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Not having sex should have a gynecological examination?


I am 18 years old this year, have not had sex but have a lot of pox-like discharge, itching in the private area, especially a week before my period. Should I go to the doctor? (Hoa, Hanoi).

Reply:

Gynecological diseases are becoming alarming diseases, seriously affecting health in general and reproductive health of women in particular. Every year, the number of gynecological diseases increases by 15-27%. Among them, vaginitis is the most common disease. However, most women only go to the doctor when they have a certain disease or have unbearable symptoms. The rest go to a gynecologist because they are about to get married.

Women who have not had sex should still see a gynecologist. Because, during puberty, female children have hormonal changes accompanied by bad effects from the environment, poor lifestyle, not clean genitals, leading to gynecological infections and diseases. other reason. Therefore, women need to have regular gynecological examinations to help them detect diseases at an early stage, improve their lifestyle, take proper care of their bodies, and prevent reproductive health problems.

In this case, the doctor only examines and observes the external genitalia or accessory gonads to detect abnormalities. During the examination, the doctor did not damage your hymen and other organs.

For women who have given birth, regular gynecological examinations help prevent and detect early urinary tract infections, uterine fibroids, even uterine cancer, and many other gynecological conditions.

Women in the reproductive stage will be consulted by doctors on reproductive health, safe and effective methods of contraception, and at the same time detecting endocrine disorders for treatment.

Therefore, women should actively visit a gynecologist at least once every 6 months. In addition, examine when there are abnormal manifestations such as abnormal discharge and unpleasant odor; genitals that are itchy, red, or have nodules or sores; painful, painful urination. In case of lower abdominal pain, pain during sex; Unusual bleeding outside of your period or bleeding after sex also requires prompt medical attention.

For the most accurate examination results, women should go to the doctor two to three days after their period is clean, and abstain from sexual intercourse. Do not douche, do not put medicine about three days before the exam. Clean the vaginal area before examination. Ensure psychological readiness and comfort during the examination.

Doctor Nguyen Thi Minh Thanh

Deputy Head of Examination Department, Hanoi Obstetrics and Gynecology Hospital

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How to take care of teenage acne skin


The disease usually begins with the appearance of pimples due to clogged pores. If left untreated or improperly treated, acne lesions can progress to inflammatory papules, nodules, cysts, and lumps.

“Especially, those of you who have a habit of touching the acne or squeezing it incorrectly such as not removing all the acne, not ensuring sterility, the risk of bacterial infection will increase, leading to severe skin lesions. heavier,” said the doctor.

In addition, you in this age group also have a habit of eating a lot of lactose, starch or fast food, foods with a lot of sugar, making the skin more prone to acne, said Dr. Do Kim Anh, Department of Plastic Surgery. High-tech aesthetic model, Hanoi Medical University Hospital, said.

Children with endocrine diseases such as polycystic ovary syndrome, hyperandrogenism … or mechanical factors such as rubbing, picking, wearing tight clothes are also prone to acne.

However, each person, each age has a different medical condition, not every teenager has acne. In general, children whose parents have had severe acne have a higher risk of developing acne than other children. In addition, children with oily or combination skin are more prone to acne than children with normal or dry skin.

Acne skin care

According to Dr. Thao, children need to take care of and clean their skin every day, remove excess oil, reduce clogging, and help unclog pores. You should remove makeup and wash your face with products that contain active ingredients that help reduce oil like salicylic acid. Limit makeup, avoid using products and cosmetics with substances that cause clogging, easy to cause acne.

Keep your hair clean and limit your hair to touch your face, avoid bringing dirt and oil into your pores. The mask should not be worn too tight and should be changed when it is dirty or wet.

Change lifestyle, maintain a healthy lifestyle, exercise diligently, drink plenty of water, get enough sleep, limit stress, abstain from products containing a lot of sugar, milk, and fat.

In cases where there are many pustules, inflammation, children need to see a dermatologist for a prescription for treatment drugs.

