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Heart Attack Drug Proves Effective at Treating Stroke – Technology Networks

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In the largest stroke clinical trial ever run in Canada, researchers have shown Tenecteplase (TNK), a safe, well tolerated drug, commonly used as a clot buster for heart attacks, is an effective treatment for acute ischemic stroke. Led by researchers with the University of Calgary at the Foothills Medical Centre and Sunnybrook Health Sciences Centre, fully affiliated with the University of Toronto, the study included 1600 patients at hospitals throughout Canada.

“It is truly an important finding that I share with my colleagues from coast to coast. Through this collaboration these findings could revolutionize stroke treatment throughout the world,” says Dr. Bijoy Menon, MD, professor at the University of Calgary, neurologist at the Foothills Medical Centre and co-principal investigator on the study. “Tenecteplase is known to be an effective clot dissolving drug. It is very easy to administer which makes it a game changer when seconds count to save brain cells,”

Based on current guidelines, Alteplase (tPA) is the recommended drug for acute ischemic stroke patients. The challenge is that the drug is more complex to administer. It takes up to an hour and requires an infusion pump that needs to be monitored. The pump can be cumbersome when transporting a patient within a hospital, or to a major stroke center for treatment.

“One of the reasons Tenecteplase is so effective is that in can be administered as a single immediate dose,” says Dr. Rick Swartz, MD, PhD, clinician-researcher at the University of Toronto, co-principal investigator, and stroke neurologist at Sunnybrook Health Sciences Centre. “That’s a big advantage, saving critical time and complication. TNK could potentially be administered wherever the patient is seen first, at a medical centre or small hospital,”

The AcT Trial compared TNK to tPA in a randomized trial. The results published in The Lancet show that TNK worked as well as, if not better than, the current recommended drug, tPA. TNK attaches itself to the clot for a longer period of time than tPA which means that blood flow is restored faster and for a longer period of time. Along with discovering a better way to treat acute ischemic stroke, the team also established a more cost effective, and efficient way to conduct clinical trials. 

Reference: Menon BK, Buck BH, Singh N, et al. Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial. The Lancet. 2022;0(0). doi: 10.1016/S0140-6736(22)01054-6

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

 

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U.S. to give smaller doses of monkeypox vaccine amount to stretch limited supply – CBC News

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U.S. health officials have authorized a plan to stretch the nation’s limited supply of monkeypox vaccine by giving people just one-fifth the usual dose, citing research suggesting that the reduced amount is about as effective.

The so-called dose-sparing approach also calls for administering the Jynneos vaccine with an injection just under the skin rather than into deeper tissue — a practice that may rev up the immune system better. Recipients would still get two shots spaced four weeks apart.

The highly unusual step is a stark acknowledgement that the U.S. currently lacks the supplies needed to vaccinate everyone seeking protection from the rapidly spreading virus.

Federal officials consider about 1.6 million to 1.7 million Americans to be at highest risk from the disease, primarily men with HIV or men who have a higher risk of contracting it. Vaccinating that group would require more than 3.2 million shots.

White House officials said the new policy would immediately multiply the 440,000 currently available as full doses into more than two million smaller doses.

The U.S. will stretch its supply of the monkeypox vaccine by giving people one-fifth of the usual dose. In this photo, a Montreal health-care worker prepares a dose of the monkeypox vaccine on July 23. (Graham Hughes/The Canadian Press)

“It’s safe, it’s effective, and it will significantly scale the volume of vaccine doses available for communities across the country,” Robert Fenton, the White House’s monkeypox response co-ordinator, told reporters.

CBC News has reached out to Health Canada to ask if it is considering reducing dose sizes in order to stretch its supply of the same vaccine, which goes by the trade name Imvamune in Canada. Just over 1,000 cases of monkeypox have been confirmed in Canada.

Different vaccination technique

The smaller doses also require a different type of injection that penetrates only the top layer of skin, rather than the lower layer between the skin and muscle. That’s a less common technique that may require extra training for some health practitioners. But infectious disease specialists said it shouldn’t be a major obstacle.

“Intradermal administration is certainly something that has been used for other vaccines, including the smallpox vaccine, which was administered to hundreds of millions of people during the 20th century,” said Anne Rimoin, director of UCLA’s Center for Global and Immigrant Health.

The shallower injection is thought to help stimulate the immune system because the skin contains numerous immunity cells that target outside invaders.

People line up at a monkeypox vaccination site in Encino, Calif., on July 28. Officials say giving Americans smaller doses of the vaccine means 400,000 doses can be stretched into more than two million doses. (Marcio Jose Sanchez/The Associated Press)

The CDC said it will provide educational materials on the technique along with a broader awareness campaign for U.S. health departments.

The Biden administration declared monkeypox a public health emergency last week in an effort to slow the outbreak that has infected more than 8,900 Americans.

Officials announced a separate determination Tuesday that allows the Food and Drug Administration to expedite its review of medical products or new uses for them, such as the dose-sparing technique for Jynneos.

The FDA authorized the approach for adults 18 and older who are at high risk of monkeypox infection. Younger people can also get the vaccine if they are deemed high risk, though they should receive the traditional injection, the agency said.

‘Robust immune response’ to smaller dose

Regulators pointed to a 2015 study showing that inoculation with one-fifth of the traditional two-dose vaccine generated a robust immune-system response comparable to that of the full dose. About 94 per cent of people receiving the smaller dose had adequate levels of virus-fighting antibodies, compared with 98 per cent of those receiving the full dose, according to the study funded by the National Institutes of Health.

