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Dengue vaccine now available at select Watsons stores

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Dengvaxia, a vaccine against dengue, is now available over-the-counter nationwide at select stores of Watsons, the first retailer to offer the vaccine in the Philippines.

Watsons Dengue Vaccine KV 2

“We decided to offer dengue vaccination in our 108 selected stores nationwide as we recognize the importance of having vaccination accessible to Filipinos to protect them against dengue infection and make them healthier. It is our latest addition that we offer in our stores, aside from cervical cancer, flu and pneumonia vaccinations,” says Danilo Chiong, Watsons Trading Health Director.

Produced by pharmaceutical firm Sanofi Pasteur, Dengvaxia took over 20 years of extensive research and tests to develop. Studies on the vaccine were conducted on 41,000 people and were carried out in 15 countries including the Philippines. With test results fully reviewed by a committee of independent experts, the vaccine has been recommended by the World Health Organization (WHO).

In a WHO position paper published in July 29, 2016, it says that to prevent dengue infection, dengue vaccine should be a part of a comprehensive dengue control strategy, which include well-executed and sustained vector controls, evidence-based best practices for clinical care and strong dengue surveillance.

The vaccine has also been endorsed by the Philippine Society for Microbiology and infectious Diseases (PSMID) and Philippine College of Physicians (PCP). In February 2017, the vaccine got the approval to be administered in 14 countries, including the Philippines, where dengue is endemic.

In the Philippines, there were 211,106 reported dengue cases in 2016. The most number of cases was reported in Regions VI, VII, III, IV-A, and XII. All age groups were affected by dengue.

Age bracket and dosage

Since there is no specific treatment for dengue, Dr. Rontgene Solante, Past President at PSMID, said the dengue vaccine can protect individuals against the illness. It can be administered to individuals 9 to 45 years old living in endemic areas for prevention of dengue illness caused by dengue virus serotypes 1, 2, 3 and 4. It is to be taken in three doses of 0.5ml at six-month intervals to increase antibodies response, thereby protecting them from all four strains of the virus. The vaccine, when correctly administered in three doses, stays effective in four to five years.

The vaccine costs P4,000 per dose or P12,000 for all three doses, which is reasonable considering the high incidence of dengue and high cost of treatment in the Philippines.

“The vaccine is not just for kids but adults should also be vaccinated as this is safe and can modify infection. Don’t look at the price but in the long-term benefits it provides,” said Solante.

Solante, however, relayed the vaccine is not effective for children below nine years old. A study made on the vaccine and these children showed that the efficacy of the vaccine was below 50%. Likewise, the vaccine cannot be administered to persons over 45 years old as there was no study made yet about its effectiveness for these individuals.

Apart from these, other persons who have the following cannot take the vaccine: history of severe allergic reaction; congenital or acquired immune deficiency diseases; symptomatic HIV infection; and pregnant or breastfeeding women.

Solante, however, said that those were infected by dengue in the past can still avail of the vaccine.

Solante advised individuals to administer the vaccine correctly. “If a person who has taken the first dose fails to take the second dose on the scheduled (sixth) month, and instead take it, let’s say, on the eighth month, the vaccine is still effective. But, if he misses taking it for a couple of years, the vaccine became ineffective and has to start taking it all over again.”

The vaccine is injected in arms via the subcutaneous route over the deltoid region. How is it effective? In his presentation, Dr. Solante said the vaccine can result to 80.8% reduction in hospitalized dengue; 93.2% drop in severe dengue; and 65.6% decline in symptomatic dengue, which means that if a person is infected, symptoms are reduced.

The vaccine does not contain adjuvants or preservatives so the adverse effect or reaction is lower, according to Solante. Adverse reactions include headache, malaise, myalgia, pain, injection site reaction, and other mild to moderate reactions.

A study conducted by the University of the Philippines showed that the vaccine is expected to reduce dengue cases in the country by over 24% in a span of five years.

Meanwhile, Chiong said that they will have a doctor in over 100 selected Watsons stores to administer the vaccine during vaccination dates. The first scheduled dengue vaccination will be on April 30, 2017 (1st dose); October 29, 2017 (2nd dose) and April 29, 2018 (3rd dose). The second schedule vaccination will be on May 14, 2018 (1st dose); November 12, 2018 (2nd dose); and May 13, 2018 (3rd dose).

