Symdeko for treating cystic fibrosis

The U.S. Food and Drug Administration (FDA) has approved Symdeko (ivacaftor/tezacaftor tablets and ivacaftor tablets) for treating the underlying cause of cystic fibrosis (CF) in people ages 12 and older who have two copies of the F508del mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene or who have at least one mutation that is responsive to tezacaftor/ivacaftor.

Do not take Symdeko if you take certain medicines or herbal supplements such as: antibiotics such as rifampin (Rifamate, Rifater) or rifabutin (Mycobutin) seizure medicines such as phenobarbital, carbamazepine (Tegretol, Carbatrol, Equetro), or phenytoin (Dilantin, Phenytek)

Symdeko consists of 2 different tablets. The yellow tablet is marked with ‘V100’ and contains the medicines tezacaftor and ivacaftor. Take one yellow tablet in the morning. The light blue tablet is marked with ‘V150’ and contains the medicine ivacaftor. Take one light blue tablet in the evening. Take the yellow tablet and the light blue tablet about 12 hours apart.

Always take Symdeko with food that contains fat. Foods like egg, butter, peanut butter, cheese, pizza, and whole-milk dairy products such as whole milk, cheese, and yogurt. If you miss a dose and it is six hours or less from the time you usually take the yellow tablet in the morning or the light blue tablet in the evening, take the missed dose with food that contains fat as soon as you can. Then take your next dose at your usual time and it is more than six hours from the time you usually take the yellow tablet in the morning or the light blue tablet in the evening, do not take the missed dose. Take your next dose at the usual time with food that contains fat. Do not take more than usual dose to make up for a missed dose.

Symdeko can cause dizziness in some people who take it. Do not drive a car, use machinery, or do anything that needs you to be alert until you know how Symdeko affects you. Avoid food or drink that contains grapefruit or Seville oranges while you are taking Symdeko. It can cause serious side effects, including: high liver enzymes in the blood.

Call your doctor right away if you have any of the following symptoms of liver problems:pain or discomfort in the upper right stomach (abdominal) area, yellowing of your skin or the white part of your eyes, loss of appetite, nausea or vomiting, dark amber-colored urine. Abnormality of the eye lens (cataract) in some children and adolescents treated with Symdeko or treated with ivacaftor alone. If you are a child or adolescent, your doctor should perform eye examinations before and during treatment to look for cataracts. The most common side effects include: headache, nausea, sinus congestion and dizziness.
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Fasting diets boost brain power

Intermittent fasting may provide brain with more energy, improves memory and learning capabilities. When mice were fed every other day, they grew more neurons and synaptic connections, improving their cognitive functions. During intermittent fasting, the body switches energy sources from glucose, made in the liver, to fat cells, which stimulate activity and cell growth in the brain.

The body runs off of the liver's energy stores for about 10 to 14 hours in humans, when those stores are out, human, as well as animal bodies switch to fat stores, which are converted into compounds called ketones in the blood. Ketones act directly on the nerve cells to stimulate production of BDNF'- a key protein to neuron growth-and may help optimize cognition, learning and memory building.

Simply eating less will not have the same effects, eating three meals a day and having an overall relatively low calorie intake - between 1,800 and 2,000 every time-replenish their liver energy stores. The mice in the study were more alert and showed more activity in the areas of their brains responsible for learning and memory during the fasting period. Every-other-day fasting his team used for the mice wouldn't work in human, two days of fasting each week can help in human.
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Fat distribution increases the risk of heart attack

It's not the amount of fat in the body but where it's stored that may increase the risk for heart attack, stroke and diabetes. People of the same weight or body mass index (BMI) may have different risk profiles, based on genetics, lifestyle and diet. In addition, body composition differs between men and women, with women having proportionately more fat and men having more muscle mass.

Fat distribution is an important determinant of cardiometabolic risk.  There are different body shapes, common descriptors of human body shapes, based on where fat tends to be stored in the body. In apple-shaped bodies, fat is distributed largely around the midsection, while in pear-shaped bodies, fat is distributed lower around the hips and thighs. The type of fat stored also plays a role in cardiometabolic risk. One type of fat-ectopic fat-is dangerous. It may be found in places such as the abdominal region, muscles, liver and other organs.

