First-of-Its Kind Guideline on Lipid Monitoring in Endocrine Diseases

Endocrine diseases of any type — not just diabetes — can represent a cardiovascular risk and patients with those disorders should be screened for high cholesterol, according to a new clinical practice guideline from the Endocrine Society.

“The simple recommendation to check a lipid panel in patients with endocrine diseases and calculate cardiovascular risk may be practice changing because that is not done routinely,” Connie Newman, MD, chair of the Endocrine Society committee that developed the guideline, told Medscape Medical News.

“Usually the focus is on assessment and treatment of the endocrine disease, rather than on assessment and treatment of atherosclerotic cardiovascular disease risk,” said Newman, an adjunct professor of medicine in the Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, at the New York University Grossman School of Medicine in New York City.

Whereas diabetes, well-known for its increased cardiovascular risk profile, is commonly addressed in other cardiovascular and cholesterol practice management guidelines, the array of other endocrine diseases are not typically included.

“This guideline is the first of its kind,” Newman said.

“The Endocrine Society has not previously issued a guideline on lipid management in endocrine disorders (and) other organizations have not written guidelines on this topic.” 

“Rather, guidelines have been written on cholesterol management, but these do not describe cholesterol management in patients with endocrine diseases such as thyroid disease (hypothyroidism and hyperthyroidism), Cushing’s syndrome, acromegaly, growth hormone deficiency, menopause, male hypogonadism, and obesity,” she noted.

But these conditions carry a host of cardiovascular risk factors that may require careful monitoring and management.

“Although endocrine hormones, such as thyroid hormone, cortisol, estrogen, testosterone, growth hormone, and insulin, affect pathways for lipid metabolism, physicians lack guidance on lipid abnormalities, cardiovascular risk, and treatment to reduce lipids and cardiovascular risk in patients with endocrine diseases,” she explained.

Vinaya Simha, MD, an internal medicine specialist at the Mayo Clinic, in Rochester, Minnesota, agrees that the guideline is notable in addressing an unmet need.

Recommendations that stand out to Simha include the suggestion of adding eicosapentaenoic acid (EPA) ethyl ester to reduce the risk of cardiovascular disease in adults with diabetes or atherosclerotic cardiovascular disease who have elevated triglyceride levels despite statin treatment.

James L. Rosenzweig, MD, an endocrinologist at Hebrew SeniorLife, in Boston, Massachusetts, agrees this is an important addition to an area that needs more guidance.

“Many of these clinical situations can exacerbate dyslipidemia and some also increase the cardiovascular risk to a greater extent in combination with elevated cholesterol and/or triglycerides,” he told Medscape Medical News

“In many cases, treatment of the underlying disorder appropriately can have an important impact in resolving the lipid disorder. In others, more aggressive pharmacological treatment is indicated,” he said.

“I think that this will be a valuable resource, especially for endocrinologists, but it can be used as well by providers in other disciplines.”  

Key Recommendations for Different Endocrine Conditions

The guideline, published in the Journal of Clinical Endocrinology & Metabolism, details those risks and provides evidence-based recommendations on their

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Dubai launches new dedicated centre for treating infectious diseases



a group of people in a room: Hospitality Care Centre Dubai Healthcare Authority


© Motivate Publishing
Hospitality Care Centre Dubai Healthcare Authority

The Dubai Health Authority (DHA) has inaugurated a Hospitality Care Centre dedicated to the treatment of infectious diseases, including Covid-19.

The specialised facility is located in the Dubai Industrial Zone and has 170 rooms spread across of three floors.

The state-of-the art centre includes clinics, pharmacy, laboratory, radiology and follow-up services.

It is operational 24×7 and has already begun receiving Covid-19 cases. There are 88 rooms dedicated for treatment of Covid-19 patients.

Patients will be treated under the supervision of staff from Rashid Hospital, since the centre is directly affiliated with the hospital.

Humaid Al Qutami, director-general of the DHA said that the authority had worked towards increasing the capacity of its medical facilities, in anticipation of any developments.

He added that the objective is for the facility in the future to become an international centre specialised in treating communicable diseases, providing highly advanced laboratory for radiology and diagnostic tests, and serving as unit for epidemiological research and studies.

Earlier this month, the authority launched three new dedicated Covid-19 testing facilities in the emirate at Al Rashidiya Majlis, Al Hamriya Port Majlis and Jumeirah 1 Port Majlis, in collaboration with the Community Development Authority Dubai.

Read: DHA opens three new Covid-19 testing facilities in Dubai

It takes the number of DHA centres exclusively for Covid-19 testing up to five – which includes those already opened at Al Shabab Al-Ahli and Al Nasr Clubs.

On Tuesday, the UAE reported 1,390 new cases, 1,708 recoveries and two deaths in the last 24 hours. The registered infection count has therefore risen to 127,624.

