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SharecloseShare pageCopy linkAbout sharingAt least 23 people have been killed in a fire at a hospital treating coronavirus patients in the capital of Iraq, Baghdad.Dozens of others were injured in the blaze, which erupted at the Ibn Khatib hospital on Saturday night.Reports say an accident had caused an oxygen tank to explode, sparking the blaze.Videos on social media show firefighters scrambling to extinguish the flames as people flee the building.Iraq’s Prime Minister Mustafa al-Kadhimi called for an immediate investigation into the causes of what he called a “tragic accident”.image copyrightReutersThe head of Iraq’s Civil Defence, Major General Kadhim Bohan, told state media the fire broke out in the hospital’s intensive-care unit, on a floor “designated for pulmonary resuscitation”.So far, emergency crew had rescued 90 out of 120 patients and relatives, state news agency INA quoted him as saying.About “30 patients were in the intensive care unit”, which was reserved for the most severe cases of Covid-19 in Baghdad, a hospital source told the AFP news agency.The injured and patients who weren’t hurt have been taken by ambulance to other hospitals nearby.The fire caused many of the oxygen tanks designated to support the #COVID19 patients in the hospital to explode. #Baghdad so far dozens of victims have been reported. pic.twitter.com/OAC8Jt3jq3— Steven Nabil (@thestevennabil) April 24, 2021
The BBC is not responsible for the content of external sites.View original tweet on TwitterIraq’s Civil Defence said the fire was under control by the early hours of Sunday morning.Baghdad Governor Mohammed Jaber echoed the prime minister’s call for an urgent investigation to determine if anyone should be “brought to justice” for negligence.In a statement, the government’s human rights commission said the incident was “a crime against patients exhausted by Covid-19”.image copyrightGetty ImagesIraq’s hospitals have been pushed to the limit during the coronavirus pandemic, adding to the strains wrought by years of war, neglect and corruption.Coronavirus infections have been rising steeply since February in Iraq, and passed one million cases in total this week.The health ministry has recorded a total of 1,025,288 cases of the disease and 15,217 deaths since the pandemic began.The country launched its vaccination campaign last month, and has received nearly 650,000 doses, most of which have come from Covax, a global programme for sharing jabs.

U.S. experts weigh the risks for younger women and cases of a rare blood-clotting disorder, and lift the pause in giving the one-shot vaccine.Use of the one-shot Johnson & Johnson Covid vaccine will resume within days, but with a warning added to its label about the risk for a rare blood-clotting disorder that has occurred among young women, the Food and Drug Administration said on Friday.Concerns about the disorder had led to a pause in the use of the vaccine that began 10 days earlier. The F.D.A. decided against limiting the vaccine’s use by age or gender, although some European countries have imposed such restrictions on a vaccine made by AstraZeneca because of a similar clotting disorder. Federal health officials said information about the disorder would be provided at vaccination sites. Dr. Peter Marks, the F.D.A.’s top vaccine regulator, predicted that the vaccine could be deployed again by Saturday morning.The Johnson & Johnson suspension came after officials learned that six women had developed a severe disorder that led to blood clots in their brains within about two weeks of receiving the vaccine. One died. The pause was widely considered a blow to national and global vaccination efforts and removed an effective vaccine that many states and countries had counted on to deploy in hard-to-reach places. Unlike the vaccines made by Pfizer-BioNTech and Moderna, Johnson & Johnson’s vaccine requires only one shot and is easier to store and distribute because it does not require extremely cold temperatures. At the advisory panel meeting about the blood-clotting issue on Friday, the C.D.C. reported that it had identified a total of 15 cases, including three deaths. But the risk is considered extremely small — nearly eight million Americans have received the Johnson & Johnson vaccine — and the panel ultimately decided that the vaccine’s benefits far outweighed its risks. It also concluded that failing to use it would lead to more deaths