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kalip

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kalip last won the day on February 5

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About kalip

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    Food Ideas and Healthy Recipes Moderator
  • Birthday 12/20/1954

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    Jogging, Reading, Surfing the Internet , Meditation and travelling.

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    Suffered a heart attack in October 2001, Cardiologist prescribed, Aspirin, Simvastatin, and Coreg, all of which I am still using. Had two CYPHER® Sirolimus-eluting Coronary Stents inserted in my LAD artery in June 2004. Go jogging and walking on mornings from 5:00 am 5 days a week (Mondays to Fridays 8 km a day)
  1. BBQ Tempeh Vegan Ribs Ingredients 1 pkg Tempeh (12 oz) 2 Tbs Apple Juice 2-3 Tbs BBQ Rub 2 cups Hickory Wood Chips (for outdoor smoking) BBQ Rub 1/4 cup Paprika 2 Tbs Kosher Salt 2 Tbs Chili Powder 2 Tbs Brown Sugar 1 Tbs Black Pepper 2 tsp Garlic Powder 2 tsp Onion Powder 1/2 tsp Cayenne Pepper (or more to taste) Instructions If using outdoor grill or smoker: Soak Hickory Wood Chips in water for at least 30 minutes. Prepare ribs by slicing Tempeh into 6" long strips about 1" wide. Brush ribs with Apple Juice and then liberally apply rub working it into all the nooks and crannies of the Tempeh. Place ribs on grate as far away from the coals as possible (indirect-heat). Add a handful of soaked Hickory Chips to coals and allow Tempeh to smoke in low-heat (122 °C) for 1 hour. Occasionally add more chips to coals for a smokier flavour. Additionally, spritz (or brush) Apple Juice on ribs occasionally to keep them from drying out. Finally, move the ribs down to the direct heat and slather with your favourite BBQ sauce. Cook for 1-2 minutes per side, turn and apply more sauce until a nice crust or bark is formed. Serve with your favourite BBQ Sides, like my Coleslaw or Potato Sala Servings: 3 https://www.brandnewvegan.com/recipe-index kalip
  2. Face Shields May Be Next Step to Prevent COVID Face masks have become commonplace in the effort to combat COVID-19, but some doctors say it is time to take protection a step further and try full face shields as restrictions slowly begin to loosen. Face shields are nothing new in medical settings -- doctors and nurses who treat coronavirus patients are using them along with standard face masks. Health care professionals are split on whether they should also be worn by children, teachers, and in offices while states reopen. “Face shields appear to have a number of advantages: They’re easy to wear correctly and good at blocking droplets,” says Eli Perencevich, MD, an infectious disease doctor at the University of Iowa and the Iowa City Veterans Affairs Health Care System. “They’re really a better option for protection.” Perencevich and his colleagues published a report in JAMA last month, arguing that face shields have more COVID-fighting potential than standard masks when used with increased testing, contact tracing, and social distancing. A few things make shields superior; he says. For one, many people wear masks that don’t fit well, so they don’t work as well. They also prompt people to touch their faces more, increasing the risk of viral spread. They leave much to be desired in terms of comfort, he says, and they make it harder to breathe. Shields come with the perk of being easily sanitised and reused, says Keith Kaye, MD, a professor of medicine and director of research for the division of infectious diseases at the University of Michigan Medical School. Unlike masks, clear shields also allow for better communication -- people can read facial expressions, and those who are hearing impaired can read lips, he says. “I do think we're going to see more and more face shield use,” Kaye says. “Particularly as COVID continues to cause problems.” While there is not a lot of data on how well masks work, one recent study in China found that wearing a mask at home reduced transmission to other members of the same household by nearly 80%. Shields, meanwhile, have been found to successfully block droplets. One cough simulation study in 2014 found that a shield may reduce exposure by 96% when worn within 18 inches of someone coughing. In addition, face masks are not meant to protect the wearer -- they leave other vulnerable parts of the face exposed, like the eyes. They are meant to keep an asymptomatic or pre-symptomatic person from spreading it to others. But not all doctors are sold on everyday use of more extreme protective gear. Dan Kuritzkes, MD, chief of infectious diseases at Brigham and Women’s Hospital in Boston, says the eye coverage that shields provide is likely not necessary for people unless they are providing medical care to COVID-19 patients. “In theory, it may be possible that particles could land in someone’s eye and cause infection, but we don’t have good evidence that happens,” he says. “I think the bottom line is for the general public, there's no reason to be wearing face shields.” He also says they may not help prevent airborne transmission, because air that has droplets in it could get sucked under the shield from the bottom opening. Face shields are important in health care settings because, in those situations, mucous membranes around the caregivers’ eyes that could come into contact with harmful droplets while they do procedures like intubation, says Timothy Brewer, MD, a professor of medicine and epidemiology at the UCLA Fielding School of Public Health and Medicine. As long as everyone abides by recommendations to wear a face mask, that risk won’t exist for non-health care workers. “It could potentially get in someone’s eyes if someone sneezes -- that's why the person sneezing should also be wearing a mask,” Brewer says. Meanwhile, other parts of the world are embracing the use of face shields outside of hospitals. School children in Singapore are being given face shields as they head back to classes in the coming days. The Infectious Diseases Society of America has listed widespread use of protective gear, including face shields, in the process of lifting restrictions, but the CDC still recommends just face masks for people outside the health care realm. Still, people and companies have jumped in to help supply shields to both health care workers and other people at higher risk of catching the virus. Amazon announced this month that its engineers are developing face shields to sell on its site after donating almost 10,000 to people on the front lines. Other efforts have come from everyday citizens. Katherine Marcano-Bell and her family have converted part of their 1,300-acre pig farm into a shield-making operation, and have delivered them to hospitals, clinics, meatpacking plants, and families who have made specific requests for them. “I think it wouldn't hurt to wear one, especially if you're sick or immunocompromised,” Marcano-Bell says. https://www.webmd.com/ https://jamanetwork.com/journals/jama/fullarticle/2765525 kalip
  3. Make These Vegan Tempeh Spring Rolls With Peanut Sauce Ingredients Tempeh: 1/2 block tempeh (113g) thinly sliced 1/4 cup coconut aminos (60ml) 2 tsp chili garlic sauce (5ml) 2 tsp minced ginger (5g) 1 tsp minced garlic (3g) Peanut Butter Sauce: 1/4 cup peanut butter 3 tbsp coconut aminos 45ml 2-3 tbsp water 1 tbsp sriracha 15ml 1 tsp seasoned rice vinegar 5ml 1 tsp agave nectar 1/4 tsp garlic powder 1/8 tsp ginger powder Summer Rolls: Vietnamese rice paper (six) lettuce 36g Shredded Red cabbage 125g 2 sliced Green onions sliced Yellow bell pepper 120g grated carrots 120g cucumber batonnets (sliced lengthwise) 180g Instructions Tempeh: Slice the half tempeh block in thin slices lengthwise. In a small bowl, combine the tempeh and the marinade ingredients. Mix to coat the tempeh well. Heat a pan on medium-low heat, add the tempeh and the rest of the marinade to the pan. Cook until the tempeh is browned on both sides. About 10-15 mins. Peanut Butter sauce: Combine ingredients and whisk until smooth. Set aside. Summer Rolls: Fill a large bowl with water. Immerse one wrapper in the water to soften. Pull it out, being careful so it doesn't collapse on itself, and lay it on a cutting board. Fill the wrapper with the veggies, a few pieces each, add three slices of tempeh. Fold the top and bottom of the wrapper over the filling. Fold the left&right sides, and roll tightly. Repeat with remaining rice papers. Makes six rolls. Slice in half to serve, if desired. https://www.livekindly.co/vegan-food/ kalip