Mild cases of inflammatory acne can be treated with topical medications prescribed by your doctor. Treating acne at an early stage requires only a combination of facial cleansers, ointments to reduce sebum, dry acne cores, and reduce clogging of hair follicles. Do not arbitrarily squeeze acne causing skin damage, acne bacteria easily penetrate and spread to the surrounding skin, causing scars and bruises. Do not buy and use products of unknown origin to treat acne.

In case of failure to respond to topical treatment, systemic treatment will be required, for a course of 1-3 months or more depending on the acne condition and response ability of each person.

According to doctors, acne during puberty may decrease when children go through this stage but not completely. When a child has acne, the family should take the child to the doctor and be persistent in the whole course for the drug to work, minimizing sequelae such as pitted and dark scars that affect the child’s appearance and confidence later on.

Thuy An

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Old father gave birth to stunted children?


Many people believe that “old father and children pile up”, men get married and give birth late, the children are not born healthy, in fact age affects male physiology more than fetal health.

Dr. Le Duy Thao, Department of Andrology, Hong Ngoc General Hospital, explained that women only have a limited number of eggs, which cannot be increased; In males, sperm is produced continuously since birth. Men have the ability to produce sperm and maintain reproductive function for most of their life. However, as we age, testosterone levels decrease, libido decreases, and erectile dysfunction or ejaculation directly affects the quantity and quality of sperm, and the ability to fertilize is also reduced.

Age also puts men at risk of developing chronic diseases such as diabetes, hypertension, cardiovascular and other metabolic diseases, negatively affecting the reproductive system such as erectile dysfunction… When evaluating fertility, the doctor needs to evaluate the health of the couple. In women, age not only causes difficulty in conceiving, but also increases the risk of fetal abnormalities. Therefore, the optimal recommended reproductive age for women is under 35 years old, men under 40 years old.

The doctor led a study in Massachusetts in 2010, the average frequency of intercourse in men under the age of 40 was 6.5 times / month. This frequency decreases once to twice a month after age 50 and once to twice a month after age 60. Besides, between the ages of 40 and 70, the probability of severe erectile dysfunction triples and increases twice that of the younger group. The frequency of intercourse decreases with age in part due to decreased sexual function.

“Sexual dysfunction does not affect sperm cells and can be overcome with current assisted reproductive technologies,” said Dr.

Doctor Ta Viet Cuong, Hanoi Obstetrics and Gynecology Hospital, said that the notion that an old father gives birth to a “pile” child is not entirely correct, because if the sperm has a non-abnormal set of chromosomes, a man can still give birth. produce healthy children. In addition, when men ejaculate there are hundreds of millions of sperm, the body will choose the best ones. Weak, malformed sperm are very difficult to swim to meet the egg. “The case of stunted children is often related to care, nutrition … not necessarily due to sperm when conceiving,” the doctor said.

According to Dr. Thao, the impact of age on the body is difficult to avoid. Therefore, men need to have an active lifestyle such as changing a reasonable diet with lots of green vegetables, avoiding fast food, not smoking, alcohol, stimulants.

Exercise regularly, maintain a reasonable weight, minimize stress, stress… Limit alcohol, beer, and tobacco. Take care of the body’s hygiene carefully, avoid repeated infections, which can easily cause infertility due to vasectomy. Have faithful sex with your partner and see a gynecologist early when there is an abnormality.

Thuy Anh

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How effective is the ‘listen to your body’ diet?


Many experts oppose fasting or extreme weight loss, saying that people should listen to their bodies to find a balanced and suitable diet.

Caroline Dooner, a 34-year-old writer, now in Philadelphia, USA, spent her teenage years and early 20s trying to lose weight.

She was diagnosed with an endocrine disorder by a doctor and must control her weight if she does not want the disease to become more serious. Dooner tried the famous Atkins diet: low carbohydrate, high fat.

All the while, she kept thinking about her food and favorites. Dooner fell into a vicious cycle of weight loss, binge eating, weight gain, and then trying to lose weight again. She also tried other diets but to no avail.

“I obsess over my weight and what I put in,” she says.

In 2019, Dooner decided to stop dieting. She published a book about her struggles, diet, and cultural obsession with “having to be thin”. Now, she is happier than ever with her body, the female writer shared.

Dooner is not the only one exhausted and stressed with weight loss, having to limit his favorite foods and try to achieve a certain figure. They question whether the diet should be completely abandoned.

