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Fresh doubts, new support for flu shots for seniors

first_imgOct 9, 2007 (CIDRAP News) – In quick succession, the view that influenza shots yield life-saving benefits for elderly people has come under serious attack and received fresh support in recent weeks.One group of experts, writing in the October issue of Lancet Infectious Diseases, argued that the mortality benefits of flu shots for the elderly have been greatly exaggerated because of a subtle bias and other methodologic problems in many of the relevant studies.”The remaining evidence base is currently insufficient to indicate the magnitude of the mortality benefit, if any, that elderly people derive from the vaccination programme,” says the analysis by Lone Simonsen, PhD, of George Washington University in Washington, DC, and colleagues.But in the Oct 4 New England Journal of Medicine (NEJM), another team of experts presented a study showing that in the course of up to 10 flu seasons, flu shots reduced the risk of hospitalization for pneumonia and flu by 27% and shrank the risk of death by 48% for elderly members of three health maintenance organizations (HMOs). The study addresses several of the methodologic problems raised by the Lancet authors.”Vaccine delivery to this high-priority group should be improved,” states the report by Kristin Nichol, MD, of the Minneapolis Veterans Affairs Medical Center and University of Minnesota, and four coauthors.The controversy has major policy implications, since the Centers for Disease Control and Prevention (CDC) and other medical groups heavily promote flu shots for elderly people, given their risk for serious complications if they contract the flu. This policy is reinforced by Medicare coverage of flu shots for this age-group.A sharp critique of the evidenceThe Lancet Infectious Diseases authors offer several reasons for questioning the notion that flu immunization saves lives in the elderly population:Vaccination coverage among the elderly has increased from 15% to 65% since 1980, but instead of declining, overall mortality due to pneumonia and influenza in elderly people has increased in that period.Few randomized, placebo-controlled trials have examined flu vaccine effectiveness in elderly people. The largest and best study, done in the Netherlands, showed a 50% reduction in confirmed flu cases among all the volunteers, but the reduction for those older than 70 was only 23%. There was no significant reduction in influenza-like illness.A number of investigators have reported finding evidence of flu vaccination benefits in the elderly by analyzing the records of large healthcare organizations. But these studies typically are flawed in that investigators looked for an effect on all-cause mortality, a nonspecific outcome, rather than on lab-confirmed flu. Further, many such studies may be marred by a subtle selection bias, wherein relatively healthy older people were more likely to be vaccinated than frail seniors were, thereby making vaccination look more beneficial than it really was. A further problem is that cohort studies typically have defined the flu season arbitrarily as December through March, rather than on the basis of flu surveillance.Simonsen and colleagues also write that since 1968, flu has accounted for an average of about 5% of all winter deaths in older people. Yet the results of cohort studies have prompted claims that flu vaccination reduces the risk of winter death from any cause by about 50% for community-dwelling people older than 65. “That influenza vaccination can prevent ten times as many deaths as the disease itself causes is not plausible,” say Simonsen et al.They argue that in view of the “slim” evidence that flu immunization prolongs elderly people’s lives, it may be time to consider doing more randomized, placebo-controlled trials—even though using a placebo would be “ethically unappealing.” In addition, they suggest, other options for protecting the elderly should be pursued, such as developing vaccines that are more immunogenic, using larger vaccine doses, and employing antiviral drugs more aggressively.Meanwhile, the researchers say elderly people should continue to be vaccinated, because “even a partly effective vaccine would be better than no vaccine at all.”Critiquing the critiqueThe review by Simonsen and colleagues drew praise in an editorial in The Lancet, written by two other vaccine experts who have reviewed the case for flu immunization in the elderly. Tom Jefferson and Carlo Di Pietrantonj of the Cochrane Vaccine Fields in Alessandria, Italy, write that Smonsen et al “prove that statistical methods for adjustment for residual bias used in the observational studies of influenza vaccines did not work, largely because of the difficulty of adjusting for frailty with data available in electronic records.”Jefferson and Di Pietrantonj endorse the idea of doing new randomized, placebo-controlled trials of flu vaccination in older people, arguing that such studies are “the only ethical and scientific way” to settle conclusively whether the vaccines are protective. The trials must cover more than one flu season and be large enough to detect rare outcomes, such as deaths due to flu, the pair assert.In an interview, a flu expert with the CDC asserted that the evidence of effectiveness remains strong enough to justify the US policy of promoting flu shots for the elderly. David K. Shay, MD, MPH, a medical officer in the CDC’s influenza division, agreed that better vaccines are needed, but he rejected the idea of doing placebo-controlled trials in the elderly as unethical.Shay said the randomized, controlled trial from the Netherlands that showed a 50% reduction in confirmed flu cases among the elderly provided “gold standard evidence” for a protective effect. The risk was reduced 57% in 60- to 69-year-olds versus 23% in those 70 and older, but because of wide confidence intervals, the difference between the two groups was not significant, he said.The Dutch findings and the high risk of flu-related hospitalization and death in the elderly provide the major underpinnings of the US policy of promoting flu vaccination in the elderly, Shay said, adding, “We’re left with the fact that this study [by Simonsen et al] isn’t going to change policy in the US for the use of these vaccines.”He said it is very difficult to demonstrate a reduction in mortality as a result of vaccination: “No vaccine trial ever done in the developed world has been [statistically] powered to look at a mortality benefit. So we’re going to have to rely on observational data.”As for the suggestion that unmeasured confounding variables have inflated