse events or adverse events that led to trial withdrawal.
No new serious adverse events were considered by the investigators to be related to BNT162b2 after the data cutoff date of the previous report.9 During the combined blinded and open-label periods, cumulative safety data during follow-up were available through 6 months after the second dose costco ventolin price for 12,006 participants who were originally randomly assigned to the BNT162b2 group. No new safety signals relative to the previous report were observed during the longer follow-up period in the current report, which included open-label observation of the original BNT162b2 recipients and placebo recipients who received BNT162b2 after unblinding.9 During the blinded, placebo-controlled period, 15 participants in the BNT162b2 group and 14 in the placebo group died. During the open-label period, 3 participants in the BNT162b2 group and 2 in the original placebo group who received BNT162b2 after unblinding died.
None of these deaths were costco ventolin price considered to be related to BNT162b2 by the investigators. Causes of death were balanced between BNT162b2 and placebo groups (Table S4). Safety monitoring will continue according to the protocol for 2 years after the second dose for participants who originally received BNT162b2 and for 18 months after the second BNT162b2 dose for placebo recipients who received BNT162b2 after unblinding.
Efficacy Table 2 costco ventolin price. Table 2. treatment Efficacy against asthma treatment from 7 Days after Receipt of the costco ventolin price Second Dose during the Blinded, Placebo-Controlled Follow-up Period.
Among 42,094 participants 12 years of age or older who could be evaluated and had no evidence of previous asthma , asthma treatment with an onset of 7 days or more after the second dose was observed in 77 treatment recipients and in 850 placebo recipients up to the data cutoff date (March 13, 2021), corresponding to a treatment efficacy of 91.3% (95% confidence interval [CI], 89.0 to 93.2) (Table 2). Among 44,486 participants with or without evidence of previous who could be evaluated, cases of asthma treatment were observed in 81 treatment recipients and in 873 placebo recipients, corresponding to a treatment efficacy of 91.1% (95% CI, 88.8 to 93.0). Among the costco ventolin price participants with evidence of previous asthma based on a positive baseline N-binding antibody test, asthma treatment was observed in 2 treatment recipients after the first dose and in 7 placebo recipients.
Among the participants with evidence of previous asthma based on a positive nucleic acid amplification test at baseline, cases of asthma treatment were observed in 10 treatment recipients and in 9 placebo recipients (Table S5). asthma treatment was less common among the placebo recipients with positive N-binding antibodies at trial entry (7 of 542 participants, for an incidence costco ventolin price of 1.3%) than among those without evidence of at trial entry (1015 of 21,521, for an incidence of 4.7%). These findings indicate that previous conferred approximately 72.6% protection.
Figure 2. Figure 2 costco ventolin price. Efficacy of BNT162b2 against asthma treatment after Receipt of the First Dose (Blinded Follow-up Period).
The top of the figure shows the cumulative incidence curves for the first occurrence of asthma disease 2019 (asthma treatment) after receipt of the first dose (efficacy analysis population of participants â¥12 years of age who could be evaluated). Each symbol represents asthma treatment cases starting on a given day, and filled symbols represent severe asthma treatment cases costco ventolin price. Because of overlapping dates, some symbols represent more than one case.
The inset shows the same data on costco ventolin price an enlarged y axis through 21 days. The bottom of the figure shows the time intervals for the first occurrence of asthma treatment in the efficacy analysis population, as well as the surveillance time, which is given as the total time (in 1000 person-years) at risk for the given end point across all participants within each group. The time period for the accrual of asthma treatment cases was from after receipt of the first dose to the end of the surveillance period for the overall row and from the start to the end of the range stated for each time interval.
treatment efficacy was calculated as 100Ã(1âIRR), where IRR (incidence rate ratio) is the ratio of the rate (number per 1000 person-years of follow-up) of confirmed cases of asthma treatment in the BNT162b2 group costco ventolin price to the corresponding rate in the placebo group. The 95% confidence interval for treatment efficacy was derived with the use of the ClopperâPearson method, with adjustment for surveillance time.Among the participants with or without evidence of previous , cases of asthma treatment were observed in 46 treatment recipients and in 110 placebo recipients from receipt of the first dose up to receipt of the second dose, corresponding to a treatment efficacy of 58.4% (95% CI, 40.8 to 71.2) (Figure 2). During the interval from the approximate start of observed protection at 11 days after receipt of the first dose up to receipt of the costco ventolin price second dose, treatment efficacy increased to 91.7% (95% CI, 79.6 to 97.4).
From its peak after the second dose, observed treatment efficacy declined. From 7 days to less than 2 months after the second dose, treatment efficacy was 96.2% (95% CI, 93.3 to 98.1). From 2 months to less than 4 months after the second dose, costco ventolin price treatment efficacy was 90.1% (95% CI, 86.6 to 92.9).
And from 4 months after the second dose to the data cutoff date, treatment efficacy was 83.7% (95% CI, 74.7 to 89.9). Table 3. Table 3 costco ventolin price.
treatment Efficacy against asthma treatment up to 7 Days after Receipt of the Second Dose among Participants without Evidence of . Severe asthma treatment, as costco ventolin price defined by the Food and Drug Administration,13 with an onset after receipt of the first dose occurred in 31 participants, of whom 30 were placebo recipients. This finding corresponds with a treatment efficacy of 96.7% (95% CI, 80.3 to 99.9) against severe asthma treatment (Figure 2 and Table S6).
Although the trial was not powered to definitively assess efficacy according to subgroup, supplemental analyses indicated that treatment efficacy after the second dose in subgroups defined according to age, sex, race, ethnic group, presence or absence of coexisting medical conditions, and country was generally consistent with that observed in the overall population (Table 3 and Table S7). Given the costco ventolin price concern about the asthma B.1.351 (or beta) variant, which appears to be neutralized less efficiently by BNT162b2-immune sera than many other lineages,14 whole-viral-genome sequencing was performed on midturbinate samples from asthma treatment cases observed in South Africa, where this lineage was prevalent. Nine cases of asthma treatment were observed in South African participants without evidence of previous asthma , all of whom were placebo recipients.
This finding corresponds with a treatment efficacy of 100% (95% CI, 53.5 to 100) (Table costco ventolin price 3). Midturbinate specimens from 8 of 9 cases contained sufficient viral RNA for whole-genome sequencing. All viral genomes were the beta variant (Global Initiative on Sharing All Influenza Data accession codes are provided in the Supplementary Appendix).Participants Figure 1.
Figure 1 costco ventolin price. Enrollment and Randomization. The diagram represents all enrolled participants through November 14, 2020.
The safety subset (those with a median of 2 costco ventolin price months of follow-up, in accordance with application requirements for Emergency Use Authorization) is based on an October 9, 2020, data cut-off date. The further procedures that one participant in the placebo group declined after dose 2 (lower right corner of the diagram) were those involving collection of blood and nasal swab samples.Table 1. Table 1 costco ventolin price.
Demographic Characteristics of the Participants in the Main Safety Population. Between July 27, 2020, and November 14, 2020, a total of 44,820 persons were screened, and 43,548 persons 16 years of age or older underwent randomization at 152 sites worldwide (United States, 130 sites. Argentina, 1 costco ventolin price.
Brazil, 2. South Africa, costco ventolin price 4. Germany, 6.
And Turkey, 9) in the phase 2/3 portion of the trial. A total costco ventolin price of 43,448 participants received injections. 21,720 received BNT162b2 and 21,728 received placebo (Figure 1).
At the data cut-off date of October 9, a total of 37,706 participants had costco ventolin price a median of at least 2 months of safety data available after the second dose and contributed to the main safety data set. Among these 37,706 participants, 49% were female, 83% were White, 9% were Black or African American, 28% were Hispanic or Latinx, 35% were obese (body mass index [the weight in kilograms divided by the square of the height in meters] of at least 30.0), and 21% had at least one coexisting condition. The median age was 52 years, and 42% of participants were older than 55 years of age (Table 1 and Table S2).
Safety Local costco ventolin price Reactogenicity Figure 2. Figure 2. Local and Systemic Reactions Reported within 7 Days after Injection of BNT162b2 or Placebo, According to Age Group.
Data on local and systemic reactions and use of medication were collected with electronic diaries from participants in the reactogenicity subset (8,183 costco ventolin price participants) for 7 days after each vaccination. Solicited injection-site (local) reactions are shown in Panel A. Pain at the injection costco ventolin price site was assessed according to the following scale.
Mild, does not interfere with activity. Moderate, interferes with activity. Severe, prevents costco ventolin price daily activity.
And grade 4, emergency department visit or hospitalization. Redness and swelling were measured costco ventolin price according to the following scale. Mild, 2.0 to 5.0 cm in diameter.
Moderate, >5.0 to 10.0 cm in diameter. Severe, >10.0 cm costco ventolin price in diameter. And grade 4, necrosis or exfoliative dermatitis (for redness) and necrosis (for swelling).
Systemic events and medication use are shown in Panel B. Fever categories are designated costco ventolin price in the key. Medication use was not graded.
Additional scales were as costco ventolin price follows. Fatigue, headache, chills, new or worsened muscle pain, new or worsened joint pain (mild. Does not interfere with activity.
Moderate. Some interference with activity. Or severe.
Prevents daily activity), vomiting (mild. 1 to 2 times in 24 hours. Moderate.
>2 times in 24 hours. Or severe. Requires intravenous hydration), and diarrhea (mild.
2 to 3 loose stools in 24 hours. Moderate. 4 to 5 loose stools in 24 hours.
Or severe. 6 or more loose stools in 24 hours). Grade 4 for all events indicated an emergency department visit or hospitalization.
и bars represent 95% confidence intervals, and numbers above the ð¸ bars are the percentage of participants who reported the specified reaction.The reactogenicity subset included 8183 participants. Overall, BNT162b2 recipients reported more local reactions than placebo recipients. Among BNT162b2 recipients, mild-to-moderate pain at the injection site within 7 days after an injection was the most commonly reported local reaction, with less than 1% of participants across all age groups reporting severe pain (Figure 2).
Pain was reported less frequently among participants older than 55 years of age (71% reported pain after the first dose. 66% after the second dose) than among younger participants (83% after the first dose. 78% after the second dose).
A noticeably lower percentage of participants reported injection-site redness or swelling. The proportion of participants reporting local reactions did not increase after the second dose (Figure 2A), and no participant reported a grade 4 local reaction. In general, local reactions were mostly mild-to-moderate in severity and resolved within 1 to 2 days.
Systemic Reactogenicity Systemic events were reported more often by younger treatment recipients (16 to 55 years of age) than by older treatment recipients (more than 55 years of age) in the reactogenicity subset and more often after dose 2 than dose 1 (Figure 2B). The most commonly reported systemic events were fatigue and headache (59% and 52%, respectively, after the second dose, among younger treatment recipients. 51% and 39% among older recipients), although fatigue and headache were also reported by many placebo recipients (23% and 24%, respectively, after the second dose, among younger treatment recipients.
17% and 14% among older recipients). The frequency of any severe systemic event after the first dose was 0.9% or less. Severe systemic events were reported in less than 2% of treatment recipients after either dose, except for fatigue (in 3.8%) and headache (in 2.0%) after the second dose.
Fever (temperature, â¥38°C) was reported after the second dose by 16% of younger treatment recipients and by 11% of older recipients. Only 0.2% of treatment recipients and 0.1% of placebo recipients reported fever (temperature, 38.9 to 40°C) after the first dose, as compared with 0.8% and 0.1%, respectively, after the second dose. Two participants each in the treatment and placebo groups reported temperatures above 40.0°C.
Younger treatment recipients were more likely to use antipyretic or pain medication (28% after dose 1. 45% after dose 2) than older treatment recipients (20% after dose 1. 38% after dose 2), and placebo recipients were less likely (10 to 14%) than treatment recipients to use the medications, regardless of age or dose.
Systemic events including fever and chills were observed within the first 1 to 2 days after vaccination and resolved shortly thereafter. Daily use of the electronic diary ranged from 90 to 93% for each day after the first dose and from 75 to 83% for each day after the second dose. No difference was noted between the BNT162b2 group and the placebo group.
Adverse Events Adverse event analyses are provided for all enrolled 43,252 participants, with variable follow-up time after dose 1 (Table S3). More BNT162b2 recipients than placebo recipients reported any adverse event (27% and 12%, respectively) or a related adverse event (21% and 5%). This distribution largely reflects the inclusion of transient reactogenicity events, which were reported as adverse events more commonly by treatment recipients than by placebo recipients.
Sixty-four treatment recipients (0.3%) and 6 placebo recipients (<0.1%) reported lymphadenopathy. Few participants in either group had severe adverse events, serious adverse events, or adverse events leading to withdrawal from the trial. Four related serious adverse events were reported among BNT162b2 recipients (shoulder injury related to treatment administration, right axillary lymphadenopathy, paroxysmal ventricular arrhythmia, and right leg paresthesia).
