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dog

Mysterious Dog Respiratory Illness: What We Know And How To Protect Your Canine Companions

Dog owners throughout the US are worried about their furry friend’s health after a new mysterious respiratory illness has begun making dogs sick. Here’s what we know about this new bacterial infection.

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HV.1, The New Covid-19 Variant Spreading Throughout The US 

A new Covid-19 variant is dominating the cases in the US, with another version of the coronavirus already spreading overseas. 

Kelly Oakeson, the chief scientist for next generation sequencing and bioinformatics for the Utah Department of Health and Human services, stated that “virus evolution is what we’re seeing in real time,” according to Deseret News

HV.1 is the variant currently the most prevalent in the US. “The variant is just getting better at getting into our cells. It’s better at making us sick. It’s better at doing what viruses do,” Oakeson said. 

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“The variant hasn’t yet reached dominant status in Utah but should soon, since the state tends to lag about two weeks behind the national variant proportions estimated by the Centers for Disease Control and Prevention,” he said. 

When it comes to what citizens in Utah, where the variant is quite prominent, should know about HV.1, Oakeson stated that “it’s more infectious.” 

“It can definitely infect more people. That’s why we’re seeing it increase in prevalence in the population. The symptoms seem to be the same. The severity seems to be the same as EG.5. I wouldn’t call it severe but I wouldn’t call it mild.”

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“Mild seems to instill in people’s minds, ‘Oh, it’s nothing at all. I don’t have to worry about it. it’s not going to cause any serious effects.’ People are still dying from this, I wouldn’t call that mild. People are still getting long COVID from EG.5 or HV.1. I wouldn’t call that mild,” he explained. 

“People are still ending up in the hospital with this. I wouldn’t call that mild. COVID-19 could kill them … (or) they could get it, have a runny nose, and be fine. There’s a huge dynamic range there of symptoms and severity.”

“If it was happening in the summertime, it might have less of an impact on everything. But now that it’s happening in the fall/winter … people are indoors, it’s getting colder outside. There’s more holidays. 

You’re probably going to see an increase in cases for sure. Is that driven by HV.1? Is that driven solely by the seasonality, what time of year it is? No, it’s probably a combination of all of those things. … We’ve seen this now, year after year,” he explained.

brain

Software Program Powered by Artificial Intelligence May Revolutionize Treatment of Aneurysms

A medical software program powered by artificial intelligence called PreSize can potentially revolutionize the treatment of brain aneurysms. Scientists found that PreSize outperformed experienced neurosurgeons at predicting where to place a treatment stent in a patient’s brain.

Weakness in an artery wall typically causes aneurysms, which, if discovered before rupturing, can be medically monitored or surgically closed with a tiny metal clip. Brain aneurysms are more common in people over the age of 40 but can occur at any age.

Alternatively, a flexible mesh tube of metal called a stent can be implanted inside the artery via catheter insertion guided by X-ray imaging. These stents typically utilize shape memory alloys, which spring open upon being unsheathed.

Researchers analyzed data from previous brain aneurysm operations, during which a “multitude” of different stents were used, to better understand the devices’ behavior under different conditions.

Dr Katerina Spranger, founder and chief executive of the company that developed the software, Oxford Heartbeat, told the UK’s PA news agency that the placement of the device is critical during treatment.

“It’s extremely important to get the device correct, in terms of the correct size and also correct implantation. Currently, the way they do it, there is a lot of guesswork involved.”

According to Dr. Spranger, there is a high risk of complications from these complex devices, the most common of which are blood clots, which can lead to strokes.

“If the device is, for example, undersized, it can detach from the blood vessels and start traveling around the circulatory system of the body, which is huge complication. Or if it’s oversized, it can almost rupture the vessel.”

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PreSize provides doctors with a reconstructed image of a patient’s brain and a catalog of digital device replicas that mimic the behavior of various stents.

“This is another key to the complexity of the problem because all those devices are very different. Each manufacturer has their own proprietary technology. In the virtual environment, the algorithms put the two together – the complex anatomy of the patient and mechanics of the device. It can predict what’s going to happen if you put a particular device into a particular location.”

The PreSize platform allows clinicians to load a patient’s scan and test out different devices right inside the operating room to determine which will be most effective.

“We do a lot of research, a lot of experiments, to make sure that the digital twins actually correspond to the actual device’s behavior. We designed it so that it’s extremely intuitive and extremely accurate. Fit for a high-stress surgical environment because the patient is usually already on the table.”

