“We don’t need to generalize, we don’t need to say let me explain the whole world to you as an artist. You don’t have to do that. Just tell the truth about your own life, what you’re experiencing, what you’re seeing and dig into it. Don’t be afraid of it, confront it. Let’s see where it comes out. Let’s describe our most intimate relationships with the hopes that other people can see themselves in our work.”
Steven Van Zandt — https://www.forbes.com/sites/stevebaltin/2020/10/18/qa-e-streets-steve-van-zandt-and-nils-lofgren-on-the-making-of-the-new-bruce-springsteen-masterpiece-letter-to-you/#7bc47c7877e3
Diets Don’t Work so Why Are More Teens Dieting?
Well, my first thought was Body Dysmorphic Disorder (BDD) — https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd. But this is merely an educated guess from an insurance guy who has lost 200 pounds and not a trained licensed practicing clinical psychiatrist.
In 2015, 42% of 14-year-old girls and boys said they currently were trying to lose weight, compared to 30% in 2005.
Lead author Dr Francesca Solmi (UCL Psychiatry) said: “Our findings show how the way we talk about weight, health and appearance can have profound impacts on young people’s mental health, and efforts to tackle rising obesity rates may have unintended consequences.
“An increase in dieting among young people is concerning because experimental studies have found that dieting is generally ineffective in the long term at reducing body weight in adolescents, but can instead have greater impacts on mental health. We know, for instance, that dieting is a strong risk factor in the development of eating disorders.”
University College London. “Dieting and weight worries on rise in teens.” ScienceDaily. http://www.sciencedaily.com/releases/2020/11/201116112855.htm (accessed November 21, 2020). — https://www.sciencedaily.com/releases/2020/11/201116112855.htm
And in case you made it this far on this blog post my estimated BMI at age 20 was 53.1. My current BMI is 25.1.
An Early-Onset Subgroup of Type 2 Diabetes: A Multigenerational, Prospective Analysis in the Framingham Heart Study
Abstract
OBJECTIVE To assess the relation of type 2 diabetes occurring earlier (age <55 years) versus later in life to the risk of cardiovascular death and to diabetes in offspring.
RESEARCH DESIGN AND METHODS In the Framingham Heart Study, a community-based prospective cohort study, glycemic status was ascertained at serial examinations over six decades among 5,571 first- and second-generation participants with mortality data and 2,123 second-generation participants who initially did not have diabetes with data on parental diabetes status. We assessed cause of death in a case (cardiovascular death)–control (noncardiovascular death) design and incident diabetes in offspring in relation to parental early-onset diabetes.
RESULTS Among the participants in two generations (N = 5,571), there were 1,822 cardiovascular deaths (including 961 coronary deaths). The odds of cardiovascular versus noncardiovascular death increased with decreasing age of diabetes onset (P < 0.001 trend). Compared with never developing diabetes, early-onset diabetes conferred a 1.81-fold odds (95% CI 1.10–2.97, P = 0.02) of cardiovascular death and 1.75-fold odds (0.96–3.21, P = 0.07) of coronary death, whereas later-onset diabetes was not associated with greater risk for either (P = 0.09 for cardiovascular death; P = 0.51 for coronary death). In second-generation participants, having a parent with early-onset diabetes increased diabetes risk by 3.24-fold (1.73–6.07), whereas having one or both parents with late-onset diabetes increased diabetes risk by 2.19-fold (1.50–3.19).
CONCLUSIONS Our findings provide evidence for a diabetes subgroup with an early onset, a stronger association with cardiovascular death, and higher transgenerational transmission.
Diabetes Care 2020 Dec; 43(12): 3086-3093. https://doi.org/10.2337/dc19-1758
Translation – The earlier you develop diabetes your risk of CVD and coronary death is higher. An if one or both of your parents developed either early onset or late onset diabetes you’re screwed.
Meanwhile in Oklahoma – Follow the Science
With a mask mandate in place since spring, free drive-through testing, hospitals well-stocked with PPE, and a small army of public health officers fully supported by their chief, the Cherokee Nation has been able to curtail its Covid-19 case and death rates even as those numbers surge in surrounding Oklahoma, where the White House coronavirus task force says spread is unyielding.
The Cherokee Nation, with about 140,000 citizens on its reservation in northeastern Oklahoma, has reported just over 4,000 cases and 33 deaths.
“It’s dire, but what in the world would it look like if we weren’t doing this work?’” said Lisa Pivec, senior director of public health for Cherokee Nation Health Services. Pivec leads a team that jumped into action in late February, holding coronavirus task force meetings twice a day, instituting procedures to screen thousands of employees, stockpiling PPE, protecting elders, ensuring food security, and educating residents in both English and Cherokee language. With no guidance on contact tracing available from the CDC early in the pandemic, Pivec researched the World Health Organization’s Ebola response to set up tracing protocols; after the first case appeared on the reservation March 24, she made many of the contact tracing calls herself.
‘They’ve been following the science’: How the Covid-19 pandemic has been curtailed in Cherokee Nation — https://www.statnews.com/2020/11/17/how-covid19-has-been-curtailed-in-cherokee-nation/
Take a few minutes and read the full article. You will be impressed as I was.
