Week of May 17, 2021

Vaccinated? Now You can Take off the Masks!

Brighter days are ahead! Over the last few weeks, the cases of COVID-19 in the United States have sharply declined, with a new low 7-day average dropping to around 30,000 cases/day (compared to around 250,000 cases/day peak in January). Vaccine counts estimate that about 48% (158,365,411) of the US population has received at least one dose of a COVID-19 vaccine. More than one third (34.6%) have received both doses. 

Your Health Forum supports these recommendations. The decision was based on reports of minimal risk of infection after vaccination, less likelihood of asymptomatic disease, and less likely to transmit the virus to others.

With such an abrupt change with only mild incremental changes before, it is likely that there will be an adjustment period. Businesses will look to state guidance to weigh in on these recommendations. Expect to see some changes in your city soon. If you have yet to receive the COVID-19 vaccine, Dr. Cirino recommends getting vaccinated to ensure your safety.   

 

Uncertainty Amid the Future of the 2021 Olympics

Postponed last year on account of the pandemic, the Tokyo Olympic games are scheduled to begin on July 23, 2021. However, Japan has seen a wave of coronavirus cases in its large cities. The government has called for emergency lockdowns in the two largest cities, Tokyo and Osaka, extended recently for the month of May (NY times article). The daily caseload in Japan is around 6,000 cases, with today currently at 3,680 new cases. 

Amid recommendations of a growing number of doctors and protests to cancel the Olympics, the Japanese Olympic Committee faces a dilemma: save face and hold out a little longer or cancel? Now just two months from the start, the committee is running out of time to decide. The financial and symbolic ramifications of such a cancellation would be unparalelled. Economists estimate that the cost of cancelling the 2020 the postponed 2021 olympic games could exceed 4.5 trillion Japanese yen (41 billion $US). 

Japan has had the lowest vaccination rate in the G7 countries, with less than 3% of the adult population receiving at least one dose. Likely contributing to this are a relative decreased urgency (before the spike) in a country which had a lower rate of transmission, low vaccine confidence rates, and slow vaccine roll-out (Forbes article). More doses are on the way.

 

Recent Publications

Have a Muscle Pull: Do You Use an Ice Pack or a Heat Pack?

It is a common practice to apply “RICE” to a muscle injury. Included in this acronym is ice (rest, ice, compression and elevation).  A study published in the Journal of Applied Physiology last week by Kwashima et al., showed that icing an injury in a mouse model impaired muscle regeneration and delayed the removal of necrotic muscle waste. 

Although the application of either heat or ice have biologic plausibility, there is limited scientific evidence to support one over the other, or either one for that matter. I tell patients to use the one they tolerate and see if it helps. This study does give me some pause about applying ice on every injury and certainly for more than a few minutes.

Does Obesity Originate in the Stomach? A protein produced in the stomach 

Bariatric surgeons have found that removing a threshhold amount of stomach leads to weight loss and resolves diabetes. And it may not just be related to the mechanical limits of the size of the pouch. 

The stomach affects the endocrine system. Ghrelin is a small protein produced by the stomach which signals the brain to stimulate appetite. The counter-regulator to Ghrelin is Leptin, a peptide released by fat cells to signal satiety. Why does soemone get fat if they produce leptin? This is a subject of another article, but it should suffice to mention that there is leptin resistance with obesity.

 The protein Gastrokine-1 (GKN1), made exclusively in the stomach, may also play a role in obesity. In a recent study by Overstreet et al. in Nature Scientific Reports, scientists used a specific strain of mice deficient in GKN1 and compared to wild-type mice fed normal and high-fat diets. The GKN1 deficient-mice were resistant to high-fat diet-induced obesity compared to the wild-type mice. 

Interestingly, there was a change in the microbiome in these GKN1 deficient mice, with lower levels of Firmicutes and Erysipelotrichia. There was also less fatty liver in the setting of increases in factor ANGPTL4, known to stop adipose tissue storage.

The researchers concluded that bariatric surgery may decrease GKN1 production or release and wondered if the gut microbiome changes could also promote weight loss. Could there even be a potential therapy that stops GKN1 production?

 

YHF News

The Your Health Forum Podcast 

Featuring a way to hear the articles, live updates, and interviews on the go: the Your Health Forum Podcast!

Dr. Cirino has a podcast series featuring health and wellness topics. There are Audio files, that are dictations of the articles on the site. There are also updates that Dr. Cirino conducts. Finally, there is a series titled Journey to Health, featuring interviews with various writers, researchers, doctors, and health advocates to discuss their perspectives and the questions “What is health?” and “What is the future of healthcare?”

The Journey to Health series will be showcased in the conference section (the orange button with chairs). Here is the link.

Your Health Forum’s growing catalog of articles will feature a dictation icon with a Spotify link, so that they can be listened to anywhere. Become a member of the podcast by signing up on Spotify, Apple Podcast, or the other common podcast sites. Click on the link to be directed to the podcast page on Spotify.

 

 

 

Healthcare Spotlight with Dr. Cirino 

Dr. Cirino was interviewed in April 23 by HEALTHNEEDSRX, a health website formed by students to provide health information to the general audience, with a focus on health equity. The interview was regarding the latest COVID-19 pandemic information.

Dr. Cirino Featured on Pre-Health Shadowing

Pre-Health Shadowing is a student-, minority-, women-led, non-profit company dedicated to providing information to pre-medical and other health students. Dr. Cirino discussed what it is like to be an infectious diseases physician. He brought up some important recommendations to balancing life in the profession of medicine.

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