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As virus surges anew, Milan hospitals under pressure again

MILAN (AP) — Coronavirus infections are surging anew in the northern Italian region where the pandemic first took hold in Europe, putting pressure again on hospitals and health care workers.

At Milan’s San Paolo hospital, a ward dedicated to coronavirus patients and outfitted with breathing machines reopened this weekend, a sign that the city and the surrounding area is entering a new emergency phase of the pandemic.

For the medical personnel who fought the virus in Italy’s hardest-hit region of Lombardy in the spring, the long-predicted resurgence came too soon.


“On a psychological level, I have to say I still have not recovered,’’ said nurse Cristina Settembrese, referring to last March and April when Lombardy accounted for nearly half of the dead and one-third of the nation’s coronavirus cases.

“In the last five days, I am seeing many people who are hospitalized who need breathing support,” Settembrese said. “I am reliving the nightmare, with the difference that the virus is less lethal.”

Months after Italy eased one of the globe’s toughest lockdowns, the country is now recording well over 5,000 new infections a day — eerily close to the highs of the spring — as the weather cools and a remarkably relaxed summer of travel and socializing fades into memory. Lombardy is again leading the nation in case numbers, an echo of the trauma of March and April when ambulance sirens pierced the silence of stilled cities.

So far, Italy’s death toll remains significantly below the spring heights, hovering recently around 50 per day nationwide, a handful in Lombardy. That compares with over 900 dead nationwide one day in March.

In response to the new surge, Premier Giuseppe Conte’s government twice tightened nationwide restrictions inside a week. Starting Thursday, Italians cannot play casual pickup sports, bars and restaurants face a midnight curfew, and private celebrations in public venues are banned. Masks are mandatory outdoors as of last week.

But there is also growing concern among doctors that Italy squandered the gains it made during its 10-week lockdown and didn’t move quick enough to reimpose restrictions. Concerns persist that the rising stress on hospitals will force scheduled surgeries and screenings to be postponed — creating a parallel health emergency, as happened in the spring.

Italy is not the only European country seeing a resurgence — and, in fact, is faring better than its neighbors this time around. Italy’s cases per 100,000 residents have doubled in the last two weeks to nearly 87 — a rate well below countries like Belgium, the Netherlands, France, Spain and Britain that are seeing between around 300 to around 500 per 100,000. Those countries have also started to impose new restrictions.

This time, Milan is bearing the brunt. With Lombardy recording more than 1,000 cases a day, the regional capital and its surroundings account for as many as half of that total. Bergamo — which was hardest hit last time and has been seared into collective memory by images of army trucks transporting the dead to

Arm squeezes with blood pressure cuffs may help stroke recovery

After administering clot-busting drugs to treat a stroke, using blood pressure cuffs to squeeze each arm might aid recovery, a new, small Chinese study suggests.

In the technique — called remote ischemic post-conditioning — the flow of oxygen-rich blood is repeatedly interrupted and restored using blood pressure cuffs on the arms. Earlier studies have found that the technique may prevent tissue damage by helping the body handle changes in blood flow and the damage that may occur from a stroke, researchers say.

“The findings show a promising future prospect of remote ischemic post-conditioning and have important clinical implications,” said researcher Dr. Guo-liang Li, of First Affiliated Hospital of Xi’an and Jiaotong University in Xi’an, China.

“As we all know, the therapy has a lot of advantages,” he said, calling it noninvasive, easy-to-use, cost-effective and safe.

Even though clot-busting drugs have saved many stroke patients, 32% do not have a favorable outcome. This is partly because blood flow is not completely restored and vessels can clot even after clot-busting drugs are given, Li said.

“Remote ischemic post-conditioning can be a complementary treatment that can improve the prognosis in stroke patients,” he said.

This study was done in China, but Li said the technique has also been studied in the United Kingdom, France and Denmark.

For the study, Li’s team randomly assigned 68 people (average age: 65) who suffered a stroke. All were treated within 4.5 hours with a medication that dissolves blood clots called tPA. Half also received ischemic post-conditioning therapy.

Over an average of 11 days, post-conditioning participants wore blood pressure cuffs on both arms for 40 minutes, alternating cycles of inflation for five minutes and deflation for three minutes. Treatments were done twice a day.

Stroke recovery was gauged on a scale of no symptoms no significant disability despite some symptoms or slight disability. People who had no symptoms after three months were considered to have had a favorable recovery.

Seventy-two percent of those who wore the blood pressure cuff had a favorable recovery, compared with 50% of those who didn’t, the researchers found. These findings remained significant even after taking into account age, stroke severity and other factors.

During the trial, two people dropped out — one because the cuffs caused skin redness and the other because the pressure applied during the procedure was uncomfortable. Researchers don’t know how long the treatment is needed to be most effective.

