New image from the flood disaster in Giresun! ‘Avoid … Avoid’

Days ahead Meteorology Torrential rain and cell 137 kg of precipitation fell per square meter despite warning of raids Dereli as a result of the flooding of the Akkaya Stream of the district Giresun It caused perhaps the worst flood disaster in its history.

A person who went to the balcony of his house and shared the situation on his social media account was not aware that perhaps it was the beginning of the disaster. “Run, run away” warning of the citizen, whose words “The stream is coming” was reflected on the cell phone camera, drew attention.

In a short time, 212 shops and workplaces on 2 streets of the district were flooded, millions of lira of material damage occurred.

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very cheap and long-known drugs help save the lungs with coronavirus

Cloving hospital on the basis of the Medical Scientific and Educational Center (ISSC) Moscow State University named after M.V.Lomonosov took the first patients on April 21 and completed his work on June 13. It turned out that it was possible to achieve the best treatment results for COVID-19 in Moscow. Over the entire period, 4 patients died, and among severe patients who got mechanical ventilation, the mortality rate was less than 14% (for comparison, the average for the city and the world was up to 70 – 80%). Eighteen doctors out of 220 employees of the hospital were infected with coronavirus, there were no deaths among the medical staff.

What approaches were used at the University Hospital of Moscow State University to achieve such results? We continue the conversation with the head. Department of Therapy, Faculty of Fundamental Medicine, Moscow State University, Head of the Department of Age-Associated Diseases, Medical Scientific and Educational Center, Doctor of Medical Sciences, Cardiologist Yana Orlova.

MEDICINE FOR COUGH FOR 80 RUBLES

– Most of those who are ill or are afraid to get sick are worried about fibrotic changes in their lungs. They say that you have developed special therapy that can reduce the risk of developing fibrosis. Is it possible?!

– Yes, we launched an appropriate clinical study. There are no final results yet, but we have developed clinical practice.

“What did you do to save the lungs?”

– We used a combination of bromhexine and spironolactone (both are long-known very cheap drugs. – Ed.). Bromhexine is an expectorant that has been prescribed to patients with pneumonia and cough for many years. At the same time, experimental data showed that this drug can block a specific enzyme and impede the penetration of coronavirus into cells. True, it was on this effect that we counted to a lesser extent in inpatients, since such an effect is important mainly in the early stages of the disease. But the expectorant effect of bromhexine really helps patients with COVID. I heard that our colleagues in Peter launched a study of bromhexine for prophylactic purposes. We will wait for the results.

Coronavirus infected 18 doctors from 220 employees of the hospital, there were no deaths among the medical staffPhoto: Ivan MAKEEV

FIBROSIS OBSTACLE

– The second drug – spironolactone – is traditionally widely used in cardiology for the treatment of heart failure, severe hypertension. It has a small diuretic, magnesium and potassium-preserving effect, continues Yana. Orlova. – It has several mechanisms through which it can be useful in coronavirus infection.

Firstly, a mechanism that prevents the development of fibrosis in general in the body. There are works that, in particular, show that spironolactone reduces fibrosis in the heart. At the same time, it is known that the tendency to fibrosis is not local, but systemic – where there is more inflammation, there will certainly be fibrosis. And we see, of course, fibrotic changes in the “covide” in our patients. Therefore, we prescribed spironolactone as a drug for the prevention of this process.

Secondly, this drug blocks sex hormone receptors, in particular testosterone. Some published studies suggest that “high-testosterone” men suffer from “covid” more often and develop more severe fibrotic changes. Therefore, blocking these receptors for several weeks during COVID treatment may be useful in reducing the severity of complications. We are not talking about a longer intake, since male patients are unlikely to agree with a decrease in testosterone levels in the long term.

And perhaps the most important point. In almost all of our patients, we observed hypokalemia (a decrease in potassium levels. – Ed.). With coronavirus infection, potassium is intensely excreted from the body, and scientific articles even suggest that hypokalemia serves as the trigger for a cytokine storm. So spironolactone has a real chance to reduce the risk of this dangerous complication. But the main thing, in my opinion, is that lowering the level of potassium in the body is extremely harmful to the heart and triggers life-threatening rhythm disturbances, increasing the risk of sudden death. We, like all others, replenished potassium with droppers, but it was more effective to retain it in the body with the help of spironolactone.


Men certainly get worse than women;  the elderly are heavier than the young;  overweight people are heavier than patients without excess weight Photo: Ivan MAKEEV

Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patientsPhoto: Ivan MAKEEV

WHEN PRESCRIBED PATIENTS

– Yana Arturovna, how many patients did you have on average?