than the clotting disorder might cause.The panel voted 10 to 4 to resume using the vaccine with the warning label. Some who voted “no” wanted a more prominent warning about the risk to younger women and the availability of other Covid vaccines that do not appear to pose the same risk. Lifting the pause will allow many states to restart giving the one-dose shot to college students and hard-to-reach populations like rural Americans, migrants and the homebound elderly. Their access had been hampered by the suspension, which left roughly 10 million doses sitting on shelves.In Wisconsin, where one-third of the population is fully vaccinated, officials said they intended to begin using their Johnson & Johnson doses as soon as possible. “We have also heard from a number of vaccinators who say that there are lots of people who don’t like needles,” said Julie Willems Van Dijk, the deputy secretary of the state health department. “They just want to get the vaccine that requires them to have one shot versus two shots.”Dr. Rochelle P. Walensky, the C.D.C. director, said governors had expressed intense interest in resuming use of the shot.“They wondered why we had paused and they were anxious to have this back, have an opportunity for a single-dose vaccine, for a one-and-done possibility,” she said.About 135.8 million people in the United States have received at least one shot of a coronavirus vaccine since the rollout began. But since last week, average daily doses have fallen by almost 13 percent, from a peak of 3.38 million daily doses, on average, to about 2.95 million, on average. It is the first time since early April that providers have given fewer than three million shots a day, on average.It is difficult to say exactly what is driving the decrease. Even before the use of the Johnson & Johnson vaccine was paused, shipments of it had dipped because of a factory error that had ruined millions of doses.Larry Bergner, the administrator for the health department in Newton County, Mo., population 58,000, said demand had been falling before the pause. He was concerned that the federal government’s decision had made hesitancy about the vaccine in the area worse.“Some tell me that they had planned on getting vaccinated until J.&J. was halted,” Mr. Bergner said. “Now, they say they are going to hold off until they feel confident that all vaccines are safe.”The county had distributed fliers and made phone calls to businesses, churches and other community groups to drum up interest for a vaccination clinic on Wednesday, but only 14 people showed up. It was actually about double what Mr. Bergner had expected, he said, though the health department could have handled about 100 shots.Dr. Walensky said the federal government planned to emphasize the vaccine’s safety to Americans who might be hesitant to take it after the pause.“We have to do extraordinary outreach to clinicians, as we have been doing this past week,” she said. “We already have plans to start that on Monday, to public health officials. And then we have to do extraordinary outreach to patients, to meet people where they’re at, to educate them.”She said the C.D.C. had talked to health providers for young women, including the American College of Obstetricians and Gynecologists. The pause and investigation into the rare disorder, she added, should give the public confidence in the system used to monitor vaccine safety.Registration for the Johnson & Johnson vaccine at the Charlotte Maxeke Johannesburg Academic Hospital in South Africa last month. Shots will resume there next week, officials announced Thursday.João Silva/The New York TimesEuropean Union regulators earlier this week did not recommend the kind of age restrictions for the Johnson & Johnson shots that some countries have imposed on the AstraZeneca vaccine. Johnson & Johnson did agree to include a warning of risks for the blood clots. Several European countries have since resumed use of the Johnson & Johnson vaccine, as has South Africa. Up until just hours before the pause was recommended by American officials, regulators had planned for a revision to the F.D.A.’s emergency use authorization similar to the one formalized Friday, with warnings about the blood clots. But top health officials decided in a meeting on April 12 that the government should call for a pause while federal authorities and the C.D.C.’s expert panel investigated a possible link between the clots and the vaccine. They feared a number of cases of