Lowering your cholesterol: How long does it take?

People who need to use medications such as statins to lower their cholesterol should see their cholesterol levels fall quickly.

These medications may work in a matter of weeks, and they generally work to a larger degree than lifestyle changes.

However, because diet affects the levels of cholesterol in the body, doctors commonly recommend that people make changes to their diet and lifestyle in addition to taking medications.

Making simple changes to the diet and lifestyle can help reduce cholesterol.

These changes vary depending on how strictly a person adheres to their diet, as well as other factors, such as exercise and weight loss.

Some dietary changes may cause minor reductions in cholesterol in as little as 4 weeks. Most people can expect to see the difference in a few months on a heart-healthy diet plan.

Source: Medical News Today

 

What to know about hypercapnia

 

Hypercapnia, or hypercarbia, is a condition that arises from having too much carbon dioxide in the blood.

It is often caused by hypoventilation or disordered breathing where not enough oxygen enters the lungs and not enough carbon dioxide is emitted. There are other causes of hypercapnia, as well, including some lung diseases.

Hypercapnia symptoms can range from mild to severe. There are many potential causes of hypercapnia.

This article discusses the symptoms and causes of hypercapnia and outlines some treatment options available to help manage the condition.

Symptoms

In cases where symptoms are mild and develop slowly over time, people may not even realize they have hypercapnia. Therefore, it is important to be aware of both mild and severe symptoms.

Mild symptoms

The following are considered to be mild symptoms of hypercapnia:

• dizziness
• drowsiness
• excessive fatigue
• headaches
• feeling disoriented
• flushing of the skin
• shortness of breath

These symptoms of hypercapnia may arise from shorter periods of shallow or slow breathing, such as during deep sleep.

They may not always be a cause for concern, as the body is often able to correct the symptoms and balance carbon dioxide levels in the bloodstream without intervention.

However, if the above symptoms persist for several days, it is advisable to see a doctor.

Severe symptoms

The symptoms of severe hypercapnia require immediate medical attention, as they can cause long-term complications. Some cases may be fatal.

Severe hypercapnia symptoms include:

• confusion
• coma
• depression or paranoia
• hyperventilation or excessive breathing
• irregular heartbeat or arrhythmia
• loss of consciousness
• muscle twitching
• panic attacks
• seizures

 Source: Medical News Today

What to know about low blood pressure

 

Low blood pressure, or hypotension, can lead to dizziness and faintness. It is less likely than high blood pressure to be problematic, but it can sometimes indicate an underlying health issue.

Blood pressure readings include two numbers. The top number shows the systolic pressure, which is the pressure when the heart is contracting, and the bottom number gives the diastolic pressure, which is the pressure between heartbeats. An adult with low blood pressure will have a reading of less than 90/60 millimeters of mercury (mm Hg).

According to the American Heart Association (AHA), doctors do not usually consider low blood pressure a problem unless it causes noticeable signs and symptoms.

Very low blood pressure can be a sign of an allergic reaction or internal bleeding. It can be life threatening if oxygen and nutrients are unable to reach the brain, heart, and other vital organs.

However, it is generally better to have persistently low blood pressure than high blood pressure, as it poses a lower risk of various health problems.

What is blood pressure?

The heart is a muscle that pumps blood continuously, delivering oxygen and nutrients to all parts of the body, including the vital organs.

This pumping action and the pressure of blood against the blood vessels create blood pressure.

Blood pressure can vary during the day. It is lowest while a person is sleeping or resting. It can be much higher during physical activity and times of stress and anxiety.

Blood pressure monitors are available for purchase in pharmacies and online.

Symptoms

Many people with low blood pressure have no symptoms. Those who are very fit with low blood pressure may have excellent health.

However, hypotension can also indicate a chronic problem, such as a hormone imbalance, or an acute condition, such as anaphylaxis.

Common symptoms include:

• lightheadedness
• dizziness
• fainting

Symptoms that can result from an underlying cause include:

• chest pain
• cold, pale, dry, or clammy skin
• fever
• a headache and a stiff neck
• vision changes
• diarrhea and vomiting
• allergic reactions, such as swelling
• difficulty breathing
• fatigue and weakness
• thirst and dehydration
• changes in heart rhythm

 Source: Medical News Today

What have vaccines done for us?

