In a current opinion article “Reduction of environmental pollutants for prevention of cardiovascular disease: it’s time to act”, published in the European Heart Journal this week.

A group of international environmental researchers from the University Medical Center of Mainz (Thomas Münzel and Andreas Daiber), from the University/BHF Centre for Cardiovascular Sciences, University of Edinburgh, United Kingdom (Mar Miller), the Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark (Mette Sørensen).

The Max Planck Institute for Chemistry, Atmospheric Chemistry Department, Mainz, Germany (Jos Lelieveld) and the Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center and School of Medicine, Cleveland, OH, USA (Sanjay Rajagopalan) summarized the epidemiologic and mechanistic evidence in support of an association between noise and air pollution with cardiovascular and metabolic disease, and recommended comprehensive mitigation measures.

Environmental risk factors are increasingly recognized as important determinants of cardiovascular disease (CVD).

While the contribution of high cholesterol, diabetes, arterial hypertension, obesity and smoking are well established, the contribution by factors such as noise and air pollution to cardiovascular disease are often not acknowledged, despite the recognition that they represent the two most common and pervasive environmental risk factors globally.

Recent data indicate that air pollution attributable premature deaths approach 9 million per year globally (mostly cardiovascular causes), accounting for a loss of life expectancy that rivals that of tobacco smoking. The health burden due to noise pollution is mostly based on loss of healthy life years, amounting to several 100 Mio. of disability adjusted life years per year.

In particular with respect to air pollution, 90% of the world population lives in an environment with air pollution levels higher than 10μg/m3, being recommended by the WHO.

The European levels air pollution limits for PM 25 μg/m3 is 2.5 fold higher than the WHO limit and a reduction of the air pollution limits down to the WHO recommendation mainly due to a phase out of fossil fuel use could prevent around 400.000 to 500.000 thousand excess deaths of Europeans. Thus, we urgently need to reduce these limits.”

Thomas Münzel, Researcher, University Medical Center of Mainz

The environmental stressors such as air pollution and noise pollution cause primarily cardiovascular disease such as chronic coronary artery disease, stroke diabetes mellitus, arterial hypertension but also neurological diseases and thus represent per se cardiovascular risk factors that can be positively influenced not by doctors or patients themselves but rather by politicians by introducing noise and air pollution limits that protect us from adverse health effects caused by these environmental stressors, “the lead author Münzel comments.

The author team proposes mitigation maneuvers for to protect from air pollution induced health side effects such as active personal exposure mitigation with home air cleaning and personal equipment such as N95 respirators while face masks are not effective in ?

ltering PM2.5, Modification of human behavior to reduce passive exposures such as advising patients with pre-established cardiovascular disease to continue to remain >400 m away from major roadways to avoid exposure to traffic pollutants is a reasonable measure, despite the current lack of strong evidentiary support.

Although a variety of over the counter drugs and medications have been shown to mitigate association between air pollution and surrogates, almost none can be recommended to protect against air pollution mediated adverse health effects at this time.

With respect to noise pollution the team suggests for road traffic noise that the sound generated by the contact between the tires and the pavement is the dominant noise source, at speeds above 35 km/h for cars and above 60 km/h for trucks.

Therefore, changing to electric cars will result in only minor reductions in road traffic noise. Generally applied strategies for reducing road traffic noise include noise barriers in densely populated areas, applying quiet road surfaces, and reducing speed, especially during nighttime. Furthermore, there is a great potential in developing and using low-noise tires.

As many of these mitigation methods result in only relatively small changes in noise a combination of different methods is important in highly exposed areas.

For aircraft noise, mitigation strategies include to minimizing overlapping of air traffic routes and housing zones, introduction of night bans, and implementation of continuous descent arrivals, which require the aircraft to approach on steeper descents with lower, less variable throttle settings.

For railway noise, replacing cast-iron block breaks with composite material, grinding of railway tracks and night bans, are among the preferred strategies for reducing noise.

Lastly, installing sound-reducing windows and/or orientation of the bedroom towards the quiet side of the residence can reduce noise exposure.

To this end Münzel further proposes that “increased awareness of the health burden posed by the risk factors such as noise and air pollution and their incorporation in traditional medical guidelines will help propel legislation to reduce them and significantly improve cardiovascular health.”

The post Air pollution accounts for premature deaths from cardiovascular disease appeared first on MyMedicPlus.

The post Many gains in fighting HIV appeared first on MyMedicPlus.

Researchers from Aarhus University Hospital in Denmark have found a 12 percent risk associated with being dangerously overweight.

The researchers in their new study published in the Journal of Internal Medicine found that being overweight or obese increases the risk of several common cancers.