They caution that ischemic post-conditioning is still experimental and isn’t something that should be tried on recovering stroke patients at home.

“In the future, more studies are needed to confirm that the combined therapy of clot-busting drugs and remote ischemic post-conditioning is safe and effective in much larger groups of people before this experimental therapy can be performed at home,” Li said.

Dr. Larry Goldstein, chairman of the Department of Neurology at the University of Kentucky, reviewed the findings.

“This single hospital study was aimed at determining whether the technique might be helpful in improving outcomes of patients with stroke

AHA News: Despite Recent Setbacks, Americans’ Blood Pressure Has Dropped Dramatically Since 1960 | Health News

(HealthDay)

MONDAY, Oct. 5, 2020 (American Heart Association News) — Blood pressure among adults decreased significantly during a 45-year period, according to new research that may offer encouragement for the millions who continue to struggle to control their blood pressure.

The study, published Oct. 5 in the American Heart Association journal Circulation , sought to pinpoint the magnitude of blood pressure improvement in the United States between 1960 and 2005.

Researchers looked at rates of control for systolic blood pressure, the top number in a reading that indicates how much pressure blood exerts against artery walls when the heart beats. The study looked at data from 9,459 adults ages 45 and older, most of whom lived in the so-called “stroke belt” region of the Southeast.

It found major decreases in median blood pressure levels across the board, with larger decreases for Black participants compared to white participants. Among Black people aged 45 to 54, blood pressure dropped 38 mmHg, while their white counterparts saw an 18 mmHg drop. Dramatic shifts were larger at older ages for both groups, with a 45 mmHg drop for those 75 and older.

In addition, the severe blood pressure levels of greater than 200 mmHg reported in 1960 were practically eliminated during the study period. For example, among 65- to 74-year-olds with the highest blood pressure, the levels dropped 63 mmHg for white people and 77 mmHg for Black people – most likely because of aggressive high blood pressure control strategies, said study author Dr. Daniel Lackland.

He called the results “a great public health success story.”

“This shows we’ve made great improvements in reducing blood pressures for everybody, at all levels,” said Lackland, a professor of epidemiology and neurology at the Medical University of South Carolina in Charleston.

But in recent years, some of those improvements seem to have weakened.

New preliminary research presented in September at the AHA’s virtual Hypertension Scientific Sessions showed the percentage of U.S. adults with controlled blood pressure dropped 11% between 2013 and 2018, from 54.5% to 43.4%. All age groups saw an increase in systolic blood pressure of 3-4 mmHg.

Those data, however, used the old definition of high blood pressure: 140/90. High blood pressure is now defined as a reading of 130 or higher systolic, or 80 or higher diastolic (the bottom number). Nearly half of U.S. adults – an estimated 116 million – have high blood pressure, according to AHA statistics.

Lackland said the lessons learned from 1960 to 2005 offer a roadmap for reversing recent setbacks through a combination of drug therapy and lifestyle changes that include getting more exercise and eating a healthy diet low in salt and high in fruits and vegetables.

“We’ve proven we can lower blood pressure if patients comply. We just need to put our foot back on the pedal and regain our focus. We can’t be complacent,” he said.

Dr. Sandra Taler, a nephrologist and hypertension specialist at the Mayo Clinic in Rochester, Minn., said the findings are an

Users of blood pressure medicine have a lower risk of dying from influenza and pneumonia

Drugs to lower blood pressure of the type ACE inhibitors or angiotensin II receptor blockers reduce the mortality rate of influenza and pneumonia.

This is the main conclusion of a new reassuring study published in the Journal of the American Heart Association, which Christian Fynbo Christiansen and a number of Danish colleagues are behind. He is consultant, clinical associate professor and PhD at the Department of Clinical Epidemiology, which is part of the Department of Clinical Medicine at Aarhus University and Aarhus University Hospital in Denmark.

In the study, the researchers have compared mortality rates among 500,000 Danish patients who were admitted to hospitals in Denmark with influenza and pneumonia during the period 2005 to 2018. This has been done by correlating information from the National Patient Register (activity at Danish hospitals) with statistics from the Danish Register of Medicinal Products (the consumption of medicine in Denmark).

“A little over 100,000 of the admitted patients took ACE inhibitors or angiotensin II receptor blockers, and the study shows that fewer of them were put on a ventilator and that they had lower mortality rates than the hospitalised patients who took another type of drugs against elevated blood pressure, calcium blockers,” says Christian Fynbo Christiansen.

The study arrives mid in a discussion of treatment which peaked while the corona pandemic was at its height. Some medical doctors and researchers pointed out that ACE inhibitors may actually have the completely opposite effect – that is increasing the risk of dying from COVID-19 as the virus SARS-CoV-2 which causes COVID-19 enters the lungs through the same ACE receptors as the ACE inhibitors.