the effectiveness of flu vaccines in observational studies, Shay said, “We also think that’s possible. The CDC is interested in working with HMOs to get a better handle on how to do vaccine effectiveness studies and mortality outcome studies.”But given the existing evidence that flu shots do help protect seniors, he rejected the suggestion of doing placebo-controlled trials. “If you can’t honestly answer, ‘I have no idea’ to the question whether the vaccine is effective, then you have no basis for doing a placebo-controlled trial,” he said.On the other hand, Shay commented, “Everybody would agree that we need a vaccine with greater effectiveness and greater immunogenicity in the elderly. Manufacturers are working on adjuvanted vaccines that hopefully will be more effective.”HMO study addresses methodologic issuesIn the NEJM study, Nichol and associates sought specifically to address the kinds of methodologic problems cited by Simonsen et al. They retrospectively gathered data on flu vaccination, hospitalization for pneumonia and flu, and death from any cause among community-dwelling elderly members of three HMOs. The study covered the flu seasons from 1990-91 through 1999-2000 for one HMO and those from 1996-97 through 1999-2000 for the other two. The HMOs were in Minnesota and Wisconsin, Washington state, and the New York City area.The study included 713,872 person-seasons of observation. Vaccinated subjects were slightly older and had slightly higher rates of most of the underlying medical conditions that were recorded. There were 4,599 hospitalizations for pneumonia or flu and 8,796 deaths.The per-season hospitalization rates for unvaccinated and vaccinated people were 0.7% and 0.6%, and the corresponding death rates were 1.6% and 1.0%. The figures translated into a 27% reduction in hospitalization rate for pneumonia and flu among the vaccinated (adjusted odds ratio, 0.73; 95% confidence interval [CI], 0.68 to 0.77) and a 48% reduction in mortality (adjusted odds ratio, 0.52; 95% CI, 0.50 to 0.55).The vaccine was somewhat less effective in preventing death—a 37% compared with 48% reduction—in the two seasons when the vaccine was a poor match for the circulating viral strains. For the seasons in which there was a good match, the vaccine yielded a 52% reduction in mortality risk.In an effort to detect any “healthy-vaccinee bias” (better underlying health among the vaccinated than the unvaccinated), the authors compared the risk of hospitalization among vaccinated and unvaccinated subjects during the summers (noninfluenza seasons) of 1999 and 2000. They found that the risks were similar for the two groups.The researchers went a step further by hypothesizing that an unmeasured confounding variable was influencing their findings and then estimating what that influence would be under various assumptions. They picked functional status as the unmeasured variable most likely to affect their subjects’ risk of hospitalization or death.On the basis of studies of functional status, the authors estimated that subjects with poor functional status would be half as likely to get a flu shot and two to three times as likely to be hospitalized or die, compared with those with better functional status. When they plugged these estimates into their data, along with estimates of the prevalence of the confounding variable, they found that the effectiveness of vaccination was reduced but still significant.For example, assuming that the confounder was present in 60% of subjects and that it doubled the risk of hospitalization or death, vaccination still reduced the risk of hospitalization by 14% and the risk of death by 39%. In the most extreme scenario—the confounder was prevalent in 60% and tripled the risk of hospitalization or death—vaccination still lowered the risk of hospitalization 7% and the risk of death 33%.The researchers write that their study “showed multiple benefits across multiple subgroups, a result suggesting that vaccination benefits probably extend to a broad spectrum of elderly persons.” However, they acknowledge that elderly HMO members may differ from elderly nonmembers, and the study did not include the frailest elderly, such as those living in nursing homes, who are likely to have weaker immune responses.A confidence boosterIn an accompanying NEJM editorial, John D. Treanor, MD, writes that the study by Nichol et al addresses many of the concerns raised about other observational studies “and increases our confidence in the benefits of influenza vaccination in older adults.”Because the evidence of vaccine effectiveness held up well through 10 seasons, the findings “convincingly dispel concerns that the previous studies were artifacts of a specific influenza season or a specific population,” states Treanor, who is a vaccine researcher; professor of medicine, microbiology, and immunology at the University of Rochester; and member of the CDC’s Advisory Committee on Immunization Practices.He also comments favorably on the authors’ efforts to address the concerns about unmeasured confounding variables, including the examination of summer hospitalization rates and the estimate of the effect of a hypothetical difference in functional status.”Overall, this study provides additional support for the current strategy to vaccinate elderly adults,” Treanor asserts. The methodologic issues are important, and the precise magnitude of the benefits of vaccination is not yet clear, but it is clear that vaccination is beneficial and should be used widely, he adds.However, he agrees with Shay that the development of more immunogenic and effective vaccines for the elderly is an important goal.Shay said the CDC is contemplating a special initiative to help resolve the controversy over the value of flu immunization for seniors. “Sometime in 2008 the CDC hopes to get together a panel of consultants to bring about ways to move forward and find ways to resolve this controversy,” he said. By assembling experts from the different camps, the agency hopes to come up with recommendations to guide the next series of studies, he said.Simonsen L, Taylor RJ, Viboud C, et al. Mortality benefits of influenza vaccination in elderly people: an ongoing controversy. Lancet Infect Dis 2007 Oct;7:658-66 [Abstract]Jefferson T, Di Pietrantonj C. Inactivated influenza vaccines in the elderly—are you sure? (Editorial) Lancet 2007 Oct 6;370(9594):1199-1200Nichol KL, Nordin JD, Nelson DB, et al. Effectiveness of influenza vaccine in the community-dwelling elderly. N Engl J Med 2007 Oct 4;357(14):1373-81 [Full text]Treanor JD. Influenza—the goal of control. (Editorial) N Engl J Med 2007 Oct 4;357(14):1439-41 [Full text]last_img read more