– About 10 – 14 days. But someone and 50 days.

– Have you noticed signs by which it can be assumed that the disease in the person brought is likely to go the hard way?

– Such studies were carried out in the world, our clinical practice confirmed them. Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patients. Men with a classic male type of baldness, a lot of facial hair, we can say brutal men get sick harder.

– Under what conditions did you discharge patients?

– We acted as close as possible to the recommendations Ministry of Health: so that the temperature for three days was not higher than 37.5 degrees; so that C-reactive protein (an indicator of inflammation) is lower than 10 mg / l, and saturation, that is, the level of oxygen in the blood, is higher than 96%.

“HEAD OF EPIDEMIOLOGY DEPARTMENT OF ITSELF WORKED AT SANPROPUSNIK”

– How often do you get sick doctors and nurses?

– In the first month no one got sick at all. We have a very powerful epidemiological service. The head of the sanitary-epidemiological department, a senior researcher, correctly organized the whole process, and for the first two weeks she personally worked in the sanitary inspection room at the exit from the “red zone” and helped doctors and nurses who were exhausted after the shift safely remove protective clothing.

Then both people’s fatigue and viral load accumulated. By the middle of the second month, sick people began to appear. There were no seriously ill patients. We treated part of the staff in our observation, part of it was treated at home. In total, 18 people were infected from the medical staff (less than 10%).

– Doctors take something for prevention? Vitamins C, D, Zinc?

– I saw the recommendations of American nutritionists, they speak out positively about taking zinc, melatonin and vitamin C. There were somewhat conflicting data on vitamin D. But we did not give any such recommendations to our employees. We have all the prevention was associated with minimizing contacts and other measures of epidemiological safety.

Physicians are the heroes of our time.“If you think that you are special and that a pandemic will not affect you, you are deeply mistaken,” listen to what the doctors who are fighting with coronavirus say

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experts explain why obesity “helps” coronavirus

– Has long been known that overweight people have lowered immunity, says head of the Department of endocrinology of the medical faculty Russian national research medical University. N. And. Pirogov Tatiana Demidova. Research and practice show that in these patients increases the risk of atherosclerosis sharply increases the risk of heart attacks, strokes and heart failure. Increased risk of endocrinological, oncological diseases, joint diseases, psychological disorders.

Epidemic COVID has added another item to the list of high threats to people who are overweight. It turned out that when infected with coronavirus patients with obesity more often require hospitalization, fall into the ICU, on the ventilator (artificial lung ventilation). Alas, is growing and the risk of death.

– If the original messages from China on the most severe cases COVID it was mainly about the older people with severe chronic diseases, according to the latest data from Europe and USA the risk group includes people with obesity – says Tatiana Demidova.

FACTS AND FIGURES

In what diseases most often develop complications due to coronavirus

90% of patients admitted with severe COVID-19 US hospitals, were the following comorbidities:

– hypertension — 49.7%,and

– obesity or 48.3%,

– chronic lung disease — 34,6%,

– diabetes type 2 diabetes was 28.3%,

– cardiovascular disease — 27,8%.

Thus, obesity is second among the States in which CouId be severe.

CORONAVIRUS, INFLUENZA, AND HIV, “LIKE” ADIPOSE TISSUE

Visceral adipose tissue, that is, one that is in the abdomen, is, in fact, highly individual body, experts explain. This body affects the immune, endocrine system and metabolism in the body as a whole.

– People who are overweight fat cells are much larger. So, is synthesized in much more of various hormones and inflammatory cells. Among them, including interleukin-6, interleukin-1, tumor necrosis factor, and others, – says Tatiana Demidova. Often in the body, there is a creeping inflammation.

At the same time observed that many viral infections and especially COVID-19 amplify the effects cytokines and lead to the extension of the generalization of inflammation. “It was proved that adipose tissue serves as a reservoir for some viruses, such as influenza, HIV and cytomegalovirus. Also, according to the latest data, it can be activated and coronavirus,” adds Demidov.

INSULATION NEEDS TO BE LONGER?

Studies have shown one more feature of coronavirus. As it turned out, he is able to spread rapidly in adipose tissue surrounding internal organs – lungs, liver, kidneys, heart, etc. because Of this, developing severe damage to these vital organs and people with excess weight, excess amount of adipose tissue increases the risk of death from multiple organ failure.

