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Cancer survivors may be at increased risk of cardiovascular disease | Cancer

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Evidence suggests that cancer survivors may be at increased risk of cardiovascular disease in later years.

However, heart scans can reveal early damage to the heart, potentially opening the door for more personalized follow-up care for cancer survivors.

Although previous studies have suggested that people who have been treated for cancer may be at greater risk for future cardiovascular problems such as stroke or heart failure, they have mostly focused on the first year after cancer diagnosis.

Few have examined long-term risks or included cardiovascular imaging to pinpoint damage that has not yet resulted in symptoms.

To fill these gaps, Dr Zahra Raisi-Estabrag of Queen Mary University of London and colleagues assessed the cardiovascular health of 18,714 UK Biobank participants with a previous diagnosis of lung, breast, prostate, blood, uterine or intestinal cancer and compared them. with an equal number of participants without a history of cancer tracking their cardiovascular health for almost 12 years.

Nearly a third of cancer survivors developed cardiovascular problems during the study period, compared with a quarter of people in the control group.

The highest rates of new CVD were seen in survivors of lung cancer or blood cancer, with almost half of them developing CVD in later years, the most common of which were coronary heart disease, abnormal heart rhythms, and heart failure.

In contrast, the most common cardiovascular problems among breast cancer survivors were heart failure, inflammation of the lining around the heart (pericarditis), and mechanical problems with the heart.

These differences are most likely a reflection of specific characteristics of the cancer and its treatments, Raisi-Estabrague said.

The team also reviewed the heart MRI results of 1,354 study participants for whom they were available. This revealed significant and detrimental changes in heart size and function in breast and blood cancer survivors. The results are published in the journal Heart.

Although this was an observational study and cannot prove that cancer or cancer treatment was the cause of this increased cardiovascular risk, blood cancer patients were treated with chemotherapy, which is known to be harmful to heart tissue, as well as radiation therapy aimed at heart tissue. chest, the researchers explained.

Some breast cancer treatments are also known to affect heart function, although it is likely that general vascular risk factors such as smoking, being overweight or diabetes, and biological processes associated with the cancer itself also contributed to this elevated heart rate. vascular risk. among cancer survivors.

“This study adds to existing knowledge about the impact of certain cancer treatments on cardiovascular disease in cancer survivors,” said Martin Ledwick, Chief Information Nurse at Cancer Research UK.

“This can help inform strategies for how some cancer survivors should be monitored in the long term, especially in situations where they have been discharged from cancer surveillance and are under the care of their GPs.”

Writing in related editorialProf. José Benchs of the University of Colorado and Dr. Tara Leh of Beth Israel Lahey Health in Massachusetts, said, “Fantastic progress in the treatment and even cure of cancer has undoubtedly highlighted the need for post-cancer treatment like never before.”

Confirmation that increased cardiovascular risk persists long after cancer is diagnosed, and that certain deleterious changes can potentially be detected on heart scans before patients develop symptoms, should allow clinicians to start improving strategies for following up such cancers. people.

“This study opens the door to some precision in the follow-up treatment of cancer survivors,” they said.

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HEALTH

Biden administration to fund free Covid vaccine preservation program for the uninsured

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WASHINGTON — The Biden administration plans to spend more than $1 billion on a new program to provide free coronavirus shots to uninsured Americans after the vaccines hit the commercial market later this year, administration officials said Tuesday.

V program for the uninsured, which will be modeled in part on the existing childhood vaccination program and reach approximately 30 million people, will include a first-of-its-kind partnership with pharmacy chains in which the government will pay the administrative costs of providing doses to patients. . Pfizer and Moderna have promised to offer vaccines free of charge to those without insurance.

The administration’s move partially closes a critical gap in the national coronavirus vaccination strategy ahead of a new reformulated booster campaign likely to begin as early as late summer. Federal officials said they no longer plan to buy doses for all Americans, as they did in previous coronavirus vaccination campaigns, allowing vaccines to be sold commercially and giving manufacturers the right to set their own prices.

In the new program, the administration is counting on substantial assistance from vaccine companies. In February, Moderna said it would use a so-called patient assistance program to provide free doses to uninsured Americans. Pfizer plans to offer free vaccines as part of a similar program, a company spokesperson said.

The details of these programs are still being worked out. Jennifer Cates, senior vice president of the Kaiser Family Foundation, said pharmaceutical company assistance programs vary by company and drug, a patchwork system that can be complex and out of reach. Companies often require proof of income or proof that the patient is not insured. Cates said, and it’s not clear how long drug makers’ programs can last.

“It’s a Band-Aid,” she said. “The problem is that these are not mandatory or forks. This is a voluntary effort by companies.”