Read: Covid-19 update: UAE reports 1,390 cases; 466 infections registered in Oman

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Goldfinch Bio Presents Clinical Data from Phase 1 Trial Supporting Advancement of GFB-887 as a Precision Medicine for Patients with Kidney Diseases

CAMBRIDGE, Mass.–(BUSINESS WIRE)–Goldfinch Bio, a clinical stage biotechnology company focused on discovering and developing precision medicines for the treatment of kidney diseases, today announced for the first time results from its Phase 1 clinical trial evaluating GFB-887, a first-in-class highly potent and selective inhibitor of Transient Receptor Potential Canonical Channel 5 (TRPC5), in healthy volunteers. The data are being presented today at the virtual American Society of Nephrology (ASN) Kidney Week 2020 Annual Meeting.

Goldfinch Bio is developing GFB-887 as a precision medicine for patients with kidney diseases characterized by overactivation of the TRPC5-Rac1 pathway, including focal segmental glomerulosclerosis (FSGS) and diabetic nephropathy (DN). Overactivation of the TRPC5-Rac1 pathway leads to injury of podocytes, which are cells lining the kidney that, in their healthy state, prevent essential protein loss (proteinuria). Injury to podocytes causes podocyte loss, proteinuria and, eventually, kidney failure. TRPC5-Rac1 pathway overactivation is the key cause of disease in a substantial portion of FSGS and DN patients, and there are currently no approved drugs that specifically target the TRPC5-Rac1 pathway in these diseases.

“We are excited to share these first-in-human data, which demonstrate that GFB-887 is well-tolerated and suggest a dose-dependent reduction in urinary Rac1, confirming GFB-887 target engagement in the podocyte,” said Anthony Johnson, M.D., President and Chief Executive Officer of Goldfinch Bio. “Suppressing the TRPC5-Rac1 pathway has the potential to deliver clinically meaningful benefit to patients by reducing proteinuria and, as a result, preserving native kidney function. Supported by the Phase 1 data, we are now underway with our Phase 2 TRACTION-2 study of GFB-887 in FSGS and DN, as we continue to advance our mission of protecting patients from the inevitability of dialysis and kidney transplant by delivering precision medicines for subsets of kidney disease.”

Data from the Phase 1 Clinical Trial

The primary objective of the randomized, double-blinded, placebo-controlled trial was to assess the safety, tolerability, pharmacokinetic (PK) profile and pharmacodynamics (PD) of GFB-887 in healthy volunteers. A key exploratory objective was to characterize changes in urinary Rac1. Urinary Rac1 concentration may predict therapeutic response to TRPC5 inhibition.

The study enrolled 70 subjects, who were randomized four to one to receive GFB-887 at seven dose levels (ranging from 5 mg to 900 mg) or placebo.

Primary Objective: Safety, Tolerability and PK Data

GFB-887 was observed to be well-tolerated at all doses. There were no dose-limiting toxicities, severe adverse events (AEs) or abnormalities in laboratory or clinical assessments. In total, 38 percent of subjects who received GFB-887 reported AEs, compared to 21 percent of subjects treated with placebo. GFB-887-treated subjects reported headache more frequently than placebo-treated subjects (28.6% versus 7.2% respectively). The only other AE that was reported in two or more GFB-887-treated subjects was nausea (3.6%). Slight, asymptomatic reductions in blood pressure were observed in subjects treated at the highest doses.

The PK profile of GFB-887 is consistent with once-daily dosing, with a half-life ranging from 55 to 68 hours. A single 40 mg dose was also shown to exceed the preclinical

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China Passes Biosecurity Law to Prevent Infectious Diseases | World News

SHANGHAI (Reuters) – China’s top legislative body passed a new biosecurity law aimed at preventing and managing infectious diseases, state news agency Xinhua reported late on Saturday.

The National People’s Congress Standing Committee voted to adopt the law on Saturday, according to Xinhua, and it would come into effect on April 15, 2021.

The law would establish systems for biosecurity risk prevention and control, including risk monitoring and early warning, risk investigation and assessment, and information sharing.

It would also have provisions to prevent and respond to specific biosecurity risks, including major emerging infectious diseases, epidemic and sudden outbreaks, and biotechnology research, development and application, reported Xinhua.

China had announced in May that it aimed to fast-track the passing of the biosecurity law by year-end, following the global coronavirus outbreak which was first detected in the Chinese city of Wuhan.

China has managed to nearly stamp out domestic transmissions of the coronavirus following aggressive measures to curb its spread. New infections detected last week in the eastern coastal city of Qingdao however ended China’s run of about two months without reporting a local case.

China’s health commission last reported 13 new coronavirus cases in the mainland for Oct. 17, bringing the mainland’s total number of confirmed cases to 85,672.

(Reporting by Emily Chow; Editing by Raju Gopalakrishnan)

Copyright 2020 Thomson Reuters.

