The COVID-19 Pandemic Kept Thousands of People From Getting Urgent Medical Care, CDC Says

When COVID-19 lockdowns were first announced in March, doctors also urged patients to postpone all but the most necessary procedures and appointments to save space in hospitals. Many elective surgeries were pushed off, and routine care was mostly moved online. From the beginning, doctors feared these difficult but necessary precautions would have an unintended consequence:…

The COVID-19 Pandemic Kept Thousands of People From Getting Urgent Medical Care, CDC Says

When COVID-19 lockdowns were first announced in March, doctors also urged patients to postpone all but the most necessary procedures and appointments to save space in hospitals. Many elective surgeries were pushed off, and routine care was mostly moved online.

From the beginning, doctors feared these difficult but necessary precautions would have an unintended consequence: Dissuading from people who actually did need immediate care from getting it. Now, new data from the U.S. Centers for Disease Control and Prevention (CDC) confirm that concern.

During the 10 weeks after the U.S. declared the coronavirus a national emergency, there was a noticeable drop in the number of Americans seeking care at emergency rooms, even for urgent issues like heart attacks, strokes and hyperglycemic crises (a life-threatening complication of diabetes), the CDC found. Compared to pre-pandemic times, about 20% fewer people visited emergency rooms for heart attack and stroke care during those 10 weeks, and about 10% fewer did for diabetes care.

That means about 13,000 people apparently skipped going to the ER for heart attacks during those weeks; 11,000 for strokes; and about 2,000 for hyperglycemic crises. The starkest drops were seen among adults 65 and older for heart attack and stroke, and people 44 and younger for hyperglycemic crisis.

Natural declines of that magnitude are “biologically implausible” for such a short time period, the CDC says. Instead, it’s more likely that people chose not to come to the emergency room, perhaps because they were afraid of being exposed to COVID-19 or didn’t want to break stay-at-home orders.

The CDC’s report is based on information from the National Syndromic Surveillance Program, which collects data from a subset of hospitals in 47 states and the District of Columbia and captures about 73% of emergency visits nationwide. It does not, however, track mortality data—so the CDC’s report couldn’t say how many of the people who skipped urgent care later died, or how many sought care somewhere other than an emergency room.

Previous studies have suggested that the coronavirus pandemic has driven up death rates even for unrelated conditions. For example, New York City recorded about 24,000 more deaths than would be expected from March 11 to May 2—but only about 80% were tied to COVID-19. At least some of the remaining 20% of victims likely died because they didn’t seek care for unrelated health issues when they otherwise would have.

A similar trend seems to have played out at the national level. By April 4, about 15,000 excess deaths were confirmed in the U.S., but only about 8,000 coronavirus deaths were recorded during that time period, according to a Yale data analysis commissioned by the Washington Post.

While staying home is an important way to limit the spread of COVID-19, it should not come at the expense of needed medical care. In its new report, the CDC urges Americans to seek care if they experience severe symptoms like chest pain, altered mental state or loss of motor function, “irrespective of the COVID-19 pandemic.”

Source : Time More   

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Probiotics — even inactive ones — may relieve IBS symptoms

People with irritable bowel syndrome (IBS) may take probiotics to try to restore the balance of bacteria in their gastrointestinal tract. A recent study found that an inactive form of a probiotic (which has some advantages over active versions) helped improve symptoms and quality of life in test subjects. The post Probiotics — even inactive ones — may relieve IBS symptoms appeared first on Harvard Health Blog.

Probiotics — even inactive ones — may relieve IBS symptoms

Irritable bowel syndrome (IBS) is a chronic gut-brain disorder that can cause a variety of uncomfortable gastrointestinal symptoms including abdominal pain and diarrhea, constipation, or a mix of the two. IBS can reduce quality of life, often results in missed school or work, and can have a substantial economic impact.

Physicians diagnose IBS by identifying symptoms laid out in the Rome Criteria, a set of diagnostic measures developed by a group of more than 100 international experts. Limited diagnostic testing is also done, to help exclude other conditions that could present with similar symptoms.