There is evidence that such patients are also unable to stay longer carriers of the virus, require longer hospital stay and isolation, said Tatyana Demidova.

AFTER INFECTION — DIABETES

There is evidence and that not less than one-third of patients hospitalized with COVID-19 in China, European countries and the United States, the infection resulted in damage of the pancreas. This was confirmed by elevated enzymes amylase and lipase, and glucose levels in the blood plasma.

– This is a very disturbing circumstance. Since we talking about high risk of developing diabetes type 2 diabetes in people with the original obesity after recovery from infection, says Dr. Demidov.

It is not excluded that after the break the pace of the epidemic COVID, we will see a worldwide surge in the incidence of diabetes, experts say.

So now, when the opportunity walks, sports, seasonal ripe fruits and vegetables rich in fiber, doctors suggest the obese individuals to exert their maximum effort for getting rid of really dangerous extra pounds.

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it affects not only the lungs, but the whole body

The first 10 days after the onset of symptoms of the disease, the 38-year-old American was feeling quite well. He was not at risk; he had no chronic diseases.

– The man was examined, the disease was mild. The patient had a slight cough. Therefore, he was sent home for treatment, ”says the head of the Department of Vascular Surgery at Westchester Medical Center Sean Wengerter.

And then the incredible happened.

One morning, a man woke up with icy and numb legs. The body was constrained by terrible weakness; there was not even the strength to get out of bed.

The examination showed that the patient had aortic occlusion – a large blood clot formed in the main artery at the place where the artery diverged in two directions – to the right and left leg. Because of this clot, blood enriched with oxygen did not enter the iliac arteries.

“This is extremely dangerous.” From this can die from 20% to 50% of patients, – notes Vangerter. – But such things are not typical for 38-year-olds.

An emergency operation to remove a blood clot could save the patient’s life. But doctors working with patients with COVID-19 are everywhere faced with rather strange and frightening phenomena in infected patients. For example, the formation of blood clots (actually blood clots) of various sizes throughout the body, renal failure, inflammation of the heart muscle and malfunctions of the immune system.

“Coronavirus occurs in each patient in its own way,” notes Scott Brackenridge, associate professor of emergency surgery at the College of Medicine at the University of Florida. – In some cases, the patient has a problem with breathing, in others, the internal organs begin to fail. In children, the immune system as a whole begins to rebel.

Coronavirus is not just a respiratory diseasePhoto: Ivan MAKEEV

MYSTERIOUS STROKES

A new type of coronavirus is considered to be a respiratory virus, although it is already becoming obvious – the infection affects the entire human body. The most common symptoms are fever, pneumonia, and acute respiratory distress syndrome.

In this case, the virus attacks some organs directly. First of all, the mucous membrane of blood vessels, which entails unnatural coagulation of blood.

– COVID-19 provokes a local inflammatory reaction that leads to the formation of blood clots, – explains Wengerter. – This is due to the direct effect of the virus on the arteries.

A number of doctors recorded strokes in young patients with coronavirus, as well as the formation of blood clots in the lungs. Blood clots were found even in the smallest vessels.

“Since each organ feeds on blood vessels, and the virus attacks them first and foremost, we end up with damage to internal organs,” adds Dr. Scott Brackenridge.

Another serious symptom that is observed in some patients who become ill with the new coronavirus is the “co-fingers.” The infected toes swell, becoming red or purple. It is possible that the reason for this is blockage of blood vessels. But doctors say that usually this does not have serious consequences.

Kawasaki Syndrome

One of the most alarming reactions to COVID-19 is observed in children. It has already been named as a children’s multisystem inflammatory syndrome. In newYork Doctors have identified more than 100 cases.

This syndrome is characterized by a rather long fever, inflammatory process, malfunction of one or more internal organs, as well as the general condition, which is usually observed with shock. Pediatricians also compare these symptoms with the syndrome. Kawasaki.

Kawasaki syndrome is a rare disease that affects children aged 3 to 10 years. It is characterized by damage to the medium and small arteries, thrombosis, the formation of aneurysms and rupture of the vascular wall. Cases of infection are rare. However, recently, doctors have noted an increase in the number of patients with this syndrome.

Both childhood multisystem inflammatory syndrome and Kawasaki syndrome lead to an overly aggressive immune system response to coronavirus. This may be accompanied by inflammation of the blood vessels and heart muscle.

KILLER CELLS

However, scientists note that coronavirus is not able to cause a strong immune response, but, on the contrary, suppress the entire immune system. And this can allow the infection to freely attack the internal organs.