 As the world awaits the imminent arrival of one — or several — COVID-19 vaccines, many people may wonder how important vaccines actually are to safeguarding public health. In this feature, we answer that question by looking at what vaccines have done for us throughout history.

 

Researchers who have looked at trends of vaccine acceptance around the world have found that, overall, people’s trust in vaccine safety and effectiveness has been on the rise over the past few years.

However, they have also expressed concern that the race for a COVID-19 vaccine may have triggered more hesitancy among certain groups.

Speaking at this year’s WIRED Health:Tech conference, Prof. Heidi Larson, from the London School of Hygiene & Tropical Medicine, in the United Kingdom, noted that “Because of the hyper-uncertainty and the whole environment of trust and distrust around the COVID vaccine, there are groups that have gotten together to resist” upcoming vaccination.

Many may now be wondering why researchers are so keen on vaccines — and whether vaccines have really achieved much for public health.

So, in this Special Feature, we look at some key moments in vaccine history and how vaccines have revolutionized public healthcare.

The ancient practice of ‘variolation’

Vaccines work by exposing the immune system to a very small amount of a virus or “information” about a virus — enough to “teach” it to recognize and react to that pathogen.

The idea of exposing the body to a virus in a controlled way to “train” it to prevent infection is by no means a modern conception.

Already in the 1500s, Chinese and Indian physicians practiced inoculation against the variola virus, which causes smallpox.

Some accounts from China in the 1600s suggest that doctors attempted the inoculation by grinding up smallpox scabs and blowing them into the patient’s nose through a silver tube.

In Europe, inoculation against smallpox, a process known as “variolation,” was introduced and popularized by Lady Mary Wortley Montagu in the early 18th century.

Lady Wortley Montagu was the wife of the British ambassador to the Ottoman Empire. From 1716–1718 she travelled across Europe to Constantinople, present-day İstanbul, where she learned about variolation.

She was so impressed by the evidence of its effectiveness that she submitted her own son for inoculation against the smallpox virus while in Constantinople and continued to advocate for the procedure on her return to Britain.

In a letter to a friend, Lady Wortley Montagu praised the procedure:

“The small-pox, so fatal, and so general amongst us, is here entirely harmless by the invention of ingrafting, which is the term [that the Ottomans] give it. There is a set of old women who make it their business to perform the operation every autumn. […] Every year, thousands undergo this operation… There is no example of anyone that has died in it; and you may believe I am well satisfied of the safety of the experiment.”

The eradication of smallpox

The word “vaccine” entered circulation soon after, when British physician Edward Jenner started experimenting with different ways of inoculating against variola.

In 1796, Jenner discovered that exposing people to small quantities of the cowpox virus, called “vaccinia” or the “vaccine virus,” was safer than exposing them to the variola virus that infects humans. The cowpox virus was also effective in preventing smallpox.

Thus, inoculation against the “vaccine virus” eventually became the umbrella term that we use today: vaccination.

This discovery was truly revolutionary for public healthcare worldwide, given the disastrous effects that smallpox had been having for centuries.

The World Health Organization (WHO) call smallpox “one of the most devastating diseases known to humanity,” as it caused millions of deaths worldwide over some 3,000 years.

Smallpox was officially eradicated in 1980, thanks to consistent global programs of vaccination. On May 8 of that year, the 33rd World Health Assembly made the historical announcement: “The world and all its peoples have won freedom from smallpox.”

According to the WHO, in the 20th century alone, smallpox ended the lives of around 300 million people.

