Chuckles of the Day





Social Security Sign-up

After retiring, Kent went to the local office to apply for Social Security. The clerk asked him for his driver’s license to verify his age. He looked in his pockets and realized he had left his wallet at home. He told the woman that he was very sorry.

In lieu of his going home and coming back later, the clerk said, “Unbutton your shirt.” So he opened his shirt, revealing his curly silver hair. The clerk said, “That silver hair on your chest is proof enough for me,” and she processed his Social Security application.

When Kent got home, he excitedly told his wife about the experience at the Social Security office. His wife replied. “You should have taken off the rest of your clothes. From what I see, you might have gotten disability, too.”

* * * * * * *

Hearing Problems

Three retirees, each with a hearing loss, were playing golf one fine March day. One remarked to the other, “Windy, isn’t it?”

“No,” the second man replied, “it’s Thursday.”

And the third man chimed in, “So am I. Let’s have a beer.”





What Are Researchers Doing to Stop Dementia?

Laura Williamson wrote . . . . . . . . .

They are words nobody wants to hear: Alzheimer’s disease and dementia. As the population ages, a growing number of older adults gradually lose cherished memories and the ability to think and, ultimately, to perform even the most basic functions of daily living.

Researchers say dementias are so varied and complex, there remain more questions than answers when it comes to how to thwart them.

“This is a condition with multiple pathologies,” said Cynthia Lemere, immediate past chair of the medical and scientific advisory group of the Alzheimer’s Association. “There’s a lot of research going on right now.”

While there are many causes of dementias, much of the research revolves around Alzheimer’s, which accounts for 60%-70% of all cases. According to the Alzheimer’s Association, more than 6.2 million people are living with Alzheimer’s disease, a number expected to double by 2050.

The federal government spends about $3.1 billion annually on Alzheimer’s research. Another $250 million comes from the Alzheimer’s Association, and last year the American Heart Association announced a joint brain health research project with Bill Gates, as well as support for a global networking effort among research centers to accelerate early detection and treatment of Alzheimer’s and related dementias.

Many drugs are being tested. Some work by going after what is considered one of the hallmarks of the disease – beta-amyloid protein. When this protein builds up in the brain, it clumps together to form plaques that stick in between nerve cells, interfering with the cells’ ability to communicate.

Lemere, an associate professor of neurology in the Ann Romney Center for Neurologic Diseases at Brigham and Women’s Hospital and Harvard Medical School in Boston, has spent the past two decades working on an Alzheimer’s vaccine and antibodies that would attack amyloid plaques.

While trials have shown some potential, it has been difficult to get sufficient amounts of antibodies to cross the blood-brain barrier, she said. Nonetheless, “there are three or four drugs in this class coming down the pipeline that look promising.” A drug that targets amyloid plaque received conditional approval from the Food and Drug Administration this summer and requires further testing to verify its benefits.

A newer area of investigation focuses on drugs to stop the spread of a protein called tau, needed to stabilize the structure of nerve cells. In the brains of people with Alzheimer’s disease, tau changes its structure and aggregates inside the cells, causing tangles to form. The tangles block nutrients and any communication from moving through the cells, which eventually die. That’s when symptoms appear.

“Alzheimer’s disease doesn’t start when you begin to see memory loss. It starts 15-25 years earlier, when these plaques and tangles are forming,” Lemere said. “When you have them both for a long period of time, neurodegeneration starts.”

So far, researchers have seen the best results with patients who are in the earliest stages of Alzheimer’s, Lemere said. “Previous clinical trials have shown that these drugs do not work well for people with moderate to severe Alzheimer’s disease. If someone has already lost 40% of their hippocampal neurons, clearing plaque won’t bring those back. That’s why we still need to continue to find ways to help those in later stages of the disease.”

What’s causing beta-amyloid to accumulate in the first place remains unclear. Some believe it may be an immune system response to viral infections, such as herpes, and may even be linked to the bacteria in gum disease.

“It turns out that amyloid plays a role in protecting the brain from infection,” said Dr. Mitchell Elkind, immediate past president of the American Heart Association. He is a professor of neurology and epidemiology at Columbia University Irving Medical Center in New York City.

When an infection attacks the brain, beta-amyloid may be overproduced as part of an immune response, he said. One avenue of investigation hypothesizes that anti-viral agents could therefore prevent Alzheimer’s or slow progression of the disease based on the theory that “if we eliminate the inciting insult of the infection, perhaps we can decrease the amount of amyloid. That’s an exciting possibility.”