Partly this theory was confirmed by Chinese experts, led by Dr. Zhang Zhang. Scientists analyzed samples of immune cells taken from the lungs of 9 patients infected with coronavirus. The results of the study showed an abnormally high level of leukocytes – macrophages and neutrophils responsible for the destruction of harmful pathogen – in severe patients. At the same time, these patients had a rather low level of CD8 T cells, which are called killer cells. They are responsible for killing virus-infected cells.

But doctors are reassuring, noting that they have drugs that can thin the blood, and also help the work of white blood cells that resist infection.

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“I have a good memory of the month I was isolated in a jail cell”

After finishing last year the publication of his ‘Diarios’ (Ed. Pepitas de Calabaza) with the edition in a single volume with an unpublished epilogue of his literary project, Iñaki Uriarte (New York, 1946) lives these days of confinement without excessive anxiety at his home in Bilbao. “I have been training for this all my life,” jokes the writer, whose work has attracted the admiration of a select group of readers, the praise of distinguished colleagues, and who has been able to read the excellent reviews garnered after his recent translation into French.

– Has home confinement changed a lot in your daily life?

– No. I used to go out in the morning, late, around twelve-thirty, I would go for the newspaper, the bread, tobacco, something in the pharmacy, a purchase in the supermarket, things like that, and then I would have a coffee on a terrace, that this has changed. The rest of the day was practically spent at home. And a couple of times a week he ate or dined with a small group of friends. So this life is quite similar to the one before.

– Well, you joke that you have never worked, many people are imitating you these days …

– Well, with that that I have never worked I mean that I have never been on the payroll, nor have I had a fixed schedule, but I have done some things, such as writing encyclopedias, translating, writing some literary criticism … But well, i haven’t been a salaried. In fact, I have no pension.

– And being a risk group, do you live the pandemic with fear?

– I am not afraid, although I am in fourteen risk groups. My wife is more obsessed and protects me a lot. The last thing he said to me is that I have to wash my hands fifteen times a day, but I laugh. On the street I have the impression that people are more afraid of me than I am of them. These days I have remembered when I first went to that tough New York of the early eighties, I went down to the street with a little fear and immediately realized that the one they were afraid of was me, because I was the brunette. People moved away. And now the same thing is happening to me: I see someone with a mask that comes from far away and I’m not afraid, but I notice that he is. And a strange thing: if you go through the mountains walking alone and you meet someone on a path you say ‘hello’, or whatever, normally; Well now, you meet someone on a completely empty street and you don’t greet each other, or anything, not a word, you hardly even look at each other.

– He spent four months as a young man locked up in prison.

– Sure, and an entire one in a three by three meter isolation cell. It was for a strike against the Burgos trial. It was the best month in prison because I was sick of being with people all the time. I have a good memory of that month, I read ‘Zero and infinity’, by Koestler, and ‘Resurrection’, by Tolstoi, and I made myself a pipe with breadcrumbs to smoke the tobacco bits that were left in my pockets. Being alone doesn’t worry me much, other than that now I’m in a big house, with lots of light, my wife and the two cats, Tom and Woody.

– Precisely, of that prison experience there is an episode of which he is proud, although he does not remember.

– A friend who was with me in the cell told me about it. When they were released, the prisoners usually took their suitcase running, said goodbye and went out whistling, but we were three in the cell and each day we had to clean one, and the day they released me it was my turn. And, according to this friend, I, very serious, in Burt Lancaster plan, instead of running away, I took the mop and the bucket, and I started to clean the cell to leave it well to my colleagues and when I finished I left. I don’t remember that, but my friend Álvaro always tells it.

– He told me that he had been training his whole life for this.

– That is a bit of a ’boutade’, but there is some truth. I’ve been training my whole life for this. Due to my introverted or not very sociable character or something misanthropic or whatever, I have been looking for thinkers and books that fit with my way of being, starting with Epicurus, for example, whose motto was “hide your life”, although later I have done quite the opposite when publishing the newspaper! I liked those ancient philosophers who sought self-sufficiency and did not depend on others. Ovid said something like this: “He who lived unnoticed lived well.” And my favorite writer, Montaigne, also more or less hid from very young society, at 38 years old.

– Were you surprised by the reaction of society in these circumstances? For example, around the elderly and their screening or not when going to the ICUs.

– I don’t know how far that debate will go, which seems pretty Nazi to me. But I also don’t know very well what to do or what not to do in a particular case. If you have an ICU for two, who’s up?

– The first one to arrive?