Some have found that the “diet like no diet” movement could flourish in the future, when people aren’t trying to control their weight. Instead of relying on weight and body mass index, recent groups of nutritionists advocating for weight loss focus more on other indicators such as physical endurance, sleep quality and mental health.

Experts support New dietary trends think that everyone should listen to signals from the body, approach nutrition, exercise with purpose “take care of yourself” rather than “self-control”.

Experts also warn that forms of rapid weight loss, weight loss in a short time have bad effects on health. A study that analyzed medical data from 9,500 volunteers found that those who lost or gained weight suddenly over five years had a significantly higher risk of heart attack, stroke or death than those of a healthy weight. determined.

Extreme dieting can also predispose many people to eating disorders, especially young adults or teenagers.

Most doctors and medical experts say maintaining a specific weight within a specific range is also important for general health. The risk of morbidity and mortality is higher in people with a BMI of 30 or higher.

Steven Heymsfield, director of the Nutrition-Metabolism Laboratory at the Pennington Biomedical Research Center, advocates for weight loss that doesn’t focus on body weight, but doesn’t eliminate the weight factor entirely. According to him, instead of emphasizing body mass index, the medical community should encourage people to treat problems such as cholesterol, high blood pressure, exercise and smoke less.

In fact, maintaining a certain weight is more difficult than losing it. A meta-review of 12 different studies on the diet found that volunteers mostly lost weight after 6 months. But within the next year, they returned to their original weight.

Christy Harrison, nutritionist advocates intuitive eating, weight loss based on the body’s biological signals. Photo: WSJ

In addition, dietary guidelines often overlook the psychological effects of having to limit the intake of certain foods. According to registered dietitian Christy Harrison, this can cause people to fear and become obsessed with that food, leading to eating disorders or binge eating habits.

Instead, many advocate listening to the body’s innate cues, satiety, hunger, and food preferences. The heart of this approach is to abandon weight tracking and categorize food as “good or bad”. The idea is that the less restrictive you are on certain foods, the less cravings you will have. Dieters can eat a variety of foods from french fries and fried chicken to vegetables and fruits. This is called “visual eating”.

A meta-review of 24 studies published in 2016 found that intuitive eating improves motivation to exercise and overall life satisfaction. Another study, published in 2014 found this approach to help control blood sugar in young adults.

“In my opinion, obesity is a medical disease. But we have to abandon preconceptions and find a more effective approach, so that weight loss does not become an invincible battle between the two. mind and body,” said David Ludwig, a professor of nutrition at the Harvard TH Chan School of Public Health.

He advocates biological weight management, focusing on the underlying causes of hunger rather than calorie restriction. This, he thinks, could overcome the problems of conventional diets.

Thuc Linh (Follow WSJ)

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Doctors struggle when Delta and Omicron circulate simultaneously


American doctors are facing a dilemma when they cannot distinguish F0 infected with Delta or Omicron mutations, which can cause patients to miss the golden time of treatment.

In F0s belonging to the high-risk group for Delta variant infection, monoclonal antibody treatment can reduce morbidity and mortality. But this method is less effective in people infected with Omicron.

US officials have advocated using a test kit that can distinguish Omicron infections based on the genetic characteristics of the mutation. But experts say this is not enough for large health systems, which are receiving huge numbers of patients.

The condition makes it difficult to get treatment in hot spots like Maryland. Here, Omicron infections account for about 58%. Meanwhile, the Delta variant is also thriving in the Great Plains and the Western Territories, including California.

Although there are no global studies on individual mutation rates, national networks and laboratories are still able to sequence genomes to track Omicron infections in the community. The local health system then uses this data to decide what treatment each patient should receive.

Many experts believe that the majority of patients infected with the Delta variant are suitable for monoclonal antibodies produced by Regeneron and Eli Lilly. Meanwhile, Omicron-infected F0s will improve health more quickly if using therapy from GlaxoSmithKline and Vir Biotechnology.

Federal officials are also adapting drug distribution strategies based on this recommendation. On December 23, the government halted shipments of Lilly and Regeneron’s antibody drugs after the Centers for Disease Control and Prevention (CDC) said 73% of the country’s infections were Omicrons.