Studying COVID-19 may help, Elkind said. “For those of us interested in the concept that infections may worsen dementia, COVID provides a great model because there is so much of it around. It can help us answer the question of whether a virus can cause long-term cognitive decline. We don’t know yet.”

When viruses and bacteria activate the immune system, they also produce inflammation, which researchers believe contributes to plaque development.

“Inflammation is a hot button now for Alzheimer’s disease research,” Elkind said. Investigators are exploring whether anti-inflammatory agents can be used to ward off symptoms.

Lemere said she believes the most promising approach may be combinations of drugs that help the immune cells in the brain do their job while tamping down inflammation.

“That is going to be the wave of the future,” she said. “Maybe an anti-inflammatory agent with a tau antibody to prevent the downstream neurodegeneration.”

But even if researchers succeed in developing drugs that clear the brain of amyloid plaques and tau tangles, it won’t stop other forms of dementia, said Dr. Mary Sano, director of the Alzheimer’s Disease Research Center at Mount Sinai Health System in New York City.

About 10% of dementias are vascular – they’re linked to strokes or issues with poor blood flow to the brain. Others have mixed dementia, which can be a combination of Alzheimer’s, vascular and other less common types of dementia.

Sano’s center works with people who often develop dementias related to Type 2 diabetes and heart disease risk factors, such as high blood pressure, and these “have a very different profile of cognitive deficits.” For example, people with diabetes begin with greater problems with executive functions, such as the ability to plan and organize. Memory may be less impaired.

Lifestyle behaviors remain an important avenue for preventing vascular dementia, she said. Controlling blood pressure, cholesterol and blood sugar levels and making other lifestyle changes, such as quitting smoking, exercising, eating a nutritious diet and losing weight – metrics the AHA has dubbed Life’s Simple 7 – all have been shown to help maintain good brain health as people age.

This has to start early, Elkind said. “It’s not your blood pressure in your 70s and 80s that causes dementia, but what it was in your 40s and 50s.”

One of the best things people can do is exercise, Lemere said. “It promotes cardiovascular health, which is related to brain health. It’s anti-inflammatory and it promotes better sleep. Lack of sleep is a risk factor for Alzheimer’s disease, and exercise is one of the biggest ways people can stave off or reduce their risk for dementia.”

Source: American Heart Association

Pork Shoulder Doughnut of From The Ashes BBQ in London, U.K.

Features handmade doughnut, chili jam, bbq sauce, smoked pork shoulder and a dusting of crackling.

The price is £8.

COVID-19 Booster Shots Alone Might Not Stop Delta and Other Variants

Frank Diamond wrote . . . . . . . . .

Recently booster shots were approved—and are now available—to people with compromised immune systems, thanks to action taken by the Food and Drug Administration and the Centers for Disease Control and Prevention as evidence mounts that the efficacy of COVID-19 vaccines wane over time.

This week, plans are in the works to offer booster shots come October to other higher-risk populations in the United States, including infection preventionists and other health care professionals, residents in nursing homes, and Americans aged 60 or older. In other words, the booster shots will be offered in more or less the same order in which the original vaccines were distributed.

But as Sakia V Popescu, PhD, MPH, MA, CIC, a member of Infection Control Today®’s (ICT®’s) Editorial Advisory Board (EAB) wrote in the December 2020 issue of ICT®, effective infection prevention and control should follow the Swiss cheese model championed by virologist Ian Mackay, PhD. Popescu wrote: “In one succinct image, this captures what we do in infection prevention—stress the additive layers that are needed to reduce the spread of infection. From masking to government messaging and vaccines, these layers all work cohesively to reduce the risk of not only COVID-19 infection, but also transmission. Really, this is a concept we have been reinforcing and growing in the field of infection prevention—a wholistic approach to disease prevention.”

Talk about booster shots over the weekend grabbed headlines. Francis Collins, MD, PhD, the director of the National Institutes of Health, said of the delta virus that “this is going very steeply upward with no signs of having peaked out,” according to the Associated Press (AP). The US saw an average of 129,000 new infections a day over the last seven days, according to the Johns Hopkins Coronavirus Resource Center. That’s a 700% increase from the beginning of July and the number could rise to 200,000, which has not been seen since the January/February surge.