the disorder had not been identified and wanted to allow more time for those who had just received the vaccine to reach the point at which the rare clotting typically appears. “As we did this intensive scientific evaluation over recent days, I think we became more and more confident about the decision that was made today,” Dr. Janet Woodcock, the acting F.D.A. commissioner, said on Friday.In the C.D.C. panel analysis, women between 30 and 39 appear to be at greatest risk, with 11.8 cases per million doses given. Among women 18 to 49, there have been seven cases per million doses. The condition, which the C.D.C. is calling thrombosis with thrombocytopenic syndrome, causes severe blood clots and also a tendency to bleed at the same time, because of abnormally low levels of platelets, a blood component involved in clotting.The disorder is “rare but clinically serious,” Dr. Tom Shimabukuro, the deputy director of the C.D.C.’s immunization safety office, said at the meeting.Additional potential cases, including some in men, are being reviewed. There was also a case in a 25-year-old man who participated in a clinical trial of the vaccine.The patients’ symptoms closely resemble a rare syndrome that can be caused by heparin, a widely used blood thinner, Dr. Michael Streiff, a hematologist at Johns Hopkins University, told the panel. Heparin, typically used to treat blood clots, should not be given to these patients, he said.Symptoms include severe headaches, abdominal pain, leg pain or shortness of breath. Those problems generally do not set in before about six days after the vaccination. Once the symptoms occur, treatment should begin as soon as possible, because it can worsen rapidly, researchers say. Dr. Marks, the F.D.A. regulator, said the agency was recommending blood thinners other than heparin, and a blood product called intravenous immune globulin, which can help ease the immune reaction causing the problem.“That appears to reverse this process,” he said.Officials warned that women under 50 have an increased risk of a rare but serious blood-clotting disorder, and “may choose” to receive a different vaccine instead.Mario Tama/Getty ImagesResearchers suspect that in these rare cases, the vaccine causes an intense reaction by the patient’s immune system, which churns out antibodies that activate platelets, a blood component needed for clotting. Why this occurs in some people, many of them younger women, is not known, and experts say that they have so far been unable to identify traits or underlying conditions that may make some people susceptible. Top U.S. health officials have stressed that finding the small number of cases of a rare disorder, and pausing use of the vaccine, indicated that safeguards were in place to assess risks and to raise awareness among doctors and hospitals about the unusual symptoms.“This pause was essential to our ability to inform the public,” Dr. José R. Romero, chairman of the expert panel, the Advisory Committee on Immunization Practices, said on Friday.But some public health experts have expressed concerns that the government’s actions would fuel vaccine hesitancy just when the Biden administration is heavily pushing to have all adults immunized by the summer.The impact of the Johnson & Johnson vaccine on vaccine hesitancy is still evolving. A poll released this week from Ipsos/Axios found that the pause itself boosted confidence in federal vaccine monitors, with 81 percent saying that the C.D.C. and the F.D.A. acted appropriately. The sentiment was unusually bipartisan, with 87 percent of Republicans and 91 percent of Democrats sharing that view.Measuring the impact of the Johnson & Johnson pause is rather tricky because as Liz Hamel, vice president of public opinion and research survey at the Kaiser Family Foundation, said, “You don’t know what the trajectory of the vaccine uptake would have been in the absence of this pause.”The biggest challenge ahead, she noted, will be the creation of vaccine-confidence messages that resonate, especially in light of the setback with Johnson & Johnson. “We don’t know whether it has increased hesitancy among women in particular,” she said.Rob Barss, a paramedic, talked with Romeo Porier before administering a Johnson & Johnson shot, part of a mobile vaccine distribution program in Leominster, Mass.Cj Gunther/EPA, via ShutterstockBenjamin Mueller, Matina Stevis-Gridneff, Julie Bosman, Jan Hoffman, Carl Zimmer and Emily Anthes contributed reporting.

