Santo Domingo.- The demand for medical care for feverish patients with suspected dengue remained high in emergency and hospitalization areas yesterday. Healthcare centers and medical staff continued to experience significant pressure due to the influx of patients seeking treatment, with many requiring hospitalization.

Over the course of 24 hours, 76 patients were admitted to hospitals in Greater Santo Domingo, as reported by the National Health Service (SNS).

The Robert Reid Cabral Children’s Hospital admitted 16 patients with suspicious dengue symptoms, bringing the total number of admissions to 78 by mid-morning. Four of these patients were in intensive care. Additionally, in the early morning hours, seven patients with a confirmed dengue diagnosis were still awaiting available beds, and this number increased as more patients arrived at the emergency area.

In terms of prevention, state institutions, along with volunteers and collaborators, conducted extensive mobilization efforts over the weekend. The goal was to eliminate breeding sites for the Aedes aegypti mosquito, which is the carrier of the dengue virus and breeds in clean water, including containers found in yards and streets.

Out of the 74 patients in the wards with suspected dengue at the Reid Cabral hospital, eight had confirmed cases of the disease. Four of these confirmed cases were in the Intensive Care Unit and were reported to be in stable condition. Fortunately, there were no reported deaths due to dengue at the health center in the last 24 hours.

The Reid Cabral hospital is the second-largest pediatric center in the country that has admitted a significant number of patients with suspected dengue this year, following the emergence of the epidemic.

SOURCE: AP – The only cure for painful sickle cell disease today is a bone marrow transplant. But soon there may be a new cure that attacks the disorder at its genetic source.

On Tuesday, advisers to the Food and Drug Administration will review a gene therapy for the inherited blood disorder, which in the U.S. mostly affects Black people. Issues they will consider include whether more research is needed into possible unintended consequences of the treatment.

If approved by the FDA, it would be the first gene therapy on the U.S. market based on CRISPR, the gene editing tool that won its inventors the Nobel Prize in 2020.

The agency is expected to decide on the treatment in early December, before taking up a different sickle cell gene therapy later that month.

Dr. Allison King, who cares for children and young adults with sickle cell disease, said she’s enthusiastic about the possibility of new treatments.

“Anything that can help relieve somebody with this condition of the pain and the multiple health complications is amazing,” said King, a professor at Washington University School of Medicine in St. Louis. “It’s horribly painful. Some people will say it’s like being stabbed all over.”

The disorder affects hemoglobin, the protein in red blood cells that carries oxygen. A genetic mutation causes the cells to become crescent-shaped, which can block blood flow and cause excruciating pain, organ damage, stroke and other problems.

Millions of people around the world, including about 100,000 in the U.S., have the disease. It occurs more often among people from places where malaria is or was common, like Africa and India, and is also more common in certain ethnic groups, such as people of African, Middle Eastern and Indian descent. Scientists believe being a carrier of the sickle cell trait helps protect against severe malaria.

Current treatments include medications and blood transfusions. The only permanent solution is a bone marrow transplant, which must come from a closely matched donor without the disease and brings a risk of rejection.

No donor is required for the one-time gene therapy, “exa-cel,” made by Vertex Pharmaceuticals and CRISPR Therapeutics. This new treatment involves permanently changing DNA in a patient’s blood cells.

The goal is to help the body go back to producing a fetal form of hemoglobin — which is naturally present at birth but then switches to an adult form that’s defective in people with sickle cell disease.

When patients undergo the treatment, stem cells are removed from their blood and CRISPR is used to knock out the switching gene. Patients get medicines to kill off other flawed blood-producing cells and then are given back their own altered stem cells.

The treatment has been tested in a relatively small number of patients thus far, the nonprofit Institute for Clinical and Economic Review said in an evidence report.

In a briefing document released Friday before the advisory committee meeting, Vertex said 46 people got the treatment in the pivotal study. Of 30 who had at least 18 months of follow-up, 29 were free of pain crises for at least a year and all 30 avoided being hospitalized for pain crises for that long.

The company called the treatment “transformative” and said it has “a strong safety profile.”

Victoria Gray, of Mississippi, the first patient to test the treatment, shared her experience with researchers at a scientific conference earlier this year. She described suffering with terrible bouts of pain since childhood and receiving high-dose pain medications and sometimes blood transfusions. She described feeling she “was being reborn” the day she got the gene therapy.

Now, she’s able to run around with her kids and work a full-time job. “My children no longer have a fear of losing their mom to sickle cell disease,” she said.