Source: Medical News Today

 

Premature babies: 'Most will do very well,' says expert

 When babies are born prematurely, caregivers and hospital staff rightly worry. However, as Dr. Mercurio, a professor of neonatology from Yale School of Medicine, explains, ‘the outcomes will be good’ for most of these babies.
Premature babies are born before 37 weeks of pregnancy. Each year, this is the case for about 15 million babies across the world and 10% of babies born in the United States.
For caregivers, a premature birth and the time spent in the hospital afterward can be exceedingly worrying and stressful.
But the care of premature babies has improved immensely in the last 50 years.
In this Special Feature interview to mark Prematurity Awareness Month, Medical News Today spoke to Dr. Mark Mercurio, a professor of pediatrics (neonatology) and the chief of Neonatal-Perinatal Medicine at Yale School of Medicine in New Haven, CT.
Dr. Mercurio is also the director of the Program for Biomedical Ethics and the director of the Yale Pediatrics Ethics Program.

In this interview, Dr. Mercurio explains why taking care of premature babies is challenging, how this care has changed during his career, and what research he is keen to see. He also tells us what he wants caregivers of premature babies to know.

Better equipment and a better understanding

Medical News Today: What are the biggest challenges that healthcare professionals face in the care of premature babies?
Dr. Mercurio: There are many challenges, really, but we could break these down into the technical and medical challenges and then the psychological and ethical aspects.
There are technical challenges in part just because the patients are so small.
This can make things more difficult. For example, most people are familiar with the fact that sometimes it can be hard to place an IV in an adult or an older child. So you can imagine the technical difficulties in someone who weighs just a pound or two.
In terms of the medical aspects, every organ system is immature.
A primary example is the lungs. The challenge is to ensure that enough oxygen can get into the blood via the lungs, and this is often much more difficult with premature, underdeveloped lungs. To accomplish this, there are various modes of assisted ventilation that might be needed.
In the brain, there is a possibility of injury because the baby is born very early. That has to do with the immaturity of the brain structurally at the time of delivery and possibly further injury during the intensive care course.
We know that premature babies, especially those born extremely premature, are at increased risk for long-term problems with brain function.
A third example would be the gastrointestinal system, which is also immature. So, getting adequate nutrition into these children can sometimes be a challenge.
MNT: How has the care of premature babies changed during your career, and what has made the biggest impact on this?
Dr. Mercurio: The care of premature babies has changed in many ways over the course of my career.
We are constantly evaluating the data. We are constantly evaluating outcomes. There are controlled trials [happening all the time] to establish which is the better way to [provide care].
So, care evolves based on the new data, based on the outcomes of the studies that we do, and that is always a work in progress. Neonatology, like all of medicine, is rightfully always changing as we learn more.
I think we ventilate babies very differently. For example, the use of respiratory support for babies with immature lungs has evolved significantly over the course of my career and has gotten much better.

We have better equipment, and we also have a better understanding of how to go about it.

Source: Medical News Today 

 

In Conversation: Two HIV diagnoses and the difference a decade makes

 My friend Christopher found out that he had AIDS in 1994. Prof. Robert Garofalo looks after adolescents with HIV. He received his HIV diagnosis in 2010. In our conversation, we discussed their experience of living with HIV after their diagnoses over a decade apart.

Today, many people living with HIV consider it to be a chronic condition. But this was not always so. Until the advent of treatments that could successfully suppress the virus, receiving an HIV diagnosis was essentially on par with a death sentence.

The approval of the first combination antiretroviral treatments in the late 1990s proved a game-changer for those living with HIV and AIDS.

Nowadays, there are options to take preventive medication to reduce the risk of contracting HIV. The number of people contracting the virus is slowly declining in many parts of the world. Yet, we are far from eradicating the virus or successfully addressing the multifactorial issues that people living with HIV find themselves navigating.

To explore how much has changed since the first reports of a rare lung infection in 1981, I spoke to two people who live with HIV.

Dr. Robert Garofalo is the Chief of Adolescent Medicine in the Department of Pediatrics at Northwestern University Feinberg School of Medicine in Chicago, IL, as well as a professor of pediatrics at Ann and Robert H. Lurie Children’s Hospital of Chicago. Rob received his HIV diagnosis in 2010.

The other person is my friend Christopher, who worked as a dancer, then as a childcare practitioner both in the United Kingdom and in Chicago before retraining as a dispensing optician. Christopher moved back to the U.K. in 1994. He found out that he had AIDS not long after.

In our conversation, both Rob and Christopher shared how they found out that they were HIV-positive. They talked about the pivotal factors that helped them cope with their diagnosis and living with HIV long-term.