The NIH is planning an additional trial of the technique. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said her agency is already starting to track real-world vaccine effectiveness in U.S. communities, though initial estimates will take time to generate.

A man receives a monkeypox vaccine at an outdoor walk-in clinic in Montreal on July 23. (Graham Hughes/The Canadian Press)

But some experts and advocates worried that with little data to support the policy, it could backfire if it reduces vaccine effectiveness.

“We have grave concerns about the limited amount of research that has been done on this dose and administration method, and we fear it will give people a false sense of confidence that they are protected,” said David Harvey of the National Coalition of STD Directors, in a statement.

Rationing vaccine doses is common in Africa and other parts of the world with limited health resources. In recent years the World Health Organization has endorsed the strategy to address outbreaks of yellow fever, polio and other diseases.

“This is not an uncommon situation” said Dr. William Moss of Johns Hopkins’ Vaccine Access Center. “It comes down to the public health decision-making: In the midst of an outbreak where you have insufficient supply, do you make this tradeoff?”

Both the U.K. and Canada have adopted a single-dose vaccine strategy prioritizing people who face the highest risk from monkeypox. And health departments in several large U.S. cities adopted a similar strategy amid limited supplies, including New York, San Francisco and Washington.

U.S. officials have shipped more than 625,000 full vaccine doses to state and local health departments. So far the shots have been recommended for people who have already been exposed to monkeypox or are likely to get it due to recent sexual contacts in areas where the virus is spreading.

A nurse prepares a dose of a monkeypox vaccine in Salt Lake City, Utah, on July 28. The U.S. considers 1.6 million to 1.7 million Americans to be at highest risk from the disease, primarily men with HIV or men who have a higher risk of contracting it. (Rick Bowmer/The Associated Press)

As of August 8, the Public Health Agency of Canada had sent more than 85,000 doses of vaccines to provinces and territories, a spokesperson said.

CBC News has requested further information about Canada’s stockpile of the vaccine, and its ability to meet demand for immunizations, with some provinces already rationing doses.

Typically, Imvamune is a two-dose shot, given 28 days apart, with the option for a booster two years later.

But in guidance for health-care professionals released in mid-June, Ontario said it would be using a “ring vaccination approach” and offering just a single dose in areas with confirmed cases — given the “current limited supply” of vaccines.

LISTEN | The latest on Canada’s monkeypox outbreak:

Front Burner26:21The latest on Canada’s monkeypox outbreak

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Public Health Ontario reports 478 confirmed monkeypox cases, up from 449 last week – Global News

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Public Health Ontario says there are now 478 confirmed cases of monkeypox in the province.

The agency’s latest report on the illness says 75 per cent of cases were reported in Toronto.

Most cases are reported in men but three are among females.

The report on cases as of Monday represents an increase from the 449 confirmed cases in Ontario as of last Thursday.

Public health says 15 people have been hospitalized with monkeypox in Ontario and two people have been in intensive care.

There are also seven probable cases in the province.

© 2022 The Canadian Press

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Ontario’s Ministry’s of Health -Senior Living Need to Step Up. Premier too.

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3-5 years ago I would go to the local hospital with one of my two Mothers, both elderly with various health conditions. Back then our average waiting time was @6-8 hours during the weekday, and 8-15 hours during the weekend. After the front-line nurses spoke to us, we were placed in a cubicle to wait for a doctor to see us. More time passed, sometimes 3-8 more hours. A nurse would make a short visit to see the condition of my Mother and move on. I actually saw others who have waited a long time leave the hospital disgusted, angered and feeling hopeless. The timeline shows us that much has not changed, even with the pandemics’ input. A failed health system persists.

Then the pandemic happened. One of my Mothers was very ill, nearing the time when she would have to stay in the hospital. Over three days she waited on a gurney, being visited by nurses, and doctors, going for various tests. She developed blisters on her back due to her bedtime and being unable to walk to the bathroom. In the middle of this pandemic, this lovely lady lay terrified, in pain and loss to the world you find in a hospital. My wife, children and I took turns giving my Mother our 24/7 attention. I eventually talked my doctor into allowing Mom to return home, where she passed away in some form of peace, with her family at Her side. A visiting nurse provided service and kindness to Mom those weeks before Her passing. Those ladies were marvellous, top-notch.

Now the rant: Where the HELL do we live? Canada is not some tin pot republic where the people are secondary to their leader’s needs. Canada, where our ancestors provided us with a “universal care” (?) system of health care. A place where we do not have bread lines, but a place where we have to wait for any form of healthcare. If the healthcare system in Ontario were a grocery store, and it provided the same services I/We would not shop there would we? We would look for better stores, with quicker premier customer service and quality of the product. Yeah, we would seek out an alternative!!!

There is no alternative to healthcare in Ontario or Canada. If you are wealthy you can arrange for private healthcare or go to the USA, but the rest of us peons cannot. We pay into a health insurance plan that has not been working for decades and is now falling apart due to the pandemic and a total lack of governmental foresight and investment into the system and its essential services. Our governments pay some people way too much, and those who are essential to our health and well are NOT enough.

Premier Ford needs to end Bill 124 and make direct investments into the payroll structure of our nurses, medical professionals and doctors. Conservatives and their alternatives the Liberals bled the system dry by not investing in these essential pillars of our society. Of course, they would be unprepared that the pandemic was upon us years ago. They are seemingly still unprepared as an exodus of healthcare workers presents itself. The Premier says the Province is open for business, so long as you do not get ill and need a hospital.

Steven Kaszab
Bradford, Ontario
skaszab@yahoo.ca

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