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesUS health regulators have lifted an 11-day pause on the Johnson & Johnson (J&J) Covid-19 jab, but will add a warning label about the potential for extremely rare blood clots.A Centers for Disease Control and Prevention (CDC) panel earlier approved restarting US rollout of the shot. Fifteen vaccine recipients suffered from a dangerous blood clot out of nearly eight million given the jab. This week, Europe’s drug regulator also ended restrictions on the J&J vaccine. European regulators this month also linked similar, highly unusual blood clots to the AstraZeneca Covid-19 shot, but found the benefits of the drug outweighed any risks.On Friday afternoon, the CDC and Food and Drug Administration swiftly followed the recommendation of the CDC advisory panel after it voted 10-4 to continue rolling out the vaccine for people 18 years of age and older in line with its original authorisation.The decision means at least 10 million doses of the J&J vaccine, shipped from the company’s factory in the Netherlands, can be deployed across the US immediately. The health officials on Friday identified nine more cases of the blood clots, adding to six cases already identified since regulators first approved the jab as safe and effective in February.All were women, most under the age of 50. Three died and seven remain in hospital.About a dozen of the cases affected women aged 30-39. Seven of the women were obese, two had high blood pressure, and two were using oral contraceptives, according to health officials. CDC officials who presented the data on Friday said a few cases of blood clots in men were being reviewed, too.Covid map: Where are cases the highest?Covid vaccine: Pfizer v Oxford AstraZeneca v ModernaThe officials also said it was important for women be told about the potential risks of the vaccine so they could decide whether to seek alternatives.Dr Sarah Long, of Drexel University College of Medicine, was among the panel members who voted against the proposal because she thought it did not go far enough in warning women. “This is an age group that is most at risk [of the blood clot] that is getting vaccine predominantly to save other peoples’ lives and morbidity, not their own,” she told AP new agency. “And I think we have a responsibility to be certain that they know this.”Symptoms can arise within three weeks of vaccination and include acute headaches, shortness of breath, and leg and abdominal pain. US health officials are warning doctors that heparin, a common treatment for blood clots, can worsen the vaccine-linked condition.The US paused use of the single-dose shot earlier this month over a few reports of blood clotting in the brain post-vaccine among US women. Following the advice, all federal sites in the US stopped using the vaccine. It was not the first setback for J&J in its US coronavirus vaccine rollout. Last month, the ingredients for up to 15 million doses of the pharmaceutical giant’s vaccine were ruined at a Baltimore facility.Federal inspectors this week identified a series of problems at the Emergent BioSolutions plant, including cleanliness and safety issues.

A quadruple amputee, he was a relentless defender on the United States’ wheelchair rugby team, which won a gold medal at the 2008 Paralympics in Beijing.Nick Springer, who became a Paralympic gold medalist in wheelchair rugby at Beijing in 2008, only nine years after contracting meningococcal meningitis, which caused the partial amputations of his arms and legs, died on April 14 in Chandler, Ariz., a suburb of Phoenix. He was 35.His father, Gary, said that Springer, who lived in Phoenix, died in a friend’s pool after finishing a lap. A cause of death has not yet been determined, but he had been seeing a cardiologist for an arrhythmia.Wheelchair rugby — also known as “Murderball,” which was the title of a 2005 documentary about the sport — suited Springer’s love of rough-and-tumble action. He had played hockey from age 5 or 6, hoping to become a New York Ranger.In 2000, a year after losing parts of his arms and his legs above the knees, he turned to sled hockey while still in rehabilitation. He later took up wheelchair rugby, an often violent sport that contains elements of traditional rugby, basketball and handball.“A lot of people look at me like I’m fragile,” Springer told The New York Times in 2003. “Sports gives me a chance to get out there and bang myself up.”After Springer tried wheelchair rugby for the first time in 2003, “He rolled off the court with an ear-to-ear grin, saying, ‘Dad, I think I can be really good at this,’” said Gary Springer, who drove Nick from their home in Croton-on-Hudson, N.Y., in Westchester County, to Hackensack, N.J., where he practiced, and to tournaments where he competed with a team from the Eastern Paralyzed Veterans Association (now the United States Spinal Association).He excelled quickly: He joined the development squad of USA Wheelchair Rugby, the sport’s governing body, in the spring of 2005, and made the U.S. national team the next year, when it won the gold medal at the world championships. In 2008, the team won the Canada Cup and the gold medal over Australia at the Paralympics in Beijing.