Category: Medicine

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COVID-19 : Speech May Spread Through Droplets Than Feces

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Normal human speech emits droplets capable of carrying the novel coronavirus (SARS-CoV-2) that causes COVID-19, researchers say. The droplets lingered in the air for up to 14 minutes in a recent study, which could help explain why the disease has spread so rapidly.

On the other hand, a separate study turned up no infectious particles of SARS-CoV-2 in stool samples.

The findings could provide clues about how best to limit the disease’s spread. “Fecal–oral is not a happening thing,” said Andrew Noymer, PhD, MSc, associate professor of population health and disease prevention at the University of California, Irvine. “I think this reinforces the importance of masking.”

SARS-CoV-2 floats in particles in the air, and public health officials believe this is the primary route of transmission between people. Less clear is whether someone has to cough or sneeze to expel enough droplets to infect another person with COVID-19, or whether talking and other activities also spread the disease.

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COVID-19 : Potential Role Of ACE Inhibitors In Reducing The Risk Of Hospitalization Among Older Individuals With Elevated Risk Of Adverse Outcomes

A new nationwide US observational study suggests that ACE inhibitors may protect against severe illness in older people with COVID-19, prompting the start of a randomized clinical trial to test the strategy.

In addition, a new meta-analysis of all the available data on the use of ACE inhibitors and angiotensin-receptor blockers (ARBs) in COVID-19–infected patients has concluded that these drugs are not associated with more severe disease and do not increase susceptibility to infection.

The observational study, which was published on the MedRxiv preprint server on May 19 and has not yet been peer reviewed, was conducted by the health insurance company United Heath Group and by the Yale University School of Medicine, in New Haven, Connecticut.

The investigators analyzed data from 10,000 patients from across the United States who had tested positive for COVID-19, who were enrolled in Medicare Advantage insurance plans or were commercially insured, and who had received a prescription for one or more antihypertensive medications.

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Falling Splenectomy Rates in ITP Raise Questions Over Role Of Surgery

Patients with immune thrombocytopenia (ITP) are undergoing fewer and fewer splenectomies later and later in the disease course, which is resulting in lower gains from the procedure, say UK researchers, who question its ongoing role.

The research was published as an abstract from the British Society for Haematology 60th Annual Scientific Meeting, which was cancelled due to the COVID-19 pandemic. 

Role of Splenectomy ‘Unclear’

Dr Sophie Todd, Royal London Hospital, Barts Health NHS Trust, London, and colleagues studied more than 3800 ITP patients diagnosed in the UK from the early 1950s.

The results, which are an update of findings presented at the 24th European Heart Association Congress in June 2019, show that around a third of patients underwent splenectomy in the 1990s, falling to less than 4% since 2009.

This has corresponded to an increase in the use of medical therapies, with the procedure consequently performed later on in the treatment course.

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Mortality Is Lower For DOAC vs Vitamin K Antagonists In Broad VTE Registry Population

Patients in various clinical settings who were put on a direct oral anticoagulant (DOAC) for treatment of venous thromboembolism (VTE) were more likely to be alive at 1 year than those treated with a vitamin K antagonist (VKA) in a large registry study.

In the analysis, based on almost 8000 such patients in the international GARFIELD-VTE registry, adjusted all-cause mortality was 27% lower for those on a DOAC, usually rivaroxaban (Xarelto, Bayer), while their risks of major bleeding, myocardial infarction (MI), and stroke were similar to those treated with a VKA, which most often was warfarin.

The findings appeared in a report published April 28 in Thrombosis Research, with lead author Henri Bounameaux, MD, University of Geneva.

The patients were treated at more than 400 sites in 28 countries, “allowing for an analysis of real-world practices and clinical outcomes worldwide. Therefore, our conclusion that DOACs were associated with reduced all-cause mortality compared with VKA is likely to be strong,” Bounameaux told theheart.org | Medscape Cardiology.

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