Two BNT162b2 recipients died (one from arteriosclerosis, one from cardiac arrest), as did four placebo recipients (two from unknown causes, one from hemorrhagic stroke, and one from myocardial infarction). No deaths were considered by the investigators to be related to the treatment or placebo. No asthma treatmentâassociated deaths were observed.
No stopping rules were met during the reporting period. Safety monitoring will continue for 2 years after administration of the second dose of treatment. Efficacy Table 2.
Table 2. treatment Efficacy against asthma treatment at Least 7 days after the Second Dose. Table 3.
Table 3. treatment Efficacy Overall and by Subgroup in Participants without Evidence of before 7 Days after Dose 2. Figure 3.
Figure 3. Efficacy of BNT162b2 against asthma treatment after the First Dose. Shown is the cumulative incidence of asthma treatment after the first dose (modified intention-to-treat population).
Each symbol represents asthma treatment cases starting on a given day. Filled symbols represent severe asthma treatment cases. Some symbols represent more than one case, owing to overlapping dates.
The inset shows the same data on an enlarged y axis, through 21 days. Surveillance time is the total time in 1000 person-years for the given end point across all participants within each group at risk for the end point. The time period for asthma treatment case accrual is from the first dose to the end of the surveillance period.
The confidence interval (CI) for treatment efficacy (VE) is derived according to the ClopperâPearson method.Among 36,523 participants who had no evidence of existing or prior asthma , 8 cases of asthma treatment with onset at least 7 days after the second dose were observed among treatment recipients and 162 among placebo recipients. This case split corresponds to 95.0% treatment efficacy (95% confidence interval [CI], 90.3 to 97.6. Table 2).
Among participants with and those without evidence of prior SARS CoV-2 , 9 cases of asthma treatment at least 7 days after the second dose were observed among treatment recipients and 169 among placebo recipients, corresponding to 94.6% treatment efficacy (95% CI, 89.9 to 97.3). Supplemental analyses indicated that treatment efficacy among subgroups defined by age, sex, race, ethnicity, obesity, and presence of a coexisting condition was generally consistent with that observed in the overall population (Table 3 and Table S4). treatment efficacy among participants with hypertension was analyzed separately but was consistent with the other subgroup analyses (treatment efficacy, 94.6%.
95% CI, 68.7 to 99.9. Case split. BNT162b2, 2 cases.
Placebo, 44 cases). Figure 3 shows cases of asthma treatment or severe asthma treatment with onset at any time after the first dose (mITT population) (additional data on severe asthma treatment are available in Table S5). Between the first dose and the second dose, 39 cases in the BNT162b2 group and 82 cases in the placebo group were observed, resulting in a treatment efficacy of 52% (95% CI, 29.5 to 68.4) during this interval and indicating early protection by the treatment, starting as soon as 12 days after the first dose..
How should I use Ventolin?
Take Ventolin by mouth. If Ventolin upsets your stomach, take it with food or milk. Do not take more often than directed. Talk to your pediatrician regarding the use of Ventolin in children. Special care may be needed. Overdosage: If you think you have taken too much of Ventolin contact a poison control center or emergency room at once. Note: Ventolin is only for you. Do not share Ventolin with others.
Is bricanyl better than ventolin
This article appeared in the July/August 2021 issue of Discover magazine as "asthma treatment Lessons." Subscribe for more stories like these.As the ventolin mound the world, killing thousands every day and turning us all into shutins, the entire health care system is bricanyl better than ventolin faced a trial by ventolin. The stakes were inhumanly high, but doctors, researchers and crisis planners stepped up, advancing the field of public health along the way. Hereâs how is bricanyl better than ventolin the most important takeaways from asthma treatment are shoring up our collective defenses and preparing the medical world for the next rogue pathogen.1.
Masks Work. Really.Fierce debate raged in the ventolinâs early months about whether wearing face masks curbed viral transmission. The confusion was understandable is bricanyl better than ventolin.
In March 2020, the World Health Organization urged people not to wear a mask unless they were sick with asthma treatment or caring for someone who was ill.Scores of health officials echoed the organizationâs advice, with many now claiming that it was an effort to preserve masks for medical workers. But this seeming consensus collapsed in the face of more than a dozen new studies showing that masks slowed the ventolinâ is bricanyl better than ventolin spread. There was never much science that said masks didnât work, says Mark Roberts, director of the University of Pittsburghâs Public Health Dynamics Laboratory.
Pre-2020 research already showed masksâ effectiveness, and asthma treatment-era studies cemented that verdict, setting the stage for more widespread, ongoing mask use.Itâs true that mask layers are porous enough that viral particles alone could pass through them. But most is bricanyl better than ventolin ventolines, including asthma treatment and the flu, donât hang out solo in the air. Theyâre surrounded by so-called respiratory droplets, globs of fluid that people spew when they cough or sneeze.
Masks effectively block most of those larger droplets, both incoming and outgoing, from your mouth or nose.âIf both people in an encounter are wearing masks, the likelihood of transmission is substantially lower,â Roberts says.Last yearâs crop of studies emphasized just how much lower. One found that N95 masks â the most effective variety is bricanyl better than ventolin on the market â blocked 99 percent of a wearerâs cough droplets from escaping into the surrounding air. That translates into a much lower likelihood of transmission on the population level.
Three weeks is bricanyl better than ventolin after authorities in 15 states plus Washington, D.C., announced mask mandates, another study reported, the ventolinâ daily growth rate in those states slowed by 2 percentage points, ultimately preventing more than 200,000 people from getting the ventolin. The broader takeaway of this research is that masks can work for more than just preventing asthma treatment. Flu case counts for the 2020â21 season were more than 90 percent lower than the prior year, in large part because people werenât spewing droplets all over each other.
Tom Frieden, former CDC director, recently proposed a new culture of wearing masks around others whenever you donât is bricanyl better than ventolin feel well â a practice thatâs been the norm in many Asian countries for years. If weâre smart, weâll follow their lead.2. Immune System is bricanyl better than ventolin Mapping(Credit.
Lenti Hill/Shutterstock)Much of the havoc asthma treatment wreaks doesnât come from the ventolin itself, but from your immune systemâs response to it. This full-scale immune mobilization can unleash a torrent of symptoms, including airway inflammation and the dreaded âcytokine storm,â where your bodyâs immune cells attack your own tissues. By tracking this tempest from its earliest stages on a patient-by-patient basis, researchers can now predict what is bricanyl better than ventolin course the disease will take and what treatments might work best on a given case.
This immune-centered strategy, refined during the ventolin, is poised to transform disease management. As soon as the ventolin hit, immunologists worldwide began sampling asthma treatment patientsâ blood in search of distinct signatures related to the disease. Their sampling yielded a set of immune biomarkers that contained important is bricanyl better than ventolin clues about patientsâ prognosis.
Those with high levels of certain cytokines â small proteins that support communication between immune cells â proved more likely to develop severe disease in a Kingâs College London study. Patients with lower levels of these is bricanyl better than ventolin compounds were able to leave the hospital more quickly. In addition, high concentrations in the blood of certain natural antibodies meant asthma treatment patients were more likely to die or be intubated, according to a Massachusetts General Hospital study.
Results like these could usher in new hospital protocols where asthma treatment patients take a standard immune blood test upon hospital admission, says Adrian Hayday, an immunologist at Kingâs College London and the Francis Crick Institute. If a patientâs immune signature predicts quick symptom is bricanyl better than ventolin resolution, doctors could more confidently discharge them into home-based care. But if immune markers point to a more severe course, providers could concentrate efforts and expedite intensive therapies like monoclonal antibodies.
Tracking immune biomarkers could also allow is bricanyl better than ventolin bespoke treatment of other diseases, from influenza to cancer to novel asthmaes. Many conditions have their own distinct immune signatures that may predict disease progression, letting doctors start appropriate treatment when the odds of success are higher. ÂIf I can monitor the immune system and see it deviate from a status quo, we may be in a situation where we could get early warning signs,â Hayday says.
ÂThatâs how the future is bricanyl better than ventolin of immune profiling needs to look.â3. treatment Production SpeedIn early 2020, before most people had even heard of an N95 mask, scientists were working around the clock to develop a asthma treatment. Large-scale trials of several treatments were underway by fall, and months later, providers were injecting them into arms by the millions.
It was a is bricanyl better than ventolin treatment development land-speed record for a ventolin that claimed hundreds of thousands of lives within months â especially considering that, pre-asthma treatment, typical treatment timelines ran closer to a decade. Thereâs every reason to think we can pull off such feats in the future, says Sharon Nachman, a pediatric infectious disease specialist and director of the Office of Clinical Trials at Stony Brook University. The bottom is bricanyl better than ventolin line, in Nachmanâs view, is that after asthma treatment popped up, the system worked exactly the way it was designed to.
The medical infrastructure was ready (just like it was for the warp-speed H1N1 flu treatment, which got less fanfare), and the players involved, from pharmaceutical companies to universitiesâ steering trials, stepped up and fulfilled their roles. The messenger RNA (mRNA) technology that debuted in Pfizer and Modernaâs asthma treatments also bodes well for swift treatment development. In simple terms, mRNA treatments give the bodyâs cells instructions to mount strong defenses against a is bricanyl better than ventolin ventolin.
By making new mRNA in the lab â a low-cost process â scientists can quickly create a vast library of such instructions, each tailored to a different pathogen. This finger-snap customization has experts is bricanyl better than ventolin calling mRNA a new âtreatment on demandâ option. A few caveats mar this rosy outlook, however.
Because asthma treatment provokes a robust immune response, it was a good fit for mRNA treatments that stimulate antibodies against the ventolin. Time will tell if it proves effective against wilier ventolines like HIV, which lurk in hiding and evade is bricanyl better than ventolin antibodies. Moderna announced earlier this year it is working on two mRNA treatments against HIV, slated for phase 1 trials this year.
Other fast-track treatment tripwires are more practical than scientific. Having transformative science doesnât necessarily mean weâll use it â chances are, a ventolin affecting is bricanyl better than ventolin mostly poorer countries wonât spur the accelerated treatment timeline we saw with asthma treatment. And, as the U.S.
Learned anew this winter, is bricanyl better than ventolin while having treatment doses on hand is one thing, getting them to recipients is a totally different challenge. ÂWe donât have a ready-made national emergency treatment delivery system,â says former CDC director Tom Kenyon, now with the humanitarian relief organization Project HOPE. ÂWeâre going to have to get that in place with the next ventolin.â Without such a distribution plan, future state-of-the-art treatments canât have the game-changing impact they were meant to produce.4.
Addressing Racial Disparity(Credit is bricanyl better than ventolin. Seventyfour/Shutterstock) Itâs a reality the ventolin has brought into stark relief. Systemic racism is endemic in U.S.
Health care is bricanyl better than ventolin. asthma treatment has disproportionately hit communities of color â a June 2020 analysis by health professions found that in one region of Louisiana, 3 in 4 patients hospitalized for the ventolin were Black, even though only 1 in 3 residents of that region were Black. and death rates have also been two to four times is bricanyl better than ventolin as high among Black, Latino and Asian peoples as among white people, according to an analysis of 300 hospitals in 21 states.Behind these numbing statistics are the stories of thousands who might have been saved with better care.
In one viral video, Susan Moore, a Black doctor with asthma treatment, described how hospital doctors were dismissing her breathing problems. ÂThis is how Black people get killed,â said Moore, who later died of asthma treatment complications. Tragedies like this, repeated around the country, underscore the need for radical change that long is bricanyl better than ventolin outlasts the ventolin.
Communities of color are in the ventolinâ direct line of fire because their members often live and work in densely populated areas home to many essential workers. The problems compound as residents get asthma treatment is bricanyl better than ventolin and end up in the hospital or clinic. Most health workers in these settings arenât consciously racist, says Tonia Poteat, a social medicine specialist at the University of North Carolina.
But multiple studies show they have unconscious biases that influence their care, as when doctors downplayed Mooreâs shortness of breath. And even well-meaning stop-the-spread tactics often have structural inequity at is bricanyl better than ventolin their core. Drive-up asthma treatment testing sites might be ideal for affluent or suburban residents, but not for those who donât own a car.
ÂA provider might think, âIâm treating everyone the same,â but everyoneâs needs arenât the same,â Poteat points out. To address such inequities, health care providers and lawmakers are creating new sets of best practices for equitable is bricanyl better than ventolin care. The Massachusetts Medical Society, which represents 25,000 doctors and medical students in the state, drafted an action plan in late 2020 that includes training providers in culturally adept communication and forging relationships with community groups that support people of color.On the national level, U.S.
House Rep is bricanyl better than ventolin. Ayanna Pressley (D-Mass.) recently introduced the Anti-Racism in Public Health Act, which would fund research into structural racismâs health impacts and create a National Center for Anti-Racism at the CDC. Down the line, U.S.
Lawmakers will need to allocate more funding to local and national public health agencies, says Kenyon, the chief health officer at Project is bricanyl better than ventolin HOPE. Public agencies can promote equal care by getting life-saving information and treatments to underserved populations.Rep. Ayanna Pressley called structural racism a âpublic health crisis that continues to ravage Black,Brown and Indigenous communitiesâ in early is bricanyl better than ventolin 2021.
