By Anesta Henry

Pharmacies have recorded an increase in the sale of products to treat upper respiratory issues as Barbadians contend with smoke and ash from cane and grass fires that have been occurring across the country.
President of the Barbados Pharmaceutical Society (BPS) Yolan Pantin told Barbados TODAY on Tuesday that in recent weeks, there has been an increase in the number of people going to pharmacies to purchase over-the-counter medications and have prescriptions filled, as they seek relief from sinus issues and allergic reactions.
“Obviously, because of the situation we have been seeing more people passing through. It depends on what the doctor has written on the prescription and if they are looking for simple things like Histal, antihistamines, and maybe some nasal sprays, depending on how severely they are being affected by the present conditions.
“They are coming with allergies, depending on how long they leave their symptoms, and some persons will receive courses of antibiotics because respiratory tract infection has occurred and that is something that only the doctor deals with,” Pantin said.
She warned Barbadians experiencing respiratory tract infections to treat their symptoms as soon as they show up.
Additionally, Pantin said, individuals should seek medical attention if they do not get relief using over-the-counter medication after three days.
She said the Otrivin nasal spray, in particular, should not be used longer than three days, as doing so could cause “rebound rhinitis where they would actually be hooked on having to use it continuously”.
“If after three days and they find that their symptoms really haven’t dissipated they really should see a physician,” the pharmacist recommended.
Pantin said pharmacies currently have adequate stock to meet the present demand.
While some pharmacies are out of allergy and sinus tablets, people battling with sinusitis can also use the multi-symptom tablets for the time being, since they are basically the same medication, just slightly different strengths.
“Right now, as far as the oral preparations and the nasal sprays that are over-the-counter are concerned, we do have adequate stock on the island,” she said.
Pantin advised those known to suffer from sinusitis, allergies, or asthma who are working in areas affected by the smoke and ash, to resume wearing masks.
“A couple of my customers that have passed through have actually purchased masks because they work in areas close to the smoke and the ash and so on. So, because they do suffer from respiratory problems – some are asthmatics as well – they have chosen to resume wearing masks in order to help with not getting as much smoke inhaled into their lungs and their upper respiratory tract,” she said.
“So, for safety and for your own health, for persons who are compromised with respiratory illnesses of any form, I would advise them until this really dissipates in another two weeks, or unless we get a heavy rainfall, they should resume wearing the masks.”
On Monday, during an interview with Barbados TODAY, Chief Medical Officer Dr The Most Honourable Kenneth George urged asthmatics and people who suffer from allergies and sinus complications to take all precautionary measures to protect themselves amid an increase in cane and grass fires.
While indicating that he had not received reports from polyclinics or the Queen Elizabeth Hospital (QEH) regarding an alarming increase in persons reporting to those facilities complaining of health issues due to the environmental hazard, Dr George supported the Ministry of Education’s decision to closely monitor affected schools to protect students and teachers from potentially harmful effects.
anestahenry@barbadostoday.bb

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Theirs appears to be the first study to identify an increased prevalence of disease-causing genetic variants in females with unexplained infertility, the team, led by Lawrence C. Layman, MD, reports in the New England Journal of Medicine.

They hypothesized that genetic disease creates a predisposition to infertility and subsequent medical illness and their findings support that link, they write. Females with infertility, for example, have been noted to have an increased risk of cardiovascular disease.

“The connection to diseases has been known, but what has not been known was if there was a genetic connection. That was the purpose of this study,” says Layman, a reproductive endocrinologist and geneticist who is chief of the MCG Section of Reproductive Endocrinology, Infertility and Genetics at Augusta University

The investigators note that while clear, common pathways between infertility and conditions like heart disease, still have not been established, “a strong association between infertility and future disease can still assist in early detection, genetic counseling and intervention.” Fertility could be in effect a “biomarker” for future medical illness, they write.

They sequenced the exomes, which contain the protein-coding regions of genes, of 197 females ages 18 to 40 with unexplained infertility, a percentage that comprises about 30% of infertile females, to look for variants in genes that were known or suspected to cause disease.

Information on the women was pulled from the AMIGOS Trial of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Cooperative Reproductive Medicine Network, a group of some 900 couples from multiple institutions with no obvious cause for infertility, like problems with ovulation or unhealthy sperm.

