Medical Bulletin 07/ October/ 2024
Here are the top medical news for the day:
Want to Prevent Back Pain? Reduce Sitting Time
A new study from the University of Turku in Finland showed that reducing daily sitting prevented back pain from worsening over six months. The result strengthens the current understanding of the link between activity and back pain as well as the mechanisms related to back pain.
Intuitively, it is easy to think that reducing sitting would help with back pain, but previous research data is surprisingly scarce.
The study from the Turku PET Centre and UKK Institute in Finland investigated whether reducing daily sitting could prevent or relieve back pain among overweight or obese adults who spend the majority of their days sitting. The participants were able to reduce their sitting by 40 min/day, on average, during the six-month study.
"Our participants were quite normal middle-aged adults, who sat a great deal, exercised little, and had gained some extra weight. These factors not only increase the risk for cardiovascular disease but also for back pain," says Doctoral Researcher and Physiotherapist Jooa Norha from the University of Turku in Finland.
Previous results from the same and other research groups have suggested that sitting may be detrimental for back health but the data has been preliminary. The researchers also examined potential mechanisms behind the prevention of back pain.
"However, we did not observe that the changes in back pain were related to changes in the fattiness or glucose metabolism of the back muscles," Norha says.
Individuals with back pain have excessive fat deposits within the back muscles, and impaired glucose metabolism, or insulin sensitivity, can predispose to pain.
Nevertheless, back pain can be prevented or relieved even if no improvements in the muscle composition or metabolism take place.
The researchers used magnetic resonance imaging (MRI) and PET imaging that is based on a radioactive tracer to measure the back muscles.
The researchers wish to remind that switching between postures is more important than only looking for the perfect posture.
WHO Launches Global Strategic Preparedness, Readiness and Response Plan to tackle dengue and other Aedes-borne arboviruses
The World Health Organization (WHO) launched the Global Strategic Preparedness, Readiness and Response Plan (SPRP) to tackle dengue and other Aedes-borne arboviruses. The Plan aims at reducing the burden of disease, suffering and deaths from dengue and other Aedes-borne arboviral diseases such as Zika and chikungunya, by fostering a global coordinated response.
The Plan outlines priority actions to control transmission and offers recommendations to affected countries across various sectors, including disease surveillance, laboratory activities, vector control, community engagement, clinical management, and research and development, through a whole-of-society and regional approach.
An estimated four billion people are at risk of infection from arboviruses around the world, and this number is estimated to increase to 5 billion by 2050. Dengue cases have surged across all six WHO regions, and the number of cases has approximately doubled each year since 2021, with over 12.3 million cases as of the end of August this year – almost double the 6.5 million cases reported in all of 2023.
In December 2023, WHO graded the current global dengue upsurge as grade 3, the highest level of emergency for WHO, to support countries to strengthen their surveillance capacities and implement response activities.
“The rapid spread of dengue and other arboviral diseases in recent years is an alarming trend that demands a coordinated response across sectors and across borders,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “From maintaining clean environments to supporting vector control and seeking and providing timely medical care, everyone has a role to play in the fight against dengue. This plan is a roadmap to turn the tide against this disease and other Aedes-borne arboviral diseases, protect vulnerable populations and pave the way for a healthier future.”
Factors such as unplanned urbanization and poor water, sanitation and hygiene practices, climate change and international travel, are facilitating the rapid geographical spread of dengue. The disease is now endemic in more than 130 countries. Similar trends are also observed for other arboviral diseases, such as Zika, chikungunya and more recently the Oropouche virus disease. This global escalation underscores the urgent need for a robust strategy to mitigate risks and safeguard populations.
The Global Strategic Preparedness, Readiness and Response Plan comprises five key components essential for a successful outbreak response:
Emergency coordination: Establishing leadership and coordination activities;
Collaborative surveillance: Developing and using tools for early detection and control of dengue and other Aedes-borne outbreaks, including strengthened indicator and event-based surveillance, epidemiological analysis, laboratory diagnostics, and field investigations;
Community protection: Engaging communities through active dialogue and local adaptation of prevention and response measures, including mosquito population control;
Safe and scalable care: Ensuring effective clinical management and resilient health services to ensure patients can receive adequate care and prevent illness and death; and
Access to countermeasures: Promoting research and innovation for improved treatments and effective vaccines against these diseases.
The Plan will be implemented over one year until September 2025. It is aligned with the Global Vector Control Response 2017-2030, a global strategy to strengthen vector control worldwide, and the Global Arbovirus Initiative, launched in 2022, which focuses on tackling mosquito-borne arboviruses with epidemic potential.