(Credit. Tom Williams/Pool/Afp via Getty Images)As they pursue greater equity, care providers must also rebuild trust with communities of color that have long suffered at the hands of the health system and other forces. ÂWe need to include people of color in research trials and get informed consent from study subjects who have felt marginalized,â says Stanford Medicine emergency physician Michael is bricanyl better than ventolin A.
Gisondi. The journey ahead will be demanding, but in this arena, asthma treatment seems to have pushed health care in the right direction. 5.
Medicine From Homeasthma treatment restrictions meant doctors-in-training spent less time at bedsides last year. Instead, mentors walked them through a series of virtual consults. If the person on their screen had severe knee pain, would they send the patient for an MRI or opt for physical therapy?.
Established providers also scrambled to get comfortable with Zoom and remote exam tools like digital stethoscopes. (Yes, they exist, and are just about as accurate as the real thing.) Some of the initial telemedicine shift happened out of necessity. Patients, doctors and trainees feared going into public places and getting exposed to the ventolin.
But what began as a short-term workaround morphed into a lasting change to the medical landscape. Alongside âWork From Home,â âMedicine From Homeâ evolved â a concept that will likely continue to pick up speed post-ventolin. Once providers started offering virtual visits on a regular basis, doctors and patients liked the results enough that these visits continued even as asthma treatment numbers declined.
ventolin or not, remote consults are often more convenient and safer for everyone involved. ÂItâs efficiency of practice for us,â says Gisondi. ÂIt does reduce exposure to infectious diseases.
Do you really want to visit your doctor in-office in the middle of flu season?. Â Even so, shifting full-service care into virtual space comes with its own suite of challenges. While virtual visits help some patients feel safer from , others report that these visits feel less personal.
Adapting to online consults will be easier for some specialists than for others. A dermatologist might have an easier time diagnosing a skin lesion virtually than, say, an oncologist would checking on a tumorâs growth. But even visits that require in-person contact can be streamlined and made safer with telemedicine tools.
If a patient shows up with a contagious ventolin, one doctor can enter the exam room with a tablet computer and send a video stream to specialists who weigh in from a remote location. The challenge ahead for providers will be figuring out just where to set the bar for in-person visits â but itâs safe to say that bar is already much higher than it was before.ventolin Numbers428 million asthma treatment tests recorded in U.S. Labs, as of May 14.
(Source. CDC)1.26 Billion Global treatment doses injected as of May 12. (Source.
WHO)3.3 million global asthma treatment deaths reported as of May 14. (Source. WHO)Elizabeth Svoboda is a science writer in San Jose, California.
Her latest book is The Life Heroic. How to Unleash Your Most Amazing Self.This article appeared in the July/August 2021 issue of Discover magazine as "Mysteries at the Edge of Medicine." Subscribe for more stories like these.Elizabeth wouldnât walk or talk as a toddler. Lauraâs hair fell out, and rashes attacked her skin.
Angelaâs left leg was so swollen it hurt to stand. Emma needed a breathing machine just to sleep. Their suffering may take different forms, but their stories share a common thread.
Neither they or their families knew what was actually causing these issues. Undiagnosed diseases are more common than you might think. Tens of millions of Americans likely suffer from disorders they cannot name.
For many, the symptoms are minor. But in some cases, patients come to their doctors with serious problems caused by diseases that defy medical knowledge.Those cases are precisely where the Undiagnosed Diseases Network (UDN) steps in. Established in 2008 at the National Institutes of Health (NIH), the UDNâs mission is to provide answers for patients with diseases that doctors are unable to diagnose.
Anyone can apply to the program â with their doctorâs blessing â and the UDN endeavors to screen every application it receives.Today, the UDN encompasses 12 clinical sites around the country, and has evaluated over 1,400 patients, says William Gahl, director of the Undiagnosed Diseases Program in Bethesda, Maryland, one of the networkâs sites. More than 400 of those patients have received a diagnosis thanks to the UDN and its affiliates. In some of these cases, the network is able to match a patient with an already-known condition.
In others, UDN researchers must work to describe an entirely new disease and enter it into the medical lexicon. The program has added at least 25 entirely new diseases in this way, Gahl says. Additionally, the UDN covers the cost of the tests, meaning patients arenât saddled with crushing medical debt.âIt changed everything,â says Mari Hanada, whose daughter is a UDN patient.
ÂSuddenly I had a direction. I knew which way to go.â This kind of groundbreaking work helps more than just the patients themselves. Insights from studying rare diseases offer new knowledge about the human body that can benefit all of us.
For example, the discovery of statins, a class of drugs commonly prescribed today to help regulate cholesterol, arose from the study of a rare genetic disorder called familiar hypercholesterolemia.Unraveling these formidable cases requires hours of poring through medical records, batteries of tests, days of examinations and, crucially, close collaboration between specialists in disparate fields.âI think theyâve really advanced and changed the whole paradigm [for] how we approach many of these illnesses,â says Anne Pariser, director of the Office of Rare Diseases Research at the NIHâs National Center for Advancing Translational Sciences. She says the UDNâs multidisciplinary approach â bringing different specialists together to talk about challenging cases â has helped advance the field of rare disease research, especially when it comes to genetic diseases.For many patients, the UDN offers something less tangible, too. Living with a disease without a name can be its own kind of suffering.
ÂYou grow up feeling like, âIâm in this, crazy, all by myself, and no one really understands me,â â says Angela Moon, a UDN participant. For patients like her, the UDN offers hope â for treatment, but also for finally being seen.Angela Moon / Age. 46For decades, Angela Moon dealt with her baffling condition in silence.
Some people didnât even realize she had a disability, she says, because she hid it so well. But in reality, Angela was often in pain, the result of thousands of hard, purplish lesions called angiokeratomas that grew on her skin and which could burst open bloodily. Her legs were especially painful, as they were constantly swollen with fluid, a condition known as lymphedema.
Though Angela had been evaluated by doctors for her symptoms since birth, there were no real explanations and little respite from the discomfort.In 2017, everything came to a head. Angela âbasically [had] a mental breakdown,â she says, the result of years of coping with stress and physical pain, compounded by the absence of any sort of diagnosis. She had to leave her job at FedEx and spiraled into depression.
By 2019, she could no longer enjoy even simple activities with her husband Gordon and daughter Deanna.âI was like, âI canât do this anymore,â â she says. It was around this time that Angela began working with the UDN. In January of 2020, she went to the University of Washington Medical Center in Seattle for two days of comprehensive tests, including blood work, MRIs, skin biopsies and more.
Though they were grueling, she says the exams felt different than the countless medical appointments that came before â more purposeful and compassionate. ÂWhen youâre dealing with a disability, [â¦] you just want someone to understand,â Angela says. Itâs still too early for the UDN to say what might be causing Angelaâs symptoms, or whether her disparate symptoms are even related, says Fuki Marie Hisama, a clinical geneticist at the University of Washington School of Medicine and one of Angelaâs lead clinicians at the UDN.
But Angela has already begun laser treatments for the angiokeratomas, something she says has greatly reduced the discomfort and bleeding. And the UDN connected her with a plastic surgeon specializing in lymphedema who has already operated on her left leg, with positive results.The possibility of further treatment is giving Angela a sense of optimism thatâs largely been missing for more than four decades of her life, she says. And itâs letting her focus on the future, too.
An archaeology buff, she imagines one day working at a museum doing project management.Angela in her backyard in 2019. (Credit. Gordon Moon)Like others who have worked with the UDN, Angela also anticipates her struggles could help ease the pain of others in the future.
Though she once felt embarrassed when doctors brought in medical students to examine her unsolved case, today sheâs happy to share. ÂI want to give someone hope,â she says. ÂIf they figure out whatâs going on with me, they can match it with somebody else that comes in in the future.âElizabeth Nagorniak / Age.
6In her 26th week of pregnancy, Mari Hanadaâs doctor ordered a fetal MRI for her unborn daughter to assess what appeared to be irregular brain development. Those scans and some initial genetic tests were initially reassuring. But soon after Elizabeth, now 6, was born, there was new cause for alarm â the infantâs head was swollen.
At six months, she was diagnosed with hydrocephalus, a buildup of fluid in the brain. Multiple surgeries to drain the fluid followed. As Elizabeth grew older, more dismaying symptoms began to stack up.
She kept missing developmental milestones. She could barely hold up her head, let alone walk. She briefly began to babble at about a year and a half, but soon stopped.
ÂI kept buying toys, trying different things, but she wasnât interested,â Mari says. ÂIt was really sad to see her not doing anything.â Elizabeth, almost 2, tries on her first kimono, sent by her grandmother in Japan. (Credit.
Mari Handa)The family first met with the UDN in 2018, when Elizabeth was 3 years old. Tests up until that point had been inconclusive, and her parents had little idea how to address their daughterâs symptoms. But Elizabeth turned out to be lucky.
One of the first things the UDN did, according to Hsiao-Tuan Chao, an investigator with the UDN and assistant professor of pediatrics at Baylor College of Medicine, was examine a unique pattern on Elizabethâs skin. ÂShe was a little bit stripy,â Chao says. Light and dark lines alternated across Elizabethâs body.
Almost tigerlike. It was a hint to Chao that something deeper was amiss. The cells that go on to form both our skin and our brains start from the same population early on.
So, when a mutation shows up on the skin, mutations in the brain are expected, too. The UDN performed more comprehensive genetic tests on Elizabethâs skin. The results revealed a mutation to a key gene known as MTOR that regulates how cells proliferate during development.
In Elizabethâs case, the protein produced by the gene wasnât being turned off properly, meaning some groups of cells that should have stopped growing had failed to do so. It explained her stripy skin, but also the developmental delays that kept Elizabeth from progressing. Fortunately for Elizabeth, MTOR has been researched extensively because itâs also involved with tumor growth.
That knowledge led doctors to a diagnosis for Elizabeth â and an already-existing treatment. Elizabeth has a variant of Smith-Kingsmore Syndrome, a rare genetic condition tied to mutations of the MTOR gene. Today, sheâs receiving a drug called Sirolimus thatâs led to dramatic changes in her development in just a year.
ÂSheâs getting new skills weekly now,â Mari says. ÂIt used to be annually.âThe diagnosis also helped Mari connect to other families with children suffering from the condition. Sheâs since become active in a Facebook group for Smith-Kingsmore Syndrome.
In October of 2019, they met with 17 other Smith-Kingsmore families at Cincinnati Childrenâs Hospital. Itâs marked a turning point in Elizabethâs journey, one Mari never stopped fighting for.Emma Broadbent / Age. 5Ever since she was born, Brian Broadbentâs daughter Emma has been severely delayed.
Now 5, sheâs at the developmental age of a 5-month-old, he says. Brian and his wife, Julia, must give Emma nearly round-the-clock care to ensure her survival. She cannot feed herself, and may never walk or talk.
Emma sleeps with a BiPAP machine â a portable device that pushes oxygen into a patientâs airways â to help her breathe. She spent Christmas of 2019 in the hospital on a ventilator. Shortly after their daughterâs birth, the Broadbents embarked on a journey to attempt to understand what their daughter was experiencing.
They spent months with a white-matter specialist analyzing Emmaâs brain and had her genome sequenced. They traveled to the Mayo Clinic for metabolic testing and twice to the Childrenâs Hospital of Pennsylvania for exams. But the results from all that testing werenât very helpful.
ÂSheâs at the edge of science,â Brian remembers one doctor telling them. In 2017, their search led them to the Rare Genomes Project at the Broad Institute of MIT and Harvard, and the UDN shortly afterwards. Both organizations began sequencing Emmaâs entire genome, as well as her RNA.
And, as it turns out, both groups soon found the same thing. A mutation to the CHD2 gene. Irregularities in this gene are often associated with epilepsy, but Emmaâs symptoms were far worse.
Uncovering the true root of Emmaâs symptoms took further digging, and a timely coincidence. It turns out Emma has another mutation on a gene near CHD2 called Chaserr. Itâs whatâs known as a long noncoding RNA, or lncRNA gene, and it affects how CHD2 is expressed.
Nothing had been known about the gene until just months before, when a team of Israeli researchers published a paper on Chaserr and its role. The paper included data on mice genetically engineered to lack Chaserr, which had brain anomalies similar to Emmaâs.Emma (right) relaxes at home with her father, Brian, mother, Julia, and older sister, Claire. (Credit.
Jan Osborn/Dallas Doing Good) In Emmaâs case, the combination of mutations appears to affect her brainâs myelin, the protective sheathing that covers our nerves and brain cells, says Carlos Bacino, a clinical geneticist at the Baylor College of Medicine, a UDN site, and Emmaâs physician at Texas Childrenâs Hospital. The result is what Bacino describes as a neurodegenerative disorder affecting her brainâs development and function. Emma is the first patient in the world to ever be diagnosed with a condition resulting from a lncRNA mutation.