They found 6.6% of the females they studied had variants in 59 genes termed “medically actionable,” which means they are likely to cause conditions like heart disease and breast cancer but there are interventions, lifestyle and/or medical, that might remove or at least reduce their risk. By comparison about 2.5% of the general population have been found to have variants in these genes.

An additional 10% of the females had gene variants known to cause disease for which little to no action could be taken to ameliorate the problem, like Parkinson’s disease, Layman says.

They found 14 variants of the medically actionable genes in 13 of the females; one woman had two variants. The most common were those that contribute to cardiovascular disease and cancer, the nation’s top two killers.

Those included relatively well-known variants, like four women with variants of BRCA1 and BRCA2, which are associated with a high risk of breast or ovarian cancer. Six females had variants in five genes associated with the increased risk of cardiovascular disease, things like having a genetic predisposition to high cholesterol levels and irregular heart rhythms, some of which can be lethal.

One female had a variant in the gene MYH11, which is associated with increased risk of a rupture of the aorta, the largest blood vessel in the body. Numerous rare variants of uncertain significance also were found in the medically actionable genes.

Comparatively large datasets that better represent the entire population, like 50,000 people in the United Kingdom Biobank and nearly 22,000 in the National Human Genome Research Institute-funded eMERGE network, yielded percentages of 2 and 2.5% respectively.

That translates to about a threefold increase in variants in medically actionable genes among the females who were infertile compared with the general population, Layman says.

Additionally, they found 20 variants in 21 other females in genes associated with conditions that likely could not be mitigated, like a dramatically increased risk of developing muscle wasting ALS, or Lou Gehrig’s disease, and kidney-destroying polycystic kidney disease, which will ultimately require dialysis and/or a kidney transplant, a finding that requires more study, Layman and his colleagues write.

All told about 17% of the females with unexplained infertility had variants that are known to cause or suspected to cause a future medical illness. They note that their findings are likely relevant only to this group of women.

While more study is needed before moves are made like recommending genetic testing for all females or males with unexplained infertility, the investigators say their findings support the notion that the higher incidence of future medical problems in these women may have a genetic component.

At the moment, genetic testing in infertility is done selectively, such as if the suspected problem points to a genetic cause, like a male having no sperm, which may indicate Klinefelter syndrome, where males are born with an extra copy of the X chromosome that results from a random genetic error.

“We don’t do genetic testing right now because there hasn’t been good evidence for it and it’s not going to be covered by insurance,” Layman says. Their new study provides more evidence that genetic testing might need to be considered a handful of years down the road if findings continue to hold.

“We need to study a lot more people and other people need to do that too,” Layman says.

Another area that needs further exploration is whether some of the gene variants may be causative of both infertility and disease, Layman says. Right now, the only variants familiar to him that appear to have a role in both are cancer-causing BRCA 1 and 2, because they also are involved in meiosis, which is important to sperm and egg formation and function. They also are both involved in repairing double-strand breaks in the DNA, which has been associated with ovarian aging and cancer risk, Layman says.

Another is a variant that causes early menopause, which is known to increase the risk of heart disease, because estrogen is considered protective of the female cardiovascular system.

He hopes the new findings will inspire others to further explore whether the disease-causing variants they found present in these females also are factors in their infertility.

Layman also notes that the database they studied happened to be largely white females, but that infertility is a problem common to both Blacks and whites as well as other races, and needs to be studied in these populations.

Infertility also affects men and women equally, according to the American Society for Reproductive Medicine.

Reference:

Unexplained Female Infertility Associated with Genetic Disease Variants,New England Journal of Medicine,MEDICAL COLLEGE OF GEORGIA AT AUGUSTA UNIVERSITY.

MANY PERSONS struggle to eat healthier; they try to kick-start a weight loss journey or find another way to maintain dietary health. However, there are many ways to keep track of your food intake and there is online advice to help you eat healthier...

UPPER NYACK, N.Y.–(BUSINESS WIRE)–#accumulators–The Global Healthy Living Foundation (GHLF), an international, patient-centered, nonprofit organization whose mission is to improve the quality of life for people with chronic illness, in partnership with the Association of Women in Rheumatology and the AIDS Institute, will host on Thursday, March 30, 2023 a Congressional Briefing on copay accumulator programs, the focus of the HELP Copays Act (H.R. 830).