There are gender-based differences in body composition and ectopic fat depots and that these could be associated with gender-specific risk profiles for diseases like diabetes, heart disease and stroke, researchers examined overweight and obese men and women wit the same BMI who were otherwise healthy. After fasting overnight, the study participants underwent dual-energy x-ray absorptiometry (DXA) and CT scans to determine body composition, as well as magnetic resonance spectroscopy (MRS) for fat quantification and analysis.

The results showed that the women had a higher percentage of fat and more subcutaneous (below-the-skin) fat but lower lean mass, compared to men. However, men had more visceral adipose tissue (VAT), or ectopic fat depots located in the abdomen around the internal organs known as a "beer belly", and more ectopic fat in the muscles and liver. Obese men have relatively higher visceral fat, fat within muscle cells and liver fat, which are all risk factors for cardiometabolic disease, compared to women with the same BMI. However, men have higher muscle and lean mass, which are protective for cardiometabolic health.

Women have a higher relative amount of total body fat and higher superficial thigh fat, which is protective for cardiometabolic health. Compared to women, men had higher measures of cardiometabolic risk overall, but ectopic fat was not significantly associated with cardiometabolic risk in men. Ectopic fat in women, however, was strongly associated with cardiometabolic risk measures. The detrimental fat depots deep in the belly, muscles and liver are more damaging for cardiometabolic health in women compared to men.

The researchers looked at the relationship between sarcopenic obesity-or the loss of skeletal lean muscle mass in the presence of obesity and its relationship to cardiometabolic risk. Many factors can lead to sarcopenic obesity in young adults, particularly obesity and lack of exercise. Growth hormone helps to build muscle mass. Nutrition also plays an important role, and too little intake of protein can lead to muscle loss. The researchers studied  young, overweight and obese adults who were otherwise healthy.

Participants underwent DXA and CT scans and various metabolic tests. Results showed that having a lower lean muscle mass to BMI ratio was associated with cardiometabolic risk, and these effects were stronger in women than in men. Sarcopenic obesity may be an under-appreciated mechanism linking obesity to cardiometabolic disease.
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Heplisav-B for prevention of Hepatitis B

U.S. Food and Drug Administration (FDA) has approved Heplisav-B [Hepatitis B Vaccine, Recombinant (Adjuvanted)] for prevention of infection caused by all known subtypes of hepatitis B virus in adults. Hepatitis B is an extremely infectious and potentially deadly virus.

 There is no cure for hepatitis B, and infections are on the rise. Hepatitis B can be prevented through effective vaccination. Current hepatitis B vaccines require three shots over a six-month period, however, almost half of adults fail to complete the series within one year.

Prevention of hepatitis B in adults through vaccination is more important than ever given the increase in the rate of infections. A two-dose schedule with higher rates of protection, along with other strategies, may help us move closer to the goal of eliminating hepatitis B.

Hepatitis B is a viral disease of the liver that can become chronic and lead to cirrhosis, liver cancer and death. The hepatitis B virus is 50 to 100 times more infectious than HIV, transmission is on the rise. There is no cure for hepatitis B, but effective vaccination can prevent the disease. In adults, hepatitis B is spread through contact with infected blood and through unprotected sex with an infected person.

 The CDC recommends vaccination for those at high risk for infection due to their jobs, lifestyle, living situations and travel to certain areas. People with diabetes are particularly vulnerable to infection, the CDC recommends vaccination for adults age 19 to 59 with diabetes as soon as possible after their diagnosis, and for people age 60 and older with diabetes.

Heplisav-B is an adult hepatitis B vaccine that combines hepatitis B surface antigen with Dynavax's proprietary Toll-like Receptor (TLR) 9 agonist to enhance the immune response. Dynavax has worldwide commercial rights to Heplisav-B. Heplisav-B is indicated for active immunization against infection caused by all known subtypes of hepatitis B virus. Heplisav-B is approved for use in adults 18 years of age and older.