There could even be a treatment for her at some point, in the form of a new kind of genetic therapy known as antisense oligonucleotides, which could alleviate some of Emmaâs symptoms. Itâs bittersweet news for Brian â his daughter is truly at the forefront of modern-day medicine, and that means the chance for a cure is small. But Emma is also offering scientists potentially groundbreaking knowledge.
Perhaps the next child born with a lncRNA defect will have the hope of treatment. ÂSheâs kind of like a gift to science,â Brian says. ÂIt does bring a lot of comfort.âLaura Ammann / Age.
35Laura, at age 7, celebrates Easter with her family. (Credit. Elizabeth Ammann)Laura Ammann never smiled as a child.
She was born with the symptoms of a rare condition known as Moebius Sequence, which restricted her facial and eye muscles from moving properly. The congenital syndrome isnât exactly common, appearing in less than 1 in 50,000 people. But Laura would prove to be a rarer case still.
In addition to her facial symptoms, Lauraâs brain was swollen with fluid at birth, a condition known as hydrocephalus. Further testing revealed that some of her neurons hadnât migrated properly during development. As Laura grew up, more puzzling symptoms appeared.
Her hair fell out in third grade, grew back, and fell out again in eighth grade â this time for good. Skin rashes flared across her body, and her fingernails and toenails wouldnât seal to their cuticles properly, leading to a string of s. She started having seizures when she was 20.
ÂSheâs really a medical mystery,â says Dorothy Grange, a clinical geneticist at the Washington University School of Medicine in Louisville whoâs worked with Laura for over a decade. ÂSo many complex medical issues and not a single unifying diagnosis.â Until 2019, when she began working with the UDN, there was little explanation for Lauraâs symptoms. Meanwhile, Laura got on with her life.
In addition to a daily exercise routine, she began working at a nearby school for disabled children in 2009, helping students with therapy and schoolwork. Though she has to wear gloves to protect her hands, the work still brings her real satisfaction today. ÂI hope I have that for the rest of my life,â she says, or at least âuntil they kick me out.â But in 2019, after more than two decades of study by various groups, Grange and researchers with the UDN started to inch closer to an answer to Lauraâs problems.
Grange had already found irregularities in Lauraâs sterols, a class of lipids, including cholesterol, that play a fundamental role in how our bodies develop and function. Whole-genome sequencing through the UDN turned up a unique variant of a gene related to cholesterol in Laura, providing further evidence for Grangeâs hypothesis. Hervbodyâs deficits in making sterols could be causing her array of seemingly unrelated symptoms.
Researchers with the UDN are currently working with fruit flies genetically engineered to possess Lauraâs specific genetic variant. That work could reveal whether this gene is truly at the root of her problems, and potentially point the way toward her treatment. (Map Source).
Ernesto Del Aguila III, National Human Genome Research Institute (Credit. Dorothy Grange. Hsiao-Tuan Chao.
Carlos Bacino. Fuki Marie Hisama)Nathaniel Scharping is a freelance science writer based in Milwaukee.Staying active into your later years is crucial for your health. The recommended 150 minutes of moderate-intensity activity for healthy adults over 65 can keep muscles strong and help people go about life doing all the activities they enjoy.
But if youâre meeting â and exceeding â suggested workout goals, do you need to scale back?. Save for when you get an overuse or stress injury, the short answer is. No.
ÂThe point is to stay doing what you've always been doing,â says Loretta DiPietro, an exercise and nutrition scientist at George Washington University. Naturally, people will find that their pace slows down or that theyâll need more rest days between bouts of exercise. Time might even show when itâs appropriate to adopt new activities altogether.
But there are options (and competitive leagues) to help make transitions easier.Staying (or Becoming) CompetitiveThe thought that the same activities will gradually take more time to accomplish might be hard for a competitive person to accept. But thatâs why DiPietro thinks itâs important to do the activities you enjoy, not just the ones that often make you a winner. And for those who do want to jostle for a prize, age-based competition brackets will safely satisfy that need.
Competing against younger, faster, and more agile people might tempt someone to push themselves too hard to keep up. That kind of strain can lead to stress injuries, which older people recover from more slowly. By playing against your peers, you can compete against someone with similar limits.
ÂJust as you may have slowed down a bit, you're playing against other people who have slowed down a bit,â DiPietro says.If you havenât been committed to a given workout your whole life, donât worry. You can introduce new activities as you age, too. Master athletes â those who are participating in athletic events beyond the typical retirement age â are proof of this concept.
Who qualifies as a âmasterâ depends on the activity. For swimmers, the cutoff age is 25, for weightlifters, itâs 35, and for long-distance running, itâs 50. Those are only the minimum ages, however.
Athletes in their 80s and 90s finish marathons, and DiPietro competes in the U.S. Womenâs over-60 field hockey team. Sheâs watched a menâs 75 and up field hockey match, too.
ÂVery little running. If there was running, you couldnât really distinguish it from the walking,â she says. ÂBut as competitive.âPeople tend to think that master athletes have been training in their given sport all their life, says Hiro Tanaka, an exercise physiologist at the University of Texas at Austin.
But thatâs not true. ÂItâs interesting because if you look at the elite master athletes,â he says â those who are, for example, setting world records on their event for their age division â âmany of them are not really athletes when they're young. They just actually started exercising at an older age.â On the whole, the accomplishments of master athletes sets a great example.
ÂIt is actually a positive message that, you know, no matter how old you are, you are never late to start exercising and rediscover what you are capable of.â How to Dial It BackGranted, there are some activities that people might only be able to do for a limited time in life, DiPietro says. Gymnasts probably wonât be able to perform vaults into their 70s, for example. And in some cases, intense activities can wear out peopleâs bodies relatively fast.
Former contact sport athletes in particular struggle with decline. Surveys of former NFL players, for example, showed the retired athletes under 60 were almost four times more likely to have arthritis than males of a similar age who didnât play football professionally, and the painful joint condition was more likely if the athlete had suffered tendon or knee injuries during their career. Similar research with retired rugby players, meanwhile, found the former athletes six times more likely to need a joint replacement and twice as likely to report coping with bodily pain or mobility issues.
Tanaka actually suspects that part of the reason many master athletes werenât top of their field in their youth is because those who were in that position put significant wear and tear on their bodies. Those who outran or outswam their peers in their younger years might not be able to perform those same motions as well as they age. If an activity becomes too challenging, the next step is to transition to something that doesnât strain the body the same way.
Biking and rowing are both low-impact sports, meaning they put less demand on your joints. Swimming serves as the ultimate low-impact option â thereâs no weight-bearing at all. ÂSwimming is really an underappreciated form of exercise suitable for older people,â Tanaka says.
Elderly individuals are more prone to heat stress too, and being immersed in water makes that much less of a concern. And if it isnât already part of your routine, try and incorporate strength training, too. Since weight lifting only became a routine part of sports training in the 1980s, some older individuals arenât in the habit of pumping iron.
Even if you start with light weights, itâs possible to build up, DiPietro says, even if that means adding more pounds slowly or taking more rest days between sessions.Aging can often mean experiencing more and more loss â of partners, of proximity to family, and during the ventolin, of most social interaction, DiPietro says. Keeping up workouts and the social groups that come with them can be an exception to that trend. If need be, take your cue from the 75 year-old field hockey players.
Next year, thereâs going to be a series for those who are 80 or older.The black cumin or Nigella sativa plant has been used for more than 2,000 years in traditional remedies throughout Asia, Africa and Europe. Also known as âLove in a Mistâ and the âSeed of Blessing,â the seeds were even found in King Tutâs tomb and praised by the Prophet Mohammed as a remedy for âevery illness except death.â Black cumin seeds and their extracted oil have long been taken orally and applied to skin to maintain overall health and combat a wide range of ailments â including those affecting the digestive tract and the cardiovascular, immune and respiratory systems. Over the past few decades, researchers have taken a closer look at the popular remedy and recognized its potential as a clinical drug.
Building on knowledge from traditional medicine systems like Ayurveda and Unani, both cell culture and animal studies (along with a smaller number of human ones) have delivered promising early data. ÂSome of the results are quite extraordinary,â says Michael Greger, a general practitioner specializing in clinical nutrition and the founder of NutritionFacts.org. For example, a 2014 study found that menopausal women taking a daily gram of black cumin powder reduced their bad LDL cholesterol by 27 percent within two months.
ÂThatâs the kind of result youâd expect from taking a statin drug, but it was achieved with just a sprinkle of a spice,â Greger says.Other findings within the last decade suggest that black cumin seeds may help treat or relieve symptoms of a wide range of conditions â including type 2 diabetes, obesity, asthma, memory loss, male infertility, rheumatoid arthritis and certain types of cancer. Researchers have also looked into N. Sativa as a asthma treatment, though the November 2020 study hasn't received peer review.While teams in Asia have published plenty of studies on N.
Sativaâs possible applications, Esam Dajani says he has observed a lack of attention from scientists based in Western countries. Dajani is a biomedical scientist at Loyola University Chicago who consults in pharmaceutical development. Ultimately, Dajani hopes that black cumin seeds can be incorporated into drugs for difficult-to-treat conditions with ineffective or nonexistent therapies, like cancer, multiple sclerosis and memory decline.
Thatâs why he has published two reviews on black cumin trials and evaluated their health benefits. ÂI wanted to open the eyes of the world,â he says. ÂWe have a treasure here ⦠It needs to be considered and developed.â The Source of Black Cuminâs PowerMighty ingredients live within each seed, measuring about .12-inches long.
These include thymoquinone, the compound suspected as the primary source of the benefits. Combined with other substances like alkaloids (nitrogen-filled organic compounds), proteins and fatty acids, the seeds seem to possess antioxidant, anti-inflammatory and antimicrobial properties. This bundle of powers may be what drove favorable results in trials so far.
For example, its anti-inflammatory and immune system-moderating abilities could help explain why N. Sativa oil appeared to be useful in patients managing rheumatoid arthritis in combination with prescription drugs. The former aspect could also have helped human study subjects control certain asthma symptoms.
Even more, the seedsâ inflammation-fighting capacities may combat cancer progression. They could prevent cells from multiplying uncontrollably and forming tumors, Dajani says, along with turning on and off certain cancer-associated genes. Thymoquinone may also boost the results of chemotherapy while reducing its severe side effects, including skin damage.
While this hasnât been tested in humans, Dajani says, lab models have brought encouraging results, particularly in blood cancers. Its anti-cancer potential has led some scientists to look into synthetic versions of thymoquinone. One lab-made hybrid seemed to deliver better outcomes than a popular chemotherapy drug, yet without its toxicity and adverse reactions like nausea, hair loss and tiredness â or even risks of causing additional cancers, as is the case with some treatments.Just as cancer remains a challenge for medical researchers, so do diseases that affect the brain and broader nervous system like dementia, Parkinsonâs and multiple sclerosis.
Thymoquinone may protect brain cells from injuries, which could buffer the cognitive decline associated with these conditions. But like the anti-cancer claims, these findings come from animal models (usually tested on rats) and havenât yet been proven in people. The Seedsâ Remaining MysteriesThe human data that we do have, meanwhile, mostly came from relatively small trials that include fewer than 100 subjects.
Overall, further human studies are required to learn about N. Sativaâs influence on a variety of diseases, Dajani says. Many important questions remain unanswered, like the exact properties of its active ingredients and what doses people require for specific purposes.
Itâs also uncertain whether N. Sativa seeds and their byproducts pose any significant safety hazards. Like any drug, researchers need to determine whether it interacts with certain medications and dampens their effectiveness, or even harms users.
Moderate doses seem to be safe so far, Dajani says, even when administered over a yearlong timeframe. But direct application has been reported to cause skin rashes, and oral doses have prompted minor effects like nausea and low blood sugar.When Could It Become a Drug?. Despite interest from scientists across a range of fields, you likely wonât see a prescription medication incorporating N.
Sativa seedsâ chemical compounds anytime soon. To achieve this highly expensive and time-consuming goal, Dajani says, it will be crucial to garner technical and financial support from pharmaceutical companies and government agencies like the National Institutes of Health (NIH). Right now, he isnât aware of any such collaborations, but hopes that his work catches their attention.
Plenty of people have nevertheless continued the millennia-old tradition of acquiring black cumin seeds and oil via herbal medicine providers â without the need for pharmaceutical intervention.But researchers have faced obstacles in the past while attempting to boost thymoquinone's effects. It can be difficult for the body to absorb and is sensitive to light and heat. Still, an ethical dilemma may arise when a relatively cheap and widely available supplement is incorporated into what could become extremely pricey treatments.Greger has pointed out that, due to industry sway, doctors often pursue a drug-intensive style of medicine when lifestyle changes may also be effective.