The team of researchers raised concern that the rising rates of obesity and severe obesity will increase the rates of cancers across the board, as well as take a toll on healthcare costs and see more people dying prematurely.

The team looked at cancer data in Denmark over a 40-year period, from 1977 to 2016 and found 20,706 cancers among 313,321 adults who were clinically diagnosed as being overweight or obese.

By comparison, there were 18,480 cancers diagnosed among the general Danish population over the same time period, which means that weighing above average increased the risk of all cancers by 12 percent, according to their findings.

According to the researchers, the heightened risk was the same for cancers previously identified as obesity-related, such as kidney cancer and pancreatic cancer, and for blood and neurological cancers.

Explaining reasons obesity is linked to an increase in cancer risk, the scientists found that obesity is associated with a rapid rise in the number of cells, as well as the secretion of high levels of proteins and hormones that are pro-inflammatory such as estrogen – all of which is linked to cancer.

The authors wrote in the study: “Given the increasing obesity epidemic, our findings have contributed much needed recent data on the overall burden of cancer among patients hospitalized for overweight and obesity.”

Obesity is known as a risk factor for several chronic health conditions aside from cancer including type 2 diabetes, strokes and heart attacks.

The United States health officials say that addressing the obesity epidemic will not only lead to better health outcomes but also reduce medical costs.

Meanwhile, in 2012, a study from Cornell University in New York found obesity to account for about 21 percent of total US healthcare costs, approximately $190.2 billion per year.

Obesity, however, continues to plague more than one-third of adults in the US, and experts have warned that the proportion will only grow as younger generations do.

Also, researchers from Harvard’s TH Chan School of Public Health predict that nearly half of all Americans will be obese by 2030.

The post Overweight increases risk of cancers by 12%, fuels premature deaths appeared first on MyMedicPlus.

ISLAMABAD: Few medical conditions trigger the kind  of fright HIV elicits. Given popular beliefs regarding how it is transmitted and its reputation as incurable, those who contract it can sometimes end up paying a heavy social toll even before any medical symptoms manifest.

A lot of what condemns HIV patients to a life of suffering in silence is misinformation surrounding the disease. Foremost among them is the notion that being infected means certain death. That may have been true in the early years of the virus’ emergence, but the decades since have made it possible for patients to lead a considerably long life normally.

“Not many people have bothered to learn about HIV,” complained 40-year-old Asghar, who has lived with HIV for some time. “I have been on treatment ever since I was diagnosed and the medicines I’ve been prescribed make me feel quite well,” he said. “To this day, however, many relatives and friends look at me negatively. By and large, they avoid and ignore me, and in the few social interactions we have had, I have felt they see me as someone who lived an immoral life.”

“The prevailing impression among them and I believe others in our society is that HIV is only spread through sexual contact,” Asghar, who is an NGO worker by profession, lamented. “Even though health experts have quashed this belief time and again, many still think those with HIV must have contracted it through sex workers or same-sex contact,” he said.

“And then there are those who believe even shaking the hand of someone with HIV or being in their general vicinity is contagious. Harmful beliefs like these are why many HIV patients are reluctant to disclose their condition and may even contemplate suicide,” Asghar pointed out. Even so, he urged everyone who contracted the virus to register themselves and obtain treatment.

“We hold awareness drives several times a year to get the message out that HIV is no reason to judge those who suffer from it,” said National AIDS Control Programme Managing Director Baseer Achakzai. “We make it clear that anyone can contract HIV and that it is not a sign of personal flaws. The virus does not make those who suffer from it ‘sinful’.”

“Putting an end to such beliefs is necessary if we are to implement an HIV policy on a national level,” he stressed. “Such misinformation deters many an HIV patient from seeking treatment and getting registered.”

However, Achakzai too urged those suffering with HIV in silence to overcome any feelings of guilt and shame imposed on them and come forward for registration.

According to United Nations HIV AIDS Programme data, as of last year, there were 37.9 million HIV/AIDS cases worldwide with 1.77 million new cases emerging every year. According to a UN report released this year, Pakistan is among the 11 countries with the highest prevalence of HIV.

Earlier this year, a large number of people, mostly children, in Ratodero, Larkana were exposed to the virus. A massive screening found 1,200 residents to be HIV-positive. A staggering 900 of them were children without a family history of the virus. Investigations revealed the outbreak was caused by repeated use of the same syringe.

“Pakistan has the highest rate of injections per person in the world, but what is concerning is that 95 per cent of them are entirely unnecessary,” said Special Assistant to the Prime Minister on Health Dr Zafar Mirza. “This overuse of injections is the most potent vector for transmission of blood-borne illnesses, like HIV and Hepatitis C.”