  4. Drug Combos May Be Advance Against Heart Failure Many patients with heart failure might live years longer if they were on a combination of newer medications, a study suggests. Researchers estimate that if certain heart failure patients were prescribed a four-pill regimen -- including three recently proven therapies -- they could live up to six years longer, compared with the regimen patients commonly use. The findings, published online recently in the medical journal The Lancet, are projections, not guarantees. But they do make a strong case for the medication cocktail, said lead author Dr. Muthiah Vaduganathan, a cardiologist at Brigham and Women's Hospital in Boston. "Combined use of these four pills would be anticipated to keep patients out of the hospital and alive for more years," he said. Heart failure is a chronic condition in which the heart muscle cannot pump blood efficiently enough to meet the body's demands -- causing symptoms such as fatigue, breathlessness and leg swelling. The new study focused on patients who had heart failure with reduced ejection fraction, which refers to how much blood the heart pushes out with each contraction. Reduced ejection fraction affects about half of heart failure patients. For a long time, the standard medication regimen for those patients was a beta blocker plus an ACE inhibitor or an angiotensin II receptor blocker (ARB). All three drugs lower blood pressure and ease the heart's workload through different mechanisms. But more recently, clinical trials have found that three other drug types can help patients live longer, beyond standard drugs alone. One is a medication called Entresto, which combines the ARB valsartan with another drug, sacubitril. Another is a diabetes drug called dapagliflozin (Farxiga), which was recently shown to benefit heart failure patients with or without diabetes. The third drug class is actually an old one: mineralocorticoid receptor antagonists, which include spironolactone and eplerenone. They help control blood pressure by blocking a hormone called aldosterone. Despite the positive findings, though, many doctors still do not prescribe those drugs for heart failure, Vaduganathan said. And there is little evidence on what would happen if patients used all three types of medication. "The optimal combination really hasn't been studied," Vaduganathan said. So his team tried to estimate the benefits of taking the newer therapies, together, over many years. To do that, they combed shorter-term data from three large clinical trials that tested the drugs against standard treatment. Then they made some projections: What would happen if patients started on a beta blocker plus the three drug classes, instead of an ACE inhibitor or ARB -- and stuck with the regimen for the long haul? For a 55-year-old, the researchers estimate, that could translate into an extra six years of life, and eight years free of hospitalisation for heart failure. For an 80-year-old, the benefits would be smaller but still important -- an extra year of life, on average, and nearly three extra years out of the hospital. In an "ideal world," all eligible patients would be on the medications, said Dr. Mary Norine Walsh, past president of the American College of Cardiology. "But here's the rub," she added. "Two of these drugs [Entresto and Farxiga] are not available as generics." So, many patients may be unable to afford the pricey medications, even with insurance. Farxiga costs roughly $500 for 30 pills, while Entresto costs about $600 for 60 pills, according to an online search. Beyond cost, not all patients should be on the drugs. Walsh, who was not involved in the study, stressed that the findings apply only to patients with reduced ejection fraction -- which leaves out half of people with heart failure. And any one patient, she said, might have other health issues that are contraindicated for a given drug. "There may be reasons not to take a medication," Walsh said. "But that shouldn't stop patients from asking their doctor questions." Specifically, she said, patients who are still on an ACE inhibitor or ARB can ask their doctor why they have not been switched to Entresto -- which guidelines say is the preferred choice. The diabetes drug Farxiga was only just approved for treating heart failure with reduced ejection fraction, Vaduganathan noted. So, it's not yet included in treatment guidelines. The study received no funding, but the researchers report connections to various drug companies that make heart failure medications. More information The American Heart Association has more on heart failure treatment. Healthday. kalip
  5. Another COVID-19 vaccine candidate has achieved good early results, a research team in China reported Friday. The experimental vaccine produced important signs of immune response in a small group of adults, a sign that it could potentially protect people against COVID-19, researchers reported May 22 online in The Lancet medical journal. "These results represent an important milestone," researcher Wei Chen, part of a team with the Beijing Institute of Biotechnology, said in a journal news release. "However, these results should be interpreted cautiously," Chen continued. "The challenges in the development of a COVD-19 vaccine are unprecedented, and the ability to trigger these immune responses does not necessarily indicate that the vaccine will protect humans from COVID-19." This particular vaccine candidate used a weakened common cold virus called an adenovirus to safely deliver COVID-19 coronavirus genetic material into human cells. This causes the body to produce the "spike" protein that the coronavirus uses to invade human cells. In turn, the immune system responds to the presence of the protein by creating antibodies that potentially could fight off future coronavirus infections, the researchers said. Within a month, most of the 108 healthy adult participants in the phase 1 trial had a fourfold increase in binding antibodies. These antibodies can bind to the coronavirus, but don't necessarily attack it. Half of the participants who received low or moderate doses and three-quarters of those who received a high dose also developed neutralising antibodies, which can protect the body against the coronavirus, researchers reported. "Not only did the virus induce antibodies but also T-cell immunity, which will also be important for confirming protection," said Dr. Amesh Adalja, a senior scholar with the Johns Hopkins Centre for Health Security, who called the trial results "very welcome." However, Adalja said the vaccine's use of a common cold virus to deliver its genetic payload could hamper its effectiveness. "Adenoviruses are very common and there are many people with pre-existing immunity," Adalja said. "In a prior trial using this type of platform for HIV vaccination, there was a paradoxical increase in risk of infection in those who are vaccinated who had pre-existing adenovirus 5 immunity. Whether this phenomenon is present with this vaccine will be important to investigate in detail in phase 2 and phase 3 trials." There was some evidence of this in the clinical trial, with people who had existing cold virus immunity showing a reduced immune response to the vaccine, the Chinese researchers noted. A full-fledged phase 2 trial has been initiated in Wuhan to see if the results can be replicated in 500 healthy adults, which would include 250 volunteers given a moderate dose, and another 250 given either a low dose or a placebo. The U.S. Department of Health and Human Services has entered a full-court press to develop potential COVID-19 vaccine candidates. U.S. federal officials said Thursday the agency would provide up to $1.2 billion to the drug company AstraZeneca to develop a potential coronavirus vaccine from a lab at the University of Oxford in England. The fourth, and largest, vaccine research agreement funds a clinical trial of the potential vaccine in the United States this summer with about 30,000 volunteers, the New York Times reported. The goal? To make at least 300 million doses that could be available as early as October, the HHS said in a statement. However, many experts have said that the earliest an effective, mass-produced vaccine would be available won't be until sometime next year, and billions of doses would be needed worldwide. The United States has already agreed to provide up to $483 million to the biotech company Moderna and $500 million to Johnson & Johnson for their vaccine efforts. It is also providing $30 million to a virus vaccine effort led by the French company Sanofi, the Times reported. More information The U.S. Centres for Disease Control and Prevention has more on COVID-19. https://consumer.healthday.com/ kalip
