Nutrition, cardiovascular disease experts urge evaluation of diet at routine healthcare check-ups

Agencies
August 11, 2020

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Dallas, Aug 11: A group of nutrition and cardiovascular disease experts issued a new scientific statement which states that the time has come for routine healthcare visits to include some form of dietary assessment and counselling.

The statement issued from the American Heart Association was published today in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal. The experts recommend the adoption of a rapid diet screening tool that can be integrated into electronic health record platforms across all healthcare settings.

"Dietary patterns and quality are not sufficiently prioritised when addressing modifiable risk factors during regular healthcare office visits. Given the evidence that diet contributes to disease and mortality, it is a risk factor worth screening for continuously," said Maya Vadiveloo, Ph.D., RD, chair of the statement writing group and assistant professor of nutrition and health sciences in the College of Health Science at the University of Rhode Island in Kingston, Rhode Island.

Poor diet quality has surpassed all other risk factors for death, accounting for 11 million deaths and about half of the cardiovascular disease (CVD) deaths globally, according to the 2017 Global Burden of Disease Study, a comprehensive report on the health impact of diet in 195 countries around the world.

The statement authors reviewed 15 existing screening tools, assessing each to provide insight into the feasibility of incorporating an evidence-based dietary screening tool into routine practice.

The authors list numerous reasons why members of a healthcare team may not address diet quality during a routine office visit: lack of training and knowledge; lack of time and reimbursement; competing demands during the often short office visit and that nutrition services aren't integrated into many healthcare settings.

"However, these barriers can be overcome," said Vadiveloo. "We want a valid, reliable way to assess diet that reflects the best science and most of the tools assessed take under 10 minutes to use."

Three of the tools assessed to meet criteria set forth in the statement and may provide a framework to help practices incorporate diet screening into their workflow. The Powell and Greenberg Screening Tool asks two questions about fruit and vegetable consumption and sugary food and juice consumption.

The Rapid Eating Assessment for Participants-Shortened assessment and the Mediterranean Diet Adherence Screener ask more than 10 questions and cover major food groups, as well as processed foods and alcohol consumption.

The keys to an effective diet screening tool include:

-Using an evidence-based approach;
-Assessing the total dietary pattern, not just a single food or nutrient;
-Speed;
-The ability to give actionable next steps and support to patients; and
-The ability to track and monitor dietary change over time.

"There are other tools beyond what was assessed and additional tools could be developed," said Vadiveloo.

While the statement does not endorse a specific screening tool, it encourages critical conversations among clinicians, individuals with diet/lifestyle expertise, and specialists in information technology to adopt rapid diet screening tools for adults in primary care and relevant specialty care and prevention settings.

"An important component in addition to evaluating diet quality is targeting actionable changes - helping patients set achievable dietary goals - and then following up at the next visit," said Alice H. Lichtenstein, D.Sc., vice-chair of the writing group and lead and senior scientist of the Cardiovascular Nutrition Team at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston.

Areas for future study include testing and validating screener tools in diverse populations, as well as among special clinical populations (paediatrics, geriatrics), and evaluating the feasibility of implementing these tools in clinical settings.

A healthy diet can improve cardiovascular disease risk and outcomes. What you eat (and how much) can affect other controllable risk factors, such as cholesterol, blood pressure, diabetes, and being overweight. 

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Agencies
September 26,2020

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The World Health Organisation (WHO) warned that the global coronavirus death toll could hit two million before an effective vaccine is widely used.

WHO emergencies head Mike Ryan on Friday said the figure could be even higher without concerted international action, the BBC reported.

The number of Covid-19 deaths is fast approaching one million - nine months after the outbreak started in China.

Ryan also urged Europeans to ask themselves whether they had done enough to avoid the need for lockdowns.

He questioned whether all the alternatives had been implemented, like testing and tracing, quarantine, isolation, social distancing, wearing masks and hand-washing.

Earlier, Spain's capital Madrid brought another eight districts under tougher coronavirus restrictions, which now affect a million people in the city.

In France, staff from bars and restaurants in the southern city Marseille protested against the closure of their workplaces which was brought in on Saturday.

And in the UK, tougher restrictions were announced in several regions as new daily infections rise.

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News Network
September 18,2020

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Ludhiana, Sept 18: DMCH Cancer Care Centre in collaboration with American Oncology Institute recently started a new diagnostic service (PSMA-PET Scan) in treating various prostate cancer.

Prostate cancer is the most common cancer in men and one of the leading causes of cancer death. Prostate Specific Membrane Antigen (PSMA ) is highly expressed in prostate cancer and its expression increases with tumour aggressiveness, metastatic disease and disease recurrence.