According to Dr. Spranger, the best device can be determined in just three minutes using PreSize instead of the usual 10-15 minutes.

“A fraction of a millimeter can make or break a surgery. We knew that for a software to be successful in such a high-stress environment, it has to be super easy. We designed it so that it can be used without even any training. They get real-time feedback. For example, if they want to try another device, reposition the device, elongate the device, choose another – it immediately reacts and immediately tells them ‘this is how it’s going to look.’”

Dr. Spranger predicts that the use of software in the medical field will soon become a “standard of care” due to its high accuracy, marking it as “a medical device of a new generation.”

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According to The Independent, 375 people have had procedures using PreSize. Seven hospitals across England, Scotland, Germany, Finland, and Ukraine have been taking advantage of the new technology.

PreSize was found to be more accurate than human clinicians at predicting where a stent will “land” in the brain, according to research published in the BMJ Journal of Neurointerventional Surgery.

In the study, eight neurointerventionalists were given 3D images and data showing a stent’s initial landing location for 51 cases.

The medics were given the stent’s origin and instructed to plot its course as they usually would, using the information provided and the stent’s dimensions to make an educated guess as to where it would ultimately land.

PreSize could predict its final landing location with a 95% accuracy rate, while the neurointerventionalists had an 81% accuracy rate.

England’s healthcare system is currently using AI to help clinicians read scans and X-rays to speed up diagnoses and decision-making on treatments. However, Dr. Spranger recommends “rigorous testing” before deploying new systems.

“AI has the potential to revolutionize healthcare, but before we adopt it, we must rigorously test new systems. Medical device software companies like ours should be held to account to address any distrust about AI.”

chemo

US Cancer Centers Are Experiencing Ongoing Widespread Shortages Of Chemotherapy Drugs, According To Survey 

According to a survey released last week by the National Comprehensive Cancer Network, among 29 cancer centers across America, 72% have reported a shortage of carboplatin, a chemotherapy medication. Additionally, 59% have been experiencing a shortage of the drug cisplatin. 

Of all the centers involved in the survey, 86% reported a shortage of at least one kind of anti-cancer or chemotherapy drug. 

This specific survey from the network is an updated version of their survey May in which they found that 93% of the respondents reported a shortage of carboplatin with 70% reporting a shortage of cisplatin. The updated survey was conducted between September 6th to the 20th and took data from 29 of the 33 institutions within the cancer network. 

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“Cisplatin and other similar platinum-based drugs are prescribed for an estimated 10% to 20% of all cancer patients,” according to the National Cancer Institute.

According to the American Association for Cancer Research, several cancer medications have been experiencing shortages within the past few years, with record breaking shortages occurring this year. 

In September, The White House released a report that stated the US has a shortage of 15 cancer drugs. Cisplatin, carboplatin and methotrexate are three of the more generic medications for cancer treatments that have been used for decades. In the report, the White House stated these shortages are mainly due to manufacturing and supply chain issues. 

“Everyone with cancer should have access to the best possible treatment according to the latest evidence and expert consensus guidelines,” Dr. Robert Carlson, CEO of the National Comprehensive Cancer Network, said.

“Drug shortages aren’t new, but the widespread impact makes this one particularly alarming. It is extremely concerning that this situation continues despite significant attention and effort over the past few months. We need enduring solutions in order to safeguard people with cancer and address any disparities in care.”

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Dr. William Dahut, the chief scientific officer for the American Cancer Society, stated that carboplatin and cisplatin are known as “core drugs for treating cancer.” 

“The manufacturing side is really the aspect that’s most important to get this right,” he said, as reported by CNN.

“Should there be some drugs in reserve? Should there be the ability to look at supply chains or economic issues? But who actually would enforce those? Who would pay for those? How would that work? I think that needs to be worked out. But I do think a short-term, medium-term and long-term philosophy is needed, as opposed to moving from crisis to crisis,” Dahut stated. 

The centers also stated that several other cancer medications are in short supply; 66% reported a shortage of methotrexate, a chemotherapy drug, 55% experienced a shortage of 5-fluorouracil, 45% for chemotherapy fludarabine, and 41% for hydrocortisone. 

“These drug shortages are the result of decades of systemic challenges,” Alyssa Schatz, the network’s senior director of policy and advocacy, said according to CNN..

