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Winnipeg lupus patients on edge amid shortage of drug at centre of COVID-19 trials – CBC.ca

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An unproven claim a drug used to treat lupus can combat COVID-19 is causing an increase in prescriptions of the drug, creating shortages and putting Winnipeggers who rely on it on edge. 

Elena Anciro was diagnosed with lupus eighteen years ago and relies on taking hydroxychloroquine daily in order to function without being in intense pain, and to reduce the flare-ups that make it hard to get out of bed.

“People have called this medication ‘lupus life insurance,'” Anciro said. “It is vital.”

While the drug was created in the 1950’s to treat malaria, it is commonly prescribed to control inflammation and pain for those with lupus and rheumatoid arthritis. 

However, it came to the forefront in the fight against COVID-19 thanks to a famous tweet by U.S President Donald Trump.

The tweet sent earlier this month heralded it as a possible way to treat COVID-19.

It sent people scrambling to get their hands on the drug, causing a spike in prescriptions in Manitoba and a dire warning from the province’s health regulators — it was being over-prescribed and now they are facing “serious shortages.” 

“Due to the recent yet-to-be-proven claims of effectiveness of hydroxychloroquine sulfate against COVID-19 and the growth in prescribing for it, we are now faced with a very serious shortage (and some brands, outages) of the product,” read a March 26 notice co-authored by the College of Physicians and Surgeons, Nurses and Pharmacists.

“This presents very serious challenges for long-term continuity of care for patients suffering from rheumatoid arthritis and lupus.”

Manitoba reports spike in prescriptions of hydroxychloroquine

According to the notice there has been a “significant increase” in Manitoba over the past two weeks in the number of prescriptions written and dispensed for hydroxychloroquine and Kaletra — an antiretroviral used to treat HIV.

As part of mandatory reporting requirements, a drug shortage report was given to Health Canada on March 19 by the drugs’ manufacturer, Apotex Inc. It cited the shortage was due to “demand increase” for the drug.

Anciro is just one of the 15,000 Canadians who have lupus, an autoimmune disease that cause severe inflammation of the joints among other symptoms. A further 300,000 Canadians have rheumatoid arthritis, many of whom also rely on the drug to function in their lives. 

“When Trump announced that and this all happened, to have to not only worry about getting this sick from this highly contagious virus, [but also] having to worry about the pills that allow me to be well, is very stressful,” said Anciro.

Stephanie Corbett has lupus and says if she wasn’t able to take the drug, she would have to be hospitalized and would be in immense pain. (Supplied)

Stephanie Corbett is another Winnipegger who takes hydroxychloroquine daily to treat lupus. The mother of five was diagnosed with lupus nine years ago and says without the drug, she’d likely end up in the hospital.

So far, both have been able to fill their prescription without any issues. Both say it would take weeks for the drug to leave their system, but when it does, it’ll be devastating.

“It will be life-threatening for people like me,” said Corbett. 

“I’ll end up in the hospital. The rashes will start. The pain will get worse. You know, every symptom will start rearing.”

Clinical trial at U of M

While a clinical trial is currently underway at the University of Manitoba to see if hydroxychloroquine can be repurposed to reduce the severity of COVID-19, there are currently no approved treatments or vaccines for the virus.

Virologist Jason Kindrachuk says the key message for Manitobans is they need to wait and see the outcomes of these trials before jumping to conclusions.

“The data is simply not there. I’m not arguing for or against it. I’m just saying that right now we don’t have data to support that it is actually truly beneficial for patients,” said Kindrachuk, an associate professor at the University of Manitoba and Canada research chair in emerging viruses.

Jason Kindrachuk of the University of Manitoba says the scientific community needs to explain that they are still studying these drugs and don’t know all their benefits or possible negative affects. (Jaison Empson/CBC)

He says the scientific community needs to do a better job of communicating to the public the proven benefits of a drug.

“Our biggest concern is that we don’t want to give people false hope if we truly don’t know whether or not there’s a benefit, because, again, we can have a position where people are demanding hydroxychloroquine,” Kindrachuk said 

CBC reported last week that medical regulators across the country were seeing overprescription of drugs such as hydroxychloroquine and azithromycin, another drug being studied as part of the fight against COVID-19.

Regulators reported an increase in orders for the drugs from doctors who list it as “for office use.” These requests are typically from doctors who want to keep a supply on hand for future use, raising concerns that stockpiling was occurring. 

The Manitoba College of Physicians and Surgeons cautioned its members against stockpiling, warning that it may be reviewing prescriptions of these drugs and “prescribers must be able to demonstrate good medical care.”  

“These drugs have an intended use and prescribing these drugs as a precautionary measure leads to drug shortages and is compromising care for other patients,” the College wrote on Thursday.

Chief provincial public health officer Dr. Brent Roussin talks about a new Manitoba clinical trial looking at the effectiveness of using hydroxychloroquine, which has been used for malaria and other conditions, to treat COVID-19. 1:16

A warning was only given to nurses from their regulator, warning them not to prescribe Hydroxychloroquine or azithromycin to treat COVID-19.

“Nurses have an obligation to ensure that their practice and any treatment they prescribe is evidence-informed,” wrote the College of Nurses. 

Both Corbett and Anciro say they understand Manitobans are gravitating to the drug because they are scared. 

“But as of right now, there is nothing saying that the public should to be taking it,” said Corbett.

“So leave the drug for the people with the diseases that are taking it and that need it to survive.”

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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