“He was a great defender — probably for a long period of time the best defender in the world,” said Scott Hogsett, a friend and a teammate of Springer’s on the 2008 team. “He’s the main reason we won the gold; he defended one of the best players in the world” — the Australian wheelchair rugby star Ryley Batt — and shut him down.”But the victory in China came amid sadness. Springer’s mother, Nancy (Ford) Springer, was dying of cancer while her husband and their daughter, Olivia, were at the Paralympics.When she first learned she had cancer, in January 2008, Springer had offered to stop playing wheelchair rugby and move home.“She looked me in the eye and said, ‘It would crush me if you don’t go to the Olympics,’” he said, recalling her conversation to The Journal News, a newspaper based in White Plains, N.Y., in 2008. “And she said, ‘The one thing you have to promise is that you won’t let this keep you from winning the gold medal.’”Ms. Springer was in a coma, surrounded by friends and family watching the gold medal game on a laptop and hearing the announcer refer to her son as “Nick the Tank.” She died the next day, before her son, husband and daughter got home.The gold medal, Springer said, was how he would remember her.“It’s my mother’s medal,” he told The Journal News.Springer playing sled hockey in 2003. “A lot of people look at me like I’m fragile,” he said. “Sports gives me a chance to get out there and bang myself up.”Dith Pran/The New York TimesNicholas Bowen Springer was born on June 9, 1985, in Manhattan and grew up in Brooklyn and Croton-on-Hudson. His father is an entertainment publicist, and his mother taught deaf children and was one of several founders of the National Meningitis Association.Springer had hockey on his mind in August 1999. He had just completed two weeks of goaltender camp near Toronto — he was going to play the position on his high school’s junior varsity team that fall — and was attending sleepaway camp in western Massachusetts.After a three-day, 30-mile hike, he began feeling flulike symptoms, which continued to worsen over the next 16 hours. Purple blotches appeared on his abdomen, indicating blood clots. All were symptoms of meningococcal meningitis, a bacterial infection that causes swelling of the protective membranes that cover the brain and spinal cord.Up to one in five people who survive meningitis may suffer amputations, deafness, and brain and kidney damage; 10 to 15 percent die, even with rapid treatment, according to the National Meningitis Association.Springer was sent to a hospital in Pittsfield, Mass., then was quickly airlifted to another in Springfield, where his organs began to fail and his blood pressure fell to almost zero. He was given a 10 percent chance of survival.He was transferred to a hospital in Manhattan, where, while he was in a medically induced coma that would last eight weeks, he underwent the amputations.After awakening, according to the 2003 New York Times article, he told his father: “Dad, I don’t think I have any fingers. I think I know about my legs, too.” Mr. Springer recalled: “My wife and I looked at each other and said, ‘This is our new normal.’ Because Nick is alive. He’s still Nick.”Springer declined to wear prosthetics or use an electric wheelchair. And he played wheelchair rugby relentlessly.“At a very high level, it can be really violent, and that’s what people like about it,” his friend Scott Hogsett said. “Who doesn’t want to watch two people crash in wheelchairs as hard as you can?”Springer was named the 2009 athlete of the year by the United States Quad Rugby Association, which oversees a league of local teams like the ones he played for in Sarasota, Fla., and in Phoenix, where Hogsett was a teammate. He was also on the 2010 world championship team and the 2012 Paralympic team that won a bronze medal.“Nick was just ferocious,” Joe Delagrave, a teammate on the 2012 Paralympic team, said. “We met in 2009 and he got me playing at a high level. He was phenomenal at mentoring people and loving them.”In addition to his father, Springer is survived by his sister, Olivia McCall, and his father’s partner, Elizabeth Cier.Springer, who graduated from Eckerd College in St. Petersburg in 2010 with a bachelor’s degree in communications, had been an advocate for vaccine awareness. He began speaking at colleges and community organizations and to health professionals in 2005 on behalf of the meningitis association and Novartis, which made a vaccine. In 2015, he began speaking exclusively to health workers after Novartis sold most of its vaccine business to GlaxoSmithKline.“He talked,” his father said, “about before he got sick, getting sick, and how his parents didn’t know there was a vaccination that could have prevented it.”