Do not administer Heplisav-B to individuals with a history of severe allergic reaction like anaphylaxis after a previous dose of any hepatitis B vaccine or to any component of Heplisav-B, including yeast. Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of Heplisav-B.

Immunocompromised persons, including individuals receiving immunosuppressant therapy, may have a diminished immune response to Heplisav-B. Hepatitis B has a long incubation period. Heplisav-B may not prevent hepatitis B infection in individuals who have an unrecognized hepatitis B infection at the time of vaccine administration. The most common patient reported adverse reactions reported within 7 days of vaccination were injection site pain, fatigue and headache.
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Eating at the wrong time increase the risk of heart disease

Eating late at night increases the risk of heart disease and diabetes by raising levels of harmful blood fats. Shift work, is triggering the killer illnesses by leading to people eating their meals at the wrong time of the day. Experiments on rats found when they ate at the start of their rest period there was a dramatic spike in triglycerides, compared to being fed just before they became active.

Triglycerides are blood fats produced in the liver and derived from foods such as meat, dairy products and cooking oils. They are different from cholesterol but can also clog arteries, leading to cardiovascular disease, or inflame the pancreas, triggering diabetes. People with high levels of triglycerides in their blood are more likely to have heart problems when the part of the rat's brain that controls the circadian rhythm was no longer in change of the fat levels.

Cardiovascular disease and diabetes are linked to a lifestyle where humans ignore the signals of the biological clock and eat in the evening and late at night. The researchers said the study demonstrates why such a routine is out of sync with 24-hour cycle and may result in high blood fat levels and a higher risk for illnesses.

Eating late frequently during with shift work, jet lag, or staying up late at night will harm human health in the long term especially when we eat at times when we should sleep. People put on more weight when they ate three meals a day between noon and 11pm than when they consumed the same amount of calories from 8am to 7pm. The late night meals caused them to pile on by reducing the breaking down of fats.

Delayed eating also led them to store carbohydrates which can lead to weight gain and raised blood sugar and insulin levels, increasing the risk of diabetes. Their cholesterol and triglyceride levels rose too, raising the likelihood of heart disease. Disruption of circadian regulation has been linked to metabolic abnormalities. Epidemiological evidence shows night work is a risk factor for cardiovascular disease.

As rats are nocturnal, they rest during the day and are active at night. When they ate two hours after the onset of daylight, rather than dark, their triglyceride levels soared. The suprachiasmatic nucleus SCN has a major role in day-night variations in plasma triglycerides by promoting their uptake into skeletal muscle and brown adipose tissue.

Disturbance of the biological clock might be an important risk factor contributing to the development of hyperlipidemia (high blood fats). In the last decade studies have documented triglycerides can cause strokes and heart attacks. In humans they rise during the resting phase, suggesting the involvement of the SCN on behavioral activity.

Since triglyceride levels are an important factor in the progress of blood clots, these results may have potential implications for the cause of cardiovascular diseases in the context of inadequate feeding times, shifted towards the rest phase. According to a 2013 study early eaters lost twelve percent of their body weight, while late eaters lost only 8 percent, even though they all followed the same diet and exercise regime.

According to a 2007 study people who eat most of their food at night have higher body mass indexes than those who eat earlier in the day. Another study showed participants who ate between 11 pm and 5am gained more weight than those who did not eat during those hours.
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Alcohol affects levels of cholesterol through epigenetics

In an analysis of the epigenomes of people and mice, researchers discovered that drinking alcohol may induce changes to a cholesterol regulating gene. The findings suggest that these changes to the gene, PCSK9, may be responsible for some of the differences in how cholesterol is processed in people who drink alcohol, or may affect those taking a relatively new class of PCSK9 cholesterol-lowering drugs designed to reduce LDL cholesterol.