Copay accumulator programs are used by insurance companies to prevent any charitable copay assistance provided by biopharmaceutical manufacturers from counting toward a patient’s deductible or maximum out-of-pocket expenses, forcing patients to pay for their treatment twice. First, patients pay at the pharmacy with the funds from their copay card. They pay again when the copay card has been depleted and their deductible, supposedly, has not been met. These programs most often impact chronic disease patients taking specialty drugs because those products have the highest out-of-pocket costs, have well-funded out-of-pocket support programs, and lack generic or biosimilar medication substitutions. Patients surprised by these programs, buried in their insurance plan’s fine-print, may find that the medication prescribed by their health care provider is suddenly unaffordable.

While sixteen states have passed laws to prevent co-pay accumulator programs, federal law is needed to ensure all patients are protected. GHLF research demonstrates that these laws do not increase health insurance premiums.

Members of the media are invited to attend this event with advanced RSVP.

Event: Congressional Briefing on Copay Accumulator Programs and the HELP Copays Act (H.R. 830)
When: Thursday, March 30, 2023, 12:00 to 1:00 p.m. (ET)
Where: Capitol Visitors Center, HVC-215

Speakers:

• Stephanie Ott, MD, Co-Chair of Advocacy, Association of Women in Rheumatology
• Steven Newmark, JD, MPA, Director of Policy and General Council, Global Healthy Living Foundation
• JP Summers, Patient Advocate, Community Outreach Manager, Global Healthy Living Foundation
• Stephanie Hengst, Manager of Policy & Research, the AIDS Institute

RSVP: https://bit.ly/CopayAccumulatorCongressionalBriefing

About Global Healthy Living Foundation

The Global Healthy Living Foundation is a U.S. based, 501(c)(3) nonprofit, international organization whose mission is to improve the quality of life for people with chronic illnesses (such as arthritis, osteoporosis, migraine, psoriasis, inflammatory bowel disease, and cardiovascular disease) by advocating for improved access to health care and amplifying education and awareness efforts within its social media framework. GHLF is also a staunch advocate for vaccines. The Global Healthy Living Foundation is the parent organization of CreakyJoints®, the international, digital community for millions of people living with arthritis and their supporters worldwide who seek education, support, activism, and patient-centered research in English, Spanish, and French. Our ArthritisPower® (ArthritisPower.org) patient registry has more than 40,000 consented patients who participate in best-in-class patient-reported outcomes research. In response to the COVID-19 pandemic, GHLF started a Patient Support Program, informed by a patient council made up of people living with a wide range of chronic illnesses, that now serves more than 46,000 subscribers. Via CreakyJoints, GHLF also hosts PainSpot (PainSpot.org), a digital risk-assessment tool for musculoskeletal conditions and injuries, eRheum (eRheum.org), for telehealth and virtual-care support, and a constantly refreshed library of podcasts via the GHLF Podcast Network. GHLF never asks the public for donations. Visit ghlf.org for more information.

Find us online:

Global Healthy Living Foundation: ghlf.orgCreakyJoints Canada: CreakyJoints.caCreakyJoints: CreakyJoints.orgCreakyJoints Español: CreakyJoints.org.esCreakyJoints Australia: CreakyJoints.org.auFacebook: facebook.com/CreakyJoints & facebook.com/GlobalHealthyLivingFoundationTwitter: @GHLForg, @CreakyJoints, #CreakyChats
Instagram: @creaky_joints, @creakyjoints_aus, @creakyjoints_espTikTok: globalhealthylivingfndYouTube: @GHLForg, @CreakyJointsLinkedIn: linkedin.com/company/ghlf

Contacts

Jessica Daitch
Phone: 917-816-6712
Email: jdaitch@ghlf.org

The post Global Healthy Living Foundation, Association of Women in Rheumatology, and the AIDS Institute To Host Congressional Briefing on Co-Pay Accumulator Programs appeared first on Caribbean News Global.