WHO Approves First Mpox DiagnosticTest for Emergency Use, Expanding Global Reach
The World Health Organization (WHO) has listed the first mpox in vitro diagnostic (IVD) under its Emergency Use Listing (EUL) procedure, an important step in improving global access to mpox testing. The approval for emergency use of the Alinity m MPXV assay, manufactured by Abbott Molecular Inc., will be pivotal in expanding diagnostic capacity in countries facing mpox outbreaks, where the need for quick and accurate testing has risen sharply. Early diagnosis of mpox enables timely treatment and care, and control of the virus.
The presence of the monkeypox virus is confirmed by nucleic acid amplification testing (NAAT), such as real-time or conventional polymerase chain reaction (PCR), as stated in the WHO Interim Guidance on Diagnostic testing for the monkeypox virus (MPXV). And the recommended specimen type for diagnostic confirmation of monkeypox virus (MPXV) infection in suspected cases is lesion material.
The Alinity m MPXV assay is a real-time PCR test that enables detection of monkeypox virus (clade I/II) DNA from human skin lesion swabs. It is specifically designed for use by trained clinical laboratory personnel who are proficient in PCR techniques and in vitro diagnostic procedures. By detecting DNA from pustular or vesicular rash samples, laboratory and health workers can confirm suspected mpox cases efficiently and effectively.
"This first mpox diagnostic test listed under the Emergency Use Listing procedure represents a significant milestone in expanding testing availability in affected countries,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products. “Increasing access to quality-assured medical products is central to our efforts in assisting countries to contain the spread of the virus and protect their people, especially in underserved regions."
The Emergency Use Listing for Alinity m MPXV assay, allowing for its use, will remain valid as long as the Public Health Emergency of International Concern, justifying the emergency use of mpox in vitro diagnostics, is in effect.
Study Unveils Connection between Snoring and Elevated Blood Pressure: Nature Medicine
Australian research has found a link between snoring and elevated blood pressure.
According to the study, which was conducted by sleep scientists from Flinders University in South Australia, people who regularly snore at night are more likely to have elevated blood pressure and uncontrolled hypertension.
The study found that 15 percent of 12,287 participants snored for more than 20 percent of the night on average over a six-month monitoring period and that those with high snoring levels had a 3.8 mmHg higher systolic blood pressure and 4.5 mmHg higher diastolic blood pressure than participants who did not snore.
The Flinders University study was the first to use multiple night home-based monitoring technologies over a prolonged period to investigate the link between snoring and hypertension. Participants in the study were middle-aged and 88 percent were male.
"For the first time, we can objectively say that there is a significant connection between regular nighttime snoring and high blood pressure," Bastien Lechat, lead author of the research from the College of Medicine and Public Health at Flinders University, said in a media release on Wednesday.
"These results emphasize the significance of considering snoring as a factor in healthcare and treatment for sleep-related issues, especially in the context of managing hypertension."
The World Health Organization (WHO) estimates that 1.28 billion adults aged 30-79 years worldwide have hypertension and that 46 percent of adults with hypertension are unaware they have the condition.
Reference: Lechat, B., Naik, G., Appleton, S. et al. Regular snoring is associated with uncontrolled hypertension. npj Digit. Med. 7, 38 (2024). https://doi.org/10.1038/s41746-024-01026-7
WHO recommends maternal vaccine and antibody shot to prevent RSV in infants
The World Health Organization recommended vaccinating pregnant women and administering infants with an antibody to prevent severe respiratory synctial virus (RSV) infection in newborns.
Respiratory synctial virus, which typically causes cold-like symptoms, is a leading cause of severe infection and death in babies and older adults. A majority of respiratory synctial virus -related deaths occur in low- and middle-income countries, with about 101,400 annual deaths in children under the age of five, according to the WHO.
WHO recommended a single shot for pregnant women, in the third trimester that typically starts at 28 weeks, to protect their babies.
Pfizer's respiratory synctial virus shot, opens new tab respiratory synctial virus shot, sold as Abrysvo, is the only available vaccine in the United States and Europe for use in pregnant women. It is also approved in a few other markets such as Japan and Canada.
For infants and toddlers, Sanofi and AstraZeneca's antibody, Beyfortus, is again the only approved shot in the U.S., United Kingdom and some other countries - but its supply has been limited.
The manufacturers recently received approval for an additional manufacturing line for Beyfortus from the U.S. Food and Drug Administration. WHO's strategic advisory group noted the concerns around supply and the high cost of the antibody, which it said could seriously limit global access and equity for the treatment.
"We are looking forward to more products to enter the market to allow for global access and increase the equity to use these products," said Hanna Nohynek, chair of WHO's strategic advisory group on immunizations.
This time WHO's advisory group focused on children, Nohynek said, adding that it had received requests from several countries about recommendations for the elderly.
WHO executive Joachim Hombach said there were challenges to implement recommendations for older adults, as many countries did not have vaccination programs in place for that age group.
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