Similar Processes Could Link MS With Heart Disease

Similar Processes Could Link MS With Heart Disease

WEDNESDAY, March 22, 2023 (HealthDay News) — Multiple sclerosis (MS) and atherosclerosis both involve an abnormal hardening of body tissue, and recent research suggests they may be linked.

MS is a neurodegenerative disease that attacks the brain and spinal cord. Atherosclerosis is hardening of the arteries.

Studies show connections between the two, according to Ochsner Health System in New Orleans. In 2018, a team of Romanian researchers led by Dr. Raluca Ileana Mincu of the University of Medicine and Pharmacy Carol Davila, Bucharest, used state-of-the-art echocardiography to conduct heart and vascular assessments in patients with MS.

The exams, which show how blood flows through the heart and valves, found that MS patients had more impairments on both sides of the heart compared to healthy people.

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A more recent study followed more than 84,000 people for 10 years, comparing heart health in participants with and without MS. People with MS were 50% more likely to die from heart disease, researchers found. They were 28% more likely to have a heart attack and 59% more likely to have a stroke. Raffaele Palladino of Imperial College London led the study.

The findings highlight the importance of comprehensive heart exams for people with MS. Advanced techniques can help prevent life-threatening heart disease in patients who are at high risk.

This preliminary research doesn’t show that MS causes atherosclerosis, but a strong association between the two diseases is emerging, according to Ochsner Health.

More studies are needed to understand the underlying processes that link these two conditions.

In atherosclerosis, fatty deposits build up in the arteries, causing a thickening of the blood vessel wall, curtailing blood flow. As a result, lower levels of oxygen and important nutrients are able to reach various parts of the body.

A chronic condition, it can lead to coronary artery disease, angina, peripheral artery disease and kidney problems.

Causes aren’t fully known, according to the American Heart Association, but elevated cholesterol and triglycerides in the blood, high blood pressure, cigarette smoking and diabetes are risk factors.

In MS, the body’s immune system mistakenly attacks its own central nervous system. This interrupts nerve signals between the brain and spinal cord and other parts of the body, leading to hardened scar tissue after each attack.

About 1 million U.S. adults live with MS. Symptoms can include impaired vision, sensory changes, cognitive changes, weakness, pain, fatigue, bowel and bladder incontinence, impaired coordination and walking difficulties, according to the National MS Society.

The U.S. National Institutes of Health has more on atherosclerosis, and the National Multiple Sclerosis Society has more on MS.

SOURCE: Ochsner Health, news release, March 17, 2023

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Two additional deaths linked to bacteria in recalled eye drops, CDC says

Two additional deaths linked to bacteria in recalled eye drops, CDC says

Editor’s note: This story contains graphic images.

(CNN) — A rare strain of bacteria found in recalled eye drops has been linked to dozens of infections, as well as cases of vision loss and surgical removal of eyes. This week, the US Centers for Disease Control and Prevention reported two additional deaths — a total of three — have been linked to the bacterial infection.

Global Pharma Healthcare recalled its Artificial Tears Lubricant Eye Drops that were distributed by EzriCare and Delsam Pharma last month, and the agency has been warning people not to use the drops.

As of March 21, the CDC has identified 68 people in 16 states with infections of a rare strain of drug-resistant Pseudomonas aeruginosa never before reported in the United States. Most of the patients reported using artificial tears, the CDC said, and EzriCare Artificial Tears was the brand most commonly reported.

Reported adverse events include infections of the cornea, bloodstream, respiratory tract and urinary tract. There are eight reports of lost vision and four reports of surgically removed eyeballs.

On Wednesday, two case reports published in JAMA Ophthalmology offered more details about how these problems developed

One of the new case reports described a 72-year-old woman who lost vision in her left eye after using EzriCare artificial tears for dry eyes for about a week.

“She started noticing some blurry vision in her left eye for a few days,” said Dr. Ahmed Omar, an ophthalmologist at University Hospitals Cleveland Medical Center, who treated the woman. “It was initially painless, but according to the patient and her husband, one morning she woke up and she had a yellow discharge on her pillow. And that’s when she started noticing that the appearance of her eye had changed.”

The woman went to the emergency room, where doctors discovered a large ulcer on her left cornea, nearly involving the entire eye. She was admitted to the hospital for three weeks, requiring IV antibiotics, antibiotic eye drops and multiple surgical interventions.

The woman’s case was complicated by a serous choroidal detachment, an abnormal accumulation of fluid, which ultimately led to vision loss in the left eye.

Another case involved a 72-year-old man who developed multidrug-resistant Pseudomonas aeruginosa keratitis, an infection of the cornea.

The man went to the Bascom Palmer Eye Institute in Miami after a day of severe pain and decreased vision in his right eye. He had no previous eye problems but said he had used EzriCare artificial tears for eye dryness.