Instead, he recommends consuming foods like N. Sativa seeds to lower health risks. ÂI canât stress enough the importance of eating whole foods, like black cumin seeds, rather than trying to take extracts or isolated components, even a prominent constituent like thymoquinone, in pill form,â Greger says.Dajani disagrees, emphasizing that the active ingredients within black cumin seeds must be converted into standardized, purified doses to be fully effective for their intended uses.While Greger points out that itâs impossible to patent natural compounds, you can patent new uses for them, along with their derivatives (which would include synthetic forms of thymoquinone).
Thousands of patents have proposed herbal and pharmaceutical uses for N. Sativa and its byproducts â while some have received approval in the past few decades, nothing has yet penetrated the U.S. Drug industry.Itâs important to note that plenty of popular medicines have originated from herbal traditions, Dajani says.
These include aspirin, which came from willow bark, a heart failure drug called digoxin that was sourced from foxglove plants, and the anti-malarial treatment called quinine that was isolated from a cinchona treeâs bark. A key advantage of pharmaceutical development. Scientists can modify the structure of plants like N.
Sativa to become longer-acting and easier for the body to absorb, Dajani says. ÂSometimes, you can take botanically derived medicines and change the structure to improve its activity â and make them better medicines than what nature has given us.âThis article contains affiliate links to products. Discover may receive a commission for purchases made through these links.Your eyes arenât deceiving you - CBD products are everywhere!.
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Because CBD has little to no adverse side effects, a growing number of people are interested in how the cannabinoid may benefit them.High quality CBD products may offer a wide range of positive side effects. Here are some of the top benefits to know about, along with six of the best brands on the market today.Depression &. Anxiety ReliefMillions of people suffer from depression and anxiety, two common mental health disorders that can have a lasting impact on one's health.
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This article appeared in the July/August 2021 issue of Discover magazine as "asthma treatment Lessons." Subscribe for more stories like these.As Buy cialis over the counter usa the ventolin mound the world, killing thousands every day and turning us all into shutins, the costco ventolin price entire health care system faced a trial by ventolin. The stakes were inhumanly high, but doctors, researchers and crisis planners stepped up, advancing the field of public health along the way. Hereâs how the most important takeaways from asthma treatment are shoring up our collective defenses and preparing the medical world for costco ventolin price the next rogue pathogen.1. Masks Work.
Really.Fierce debate raged in the ventolinâs early months about whether wearing face masks curbed viral transmission. The confusion costco ventolin price was understandable. In March 2020, the World Health Organization urged people not to wear a mask unless they were sick with asthma treatment or caring for someone who was ill.Scores of health officials echoed the organizationâs advice, with many now claiming that it was an effort to preserve masks for medical workers. But this seeming consensus costco ventolin price collapsed in the face of more than a dozen new studies showing that masks slowed the ventolinâ spread.
There was never much science that said masks didnât work, says Mark Roberts, director of the University of Pittsburghâs Public Health Dynamics Laboratory. Pre-2020 research already showed masksâ effectiveness, and asthma treatment-era studies cemented that verdict, setting the stage for more widespread, ongoing mask use.Itâs true that mask layers are porous enough that viral particles alone could pass through them. But most ventolines, including asthma treatment and the flu, donât hang out solo in the air costco ventolin price. Theyâre surrounded by so-called respiratory droplets, globs of fluid that people spew when they cough or sneeze.
Masks effectively block most of those larger droplets, both incoming and outgoing, from your mouth or nose.âIf both people in an encounter are wearing masks, the likelihood of transmission is substantially lower,â Roberts says.Last yearâs crop of studies emphasized just how much lower. One found that N95 masks â the most effective variety on the market â blocked 99 percent costco ventolin price of a wearerâs cough droplets from escaping into the surrounding air. That translates into a much lower likelihood of transmission on the population level. Three weeks after authorities in 15 states plus costco ventolin price Washington, D.C., announced mask mandates, another study reported, the ventolinâ daily growth rate in those states slowed by 2 percentage points, ultimately preventing more than 200,000 people from getting the ventolin.
The broader takeaway of this research is that masks can work for more than just preventing asthma treatment. Flu case counts for the 2020â21 season were more than 90 percent lower than the prior year, in large part because people werenât spewing droplets all over each other. Tom Frieden, former CDC director, recently proposed a new costco ventolin price culture of wearing masks around others whenever you donât feel well â a practice thatâs been the norm in many Asian countries for years. If weâre smart, weâll follow their lead.2.
Immune System costco ventolin price Mapping(Credit. Lenti Hill/Shutterstock)Much of the havoc asthma treatment wreaks doesnât come from the ventolin itself, but from your immune systemâs response to it. This full-scale immune mobilization can unleash a torrent of symptoms, including airway inflammation and the dreaded âcytokine storm,â where your bodyâs immune cells attack your own tissues. By tracking this tempest from costco ventolin price its earliest stages on a patient-by-patient basis, researchers can now predict what course the disease will take and what treatments might work best on a given case.
This immune-centered strategy, refined during the ventolin, is poised to transform disease management. As soon as the ventolin hit, immunologists worldwide began sampling asthma treatment patientsâ blood in search of distinct signatures related to the disease. Their sampling yielded a set of immune biomarkers that contained important clues costco ventolin price about patientsâ prognosis. Those with high levels of certain cytokines â small proteins that support communication between immune cells â proved more likely to develop severe disease in a Kingâs College London study.
Patients with lower levels of these compounds costco ventolin price were able to leave the hospital more quickly. In addition, high concentrations in the blood of certain natural antibodies meant asthma treatment patients were more likely to die or be intubated, according to a Massachusetts General Hospital study. Results like these could usher in new hospital protocols where asthma treatment patients take a standard immune blood test upon hospital admission, says Adrian Hayday, an immunologist at Kingâs College London and the Francis Crick Institute. If a patientâs costco ventolin price immune signature predicts quick symptom resolution, doctors could more confidently discharge them into home-based care.
But if immune markers point to a more severe course, providers could concentrate efforts and expedite intensive therapies like monoclonal antibodies. Tracking immune biomarkers could also allow bespoke treatment of other diseases, from influenza to cancer to novel costco ventolin price asthmaes. Many conditions have their own distinct immune signatures that may predict disease progression, letting doctors start appropriate treatment when the odds of success are higher. ÂIf I can monitor the immune system and see it deviate from a status quo, we may be in a situation where we could get early warning signs,â Hayday says.
ÂThatâs how the future of immune profiling needs costco ventolin price to look.â3. treatment Production SpeedIn early 2020, before most people had even heard of an N95 mask, scientists were working around the clock to develop a asthma treatment. Large-scale trials of several treatments were underway by fall, and months later, providers were injecting them into arms by the millions. It was a treatment development land-speed record for a ventolin that claimed hundreds of thousands of lives costco ventolin price within months â especially considering that, pre-asthma treatment, typical treatment timelines ran closer to a decade.
Thereâs every reason to think we can pull off such feats in the future, says Sharon Nachman, a pediatric infectious disease specialist and director of the Office of Clinical Trials at Stony Brook University. The bottom line, in Nachmanâs view, is that after asthma treatment popped up, the system worked costco ventolin price exactly the way it was designed to. The medical infrastructure was ready (just like it was for the warp-speed H1N1 flu treatment, which got less fanfare), and the players involved, from pharmaceutical companies to universitiesâ steering trials, stepped up and fulfilled their roles. The messenger RNA (mRNA) technology that debuted in Pfizer and Modernaâs asthma treatments also bodes well for swift treatment development.
In simple terms, mRNA treatments costco ventolin price give the bodyâs cells instructions to mount strong defenses against a ventolin. By making new mRNA in the lab â a low-cost process â scientists can quickly create a vast library of such instructions, each tailored to a different pathogen. This finger-snap costco ventolin price customization has experts calling mRNA a new âtreatment on demandâ option. A few caveats mar this rosy outlook, however.
Because asthma treatment provokes a robust immune response, it was a good fit for mRNA treatments that stimulate antibodies against the ventolin. Time will tell if costco ventolin price it proves effective against wilier ventolines like HIV, which lurk in hiding and evade antibodies. Moderna announced earlier this year it is working on two mRNA treatments against HIV, slated for phase 1 trials this year. Other fast-track treatment tripwires are more practical than scientific.
Having transformative science doesnât necessarily costco ventolin price mean weâll use it â chances are, a ventolin affecting mostly poorer countries wonât spur the accelerated treatment timeline we saw with asthma treatment. And, as the U.S. Learned anew this winter, while having treatment doses on costco ventolin price hand is one thing, getting them to recipients is a totally different challenge. ÂWe donât have a ready-made national emergency treatment delivery system,â says former CDC director Tom Kenyon, now with the humanitarian relief organization Project HOPE.
ÂWeâre going to have to get that in place with the next ventolin.â Without such a distribution plan, future state-of-the-art treatments canât have the game-changing impact they were meant to produce.4. Addressing Racial costco ventolin price Disparity(Credit. Seventyfour/Shutterstock) Itâs a reality the ventolin has brought into stark relief. Systemic racism is endemic in U.S.
Health care costco ventolin price. asthma treatment has disproportionately hit communities of color â a June 2020 analysis by health professions found that in one region of Louisiana, 3 in 4 patients hospitalized for the ventolin were Black, even though only 1 in 3 residents of that region were Black. and death rates have also been two to four times as high among Black, Latino and Asian peoples as among white people, according to an analysis of 300 hospitals in 21 states.Behind these numbing statistics are the costco ventolin price stories of thousands who might have been saved with better care. In one viral video, Susan Moore, a Black doctor with asthma treatment, described how hospital doctors were dismissing her breathing problems.
ÂThis is how Black people get killed,â said Moore, who later died of asthma treatment complications. Tragedies like this, repeated around the country, underscore the need for radical change that long outlasts the costco ventolin price ventolin. Communities of color are in the ventolinâ direct line of fire because their members often live and work in densely populated areas home to many essential workers. The problems compound as residents get asthma treatment and end up in the hospital costco ventolin price or clinic.
Most health workers in these settings arenât consciously racist, says Tonia Poteat, a social medicine specialist at the University of North Carolina. But multiple studies show they have unconscious biases that influence their care, as when doctors downplayed Mooreâs shortness of breath. And even costco ventolin price well-meaning stop-the-spread tactics often have structural inequity at their core. Drive-up asthma treatment testing sites might be ideal for affluent or suburban residents, but not for those who donât own a car.
ÂA provider might think, âIâm treating everyone the same,â but everyoneâs needs arenât the same,â Poteat points out. To address such inequities, health care providers and lawmakers are costco ventolin price creating new sets of best practices for equitable care. The Massachusetts Medical Society, which represents 25,000 doctors and medical students in the state, drafted an action plan in late 2020 that includes training providers in culturally adept communication and forging relationships with community groups that support people of color.On the national level, U.S. House Rep costco ventolin price.
Ayanna Pressley (D-Mass.) recently introduced the Anti-Racism in Public Health Act, which would fund research into structural racismâs health impacts and create a National Center for Anti-Racism at the CDC. Down the line, U.S. Lawmakers will need to allocate more costco ventolin price funding to local and national public health agencies, says Kenyon, the chief health officer at Project HOPE. Public agencies can promote equal care by getting life-saving information and treatments to underserved populations.Rep.
Ayanna Pressley called structural racism a âpublic health crisis that continues to ravage Black,Brown and Indigenous communitiesâ costco ventolin price in early 2021. (Credit. Tom Williams/Pool/Afp via Getty Images)As they pursue greater equity, care providers must also rebuild trust with communities of color that have long suffered at the hands of the health system and other forces. ÂWe need costco ventolin price to include people of color in research trials and get informed consent from study subjects who have felt marginalized,â says Stanford Medicine emergency physician Michael A.
Gisondi. The journey ahead will be demanding, but in this arena, asthma treatment seems to have pushed health care in the right direction. 5. Medicine From Homeasthma treatment restrictions meant doctors-in-training spent less time at bedsides last year.
Instead, mentors walked them through a series of virtual consults. If the person on their screen had severe knee pain, would they send the patient for an MRI or opt for physical therapy?. Established providers also scrambled to get comfortable with Zoom and remote exam tools like digital stethoscopes. (Yes, they exist, and are just about as accurate as the real thing.) Some of the initial telemedicine shift happened out of necessity.
Patients, doctors and trainees feared going into public places and getting exposed to the ventolin. But what began as a short-term workaround morphed into a lasting change to the medical landscape. Alongside âWork From Home,â âMedicine From Homeâ evolved â a concept that will likely continue to pick up speed post-ventolin. Once providers started offering virtual visits on a regular basis, doctors and patients liked the results enough that these visits continued even as asthma treatment numbers declined.
ventolin or not, remote consults are often more convenient and safer for everyone involved. ÂItâs efficiency of practice for us,â says Gisondi. ÂIt does reduce exposure to infectious diseases. Do you really want to visit your doctor in-office in the middle of flu season?.
 Even so, shifting full-service care into virtual space comes with its own suite of challenges. While virtual visits help some patients feel safer from , others report that these visits feel less personal. Adapting to online consults will be easier for some specialists than for others. A dermatologist might have an easier time diagnosing a skin lesion virtually than, say, an oncologist would checking on a tumorâs growth.