Thanks to the vaccines, we will not see the horrendous death rates of those surges. But as ICT® EAB member Kevin Kavanagh, MD, has argued for over year, mortality isn’t the only metric that needs to be taken into account. For instance, medical experts still don’t know exactly what the long-term effects of COVID-19 are. In a recent interview with ICT®, Kavanagh pointed out that “COVID-19 is not just respiratory, it affects every organ of the body. This is a serious type of infection. And we need to be focusing on trying to keep this virus from spreading, plus protecting our young.”

Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases and President Biden’s chief medical advisor, said that “if it turns out as the data come in, we see we do need to give an additional dose to people in nursing homes, actually, or people who are elderly, we will be absolutely prepared to do that very quickly.

But that won’t be enough, Kavanagh argues in an article scheduled to be printed in an upcoming issue of ICT®.

“SARS-CoV-2 has continued to evolve,” Kavanagh writes. “It has now become evident that with each emerging variant, the virus has appeared to progressively become more infective. Variants which increase viral load may also increase transmissibility and the opportunity to mutate, along with overwhelming a host’s immune system and becoming more virulent.” And there seems to be wave after wave of variants.

Kavanagh adds that “to make matters worse, SARS-CoV-2 is infecting a number of animals, including cats, large cats, dogs and gorillas. Most recently, concern has been raised that it may have found an animal host in white tail deer, with SARS-CoV-2 antibodies identified in 40% of surveyed animals.”

Peter Hotez, MD, PhD, professor of the departments of pediatrics, molecular virology & microbiology and health policy scholar at Baylor College of Medicine, tells ICT®’s sister publication Contagion that recent data has indeed suggested that COVID-19 vaccine-induced immunity from infection is “not as high as it was.” It remains unclear whether that is due to waning immunity or decreased vaccine effectiveness versus the delta variant—a matter which is difficult to discern because the delta outbreak is occurring well into the post-vaccination phase for most adults in the US.

“Right now, the data are showing that the protective efficacy against hospitalization and deaths are holding, but the question is will that start to slip over time as well, and at what point do we pull the trigger?” Hotez said. “And how generalizable do we make it—do we keep it restricted over a certain age, are there other criteria, or do we just open it up the whole population?”

Kavanagh has always said that COVID-19 vaccines alone are not a panacea in stopping the pandemic. And although booster shots are crucially important, one should also not rely on booster shots alone, either.

There must be a multi-pronged approach to COVID-19 if we have any hope of returning to our pre-COVID normal lives, Kavanagh writes in his article. That includes:

  • Upgrade recommendations for mask usage and to use N95 or KN95 masks whenever possible.
  • Everyone who can needs to become vaccinated. Similar to Israel, we should fast track approval for mRNA boosters to those who are at higher risk, including those who are immunosuppressed and over the age of 60 and 5 months out from vaccination.
  • Upgrade building ventilation systems to increase air exchanges and air sanitization.
  • Expand testing capabilities to be able to test frontline workers and school children at least twice a week, and other workers at least once a week.
  • Limiting sizes of gatherings, including podding in schools and plans for permanent hybrid instruction to limit class sizes.
  • Businesses, including restaurants, need to offer online ordering along with curbside pickup and when possible, home delivery.
  • Everyone needs to be vaccinated. Mandatory vaccines should be required in many settings, including health care. Vaccine passports or green cards are being implemented in Israel and France and need to be implemented in the United States.

    Source : Infection Control Today

Coriander and Garlic Pork

Ingredients

4 (6 oz) pork cutlets
1 lb baby/chat (new) potatoes, sliced
2 green onions, sliced
1/4 cup mint leaves, chopped
rocket (arugula) leaves, to serve

Coriander Marinade

1 cup chopped coriander leaves
4 cloves garlic, crushed
sea salt and cracked black pepper
2/3 cup olive oil

Method

  1. Place the coriander marinade ingredients in a bowl and stir to combine.
  2. Place the pork and half of the coriander marinade in a bowl and toss to coat. Allow to stand for 10 minutes.
  3. Place the potatoes in a large saucepan of salted cold water. Bring to the boil and cook for 10-12 minutes or until tender when tested with a skewer. Drain and return to the saucepan.
  4. Add the remaining coriander marinade, mint and green onions and toss to combine. Set aside and keep warm.
  5. Heat a large non-stick frying pan over medium heat. Add the pork, cover with a tight-fitting lid and cook for 3-4 minutes each side or until cooked to your liking.
  6. Serve with the potatoes and rocket.

Makes 4 servings.

Source: Beef, lamb + Pork


Today’s Comic