Chronic alcohol use can have detrimental effects on the liver and the cardiovascular system. Regulation of PCSK9 seems to correlate with this pattern and may be a significant underlying factor behind the variations in the relationship between cholesterol and cardiovascular disease when it comes to alcohol use. Researchers measure how drinking of alcohol can leads to changes in which genes are expressed.

They examined information from DNA chips- microarrays that can show which genes have chemical methyl groups added across the whole genome. These chips looked at about 500,000 methyl groups at a time. methylation affects the level of gene expression. The researchers used different sets of data: DNA from the brains of deceased people with documented alcohol dependence compared to healthy controls and DNA from blood samples of people who had documented alcohol dependence with healthy controls.

When the investigators cross-compared epigenetic data from the sets of data to find out what changes occurred in common in the two data sets and what changes did not, the common factor highlighted the gene PCSK9. The human liver samples from people with alcohol dependence who underwent a liver transplant and noticed a similar pattern: more methylation on PCSK9 and unexpectedly lower PCSK9 protein levels. In samples from people who abused alcohol, the researchers detected that PCSK9 gene expression was only a third of the level in people who didn't abuse alcohol.

Alcohol is metabolized by the liver and can cause liver damage if used in large amounts over long periods of time. In people, PCSK9 is found at its highest levels in liver, but is also found in other tissues, such as brain and blood. PCSK9 binds to the bad cholesterol receptors and blocks uptake and breakdown of bad cholesterol by cells, leading to accumulation in the bloodstream, where it presumably clogs arteries.
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Fetal gene can cause preeclampsia

Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to kidneys and liver. Preeclampsia usually starts after 20 weeks of pregnancy in women whose blood pressure had been normal. Slight rise in blood pressure may be a sign of preeclampsia.

Pregnant women risk of preeclampsia can be linked in some cases to genes from fetus. Preeclampsia usually starts with a problem in the placenta, which is mainly composed of fetal cells.
Researchers analysed a large number of women, and discovered several genetic variables that identified  the same gene associated with the risk.

The genetic variants identified by the researchers are associated with the FLT-1 gene, which encodes a protein that, in soluble form, is known as a biomarker for preeclampsia.

The protein contributes to damaging the mother's vascular system causing high blood pressure and an increased amount of protein in the urine. This happens as a result of problems with the placenta, essentially because fetal cells in the placenta produce the protein.

The risk of the disease may be because changes in the gene affect how the protein works and how it affects the mother. This is a fetal gene that gives the mother an increased risk of developing preeclampsia.
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Drinking of coffee may increase lifespan

Coffee contains a lot of compounds like caffeine, diterpenes and antioxidants that interact with the body systems and prevent so many diseases.

 It has a lot of antioxidants and phenolic compounds that play an important role in cancer and disease prevention.

Coffee reduces inflammation, controls glucose and strengthens the immune system. Drinking of coffee is associated with a reduced risk of death from circulatory and digestive tract diseases.

 It prevents womb and liver cancer and reduce the risk of Parkinson’s disease, and Alzheimer’s. Moderate drinking of coffee every day is essential for sound health.

Dinking more than 0.4g of caffeine a day can cause anxiety, sleeplessness and disturbed heart rhythm.
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HIV positive women with cytomegalovirus may infect their babies with the virus

HIV-positive women with cytomegalovirus CMV, in their urine at the time of delivery may pass the virus to their babies.

Women who had gonorrhea when they gave birth may also infect their babies with CMV. Babies infected through their mothers and those with weakened immune systems will experience serious health problems.

CMV can impair fetal growth, cause birth defects and babies born with the virus can have damage to their brain, liver, lung and spleen.

 Researchers examined 260 pairs of mothers and 222 babies from who were enrolled in a perinatal study by the National Institute of Child Health and Human Development.

After testing the mothers' and infants' urine for detectable CMV, the researchers discovered that- 2 percent of the women had detectable CMV and 3.8 percent of babies had the virus.

Eight percent of women with detectable CMV had babies with the virus, as opposed to 2.1 percent of women who did not have CMV.

Two percent of women with detectable CMV transmitted the virus to their babies compared with 8.1 of those who did not have CMV.