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Obesity And Overweight: Five Diseases And Health Conditions

A health care professional can readily tell if you are obese, overweight, or healthy by simply measuring your Body Mass Index, or BMI, in short. It effectively determines your weight in proportion to your height and the further it goes outside the scope of the standard range, the greater your odds are of developing a host of critical health issues from obesity and overweight.

Accomplishing and sustaining a healthy weight is something that cannot be achieved overnight and might turn out to be a challenging task for obese and overweight individuals in the long-term. Ensuring a healthy weight through appropriate means or at least preventing yourself from gaining more weight can help overweight people reduce the likelihood of developing specific medical conditions.

Obesity is on the verge of becoming a national epidemic in the USA and is associated with several chronic diseases, including type 2 diabetes, high blood pressure, hyperlipidemia, cancer, and cardiovascular disease. The grave medical condition is responsible for an astounding 18% mortality rate in the age group of 40 to 85 among American population, as observed by a health research study carried out in 2013, questioning the deeply-rooted, prevailing notion of the medical and scientific community that a mere 5 in every 100 deaths in the country are related to obesity. The new finding essentially suggests that it is as fatal as cigarette smoking, when it comes to the discussion of public health hazards, as the particular way of nicotine consumption can be linked to 20 in every 100 deaths in the USA and is acknowledged as the major preventable cause of mortality in the country.

Almost 2 in every 5 American adults were diagnosed with obesity in 2015-16, which is a significant increase from 34% in 2007-08, and its impact became more profound with a steep increase from 5.7% to 7.7% during that time. While not a single state reported an obesity rate of over 15% in 1985, as many as 5 of them registered rates higher than 35% for the year 2016.

Obesity and overweight are often associated with emotional health issues like depression. People who are either obese or overweight may also experience weight bias as well as face the stigma of the medical care services providers and others, which, in turn, can result in guilt, feeling of rejection, or shame, further worsening the prevailing problems concerning one’s mental well-being.

The major diseases and health complications caused by obesity and overweight are illustrated below in brief.

I. TYPE 2 DIABETES

When the blood glucose concentration becomes abnormally high on a permanent basis, the particular medical condition is termed as type 2 diabetes. About 4 in every 5 individuals with the said form of diabetes are known to be either obese or overweight. High blood sugar levels can manifest a large number of medical conditions, such as stroke, heart conditions, eye issues, neuropathic damage, eye problems, and other health issues.

Allowing yourself to engage in periodic physical activities and reducing 5% to 7% of your …

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Diseases of Dentistry: What Is Your Dentist Looking for at Exam Appointments?

You enter the dental office and it is time for your yearly exam. Have you ever wondered what is going on with the x-rays and what is going on inside your mouth? There is a method to all this madness, just like at your physical you are getting checked for various diseases.

Cavities

Cavities, or dental caries are caused by acid and bacteria. The bacteria themselves cause acid which dissolves the enamel of the tooth. When the bacteria feed on carbohydrates the produce this acid, which is why sugary snacks are a risk for tooth decay. Other sources of acid can also cause damage. Carbonation from soda, energy drinks, and even acid reflux and vomiting can weaken the enamel. The enamel softens gradually and decays,eventually the softened area becomes large enough that it needs to be filled.

At your dental visit there are a few ways that cavities are detected. One way is x-rays. Your dentist will look for areas on the x-ray that look like shadows, these areas are where the enamel is less dense and cavities have formed. Another method that may be used is a visual exam by the dentist. They may blow air on the teeth to see if the tooth has a chalky color that is common in early cavities or areas where there is obvious visual decay. They may also feel the teeth with an instrument to check for soft areas. Finally there is a method that uses laser fluorescence to detect decay. These instruments give a numerical value that equates to how severe the decay is, from healthy with no decay to severe decay. The DIAGNOdent and the Spectra Caries Detection Aid are the most common ones used. These instruments allow detection of early decay so it can be treated before it becomes more severe and costly.

Periodontal Disease

Periodontal Disease is extremely common. The most obvious result of periodontal disease is loss of bone and eventually teeth. If you have ever looked at someone’s smile and their teeth appear long you have seen someone with periodontal disease. The way level of periodontal disease is assessed at the dentist includes a full periodontal assessment. During this assessment your gums will be measured with an instrument that is like a little ruler. It measures the space between the tooth and the gum called the sulcus or pocket. Additionally any root surface showing above the gum-line will be measured. The teeth will be checked for mobility or looseness, bleeding and the degree of plaque and tartar on the teeth will be assessed. The combination of this data, along with your health history will help determine your treatment.

Your x-rays are another way that your bone level can be evaluated. There are additional screenings that can be done which will tell which particular bacteria are in your mouth but those are not used as frequently in initial screenings.

If there is no bone loss or bleeding your gums are healthy. That is great. If there is …

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