Mirza said the government is working on controlling the use of syringes and introducing a safe-injection policy to make auto-lock syringes mandatory. He added that they are also taking action against shady blood banks to curtail the spread of blood-borne viruses.

The post HIV myths abound: A sentence worse than death appeared first on MyMedicPlus.

UNITED NATIONS – New United Nations data shows that global HIV/AIDS infection rates and deaths are down and treatment is up, but new infections remain a serious challenge in certain high-risk groups.

In a report launched Tuesday ahead of World AIDS Day on Dec. 1, UNAIDS reports that of the nearly 38 million people globally living with HIV — the virus that causes AIDS — more than 24 million patients are receiving antiretroviral therapy (ARVs). That is a significant increase from nine years ago, when about 7 million people were accessing the life-saving treatment.

UNAIDS says about 8 million people do not know they are infected with HIV.

AIDS-related deaths worldwide are also down by more than half since 2004. Some 770,000 people died of the disease last year.

“The gains continue to be made against the epidemic, but those gains are getting smaller year after year,” said Ninan Varughese, director of the UNAIDS New York office.

He said improvements in eastern and southern Africa are driving global progress rates, but many other areas of the world have faced setbacks, such as Central Asia and Eastern Europe.  

High-risk groups
 
More than half of new infections are among high-risk groups and their sexual partners.

“If you look outside sub-Saharan Africa it is 75%,” Varughese said. “For example, more than 95% of new infections in Central Asia and Eastern Europe are among key populations.”

He said the risk of being infected with HIV is 22 times higher among homosexual men and intravenous drug users, 21 times higher for sex workers, and 12 times higher for transgender persons.

Women and girls

Another demographic group that is seeing a negative trend is adolescent sub-Saharan African women and girls, with 6,000 new infections each week among those between the ages of 15 and 24.

“In sub-Saharan Africa, 4 in 5 new infections among adolescents age 15 to 19 are among girls,” Varughese added.

More money is needed to fund the global response. UNAIDS estimates a need of $26.2 billion for 2020.

While 19 countries are on track to reach the 2030 target of ending the AIDS epidemic, most of the world is not.

The post UN: HIV/AIDS Infections and Deaths Down, but Challenges Remain appeared first on MyMedicPlus.

PANAJI: A total of 11 acquired immune deficiency syndrome (AIDS) deaths have been reported in the state from January to July this year.

AIDS claimed a total of 31 lives in 2016, while the same number of people succumbed to the deadly disease in 2017. In 2018, the death toll came down to 21.

The latest data available with the Goa State AIDS Control Society (GSACS) reveals that a total of 192 new Human Immunodeficiency Virus (HIV) cases have been reported in the state from January to August this year while there are 14 HIV cases that have reached the stage of AIDS during the same period.

The figures indicate that the HIV cases, which were declining sharply from 959 HIV positive cases in 2009 to 345 in 2015, rose to 390 in 2017. However, the state witnessed a significant decline in 2018 wherein the new HIV cases recorded were 280.

In the year 2016, 30 cases of AIDS were registered followed by 55 cases in 2017. However, with a change in the treatment strategy and by providing antiretroviral therapy (ART) to the affected HIV patients at the very initial stage of the infection as per the guidelines of the World Health Organisation, from the year 2017, the state managed to bring the number of AIDS cases down to 29 in 2018.

The data reveals that 72 per cent of the cases detected in Goa during 2018 were in the age group of 15-49 years. In the same year, out of the total females infected, nearly 26 per cent belonged to the age group 15-34 years whereas around 28 per cent of the infected males were in this age group. Over 41 per cent infected males and about 50 per cent infected females belonged to the age group 35-49 years.

Between the years 1999-2018, sex has been the predominant mode of HIV transmission (83 to 93 per cent) followed by perinatal transmission of HIV (4 to 8 per cent).

According to the GSACS, HIV infection is prevalent in all parts of Goa and majority of the cases were reported in the four coastal talukas of Salcete (12.2 per cent), Mormugao (21.1 per cent), Tiswadi (7.8 per cent) and Bardez (7.8 per cent) in 2018.

To raise awareness, improve knowledge and understanding among the general population about AIDS infection and sexually transmitted diseases, routes of transmission and methods of prevention, the GSACS regularly conducts information, education and communication programmes.

The GSACS also conducts general education programmes on HIV/AIDS for youth organisations, voluntary bodies, government departments, women, high-risk groups, schools, colleges, industrial estate workers, etc.

The post Goa witnesses 11 AIDS deaths this year till July appeared first on MyMedicPlus.

That was Brenda Scurlock’s last text from her son, Avery, before he was shot eight times, his body abandoned in a field in eastern North Carolina.

Scurlock had always worried about Avery’s safety. He was young and black in a society where those qualities could make him vulnerable.