GRASS FIRES STRETCHING RESOURCES OF FIRE SERVICE

By Sheria Brathwaite

The recent uptick in grass fires has been putting the Barbados Fire Service under strain and Chief Fire Officer Errol Maynard is pleading with Barbadians to avoid starting fires.
Meanwhile, the Barbados Union of Teachers (BUT) is urging the Ministry of Education to act more promptly in closing schools impacted by heavy smoke.
In an interview with Barbados TODAY on Monday after 8 p.m., at which time crews were still out fighting fires, Maynard expressed concern that many of the grass fires were caused by people, intentionally or otherwise.
“We are definitely extremely concerned because the fires are stretching our resources beyond limit. Just today, we had in excess of 14 fires up to 7 p.m. and now we are still having fires. They are stretching our resources to the limits, [to the point that] the admin staff, the senior officers, everybody had to come out today,” he said.
Maynard said crews were out from as early as 9 a.m. on Monday in Colleton and Greenidges in St Lucy, Pool in St John, Padmore Village and Farm Road in St Philip, and Callenders and Coral Ridge in Christ Church.
So far this year, there have been 176 grass fires, 20 more than during the January to March period last year.
“All are not due to combustion. Some have to deal with human intervention, accidental or otherwise,” Maynard said about the cause of the fires. “So we are encouraging all persons to avoid burning. Those who are doing it intentionally should stop it and those [doing it] unintentionally should avoid burning; because of the dry conditions and high winds, you will lose control of these fires.”
For the past few weeks, classes at several schools have been affected by billowing smoke.
While saying he was concerned about the disruption, president of the BUT Rudy Lovell said the health of those being impacted by the smoke was more important.
He said he was also concerned about how long it took the Ministry of Education to give the directive to close schools in these circumstances.
“Complaints from our members suggest that in some instances, schools remain open for a prolonged period, waiting for official notice from the Ministry of Education to close, and we would want the ministry to establish a protocol which gives the principal of the school the leeway to make decisions in the best interest of the occupants of the school compound,” Lovell said, noting that while principals wait for the green light from the ministry, students and staff “are suffering from smoke inhalation”.
“We know there are a lot of asthmatics and people with other respiratory ailments and we do not want to expose these people unnecessarily to these environmental issues that can be avoided,” the BUT president added.
In a press release, the Ministry of Education advised parents and guardians to ensure their wards walk with medication if they have respiratory illnesses, noting that they should also have a plan to ensure they can collect their children in a timely manner.
sheriabrathwaite@barbadostoday.bb

The post FIRES WREAK HAVOC appeared first on Barbados Today.

THE HONOURABLE KAY MCCONNEY
MINISTER OF EDUCATION, TECHNOLOGICAL AND VOCATIONAL TRAINING, BARBADOS

And
SENATOR DR. THE MOST HONOURABLE JEROME WALCOTT
MINISTER OF HEALTH AND WELLNESS BARBADOS

And
DR. THE HONOURABLE SONIA BROWNE
MINISTER OF STATE IN THE MINISTRY OF HEALTH AND WELLNESS BARBADOS

CONGRATULATIONS ON THE IMPLEMENTATION OF
BARBADOS NATIONAL SCHOOL NUTRITION POLICY

March 20th, 2023

Dear The Honourable Kay McConney, Senator Dr. The Most Honourable Jerome Walcott, and Dr. The Honourable Sonia Browne,

The Healthy Caribbean Coalition (HCC) extends congratulations to the Government of Barbados and the Ministries of Health and Education on the successful launch of the Barbados National School Nutrition Policy in February 2023 and the banning of the sale of beverages containing added sugars, artificial sweeteners or additives in schools beginning in the third term in April 2023. This significant policy action taken by the Government of Barbados delivers on national and regional commitments to tackle childhood overweight and obesity through a package of evidence-based policy measures including banning the sale and marketing of unhealthy foods and beverages in and around school settings. The Barbados National School Nutrition Policy, originally approved by Cabinet in May 2022, realises a commitment made by Honourable Prime Minister Mia Amor Mottley, at the 39th Summit of CARICOM Heads of Government and State in 2018 when Heads endorsed a number of priorities for the 3rd UN High Level Meeting on Noncommunicable Diseases (NCDs) including: “implementing policies geared to preventing childhood obesity, including health-promoting school environments”.

The HCC, both local and regional members, strongly support this policy measure which complements the recently increased sugar sweetened beverage (SSB) tax at 20% – as part of a wider strategy to combat the urgent health, economic and economic challenges posed by childhood and adult obesity and NCDs in Barbados.