But Xavier Becerra, Biden’s secretary of health and human services, said it was in the interests of companies to continue the programs.

“It’s their business sense,” Mr. Becerra said in an interview. “The last thing they want is to become an object of ridicule, because people say: “What gives? What if we have to pay for this vaccine?”

The new vaccine initiative comes as the administration moves beyond the coronavirus public health emergency that was declared under President Donald J. Trump in 2020 and extended under Biden. The administration plans to allow the state of emergency to expire on May 11, putting the country on a path to treating Covid-19 as just another respiratory illness like the flu.

The new initiative will also cover some of the costs associated with treating Covid-19 for the uninsured. In addition, the administration is working on a $5 billion program to track next-generation coronavirus vaccines and treatments.

“Covid is not over yet,” the doctor said. Ashish K. Jha, White House Coronavirus Response Coordinator. “While we are emerging from the public health emergency and all the flexibilities it provides, we are committed to continuing to fight Covid. And that means people should have access to vaccines, treatments and tests.”

The end of the public health emergency will not have an immediate impact on Americans’ ability to access coronavirus vaccines. For now, people can still get vaccinated for free from a stockpile of doses already purchased by the federal government. On Tuesday, the Food and Drug Administration authorized a second updated booster shot for people aged 65 and over or those who are immunocompromised.

In June, federal regulators are expected to select the new formula to use in another round of booster shots later in the year, around the time people get their annual flu shot.

As part of a new initiative called the HHS Vaccine and Treatment Bridge Access Program for Covid-19, federal officials will also purchase vaccines and distribute them to state and local health departments for the uninsured.

When coronavirus vaccines hit the commercial market, Pfizer and Moderna said they plan to charge them. over $100 per can, which is about four to five times the price the federal government paid to vaccinate companies in the last ad campaign. Dr. Jah said White House officials “do not see such price increases as justified.”

But Mr. Becerra acknowledged there was little the administration could do. “We do not control the commercial market,” he said.

For most Americans, there will be no personal cost to the recast at the end of this year. They are covered by most private health plans, as well as Medicare and Medicaid. The cost of doses for uninsured children will be covered by the federal Program “Vaccines for Children”.

The Biden administration proposed creating a program called Adult Vaccines that would mimic the concept used for uninsured children. But administration officials failed to persuade lawmakers to come up with such an initiative.

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FDA clears extra COVID boosters for some high-risk Americans

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WASHINGTON– U.S. regulators on Tuesday approved another booster dose of Pfizer or Moderna COVID-19 vaccines for older Americans and people with weak immune systems.

The Food and Drug Administration has also taken steps to make coronavirus shots easier for everyone, saying that anyone who gets a dose of Pfizer or Moderna — whether it’s a booster or their first ever vaccination — will get the latest formula, and non-original vaccines.

The FDA said those 65 and older can roll up their sleeves again for another booster dose if at least four months have passed since their first dose of a so-called bivalent vaccine that targets omicron strains.

Most immunocompromised people can also opt for this additional spring booster dose at least two months after the first, with additional doses down the road at the discretion of their physician, the agency said.

If the Centers for Disease Control and Prevention approves, these spring boosters could start within a few days. CDC advisors are set to meet on Wednesday.

“COVID-19 remains a very real risk for many people,” said FDA vaccine chief Dr. Peter Marks said.

It’s still too early to know if younger, healthier people will end up being offered another shot, but an extra dose for the most vulnerable is one of several steps the FDA is taking to make COVID-19 vaccines easier in the future.

Here’s what you need to know:

ONE FORMULA FOR PFIZER AND MODERNA SHOTS

COVID-19 vaccines have saved millions of lives, but protection wanes over time and as new, more infectious options become available, so last fall Pfizer and Moderna released updated “bivalent” boosters that added protection against the omicron strains then circulating compared to with parent vaccines. vaccine prescription. On Tuesday, the FDA said the updated formula would be used for anyone receiving the Pfizer or Moderna vaccine. For unvaccinated adults, this means that one combination shot will replace the need to get multiple doses of the original vaccine first.

WHO NEED A BOOSTER?

Anyone who has received their original immunizations but has not yet received the updated booster vaccine can still receive it. Only 42% of Americans aged 65 and over — and just 20% of all adults — have received one of these upgraded boosters since September. “These people could certainly go and get a bivalent booster now to improve their defenses,” Marks said.

SOME PEOPLE ARE AT INCREASED RISK

For many Americans, COVID-19 has become less of a health concern and more of an inconvenience, with mask-wearing, routine testing and other precautions largely taken a back seat. But at least 250 people in the US still die from COVID-19 a day, and high-risk Americans who last received a dose in the fall were anxiously wondering when they could get another.