We also discussed their views on the continued stigma surrounding those living with HIV and what the future may hold.

Source: Medical News Today

What ingredients are in vaccines?

 Vaccines are a central player in our fight against infectious diseases. What components are commonly found in vaccines, and what is their purpose? In this Special Feature article, we find out.

Many people will be familiar with the concept that a vaccine against a particular virus will contain a small amount of the pathogen or a part of it, at least.

When we receive the vaccine, the viral interloper triggers our immune system to launch a series of events that leave us protected against the pathogen in the future.

But a glance at the ingredients in common vaccines reveals a long list of other components, the roles of which might not seem so clear cut.

What is the purpose of the likes of gelatin, thimerosal, and Polysorbate 80? And why do some vaccines contain aluminum?

In this Special Feature article, we look at the active and inactive ingredients that make their way into vaccines and reveal what their role is in protecting us from infectious diseases.

Our immune system and active ingredients

The active ingredient in a vaccine is usually made from the viral or bacterial pathogen itself. There are two different approaches to this, with the pathogen being either alive or inactivated.

Vaccines that incorporate living bacteria or viruses are called live attenuated vaccines. The pathogen is weakened to prevent it from causing the disease, but it is still able to elicit a strong immune response.

Live attenuated vaccines work very well, but they are not suitable for everyone. If a person is immunocompromised, they may contract the very disease from which the vaccine should be protecting them.

Many vaccines, therefore, use an inactivated version of the active ingredients, which can take the form of whole bacteria or viruses that have been killed.

However, most vaccines are actually acellular, which means that they do not contain the whole pathogenic organism. Instead, they are made from parts of the pathogen, such as proteins or sugar molecules. Our bodies recognize these molecules as foreign and mount an immune response.

Examples of acellular vaccines are:

• toxoid vaccines that contain inactivated toxins from pathogenic bacteria
• conjugate vaccines made from a combination of pathogen-specific sugar molecules and toxoid proteins, as the sugars themselves do not cause sufficiently strong immune responses
• recombinant vaccines made by using bacteria or yeast cells to make many copies of specific molecules from the pathogen

Aside from the active ingredient, vaccines contain many other things. The technical term for these is excipients.

Excipients include preservatives and stabilizers, traces of things that were used to produce the vaccine, and adjuvants.

Adjuvants make vaccines stronger

Although many vaccines contain active ingredients that are strong enough to kick our immune system into gear, some need a little bit of extra help to be effective.

Adjuvants are compounds that elicit a strong immune response, improving how well a vaccine works.

Examples of adjuvants include:

• metals
• oils
• biological molecules, such as components isolated from bacteria and synthetic DNA

Aluminum, in the form of aluminum salt, features in a variety of vaccines, including several routine childhood vaccines. Scientists believe that this adjuvant increases the production of antibodies.

Aluminum is a naturally occurring metal that has many uses aside from its adjuvant properties. Cans, foil, and some window frames contain aluminum.

Aluminum salts are also used in the food industry as additives.

As an adjuvant, aluminum has a long history going back to the 1930s. Despite its widespread use, some scientists believe that the metal can cause damage to the nervous system and promote autoimmunity.

However, many experts disagree with this assessment, pointing out that some of the research implicating aluminum has been retracted.

The Food and Drug Administration (FDA) published a study in 2011 in the journal Vaccine, which concluded that “episodic exposures to vaccines that contain aluminum adjuvant continue to be extremely low risk to infants and that the benefits of using vaccines containing aluminum adjuvant outweigh any theoretical concerns.”

Another example of an adjuvant is squalene, a naturally occurring oil.

The Fluad vaccine, a flu vaccine licensed for adults aged 65 years and older, contains an adjuvant called MF59, which is an oil-in-water emulsion containing squalene. The squalene used in MF59 is purified from shark liver oil.

In 2000, a research team pointed to a link between squalene and Gulf War Syndrome, prompting fears about the safety of this adjuvant.

However, subsequent research did not back up the findings, and the World Health Organization (WHO) concluded in 2006 that these fears were “unfounded.”

Source: Medical News Today