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Study finds differences in heart failure trends between former East, West Germany

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July 1 (UPI) — Differences in heart health between people in the eastern and western parts of Germany show a long-term effect of the Berlin Wall on the country, according to new findings presented Wednesday on HFA Discoveries.

Germany was divided in the aftermath of World War II, and different healthcare structures developed in East and West Germany. The country became unified again in 1990, but new research shows effects of the decades-long separation persist, researchers say.

From 2000 to 2017, the absolute number of hospital admissions due to heart failure throughout Germany increased continuously by nearly 94 percent — to approximately 465,000 from just under 240,000 — researchers said.

However, the increase was much higher, at 119 percent, in the region that once encompassed East Germany, compared to just over 88 percent in the region once known as West Germany, they said.

Study co-author Marcus Dörr, a professor at the University Medicine Greifswald in Germany, said differences between the two regions in prevalence of heart failure risk factors may explain the findings.

“In fact, previous research has shown that, for example, hypertension, diabetes and obesity are much more common in East than in West Germany,” Dörr said in a press release.

In addition, lingering differences in patient care, as well as in the management of healthcare systems between the two regions, still might exist, Dörr said.

In general, heart failure is the most common reason for hospital admissions in the United States, Germany and much of the world, he said.

For their research, Dörr and his colleagues analyzed data from the Federal Health Monitoring project, an annual census of routine health data in Germany, for 2000 through 2017.

Heart failure was the leading cause of disease-related hospitalization in Germany in 2017, they found.

However, heart failure hospitalization rates nearly doubled in the former East Germany — to 2.9 percent from 1.5 percent — from 2000 to 2017, while it increased to 2.2 percent from 1.4 percent in the former West Germany over the same period, the researchers said.

While the overall length of hospital stays decreased continuously over the same period, the total number of heart failure-related hospital days increased by 51 percent in East Germany, compared to 35 percent in West Germany.

In 2017, heart failure was by far the leading cause of in-hospital death across Germany, accounting for 8.2 percent of deaths, they found.

However, in the region that once was East Germany, heart disease caused 65 deaths per 100,000 inhabitants in 2017, compared to 43 deaths per 100,000 inhabitants in the former West Germany, they said.

The differences may have to do with the average age of people in East Germany — four years older than it is in the West — but the differences in heart failure-related parameters were similar after standardization, the researchers said.

Before reunification in 1990, East and West Germany had distinct healthcare systems, Dörr said. The system in East Germany was essentially run by the state, with less than 1 percent of physicians working in private practice, and there were often shortages of technical equipment, he said.

“Since 1990, both regions have the same federal healthcare system with more physicians in private practice and similar clinical care pathways” Dörr said. “More research is needed to explain the huge differences observed between East and West Germany.”



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Antidepressant might help prevent severe COVID-19

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The antidepressant drug fluvoxamine — best known by the brand name Luvox — may help prevent serious illness in COVID-19 patients who aren’t yet hospitalized, a new study finds.

The study included 152 patients infected with mild-to-moderate COVID-19. Of those, 80 took fluvoxamine and 72 took a placebo for 15 days.

By the end of that time, none of the patients who took the drug had seen their infection progress to serious illness, compared with six (8.3%) of the patients who took the placebo, according to researchers at Washington University School of Medicine in St. Louis.

“The patients who took fluvoxamine did not develop serious breathing difficulties or require hospitalization for problems with lung function,” said first author Dr. Eric Lenze, professor of psychiatry.

“Most investigational treatments for COVID-19 have been aimed at the very sickest patients, but it’s also important to find therapies that prevent patients from getting sick enough to require supplemental oxygen or to have to go to the hospital. Our study suggests fluvoxamine may help fill that niche,” Lenze noted in a university news release.

Fluvoxamine — widely used to treat depression, obsessive-compulsive disorder and social anxiety disorder — is a type of drug called a selective serotonin-reuptake inhibitor (SSRI). This class of drugs also includes medicines such as Prozac, Zoloft and Celexa.

But unlike other SSRIs, fluvoxamine has a strong interaction with a protein called the sigma-1 receptor, which helps regulate the body’s inflammatory response.

“There are several ways this drug might work to help COVID-19 patients, but we think it most likely may be interacting with the sigma-1 receptor to reduce the production of inflammatory molecules,” explained study senior author Dr. Angela Reiersen, associate professor of psychiatry.

“Past research has demonstrated that fluvoxamine can reduce inflammation in animal models of sepsis, and it may be doing something similar in our patients,” she said in the release.

By reducing inflammation, fluvoxamine may prevent a hyperactive immune response in COVID-19 patients. That, in turn, may decrease their risk of serious illness and death, Reiersen said.

“Our goal is to help patients who are initially well enough to be at home and to prevent them from getting sick enough to be hospitalized,” Dr. Caline Mattar, assistant professor of medicine in the Division of Infectious Diseases, said in the release. “What we’ve seen so far suggests that fluvoxamine may be an important tool in achieving that goal.”