A 72-year-old woman lost vision in her left eye after using EzriCare artificial tears. Details of her case were published Wednesday in the journal JAMA Ophthalmology.

“When we examined his right eye, there was a severe corneal infection,” said Dr. Marissa Shoji, a resident physician at the institute, who treated the patient. “He could only see shadows and was not able to see letters due to the extent of the ulcer.”

The man was started on strong antibiotics, said Dr. Naomi Gutkind, a resident physician who also treated him.

“We typically expect some degree of improvement these medications, but when we saw him two day later, he was getting far worse,” she said. “So that’s when we inquired about specifically the EzriCare tears, because we knew they were associated with resistant infection that may not respond to those really strong antibiotics.”

Cultures from the man’s cornea and EzriCare bottle grew the same strain of multidrug-resistant Pseudomonas.

The man’s vision at his two months follow-up appointment was 20/400, meaning he can see at 20 feet what healthy people can see at 400 feet.

“At some point, he was in danger of having permanent vision loss,” said Dr. Guillermo Amescua, an ophthalmologist at Bascom Palmer Eye Institute. “He now has what is called corneal blindness because he’s 20/400 and has a corneal scar, but with corneal transplantation, he might have a better prognosis.”

Shoji says this case highlights the short-term and long-term effects of Pseudomonas keratitis. In the short term, people may have terrible pain, decreased vision and a risk of a hole in the eye that could spread infection.

“In the long term, even after the infection is cleared, there’s a risk of needing a surgery such as a corneal transplant or other different types of surgeries to address scarring that may also significantly limit the vision,” she said.

What to know about infections

EzriCare said in a statement that after learning about the CDC’s investigation of Pseudomonas infections on January 20, it “immediately took action to stop any further distribution or sale of EzriCare Artificial Tears. To the greatest extent possible, we have been contacting customers to advise them against continued use of the product.”

The physicians involved in the new studies hope that by highlighting these cases, they can spare others from similar problems.

Shoji advises against using EzriCare or Delsam eye drops while the investigation is ongoing.

“If you have any eye symptoms, things like eye pain, eye redness, decreased vision, please see an ophthalmologist for evaluation,” she said. “And when you come, please bring anything that could potentially be causing this infection, especially eye drops, contact lenses or contact lens cases.”

The CDC says symptoms can include yellow, green or clear discharge from the eye; eye pain or discomfort; redness of the eye or eyelid; feeling like something is in the eye; increased light sensitivity; and blurry vision.

Doctors urge everyone to use caution with eye drops.

“I think a lot of times, people don’t think of eye drops or even things like contact lenses as medical devices. I think they think of them more as kind of just an over-the-counter product like a skin lotion or something like that,” said Dr. Christina Prescott, a NYU ophthalmologist who wrote a commentary published alongiside the case reports on the potential rare dangers of presumably benign artificial tears.

Prescott says people should keep eye drops sterile. That means avoiding touching the tip of the bottle with their hands, skin or eye; not sharing the bottle with someone else; and not using expired products.

People should also use caution with preservative-free eye drops because contamination can lead to serious infection.

“Anything you’re putting in your eye, if it’s contaminated, is going to have a high risk of infection just because your eyes are so vulnerable,” she said.

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Boris Johnson faces high-stakes grilling over 'partygate'

Boris Johnson faces high-stakes grilling over 'partygate'

LONDON (AP) — Boris Johnson is back where he likes to be: at the center of attention. But he’s not so happy about the reason.

Britain’s former prime minister faces a grilling Wednesday by a committee of lawmakers over whether he misled Parliament about rule-breaking parties in government buildings during the coronavirus pandemic.

In a statement, a bullish Johnson said “the evidence conclusively shows that I did not knowingly or recklessly mislead Parliament.”

“The committee has produced not a shred of evidence to show that I have,” he said.

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Expected to last several hours, the hearing is a moment of peril for a politician whose career has been a roller coaster of scandals and comebacks. If the House of Commons Committee of Privileges concludes Johnson lied deliberately, he could be suspended or even lose his seat in Parliament.

That would likely end hopes of one more comeback for the 58-year-old politician, who led the Conservative Party to a landslide victory in 2019 but was forced out by his own party in July 2022 after getting mired in scandals over money, ethics and judgment.

In an interim report this month, the committee — made up of Conservative and opposition lawmakers — said evidence strongly suggested that it would have been ”obvious” to Johnson that gatherings in his Downing Street offices in 2020 and 2021 broke COVID-19 lockdown rules.

Johnson acknowledged on Tuesday that his repeated reassurances to Parliament that the rules were followed at all times “did not turn out to be correct.” But he said he “did not intentionally or recklessly mislead” lawmakers.