Although the precise cause of IBS remains unknown, recent research suggests that an imbalance in intestinal microbiota (the microorganisms living in your digestive tract) and a dysfunctional intestinal barrier (which, when working properly, helps keep potentially harmful contents in the intestine while allowing nutrients to be absorbed into the bloodstream) may be involved in the development of IBS in some people. Because of this, methods to restore the microbiota have been explored as treatment for this condition.

Balance of bacteria is important for gut health

Many digestive processes rely on a balance of various bacteria, which are found naturally in the gastrointestinal tract. If these bacteria fall out of balance, gastrointestinal disorders may occur, possibly including IBS.

Probiotics, which are bacteria or yeast that are associated with health benefits, may help restore this balance. Most probiotics used in IBS treatment fall under two main groups: Lactobacillus and Bifidobacterium. These probiotics are thought to assist the digestive system. Among other functions, they may strengthen the intestinal barrier, assist the immune system in removing harmful bacteria, and break down nutrients.

Probiotics may relieve symptoms of IBS

The American College of Gastroenterology conducted a meta-analysis of more than 30 studies, which found that probiotics may improve overall symptoms, as well as bloating and flatulence, in people with IBS. However, the overall quality of evidence of studies included in the meta-analysis was low, and specific recommendations regarding use of probiotics for IBS remained unclear.

The probiotic strain Bifidobacterium bifidum MIMBb75 has been reported to adhere particularly well to intestinal cells, and therefore may have an advantage in altering the intestinal microbiota and increasing the intestinal barrier.

In a clinical trial published in Alimentary Pharmacology & Therapeutics, once-daily Bifidobacterium bifidum MIMBb75 significantly improved overall IBS symptoms, as well as individual IBS symptoms including abdominal pain, bloating, and fecal urgency.

Recent study finds inactive probiotics relieve IBS symptoms

More recently, Bifidobacterium bifidum MIMBb75 has been shown to improve symptoms of IBS, even in its inactivated form. For the eight-week, double-blind, placebo-controlled clinical trial published in Lancet Gastroenterology, researchers studied whether the heat-inactivated form of Bifidobacterium bifidum MIMBb75 could alleviate IBS symptoms. (The heat-inactivated Bifidobacterium bifidum bacteria were nonviable, but retained their shape as well as their ability to adhere to intestinal cells.)

Overall, 443 patients (average age 41, 70% women) were randomized to receive heat-inactivated Bifidobacterium bifidum MIMBb75 or placebo once daily. A total of 377 patients (190 probiotic and 187 placebo) completed the trial. The primary endpoint was defined as a 30% or greater improvement of abdominal pain and at least “somewhat relieved” overall IBS symptoms for four or more weeks of the eight-week study duration. Significantly more patients receiving the Bifidobacterium probiotic met the primary endpoint compared to patients receiving placebo (34% versus 19%). In addition, a significantly greater percentage of patients receiving the probiotic also reported adequate relief of symptoms compared to placebo. Finally, individual symptoms including bloating, bowel movement satisfaction, and quality of life were also significantly improved with Bifidobacterium bifidum MIMBb75 compared to placebo.

Advantages of inactive probiotics

Previously, general consensus held that only active, living bacteria may have beneficial effects. But these results suggest that heat-inactivated Bifidobacterium can play a significant role in relieving symptoms of IBS, a syndrome with typically limited options for relief.

This is important because inactive probiotics have several potential advantages over active probiotics. For example, they are more likely to be stable, particularly if exposed to excessive heat. Inactive probiotics are also easier to standardize than active probiotics. Active probiotics also raise concerns for patients who may be susceptible to infection; inactive probiotics should relieve these concerns. Whether other strains of heat-inactivated probiotics will also improve IBS symptoms remains unknown.

The post Probiotics — even inactive ones — may relieve IBS symptoms appeared first on Harvard Health Blog.

Source : Harvard Health More   

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