Dr. Amesh Adalja is a senior scholar at the Johns Hopkins Center for Health Security in Baltimore. He wasn’t involved in the study, but said the research is “notable not only because of its positive outcome — we desperately need a medication that keeps COVID patients out of the hospital — but also because of the manner in which it was conducted.”

But Adalja stressed that a larger trial is needed “to see if the promising findings hold up.”

The researchers said they plan to begin such a study in the next few weeks and it will include patients from across the United States.

The preliminary study was published online Nov. 12 in the Journal of the American Medical Association.

More information

For more on COVID-19, go to the U.S. Centers for Disease Control and Prevention.

SOURCES: Amesh Adalja, M.D., senior scholar, Johns Hopkins Center for Health Security, Baltimore; Washington University in St. Louis, news release, Nov. 12, 2020

Copyright 2020 HealthDay. All rights reserved.



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Survey: 40% in U.S. planning large gatherings for holidays despite COVID-19 warnings

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Nov. 12 (UPI) — Nearly 40% of U.S. residents plan to participate in gatherings of 10 or more people this holiday season despite concerns over the spread of COVID-19, according to the findings of a survey released Thursday by Ohio State University.

In addition, one-third of respondents said they wouldn’t ask attendees at holiday parties with family or friends to wear masks, and just over 25% indicated that they wouldn’t practice social distancing, the data showed.

“We’re going to look back at what happened during this holiday season and ask ourselves, ‘Were we part of the solution or were we part of the problem?'” Dr. Iahn Gonsenhauser, part of the team that conducted the survey, said in a statement.

“When you’re gathered together around the table, engaged in conversation, sitting less than 6 feet apart with your masks down, even in a small group, that’s when the spread of this virus can really happen,” said Gonsenhauser, chief quality and patient safety officer at Ohio State University Wexner Medical Center.

Researchers at Ohio State surveyed more than 2,000 U.S. residents on their holiday plans in the context of the COVID-19 pandemic.

As of Thursday afternoon, nearly 10.5 million people nationally have been sickened by the virus, and more than 240,000 have died, according to figures from Johns Hopkins University.

In recent weeks, federal, state and local public health officials have advised against traveling or partaking in large social gatherings as the holiday season approaches to limit the risk of spreading the new coronavirus to vulnerable loved ones.

At the very least, they’ve asked that gatherings not happen without wearing a mask and practicing social distancing, or staying 6 feet apart.

Those at risk for severe COVID-19 include the elderly, as well as those with diabetes, heart disease and high blood pressure, all of which are common across the United States, according to the Centers for Disease Control and Prevention.

Still, 38% of respondents to the Ohio State survey indicated they would host or attend a gathering with 10 or more people during the holidays and 33% would not ask others to wear masks, the researchers said.

However, 73% of respondents said they would practice social distancing during the holidays and 79% suggested that they would celebrate or gather only with people with whom they live, the data showed.

Just over 80% indicated that they would ask family and friends invited to events not to come if they had symptoms of COVID-19.

“If you have someone in your household who’s high risk and you’re in a low incidence area, you’re going to want to think twice about having a celebration where people are coming from an area where there’s a lot of virus in the community,” Gonsenhauser said.



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Healthy diet, exercise good for heart regardless of medication use

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No matter how many medications you take, eating a healthy diet, not smoking and getting plenty of exercise will help keep you alive, a new study finds.

“We’ve long known about the benefits of leading a healthy lifestyle. The results from our study underscore the importance of each person’s ability to improve their health through lifestyle changes even if they are dealing with multiple health issues and taking multiple prescription medications,” said researcher Neil Kelly. He’s a medical student at Weill Cornell Medicine of Cornell University in New York City.

For the study, Kelly’s team collected data on more than 20,000 people who took part in a study on racial differences in stroke.

At the start of the study, 44% of participants were taking four or fewer prescription medications, 39% were taking five to nine, and 17% were taking 10 or more medications.

After about 10 years, the researchers found that a healthy lifestyle reduced the risk of death during the study period regardless of the number of medications a person was taking, and the more healthy lifestyle habits one had, the lower the risk of death.

The findings were scheduled for presentation at the American Heart Association’s virtual annual meeting, Nov. 13 to 17. Such research should be considered preliminary until published in a peer-reviewed journal.

“It’s especially important for health care professionals to counsel patients and develop interventions that can maximize healthy lifestyle behaviors, even among patients with several prescription medications,” Kelly said in an AHA news release.

“It’s important for the public to understand that there is never a bad time to adopt healthy behaviors. These can range from eating a healthier diet to taking a daily walk in their neighborhood,” he added. “A healthier lifestyle buys more time.”

More information

For more on a healthy lifestyle, head to the American Heart Association.

Copyright 2020 HealthDay. All rights reserved.



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