A panel of advisers to the Centers for Disease Control and Prevention on Friday voted to recommend lifting the pause on the Johnson & Johnson Covid-19 vaccine for all adults and adding a label about an exceedingly uncommon, but potentially dangerous, blood clotting disorder.The vote came after a C.D.C. scientist presented nine new confirmed cases of the disorder, bringing the total to 15. All the cases have been in women, and 13 have been in women between 18 and 49 years old.Federal health officials are expected to respond quickly and formally recommend that states lift the pause.Administration of the vaccine ground to a halt last week after reports emerged of a rare blood clotting disorder in six women who had received the vaccine. The disorder combines blood clots, often in the brain, and a low level of platelets, blood cells that typically promote clotting.“This pause was essential to our ability to inform the public,” Dr. José R. Romero, the chair of the advisory panel, said at the meeting.The overall risk of developing the clotting disorder is extremely low. Women between 30 and 39 appear to be at greatest risk, with 11.8 cases per million doses given. There have been 7 cases per million doses among women between 18 and 49.Three women have died from the rare clots and seven remain hospitalized, four of whom are in the intensive care unit, a C.D.C. scientist said at Friday’s meeting.“These cases are not just numbers to any of us, and we take them very seriously,” Dr. Joanne Waldstreicher, the chief medical officer of Johnson & Johnson, said at the meeting. “These are people.”The company supported adding a warning label to the vaccine, and has agreed upon language for a potential label with the F.D.A., she said. The label she presented notes that “most cases” of the clotting disorder have occurred in women between 18 and 49 years old.Nearly 8 million doses of the Johnson & Johnson vaccine have now been administered. Among men and women who are 50 or over, there has been less than one case per million doses.The clotting disorder is “rare but clinically serious,” Dr. Tom Shimabukuro, the deputy director of the C.D.C.’s immunization safety office, said at the meeting.Roughly 10 million doses or more of the Johnson & Johnson vaccine, produced at the company’s factory in the Netherlands, are sitting on shelves across the United States and could be deployed immediately.The vaccine has immense potential benefits for the population. If vaccinations resume for all adults, 26 to 45 cases of the clotting disorder would be expected over the next six months, according to a model presented by Dr. Sara Oliver, a C.D.C. scientist. However, 600 to 1,400 fewer Covid-19 related deaths would be expected over the same time period.The vaccine, which is easy to store and requires just one shot, is also especially well-suited for use in hard-to-reach populations, including people who are homebound, homeless, or incarcerated.Additional potential cases of the clotting disorder, including some in men, are currently being reviewed. The C.D.C. scientist also mentioned one case that developed in a 25-year-old man who participated in a clinical trial of the vaccine.Twelve of the 15 women in the confirmed cases developed blood clots in the brain. Many also had clots elsewhere. Initial symptoms, which include headaches, typically begin six or more days after vaccination, Dr. Shimabukuro said. As the disorder develops, it can cause more severe headaches, nausea and vomiting, abdominal pain, weakness on one side of the body, speech difficulties, loss of consciousness and seizures.Dr. Shimabukuro noted that seven of the women were obese, two had hypothyroidism, two had high blood pressure, and two were using oral contraceptives. It is not yet clear whether any of these factors might increase the risk of developing the clotting disorder after vaccination.The patients’ symptoms closely resemble a rare syndrome that can be caused by heparin, a widely used blood thinner, Dr. Michael Streiff, a hematologist at Johns Hopkins University, told the panel. Heparin, which might typically be used to treat blood clots, should not be used to treat these patients, he said.Doctors should consider the rare clotting disorder in patients who present with blood clots and low levels of platelets within three weeks of receiving the Johnson & Johnson vaccine, Dr. Streiff said.“Recognition that this syndrome exists is helping to improve outcomes,” he said.The meeting comes as the federal government is also investigating problems at a Baltimore factory that was slated to help satisfy the country’s vaccine demand. Emergent BioSolutions, the plant’s operator, has produced tens of millions of doses of Johnson & Johnson’s vaccine, but they cannot be distributed until regulators certify the plant.After Emergent had to discard up to 15 million possibly contaminated doses of the vaccine last month, federal regulators conducted an inspection that found a series of problems, including the risk that other batches could have been contaminated.