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[UPDATED] COVID-19 patient, a doctor who traveled to Italy, dies in Medan

first_imgMeanwhile, in Malang, East Java, the administration reported that two patients under COVID-19 surveillance had died. However, the director of Malang Saiful Anwar Public Hospital, Kohar Hari Santoso, said the tests done on them for the coronavirus had come back negative.”It’s true they had lung problems but the cause of their death was not the coronavirus but another type of virus,” Kohar told reporters after meeting East Java Governor Khofifah Indar Parawansa in Surabaya on Tuesday.Kohar, however, said the two patients had met with foreigners several days before being admitted to the hospital.Asip A. Hasani contributed to this story from Surabaya, East JavaEditor’s note: The status of the patient has been updated from suspect to confirmed.  Topics : Alwi said the patient was a medical doctor. “He just got back from Jerusalem and visited Italy afterwards. He went with a group of people and we’re tracing them,” Alwi said on Wednesday. Adam Malik hospital confirmed later that he was tested positive and among 19 people who died of COVID-19 nationwide.As of Tuesday, the hospital had eight patients under COVID-19 surveillance in isolation rooms, including the doctor who just died.The hospital’s coordinator for COVID-19, Ade Rahmaini, said the isolation rooms in the hospital were already full. She said the hospital would refer new patients to other hospitals.Earlier, the North Sumatra administration reported it was tracking about 350 residents of the province who attended a mass religious gathering in Kuala Lumpur, Malaysia, where dozens of people from several countries had contracted the COVID-19 coronavirus. A medical doctor who had been under surveillance and tested positive for COVID-19 at Adam Malik General Hospital in Medan, North Sumatra died on Tuesday night.Authorities reported the doctor had traveled to Jerusalem and Italy before his death but they did not divulge the timeline of his travel history. His death was the first related to COVID-19 in North Sumatra.The head of the North Sumatra Health Agency, Alwi Mujahi Hasibuan, said the patient died at 8:45 p.m. in the hospital. He said the patient had gone to Jerusalem and Italy with several people.last_img read more