– Yes, that seems the most logical, now, I am not saying that I did not give it to the other in any case … Man, if he is an imbecile, no, but if he is a relative, or an uncle that I like and I’m already very bad, very bad, because maybe I would leave the ICU for him. Now, what if you have to make lists, look at age or state of health coldly, classify everyone, etc.? That strikes me as terrifying.

“I do not go down the street in fear of catching it, although I am in fourteen risk groups”

“Once the ‘Diaries’ have been published, I am encouraged because what I write is again for me”

– And how obedient have we been?

– That didn’t surprise me. It has confirmed in my idea that society is very … meek, although this meek does not sound good. Prefer security to freedom, we tend to the former and stick to what they tell you to do if you think you will be safer. It did surprise me when they banned smoking in closed public spaces, from one day to the next, and nobody protested, nothing happened. Authority tends to be listened to.

– And that, do you find it positive or negative?

– I guess it’s a genetic determinism. Freedom excludes you from the group and leaves you a little more unprotected, although if I think about what freedom and non-freedom are, I don’t know very well either. It happens to me like Saint Augustine with Time: «If they don’t ask me what Time is, I know perfectly well what it is, but if they ask me what it is, I start to build a taco». That happens to me with a lot of words, especially abstract and capital letters. Freedom… You don’t have to think about it too much either because I’m not sure that someone is truly free.

– Do you detect a certain social contempt for culture?

– I’m afraid to say that I don’t know very well what Culture is, either, in the abstract and with a capital letter. For me everything is culture. Sure, then they tell you about the culture workers … but I don’t know what culture is.

– A bookstore, say?

– Sure, it seems to me a fundamental element of what they call culture … but well, yes, they help them. I just read that the City Lights bookstore, which Lawrence Ferlinghetti founded in San Francisco in 1953, had closed in March because of the coronavirus and asked people for help. In four days they gave them half a million dollars. So, of course, that bookstore is culture, but it is a culture that people adore and they pay it with great pleasure. Another thing is that you have to subsidize everything. Man, at this moment it would have to be done, because the famous culture is not only the four figures that appear out there, but also the entire network of workers that is below and that you have to help in some way.

“If there was an ICU for two, I’m not saying that I wouldn’t give it to the other … If he’s an asshole, no”

“When I’m alone I never get bored, I get bored when I’m with people, who are boring”

– For you, is there boredom?

– I have written contradictory things. I say that when I’m alone I never get bored, I get bored when I’m with people, I mean boring people, and there is some truth to that. And what bores me the most in the world, which is the time that passes between you start to say goodbye in a meeting of people until you leave a fucking time. A terrible quarter of an hour passes in which I am no longer there, but at the same time I am. It is the most boring thing in the world. I never have boredom in general, but once it has turned into a small anguish that I attribute to not being busy.

– You who lived through time and place, what did you think of the series’ The invisible line?

– It is the series with the most interest I have seen in a long time. I liked it, it seemed to me that I had a good invoice and I was more interested in many personal things. I was walking around studying in Deusto. I once saw Txabi Etxebarrieta, I did not know him, but I know very intelligent and non-nationalistic people of whom he was intimate. I perfectly remember Sarriko’s mani, Sarrico then, who appears in the film. I remember having gone with a box of eggs to the conference of a foreign economist who seemed to us to legitimize the Franco regime. I threw an egg and someone told me that Amedo was running after me … I was surprised that the character of Melitón Manzanas is very tempered because, from what I have read, that bird should not look so good. It is also interesting because many people do not know how that great disaster started. And that the mythical Etxebarrieta was, in addition to being a fanatic, a highly educated poet. There are very dangerous writers.

– Do you come out at eight to clap on the balcony?

– You are right. At first I was embarrassed, but my wife started dating and yes, now we do. Three minutes, because we talk to my brother, who lives next door. I don’t know if we applaud us more than anything else, but hey… The other day a car from the Ertzaintza passed by and we applauded him with delight. Here there is no joking, no singers, there are three minutes of applause and you take the air. What I have done is personally thank the newspaper kiosk, the pharmacists, the baker, the supermarket … and I hope to give them more times.

– What will be the first thing you do when the confinement is over?

– I would like to take a trip that I had planned: drive to Lake Como and Sils-Maria, where Nietzsche practically lived confined during the summers, like someone who goes to a sanctuary. I was very excited, but I don’t think I will. Taking that away, the coffee on the terrace, seeing a few friends again and I don’t know if we can go to Benidorm.