  6. SPICY TOFU AND MEATY MUSHROOM VEGAN KOREAN BBQ STIR-FRY Ingredients 2 white potatoes peeled and cubed 1 cup of soy sauce 1/4th white onion diced 1/2 cup freshly chopped cilantro 1 cup of snow peas 3 cups pre-cooked brown rice ½ red pepper diced ½ green pepper diced ½ poblano pepper diced 2 cups broken up broccoli florets 1 carrot diced ½ cup white button mushrooms 1 pack of firm tofu drained and cubed 2 tablespoons of coconut oil ½ cup of slivered almonds Korean BBQ Sauce Ingredients: 1 cup soy sauce 1/2 cup brown sugar 1 tablespoon of rice vinegar 1 clove of garlic 2 table spoons of toasted sesame oil 1 tablespoon black pepper 1 teaspoon tapioca flour 1 teaspoon ground ginger Instructions Combine ingredients to make Korean bbq sauce into blender and blend until smooth. Put chopped potatoes and tofu in a large mixing bowl. Add 1 cup of Korean bbq sauce and ¼ cup chopped cilantro. Massage mixture into potatoes and tofu vigorously for 5 minutes. Let stand for another 10 minutes. Sauté potato and tofu mixture for 10 minutes until browned on each side. Add in the rest of your pre-cut veggies. Then sauté with coconut oil, 1 cup of soy sauce and the remainder of your Korean BBQ mixture until veggies are tender yet firm. Spoon 1 cup of stir fry on you plate and top with a tablespoon of silvered almonds. Nutrition Facts Spicy Tofu and Meaty Mushroom Vegan Korean BBQ Stir-Fry Serves: 8 Amount Per Serving Calories 162 % Daily Value* Total Fat 9.5 grams 14.6% Saturated Fat 0 Trans Fat Cholesterol 0 Sodium 329 milligrams 13.7% Total Carbohydrate 11 grams 3.7% Dietary Fiber 0 Sugars 3.5 grams Protein 12 grams Vitamin A Vitamin C Calcium Iron * Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs. https://www.livekindly.co/vegan-food/vegan-recipes/ kalip
  7. As some countries ease up, others are reimposing lockdowns amid a resurgence of coronavirus infections As many parts of the world, including the United States, explore ways to ease restrictions aimed at containing the spread of the coronavirus, countries that had already opened up are closing down again after renewed spikes in infections. Such a resurgence of cases had been widely predicted by experts, but these increasing numbers come as a sobering reminder of the challenges ahead as countries chafing under the social and economic burdens of keeping their citizens indoors weigh the pros and cons of allowing people to move around again. Lebanon on Tuesday became the latest country to reimpose restrictions after experiencing a surge of infections, almost exactly two weeks after it appeared to have contained the spread of the virus and began easing up. Authorities ordered a four-day, near-complete lockdown to allow officials time to assess the rise in numbers. The re-emergence of coronavirus cases in many parts of Asia is also prompting a return to closures in places that had claimed success in battling the disease or appeared to have eradicated it altogether, including South Korea, regarded as one of the continent’s top success stories. South Korea last week rescinded a go-ahead for bars and clubs to reopen after a spike in cases, hours after officials announced the lifting of previous social distancing restrictions and the start of a “new everyday life with the coronavirus.” South Korean President Moon Jae-in warned his country Sunday to “brace for the pandemic’s second wave,” calling the battle against covid-19 a “prolonged” fight. In the Chinese city of Wuhan, where the pandemic first emerged, authorities on Tuesday ordered the testing of all 11 million inhabitants after a cluster of six new infections emerged, five weeks after the city had apparently rid itself of the disease. Germany, which is widely regarded as the model in Europe of a balanced coronavirus response, is warning that some areas may have to reinstate restrictions after localised outbreaks caused a rise in cases. “We always have to be aware that we are still at the beginning of the pandemic,” German Chancellor Angela Merkel cautioned last week as a cluster of new cases in a meatpacking plant raised fears of an intensified outbreak. “And there’s still a long way in dealing with this virus in front of us.” Some countries are going ahead with plans to lift restrictions despite evidence that cases are on the rise and the disease is far from being contained. India and Russia eased their restrictions Tuesday even as the number of infections in both countries continued to soar. Iran, the epicentre of the disease in the Middle East, with more than 110,000 reported cases, has ordered a county in the southwestern province of Khuzestan to reimpose a lockdown after cases spiked there. But the government is still planning to proceed with the reopening of schools later this week, despite a marked jump in new infections since restrictions were eased in late April. The new spikes underscore the question of when — or whether — it will ever be fully safe for coronavirus-stricken countries to lift their lockdowns. The latest cluster in Wuhan demonstrates how hard it will be to measure whether any location is truly free of coronavirus. The new cases there suggest the virus can flare up in patients up to 50 days after they have apparently recovered, said Wu Zunyou, chief epidemiologist at the Chinese Centre for Disease Control and Prevention, in an interview with state broadcaster CCTV. “The course of disease could last 30 to 50 days for some patients,” Wu said. “The virus could take longer to manifest itself in patients with weak immunity, who are also prone to ‘ons’ and ‘offs’ of symptoms.” He sought to reassure citizens that the new cases did not represent a new wave of the pandemic. “There will not be a new minor peak,” Wu said. “We have had the epidemic under control after more than three months of efforts and accumulated considerable experience in both diagnosis and [epidemic] notification. Therefore, we will not allow scattered cases to develop into massive outbreaks.” Firass Abiad, who oversees coronavirus efforts at the Rafik Hariri University Hospital in Beirut, Lebanon’s main government hospital, said a country’s success will depend less on how it curtails the spread of disease during a lockdown than on how the country manages the inevitable resurgence after lockdowns end. “A lockdown is a means and not an end,” he said. “It’s a means either to allow you to regain control or put measures in place to control coronavirus when it comes back. When we eased the lockdown, we knew there would be an increase in the number of cases.” Lebanese government officials said the lockdown was being reimposed for four days starting at midnight Wednesday to allow the authorities time to conduct contact tracing and isolation for several new clusters that have broken out in different parts of the country. They represent 104 cases in the past four days, a big jump in a small country after infections had stabilised at the rate of one or two new cases a day. Most are linked to some of the thousands of Lebanese who have been repatriated in recent weeks from around the world, said Souha Kanj, who heads the infectious diseases department at the American University of Beirut. All the returnees are tested for the coronavirus and required to quarantine for two weeks even if they are negative. But some have not been adhering to the requirement, she said, citing the case of a man who returned from Nigeria and then held a party for his relatives, infecting at least 10 of them. One was a member of the security forces, who has in turn infected a dozen or so of his colleagues. There may also be cases of renewed local transmission, perhaps stemming from people who were asymptomatic but have been silently spreading the disease, Abiad said. Lebanese released from nearly six weeks of lockdown last month have surged onto the streets, openly defying some of the continued restrictions and social distancing rules that remain in force. Similar scenes have occurred in other countries that are ending closures. Crowds of Parisians gathered on the banks of the Seine to toast their release Monday from six weeks of one of the world’s toughest confinements, prompting police on Tuesday to ban the consumption of alcohol in the vicinity of the river. “In any country where people don’t adhere to social distancing, this is going to happen. You are going to have a surge in cases for sure,” Kanj said. Correction: A line in the story about the increase of cases in France was removed because it referred instead to fatalities. https://www.washingtonpost.com/ kalip