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Lakers’ Kyle Kuzma doubts ankle sprain a ‘big deal,’ but is held out against Warriors

first_img Dwayne ‘The Rock’ Johnson motivates Lakers with stories of life experiences, overcoming disappointment Julius Randle, Lakers put on show for LeBron James in win over Cavaliers OAKLAND — The waiting line for the training table in the Lakers’ locker room keeps getting longer.A night after scoring 26 points to lead the Lakers to a 112-103 win over the Denver Nuggets, Kyle Kuzma was held out against the Golden State Warriors due to the sprained right ankle he suffered at the end of the third quarter against Denver.Before the game at Oracle Arena, Coach Luke Walton said Kuzma “came over earlier, tried to push through it a little bit, so it isn’t really worth it.”Kuzma said he doesn’t “think it is a major thing,” but Wednesday marked just the second game he has missed during his rookie season. He was held out due to back spasms on Nov. 29. AD Quality Auto 360p 720p 1080p Top articles1/5READ MOREUCLA alum Kenny Clark signs four-year contract extension with PackersThe Lakers have mostly survived a rash of injuries this month, winning eight of their last 10 games entering Tuesday’s matchup. However, injuries to Brandon Ingram (strained groin), Josh Hart (hand fracture) and Channing Frye (appendectomy) have certainly taken their toll.After going through his pregame trial, Kuzma said, “Didn’t necessarily feel the way I kind of wanted it to so try to get in another time.”He is aiming for Friday against Miami at Staples Center, and expects to be back on the court well before the end of their upcoming four-game trip, when the Lakers face the Detroit Pistons in Kuzma’s native Michigan on March 26.“Can’t miss the Detroit game,” he said. “Definitely. My mom might be mad if I do.”ZO-FERThe Lakers led by seven points late in Tuesday’s victory over the Nuggets when Coach Michael Malone resorted to a tactic that had not yet been seen this season. Remember Hack-A-Shaq? It’s not just for big guys anymore.Nuggets guard Gary Harris scrambled to foul Ball, the Lakers’ worst free-throw shooter. Ball is shooting just 46.6 percent from the line and, on Tuesday, Denver’s strategy worked.He missed both attempts. Denver’s comeback effort was immediately thwarted, however, when Kentavious Caldwell-Pope stole the ball from Jamal Murray, leading to a breakaway dunk from Randle.The precedent, however, was set.“I am not surprised at all,” Ball said. “When I am on the court, teams are probably going to do that. I just got to knock down free throws.”The Hack-A strategy has received much scrutiny within the league office in recent years, and has most often been utilized against players like DeAndre Jordan, Dwight Howard and Oklahoma City swingman Andre Roberson.Related Articles Ball might be the first point guard to become a hacking target, however.He acknowledged it was the first time he had been intentionally sent to the line at any level of basketball.“I just got to go to the line and hit my two,” he said.Ball rarely gets to the line. In his first 45 games, he attempted just 58 free throws, and at one point this season went seven games without a single attempt.Of the players who have attempted at least 50 free throws this season, only three – Mason Plumlee, Kosta Koufos and Tarik Black – shoot a lower percentage than Ball.BIG BILLAs Luke Walton addressed the media prior to Tuesday’s game, a familiar figure towered behind the scrum of reporters. Walton’s Hall of Fame father, Bill Walton, listened in while his son discussed the Warriors and the state of his own team.However, Luke was not worried about any second-guessing once the group dispersed, but the elder Walton is never shy with his opinions.“His advice early in the season was start winning home games,” the second-year Lakers coach said. “(He said), ‘They fire coaches that can’t win at home.’ We’ve done a nice job of winning some home games, that’s nice.”After Tuesday’s win, the Lakers have won 13 of their last 14 games at Staples Center.So, it just took Bill Walton giving the suggestion?“Yeah,” Luke said. “Simple” Newsroom GuidelinesNews TipsContact UsReport an Errorlast_img read more