REYNALDO “Rey” R. VICENTE’s career experience involves mostly research in publishing companies. He previously held the position of Research and Events Director of Media G8way Corp., publisher of Computerworld Philippines (CWP), PC World Philippines, and IT Resource. He also handled events organized for CWP. Prior to this, he was a Research Head of a business publication. Now as co-publisher of Zest Magazine, Rey also serves as Managing Editor. Rey finished his bachelor’s degree majoring in Economics at the University of Santo Tomas.

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Young vapers perform worse in exercise testing

On average, the group of young vapers had lower ‘peak exercise capacity’ (186 watts) than the group who did not vape or smoke (226 watts) but similar capacity to the group of smokers (182 watts). This is a measure of the maximum amount of physical exertion that a person can achieve.

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Young people who vape perform worse than non-vapers in tests designed to measure their capacity for exercise, according to a study presented at the European Respiratory Society (ERS) Congress in Vienna, Austria. The research also showed that the performance of young vapers was similar to that of young smokers.

The study adds to growing evidence that long-term use of vaping is harmful and challenges the idea that vaping could be a healthier alternative to smoking.

The research was presented by Dr Azmy Faisal, senior lecturer in cardiorespiratory physiology in the department of sport and exercise sciences at Manchester Metropolitan University, UK. He said: “Previous research has shown that vaping is linked to lung inflammation and damage, and harmful changes to the blood vessels. Although, some research suggests that vaping could be used to cut back or quit smoking, we don’t yet know what longer-term vaping use does to our bodies.”

The study included 60 people in their 20s who all had normal lung function according to spirometry testing. Twenty were non-smokers and non-vapers, 20 had been vaping for at least two years and 20 had been smoking for at least two years.

Each person took part in an incremental exercise test on a static bike. This is the gold-standard for testing physical ability and how well a person copes with exercise, looking at their heart, lungs, and muscles’ responses at harder and harder levels until they reach their maximum. They were also given blood tests and an ultrasound scan to analyse how well their arteries were functioning.

On average, the group of young vapers had lower ‘peak exercise capacity’ (186 watts) than the group who did not vape or smoke (226 watts) but similar capacity to the group of smokers (182 watts). This is a measure of the maximum amount of physical exertion that a person can achieve. At peak exercise, vapers and smokers were also less able to consume oxygen on average (2.7 litres per minute and 2.6 litres per minute) compared to the non-smoking non-vaping groups (3 litres per minute).

Both vapers and smokers showed signs that their blood vessels were not working as well as the non-smoking and non-vaping group, according to the blood tests and ultrasound scans. The smokers and the vapers were more out of breath, experienced intense leg fatigue and had higher levels of lactate in their blood, a sign of muscle fatigue, even before they reached their maximum level of exercise.

Dr Faisal said: “In this study, we looked at a group of young people with no apparent signs of lung damage. Among the people who had been vaping or smoking for at least two years, we saw important differences in how well they coped with exercise. The smokers and the vapers had measurably excess breathing while using the exercise bikes. They found it harder to breath, their muscles became more fatigued, and they were less fit overall. In this regard, our research indicated that vaping is no better than smoking.”

Dr Filippos Filippidis is Chair of the ERS Tobacco Control Committee, a reader in public health at Imperial College London and was not involved in the research. He said: “Vapes are being sold cheaply and in a variety of flavours to appeal to young people. As a result, we’re seeing more and more young people take up the habit without knowing what the long-term consequences could be to their health.

“Although it’s always a challenge to know if the associations we find in these studies are causal or a result of some other systematic differences between groups, people who vape need to be aware that using these products could make them less fit and able to take part in exercise. Doctors and policymakers also need to know about the risks of vaping, and we should be doing all we can to support children and young people to avoid or quit vaping.”

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Some adverse pregnancy outcomes may increase risk of heart disease later in life

A self-reported history of gestational hypertension was associated with cardiovascular disease. Women with preeclampsia or all three adverse pregnancy outcomes also had a numerically higher prevalence of heart disease, but it did not meet the standards of statistical significance. No association was found between gestational diabetes and heart disease.

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Pregnancy-related hypertension has already been proven to lead to a number of negative health outcomes later in life, including more bothersome menopause symptoms like hot flashes, the risk of dementia, kidney problems, and stroke. A new study suggests it can also lead to cardiovascular disease during menopause. Results of the study were presented at the 2024 Annual Meeting of The Menopause Society in Chicago, USA.

In the new study involving nearly 400 women with a mean age of 81.6 years, researchers sought to assess the association between a self-reported history of preeclampsia or eclampsia, gestational hypertension, and gestational diabetes with cardiovascular outcomes in postmenopausal women.