  8. coronavirus attacks the entire body — damaging the brain, kidneys and more While the coronavirus is known to cause deadly respiratory problems, research is showing the multitude of ways the disease can ravage the entire body. Through a growing number of studies, reports and doctors’ experiences, the deadly virus has been linked to issues in everything from the brain to the toes. Here is a breakdown of the ways COVID-19 can affect different parts of the body: Eyes The coronavirus has been observed to turn eyes red, causing pinkeye, or conjunctivitis, in some patients. Physicians have suggested that the condition develops in the severely ill, and one study of 38 hospitalised patients in Hubei, China, found that a third had pinkeye. Brain Neurological symptoms such as dizziness, headaches, impaired consciousness and skeletal-muscle injuries have been documented among cases. Chinese doctors in April published a study on nervous system function in the Journal of the American Medical Association that found that patients can also experience more serious issues — including seizures and stroke, which occurs when a blood clot reaches the brain, according to the Wall Street Journal. Heart Doctors have seen alarming cases of myocarditis — an inflammation of the heart muscle — in addition to irregular heart rhythms that can lead to cardiac arrest in coronavirus patients, according to the Washington Post. “They seem to be doing really well as far as respiratory status goes, and then suddenly they develop a cardiac issue that seems out of proportion to their respiratory issues,” Mitchell Elkind, a Columbia University neurologist and president-elect of the American Heart Association, told the outlet. Sensory system The loss of the ability to taste and smell has emerged as a peculiar symptom strongly associated with the virus. The condition, which is known as anosmia, was not initially recognized as a symptom of the virus, but data from a symptom-tracking app in one study found that 60 percent of people who tested positive reported losing their senses of smell and taste, according to researchers from King’s College London. About a quarter experienced the strange symptom before developing other conditions, suggesting it may be an early sign of the virus. Blood The coronavirus also causes blood thickening and clots in the veins, according to doctors. The clots can break loose and travel to the lungs and brain, potentially causing a deadly condition known as pulmonary embolism. It’s still not known why the virus causes the blood clots to form, or why the body is unable to break them up. Gastrointestinal system Digestive issues such as diarrhoea, vomiting and abdominal pain have been among the chief complaints of many patients. Nearly half of the virus patients admitted to the hospital in the central Chinese province of Hubei, where the outbreak occurred, reported experiencing digestive problems, according to a study published in the American Journal of Gastroenterology. Kidneys Kidney damage has been reported among hospitalised patients, with an alarming percentage who require dialysis. Nearly half of hospitalised patients have blood or protein in the urine, suggesting there is early damage to the kidneys, one nephrologist told the Washington Post. And early data showed that between 14 and 30 percent of intensive care patients in New York and Wuhan, China, lost kidney function and required dialysis or continuous renal replacement therapy, according to the report. Feet Foot sores nicknamed “COVID toes” have been documented as an odd symptom linked to the virus. Physicians have observed the purple foot sores, which are similar to those of chickenpox or measles, among mostly young coronavirus patients in Italy, France and Spain. Immune system Physicians have found in some cases that a patient’s immune system goes into overdrive to fight the infection. The response, which is known as “cytokine release syndrome,” can cause damage that results in severe inflammation and organ failure, NPR reported. Lungs COVID-19 is well known to cause coughing, trouble breathing and, in some cases, severe pneumonia. The infection can work its way into the lungs, filling tiny air sacs with cells and fluid that prevent the flow of oxygen, the Guardian reported. When the air sacs become inflamed, pneumonia can develop in the lungs, which then struggle to get enough oxygen to the bloodstream — reducing the body’s ability to take in oxygen and get rid of carbon dioxide, according to the outlet. Ultimately, this can lead to death in severe cases, the outlet said. https://nypost.com/coronavirus/ kalip
  9. FDA Approves Drug for Heart Failure The FDA has approved a new use for the drug dapagliflozin (Farxiga) -- to reduce the risk of a hospital stay or death in people who have a type of heart failure. People with heart failure are more likely to get complications and early death, even when they take other drugs for heart disease such as ACE inhibitors, beta-blockers, and angiotensin receptor blockers. Farxiga's new approval is to treat heart failure with reduced ejection fraction, which means the left ventricle, or lower chamber, of the heart is too weak to pump blood out to the body very well. “Heart failure is a serious health condition that contributes to one in eight deaths in the U.S. and impacts nearly 6.5 million Americans,” Norman Stockbridge, MD, PhD, director of the Division of Cardiology and Nephrology in the FDA’s Centre for Drug Evaluation and Research, says in a news release. The approval is good news for people with heart failure, says Wilson Tang, MD, a heart failure specialist and director of heart failure research at Cleveland Clinic's Heart & Vascular Institute. "This is an area where we have had few significant landmark studies and approvals over the past decade." Farxiga belongs to a class of diabetes drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors, which also includes canagliflozin (Invokana), empagliflozin (Jardiance), and ertugliflozin (Steglatro). All four drugs are already FDA-approved to treat type 2 diabetes. They lower blood sugar by stopping the kidneys from absorbing extra sugar in the urine back into the blood. In October 2019, the FDA also approved Farxiga to reduce the risk of a hospital stay for heart failure in people with type 2 diabetes plus heart disease, or risks for heart disease. Discovery of a Heart Failure Benefit Researchers discovered the benefits of SGLT2 inhibitors for treating heart failure somewhat by accident, while studying the effects of these drugs in people with type 2 diabetes. In four large studies, people with type 2 diabetes who took an SGLT2 inhibitor were 25% to 35% less likely to be hospitalized for heart failure -- whether or not they had heart failure at the start of the study. Heart failure is an early and the most common heart-related complication in people with diabetes. The new approval is based in part on a study called DAPA-HF, which was the first to look at the effects of an SGLT2 inhibitor specifically on heart failure. This study randomly assigned more than 4,700 people who had heart failure to take Farxiga or an inactive pill (placebo) along with their regular heart failure drugs. After just over 18 months, when Farxiga was added to other heart failure medications, there was an 18% decrease in the risk of death from heart disease and a 17% lower risk of death from all causes. The drug also led to a 26% combined lower risk for a hospital stay due to heart failure, worsening heart failure, or heart-related death. The drug slowed heart failure from getting worse in people both with and without diabetes. How Does It Treat Heart Failure? "That's a great question. No one's 100 percent sure. There are lots of different theories," says Deepak Bhatt, MD, executive director of interventional cardiovascular programs at the Brigham and Women's Hospital Heart & Vascular Centre. (Bhatt has received funding from AstraZeneca, Farxiga's maker, as well as from Sanofi-Aventis, for his research on SGLT2 inhibitors.) "The simplest theory is that it's just a really good diuretic -- a medicine that removes fluid from the body," he says. "People with heart failure are often on a diuretic, also called a water pill, to get extra fluid out of their body." As the drug removes sugar from the urine, it also flushes out salt and fluid. It's likely that other mechanisms are also involved. The drug might increase ketone bodies -- chemicals our bodies make when they break down fats to use for energy. Ketones might improve the heart's energy usage. Or Farxiga and other drugs like it might protect heart muscle cells from more damage. Bhatt says it will take some time and further research to figure out exactly how Farxiga works to treat heart failure. "I think it could take years to sort it all out." Side Effects Genital yeast infections, dehydration, and urinary tract infections (UTIs) are the most common side effects, which happen as Farxiga puts extra sugar into the urine. "When urine has more glucose, there is a higher likelihood for patients to get a UTI," says Tang. Your doctor can check you for these infections if you take Farxiga, and treat you with an antifungal or antibiotic drug if you need it. You may not be able to take Farxiga if you have severe kidney disease or you're on dialysis, because it could affect how your kidneys work. Your doctor might do tests to check how well your kidneys are working while you're on this drug if you: Have kidney problems Have low blood pressure Take diuretics to treat high blood pressure Farxiga can cause serious cases of necrotizing fasciitis of the genital area (Fournier’s gangrene) in people with diabetes and low blood sugar when combined with insulin. SGLT2 Drugs for Heart Failure The big challenge now is for cardiologists to figure out when to prescribe this together with several other drugs in their appropriate doses for their patients with heart failure, Tang says. "This always happens with new drug indications, particularly when the drug cost can be relatively high.” A month's supply of Farxiga for diabetes costs $492. AstraZeneca expects the price to remain the same for heart failure treatment. The company says the amount people actually pay for the drug will depend on their health insurance coverage, their doctor, and any drug assistance programs or savings programs they use. A remaining question is whether other SGLT2 drugs will also help people who have heart failure. Studies are underway to figure that out. These trials may also shed some light on exactly how this group of drugs works to treat heart failure, and whether they're as effective in people with the other type of heart failure. https://www.webmd.com/heart-disease kalip
  10. I saw it on amazon and walmart but you should get at at health food stores
  11. Ingredients For the vegan mushroom stroganoff: 250 g pasta of choice , (vegan,) 1 cup vegetable broth 1 cup non-dairy milk, 1/4 cup all-purpose flour 1 teaspoon dried thyme leaves 1 teaspoon salt 1/4 teaspoon black pepper 2 tablespoons vegan butter 1 yellow onion, chopped 4 cloves garlic, minced 454 g brown or white button mushrooms sliced (about 6 cups sliced) For garnish: 1 handful fresh parsley, roughly chopped Parmegan (vegan parmesan) Instructions Bring a large pot of water to a boil and cook the pasta according to package directions. In a large measuring cup or medium bowl whisk together the vegetable broth, non-dairy milk, flour, dried thyme, salt, and pepper. Set aside. Melt the vegan butter in a large skillet or pot. When hot add the onion and garlic and sauté for about 5 minutes until the onion turns translucent and begins to brown. Reduce the heat to medium and add the mushrooms. Continue to cook for about 5 minutes until the mushrooms have softened and begin to release their juices. Pour in the broth and non-dairy milk mixture and continue to cook, stirring as needed for about 3 to 5 minutes until the sauce thickens. If the sauce gets too thick, add more vegetable broth or water if needed to thin. If the sauce is too thin, simply cook a little longer until you reach desired consistency. Add in the cooked pasta and toss well to combine. Divide among plates and serve, garnishing with parsley and Parmegan to taste. Nutrition Calories: 345 kcal | Carbohydrates: 60g | Protein: 13g | Fat: 6g | Saturated Fat: 1g | Sodium: 873mg | Potassium: 552mg | Fibre: 3g | Sugar: 5g | Vitamin A: 475IU | Vitamin C: 6.7mg | Calcium: 33mg | Iron: 2.2mg https://itdoesnttastelikechicken.com/recipes/ kalip
  12. CAN A PLANT-BASED DIET HELP WITH AUTOIMMUNE DISEASE A growing body of evidence indicates that a healthy plant-based diet can positively impact certain autoimmune diseases. In many cases, individuals report a significant reduction—or even total reversal—of autoimmune disease symptoms when they cut out meat and dairy. Autoimmune diseases are chronic illnesses that occur when healthy cells are destroyed by the body’s own immune system. There are more than eighty different types of autoimmune diseases, including type 1 diabetes, coeliac disease, lupus, psoriasis, and rheumatoid arthritis. Some studies, including YorkTest Laboratories 2017 survey, specifically highlighted animal products such as eggs and milk as aggravators of arthritis symptoms. According to a study published by the National Centre for Biotechnology Information, accumulating scientific evidence supports the health benefits of a vegetarian diet. “Both vegetarian and vegan diets typically emphasize vegetables, fruits, grains, legumes, and nuts,” says the study. “These results suggest that a vegan diet, with a high intake of fruits and vegetables and the elimination of animal products, could protect against the development of autoimmune conditions.” “In contrast, diets high in animal products and low in fibre might increase the risk of developing these autoimmune conditions,” adds the study. In general, red and processed meat consumption is increasingly linked to chronic health conditions such as cardiovascular disease, cancer, and diabetes. And consumers are turning to plant-based alternatives as a healthier option for themselves, the animals, and the planet. Plant-based whole foods are widely considered some of the most healthy. Rheumatoid Arthritis According to a review published in the scientific journal Frontiers in Nutrition, a plant-based diet can help alleviate the symptoms of rheumatoid arthritis. The review suggests that changes in diet “might play an important role in RA management and remission.” “Several studies have shown improvements in RA symptoms with diets excluding animal products,” said the review. “Studies have also shown that dietary fibre found in these plant-based foods can improve gut bacteria composition and increase bacterial diversity.” “Although some of the trigger foods in RA patients are individualized,” explains the review. “A vegan diet helps improve symptoms by eliminating many of these foods.” However, the study also notes that “further research is needed to test the effectiveness of plant-based diets.” Specifically how it impacts joint pain, inflammation, and the general quality of life in patients with RA. Review co-author Dr. Neal Barnard is also the founding president of the Physicians Committee for Responsible Medicine (PCRM), a plant-based advocacy group. And according to PCRM, a plant-based diet is effective in the reduction of arthritis symptoms in