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Fantasy Updates: Josh Gordon rising in rankings after reinstatement

first_img2019 PPR RANKINGS:Running back | Wide receiver | Tight end | Top 200Tom Brady gets a boost with an establish down-the-field threat added to his offense. The 42-year old may have been looking at more handing the ball off this season with Sony Michel and Damien Harris in the backfield. Gordon’s return sets up as, at the very least, a dynamic play-action weapon that New England didn’t previously have. It probably doesn’t elevate Brady into starting fantasy quarterback level, but it gives him an upside he previously may not have had.ESPN reported that Gordon should be with the Patriots at their preseason game on Thursday, Aug. 22, although he’s unlikely to play. The expectation is that Gordon will be ready to go by Week 1 of the regular season. Josh Gordon has been reinstated from his suspension, per multiple reports. He’ll be set to rejoin the Patriots on Sunday and will be eligible to play Week 1. The news brings with it a big shakeup to the Patriots’ WR corps and the overall fantasy rankings and sleepers.Gordon has obviously battled off-field issues throughout his career, but he’s been mostly productive when he’s been on the field. He played 11 games for the Patriots in 2018, catching 40 balls for 720 yards and three touchdowns. His 11.3 yards per attempt his way is the highest connection with Brady in the Pro Football Focus era, per their @PFF Twitter account. During the offseason, Brady posted video on his Instagram of working out with Gordon. DOMINATE YOUR DRAFT: Ultimate 2019 Fantasy Cheat SheetWith the retirement of Rob Gronkowski, there was uncertainty as to who would catch passes in New England besides receiver Julian Edelman and running back James White. The Patriots drafted N’Keal Harry in the first round, signed Dontrelle Inman, and had undrafted rookie Jakobi Meyers running with the first team during training camp, but it was still anyone’s guess as to who would emerge as the No. 2. Now, Gordon adds to the intrigue.2019 STANDARD RANKINGS:Quarterback | Running back | Wide Receiver | Tight End | D/ST | Kicker | Top 200Josh Gordon Fantasy OutlookBecause of Gordon’s myriad suspensions throughout his career, it will be hard to count on him playing 16 games. His per-game production should make him a borderline fantasy starter, though. In his 2018 action, Gordon was the 33rd-best fantasy WR in fantasy points per game. That was right behind Calvin Ridley and Mike Williams and right ahead of Chris Godwin. That also factors in his lone game in Cleveland, where he had one catch for 17 yards and a TD. The presence of Gordon will lower expectations for everyone else in the Pats’ receiving corps, aside from Edelman. Meyers goes from a first-team contender to a potential depth piece. Harry, who hasn’t shown well in camp so far, is much less likely to be pressed into heavy duty early.last_img read more

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Arsenal fans must get behind Wenger, says Gazidis

first_img“I want the atmosphere to be united,” Gazidis said at a fans event on Friday. “It has been a struggle because we haven’t had that.“There has been disagreement. There has been a lack of unity and dissatisfaction. The board knows that.“I beg you, please come together and give our manager and this team support.”Gazidis, whose own relationship with Wenger was reported to have become strained last season, promised fans that the club were aiming to secure ‘top-quality’ new faces.However, they have seen a big money bid for French international striker Alexandre Lacazette rejected by Lyon and their only signing so far has been Bosnian international defender Sead Kolasinac on a free transfer from Bundesliga outfit Schalke 04.They also face a battle to retain their star player Chilean Alexis Sanchez — who inspired them to salvaging their season with victory in the FA Cup over champions Chelsea — as he has been increasingly linked with a move to Manchester City.“We’re looking for top-quality players,” said Gazidis.“We’ve got three times as many scouts as we had four years ago. I believe that to be a world-class football club, you’ve got to be world class off the pitch.”0Shares0000(Visited 1 times, 1 visits today) 0Shares0000Arsenal manager Arsene Wenger lifts the FA Cup trophy at Wembley stadium on May 27, 2017 © AFP/File / Adrian DENNISLONDON, United Kingdom, Jun 30 – Arsenal chief executive Ivan Gazidis on Friday urged fans to cease their heckling of Arsene Wenger and unite behind the long-serving manager.Despite speculation about his future the 67-year-old French coach finally signed a new two-year contract after the end of last season in which Arsenal finished fifth.last_img read more