As one of a growing number of countries regionally and globally prioritising NCD prevention through the implementation of regulations which meaningfully change food environments by reducing affordability and availability of ultra-processed foods high in sugars, salts and fats, Barbados is demonstrating tremendous leadership. The Caribbean has the highest NCD mortality rate in the Americas and 40% of these deaths occur prematurely before the age of 70 years affecting our most productive with dire socioeconomic consequences in a time when Caribbean populations are aging and placing significant strain on already vulnerable economies. Obesity is a major underlying factor which contributes to the development of NCDs, such as diabetes and cardiovascular disease. Two-thirds of Barbadians are either living with overweight or obesity and the corresponding figure for Barbadian children is one-third[i] placing these children on a trajectory for health complications in childhood and adolescence and increased risk of NCDs in adulthood.

Unfortunately, these figures show no sign of decline. Per the 2023 edition of the World Obesity Atlas[ii], Barbados is expected to see a 2.6% annual increase in adult obesity and a 4.7% increase in childhood obesity over the period 2020-2035. Overweight and obesity have a profound economic impact through loss of productivity, premature death and health care expenditure. By 2035, this is expected to cost Barbados US $305 million. It is imperative that bold policy action is taken immediately to reverse these alarming trends.

The 20% tax on SSBs and the National School Nutrition Policy are a step in the right direction. At least 73.3% of students aged 13-15 consume at least one carbonated soft drink per day, while 70.9% are not achieving WHO recommended levels of physical activity[iii]. As unhealthy diet and physical activity are major contributors to overweight and obesity, and related NCDs, we commend the National School Nutrition Policy for addressing both of these risk factors. Barbadians – adults and children – have a right to live, grow, work and thrive in environments which support healthy behaviours rather than encouraging unhealthy habits. Since 2016, Barbados has supported three key policy actions recommended by the Caribbean Public Health Agency (CARPHA), The Pan American Health Organization (PAHO)/WHO and the HCC – 1. Taxation of unhealthy foods while subsidising healthy options; 2. Improving the food (regulating the sale and marketing of ultra-processed foods) and physical activity environments in schools to specifically tackle childhood obesity; and 3. Maintaining support for a regional standard for the labelling of prepackaged foods which includes front of package ‘high-in’ warning labels to empower consumers to identify unhealthy foods and purchase healthier unprocessed or minimally processed foods. Such policy measures, when implemented effectively, create strong regulatory environments which support positive dietary behaviours, help drive product reformulation, and encourage manufacturers and retailers to increase the availability of affordable, healthier food and beverage options. Additionally, Barbados is a signatory to the Convention on the Rights of the Child (CRC), thereby underscoring the important role of government to ensure that those most vulnerable in the population – our children – are protected from continuous exposure to harmful environments that promote consumption of ultra-processed foods.

Finally, HCC commends Barbados’ continued commitment to a whole-of-government and whole-of-society NCD response. The National School Nutrition Policy is a product of the partnership between two Ministries with acknowledged ongoing strong support from civil society through the Heart and Stroke Foundation of Barbados and the Barbados Childhood Obesity Prevention Coalition.

We applaud the bold and visionary leadership of the Office of the Prime Minister, the Ministries of Health, Education and local civil society organisations and we pledge our continued support as Barbados implements its National School Nutrition Policy and related policies over the coming months and years.

The Board of Directors, staff and volunteers of the HCC, Technical Advisors and the 100+ HCC CSO Members

View/download the open letter here.

[i] https://data.worldobesity.org/country/barbados-17/report-card.pdf

[ii] https://www.worldobesityday.org/assets/downloads/World_Obesity_Atlas_2023_Report.pdf

[iii] https://cdn.who.int/media/docs/default-source/ncds/ncd-surveillance/data-reporting/barbados/gshs/2011_barbados_gshs_fs.pdf?sfvrsn=652e38c1_5&download=true

The post Congratulations on the Implementation of Barbados National School Nutrition Policy appeared first on Healthy Caribbean Coalition.

Immune checkpoint inhibitors (ICIs) have provided significant benefits in cancer treatment, but they could develop immune-related adverse events (irAE). ICI-associated renal adverse effects are rare and tubulointerstitial nephritis (TIN) is the most common in the renal irAE. However, only a few case reports of renal vasculitis associated with ICI have been reported. In addition, the characteristics of infiltrating inflammatory cells of ICI-associated TIN and renal vasculitis have been uncertain.