And to multiply her worries, he was transgender.

Her fears came true June 5, when the Robeson County Sheriff’s Office responded to reports of gunshots and found Avery Scurlock’s body. Friends say he was meeting a man he had met on a dating website.

Avery, 23, was one of 18 transgender people slain so far this year in the U.S., according to the Human Rights Campaign . Seventeen were black transgender women , including two killed within two weeks of each other in South Carolina. A woman in Dallas who became a vocal advocate for transgender rights after she was attacked in April was killed in May in what the mayor described as “mob violence.” In Detroit, a black transgender woman and two gay men were killed in an attack that two other people survived.

The majority of transgender people killed yearly typically are black women, said Sarah McBride, the campaign’s national press secretary. “When transphobia mixes with misogyny and systemic racism, it can often have deadly consequences,” she said.

Black transgender women have been killed this year in Alabama, Tennessee, Maryland, Ohio, Pennsylvania, Missouri, Texas, Michigan and Florida. Advocates tracked the deaths of 26 transgender people in 2018.

Although Brenda Scurlock supported her child and was accepting of his gender identity, she used male pronouns and always called him Avery, just as everyone else did. His friends say he insisted on his female name, Chanel, only when dressed as a woman in public. Because of that, The Associated Press is using Avery and male pronouns for the sake of clarity.

Avery told his mother about four years ago that he was gay. “The way he dressed, you know, that was just him,” Brenda Scurlock said.

He would leave their home in Lumber Bridge in women’s clothes and makeup — he loved false eyelashes and his jean jacket. “He dressed how he wanted to dress,” Brenda Scurlock said. “I never really hit on the transgender part. He just dressed how he wanted to dress.”

On the evening of June 4, Avery told her he was going to a Chinese restaurant in nearby St. Pauls, then coming home. At 9:49 p.m., she texted him: “Are you Okay?” Two minutes later, he responded: “Yes Mommy.” She asked him to call or text when he was on the way home.

At 9:53 p.m., he responded: “Okay Mommy. I love you.”

What Brenda Scurlock didn’t know was that Avery — presenting as Chanel — had connected with someone on a dating website who wanted to meet that night, said his best friend, 19-year-old Shania Aguirre. He left St. Pauls and first met with Aguirre at a hamburger joint in nearby Lumberton, Aguirre said.

They discussed the man who wanted to meet him, she said, and Avery told Aguirre that he had decided against it. She reminded him that another person whose friends said he was bisexual had been murdered in that same area in May 2018.

Then Shania uttered words that she wishes hadn’t come true: “I said if something happened, we’re not going to find out until the next morning or whenever.”

Aguirre said she left the restaurant parking lot about 11:50 p.m. Avery had pulled out a few minutes ahead of her. At 12:13 a.m. June 5, she texted him and got no response. A few hours later, she said she learned police had responded at 12:07 a.m. to a report of shots fired.

About 20 minutes had passed since Aguirre saw her friend pulling out in his car, she said. Before leaving, he had asked to be godfather to her 2-year-old daughter and told her he wanted eventually to have sex-reassignment surgery, she said.

Avery’s absence leaves an empty place in Aguirre’s life. She said she alternates between being too depressed to leave her home and too afraid.

“He was very supportive, always there,” she said. “We were there for each other.”

Meanwhile, Brenda Scurlock wants the death penalty for Javaras Hammonds, the 20-year-old charged with first-degree murder in Avery’s death. He’s being held without bond in the Robeson County Detention Center. Neither his attorney nor the district attorney responded to email or phone messages from the AP about the case.

She also wants authorities to charge Hammonds with a hate crime. However, Capt. Forest Obershea of the sheriff’s office says authorities believe robbery was the motive because Avery’s car and other belongings were stolen.

McBride, the Human Rights Campaign spokeswoman, says that’s another part of the safety issue for transgender people, who are more likely to live on the edges of society and take chances. While the killer might have planned a robbery, he also probably knew that a transgender woman named Chanel was more likely to risk meeting a stranger in the dark along a lonely road, McBride said.

Avery had told Aguirre he knew he took too many chances and worried his mother. He knew he had to change his ways soon, she said.

“I had told him not to meet up with anybody,” Brenda Scurlock said. “I told him it was dangerous.”

She’s learning more about what it means to be transgender and getting support from LGBTQ advocates, some of whom go to court with her. She’s determined to get justice for Avery’s memory.

“That was my child. And I had to accept him, whatever he was — gay, bisexual, whatever,” she said. “That was my child. And it shouldn’t give nobody a right to kill him.”

The post ‘That was my child’: Transgender deaths devastate families appeared first on MyMedicPlus.