The hypothesis was that when the ACE inhibitor reduces the level of ACE, the body compensates for this by activating a much greater number of ACE receptors on the surface of the cells, which the SARS-CoV-2 virus then utilises as some kind of access key. The greater the number of access keys available on the surface of the cells, the more easily the virus gains access to the cells.

The theory about increased mortality has been nurtured by the fact that a strikingly large proportion of the patients who were seriously ill due to COVID-19 had elevated blood pressure, which is extensively treated with ACE inhibitors – of the 600,000 Danes who have elevated blood pressure, approximately one-third ( 200,000) of them take ACE inhibitors.

“We haven’t examined whether what applies to patients with influenza and pneumonia can be transferred directly to patients with COVID-19, but there is some evidence to suggest that ACE inhibitors have a protective effect against lung damage which we don’t see in patients who take other types of medicine to lower blood pressure. The first studies find no correlation between ACE inhibitors/angiotensin II receptor blockers and COVID-19. However, further studies are needed using the good Danish registers,” says Christian Fynbo Christiansen.

In Denmark, the discussion for and against the use of ACE inhibitors on corona patients has taken place (in Danish) in e.g. the Journal of

Czech health care under pressure; hospitals hit virus record

PRAGUE (AP) — A record surge of new coronavirus infections in the Czech Republic in September has been followed by a record number of virus patients being hospitalized, putting the nation’s health care system under serious pressure for the first time in the pandemic.

After relaxing almost all virus restrictions in the summer, the Czech government has responded to the new spike by declaring a state of emergency on Wednesday. That has been accompanied by strict restrictions ranging from limiting public events to a ban on singing at churches and schools.

The Czech Republic faced a record surge of new COVID-19 cases two weeks ago with more than 3,000 testing positive in one day. On Wednesday, it hit almost 3,000 new cases again.


On Tuesday, 151 COVID-19 patients were admitted at hospitals across the country, bringing the total number of those hospitalized to 976. Of them, 202 needed intensive care. All three categories are records.

“(The outbreak) is not under control at this very moment,” Petr Smejkal, chief epidemiologist at the Institute of Clinical and Experimental Medicine in Prague, told The Associated Press.

September was by far the worst month for the country of nearly 10.7 million people. The number of all infected went up by more than 46,000 from 24,616 to 70,771, according to government figures released Thursday. A month ago, only 172 virus patients were being treated in hospitals and 35 were in intensive care wards.

“We have quite a robust health care system,” Smejkal said. “But the bottleneck of the system is not the ventilators and the machines. The bottleneck is the staff.”

Hospitals in the country have 6,000 beds assigned for COVID-19 patients and another 1,000 at intensive care wards.

“So, you can estimate that at the end of October, with only 1,000 ICU beds empty, they can easily fill up. (Then) all of the ICU capacity could be filled up and then you won’t have staff and you won’t be able to take care of other things besides COVID,” he said.

Some 1,700 Czech medical personnel have been infected, while others have been quarantined or remain home with their children.

Health care labor unions have urged hospitals to re-employ former staffers and to ask medical students for help. A major hospital in Uherske Hradiste county, the hardest hit area in the country with over 256 people infected per 100,000 inhabitants in the last seven days, has postponed all non-urgent operations for next week and was planning to send some coronavirus patients to nearby hospitals.

After health authorities acknowledged they could not properly trace the contacts of those infected in Prague, the capital, 250 police officers will be trained to help.

Smejkal said testing also needs to be increased because currently up to 12% of all those tested are positive.

“This should be down to 5%. If not, you’re still missing a lot of people who are positive and who can spread the disease,” he added.

Of the country’s 658 confirmed virus deaths, 217 of them

Intensive Blood Pressure Lowering Potentially Harmful in ICH

Intensive lowering of systolic blood pressure (SBP) for patients with intracerebral hemorrhage (ICH) whose initial SBP is excessively high does not improve outcomes and is linked to safety concerns, new research shows.

Investigators found that ICH patients whose initial SBP was 220 mmHg and who underwent intensive BP lowering had twice the relative risk for neurologic deterioration at 24 hours without any reduction in hematoma expansion or 3-month risk for death and disability compared to their counterparts who underwent standard SBP lowering.

“The significantly higher rate of neurological deterioration associated with intensive treatment in patients with initial systolic blood pressure of 220 mm Hg or more warrants caution against broad recommendations for intensive systolic blood pressure reduction in patients with intracerebral hemorrhage,” the investigators, led by Iryna Lobanova, MD, Zeenat Qureshi Stroke Institute, University of Missouri, in Columbia, write.

The study was published online September 8 in JAMA Neurology.

Efficacy Unknown

American Heart Association and American Stroke Association guidelines recommend lowering SBP to 140 mmHg for ICH patients whose SBP is between 150 mmHg and 220 mmHg. However, guideline authors note that the safety and efficacy of intensive SBP lowering for patients with SBP >220 mmHg “appears to be unknown.”