Case presentation

A 65-year-old man received immune checkpoint inhibitors (ICIs), anti-CTLA-4 (cytotoxic T-lymphocyte-associated protein 4) and anti-PD-1 (programmed cell death 1) antibodies for aggravated metastatic malignant melanoma. About 1 week after the second administration of nivolumab and ipilimumab, acute kidney injury developed. A renal biopsy was performed that showed TIN and non-necrotizing granulomatous vasculitis in interlobular arteries. Massive CD3+ T cells and CD163+ macrophages infiltrated both tubulointerstitium and interlobular arteries. Many infiltrating cells tested positive for Ki-67 and PD-1 ligand (PD-L1), but negative for PD-1. In CD3+ T cells, CD8+ T cells were predominantly infiltrated, and these cells were positive for Granzyme B (GrB) and cytotoxic granule TIA-1, but negative for CD25, indicating antigen-independent activated CD8+ T cells. Infiltration of CD4+ T cells was noted without obvious CD4+ CD25+ regulatory T (Treg) cells. His renal dysfunction recovered within 2 months of treatment with prednisolone in addition to discontinuation of nivolumab and ipilimumab.

Researchers herein reported a case of ICI-related TIN and renal granulomatous vasculitis with infiltration of massive antigen-independent activated CD8+ T cells and CD163+ macrophages, and none or few CD4+ CD25+ Treg cells. These infiltrating cells might be a characteristic of the development of renal irAE.

Reference:

Tominaga, K., Takeuchi, K., Takakuma, S. et al. Immune checkpoint inhibitors associated granulomatous small vessel vasculitis accompanied with tubulointerstitial nephritis: a case report. BMC Nephrol 24, 48 (2023). https://doi.org/10.1186/s12882-023-03091-8

It's Nutrition Month and this year the Jamaica Youth Advocacy Network (JYAN) wants to highlight the thoughts of Jamaican young people as it relates to their nutrition status, with some interventions designed to improve their health outcome.

Since 2021, JYAN has partnered with UNICEF and U-Report Jamaica to conduct three U-Report polls.

In July 2021, JYAN wanted to find out about the nutritional behaviours of Jamaican youth. These were some findings:

74 per cent of young people reported looking for healthy options when purchasing food and drink.

70 per cent of young people are aware of and/or read the nutritional facts on the labels of drinks and snacks they eat.

94 per cent of young people believe there should be warning labels such as HIGH IN FATS or HIGH IN SUGARS on the front of food items.

87 per cent of young people believe that if the food items had front-of-package warning labels, it would influence their food choices.

88 per cent of young people support government restrictions on excessively sugar-sweetened beverages and other unhealthy food items sold in schools.

In September 2022, we asked young people about their thoughts on the School Nutrition Policy Green Paper. Our results showed overwhelming support for the policy and the issues it aims to address.

95 per cent of young people believe that proper nutrition in schools should be a priority for the government.

80 per cent of young people support a policy that bans unhealthy food and drinks in schools.

92 per cent of young people support a policy that ensures physical activity for all students.

98 per cent of young people support a policy that ensures students learn about nutrition at school and how to prepare healthy meals.

95 per cent of young people believe that the government should provide all schools with nutrition guidelines for school meals and snacks.

In November 2022, we asked young people about the Advertising of Unhealthy Foods. Our findings were:

42 per cent of young people reported seeing unhealthy food and beverage products advertised several times daily.

31 per cent of young people reported seeing unhealthy food and beverage products advertised the most on social media/online.

77 per cent of young people reported that they would support policies or laws that restrict the advertising of unhealthy food and beverage products to children.

40 per cent of young people said the advertising of unhealthy products should be most regulated in schools.

86 per cent of young people indicated that products high in fats, salt, and sugar should NOT be advertised to children.

Young people have spoken, and it's the government's turn to listen. We want a National School Nutrition Policy. We want front-of-package warning labels. We want manufacturers to be regulated in their attempts to advertise and market unhealthy food to children.

We want to live longer, healthier, more fulfilling lives

This article was contributed by the Jamaica Youth Advocacy Network