several ways. PCRM suggests that plant-based diets can help to reduce inflammation, swelling, and pain. It also suggests that they can help lower body mass index (BMI) and encourage healthy gut bacteria. Study co-author Hana Kahleova, MD, PhD, and the director of clinical research for PCRM, echoes this theory. “A plant-based diet comprised of fruits, vegetables, grains, and legumes may be tremendously helpful for those with rheumatoid arthritis,” says Kahleova. “This study offers hope that with a simple menu change, joint pain, swelling, and other painful symptoms may improve or even disappear.” Lupus Lupus is a long-term autoimmune disease with symptoms including inflammation and swelling. As with other autoimmune conditions, it occurs when the body’s immune system targets healthy tissue. It can also cause damage to a person’s joints, skin, and organs. As with rheumatoid arthritis, many of those with experience of lupus promote a plant-based diet to help alleviate symptoms. Brooke Goldner, MD, is the bestselling author of “Goodbye Autoimmune Disease and Goodbye Lupus” (2015). The now-celebrity doctor says that switching to a plant-based diet actually reversed her lupus diagnosis. She staunchly advocates for a plant-based diet and has inspired others to treat ongoing health conditions by changing their lifestyle. One person inspired by Goldner is the Australian writer and model Robyn Lawley, who recently announced that her lupus has improved to the point that she no longer needs medication. Lawley said that going vegan and following Goldner’s anti-inflammatory diet has helped her improve her condition. “I’m no doctor but this is what’s happening in my life,” explained Lawley on Instagram. “After being vegan for almost a year I’m just beyond happy that it’s helping me.” The Grammy-award winning singer Toni Braxton is also transitioning to a plant-based diet to help manage the symptoms of lupus. She recently told the healthy lifestyle magazine Prevention: “I’m becoming plant-based. I’m in the process. But I’m going fully plant-based. It’s making me feel better, so there is some truth to it.” Those diagnosed with lupus are generally encouraged to avoid foods that can cause inflammation. Some animal products—and dairy items, in particular—are linked to increased inflammation. Conversely, research suggests that plant-based alternatives can help to reduce inflammation and swelling. Multiple Sclerosis Multiple sclerosis (MS) is a lifelong condition, the symptoms of which can range from serious to mild. In the case of MS, the immune system destroys myelin—the fatty coating surrounding nerve fibres in the brain and spine. The primary symptom of MS is fatigue. But other potential symptoms include problems with vision and movement. Saray Stancic, MD, says that adopting a plant-based diet helped her treat her own MS. After nearly a decade of other treatment, Stancic was dependent on a walking stick and several medicines that caused difficult side effects. Adopting a plant-based diet had such a positive impact on her that she founded Stancic Health and Wellness in 2012, to help others treat chronic disease holistically. According to PCRM, there are several studies that indicate adopting a diet low in saturated fat may play a key role in MS management. Nutritionfacts.org, a plant-based advocacy group founded by Dr. Michael Greger M.D., echoes this belief. Roy Swank, an academic neurologist, first proposed a low-saturated-fat diet for the treatment of MS in 1949. According to Nutritionfacts, one study reported 95 percent of patients with early-stage MS experienced no progression in their disease 34 years after adopting a low saturated fat, meat, and dairy restricted diet. Some patients, who already displayed advanced symptoms, also experienced significant benefits from adopting the diet. The Irish author, public speaker, and vegan athlete Conor Devine is also vocal about the benefits of a plant-based diet for MS. In 2018, Devine spoke to LIVEKINDLY about how he overcame his MS symptoms and became a plant-powered athlete. “I have intermittent MS symptoms every day. But since I went plant-based my health has improved substantially,” he said. While others also support the benefits of a plant-based diet, Devine noted that his positive experience was personal to him. https://www.livekindly.co/ kalip
  13. Positivity Isn’t Naïve—It’s Exactly What the World Needs Today In times when people are struggling with their health, finances, loneliness, and tragic circumstances beyond their control, it might seem simplistic or patronising to encourage them to be more positive. Here’s why it’s crucial to stay positive right now. Have you heard of being a Pollyanna? It is a common way to label someone whose glass is always half full, despite any circumstance. The term came from a film about an irrepressibly optimistic young girl named Pollyanna. I’ve never seen the movie, but I do know that characters like Olaf from Frozen, Phoebe from Friends, or Kimmy Schmidt from The Unbreakable Kimmy Schmidt all share that Pollyanna brand of positivity. Like Pollyanna, people with high levels of optimism are often judged as immature or uneducated. But what if science supported that positivity is, in fact, the smarter way to be? Positivity 101 There is a strong body of evidence that the right kind of positive thinking can change the world. Let’s look at the biology, psychology, and wisdom in the practice of positivity. First, let’s consider what positivity is and is not. Positivity is about making an effort to experience and prolong positive emotions (the ones that feel good). It is also the ability to quickly recognise and move through negative emotions (the ones that feel yucky). Positivity is not pushing negative feelings away or pretending not to experience them. When you spend more time experiencing positive emotions rather than negative ones, you are said to be flourishing—or thriving. Biology—The Evolutionary Role of Negative Emotion Emotions and your ability to regulate them is what separates you and other humans from other species. All emotions serve a function. But until recently, researchers spent more time looking at the negative ones. The oldest part of your brain, sometimes called the reptilian brain, has the job of keeping you safe. This part of your biology is primitive and animalistic, and is responsible for the fight-or-flight-or-freeze response, which is designed to protect you from potential dangers. For example, we used to live in groups of around 150 people. This helped with our health and physical safety and the sharing of responsibilities. People would know everyone in their tribe. Our strong ability to pick out things that were different in our environment helped us to notice strangers who might carry disease or threaten our safety as well as other predators who posed a real threat. There was an important evolutionary reason for negative emotions. What has not been as clear to scientists is the role of positive emotions. Your emotional responses are like the gear system in a car. All gears are important, but the last thing you want is to get stuck in a gear that isn’t right for the type of driving you’re doing. When you get stuck in the emotional response loop, you might be making fear-based decisions about things that would not normally be scary. This is like being stuck in high gear while trying to get up a hill. Simply put, you need to be able to shift emotional gears when you need to. Psychology—What Are Positive Emotions? Emotions impact your relationships, how you make choices and decisions, what you pay attention to, and your personal identity. Positive emotions help with open-minded thinking; they build your resilience and have the power to undo the impact of negative emotions. Think of how strongly you can connect with someone over an inside joke, or how good you feel when you stand at the edge of a vast forest. Positive emotions have power. The following list contains many helpful positive emotions from Barbara Fredrickson, a leading expert from UNC-Chapel Hill and author of Positivity: Awe Gratitude Hope Inspiration Interest Joy Love Pride Serenity Examples of unhelpful emotions include the following: Anger Displeasure Fear Frustration Guilt Loneliness How Wisdom