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MILK QUOTA TALKS ‘PRODUCTIVE’ SAYS SENATOR

first_imgFianna Fáil have held talks with the North’s Agriculture Minister Michelle O’Neill to propose a bilateral milk quota until 2015 to replace the current inefficient system of EU-wide national quotas.Fianna Fáil Spokesperson on Agriculture Spokesperson Michael Moynihan TD and Seanad Spokesperson on Agriculture Senator Brian Ó Domhnaill held productive talks with Minister O’Neill and her officials in Stormont yesterday.Speaking afterwards, Senator Ó Domhnaill said: “Agreement on a bilateral milk quota now looks like a very real possibility.  Minister O’Neill was very receptive to the Fianna Fáil proposals and acknowledged that steps must be taken to put an end to the current inefficient and wasteful situation facing Irish dairy farmers. “Fianna Fáil has been forced to pursue this issue due to the regrettable inaction of the Minister for Agriculture Simon Coveney. We are in farcical situation at the moment with some countries in the EU well below quota while Irish farmers are being forced to send cows for slaughter because we’re in danger of exceeding our milk quota.“Minister Coveney has failed to raise this matter with our European counterparts so Fianna Fáil has pressed ahead with discussions on a quota agreement with the UK.   The UK is expected to be below quota by as a much as 20% this year. If we could agree to a joint quota, it would ease the pressure on Irish dairy farmers at risk of over-supply.“As a result of our meeting in Stormont, the North’s Agriculture Minister Michelle O’Neill has agreed to raise the matter with Minister Simon Coveney. In addition to this, I will request that a joint meeting of the Oireachtas Agriculture Committee and its counterpart in Stormont takes place to discuss the issue. My colleague Deputy Michael Moynihan and I also plan to travel to London to further negotiations with the British Minister for Agriculture.“One of the cornerstones of Food Harvest 2020 is to double dairy production by the year 2020. If Minister Coveney does not take immediate and decisive action to address the barriers caused by our national quota, he is putting this strategy in jeopardy. “There is no doubt that the national quota system is a real barrier to the growth of the Irish dairy industry. I am hopeful that we have now taken the first step towards resolving this in the medium-term. Irish dairy produce is in demand and we have ample supply. We cannot continue to be blocked from taking advantage of this much needed growth opportunity for farmers and for the agriculture sector.”MILK QUOTA TALKS ‘PRODUCTIVE’ SAYS SENATOR was last modified: September 30th, 2011 by BrendaShare this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to share on Pocket (Opens in new window)Click to share on Telegram (Opens in new window)Click to share on WhatsApp (Opens in new window)Click to share on Skype (Opens in new window)Click to print (Opens in new window)last_img read more

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KCCA dump Rayon Sport out of Kagame Cup to book semis spot

first_imgKCCA FC players celebrate Kizza’s opener on Tuesday. (PHOTOS/Courtesy)CECAFA Kagame Cup 2019Rayon Sport 1-2 KCCA FCKigali Regional Stadium, KigaliTuesday, 16-07-2019KIGALI – Mustafa Kizza and Jackson Nunda struck either side of Herve Rugwiro’s goal to ensure KCCA FC’s dream of winning a second Cecafa Kagame Cup remains on course as the Ugandan champions booked their place in the semi finals.In a highly billed encounter at Kigali Regional Stadium, the Kasasiro Boys lived up to their pre-match talks of not being fazed by local support for their opponents.It was 33 minutes of a pulsating end to end encounter that kept both sets of defenders on their toes before Kizza calmly collected Allan Okello’s pass with deft control before cooling slotting into the the back of the net to silence the stadium.Before that goal, both sides had threatened to take the lead with Okello guilty of shooting wide from a glorious chances yards from goal.At the other end, Charles Lukwago was called in to action to deny Rayon’s Iradukunda.However, taking the lead in the nail-biting encounter did little to settle the tempos of the game as the Blues of Rwanda continued to press relentlessly.Their sweat was finally rewarded two minutes after restart with Rugwiro drawing the Rwandan giants level.The stadium erupted and Mike Mutebi, a tactician renowned for yearning for tougher opponents that can push his Kasasiro Boys to their talent’s best, must have been wryly pleased with the equaliser.KCCA had a big fight on their hands for the next 40 minutes and Mutebi was the man to guide them.True to his tact, he kept his boys composed as they played with more confidence and wore down their opponents.It was on 33rd minute that Kizza had struck and it took another 33 minutes for Nunda to do the damage.Nunda (8) scored the Kasasiros’ second on the day.If Rayon wanted to emulate KCCA by striking again after 47 minutes like their first goal, the regulation time was certainly not going to allow such as football is played for 90 minutes.The Blues, in an uncharacteristic white, found themselves frustrated as KCCA thwarted all the threats they threw at them.Instead it was KCCA who found the back of the net again, but the referee cut short their celebration as a flag was waved up for offside to chalk off Allan Okello’s efforts.Mutebi then introduced Mike Mutyaba for Saddam Juma and injured Ramathan Musa paved way for Filbert Obenchan, which shored the team’s game plan as they held on to win.Mutebi praised his players for sticking to game plan and displaying a good account of their credentials, noting that the Ugandan champions were the better side and deserved to win.“The game was watchable, we used the ball better than our opponents and my boys displayed a good performance,” Mutebi said, adding that he wants to win the tournament “beautifully.”“Our focus is to go past the semi finals and win the tournament,” he said.KCCA will face Azam of Tanzania, who defeated TP Mazembe of DR Congo 2-1 in the second quarter final.Comments Tags: allan okelloCECAFA Kagame Cupjackson nundaKCCA FCMike MutebiMustapha KizzaRayon Sportlast_img read more