«I knew little of Berrio but was very fond of him»

“He was one of those people whom I didn’t know much, but whom I had great affection for. Sometimes that happens: you know others more, but since you don’t love them so much, their death doesn’t impress you the same ». This is how Iñaki Uriarte remembers the recently deceased Rafael Berrio. The San Sebastian musician confessed several times his devotion to Uriarte’s work, to the point that he paid tribute to it by borrowing the title ‘Diarios’ for one of his albums. The two came to meet one night in San Sebastián.

– After having accumulated a select group of admirers of his ‘Diarios’ in Spain, now they begin to arrive from France, where the book has been translated.

– The translation was a very curious story and I owe it to Frédéric Shiffter, an essayist whom I admire and who lives in Biarritz. I was reading his personal blog and one day I opened it and I found a photo of me, with my cat Borges in my arms and the translation of one of my texts. We exchanged emails, he insisted on publishing it.

– Well, it has been very successful in France. Even Frédéric Beigbeder praised him.

– Yes, the ‘Basque Montaigne’, he said. The scare was the entire page of ‘Le Figaro Magazine’. Very good reviews came out, but I have no idea if the book sold well or not.

– In any case, what have you felt about this critical success?

– Amazement, the same that I keep experiencing here.

– Why did you edit the three ‘Diaries’ in one volume last year, with an added epilogue?

– Because I wanted to have the three books together, I wanted to see my complete work a little chubby and not scattered in three volumes. I did a little bit of work on that and then, since I had another thirty or forty pages, I decided to call it an ‘epilogue’, put it all together and it was over. And the truth is that I have felt very relaxed.

– It seems that between literary ambition and tranquility, you have chosen the latter.

– Yes, I have no literary ambition.

– Not even when seeing the good reception that their ‘Diaries’ had?

– It happened the other way around, it’s a bit like a psychiatrist: it came as a responsibility. I thought that the next one I would get crazy or that they were reading over my shoulder what I was writing. It happened the other way around, but now, once my complete diaries plus the epilogue have been published, I am more encouraged because what I write is again for me. I go back to the beginning, I write for myself and for two or three friends.

– And will you publish it?

– I have no idea. Five years from now and if I have thirty pages, but for now I will continue writing what I feel like and without any idea of ​​publishing more … Because I feel like it. Five years from now, between the coronavirus, diabetes or whatever, I’m not the same here anymore.

– Are you aware that diarists will come out of this confinement in blanket?

– Yes, what happens is that they are going to look a lot alike. In fact, my own book has been revived a little, there are people who are reading it and as always they treat me very well in the networks, that’s where it goes.

– How do you feel when you see that your ‘Diarios’ inspire another artistic work, as was the case with the Rafael Berrio album of the same name?

– I was really excited. I knew him very little. He played in Bilbao and I went to greet him, and then I was in San Sebastián to present the book. Then I went to dinner with those from La Tertulia Errante and I liked him very much. Of course, he also liked me and then there is a tendency that you like him. I’m not a very musician, but from then on I listened to his songs. ‘The joy of living’ I have heard millions of times because I like it so much. He was one of those people whom I did not know much, but whom I had great affection for. That happens sometimes: you know others more, but since you don’t love them so much, their death doesn’t impress you the same.

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How to prevent diabetes 1 in high-risk patients

Madrid

Updated:

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The removal of a gene of cells that make insulin prevents mice from developing Diabetes type 1 preventing cells from attacking your own immune system, as a new University study shows from Wisconsin-Madison that publishes the magazine Cell Metabolism.

Cell sleight may suggest ways to prevent type 1 diabetes in high-risk individuals, as well as other diseases in which the system immune attacks the body’s own cells.

People with type 1 diabetes, called juvenile diabetes, produce little or no insulin, a hormone needed to generate energy from blood sugar. At an early stage of the disease, the front line soldiers of your immune system, called T cells, incorrectly identify insulin-producing beta cells as a threat and kill them, leading to complete insulin deficiency.

Type 1 diabetes affects about 20 million people worldwide, contributing to glaucoma, nerve damage, high blood pressure, and stroke.

The resulting chaos must be managed for the rest of the patient’s life with diet, blood sugar measurement, and insulin vaccines. Type 1 diabetes affects about 20 million people worldwide, which contributes to glaucoma, nerve damage, high blood pressure and stroke. In the United States, it shortens life expectancy by more than a decade.

“The point is that people at high risk can be identified,” explains Feyza Engin, professor of Biomolecular Chemistry at the University of Wisconsin-Madison and lead author of the study ».