But the FDA is asking an outside panel of gene therapy experts next week to discuss a lingering issue that often comes up when discussing CRISPR: the possibility of “off-target effects,” which are unexpected, unwanted changes to a person’s genome. The FDA is looking for advice on whether the company’s research on such effects was adequate to assess the risk or whether additional studies are needed. While the agency doesn’t have to follow the group’s advice, it often does.

If the treatment is allowed on the market, the company has proposed a post-approval safety study, product labeling outlining potential risks and continuing research.

The FDA is expected to decide on the second gene therapy for sickle cell, made by Bluebird Bio, before the end of the year. Bluebird’s treatment works differently. It aims to add functional copies of a modified gene, which helps red blood cells produce “anti-sickling” hemoglobin that prevents or reverses misshapen cells.

The companies have not released potential prices for either therapy, but the institute report said prices up to around $2 million would be cost-effective. By comparison, research earlier this year showed medical expenses for current sickle cell treatments, from birth to age 65, add up to about $1.6 million for women and $1.7 million for men.

King, the St. Louis doctor, acknowledged the new treatments would be expensive. “But if you think about it,” she said, “how much is it worth for someone to feel better and not be in pain and not be in the hospital all the time?”

The post A new cure for sickle cell disease may be coming. Health advisers will review it next week appeared first on Barbados Today.

Saturday, 18 November 2023 from 9 am to 12 noon, at Perdmontemps Gospel Hall

View the full post GDA Free Diabetes & Health Clinic on NOW Grenada.

Personnel from different institutions participated in the fumigation work, elimination of mosquito breeding sites, and orientation to the citizens to stop the epidemic outbreak of dengue affecting the country in the second stage of interventions at a national level, which will continue this Sunday, informed the Ministry of Public Health.

In addition, the operations included the distribution of water tank lids, chlorine, and educational material to sensitize the population on the importance of keeping their environment clean and preventing the formation of water accumulations that serve as breeding grounds for the mosquito that transmits the disease.

The authorities focused on the sectors that have registered the highest incidence of dengue fever in different provinces of the country, including Santo Domingo, where members of the Military Commission of the Ministry of Public Works (Comipol) disinsected the facilities of the Cristo Redentor National Cemetery, applying larvicide in some 320 tombs and where they eliminated 37 mosquito breeding sites.

According to the latest figures provided by the health authorities, so far this year, 13 deaths have been confirmed due to dengue, and there are almost 14,100 suspected cases of the disease in the country.

Health professionals in the Caribbean are urging women to seek early testing for breast cancer, as recent data reveals a troubling increase in diagnoses among women between the ages of 30 and 39.

During a recent webinar titled ‘Join the Fight: A conversation about breast cancer,’ organized by Sagicor Life, a Primary Care Physician from St Kitts and Nevis, Dr Kesiha Liddie, issued a stark warning about the shifting landscape of breast cancer diagnoses over the past five to six years.

“The important thing is to become aware very early,” Dr Liddie said. She noted that while breast cancer diagnoses have historically been associated with older age and a higher incidence in females compared to males, there is a growing trend of breast cancer being detected in younger women.

Data from St Kitts underscored this concerning trend. Dr Liddie shared statistics indicating that the country reported 36 cases this year within the age group of 50 to 59 and 23 cases in ages 40 to 49. There were no cases found under the age of 30.

However, there were 14 cases diagnosed in women aged 30 to 39, marking a significant increase in diagnoses among younger women compared to previous years when the majority of cases occurred in women aged 50 and above.

Dr Asante Le Blanc, Chairperson of the Trinidad and Tobago Cancer Society, delved into potential risk factors beyond age that might be contributing to the rising number of cases among younger women. She emphasized that while family history and lifestyle choices may be influential, environmental factors, including climate change, were also playing a significant role in the escalating cancer incidence. 

Furthermore, Dr Le Blanc stressed the importance of awareness and vigilance, both personally and professionally, highlighting risks associated with the prolonged use of birth control and exposure to carcinogens, formaldehyde, and radiation in certain occupations and lifestyles. 

She pointed out that the rise in breast cancer diagnoses among younger women, while concerning, reflects an increased awareness of the disease and underscores the need for preventive measures.

“Screening for breast cancer is a very holistic programme and that means from our young age of puberty, we need to teach young girls about their breasts and how to do self-breast examinations because it aids in terms of you understanding what your breasts feel like on a monthly basis before even having to do a clinical breast exam,” Le Blanc said.

“So, from a young age, if you understand what your breasts feel like, when you’re 30 and feel something different, you won’t have to wonder and wait, you can go to your doctor and say something is different because you know what your breasts have been feeling like over the years … and that allows for earlier diagnosis and therefore early detection and therefore better survivorship.”