India’s deadly second wave is continuing to set world records for its daily total of coronavirus cases.In the past 24 hours, more than 330,000 were recorded and thousands more have died. The country’s hospitals are reporting dangerously low oxygen levels and no empty beds.The BBC’s India correspondent Yogita Limaye went to one of the hospitals in Delhi.Read more: India Covid crisis: Hospitals buckle under record surge

Fentanyl, oxycodone, morphine — these substances are familiar to many as a source of both pain relief and the cause of a painful epidemic of addiction and death.
Scientists have attempted for years to balance the potent pain-relieving properties of opioids with their numerous negative side effects — with mostly mixed results.
Work by John Traynor, Ph.D., and Andrew Alt, Ph.D., and their team at the University of Michigan Edward F. Domino Research Center, funded by the National Institute on Drug Abuse, seeks to side-step these problems by harnessing the body’s own ability to block pain.
All opioid drugs — from poppy-derived opium to heroin — work on receptors that are naturally present in the brain and elsewhere in the body. One such receptor, the mu-opioid receptor, binds to natural pain-killers in the body called endogenous endorphins and enkephalins. Drugs acting on the mu-opioid receptor can cause addiction as well as unwanted side effects like drowsiness, problems with breathing, constipation and nausea.
“Normally, when you are in pain, you are releasing endogenous opioids, but they’re just not strong enough or long lasting enough,” says Traynor. The team had long hypothesized that substances called positive allosteric modulators could be used to enhance the body’s own endorphins and enkephalins. In a new paper published in PNAS, they demonstrate that a positive allosteric modulator known as BMS-986122 can boost enkephalins’ ability to activate the mu-opioid receptor.
What’s more, unlike opioid drugs, positive allosteric modulators only work in the presence of endorphins or enkephalins, meaning they would only kick in when needed for pain relief. They do not bind to the receptor in the way that opioids do instead binding in a different location that enhances its ability to respond to the body’s pain-relieving compounds.
“When you need enkephalins, you release them in a pulsatile fashion in specific regions of the body, then they are metabolized quickly,” explains Traynor. “In contrast, a drug like morphine floods the body and brain and sticks around for several hours.”
The team demonstrated the modulator’s ability to stimulate the mu-opioid receptor by isolating the purified receptor and measuring how it responds to enkephalins. “If you add the positive allosteric modulator, you need a lot less enkephalin to get the response.”
Additional electrophysiology and mouse experiments confirmed that the opioid receptor was more strongly activated by the body’s pain-relieving molecules leading to pain relief. In contrast the modulator showed much reduced side effects of depression of breathing, constipation and addiction liability.
Their next goal is to measure their ability to enhance activation of endogenous opioids under conditions of stress or chronic pain, explains Traynor, to ensure that they are effective but don’t lead to more dangerous responses like depression of breathing.
“While these molecules won’t solve the opioid crisis,” says Traynor, “they could slow it and prevent it from happening again because patients in pain could take this type of a drug instead of a traditional opioid drug.”
Story Source:
Materials provided by Michigan Medicine – University of Michigan. Original written by Kelly Malcom. Note: Content may be edited for style and length.