In a dossier of written evidence, Johnson said it never occurred to him that the gatherings — which variously included cake, wine, cheese and a “secret Santa” festive gift exchange — broke the restrictions on socializing that his own government had imposed on the country.

He said he “honestly believed” the five events he attended, including a send-off for a staffer and his own surprise birthday party, were “lawful work gatherings.”

”No cake was eaten, and no one even sang ‘Happy Birthday,’” he said of the June 19, 2020, celebration.

Police eventually issued 126 fines over the late-night soirees, boozy parties and “wine time Fridays,” including one to Johnson, and the scandal helped hasten the end of premiership.

Revelations about the gatherings sparked anger among Britons who had followed rules imposed to curb the spread of the coronavirus, unable to visit friends and family or even say goodbye to dying relatives in hospitals.

Johnson said he was assured by “trusted advisers” that no rules had been broken — assurances that turned out to be wrong. He said he was later “genuinely shocked” by the rule-breaking uncovered by police and by senior civil servant Sue Gray, who led an investigation into “partygate.”

Johnson and his supporters have also questioned the impartiality of Gray, because she has now accepted a job as chief of staff to the leader of the opposition Labour Party.

If the committee finds Johnson in contempt, it could recommend punishments ranging from an oral apology to suspension from Parliament, though any punishment would have to be approved by the whole House of Commons.

A suspension of 10 days or more would allow his constituents in the suburban London seat of Uxbridge and South Ruislip to petition for a special election to replace Johnson as a member of Parliament.

Copyright 2023 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

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Judge to consider allowing abortions to resume in Wyoming

Judge to consider allowing abortions to resume in Wyoming

CHEYENNE, Wyo. (AP) — A judge will hear arguments Wednesday over whether abortions will be allowed in Wyoming while a sweeping new ban gets challenged in her court.

The ban took effect Sunday, making abortion illegal in Wyoming despite earlier rulings by Teton County District Court Judge Melissa Owens that blocked an earlier ban hours after it took effect last summer.

Owens will now consider whether to block the new ban, too, while a lawsuit proceeds.

She’s not expected to immediately weigh in, though, on a different new Wyoming abortion law: a first-in-the-nation ban on abortion pills. Abortion-rights supporters are also seeking to stop that law, signed by Republican Gov. Mark Gordon on Friday, but it is not set to take effect until July 1.

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So far, Owens has sympathized somewhat with the two nonprofits, two doctors and two other women who have sued to block Wyoming’s broader abortions bans.

In July, Owens found that their concerns that the law would harm women and doctors and violate the state constitution could have merit. State lawmakers then wrote their new law to try to override those objections.

Owens in her July decision found that a 2012 state constitutional amendment guaranteeing the right to make one’s own health care decisions could allow abortion.

The new sweeping ban asserts that abortion is not health care and the amendment therefore doesn’t apply to abortion.

Gordon expressed reservations about the new ban, even as he allowed it to take effect without his signature. He said voters should resolve the constitutionality of abortion in Wyoming instead of the Legislature addressing abortion piecemeal, year after year.

Wyoming has only one abortion provider, a women’s health clinic in Jackson that only provides medication abortions but has been forced to stop after the state’s broad ban took effect this week.

Wellspring Health Access has been planning to open a clinic in Casper that would provide surgical and medication abortions. After an arson attack prevented that clinic from opening as planned last summer, organizers hoped to open it next month.

Copyright 2023 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

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Lawsuit seeks to block abortion pill ban in Wyoming

Lawsuit seeks to block abortion pill ban in Wyoming

CHEYENNE, Wyo. (AP) — Abortion-rights supporters filed an amended lawsuit Tuesday seeking to block Wyoming’s new abortion pill ban from taking effect.

A group hoping to open what would be the state’s second clinic offering abortions filed the amended lawsuit days after Republican Gov. Mark Gordon signed what is the nation’s first explicit ban on abortion pills. Absent court intervention, that ban would take effect July 1.

Abortion-rights supporters already were seeking to block a separate sweeping abortion ban that took effect Sunday in Wyoming without the governor’s signature. That law seeks to overcome objections that prompted a judge to suspend a previous ban.

The abortion pill ban and the sweeping ban conflict and create confusion about what is and isn’t permissible under the new laws, according to the lawsuit. If they’re allowed to be in effect, “the fundamental rights of Wyoming women and their families will be taken away by the state government and those rights will cease to exist,” the amended lawsuit said.

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Both of the new Wyoming abortion bans make exceptions to save a pregnant woman’s life and for cases of rape or incest that are reported to police.

Until Gordon signed the ban on medication abortions, no state had passed a law specifically prohibiting such pills, according to the Guttmacher Institute, a research group that supports abortion rights. However, abortion pills already were banned in 13 other states with blanket bans on abortion, and 15 states already had limited access to the pills.