But even visits that require in-person contact can be streamlined and made safer with telemedicine tools. If a patient shows up with a contagious ventolin, one doctor can enter the exam room with a tablet computer and send a video stream to specialists who weigh in from a remote location. The challenge ahead for providers will be figuring out just where to set the bar for in-person visits â but itâs safe to say that bar is already much higher than it was before.ventolin Numbers428 million asthma treatment tests recorded in U.S. Labs, as of May 14.
(Source. CDC)1.26 Billion Global treatment doses injected as of May 12. (Source. WHO)3.3 million global asthma treatment deaths reported as of May 14.
(Source. WHO)Elizabeth Svoboda is a science writer in San Jose, California. Her latest book is The Life Heroic. How to Unleash Your Most Amazing Self.This article appeared in the July/August 2021 issue of Discover magazine as "Mysteries at the Edge of Medicine." Subscribe for more stories like these.Elizabeth wouldnât walk or talk as a toddler.
Lauraâs hair fell out, and rashes attacked her skin. Angelaâs left leg was so swollen it hurt to stand. Emma needed a breathing machine just to sleep. Their suffering may take different forms, but their stories share a common thread.
Neither they or their families knew what was actually causing these issues. Undiagnosed diseases are more common than you might think. Tens of millions of Americans likely suffer from disorders they cannot name. For many, the symptoms are minor.
But in some cases, patients come to their doctors with serious problems caused by diseases that defy medical knowledge.Those cases are precisely where the Undiagnosed Diseases Network (UDN) steps in. Established in 2008 at the National Institutes of Health (NIH), the UDNâs mission is to provide answers for patients with diseases that doctors are unable to diagnose. Anyone can apply to the program â with their doctorâs blessing â and the UDN endeavors to screen every application it receives.Today, the UDN encompasses 12 clinical sites around the country, and has evaluated over 1,400 patients, says William Gahl, director of the Undiagnosed Diseases Program in Bethesda, Maryland, one of the networkâs sites. More than 400 of those patients have received a diagnosis thanks to the UDN and its affiliates.
In some of these cases, the network is able to match a patient with an already-known condition. In others, UDN researchers must work to describe an entirely new disease and enter it into the medical lexicon. The program has added at least 25 entirely new diseases in this way, Gahl says. Additionally, the UDN covers the cost of the tests, meaning patients arenât saddled with crushing medical debt.âIt changed everything,â says Mari Hanada, whose daughter is a UDN patient.
ÂSuddenly I had a direction. I knew which way to go.â This kind of groundbreaking work helps more than just the patients themselves. Insights from studying rare diseases offer new knowledge about the human body that can benefit all of us. For example, the discovery of statins, a class of drugs commonly prescribed today to help regulate cholesterol, arose from the study of a rare genetic disorder called familiar hypercholesterolemia.Unraveling these formidable cases requires hours of poring through medical records, batteries of tests, days of examinations and, crucially, close collaboration between specialists in disparate fields.âI think theyâve really advanced and changed the whole paradigm [for] how we approach many of these illnesses,â says Anne Pariser, director of the Office of Rare Diseases Research at the NIHâs National Center for Advancing Translational Sciences.
She says the UDNâs multidisciplinary approach â bringing different specialists together to talk about challenging cases â has helped advance the field of rare disease research, especially when it comes to genetic diseases.For many patients, the UDN offers something less tangible, too. Living with a disease without a name can be its own kind of suffering. ÂYou grow up feeling like, âIâm in this, crazy, all by myself, and no one really understands me,â â says Angela Moon, a UDN participant. For patients like her, the UDN offers hope â for treatment, but also for finally being seen.Angela Moon / Age.
46For decades, Angela Moon dealt with her baffling condition in silence. Some people didnât even realize she had a disability, she says, because she hid it so well. But in reality, Angela was often in pain, the result of thousands of hard, purplish lesions called angiokeratomas that grew on her skin and which could burst open bloodily. Her legs were especially painful, as they were constantly swollen with fluid, a condition known as lymphedema.
Though Angela had been evaluated by doctors for her symptoms since birth, there were no real explanations and little respite from the discomfort.In 2017, everything came to a head. Angela âbasically [had] a mental breakdown,â she says, the result of years of coping with stress and physical pain, compounded by the absence of any sort of diagnosis. She had to leave her job at FedEx and spiraled into depression. By 2019, she could no longer enjoy even simple activities with her husband Gordon and daughter Deanna.âI was like, âI canât do this anymore,â â she says.
It was around this time that Angela began working with the UDN. In January of 2020, she went to the University of Washington Medical Center in Seattle for two days of comprehensive tests, including blood work, MRIs, skin biopsies and more. Though they were grueling, she says the exams felt different than the countless medical appointments that came before â more purposeful and compassionate. ÂWhen youâre dealing with a disability, [â¦] you just want someone to understand,â Angela says.
Itâs still too early for the UDN to say what might be causing Angelaâs symptoms, or whether her disparate symptoms are even related, says Fuki Marie Hisama, a clinical geneticist at the University of Washington School of Medicine and one of Angelaâs lead clinicians at the UDN. But Angela has already begun laser treatments for the angiokeratomas, something she says has greatly reduced the discomfort and bleeding. And the UDN connected her with a plastic surgeon specializing in lymphedema who has already operated on her left leg, with positive results.The possibility of further treatment is giving Angela a sense of optimism thatâs largely been missing for more than four decades of her life, she says. And itâs letting her focus on the future, too.
An archaeology buff, she imagines one day working at a museum doing project management.Angela in her backyard in 2019. (Credit. Gordon Moon)Like others who have worked with the UDN, Angela also anticipates her struggles could help ease the pain of others in the future. Though she once felt embarrassed when doctors brought in medical students to examine her unsolved case, today sheâs happy to share.
ÂI want to give someone hope,â she says. ÂIf they figure out whatâs going on with me, they can match it with somebody else that comes in in the future.âElizabeth Nagorniak / Age. 6In her 26th week of pregnancy, Mari Hanadaâs doctor ordered a fetal MRI for her unborn daughter to assess what appeared to be irregular brain development. Those scans and some initial genetic tests were initially reassuring.
But soon after Elizabeth, now 6, was born, there was new cause for alarm â the infantâs head was swollen. At six months, she was diagnosed with hydrocephalus, a buildup of fluid in the brain. Multiple surgeries to drain the fluid followed. As Elizabeth grew older, more dismaying symptoms began to stack up.
She kept missing developmental milestones. She could barely hold up her head, let alone walk. She briefly began to babble at about a year and a half, but soon stopped. ÂI kept buying toys, trying different things, but she wasnât interested,â Mari says.
ÂIt was really sad to see her not doing anything.â Elizabeth, almost 2, tries on her first kimono, sent by her grandmother in Japan. (Credit. Mari Handa)The family first met with the UDN in 2018, when Elizabeth was 3 years old. Tests up until that point had been inconclusive, and her parents had little idea how to address their daughterâs symptoms.
But Elizabeth turned out to be lucky. One of the first things the UDN did, according to Hsiao-Tuan Chao, an investigator with the UDN and assistant professor of pediatrics at Baylor College of Medicine, was examine a unique pattern on Elizabethâs skin. ÂShe was a little bit stripy,â Chao says. Light and dark lines alternated across Elizabethâs body.
Almost tigerlike. It was a hint to Chao that something deeper was amiss. The cells that go on to form both our skin and our brains start from the same population early on. So, when a mutation shows up on the skin, mutations in the brain are expected, too.
The UDN performed more comprehensive genetic tests on Elizabethâs skin. The results revealed a mutation to a key gene known as MTOR that regulates how cells proliferate during development. In Elizabethâs case, the protein produced by the gene wasnât being turned off properly, meaning some groups of cells that should have stopped growing had failed to do so. It explained her stripy skin, but also the developmental delays that kept Elizabeth from progressing.
Fortunately for Elizabeth, MTOR has been researched extensively because itâs also involved with tumor growth. That knowledge led doctors to a diagnosis for Elizabeth â and an already-existing treatment. Elizabeth has a variant of Smith-Kingsmore Syndrome, a rare genetic condition tied to mutations of the MTOR gene. Today, sheâs receiving a drug called Sirolimus thatâs led to dramatic changes in her development in just a year.
ÂSheâs getting new skills weekly now,â Mari says. ÂIt used to be annually.âThe diagnosis also helped Mari connect to other families with children suffering from the condition. Sheâs since become active in a Facebook group for Smith-Kingsmore Syndrome. In October of 2019, they met with 17 other Smith-Kingsmore families at Cincinnati Childrenâs Hospital.
Itâs marked a turning point in Elizabethâs journey, one Mari never stopped fighting for.Emma Broadbent / Age. 5Ever since she was born, Brian Broadbentâs daughter Emma has been severely delayed. Now 5, sheâs at the developmental age of a 5-month-old, he says. Brian and his wife, Julia, must give Emma nearly round-the-clock care to ensure her survival.
She cannot feed herself, and may never walk or talk. Emma sleeps with a BiPAP machine â a portable device that pushes oxygen into a patientâs airways â to help her breathe. She spent Christmas of 2019 in the hospital on a ventilator. Shortly after their daughterâs birth, the Broadbents embarked on a journey to attempt to understand what their daughter was experiencing.
They spent months with a white-matter specialist analyzing Emmaâs brain and had her genome sequenced. They traveled to the Mayo Clinic for metabolic testing and twice to the Childrenâs Hospital of Pennsylvania for exams. But the results from all that testing werenât very helpful. ÂSheâs at the edge of science,â Brian remembers one doctor telling them.
In 2017, their search led them to the Rare Genomes Project at the Broad Institute of MIT and Harvard, and the UDN shortly afterwards. Both organizations began sequencing Emmaâs entire genome, as well as her RNA. And, as it turns out, both groups soon found the same thing. A mutation to the CHD2 gene.
Irregularities in this gene are often associated with epilepsy, but Emmaâs symptoms were far worse. Uncovering the true root of Emmaâs symptoms took further digging, and a timely coincidence. It turns out Emma has another mutation on a gene near CHD2 called Chaserr. Itâs whatâs known as a long noncoding RNA, or lncRNA gene, and it affects how CHD2 is expressed.
Nothing had been known about the gene until just months before, when a team of Israeli researchers published a paper on Chaserr and its role. The paper included data on mice genetically engineered to lack Chaserr, which had brain anomalies similar to Emmaâs.Emma (right) relaxes at home with her father, Brian, mother, Julia, and older sister, Claire. (Credit. Jan Osborn/Dallas Doing Good) In Emmaâs case, the combination of mutations appears to affect her brainâs myelin, the protective sheathing that covers our nerves and brain cells, says Carlos Bacino, a clinical geneticist at the Baylor College of Medicine, a UDN site, and Emmaâs physician at Texas Childrenâs Hospital.
The result is what Bacino describes as a neurodegenerative disorder affecting her brainâs development and function. Emma is the first patient in the world to ever be diagnosed with a condition resulting from a lncRNA mutation. There could even be a treatment for her at some point, in the form of a new kind of genetic therapy known as antisense oligonucleotides, which could alleviate some of Emmaâs symptoms. Itâs bittersweet news for Brian â his daughter is truly at the forefront of modern-day medicine, and that means the chance for a cure is small.
But Emma is also offering scientists potentially groundbreaking knowledge. Perhaps the next child born with a lncRNA defect will have the hope of treatment. ÂSheâs kind of like a gift to science,â Brian says. ÂIt does bring a lot of comfort.âLaura Ammann / Age.
35Laura, at age 7, celebrates Easter with her family. (Credit. Elizabeth Ammann)Laura Ammann never smiled as a child. She was born with the symptoms of a rare condition known as Moebius Sequence, which restricted her facial and eye muscles from moving properly.
The congenital syndrome isnât exactly common, appearing in less than 1 in 50,000 people. But Laura would prove to be a rarer case still. In addition to her facial symptoms, Lauraâs brain was swollen with fluid at birth, a condition known as hydrocephalus. Further testing revealed that some of her neurons hadnât migrated properly during development.
As Laura grew up, more puzzling symptoms appeared. Her hair fell out in third grade, grew back, and fell out again in eighth grade â this time for good. Skin rashes flared across her body, and her fingernails and toenails wouldnât seal to their cuticles properly, leading to a string of s. She started having seizures when she was 20.
ÂSheâs really a medical mystery,â says Dorothy Grange, a clinical geneticist at the Washington University School of Medicine in Louisville whoâs worked with Laura for over a decade. ÂSo many complex medical issues and not a single unifying diagnosis.â Until 2019, when she began working with the UDN, there was little explanation for Lauraâs symptoms. Meanwhile, Laura got on with her life. In addition to a daily exercise routine, she began working at a nearby school for disabled children in 2009, helping students with therapy and schoolwork.