Giving older and immunocompromised people an extra dose of a booster dose puts the US on par with the UK and Canada, which are also offering some vulnerable populations a spring shot. It’s a smart choice, says Dr. Matthew Lawrence of the University of Maryland School of Medicine.

“We have vaccines to protect against these dire consequences, so why not use them?” He said. “They don’t do any good just sitting on the shelf.”

WILL YOUNG AND HEALTHY PEOPLE RECEIVE THE AUTUMN DOSE?

Stay tuned The FDA will hold a public meeting in June to consider whether the vaccine prescription needs further adjustment to better match the latest strains of the coronavirus — just as it adjusts flu vaccines every year. And part of that discussion will be whether younger, healthier people need boosters.

The updated Pfizer and Moderna grafts in use now target the BA.4 and BA.5 versions of the omicrons, which have been replaced by an ever-changing list of omicron descendants. However, while protection against mild infections is short-lived, these updated doses continue to do well against severe illness and death even from the newest options, Marks said.

Whether the prescription is adjusted again or not, Tuesday’s move “essentially prepares for a simpler and more direct way to vaccinate people,” he said. and winter months.

SETTINGS FOR CHILD SHOTS, ALSO

Millions of children in the US still haven’t received their initial COVID-19 shots, but Tuesday’s move means they, too, could get the most up-to-date shots. Unvaccinated toddlers aged 6 months to 5 years can choose two Moderna shots or three Pfizer-BioNTech shots. Children as young as 5 years of age may receive two doses of Moderna or one Pfizer shot.

The FDA said that children already fully or partially vaccinated with the original Pfizer or Moderna shots can receive the bivalent vaccine, but the number of doses will depend on their vaccination history.

WHAT ABOUT NOVAVAX VACCINE?

Novavax makes a more traditional type of COVID-19 vaccine, and its original formula remains available for people who don’t need the Pfizer or Moderna options. On Tuesday, Novavax said it is preparing to release several additional formulas in case the FDA requests a fall update.

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The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute Science and Education Media Group. AP is solely responsible for all content.

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What is bone grafting? – Learn different types of vaccination procedures

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Surgical treatment of bone grafting has recently gained popularity, especially in the field of dentistry. It is a complex but incredibly successful method of growing new, healthy bone to replace lost or damaged bone. When performed to restore bone loss caused by injury, disease, or other medical conditions, bone grafting can help many patients regain function and improve their quality of life.

During this process, the bone is removed from another location in the patient’s or donor’s body and transplanted to the problem site. The newly implanted bone then contributes to the development of new bone tissue, which eventually fuses with the original bone. To create a solid base for implant attachment, bone grafting is often used in dental implant treatment. This can be done on many areas of the body, including the spine, hips, and jaws. It is recommended to speak with a qualified medical expert if you are interested To learn more about bone grafting and how it can help you.

autografts

Bone grafting techniques, known as “autografts,” use the patient’s own bone to replace or repair damaged bone. This approach is often chosen because it does not carry the risk of disease transmission or tissue rejection associated with the use of foreign tissue. Autografts can be taken from the thigh, leg, or chest, among other parts of the body. The damaged area is then treated with bone tissue, which over time will grow together and develop there.

allografts

Allografts involve the transplantation of bone tissue from a donor, which can be either a living or deceased person. Donor bone is carefully cleaned and sterilized before transplantation to ensure that there are no infections or diseases. Allografts are an effective and safe option for bone grafting, as they do not require the removal of bone tissue from the patient’s body.

Alloplastic grafts

Alloplastic bone grafting procedures are a type of bone grafting that uses synthetic materials. Alloplastic grafts are typically used to fill small gaps in bones or to provide structural support. The materials used for alloplastic grafts can vary, but are most commonly ceramics, metals, and polymers. This type of bone grafting procedure is often preferred over other types of grafting procedures because it does not require a donor site and is less likely to result in complications such as infection or rejection.

xenografts

Xenografts are a type of bone grafting procedure that uses bone material from a different species, usually bovine or porcine, to replace missing or damaged bone in a human patient. This material is processed to remove any living cells that might elicit an immune response, leaving behind only the bone matrix. Xenografts have a number of advantages including availability, affordability, and ease of use. They also carry a small risk of disease transmission and may not be as effective as other types of bone grafts in certain situations.

synthetic transplants

These procedures involve the use of artificial materials such as ceramics or polymers to stimulate bone growth and regeneration. Synthetic grafts can be tailored to a patient’s specific needs, making them an ideal choice for a variety of bone-related injuries and conditions. Synthetic grafts are often less expensive and less invasive than traditional bone grafting procedures, reducing recovery time and patient discomfort.

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