Medication abortions also are a target of a separate lawsuit in Texas, where abortion opponents have asked a federal judge to reverse the Food and Drug Administration’s 2000 approval of mifepristone. A two-pill combination of mifepristone and another drug is the most common form of abortion in the U.S.

Wyoming has only one abortion provider, a women’s health clinic in Jackson that only provides medication abortions but has canceled appointments after the state’s broad ban took effect this week. Teton County District Court Judge Melissa Owens is scheduled to hold a hearing Wednesday to consider whether to block that new ban while the legal challenge over it moves ahead.

Wellspring Health Access, which is seeking to block the abortion pill ban and the broader measure, has been planning to open a clinic in Casper that would provide surgical and medication abortions. After an arson attack prevented that clinic from opening as planned last summer, organizers hoped to open it next month.

“Wyomingites deserve access to the full spectrum of reproductive health care, including both surgical and medication abortion, and that’s why we are fighting to keep medication abortion legal in Wyoming,” Julie Burkart, president of Wellspring Health Access said in a statement.

Also suing are four women, including two gynecologists, and Chelsea’s Fund, a Wyoming abortion access advocacy group.

Wyoming Attorney General Bridget Hill “will vigorously defend the legality of this law, just as she does with all statutes when their constitutionality is challenged,” Gordon spokesman Michael Pearlman said by email.

Until this week, abortion had remained legal in Wyoming despite a ban that followed the U.S. Supreme Court decision to overturn its landmark Roe v. Wade abortion ruling. In putting that ban on hold in July, Owens ruled that it stood to harm women with pregnancy complications and their doctors.

She also found that a 2012 state constitutional amendment guaranteeing the right to make one’s own health care decisions could allow abortion.

The new sweeping ban asserts that abortion is not health care and the amendment therefore doesn’t apply to abortion.

Since the reversal of the Roe in June, abortion restrictions have been up to states, and the landscape has shifted quickly.

Other states where courts have put on hold bans or deep restrictions are Arizona, Indiana, Montana, Ohio, South Carolina and Utah. Idaho courts forced the state to allow abortions during medical emergencies.

Copyright 2023 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

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Oklahoma court OK's abortion to preserve mother's life

Oklahoma court OK's abortion to preserve mother's life

OKLAHOMA CITY (AP) — A divided Oklahoma Supreme Court on Tuesday overturned a portion of the state’s near total ban on abortion, ruling women have a right to abortion when pregnancy risks their health, not just in a medical emergency.

It was a narrow win for abortion rights advocates since the U.S. Supreme Court s truck down Roe v. Wade.

The court ruled that a woman has the right under the state Constitution to receive an abortion to preserve her life if her doctor determines that continuing the pregnancy would endanger it due to a condition she has or is likely to develop during the pregnancy. Previously, the right to an abortion could only take place in the case of medical emergency.

“Requiring one to wait until there is a medical emergency would further endanger the life of the pregnant woman and does not serve a compelling state interest,” the ruling states.

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In the 5-4 ruling, the court said the state law uses both the words “preserve” and “save” the mother’s life as an exception to the abortion ban.

“The language ‘except to save the life of a pregnant woman in a medical emergency’ is much different from ‘preserve her life,’” according to the ruling.

“Absolute certainty,” by the physician that the mother’s life could be endangered, “is not required, however, mere possibility or speculation is insufficient” to determine that an abortion is needed to preserve the woman’s life, according to the ruling.

The court, however, declined to rule on whether the state Constitution grants the right to an abortion for other reasons.

The court ruled in the lawsuit filed by Planned Parenthood, Tulsa Women’s Reproductive Clinic and others challenging the state laws passed after the U.S. Supreme Court overturned the landmark Roe v. Wade decision that legalized abortion.

“People’s lives have been endangered by Oklahoma’s cruel abortion bans, and now doctors will be able to help pregnant people whose lives they believe are at risk,” Nancy Northup, President and CEO of the Center for Reproductive Rights, said in a statement after the ruling.

“We are disappointed that the Court declined to rule whether the state Constitution also protects the right to abortion outside of these circumstances,” Northrup said.

“This ruling leaves out too many Oklahomans. Oklahomans shouldn’t have to travel across state lines just to reach an abortion clinic, and it is heartbreaking that many will not be able to do so,” said Dr. Alan Braid, an abortion provider and plaintiff in the case said in a statement.

Emily Wales, president and CEO of Planned Parenthood of Great Plains called the ruling a small step toward restoring the right to abortion.

“The Oklahoma Supreme Court recognized one fundamental truth: patients must be permitted to access critical care to save their lives,” she said. “But the right recognized today is so limited that most people who need abortion will not be able to access it.”

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Copyright 2023 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

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