«They have autoantibodies in your blood serumWhich means we can actually tell who will develop type 1 diabetes in a couple of years, ” he adds. But doctors don’t have much to do but send them home, because there is no cure for type 1 diabetes. “

Engin’s lab altered a line of mice genetically engineered to develop type 1 diabetes. Right before the immune attack begins, they generally removed only one gene from beta cells called IRE1-alpha, involved in the response of mouse cells to stress.

Engin hoped that removal of this gene in insulin-producing cells would lead to accelerated diabetes. But deletion of the gene made a surprising and unexpected difference in the mice.

“We were hoping the beta cells would die soon,” says Engin. Instead, my students told me that the mice’s blood glucose levels were returning to normal after an initial spike that lasted a couple of weeks. I could not believe it”.

Beta cells were becoming normal producers of insulin. But first they were stepping back into immaturity. “Once we remove this gene, it’s almost as if the beta cells are disguising themselves, says Engin, who was joined by the first author. Hugo Lee, a graduate student, in the publication of the results ».

They lose their mature identity. They de-differentiate and show characteristics of the progenitor cells, and they express hormones from other cell types in addition to insulin, ”he adds. If that dedifferentiation occurs before an autoimmune response compromises beta cells, the T cells that are found respond differently.

“When they differentiate, they no longer act like typical beta cells. They reduce the expression of many genes that signal immune cells, “Come eat me!” Engin says. Those signals are dwindling, and that is actually altering the T cell’s diabetical activity. They really don’t recognize beta cells as a problem anymore. They don’t attack «

And then, just as importantly, immature and dedifferentiated beta cells differentiate back into functional and mature beta cells.

. Just before the immune attack began, they generally removed only one gene from beta cells called IRE1-alpha, involved in mouse cells’ response to stress.

The mice experienced a bit of transient hyperglycemia. They have a relatively high blood sugar level, which is not dangerous, for a few weeks, “says Engin, whose laboratory is supported by the National Institutes of Health and the Juvenile Diabetes Research Foundation. But then the beta cells go back to work and make insulin the way they’re supposed to. “

T cells alter their activity and adhere to the change, leaving beta cells alone as long as the laboratory has followed the mice so far. “That’s the beauty,” he says. Even after the beta cells return, the T cells leave them alone. They still have no diabetic activity a year later, which is like 40 or 50 years in human life. “

Two medications which are being tested in clinical trials for Diabetes type 1 they target the stress response of beta cells, including a drug whose efficacy Engin discovered in mice while working on the Harvard University.

New findings from his lab could help guide the way candidate diabetes drugs are used in clinical trials, or help create new therapies. And they can have a similar effect on other autoimmune disorders, such as arthritis, lupus and multiple sclerosis, in which the activity of a particular cell type attracts dysfunctional immune attention.

“We have found a very important moment in which dedifferentiation helps to greatly reduce the diabetinogenic activity of immune cells,” he says. If you can determine an appropriate cell driven by the autoimmune response, and make those victim cells less functional, less mature at first, perhaps they can also avoid their role in the progression of other diseases. ”

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A potential universal flu shot has just passed a major clinical trial

There may still be hope for a universal flu shot – a powerful dose of immunization that can provide long-lasting protection for multiple flu strains, all in one go.

Such a discovery would be a holy grail for public health and after more than a decade of careful research, a specific version called FLU-v is now moving into the final round of clinical trials.

So far, the researchers say the results have been “very encouraging” and the vaccine has successfully passed phase I and phase II clinical trials. Although the evidence at this stage is limited to evaluating the safety of the vaccine, there is also evidence that it could be effective.

In the last round of randomized, double-blind, placebo-controlled studies, jab was found to promote antibody responses and immune system changes among 175 healthy adult participants. While this does not mean that the vaccine can defend itself against the flu virus itself, these are certainly powerful attributes.

“We have so far conducted four clinical trials with FLU-v,” Olga Pleguezuelos, who works at the pharmaceutical development company SEEK, told ScienceAlert, “and the message to take home is that the vaccine induces cellular and antibody responses that may still be detected six months after immunization. “

This enduring resistance is valuable, given the rapidity with which the flu virus can change. The group of viruses collectively responsible for giving us “the flu” is such a shapeshifter, which easily slips out of our reach every season.

Each flu season, researchers need to predict upcoming strains and develop vaccines, but these don’t go well if the virus changes mid-season or if an unexpected strain suddenly occurs.