To evaluate the safety and efficacy of intensive SBP reduction for ICH patients with excessively high initial SBP, the investigators analyzed data from the Antihypertensive Treatment of Acute Cerebral Hemorrhage–II (ATACH-II) trial, which compared intensive and standard SBP reduction for patients with spontaneous supratentorial ICH.

Eligible participants had SBP >180 mmHg on two measurements. The first measurement that was recorded in the emergency department was considered the initial SBP.

Consistent with practice guidelines, treatment to lower SBP before randomization was permitted. The SBP measurement recorded immediately before randomization was the prerandomization SBP.

The treatment goal was to reduce SBP to a target range of 140 mmHg to 179 mmHg in the standard reduction group and 110 mmHg to 139 mmHg in the intensive reduction group over 24 hours.

The primary outcome was the proportion of patients who died or experienced severe disability at 90 days, defined as a Modified Rankin Scale score of 4 to 6.

Secondary outcomes included neurologic deterioration, as determined by the Glasgow Coma Scale or the NIH Stroke Scale, as well as hematoma expansion and hypotension.

Neurologic Deterioration

The study included 999 participants. Of these, 228 had an initial SBP of ≥220 mmHg. The mean age was significantly less in the excessively high SBP group than in the lower SBP group, at 59.0 and 62.8 years, respectively.

The mean minimum SBP at 6 to 7 hours and at 23 to 24 hours after randomization was significantly higher among the high SBP group than the lower SBP group.

Of the 228 patients whose initial SBP was ≥220 mmHg, 110 were randomly assigned to intensive SBP reduction, and 118 were assigned to standard SBP reduction. These two treatment groups did not differ significantly with respect to age or sex distribution.

Results showed that among participants with excessively high

Prednisone Facet Results Can Cause Excessive Cholesterol And Blood Pressure

These medicines block the transport of calcium into the graceful cells lining the coronary arteries and other arteries of the body. handout written material on a medication that sufferers are taking to include unwanted side effects and different drug interactions.

Government is hiding all of this from the individuals trigger i wager if a video of animals being tortured was placed on TELEVISION people would really feel bad and vote towards animal cruelty unless they haven’t any coronary heart. From millions of virus in a Hepatitis B patient the inhabitants of virus was decreased to solely 1000’s after treatment with infusion chelation therapy.

He was administered with blood transfusion however my mom requested that she be allowed to let him drink the boiled juice of Tawa-tawa. These are all physique painkiller medicines. For many individuals, the blood thickens because the body attempts to cope with the extraordinary heat, and nosebleeds and swollen ankles are frequent for these unused to the Greek summer season.

On the flipside, the consumerist model is the place shoppers have excessive control over their therapies while physicians have low control – think about sufferers now being able to seek second opinions, select their medical doctors, have interaction in alternative and biomedical therapies on the similar time.

The U.S. Environmental Protection Agency requires by law that insecticides be tested on canine, that are shoved into “inhalation chambers” the place they try in useless to escape the lethal poisons that are pumped in. The Meals and Drug Administration requires firms advertising fluoride merchandise to swab the teeth of 200 rats with the take a look at substance for two weeks, at which era the animals are killed and their heads baked in an oven for an hour and your tax dollars are funding all these experiments.…

Prednisone Aspect Effects Can Trigger High Ldl cholesterol And Blood Pressure

Do animals really feel the same ache that we as people really feel? Within the acute care settings equivalent to medical, surgical, pediatrics, or labor and delivery, you’ll come across all types of individuals that are in acute pain for many totally different causes.

They enjoyed the standing of free citizens and one in all their quantity, Galen (Latin name Claudius Galenus, c. ADVERT 130-201), combined the theory of the humours along with his personal studies in anatomy and physiology to supply a comprehensive medical encyclopedia, which remained an ordinary reference for more than one thousand years even if his anatomical descriptions, which were based mostly on dissections he had carried out on animals, were riddled with errors.

The ancient Greeks thought that the qualities blended to type four humours within the physique: blood (scorching and wet), yellow bile (sizzling and dry), black bile (chilly and dry), and phlegm (chilly and moist). Place your medicines within the bag, cushioning the tougher objects with the herbs and weeds.

My household went to an emerald mine in North Carolina and the stones and crystals we used had been ones that we discovered, so we take a look at the stones as having extra constructive power as a result of the household bond of the time spent hunting for them.I’ve about an eighth to 1 / 4 cherokee and my kids have more cherokee and some blackfoot indian in their bloodline so we respect the earth and all of its plants and animals.

Dr. Estuita’s hepatitis B therapy protocol is a boon for these searching for various modes of therapy however an anathema to standard medicine. There are many other ways in which products and medicine could be examined; the use of innocent animals is not wanted.…