The webinar also featured personal stories from two panelists, Tonya Byer, a digital communications specialist from Barbados, and Nurse and Counselor Emalda Benjamin from Antigua and Barbuda.

Byer shared her diagnosis experience at the age of 38, emphasizing the importance of self-awareness and prompt medical attention when faced with unexplained weight loss during breastfeeding.

In contrast, Benjamin initially dismissed a lump she felt in 2017 but sought medical help during a routine physical examination at the age of 50, which led to her breast cancer diagnosis.

Dr Liddie reflected on these personal stories, acknowledging that the lifestyle of the current generation has significantly evolved compared to previous generations. She underscored that breast cancer is an individualized disease, presenting differently for each person.

Dr Liddie stated that risk factors such as early menarche, late menopause, not having children, having a first child after the age of 30, and choosing not to breastfeed, all increase the likelihood of breast cancer.

Breast cancer stands as the leading cause of cancer-related deaths for women in the Caribbean region. As awareness about the disease continues to grow, participants in the webinar pointed to the critical need to build robust support communities for those affected by breast cancer.

Dr Le Blanc therefore encouraged patients to connect with survivor networks, highlighting the significant advancements in cancer treatment in recent years.

Concluding her remarks, Dr Blanc noted, “You’re going to have tough days, you’re going to have good days, but that’s where your support network comes into play, and though it might seem daunting, there have been remarkable strides in cancer treatment on the whole.”

The post Women urged to seek early testing for breast cancer appeared first on Barbados Today.

Family members say they do not believe the number of cases has decreased. On the contrary, they say that they know of more and more children with symptoms; they also say that spaces and beds in hospitals are scarce.

Johanna Santos, the grandmother of a nine-month-old baby, was waiting for news about her grandson outside the Hugo Mendoza Pediatric Hospital in Santo Domingo Norte after being admitted for several days with suspected dengue fever.

“Don’t pay any attention to the fact that dengue is decreasing. Dengue is ending; it is not decreasing at all. That is a lie,” said the lady. She insisted that there were no more beds available at the hospital due to the number of children hospitalized.

According to a hospital spokesman, yesterday morning, 82 patients remained in the center, which was at maximum capacity.

No beds

During the last few weeks, the number of patients in the hospitals continues to be alarming, while several health centers are at maximum capacity, and the lack of beds to attend to the infants is evident, according to parents.

Yoleidy Suarez, mother of a two-year-old boy admitted to the Robert Reid Cabral Children’s Hospital with dengue fever, indicated that although her little boy has received good care, she says that in the observation area, there are no beds.

“Upstairs (in internment) everything is fine, but downstairs, in observation, there are three and four children in a single bed,” Suarez said.

This information was corroborated by other people such as Maritza Rodriguez, aunt of a 14-year-old boy with the same disease, who assured that the emergency area has remained full.

Outside the Hugo Mendoza Hospital, several parents were waiting for news of their relatives admitted or attended by the Emergency Department. They indicated that the wards of the health center were also full of parents with their children.

“You can’t even get in here,” exclaimed a mother who came with her little girl who has sickle cell disease (sickle cell patient), referring to the fact that the place was overcrowded and that she would have to go to another health center.

Robert Reid

At the Robert Reid Cabral Hospital, in the morning hours, 33 patients had been admitted with symptoms of dengue fever.

According to a spokesman for the health center, 69 patients were still in the ward with a possible diagnosis of the disease, while eight were confirmed.

In the Intensive Care Unit (ICU), the center kept a total of four children hospitalized, all of whom were stable.

Alarming symptoms

Among the warning signs for parents coming to children’s hospitals are fever, vomiting, headache, and body aches, among other symptoms.

In addition to these febrile symptoms, children come to the centers with signs of respiratory viruses such as pneumonia or bronchopneumonia.

Dr. Griselys Alcántara pointed out that patients infected by the virus transmitted by the bite of the Aedes aegypti mosquito need special treatment and constant supervision.

“A person affected by dengue requires 24-hour supervision, due to the fact that it is an unpredictable disease that does not represent a danger now, and after half an hour it worsens,” Alcántara said.

At the Unión Médica del Norte clinic, where she directs the intensive care area, they maintain surveillance of patients with shifts of up to 24 hours.

Margarita Santana, a pediatric infectious disease specialist at the Unión Médica, added that the treatment for this virus is “totally exhausting.”

“The truth is that I don’t think there is a pediatrician in the public or private sector who is not exhausted, due to the great demand,” she said.

In addition to the large number of suspected cases of dengue, which so far this year exceeds 14,000, there are also patients with other conditions that present themselves in the emergency room.