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Low carbohydrates diets can imitate effect of ecstasy on your brain

 Low-carb diet changes your metabolic  from burning more carbohydrates to burning of more fat than carbohydrates, this is a process known as ketosis.

When human body uses up carbohydrates glucose reserves, the body stimulates the breakdown of stored fat into fatty acids and releases them into the blood.

When fatty acids reach the liver they are changed into acetoacetate, a metabolic fuel that belongs to a family of ketones.

Acetoacetate decomposes to carbon dioxide and acetone, low-carbohydrates dieters and people who are fasting usually have sweet smelling breath.

A healthy liver minimises the acetone lost through the lungs by converting most of the acetoacetate it produces to beta-hydroxybutyrate BHB. This can cause euphoric feelings.

During ketosis, BHB can reach high levels in the brain, where it can bind to the same anxiety-reducing receptors as recreational drugs with similar effects.
 Side effects of ketosis are loss of calcium from bones, kidney stones and growth retardation.

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Genes are expressed differently in men and women

Men and women differ in obvious ways for example, in the prevalence of certain diseases or reactions to drugs.

Weizmann Institute of Science researchers recently uncovered thousands of human genes that are expressed out to make proteins differently in the two sexes.

Pietrokovski and Gershoni showed that mutations in genes specific to sperm formation persist precisely because the genes are expressed only in men.

 A mutation that is problematic for only half of the population, no matter how detrimental, is freely passed on to the next generation by the other half.

In this study, the researchers expanded their analyses to include genes that, though not necessary for fertility, are still expressed differently in the two sexes.

 To identify these genes, the scientists used a very large study of human gene expression recorded for numerous organs and tissues in the bodies of close to 550 adult donors.

Pietrokovski and Gershoni looked closely at around 20,000 protein-coding genes, sorting them by sex and searching for differences in expression in each tissue. They eventually identified around 6,500 genes with activity that was biased toward one sex or the other in at least one tissue.

For example, they found genes that were highly expressed in the skin of men relative to that in women's skin, and they realized that these were related to the growth of body hair. Gene expression for muscle building was higher in men; storage were higher in women.
Apart from the sexual organs, the researchers discovered quite a few sex-linked genes in the mammary glands -- not so surprising, except that about half of these genes were expressed in men.

The researchers also identified gene expression in the liver in women that regulates drug metabolism, providing molecular evidence for the known difference in drug processing between women and men.

Faulty liver may cause sweet tooth gene

When we eat sweet food, our livers secrete a hormone called FGF21.
But new research reveals some people have particular variations of this hormone - which makes them crave more sugary treats.

Researchers at the University of Copenhagen found that people with particular variants of the FGF21 gene were about 20 percent more likely to have an unabated sweet tooth.

Matthew Gillum, an assistant professor of biological sciences, led the study with Niels Grarup, an associate professor of metabolic genetics at the University of Copenhagen.

Prof Gillum said: 'The data, mined from a study of the lifestyles and metabolic health of 6,500 Danish individuals, is a really surprising insight into the potential hormonal basis of the sweet tooth.'

The study also raises new ideas about the role of the liver in controlling what we eat. Food pass form stomach to intestines, and from intestines to liver.
The liver could also secrete other hormones that guide food choices.

When liver immune cells are weak

Fatty diet and obesity destroy liver immune system and result in type 2 diabetes.

Researchers at Toronto General Hospital Research Institute used mice cells and human livers to discover why liver of diabetes patients produce much glucose.

They discovered that obesity and fatty diet increased blood sugar, liver cells become pathogenic and destroy immune system.

Researchers fed mice with fatty diet for 4 months, they compared them with other mice and discovered that increased triglycerides in their blood and increase in CD8+ T cells in the liver.

The CD8+ T cells caused an inflammatory to bacterial components that moved to liver from the gut through the blood.

Animal protein may cause liver disease

There are more than 100 different types of liver disease, non-alcoholic fatty liver disease NAFLD is when their is a build up fat in the liver cells that is not linked to consumption of alcohol.