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Turmeric derivative could be used in eye drops to treat early stages of

first_imgJul 24 2018A derivative of turmeric could be used in eye drops to treat the early stages of glaucoma, finds a new study led by UCL and Imperial College London researchers.In the new Scientific Reports paper, the researchers report a new method to deliver curcumin, extracted from the yellow spice turmeric, directly to the back of the eye using eye drops, overcoming the challenge of curcumin’s poor solubility.The research team found the eye drops can reduce the loss of retinal cells in rats, which is known to be an early sign of glaucoma.They are also investigating how the eye drops could be used as a diagnostic tool for a range of conditions.”Curcumin is an exciting compound that has shown promise at detecting and treating the neurodegeneration implicated in numerous eye and brain conditions from glaucoma to Alzheimer’s disease, so being able to administer it easily in eye drops may end up helping millions of people,” said the study’s lead author, Professor Francesca Cordeiro (UCL Institute of Ophthalmology, Western Eye Hospital and Imperial College London).Glaucoma is a group of eye conditions affecting over 60 million people worldwide that leads to irreversible blindness in 1 in 10 cases. The condition mainly involves the loss of retinal ganglion cells, a type of neuron located near the surface of the retina. Stopping the loss of these cells early on has not yet been achieved, so it is a key focus of glaucoma research.Curcumin has previously been shown to protect retinal ganglion cells when administered orally. For the current study, the researchers were seeking to find a more reliable method to deliver curcumin. Oral administration is difficult because curcumin has poor solubility, so it does not easily dissolve and get absorbed into the bloodstream and would require people to take large amounts of tablets (up to 24 a day) that may cause gastrointestinal side effects.Related Stories’Eye-in-a-dish’ model helps scientists to uncover ‘surprising’ AMD gene variantAmerican Academy of Ophthalmology shares tips for staying safe around fireworks’Eye-in-a-dish’ model reveals genetic variants that may contribute to AMDThe team developed a novel nanocarrier, wherein the curcumin is contained within a surfactant combined with a stabilizer, both of which are known to be safe for human use and are already in existing eye products. The nanocarrier can be used in eye drops to deliver much higher loads of curcumin than other products in development, increasing the drug’s solubility by a factor of almost 400,000, and localizes the curcumin in the eyes instead of throughout the body.The researchers initially tested the product on cells that are used to model glaucoma, before conducting trials in rats with eye conditions involving the loss of retinal ganglion cells.After twice-daily use of eye drops in the rats for three weeks, retinal ganglion cell loss was significantly reduced compared to matched controls, and the treatment was found to be well-tolerated with no signs of eye irritation or inflammation.Having found an effective way to deliver curcumin, the researchers are hopeful that it could also be used to diagnose Alzheimer’s disease, as curcumin is known to bind to the amyloid beta protein deposits implicated in Alzheimer’s, and can be detected in the retina with fluorescence to highlight the malignant proteins.”We are now researching diagnostic uses for these eye drops alongside other ways to visualize the retina, as eye tests can be an opportunity to detect signs of neurodegeneration with a simple, non-invasive test,” said co-lead author Dr Ben Davis (UCL Institute of Ophthalmology and Imperial College London).Professor Cordeiro added: “As we live longer, diseases such as glaucoma and Alzheimer’s are steadily increasing. We believe our findings could make a major contribution at helping the lives of people affected by these devastating diseases.” Source:http://www.ucl.ac.uklast_img read more