Most adults who test positive for the virus that causes Covid-19 don’t require hospital care, but they tend to seek medical care in the following months, and two-thirds of those who do seek care receive a diagnosis of a new health condition they did not have previously, a new study reports.The study, conducted by investigators from the Centers for Disease Control and Prevention and Kaiser Permanente, included some 3,171 members of the Kaiser Permanente Georgia integrated health care system. More than half were Black.The message for patients is that even for those who have had only mild Covid-19, “it’s possible you may experience new or persistent symptoms months after the initial diagnosis,” said Dr. Alfonso C. Hernandez-Romieu, an infectious disease specialist with the C.D.C. who was the study’s lead author. “And it’s important for people to make sure they’re going to their clinicians,” he said, to express their concerns.“It’s equally important,” he added, “for clinicians to acknowledge that there may be these long-term effects, and to really make sure they’re validating patients, treating them with empathy, and trying to help them in the best way possible.”Clinicians need to monitor patients for Covid-19-related complications that are potentially very serious, like blood clots, he said.The study did not compare patients who tested positive for the coronavirus to patients who did not test positive, so the authors were unable to say whether people who had recovered from mild Covid-19 disease made more doctors’ visits than those who never had the virus.But two-thirds of the patients who had mild disease sought medical care a month to six months after their Covid-19 diagnoses, and about two-thirds of those who sought care were found to have an entirely new condition. The new diagnoses included cough, shortness of breath, heart rate abnormalities, chest or throat pain, and fatigue, “which likely represent ongoing Covid-19 symptoms,” the study said.Among those more likely to seek medical care were adults 50 and older, women and those with underlying health conditions. Black adults were also slightly more likely than others to seek care. But over all, the authors noted, the number of visits declined over time.The potential for long-term complications, even after a mild course of disease, underscores the need for prevention measures and vaccination, Dr. Hernandez-Romieu said.“There is a lot we don’t know about post-Covid conditions,” he said. “Even though a majority of people don’t end up with severe Covid, or end up in the hospital, the potential for long-term health effects is really important.”

Tell us how the pandemic has contributed to the guilt that you are experiencing. You may be contacted by a reporter for inclusion in an upcoming article.Have you been feeling guilty lately?For many people, this powerful emotion has become especially prevalent during the pandemic. There is guilt over surviving Covid-19 when family members or friends did not; guilt over potentially exposing other people to the virus; guilt about the distance we have had to maintain from those we care about most.The struggle to balance child care and work has been one of the most guilt-inducing aspects of the pandemic for some people. Meanwhile, others feel bad that they actually had a pretty great year. The list goes on.We want to learn more about the different kinds of guilt people are facing right now and how you are dealing with those feelings. Please use the form below to share your thoughts. A reporter may contact you about featuring your story in an article.What is causing you to have feelings of guilt and how are you coping?

As a panel of experts advising the Centers for Disease Control and Prevention discusses a handful of rare blood clots that health officials have investigated in Johnson & Johnson coronavirus vaccine recipients, a central mystery looms: How might a vaccine that has been given to nearly eight million people cause the side effect in just a few of them?There’s no clear answer yet, but Dr. Andreas Greinacher, a researcher at University Medicine Greifswald in Germany is leading one effort to find out. At a news conference on Tuesday, he said that he had reached an agreement with Johnson & Johnson to inspect the components of the vaccine to see if it can disrupt the normal blood clotting process under certain rare conditions.“We just agreed that we would like to work together,” he said.It’s possible, Dr. Greinacher said, that the Johnson & Johnson vaccine can cause rare side effects by the same process that he suspects is responsible for similar side effects from the AstraZeneca vaccine. The main ingredient in both vaccines are harmless viruses known as adenoviruses, which slip into human cells and deliver a coronavirus gene that will later trigger an immune response.On Tuesday, Dr. Greinacher and his colleagues released a report on how the AstraZeneca vaccines may trigger the side effect. The study has not yet been published in a scientific journal.The scientists found that components in the AstraZeneca vaccine can stick to a protein that platelets release during the formation of blood clots. These clumps of molecules could be seen by the body as foreign invaders, the scientists speculated, triggering a cascade of reactions that cause platelets to turn into dangerous clots.Dr. Paul A. Offit, a vaccine expert at Children’s Hospital of Philadelphia who was not involved in the study, found Dr. Greinacher’s study intriguing but far from the final word. “He throws out a lot of possibilities,” he said.Dr. Offit said it was not clear which of the many factors the researchers studied might explain the rare blood clots in people vaccinated with AstraZeneca’s doses. “It’s like sipping from a fire hose,” he said.At a news conference on Tuesday, Dr. Greinacher said that the research might point to ways, in the AstraZeneca vaccine, of lowering the risk of the clots or of treating the side effects. But he emphasized that the small risk of those side effects was strongly outweighed by the protection that vaccines such as AstraZeneca provide against Covid-19.“Not being vaccinated is far more dangerous than being vaccinated and at risk for this adverse drug reaction,” he said.