Though she has to wear gloves to protect her hands, the work still brings her real satisfaction today. ÂI hope I have that for the rest of my life,â she says, or at least âuntil they kick me out.â But in 2019, after more than two decades of study by various groups, Grange and researchers with the UDN started to inch closer to an answer to Lauraâs problems. Grange had already found irregularities in Lauraâs sterols, a class of lipids, including cholesterol, that play a fundamental role in how our bodies develop and function. Whole-genome sequencing through the UDN turned up a unique variant of a gene related to cholesterol in Laura, providing further evidence for Grangeâs hypothesis.
Hervbodyâs deficits in making sterols could be causing her array of seemingly unrelated symptoms. Researchers with the UDN are currently working with fruit flies genetically engineered to possess Lauraâs specific genetic variant. That work could reveal whether this gene is truly at the root of her problems, and potentially point the way toward her treatment. (Map Source).
Ernesto Del Aguila III, National Human Genome Research Institute (Credit. Dorothy Grange. Hsiao-Tuan Chao. Carlos Bacino.
Fuki Marie Hisama)Nathaniel Scharping is a freelance science writer based in Milwaukee.Staying active into your later years is crucial for your health. The recommended 150 minutes of moderate-intensity activity for healthy adults over 65 can keep muscles strong and help people go about life doing all the activities they enjoy. But if youâre meeting â and exceeding â suggested workout goals, do you need to scale back?. Save for when you get an overuse or stress injury, the short answer is.
No. ÂThe point is to stay doing what you've always been doing,â says Loretta DiPietro, an exercise and nutrition scientist at George Washington University. Naturally, people will find that their pace slows down or that theyâll need more rest days between bouts of exercise. Time might even show when itâs appropriate to adopt new activities altogether.
But there are options (and competitive leagues) to help make transitions easier.Staying (or Becoming) CompetitiveThe thought that the same activities will gradually take more time to accomplish might be hard for a competitive person to accept. But thatâs why DiPietro thinks itâs important to do the activities you enjoy, not just the ones that often make you a winner. And for those who do want to jostle for a prize, age-based competition brackets will safely satisfy that need. Competing against younger, faster, and more agile people might tempt someone to push themselves too hard to keep up.
That kind of strain can lead to stress injuries, which older people recover from more slowly. By playing against your peers, you can compete against someone with similar limits. ÂJust as you may have slowed down a bit, you're playing against other people who have slowed down a bit,â DiPietro says.If you havenât been committed to a given workout your whole life, donât worry. You can introduce new activities as you age, too.
Master athletes â those who are participating in athletic events beyond the typical retirement age â are proof of this concept. Who qualifies as a âmasterâ depends on the activity. For swimmers, the cutoff age is 25, for weightlifters, itâs 35, and for long-distance running, itâs 50. Those are only the minimum ages, however.
Athletes in their 80s and 90s finish marathons, and DiPietro competes in the U.S. Womenâs over-60 field hockey team. Sheâs watched a menâs 75 and up field hockey match, too. ÂVery little running.
If there was running, you couldnât really distinguish it from the walking,â she says. ÂBut as competitive.âPeople tend to think that master athletes have been training in their given sport all their life, says Hiro Tanaka, an exercise physiologist at the University of Texas at Austin. But thatâs not true. ÂItâs interesting because if you look at the elite master athletes,â he says â those who are, for example, setting world records on their event for their age division â âmany of them are not really athletes when they're young.
They just actually started exercising at an older age.â On the whole, the accomplishments of master athletes sets a great example. ÂIt is actually a positive message that, you know, no matter how old you are, you are never late to start exercising and rediscover what you are capable of.â How to Dial It BackGranted, there are some activities that people might only be able to do for a limited time in life, DiPietro says. Gymnasts probably wonât be able to perform vaults into their 70s, for example. And in some cases, intense activities can wear out peopleâs bodies relatively fast.
Former contact sport athletes in particular struggle with decline. Surveys of former NFL players, for example, showed the retired athletes under 60 were almost four times more likely to have arthritis than males of a similar age who didnât play football professionally, and the painful joint condition was more likely if the athlete had suffered tendon or knee injuries during their career. Similar research with retired rugby players, meanwhile, found the former athletes six times more likely to need a joint replacement and twice as likely to report coping with bodily pain or mobility issues. Tanaka actually suspects that part of the reason many master athletes werenât top of their field in their youth is because those who were in that position put significant wear and tear on their bodies.
Those who outran or outswam their peers in their younger years might not be able to perform those same motions as well as they age. If an activity becomes too challenging, the next step is to transition to something that doesnât strain the body the same way. Biking and rowing are both low-impact sports, meaning they put less demand on your joints. Swimming serves as the ultimate low-impact option â thereâs no weight-bearing at all.
ÂSwimming is really an underappreciated form of exercise suitable for older people,â Tanaka says. Elderly individuals are more prone to heat stress too, and being immersed in water makes that much less of a concern. And if it isnât already part of your routine, try and incorporate strength training, too. Since weight lifting only became a routine part of sports training in the 1980s, some older individuals arenât in the habit of pumping iron.
Even if you start with light weights, itâs possible to build up, DiPietro says, even if that means adding more pounds slowly or taking more rest days between sessions.Aging can often mean experiencing more and more loss â of partners, of proximity to family, and during the ventolin, of most social interaction, DiPietro says. Keeping up workouts and the social groups that come with them can be an exception to that trend. If need be, take your cue from the 75 year-old field hockey players. Next year, thereâs going to be a series for those who are 80 or older.The black cumin or Nigella sativa plant has been used for more than 2,000 years in traditional remedies throughout Asia, Africa and Europe.
Also known as âLove in a Mistâ and the âSeed of Blessing,â the seeds were even found in King Tutâs tomb and praised by the Prophet Mohammed as a remedy for âevery illness except death.â Black cumin seeds and their extracted oil have long been taken orally and applied to skin to maintain overall health and combat a wide range of ailments â including those affecting the digestive tract and the cardiovascular, immune and respiratory systems. Over the past few decades, researchers have taken a closer look at the popular remedy and recognized its potential as a clinical drug. Building on knowledge from traditional medicine systems like Ayurveda and Unani, both cell culture and animal studies (along with a smaller number of human ones) have delivered promising early data. ÂSome of the results are quite extraordinary,â says Michael Greger, a general practitioner specializing in clinical nutrition and the founder of NutritionFacts.org.
For example, a 2014 study found that menopausal women taking a daily gram of black cumin powder reduced their bad LDL cholesterol by 27 percent within two months. ÂThatâs the kind of result youâd expect from taking a statin drug, but it was achieved with just a sprinkle of a spice,â Greger says.Other findings within the last decade suggest that black cumin seeds may help treat or relieve symptoms of a wide range of conditions â including type 2 diabetes, obesity, asthma, memory loss, male infertility, rheumatoid arthritis and certain types of cancer. Researchers have also looked into N. Sativa as a asthma treatment, though the November 2020 study hasn't received peer review.While teams in Asia have published plenty of studies on N.
Sativaâs possible applications, Esam Dajani says he has observed a lack of attention from scientists based in Western countries. Dajani is a biomedical scientist at Loyola University Chicago who consults in pharmaceutical development. Ultimately, Dajani hopes that black cumin seeds can be incorporated into drugs for difficult-to-treat conditions with ineffective or nonexistent therapies, like cancer, multiple sclerosis and memory decline. Thatâs why he has published two reviews on black cumin trials and evaluated their health benefits.
ÂI wanted to open the eyes of the world,â he says. ÂWe have a treasure here ⦠It needs to be considered and developed.â The Source of Black Cuminâs PowerMighty ingredients live within each seed, measuring about .12-inches long. These include thymoquinone, the compound suspected as the primary source of the benefits. Combined with other substances like alkaloids (nitrogen-filled organic compounds), proteins and fatty acids, the seeds seem to possess antioxidant, anti-inflammatory and antimicrobial properties.
This bundle of powers may be what drove favorable results in trials so far. For example, its anti-inflammatory and immune system-moderating abilities could help explain why N. Sativa oil appeared to be useful in patients managing rheumatoid arthritis in combination with prescription drugs. The former aspect could also have helped human study subjects control certain asthma symptoms.
Even more, the seedsâ inflammation-fighting capacities may combat cancer progression. They could prevent cells from multiplying uncontrollably and forming tumors, Dajani says, along with turning on and off certain cancer-associated genes. Thymoquinone may also boost the results of chemotherapy while reducing its severe side effects, including skin damage. While this hasnât been tested in humans, Dajani says, lab models have brought encouraging results, particularly in blood cancers.
Its anti-cancer potential has led some scientists to look into synthetic versions of thymoquinone. One lab-made hybrid seemed to deliver better outcomes than a popular chemotherapy drug, yet without its toxicity and adverse reactions like nausea, hair loss and tiredness â or even risks of causing additional cancers, as is the case with some treatments.Just as cancer remains a challenge for medical researchers, so do diseases that affect the brain and broader nervous system like dementia, Parkinsonâs and multiple sclerosis. Thymoquinone may protect brain cells from injuries, which could buffer the cognitive decline associated with these conditions. But like the anti-cancer claims, these findings come from animal models (usually tested on rats) and havenât yet been proven in people.
The Seedsâ Remaining MysteriesThe human data that we do have, meanwhile, mostly came from relatively small trials that include fewer than 100 subjects. Overall, further human studies are required to learn about N. Sativaâs influence on a variety of diseases, Dajani says. Many important questions remain unanswered, like the exact properties of its active ingredients and what doses people require for specific purposes.
Itâs also uncertain whether N. Sativa seeds and their byproducts pose any significant safety hazards. Like any drug, researchers need to determine whether it interacts with certain medications and dampens their effectiveness, or even harms users. Moderate doses seem to be safe so far, Dajani says, even when administered over a yearlong timeframe.
But direct application has been reported to cause skin rashes, and oral doses have prompted minor effects like nausea and low blood sugar.When Could It Become a Drug?. Despite interest from scientists across a range of fields, you likely wonât see a prescription medication incorporating N. Sativa seedsâ chemical compounds anytime soon. To achieve this highly expensive and time-consuming goal, Dajani says, it will be crucial to garner technical and financial support from pharmaceutical companies and government agencies like the National Institutes of Health (NIH).
Right now, he isnât aware of any such collaborations, but hopes that his work catches their attention. Plenty of people have nevertheless continued the millennia-old tradition of acquiring black cumin seeds and oil via herbal medicine providers â without the need for pharmaceutical intervention.But researchers have faced obstacles in the past while attempting to boost thymoquinone's effects. It can be difficult for the body to absorb and is sensitive to light and heat. Still, an ethical dilemma may arise when a relatively cheap and widely available supplement is incorporated into what could become extremely pricey treatments.Greger has pointed out that, due to industry sway, doctors often pursue a drug-intensive style of medicine when lifestyle changes may also be effective.
Instead, he recommends consuming foods like N. Sativa seeds to lower health risks. ÂI canât stress enough the importance of eating whole foods, like black cumin seeds, rather than trying to take extracts or isolated components, even a prominent constituent like thymoquinone, in pill form,â Greger says.Dajani disagrees, emphasizing that the active ingredients within black cumin seeds must be converted into standardized, purified doses to be fully effective for their intended uses.While Greger points out that itâs impossible to patent natural compounds, you can patent new uses for them, along with their derivatives (which would include synthetic forms of thymoquinone). Thousands of patents have proposed herbal and pharmaceutical uses for N.
Sativa and its byproducts â while some have received approval in the past few decades, nothing has yet penetrated the U.S. Drug industry.Itâs important to note that plenty of popular medicines have originated from herbal traditions, Dajani says. These include aspirin, which came from willow bark, a heart failure drug called digoxin that was sourced from foxglove plants, and the anti-malarial treatment called quinine that was isolated from a cinchona treeâs bark. A key advantage of pharmaceutical development.
Scientists can modify the structure of plants like N. Sativa to become longer-acting and easier for the body to absorb, Dajani says. ÂSometimes, you can take botanically derived medicines and change the structure to improve its activity â and make them better medicines than what nature has given us.âThis article contains affiliate links to products. Discover may receive a commission for purchases made through these links.Your eyes arenât deceiving you - CBD products are everywhere!.
From tinctures to edibles to topical products, CBD-infused items are in high demand. CBD, also known as cannabidiol, is one of the more than 100 compounds found in hemp plants. CBD is such an appealing option for so many people because of the many all-natural therapeutic side effects that it may offer.For some, CBD could be a safer alternative to prescription pain medications or over-the-counter sleep aids. Because CBD has little to no adverse side effects, a growing number of people are interested in how the cannabinoid may benefit them.High quality CBD products may offer a wide range of positive side effects.
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How often can i take ventolin
By Robert generic ventolin price Preidt how often can i take ventolin HealthDay Reporter FRIDAY, Sept. 3, 2021 (HealthDay News) -- asthma treatment care is likely to get more expensive for Americans with the expiration of insurers' temporary waivers on costs associated with treating the illness. Earlier in the ventolin, patients didn't have their normal co-payments how often can i take ventolin or deductibles for emergency room visits or hospital stays for asthma treatment, and most tests were also free, The New York Times reported. As the ventolin continues to rage nationwide, federal law still requires that insurers cover testing at no cost to patients when they have a medical reason for seeking care, such as exposure to the disease or a display of symptoms. However, more of the tests now being sought by Americans are for monitoring and don't qualify as a medical reason, the Times reported.