Practices Help While negative emotions demand attention, positive emotions tend to be more fleeting and subtle. Meditators often experience greater emotional atonement over time. This is good because, in order to keep your emotions working, you need to drive them as opposed to letting them take the wheel. Try these wisdom practices to help you balance out your emotions: Loving-Kindness Meditation It has been shown that loving-kindness meditations enhance interpersonal relationships and increase compassion. Even Charles Darwin, who is more commonly remembered as the mind behind the survival-of-the-fittest theory, believed that compassion was a key to flourishing communities according to his book Sociability. Meditation helps you to avoid rumination and to transform suffering. In meditation, the practice of present-moment awareness helps put space between emotion and reaction. Mindfulness Mindfulness is a path to become more aware of how you think. As you practice, you become more attuned to your emotional sensations and more equipped to catch yourself when your negative emotions take over. Gratitude Another wisdom practice for building positive emotions is gratitude. Giving thanks for the things and the people who surround you (or maybe who you can’t wait to see) is shown to lift moods and counteract depression and negativity. How to Become More Positive If you are considering that Pollyanna may have had it right and that positive emotions might help you to cope or to thrive during this current pandemic, here are a few ways to cultivate optimism. Create a positive bedtime ritual. Think of a time where you felt a very strong positive emotion and replay that story in your head as you fall asleep. Think of telling the story to someone who wasn’t there by recreating the physical environment, the physical sensations behind the emotion, and the emotional word you would use to describe the event. Look for opportunities to have positive experiences. Even though we cannot go outside, we can look through yearbooks, spend time looking at the stars, or have a call with an old friend. Schedule time in your day to create experiences designed to provoke positive emotions. Notice and name the negative. When a negative emotion happens, notice the sensation, name the emotion, then move through it as quickly as possible. Keep hope close at hand. Hope is the one emotion that can flip a negative to a positive almost instantly. In the words of The Stress-Proof Brain author and neuroplasticity expert, Melanie Greenburg, “Positive emotions and mental states may make people more resilient to stress, like sturdy tree branches that bend but don’t break when battered by a storm.” Optimism and positivity do help, and they have a contagious effect that can spread despite social distancing. https://chopra.com/articles kalip
  14. What Is the Best Self-Care during the COVID-19 Crisis? Self-care should be uppermost in our minds during the COVID-19 crisis, for several urgent reasons. Self-care returns a sense of control over your own life. It gives you an integrative approach to mind and body. It aligns you with the best knowledge currently available about who is more at risk for developing acute symptoms after being infected. Your immune status is complex, and in mainstream medicine, the chief determining factor is traditionally considered to be genetic. However, there are strong links to underlying low-level chronic inflammation connected to lifestyle that is found in most if not all common disorders including heart disease, type 2 diabetes, some cancers, and even obesity. COVID-19 has a mortality rate that increases with age and pre-existing conditions, as we all know by now. What is less publicised is that the hospitalisation rate, which is very high at over 15%, also affects younger age groups even though their death rates are lower. In those who are most susceptible, the virus creates an acute and severe form of inflammation referred to as a “cytokine storm”, which then leads to severe symptoms and respiratory damage, even death. Cytokines are the chief protein mediators of inflammation in the body. We can use this information about the dangers of having an elevated pre-existing state of low-level chronic inflammation to perhaps offset the possibility of the kind of acute inflammation that puts a person at risk for severe infection and hospitalisation. Let me emphasise the “perhaps” caution. The research on low-level chronic inflammation grows by the year and is very significant. You can go to many websites or our recent book “The Healing Self” to discover the kinds of foods and lifestyles that are either inflammatory or anti-inflammatory. But it is only in the field of integrative medicine that there is a cumulative understanding that anti-inflammation practices need to embrace mind and body. The general public, including mainstream doctors, are more often than not ill-informed of the research that connects meditation and yoga to the benefits of anti-stress, anti-inflammation, and anti-infection. Without a doubt, meditation and yoga have no side effects and are backed by decades of research over their benefits. To this has been added so-called “vagal breathing”, related to the ability of the vagus nerve to induce a relaxed state simply by doing regular deep breathing that equalises breathing in and breathing out (there are numerous websites providing instructions on this simple but effective technique, which is now a standard recommendation for countering stress). Biophysical anthropologist William C. Bushell points to the damage created by the body’s own immune defences. To quote a recent article at Medium.com by Maureen Seaberg, “Bushell says that inflammation is the primary way COVID-19 kills. ‘Spread of the virus through the body leads to widespread and intensive activation of the inflammatory defences throughout the body, though originally intended to combat the pathogen, but at this point instead resulting in widespread tissue damage, and fatally, to acute respiratory distress syndrome (ARDS), in which the lungs become flooded and respiratory failure ensues; the viral toxins themselves play a much lesser role in the tissue damage that ultimately can produce extreme critical disease states (pulmonary aspiration, septic shock), and potentially death.” The uncharted frontier is whether chronic inflammation, which is thought to be widely prevalent in our stress-filled, junk food eating, sleep-deprived society, increases the odds that the body might erupt into acute inflammation, e.g. a cytokine storm, when infected with viruses like COVID-19. One can think of this storm as a kind of over-reaction by our immune system. The big question is whether low-grade chronic inflammation may set the stage for this over-reaction and increase the odds of a “cytokine storm” in the presence of a nasty virus like COVID-19. Meanwhile, meditation, yoga, vagal breathing, and other relaxation techniques might provide an edge in the current crisis by reducing the chronic inflammatory state of the body. We’ve joined Bushell and other concerned figures, including Michelle Williams, S.D., Dean of Harvard’s School of Public Health, in advising that meditation and yoga (in addition to a healthy diet and ample sleep) be included in front-line efforts against COVID-19. The public is woefully uninformed about the mind-body benefits of these simple, effective measures, and every model of the pandemic foresees a huge overload on this country’s hospitals. The virus is more contagious and infectious than the flu, and it hospitalises and kills a much higher percentage of cases. The message about COVID-19 and inflammation is very important. It needs to be received by all of us for our common well-being at any time, but most urgently, now, we all must strive to reduce our base level of chronic inflammation. https://chopra.com/articles kalip