In the past, Pleguezuelos says, research has focused on finding a “superantibody”. Antibodies are what make the current annual flu vaccine work, binding to the free virus and preventing it from infecting cells. A superantibody may somehow be able to bind to all flu strains in the same way.

But this approach was not entirely successful, so this time the researchers focused on the virus itself, trying to catch the parts that remain unchanged, regardless of the tension.

Using a computer algorithm, the team identified which regions in the flu virus proteins have not changed over time. Then they clung to these fragments, while the virus took them “for a ride”.

“FLU-v contains four different components against four different regions of the flu virus, so if one has changed, three will still provide efficacy,” explains Pleguezuelos.

The vaccine works by activating T cells that detect a specific region of the flu virus, thereby triggering a chain of events in the immune system that stops and destroys the infection.

“The scientific community has taken many years to recognize that the T cell approach is valid,” Pleguezuelos told ScienceAlert.

“The 2009-2010 pandemic showed that the people who were exposed to the virus but who were protected were those with pre-existing T cell responses to the regions of the virus.”

After the new H1N1 flu strain emerged in 2009, some research has certainly suggested that T cells would be a good target.

Evidence from animal models shows that T cells can provide multiple avenues of protection against the influenza virus, and some argue that this exceeds the limits of current vaccines, which are based on antibodies that are fairly limited in their range.

If FLU-v is found effective against human flu, Amesh Adalja, an infectious disease specialist from John Hopkins University, says it could change the dynamics between humans and the flu virus in a “very positive”.

The authors say the vaccine is ready to enter Phase III clinical development to test the safety and efficacy against the real flu virus and a much larger sample size. They are just waiting for funding.

“It has long been a joke that a universal flu shot is always five years away,” Adalja told Live Science.

“But I think, this time, it will really come in the next five years.”

The study was published in Annals of internal medicine.

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Furious lawyers attempting to “lift hell” as MCC Lockdown enters Day 8 – NBC New York

What to know

  • Numerous pre-trial detainees moved from the Metropolitan Correctional Center to Otisville as the blockade of the MCC facility reaches its eighth day – all while continuing the search for an alleged contraband gun
  • Federal Defender Bureau chief David Patton says defense attorneys have not yet been able to meet most clients before the trial for the eight days the MCC was blocked
  • Investigators are focusing on the fact that a corrections officer at the MCC helped smuggle a gun to a prisoner, according to sources already reported in News 4

Numerous pre-trial detainees moved from the Metropolitan Correctional Center to Otisville as the MCC blockade reaches its eighth day – all while continuing the search for an alleged contraband gun.

The head of the Federal Defenders Office in Manhattan said many MCC detainees had been transferred to Otisville, including some that are scheduled to go to court Thursday and Friday.

David Patton, head of the Federal Defenders Office, said defense lawyers had not yet been able to meet most clients before the trial for the eight days the MCC was blocked.

“Let’s get in to see our clients,” Patton said Thursday, adding that defense attorneys are trying to “lift hell” with the MCC and through the courts to gain access to their clients.

Investigators are focusing on whether a corrections officer at the MCC helped smuggle a gun into a detainee, sources previously told News 4.

Defense attorneys representing MCC detainees who were questioned by the authorities earlier said that the focus is on this theory and subsequent investigations have left them unable to see their clients.

On Thursday, the MCC released a statement stating that lawyers could start meeting clients again on Friday, floor by floor. The prosecutor’s visit could be resumed next week.

The BOP says their officials met with the New York southern district chief judge, federal defenders, US marshals, and the U.S. attorney’s office to explain the ongoing issues.

The BOP and MCC claim that inmates regularly receive hot meals, have access to medical care and are now taking a rotating shower – a statement Patton said was inaccurate. He claims that many customers have been closed 24 hours a day in the past eight days.

In the meantime, the BOP said that more time is needed to complete an in-depth investigation. However, Patton said that the time taken is the result of “sheer incompetence and total lack of concern for constitutional rights and human conditions” for the defendants.

“It’s worse than the solitary confinement and the BOP doesn’t give a damn,” Patton said in an email to News 4.

That hunt for the alleged weapon forced extensive research into the facility, both in the common areas and in individual cells, and prompted federal officials to bring teams out of town to assist in the search. Meanwhile, as the probe continues, the detainees said they have been denied access to telephones, computers and showers and are getting cold sandwiches pushed through the food ports.

The BOP said that visits from detainees’ families and friends may resume later next week, or perhaps sooner.

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