This decision was strongly opposed by some political leaders in the Republican Party because the number of people infected with Delta remained high. On December 28, the CDC announced that the number of Omicron infections was only 53%. Federal authorities resumed distribution of the antibody drug from all drugmakers.

A ward for F0s treated with monoclonal antibodies at Pembroke Pines City Hospital, USA. Photo: NY Times

In the coming weeks, as the country grapples with two types of mutations that circulate unevenly in many regions, according to Dr. Alex Greninger, assistant director of the virology lab at the University of Washington Medical Center, Categorizing treatments for individual patients would be “extremely difficult”.

Dr. Greninger and colleagues have developed a test kit that distinguishes between nCoV strains. But he worries the health system cannot adapt quickly and categorize patients. Mass reporting is also quite difficult.

Furthermore, sequencing the gene took almost a week, well past the ideal time for treatment with antibody methods that reduce the risk of hospitalization in the first place. This makes it difficult for doctors and nurses, said Dr. Mark Siedner, a researcher at Massachusetts General Hospital.

In Massachusetts and surrounding states, an estimated 44.5% of infections are Omicrons. Dr. Siedner said his medical system has stopped using the monoclonal antibodies of Regeneron and Eli Lilly because they are not effective against the new strain.

A promising solution to this situation is Covid-19 drugs such as Paxlovid and molnupiravir, which can be easily used at home at the onset of symptoms. However, the supply of oral drugs is extremely limited.

Health officials and doctors across the country have a difficult time deciding which patients to take the drug. Some people who are at high risk for severe disease after nCoV infection are overlooked because they have been vaccinated.

Many hospitals run out of certain drugs, others only have a few dozen courses available. Medical staff must dispense vitamins to patients instead of therapeutic drugs. Others raced to establish patient selection criteria.

Dr Natasha Bagdasarian, director of the Michigan Department of Health, said: “We simply don’t have enough medication to distribute to people with Covid-19 in the coming weeks, including patients at risk of complications. severe illness. There’s no way to guarantee getting the drug to the right people at this time.”

Thuc Linh (Follow NY Times)

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Omicron could be the last disturbing strain


According to experts, Omicron could be the last worrying variant of nCoV due to genetic limitations.

During its existence and development, the virus changes to adapt to its environment and continues the cycle of infection. This fact became even more apparent during the two years of the pandemic, when disturbing strains emerged every few months.

Some strains spread from person to person more efficiently, eventually prevailing when competing with other versions of nCoV. The mutation allowed Alpha, then Delta, to rule the world. Scientists predict Omicron to evolve in a similar direction.

Immunologist Dr Ben Krishna, from the University of Cambridge, believes that viruses do not mutate indefinitely. According to the laws of chemistry, the spike protein of nCoV will grow to bind to the ACE2 receptor (located on the surface of human cells) as strongly as possible. However, the ability of the virus to spread is not limited by the virus’s attachment to human cells. Other factors will limit the spread of the virus, such as the rate at which the genome replicates, how quickly the virus enters cells, and how much virus an F0 can shed.

In principle, all of these elements will be at their peak at some point in time. The question is whether Omicron has evolved to the highest degree or not? The study, published in the journal Nature, identified numerous mutations that improve the spike protein’s ability to bind to human cells that Omicron does not have. Even in the case that Omicron is the most contagious strain, it is still limited by genetic probability.

“This is similar to the fact that zebras cannot evolve to the level of transcendence, having an extra third eye on the back of the head to observe and evade enemies. nCoV also does not recognize the mutations necessary to reach the level of evolution. This process requires all mutations to occur simultaneously, which is very unlikely,” explained Dr. Krishna.

People line up to be tested for Covid-19 in New York, USA, December 21. Photo: Reuters

In addition, even if Omicron is the dominant strain, new strains emerge and train the human immune system. Accordingly, after infection with any virus, the immune system adapts by creating antibodies that neutralize the pathogen. T cells destroy infected cells and remember them through molecular shape.

nCoV can evade the immune system by changing the shape of its molecules. This is why Omicron successfully infects people with antibodies from vaccines or natural infections. However, the activity of immune cells (T cells and B cells) still prevents the patient from turning severe. In South Africa, where Omicron was first discovered, mortality and hospitalization rates are low. The above characteristics are suitable for the world to live with Covid-19.