  15. Blood Clots Are Another Dangerous COVID-19 Mystery Hooman Poor, MD, was tired of watching his patients die, and it looked like another was slipping away. She was on a ventilator, but it wasn’t helping. Oxygen wasn’t getting to her organs. Acid was building in her blood. Her body was in shock. Her kidneys were failing, but he couldn’t put her on dialysis. She was too sick and probably wouldn’t survive it. Poor, a pulmonologist and critical care specialist at Mount Sinai Hospital in New York City, was about to call her family to deliver the crushing news. As he studied her lab results, he noticed that like many other COVID-19 patients, she had high levels of protein pieces called D-dimers, which are left over when the body breaks up blood clots. Her body was desperately trying, but failing, to clear blood clots, Poor believed. A Medical Mystery Around the world, doctors caring for COVID-19 patients have been trying to make sense of the same thing. When they draw blood from COVID patients, it clots in the tubes. When nurses insert catheters for kidney dialysis and IV lines to draw blood, the tubes quickly become clogged with clots. “Patients are making clots all over the place,” says Adam Cuker, MD, a hematologist and associate professor of medicine at the Hospital of the University of Pennsylvania. “That’s making management of these patients very challenging.” In addition to the well-known breathing problems, blood clots are a significant danger for COVID-19 patients. Clots are causing patients with COVID to have heart attacks and strokes; form strange rashes on their skin; and get red, swollen wounds that look like frostbite on their fingers and toes. On autopsy, the small vessels of the lungs and bowels, liver, and kidneys of COVID patients are choked with clots. With his patient desperately ill, Poor suspected he had nothing to lose, so he punted. “This is screaming blood clots. Why don’t we try tPA and see if it works?” he said. He gave his patient a powerful clot-busting drug that’s normally used to treat strokes. It’s risky. If used improperly, it can cause uncontrolled bleeding, which can be deadly. Within 30 minutes of getting the drug, his patient showed signs of improvement. Her carbon dioxide levels dropped, and other signs linked to shock seemed to improve. She lived for about another week, before ultimately dying. Poor has tried the drug on other COVID-19 patients, too. It hasn’t helped them survive, but he feels like it has shown him something about the disease. “It did bring to light the possibility that blood clots are playing a bigger role in this disorder than we previously appreciated,” he says. Lessons from the Dead Sharon Fox, MD, PhD, agrees with him. She’s a pathologist at Louisiana State University Health in New Orleans and has been doing autopsies on patients who have died with COVID-19. She’s finished 20 cases so far, and they share something in common: They are riddled with blood clots in the smallest vessels of the body. Lungs seem to be especially hard-hit. There, clots appear to have cut off blood flow to the small air sacs where blood cells would be exchanging oxygen and carbon dioxide. “There’s no ability for the blood to flow through and exchange oxygen like it should,” she says. Fox says the pattern of damage is striking. “I’ve never had a series of cases like this, where they all look the same, and all of the lungs have a similar pattern. There are types of vascular injury at autopsy that I haven’t seen before. I would say it’s new,” she says. Dangerous blood clotting is always a risk for critically ill patients. That’s especially true for those who are immobilized and on mechanical ventilators, as patients with COVID-19 often are. But a recent French study, which compared 150 patients with COVID-related respiratory failure who were treated in intensive care units to 145 patients who had respiratory failure, but were not infected with the new coronavirus, found significantly higher rates of blood clotting in the COVID patients. “We still need more controlled data, but based on clinical observations and the few studies that have been published, it looks like thrombosis [blood clotting] is more common in these patients,” Cuker says. Why blood congeals the way it does in some COVID patients is still an open question. One theory is that the body launches an immune attack called a cytokine storm to fight the virus that becomes self-directed, causing cells to kill themselves in an attempt to shut down the infection. Doctors believe that for some patients, the immune attack can end up doing the body more damage than the virus itself. This hyper-inflamed state is itself a well-known risk for blood clots. Cytokine storms can cause a condition called disseminated intravascular coagulation, or DIC, where patients both bleed uncontrollably and clot too much at the same time. Another possibility is that the virus may more directly cause the clotting. New Insights into ‘Why’ A research letter published this week in The Lancet reported evidence of viral bodies of the new coronavirus invading endothelial cells. The endothelium is the lining of our blood vessels. It directs important functions of the vascular system like clotting and swelling. Images captured with an electron microscope found traces of the coronavirus in endothelial cells in the heart, kidney, small bowel, and lung -- pretty much all over the body. Researchers collected the tissues during autopsies of three patients who died of COVID-19. Study co-author Mandeep Mehra, MD, medical director of the Brigham and Women’s Heart and Vascular Centre in Boston, says the findings suggest that the virus can directly infect the endothelium. He says that while COVID-19 can certainly cause breathing problems, he doesn’t think it’s just a lung disease. “This is actually a disease of the endothelium,” he says. Mehra says the infection starts in the lungs because breathing is the easiest way for the virus to enter the body. Once it infects the lung cells and begins to destroy them, it travels into the bloodstream. There, it infects endothelial cells, causing endotheliitis. Mehra thinks this endotheliitis comes from not only the direct infection of the blood vessel cells, but also from the haywire cytokine storm that the body launches to fight it off. “We’ve shown evidence of both.” He says this theory of infection explains some things that doctors have been trying to puzzle out. For example, certain conditions like high blood pressure, diabetes, and heart disease stress the endothelium. It’s no surprise, then, that people who have these conditions are also the ones who get the sickest when they catch COVID-19. It also helps to explain why patients have such low oxygen in their blood, but their lungs may not be as stiff as they typically are in patients who have respiratory distress with pneumonia. Mehra explains that one consequence of endotheliitis is that blood vessels can’t constrict the way they normally would. Typically, when a part of the lung becomes damaged, tiny blood vessels in that area close off so that blood will flow to a part of the lung that’s still working, where it can collect oxygen. This system protects the body from a sudden drop in oxygen, and it appears to break down in patients with severe COVID-19 infections. Mehra believes the infection of the endothelium is to blame. The bottom line, he says, is that clotting is a feature of the COVID-19 syndrome. When it becomes a big problem, the disease is advanced and very severe. For that reason, treating the resulting blood clots probably won’t work. He believes something worth trying might be to give patients drugs to support the endothelium, like ACE inhibitors and statins, along with anti-inflammatory drugs to tackle the cytokine storm, early in the course of the disease, but more research is needed to know for sure. If COVID-19 is really an endothelial infection, Mehra thinks that also helps to explain why ventilators aren’t helping more patients. A study of 5,700 patients hospitalized with COVID-19 in New York City found that while just 12% needed a ventilator to help them breathe, 88% of those patients died. “It’s not acting like influenza or other bacteria pneumonia where you get inflammation in the lungs and fluid buildup and very stiff lungs. That doesn’t seem to be the case, at least early on,” Poor says. “The virus is acting as if its primary target is the endothelium,” he says. That means the clots are just part of a much larger problem, one Poor says doctors don’t yet know how to solve. https://www.webmd.com/ kalip
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