For example, the federal rules for free asthma tests have exemptions for routine workplace and how often can i take ventolin school testing. Some patients have already received bills as high as $200 for routine screenings, according to patient documents submitted to a Times project tracking the costs of asthma treatment testing and treatment. However, "insurers are confronting the question about whether the costs of asthma treatment should fall on everyone, or just the individuals who have chosen not to get a treatment," Cynthia Cox, a vice president at the Kaiser how often can i take ventolin Family Foundation who has researched how insurers are covering asthma treatment, told the Times. Some of the highest bills are likely to be faced by asthma treatment patients who require extensive hospital care, and most of those patients are now unvaccinated. A recent Kaiser Family Foundation study found that 72% of large health plans are no longer making asthma treatment free for patients.
Unvaccinated people how often can i take ventolin could also face other increased costs. Delta Air Lines and some other businesses plan to charge unvaccinated workers higher rates for insurance, pointing to high hospitalization costs for asthma treatment, the Times reported. Research shows that the average asthma treatment hospitalization costs about $40,000, while a longer stay that includes time in the intensive care unit or air ambulance transfer can cost many times more. More information Visit how often can i take ventolin the U.S. Health Resources and Services Administration for more on asthma treatment and testing relief costs.
SOURCE. The New York Times WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.Sept. 3, 2021 -- Scientific research is becoming one of the casualties as the Taliban again take control of Afghanistan, say experts who have lived and worked in the region. Kenneth Holland, PhD, dean of academics, research and international affairs at O.P.
Jindal Global University in India, was president of the American University of Afghanistan in Kabul from 2017 to 2019. "The people of Afghanistan are losing one of their most valuable national assets -- the scientific mind," he told WebMD. Holland says that researchers, funded by the United States government and grants from other Western organizations, "are now in danger, since the Taliban consider anyone who worked for the U.S. Or its allies as 'traitors.'" Holland says over the past decade, there has been a significant increase in the amount and quality of scientific research done in Afghanistan. The Ministry of Higher Education, he points out, prodded by one of its major donors, the World Bank, changed the criteria for academic promotion 5 years ago.
"Faculty for the first time were required to publish articles in peer-reviewed international journals in order to be promoted to full professor," he explains. The World Bank-funded Higher Education Development Project provided grants to faculty who submitted strong research proposals to the Ministry of Higher Education. The higher education project and the United States Agency for International Development's University Support and Workforce Development Project funded upgrades for scientific laboratories and training for lab assistants and technicians. "The Taliban are suspicious of science in general and scientific research in particular, since they regard Western science as 'anti-Islamic,'" Holland says. "There are no internal sources of funding for scientific research, and external funding sources are suspect, especially those in the West." In an article in Nature, Hamidullah Waizy, a researcher at Kabul Polytechnic University, said across Kabul, most universities and public offices remain closed.
Offices Closed The Taliban say they want officials to continue working, the article explains, but it is not clear what that means. "The future is very uncertain," Waizy told Nature, adding that he has been seeking safety at home. Academics have been reaching out to colleagues in other countries for help. Shakardokht Jafari, PhD, grew up in Afghanistan, and her family was forced to flee to Iran when war broke out when she was 6 years old. She tells WebMD she has worked in Surrey in the United Kingdom for the last decade, and is a visiting researcher at the University of Surrey, but she has returned, now and then, to work as a medical physicist and lecturer in Kabul.
"Because I was among the minority scientists [in Afghanistan], I felt unsafe and my family was unsafe," she says. Jafari says she needed the safety and technological capabilities offered in the United Kingdom for her business to be successful. She has become well-known to her international colleagues for starting her own research company, TRUEInvivo, which is developing radiation-detecting technology to track the amount and spread of radiation therapy in cancer patients to help doctors with more accurate dosing. The situation in Afghanistan is dire, esp. For engineers, scientists &.
Technical professionals who are increasingly becoming targets of violence. AGU is proud to stand with other professional societies asking @WHOSTP45 for visas. Read the letter here. Https://t.co/RX1tsHtoYrâ AGU Science Policy (@AGUSciPolicy) August 30, 2021 She says that in the last week alone, she has heard from more than 1,000 researchers asking her for help and advice on continuing their work. "They are so confused.
They are terrified. They are in hiding," she says. Jafari says she is looking for assistance from outside governments that can help her colleagues continue their work outside Afghanistan until it is safe for them to return. The scientists need to be taken to a safe place, and then helped to integrate their skills into appropriate professional work, she says, so they "don't end up as a taxi driver." She says she has been accused of "contributing to the brain drain" in Afghanistan, but once it is safe, "these researchers are nationalist enough to go back to Afghanistan." "I ask the scientific community in other countries not to forget the scientists of Afghanistan," she says. An editorial in Nature on Wednesday made a similar plea.
Pleas for Help "Researchers at risk must be able to leave and to resume their lives in countries that can provide them with safety and security," the editorial said. "But, at the same time, research leaders in Afghanistan's neighboring countries -- and those farther afield -- must work strenuously to support those Afghans who are staying, and who must not be forgotten or neglected." The Scholars at Risk organization has issued an urgent plea for help. Among the requests of European governments and European Union institutions is to "Waive any intent-to-return and home residency requirements that may apply to visa applications for Afghan scholars and researchers for the foreseeable future." The Scholars at Risk website says many European higher education institutions are ready to host scholars temporarily, and it asks government leaders to "capture that opportunity by expediting the processing of individuals for whom they are ready to step forward, and providing logistical support." WebMD Health News Sources Kenneth Holland, PhD, professor of law, dean of academics, research and international affairs, O.P. Jindal Global University, Sonipat, Haryana, India. Nature.
ÂAfghanistanâs terrified scientists predict huge research losses,â âThe global research community must not abandon Afghanistan.â Shakardokht Jafari, PhD, visiting researcher, University of Surrey, United Kingdom. Founder, TRUEInvivo. Scholars at Risk. ÂUrgent appeal to European Governments and EU Institutions. Take Action for Afghanistanâs scholars, researchers, and civil society actors.â © 2021 WebMD, LLC.
By Robert Preidt HealthDay Reporter FRIDAY, Sept costco ventolin price why not find out more. 3, 2021 (HealthDay News) -- asthma treatment care is likely to get more expensive for Americans with the expiration of insurers' temporary waivers on costs associated with treating the illness. Earlier in the ventolin, patients didn't have their normal co-payments or deductibles for emergency room visits or hospital stays for asthma treatment, and costco ventolin price most tests were also free, The New York Times reported. As the ventolin continues to rage nationwide, federal law still requires that insurers cover testing at no cost to patients when they have a medical reason for seeking care, such as exposure to the disease or a display of symptoms. However, more of the tests now being sought by Americans are for monitoring and don't qualify as a medical reason, the Times reported.
For example, the federal rules for costco ventolin price free asthma tests have exemptions for routine workplace and school testing. Some patients have already received bills as high as $200 for routine screenings, according to patient documents submitted to a Times project tracking the costs of asthma treatment testing and treatment. However, "insurers are confronting the question about whether the costs of asthma treatment should fall on everyone, or just the individuals who have chosen not to get a treatment," Cynthia Cox, a vice president at the Kaiser Family Foundation who has researched how insurers are covering costco ventolin price asthma treatment, told the Times. Some of the highest bills are likely to be faced by asthma treatment patients who require extensive hospital care, and most of those patients are now unvaccinated. A recent Kaiser Family Foundation study found that 72% of large health plans are no longer making asthma treatment free for patients.
Unvaccinated people costco ventolin price could also face other increased costs. Delta Air Lines and some other businesses plan to charge unvaccinated workers higher rates for insurance, pointing to high hospitalization costs for asthma treatment, the Times reported. Research shows that the average asthma treatment hospitalization costs about $40,000, while a longer stay that includes time in the intensive care unit or air ambulance transfer can cost many times more. More information Visit the costco ventolin price U.S. Health Resources and Services Administration for more on asthma treatment and testing relief costs.
SOURCE. The New York Times WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.Sept. 3, 2021 -- Scientific research is becoming one of the casualties as the Taliban again take control of Afghanistan, say experts who have lived and worked in the region. Kenneth Holland, PhD, dean of academics, research and international affairs at O.P.
Jindal Global University in India, was president of the American University of Afghanistan in Kabul from 2017 to 2019. "The people of Afghanistan are losing one of their most valuable national assets -- the scientific mind," he told WebMD. Holland says that researchers, funded by the United States government and grants from other Western organizations, "are now in danger, since the Taliban consider anyone who worked for the U.S. Or its allies as 'traitors.'" Holland says over the past decade, there has been a significant increase in the amount and quality of scientific research done in Afghanistan. The Ministry of Higher Education, he points out, prodded by one of its major donors, the World Bank, changed the criteria for academic promotion 5 years ago.
"Faculty for the first time were required to publish articles in peer-reviewed international journals in order to be promoted to full professor," he explains. The World Bank-funded Higher Education Development Project provided grants to faculty who submitted strong research proposals to the Ministry of Higher Education. The higher education project and the United States Agency for International Development's University Support and Workforce Development Project funded upgrades for scientific laboratories and training for lab assistants and technicians. "The Taliban are suspicious of science in general and scientific research in particular, since they regard Western science as 'anti-Islamic,'" Holland says. "There are no internal sources of funding for scientific research, and external funding sources are suspect, especially those in the West." In an article in Nature, Hamidullah Waizy, a researcher at Kabul Polytechnic University, said across Kabul, most universities and public offices remain closed.
Offices Closed The Taliban say they want officials to continue working, the article explains, but it is not clear what that means. "The future is very uncertain," Waizy told Nature, adding that he has been seeking safety at home. Academics have been reaching out to colleagues in other countries for help. Shakardokht Jafari, PhD, grew up in Afghanistan, and her family was forced to flee to Iran when war broke out when she was 6 years old. She tells WebMD she has worked in Surrey in the United Kingdom for the last decade, and is a visiting researcher at the University of Surrey, but she has returned, now and then, to work as a medical physicist and lecturer in Kabul.
"Because I was among the minority scientists [in Afghanistan], I felt unsafe and my family was unsafe," she says. Jafari says she needed the safety and technological capabilities offered in the United Kingdom for her business to be successful. She has become well-known to her international colleagues for starting her own research company, TRUEInvivo, which is developing radiation-detecting technology to track the amount and spread of radiation therapy in cancer patients to help doctors with more accurate dosing. The situation in Afghanistan is dire, esp. For engineers, scientists &.
Technical professionals who are increasingly becoming targets of violence. AGU is proud to stand with other professional societies asking @WHOSTP45 for visas. Read the letter here. Https://t.co/RX1tsHtoYrâ AGU Science Policy (@AGUSciPolicy) August 30, 2021 She says that in the last week alone, she has heard from more than 1,000 researchers asking her for help and advice on continuing their work. "They are so confused.
They are terrified. They are in hiding," she says. Jafari says she is looking for assistance from outside governments that can help her colleagues continue their work outside Afghanistan until it is safe for them to return. The scientists need to be taken to a safe place, and then helped to integrate their skills into appropriate professional work, she says, so they "don't end up as a taxi driver." She says she has been accused of "contributing to the brain drain" in Afghanistan, but once it is safe, "these researchers are nationalist enough to go back to Afghanistan." "I ask the scientific community in other countries not to forget the scientists of Afghanistan," she says. An editorial in Nature on Wednesday made a similar plea.
Pleas for Help "Researchers at risk must be able to leave and to resume their lives in countries that can provide them with safety and security," the editorial said. "But, at the same time, research leaders in Afghanistan's neighboring countries -- and those farther afield -- must work strenuously to support those Afghans who are staying, and who must not be forgotten or neglected." The Scholars at Risk organization has issued an urgent plea for help. Among the requests of European governments and European Union institutions is to "Waive any intent-to-return and home residency requirements that may apply to visa applications for Afghan scholars and researchers for the foreseeable future." The Scholars at Risk website says many European higher education institutions are ready to host scholars temporarily, and it asks government leaders to "capture that opportunity by expediting the processing of individuals for whom they are ready to step forward, and providing logistical support." WebMD Health News Sources Kenneth Holland, PhD, professor of law, dean of academics, research and international affairs, O.P. Jindal Global University, Sonipat, Haryana, India. Nature.
ÂAfghanistanâs terrified scientists predict huge research losses,â âThe global research community must not abandon Afghanistan.â Shakardokht Jafari, PhD, visiting researcher, University of Surrey, United Kingdom. Founder, TRUEInvivo. Scholars at Risk. ÂUrgent appeal to European Governments and EU Institutions. Take Action for Afghanistanâs scholars, researchers, and civil society actors.â © 2021 WebMD, LLC.