Predicting the future of nCoV, Dr. Krishna said that in the long run, the virus still replicates and grows, but the community is no longer seriously ill as in the beginning. He likens this to a “compromise” between humans and viruses.

New strains (after Omicron) improve transmission, but do not increase mortality. nCoV then just randomly mutates, becoming unrecognizable to the immune system and causing reinfection.

Experts predict that the world will have a Covid-19 epidemic every winter like flu. Influenza viruses also have a similar form of mutation over time, known as “antigen drift,” that leads to reinfection. But the new strains of flu that appear every year are no more dangerous than the year before.

Mr. Krishna thinks that Omicron is not the last, but very likely the last to worry about. With luck, nCoV will become an endemic virus, changing slowly over time. At that time, Covid-19 symptoms will be very mild, because the human body already has immunity that reduces the risk of hospitalization and death. Most people will first contract the disease as children, before or after vaccination. Subsequent reinfections will go unnoticed because they are not so serious.

Thuc Linh (Follow Conversation)

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Singapore launches 90-minute Omicron test kit


Biotechnology company BioAcumen Global on November 6 launched a PCR test kit to help detect the Omicron variant, giving results after 90 minutes.

Kit users will receive one of three results: positive for nCoV and positive for Omicron; positive for nCoV and negative for Omicron; negative for both nCoV and Omicron.

Typically, PCR test results are available within a few hours to a day, including sample collection time, logistics, and upload of test results. Scientists will take another day to sequence the gene, identify the specific variant. The use of a specific kit to detect the Omicron variant will speed up that process.

Another advantage of specific PCR kits is their lyophilized form, which can be stored at room temperature for up to one year. After taking a sample, scientists will dip a cotton swab in a pre-mixed solution, then pass the mixture through a PCR machine. Results are available within 90 minutes of sampling.

Mr. Jimmy Toh, Director of BioAcumen Global, said: “We are looking to cut down on the steps and time required for testing. This is very important, especially in an area where accurate on-site testing is required. Then, you don’t need to wait for the results of gene sequencing to know if the patient has Omicron infection.”

The Omicron test kit in Singapore gives results in 90 minutes. Photo: Straits Times

According to scientists, Omicron has more than 30 mutations in the protein. It also lacks a gene segment compared to previous variants. Singapore’s toolkit can detect this shortfall. The team can now create up to 8,000 lyophilized test kits and 25,000 traditional solution tests in a day.

Omicron first appeared in Botswana on November 11, then was discovered and announced by South Africa on November 24, when the number of infections in the country increased exponentially in just a few weeks. Two days later, the WHO announced that this variant was listed as “worrying”.

Scientists have mixed opinions about Omicron. Some argue that vaccines will be less effective than mutations. Others said that the community should not be too confused, the current vaccine is still effective and does not need to be produced a new generation.

Thuc Linh (Follow Straits Times)

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The weakening Covid-19 in Japan may be caused by the virus ‘self-destructing’


Experts hypothesize that Covid-19 in Japan weakened because the virus struggled to correct its own mistakes for a long time, eventually leading to “self-destruction”.

After the Olympic Games, the number of nCoV infections in Japan is still dizzyingly high, pushing the health system to the brink. At the end of August, the daily number of patients usually reached more than 26,000, the government had to impose some restrictive measures to reduce transmission. But in recent weeks, the number of new cases has dropped below 200. On November 7, the country recorded no deaths for the first time in 15 months.

In October, experts “couldn’t understand” the cause of the rapid decline of Covid-19 in Japan. This time, they came up with different theories to explain the situation. Many attribute this to the fact that Japan has the highest vaccination rate among developed countries. To date, 75% of Japan’s population has received two doses of the vaccine.

