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Stroke research: Tested implant offers hope to survivors

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WASHINGTON –

A stroke left Heather Rendulic with little use of her left hand and arm, putting certain everyday tasks like tying shoes or cutting foods out of reach.

“I live one-handed in a two-handed world and you don’t realize how many things you need two hands for until you only have one good one,” the Pittsburgh woman told The Associated Press.

So Rendulic volunteered for a first-of-its-kind experiment: Researchers implanted a device that zaps her spinal cord in spots that control hand and arm motion. When they switched it on, she could grasp and manipulate objects — moving a soup can, opening a lock and by the end of the four-week study, cutting her own steak.

It’s not a cure — the improvements ended after scientists removed the temporary implant — and the pilot study included only Rendulic and one other stroke survivor. But the preliminary results, published Monday, mark a step toward one day restoring mobility for this extremely common type of paralysis.

“They’re not just getting flickers of movement. They’re getting something important,” said Dr. Jason Carmel, a Columbia University neurologist who wasn’t involved with the new experiment but also studies ways to recover upper-limb function. “It’s a very exciting proof of concept.”

Nearly 800,000 people in the U.S. alone suffer a stroke each year. Even after months of rehabilitation, well over half are left with permanently impaired arm and hand function that can range from muscle weakness to paralysis.

Experiments by multiple research groups have found that implanting electrodes to stimulate the lower spine shows promise for restoring leg and foot movement to people paralyzed after a spinal cord injury — some have even taken steps.

But upper-limb paralysis has gotten little attention and is inherently more challenging. The brain must signal multiple nerves that control how the shoulder lifts, the wrist turns and the hand flexes. Stroke damage makes it harder for those messages to get through.

“People still retain some of this connection, they’re just not enough to enable movement,” said University of Pittsburgh assistant professor Marco Capogrosso, who led the new research with colleagues at Carnegie Mellon University. “These messages are weaker than normal.”

His idea: Stimulate a pathway of related nerve cells so they’re better able to sense and pick up the brain’s weak signal.

“We’re not bypassing their control. We’re enhancing their capabilities to move their own arm,” he said.

Researchers turned to implants the size of spaghetti strands that already are used to stimulate the spine for chronic pain treatment. The implants carry electrodes that are placed on the surface of the spinal cord to deliver pulses of electricity to the targeted nerve cells — which for hand and arm control are in the spine’s neck region.

Rendulic and a second, more severely impaired volunteer could move better as soon as the stimulator was switched on — and by the study’s end showed improved muscle strength, dexterity and range of motion, researchers reported Monday in the journal Nature Medicine. Surprisingly, both participants retained some improvement for about a month after the implants were removed.

Rendulic, now 33, was performing some fine-motor tasks for the first time since suffering a stroke in her 20s. That unusually young stroke, caused by weak blood vessels that bled inside her brain, initially paralyzed her entire left side. She learned to walk again but — with the exception of those four weeks with spinal stimulation — cannot fully open her left hand or completely raise that arm.

“You feel like there’s a barrier between your brain and your arm,” Rendulic said. But with the stimulation on, “I could immediately sense that, like, oh my arm and hand are still there.”

Two other researchers who helped pioneer experiments stimulating the lower limbs of people with spinal cord injuries say it’s logical to now try the technology for stroke.

While bigger and longer studies are needed, the new results “are really promising,” said Mayo Clinic assistant professor Peter Grahn.

Scientists have learned from research with lower limbs that “it may not matter where that injury occurs, if it’s something in the brain or it’s a spinal cord injury,” added University of Louisville professor Susan Harkema. “Targeting the human spinal cord circuitry has a lot of potential.”

With National Institutes of Health funding, Capogrosso is studying the approach in a few more stroke survivors. The researchers also have formed a company to further develop the technology.

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

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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