“We recognize that comprehensive solutions take time and we appreciate everyone who has put forth proposals to improve investment in generics and our data infrastructure. At the same time, we have to acknowledge that the cancer drug shortage has been ongoing for months, which is unacceptable for anyone impacted by cancer today. These new survey results remind us that we are still in an ongoing crisis and must respond with appropriate urgency,” Schatz said.

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Getting Your Next Covid-19 Vaccine, With Or Without Insurance

Federal authorities are urging Americans to get the new Covid-19 vaccine, and to reach out to their insurers if they’re having issues getting the shot for free, as it’s been made available for no cost to any American citizen.

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Narcan Now Made Available Over-The-Counter Nationwide

Narcan is now available over-the-counter nationwide in the US. Prior to the approval of this move from the US Food and Drug Administration, Naloxone, the technical name for Narcan, was prescription-only and given out by specific organizations.

Now, anyone in the US can go to their local pharmacy and pay $44.99 for two doses of Narcan. 

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Dr. Susan Bissett, the president of the West Virginia Drug Intervention Institute, stated on the matter: “That’s a very positive thing. It’s better to not need it and have it than to need it and not have it.” 

This announcement was also made during overdose awareness week, and according to the Drug Enforcement Administration, fentanyl is being found more and more in fake prescription pills across the country. In fact, six out of 10 pills containing fentanyl had a lethal dose of the synthetic opioid when tested by the DEA. 

“We have a generation of people that are much more vulnerable to an overdose, and we might not think about them being vulnerable because they’re not in active use,” Bissett said. 

“It could be a student, for example, on a college campus who says I’m gonna take this Adderall that someone gave me because I need to stay up all night and cram for this exam, and what they don’t know is that Adderall might be laced with fentanyl and that could cause an overdose.” 

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Public health experts are worried that the price point is too high, however, many organizations are working to make the price as accessible as possible. Specifically, the West Virginia Drug Intervention Institute, according to Bissett. 

“It’s almost like it’s another tool in the toolkit in the fight against overdose,” she stated.

She also discussed how the nonprofit organization is already supplying college campuses and libraries with ONEBox; an emergency kit that contains the Naloxone and a one minute video where former fire chief Jan Rader explains how to use and administer it. 

“We’re going to continue to do this work and make sure that Naloxone is in proximity of anywhere an overdose may occur. We’re really focused on that work,” Bissett said. 

“We’re thrilled about it going over the counter but we also know we are going to have to continue with the one box and community distribution as well.”

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Covid-19 Is Still A Part Of Our Reality: How The Virus And Our Immunity Has Changed

According to the US Centers for Disease Control and Prevention, 97% of people in the US have some level of immunity against Covid-19 through vaccination, infection, or both. Covid-19 infections are now on the rise again, and with the government slowing down on health and safety measures since the public health emergency was declared over in May, many individuals are wondering what to do as we enter this next wave of infections.

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US Experts Warn Of New Covid Variant, Eris

This summer in the US, a new Covid-19 variant has become the dominant strain currently spreading throughout the nation, according to infectious disease experts. Experts are warning Americans to remain diligent about their Covid-19 safety procedures and vaccine boosters to keep themselves protected from this spike. 

The technical name of this strain is EG.51, a subvariant of Omicron also referred to as Eris. The Eris variant is currently the leading strain of the virus, accounting for about 17% of Covid cases in the US, according to the Centers for Disease Control and Prevention.

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Experts state that the rise in infection and hospitalizations do not indicate a need for health and safety measures to be mandated, however, the new variant is a part of a potential evolution of the virus, so it’s important for people to protect themselves. 

​​“As this virus continues to circulate, the potential for mutations to occur remains, and so we will see new genetic variants. It’s very often the case when we see new genetic variants that they may increase in circulation. Sometimes they replace the variants that came before; sometimes they just kind of burn themselves out,”  said Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University School of Public Health.

People should continue to take Covid-19 tests if they feel sick, and stay diligent about monitoring virus data, especially if they’re in a vulnerable immunocompromised position. 

“We do need to continue to keep our eye out and be cautious for something that is truly like a new pandemic strain, which EG.5.1 is not,” said Justin Lessler, an epidemiology professor at the University of North Carolina.

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“The biggest concern that we have right now is that testing is not nearly what it was in many, many countries, including the United States,” Nuzzo said. This means it’s more difficult to track trends in the virus. 