Statistics show that this center is attending about 300 children with febrile processes in the pediatric area, of which an average of 18 cases are positive for the disease. To date, the Unión Médica has treated 854 probable dengue fever patients.

Baby worsened due to lack of timely care.
At the door of the Emergency Room of the Hugo Mendoza Hospital, Kelcy Zabala was accompanied by her parents on her way to the cafeteria to have a quick snack since her nine-month-old baby has been in the Intensive Care Unit for two days with a positive diagnosis of dengue.

The new mother said that her situation worsened because she took him to a private clinic in Santo Domingo East, and the answer she received was to treat him with acetaminophen at home because the clinic was full. “They bounced us from the clinic, and the baby got worse,” she said.

This was the reason why they went to Hugo Mendoza, where they already had to give him a platelet transfusion because of the low level he presented.

“Here the treatment has been very good,” she added.

This Thursday, the emergency room of the health center looked more evident than on previous occasions, with only about twenty children waiting, when in the past days, there were more than 70. In the case of Robert Reid, this Thursday, there were 67 children admitted and four in intensive care.

Tests do not need an indication.
Diario Libre visited branches of private clinical laboratories to observe the demand for serological and molecular tests for dengue diagnosis.

“It is not necessary to have an indication. For antigen tests it is recommended that the patient has at least three days of fever. The PCR tests are more specialized tests that are normally done if requested by the physician,” responded a collaborator of the Amadita Laboratory.

Georgetown Public Hospital Corporation (GPHC) on Friday announced a significant enhancement to its medical services by providing free knee and hip replacement surgeries, including revision procedures, free of cost to patients. The GPHC said following a proactive proposal from the hospital management to the Board of Directors, the decision to remove all charges for these ...

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Hi! Today we see that prime editing works nicely in monkeys, learn more about the potential new bill to speed treatments for life-threatening diseases, and find that a Regeneron (formerly Decibel) therapy may restore hearing in children.

The need-to-know this morning
• Sanofi said it will spin out its consumer health unit and cut costs in other areas in order to increase spending on research and development of new medicines. Separately, the French pharma giant reported third-quarter earnings and revenue that fell short of analyst consensus. Sanofi reiterated its financial forecast for the remainder of the year, but new, long-range guidance for 2024 and 2025 implies financial results lower than current analyst estimates.
• Abbvie reported adjusted third-quarter earnings of $2.95 per share, beating the consensus estimate. Revenue was $13.93 billion, down 6% year over year but better than consensus. Sales of the arthritis medicine Humira fell 36% from the previous year to $3.5 billion, largely due to generic competition, but were still in line with consensus. The company raised financial guidance for the remainder of the year.
• The FDA approved a new treatment for ulcerative colitis made by Eli Lilly. As Jonathan Wosen reports, the drug, called Omvoh, is the first to target an immune signaling pathway that plays a key role in sustaining the chronic, gastrointestinal disease.

Continue to STAT+ to read the full story…

This is the opinion of the international expert Javier Marin, director for Latin America of Healthcare of Llorente y Cuenca (LLYC) when he was interviewed during a visit to the editorial office of Listin Diario.

The specialist emphasized that the control of health conditions affecting the population is not only the responsibility of the State and that service companies, clinics, pharmaceutical companies, laboratories, and diagnostic centers must play a more empowering role in the health care of the population.

Marín was in the country participating as a speaker at the congress “Innovation, Trends and Challenges: where we must move,” held last weekend by the Association of Representatives, Agents and Pharmaceutical Producers, Inc (ARAPF).

He understands that companies must stop considering only suppliers and start getting more involved in society’s health care.

Effective communication

With dengue, Marín said that if companies get involved and work directly with the State, there would be better results in prevention and response and that effective communication is fundamental because, many times, the aggravation of cases of a particular disease occurs mainly because people confuse the symptoms and arrive late to the health system.

He explained that in the activity organized by ARAPF, he explained how communication can contribute to improving the reasoning of companies’ impact in improving health in each country.

He said that the sustainability of health systems must be considered.

He said that sometimes it is thought that this sustainability is the responsibility of the State, without understanding that the companies involved in the sector cannot be seen only as suppliers and that the individual himself assumes a more empowered role in health care.

He pointed out that at LLYC, they study the challenges facing healthcare systems. He said that governments must establish processes to monitor what is happening and, above all, to know what the population is feeling, to analyze volumes of data, and to take immediate action.

He emphasized that social networks are of great importance in monitoring because people express themselves without filters, and they make it possible to understand what is happening in some regions of the country and about specific health conditions, including what is happening with the high incidence of non-communicable diseases.