Oxford vaccine found safe and immunogenic in Phase 2 Trial Results— Science Chronicle
Results of the Phase-2 trial of the Oxford vaccine show that the vaccine is safe across age groups — younger (18-55 years age) and older adults (over 56 years age). In fact, older adults better tolerated the vaccine than younger adults, the results show. The vaccine also induced T cell immune responses and neutralising antibodies […]
Oxford vaccine found safe and immunogenic even in older adults — Science Chronicle
Meanwhile in Oklahoma — First-of-Its-Kind Med School Makes History
Ashton Glover Gatewood, 31, a member of the Choctaw Nation and descendent of both the Chickasaw and Cherokee Nations, has long lamented the glaring lack of Native American physicians. So she decided to become one.
Gatewood is a student in the inaugural class of the first tribally affiliated medical school in the United States, the Oklahoma State University (OSU) College of Osteopathic Medicine at the Cherokee Nation. The school opened this fall on Cherokee land in Tahlequah, the capital of the Cherokee Nation’s 14-county reservation in the rolling hills of rural Oklahoma, about an hour east of Tulsa.
First-of-Its-Kind Med School Makes History — https://www.medscape.com/viewarticle/941187?src=rss#vp_1
I’ll have to ask Project #1 on my Project List if he will be teaching any classes at the new medical school.
More on Vulvar Melanoma
Lesions could be angiokeratomas, petechiae, purpura, melanosis, and nevi, for example. Seborrheic keratoses can mimic melanoma. “If it looks odd, don’t be afraid to biopsy it,” said Mauskar, assistant professor of dermatology and obstetrics and gynecology at the University of Texas Southwestern Medical Center in Dallas.
Low Threshold to Biopsy Atypical Lesions May ID Vulvar Melanoma Early, Experts Say — https://www.medscape.com/viewarticle/941157?src=rss
I first became aware of melanoma down there back in June of this year. See Vulvar Melanoma Is Increasing in Older Women
So remember, if it looks odd get it biopsied.
Can 2020 Get Any Worse? (si)
Until now, there had been only one confirmed case of Chapare virus, an Ebola-like illness that turned up in the rural Bolivian province of Chapare in 2004 and then disappeared. But in 2019, at least five more people caught the bug, according to research now made public. The virus spread from person to person through bodily fluids in a region near Bolivia’s capital city of La Paz, killing three people. There are no active outbreaks of Chapare in 2020, and even in the event of further outbreaks the virus would be unlikely to cause a pandemic, according to virus experts.
There are reasons to be concerned about the news, however. Three of the five confirmed patients from the 2019 outbreak were health care workers, according to a CDC statement; a “young medical resident,” an ambulance medic and a gastroenterologist all contracted Chapare after contact with bodily fluids from infected patients. Two of them died.
Deadly hemorrhagic fever in Bolivia can spread between people — https://www.livescience.com/chapare-virus-human-transmission.htm
In my next life I want to come back as an Infectious Disease specialist.
ATTENTION Anti-Vaxxers — (you probably don’t want this vaccine either)
The 30,000-person trial included 11,000 volunteers from communities of color, making up 37% of the total study population. It also included more than 7,000 volunteers over the age of 65 and more than 5,000 people under 65 who have high-risk medical conditions that put them at high risk of suffering from a severe infection, should they contract Covid, things like diabetes, severe obesity and heart disease.
Moderna’s Covid-19 vaccine is strongly effective, early look at data show – https://www.statnews.com/2020/11/16/modernas-covid-19-vaccine-is-strongly-effective-early-look-at-data-show/?utm_campaign=rss
Refrigeration Requirements
The mRNA-1273 vaccine can be shipped and stored for up to 6 months at –20° C (about –4° F), a temperature maintained in most home or medical freezers, according to Moderna. The company expects that after the product thaws, it will remain stable at standard refrigerator temperatures of 2° to 8° C (36° to 46° F) for up to 30 days within the 6-month shelf life.
Because the mRNA-1273 vaccine is stable at these refrigerator temperatures, it can be stored at most physicians’ offices, pharmacies, and hospitals, the company notes. In contrast, the similar Pfizer BTN162b2 vaccine ― early results for which showed a 90% efficacy rate, as reported by Medscape Medical News ― requires shipment and storage at “deep freeze” conditions of –70° C or –80° C, which is more challenging from a logistic point of view.
Moderna’s mRNA-1273 can be kept at room temperature for up to 12 hours after removal from a refrigerator for patient administration. The vaccine will not require dilution prior to use.
Moderna: Interim Data Show 94.5% Efficacy for COVID-19 Vaccine, Will Seek FDA EUA — https://www.medscape.com/viewarticle/941023?src=rss
Game changer!
COVID-19: Study Suggests Durable Immune Response After SARS-CoV-2 Infection
Immune responses to SARS-CoV-2 might last for years, according to a study posted on the preprint server bioRxiv.
Some 185 adults who recovered from COVID-19 (most had mildly symptomatic disease) provided blood samples for analysis. The majority provided a single sample, but roughly 20% provided multiple samples over several months.
The researchers found that levels of spike-specific memory B cells (which make antibodies as needed) increased with time — and were higher at 4–6 months than at earlier time points in most participants who gave multiple samples. In addition, SARS-CoV-2 spike IgG titers were generally stable, showing only modest declines at 6–8 months.
COVID-19: Study Suggests Durable Immune Response After SARS-CoV-2 Infection — https://www.jwatch.org/fw117245/2020/11/17/covid-19-study-suggests-durable-immune-response-after
I hope these findings are replicated in other studies.
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