Excess consumption of animal protein can cause NAFLD, when quantities of fat in liver is more than 10 percent of its total weight, then too much fat is affecting the functions of the liver.

 NAFLD can cause liver cirrhosis, cancer and dysfunction of the liver. Researchers examined adults to discover the contribution of diet on NAFLD.

Researchers collected data from 3,440 people, 30 percent were lean and 70 percent overweight. Ultrasound scan found NAFLD in 35 percent of the people examined.

The ultrasound result shows that animal protein is linked with NAFLD in overweight people. Diet rich in animal proteins and over processed food can disturb body homoeostasis, glucose metabolism and acid-based balance in the body.

Protein in Liver may cause exercise resistance

Physical activity involves movement of the body like walking, running, swimming and jumping. Regular physical activity controls weight, reduces risk of cardiovascular disease and risk of diabetes.

Researchers discovered that high deposit of selenoprotein secreted in the liver was responsible for low participation in exercise.

Current guidelines started that adults should engage in 150 minutes of moderate exercise or 75 minutes of vigorous exercise.

Researchers engaged 31 healthy women in regular exercise for 8weeks and monitored their oxygen intake.

They discovered that women with high level of selenoprotein in their blood before the exercise displayed lower oxygen intake than women with lower level of selenoprotein.

Hepatitis may increase the risk of Parkinson's disease

Hepatitis is an inflammation of the liver, there are five hepatitis viruses: type A, B, C, D and E.

Types B and C are very common, a new study claims that hepatitis B and C may increase the risk of Parkinson's disease.

Hepatitis B is spread by having contact with infected blood and body fluids, hepatitis C is spread by blood to blood contact like sharing of sharp objects with infected person.

The researchers discovered that 76 percent ot type B patients and 51 of type C patients are at the risk of developing Parkinson's disease.

Symptoms of metastatic breast cancer

Metastatic breast cancer is an advanced cancer that has spread to other organs in the body, if initial cancer treatments failed it can result into stage 4 cancer which can spread to brain, bones, lungs and liver.

Symptoms of the spread to bones are: pain, fractures, swelling and spinal cord compression.

Symptoms of the spread to liver are: loss of appetite, vomiting, nausea, bleeding, skin rash and pain.

Symptoms of the spread to brain are: headache, seizure, blurred vision, irrational behavior and nausea.

If it spreads to lungs it can cause chest pain, coughing of blood and shortness of breath.

Treatment
Systemic therapy or medication like chemotherapy and hormone therapy are required for treating metastatic cancer.

Obesity may cause liver disease

Obesity is a condition of having excess fat in the body that is having negative effect on the body, you are obese if your body mass index BMI is or greater than 30.

Excess food intake and lack of physical activity can cause obesity, Obesity is one of the major causes of liver disease.

Excess weight can cause non - alcoholic fatty liver disease NAFLD, this is a condition of building - up of fat within liver cells.

Recent study provides link between obesity and liver disease, being overweight or obese can cause NAFLD, it is good to work on weight reduction from early age to prevent liver disease later in life.

How HIV affects the immune system

Human Immunodeficiency virus (HIV) is a lentivirus that causes HIV and later AIDS. Early signs of HIV are: fever, joint pain, sore throat and skin rashes.

A T-cell is a type of lymphocyte - white blood cell that defend the body against disease, HIV infects a cell by attaching itself to T-cell, multiplies its virus and destroy the T-cell.

CD4 count shows the strength of one's immune system which is between 500 1500 for healthy people, being infected with HIV without treatment will reduce the count below 200.

 HIV  exposes the infected person to opportunistic  infections like: pneumonia, toxoplasmosis, thrush, and tuberculosis.

Presently, there is no cure for HIV. Antiretroviral therapy is recommended for people living with HIV virus.

Common side effects of Antiretroviral drugs are: glucose intolerance, kidney failure, hepatitis of the liver, insulin resistance, osteoporosis, anemia and inflamed pancreas.