“Even if there is a high percentage of test positivity, it’s unclear whether it’s because the only people getting tested right now are people who are really quite ill and know very well that they have Covid, versus maybe in the past people getting tested were people who needed a negative test before they could play sports or go to camp. That meant that we were sampling a larger portion of the population,” Nuzzo said

“Public health agencies rely on wastewater testing, which allows them to see the amount of Covid and what variants are in that concentration. But it’s harder for people collecting that data to determine whether that means people are getting sicker or whether a person who is infected is infecting more people on a per-person basis,” Nuzzo said.

“We can’t link the wastewater data to people. It’s totally anonymous. If the variant is a problem, we will see it, but the question is: how early will we see it? I don’t think there is this hidden severe wave,” Nuzzo added.

“Also, as the fall virus season approaches – meaning a likely uptick in Covid, flu and RSV cases – it’s important for healthcare workers to conduct tests in places with inadequate healthcare infrastructure, such as rural areas and low-income communities,” Nuzzo said.

According to the CDC, there were around 9,000 Covid-19 hospitalizations during the last week of July, marking a 28% increase from June.

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Cases of Leprosy Spike in Central Florida

The U.S. Centers for Disease Control and Prevention (CDC) has reported an increase in leprosy cases across Central Florida. Growing evidence suggests that the region has become an “endemic location for leprosy,” accounting for one-fifth of all cases nationwide.

The report released by the CDC states the most recent data shows there were 159 new cases of leprosy across the country in 2020, significantly lower than the 216 reported in 2019. However, the number of cases in Southeastern United States has more than doubled over the last decade.

“Central Florida, in particular, accounted for 81% of cases reported in Florida and almost one-fifth of nationally reported cases. Whereas leprosy in the United States previously affected persons who had immigrated from leprosy-endemic areas, ≈34% of new case-patients during 2015–2020 appeared to have locally acquired the disease.”

According to the federal Human Resources and Services Administration (HRSA), most new cases have been found in Florida, California, Louisiana, Hawaii, New York and Texas. However, a travel advisory for Central Florida is included in the report due to a disproportional uptick in cases in the region. In the last year alone, the Florida Department of Health reported 19 cases.

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“Travel to this area, even in the absence of other risk factors, should prompt consideration of leprosy in the appropriate clinical context. By increasing local physician efforts to report incidence and supporting further research to assess routes of transmission, a congruent effort can be made to identify and reduce spread of the disease.”

The HRSA states, “95% of the human population is not susceptible to infection with M. leprae, the bacteria that causes Hansen’s disease (leprosy).” Treatment with antibiotic drugs is very effective in combating the disease, but an early diagnosis is critical.

Without treatment, leprosy can damage nerves and lead to permanent disabilities, but early treatment can prevent this. In the absence of nerve involvement, the HRSA states leprosy would only present as a “minor skin disease.”

Leprosy is spread through droplets “from the nose and mouth during close and frequent contact with untreated cases.” The CDC states that though uncommon, leprosy can also be contracted via contact between humans and armadillos.

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“In the Southern United States, some armadillos are naturally infected with the bacteria that cause Hansen’s disease in people, and it may be possible that they can spread it to people. However, the risk is very low, and most people who come into contact with armadillos are unlikely to get Hansen’s disease.”

Still, the HRSA advises that armadillos are “wild animals and should be treated as such, with all the proper precautions.” In the report, the CDC cited a recent case of a 54-year-old man who contracted the disease in Central Florida. The man “denied any domestic or foreign travel, exposure to armadillos, prolonged contact with immigrants from leprosy-endemic countries, or connections with someone known to have leprosy.”

He is described as having resided in Florida his entire life, working in landscaping and spending long periods of time outdoors.

“The absence of traditional risk factors in many recent cases of leprosy in Florida, coupled with the high proportion of residents, like our patient, who spend a great deal of time outdoors, supports the investigation into environmental reservoirs as a potential source of transmission.”

Dr. Jason S. Litzinger Nurse

Breaking Barriers and Bridging Gaps: A Nurse’s Journey to the Frontlines of Rural Healthcare | Dr. Jason S. Litzinger, DNP, APRN, FNP-BC

In the bustling corridors of our healthcare institutions, amid the beeping monitors and hurried footsteps, there exists a field of dedicated professionals who possess an unwavering love for their vocation: the nurses. Standing out among these compassionate caregivers is Dr. Jason S. Litzinger, DNP, APRN, FNP-BC —a nurse who not only ardently serves the needs of patients but also holds an unshakable reverence for the nursing profession in the face of its continuing challenges and impending shortages.