What they found is that a self-reported history of gestational hypertension was associated with cardiovascular disease. Women with preeclampsia or all three adverse pregnancy outcomes also had a numerically higher prevalence of heart disease, but it did not meet the standards of statistical significance. No association was found between gestational diabetes and heart disease.

“Future research based on a larger sample size is needed to better understand the role adverse pregnancy outcomes may have in cardiovascular disease development and risk stratification,” says Marie Tan, lead author from Drexel University College of Medicine in Philadelphia.

More detailed results will be discussed at the 2024 Annual Meeting of The Menopause Society as part of the presentation entitled “The association between adverse pregnancy outcomes and cardiovascular disease in menopausal women: results from a cross-sectional analysis.”

“Cardiovascular disease is the number one cause of mortality in women and it’s important to study any new risk factors” says Dr. Stephanie Faubion, medical director for The Menopause Society. “Although future research is still needed, studies like this are important and remind us to thoroughly discuss a patient’s health history, including any complications or adverse outcomes during pregnancy.”

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Babies born to women consuming a high fat, sugary diet at greater risk of cardiovascular disease and diabetes in later life

Consuming a high-fat, sugary diet during pregnancy also increases the likelihood of the unborn baby becoming insulin resistant in adulthood, potentially triggering diabetes and causing cardiovascular disease. This is despite babies being a normal weight at birth.

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Babies born to pregnant women with obesity are more likely to develop heart problems and diabetes as adults due to fetal damage caused by the high-fat, high-energy diet of their mother.

That’s the groundbreaking finding from a new study published in the Journal of Physiology that shows for the first time that maternal obesity alters a critical thyroid hormone in the fetal heart, disrupting its development.

Consuming a high-fat, sugary diet during pregnancy also increases the likelihood of the unborn baby becoming insulin resistant in adulthood, potentially triggering diabetes and causing cardiovascular disease. This is despite babies being a normal weight at birth.

University of South Australia researchers identified the link by analysing tissue samples from the fetuses of pregnant baboons fed a high-fat, high-energy diet in a biomedical research institute in the United States. They then compared this to fetuses from baboons on a control diet.

Lead author, University of South Australia PhD candidate Melanie Bertossa, says the findings are significant because they demonstrate a clear link between an unhealthy diet high in saturated fats and sugar, and poor cardiovascular health.

“There has been a long-standing debate as to whether high-fat diets induce a hyper- or hypothyroid state in the fetal heart. Our evidence points to the latter,” Bertossa says.

“We found that a maternal high-fat, high-energy diet reduced concentrations of the active thyroid hormone T3, which acts like a switch around late gestation, telling the fetal heart to start preparing for life after birth. Without this signal, the fetal heart develops differently.”

Bertossa says that diets high in fat and sugar can alter the molecular pathways involved in insulin signalling and critical proteins involved in glucose uptake in the fetal heart. This increases the risk of cardiac insulin resistance, often leading to diabetes in adulthood.

“You’re born with all the heart cells you will ever have. The heart doesn’t make enough new heart muscle cells after birth to repair any damage, so changes that negatively impact these cells before birth could persist for a lifetime.

“These permanent changes could cause a further decline in heart health once children reach adolescence and adulthood when the heart starts to age.”

Senior author, UniSA Professor of Physiology Janna Morrison, says the study demonstrates the importance of good maternal nutrition in the leadup to pregnancy, not only for the mother’s sake but also for the health of the baby.

“Poor cardiac outcomes were seen in babies that had a normal birth weight – a sign that should guide future clinical practice,” Prof Morrison says.

“Cardiometabolic health screening should be performed on all babies born from these types of pregnancies, not just those born too small or too large, with the goal being to detect heart disease risks earlier.”

Prof Morrison says that if rising rates of high-fat sugary diets are not addressed, more people will develop health complications such as diabetes and cardiovascular disease, which could result in shorter life spans in the decades ahead.

“Hopefully, with the knowledge we have now about the negative health impacts of obesity, there is potential to change this trajectory.”

The researchers are currently undertaking long-term studies of babies born to women on high- fat high-energy diets to track their health over decades.

Maternal high-fat high-energy diet alters metabolic factors in the non-human primate fetal heart” is published in the Journal of Physiology and authored by researchers from the University of South Australia, University of Wyoming and Texas Biomedical Health Institute.

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