Secretary of DMCH Managing Society, Sh. Prem Kumar Gupta said, “Very few facilities in the region have this state-of-art facility and will be of great benefit for the patients.” He further added, “DMCH Cancer Care Centre is always in the process of acquiring new techniques and facilities for diagnosing and treating various cancer diseases. The availability of this facility will go a long way to help both patients and clinicians in knowing about the proper stage of prostate cancer, thereby helping patients with better outcome.”

Dr. Puneet Bhutani from the Department of Nuclear Medicine, American Oncology Institute stated, “This is a major milestone in diagnosis of prostate cancer. The procedure of diagnosing prostate cancer through PSMA-PET Scan is more accurate method for early detection of recurrent disease. It allows the oncologists to treat patients at an early stage and provide them a better treatment outcome.”

About American Oncology Institute:

American Oncology Institute is the leading cancer care provider across South Asia operating a chain of cancer hospitals in multiple cities across South Asia. AOI today is a wholly owned subsidiary of Varian Medical Systems (NYSE: VAR).

The team of clinical, paraclinical and healthcare operations experts pride themselves with the aim of closing the gap between standards of cancer care in South Asia and the developed cancer hospitals in the West. AOI provides comprehensive cancer management that is powered by clinical excellence, world class technology as well as best in class clinical pathways and protocols for treatment planning and execution, providing best in-class quality in cancer care across South Asia.

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Agencies
September 22,2020

Scientists have developed a new tool that mimics how the novel coronavirus which causes COVID-19 enters and infects cells, an advance that could potentially speed up the search for treatments against the deadly disease.

The novel tool, described in the journal ACS Nano, is a fluorescent nanoparticle probe with the spike protein that is present on the surface of the SARS-CoV-2 virus, which it uses to bind to human cells and enter them.

According to the researchers, including those from the National Center for Advancing Translational Sciences (NCATS) in the US, the probe could be used in tests to rapidly gauge the ability of therapeutics to block the actual virus from infecting human cells.

"Our goal is to create a screening system to find compounds that block SARS-CoV-2 from binding to cells and infecting them," explained Kirill Gorshkov, a co-author of the study from the Naval Research Laboratory (NRL) in the US.

Since using the actual virus in such screening studies would be difficult and require special facilities, the scientists said they used nanoparticles to mimic the viral function of binding to and invading the host human cell.

"We at NRL are experts in nanoparticles, and the NCATS researchers are experts in drug screening using cellular systems. So, it was the perfect match," explained Eunkeu Oh, another co-author of the study from NRL.

To create the probe, the scientists built an ultrasmall fluorescent particle called a quantum dot, fashioned from cadmium and selenium.

According to the researchers, these particles are at around 10 nanometers in size, which makes them 3,000 times smaller than the width of a single human hair.

They studded the quantum dots' surfaces with a section of the SARS-CoV-2 spike protein which binds to ACE2 -- a human cell surface protein.

The study noted that the first step in the pathway to novel coronavirus infection is the union of the spike protein with ACE2.

The scientists could track the dots' behaviour under a microscope based on their fluorescent glow.

"Because they're such bright fluorescent objects, the quantum dots give us a powerful system to track viral attachment and effects on the cell in real time," Gorshkov said.

The researchers observed how the nanoparticle probes attach to ACE2 in a lung cell line commonly used in coronavirus assays.

According to the scientists, the probes were not toxic to the test cells at the concentrations and exposure times used in the study.

While the quantum dots followed the SARS-CoV-2 pathway into cells, they said the probes also mimicked the virus in the presence of antibodies, which are proteins made by the immune system that can specifically neutralise invading foreign agents like viruses.

The study noted that the antibodies were potent inhibitors of the quantum dot probes as well, preventing them from binding to ACE2 and entering human cells.

Based on the observation, the researchers said the quantum dot probes could help rapidly test the ability of potential therapeutic agents to block the virus from entering and infecting cells.

They said assays using the probes could also determine the concentrations at which potential treatments may safely and effectively block infection.

"Using the quantum dots, we could create tests to use in drug screening and drug repurposing, using libraries of compounds that have activity but that also are approved by the U.S. Food and Drug Administration," Gorshkov said.

"Such assays could rapidly identify promising, safe treatments for COVID-19," he added.

The scientists believe the probe's flexible design can allow researchers to swap in spikes that bind to other receptors as well since ACE2 may not be the only protein SARS-CoV-2 targets.

According to the researchers, the probe could also be used to test how mutations in the spike change the way the virus behaves by adding mutated spikes to the quantum dots.

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