However, according to Professor Mike Toole, an epidemiologist at the Burnet Institute, vaccination is not the only reason for the sudden drop in the number of infections in this country. “It is not possible to take each vaccine to explain the situation in Japan. 30% of the 100 million people have not been vaccinated, which means there is still room for the virus to spread,” he said.

nCoV self-destructs during mutation

Many experts believe that the main reason lies in the genetic changes of nCoV during replication, a rate of about two mutations per month.

Ituro Inoue, a professor at the National Institute of Genetics, offers a potentially revolutionary theory: The Delta variant in Japan has accumulated too many mutations with a nonstructural protein, capable of correcting genetic errors. transmission of nCoV named nsp14. As a result, the virus struggled to correct its own errors for a long time, eventually leading to “self-destruction”.

Studies show that many Asians have a defense enzyme called APOBEC3A, which attacks RNA viruses (including nCoV) more effectively than Europeans and Africans.

So, experts at the National Institute of Genetics and Niigata University explored how the human APOBEC3A protein affects the nsp14 protein of nCoV. They wanted to find out if it inhibited viral activity in general.

Professor Inoue and colleagues analyzed the genetic diversity data of Delta and Alpha variants in Japanese samples from June to October. They then modeled the relationships between the sequences. DNA of nCoV to represent genetic diversity in the diagram, called haplotype network. To put it simply, the larger the network, the more positive cases it records.

Haplotype network of mutants Alpha, which was the main factor in Japan’s 4th wave of infections from March to June, there are 5 main groups with many branching mutations. This confirms the high level of transmission.

Initially, the researchers assumed that the Delta variant had a much greater degree of genetic diversity. Previously, the US Centers for Disease Control and Prevention (CDC) said that Delta spreads twice as quickly as previous variants, causing severe illness in unvaccinated people. But after researching, they found the opposite.

Haplotype network of Delta There are only two main groups. The mutations suddenly stop mid-development. When they continued to test the virus’s error-correcting enzyme nsp14, they found that the majority of the nsp14 sample in Japan appeared to undergo multiple genetic changes at mutation sites named A394V.

This means the Delta variant in Japan is contagious. But when mutations pile up, the virus eventually fails, unable to replicate itself. Compared to the fact that the number of infections in this country did not increase, scientists surmised that nCoV was naturally extinct after a period of mutation.

“We were really shocked when we discovered this,” said Prof Inoue.

Japanese people walk in Shibuya shopping district, Tokyo city, on August 7. Photo: Reuters

The premise of ending Covid-19

Mr. Inoue’s theory partly explains the mysterious weakening of the epidemic in Japan. While most countries with similar high vaccination rates (like South Korea) are suffering a record Covid-19 wave, Japan seems to be a special case, infections have not increased despite restaurants and train stations. Electricity is crowded.

“If the virus is still active, cases will definitely increase because vaccination cannot prevent breakthrough infection in some cases,” said Professor Inoue.

According to Takeshi Urano, a professor at Shimane University’s Faculty of Medicine, the sudden weakening of Covid-19 is the subject of lively discussion among many experts.

nsp14 works with other viral proteins, he explained, and has an important function to protect RNA from breaking down. Paralyzing nsp14 will help reduce the virus’s ability to replicate. This protein is derived from a virus, so by targeting this protein, scientists can create a promising drug against Covid-19.

The difference in Japan is that Delta has almost dominated Alpha and the rest of the variants since August. In countries like India and Indonesia, variants are still circulating simultaneously.

Professor Inoue’s hypothesis could also explain why the SARS epidemic suddenly ended in 2003 without any vaccine or drug. In one experiment, researchers subjected the SARS virus to the nsp14 mutation. Eventually the virus cannot replicate itself because the mutations pile up.

“This is just a hypothesis, we don’t have genomic data. But the virus has disappeared and never came back,” he said.

The question is, will Covid-19 end naturally like SARS, when the virus self-destructs, unable to multiply anymore?

“It’s not impossible, but it’s a bit premature to expect that right now. We don’t have scientific evidence yet, even though we’ve looked at data from different countries,” Mr. Inoue said.

After peaking in mid-August, daily Covid-19 cases in Japan fell below 5,000 in mid-September and below 200 by the end of October. According to Mr. Inoue, the country is in the group with a low infection rate. Most of the developed countries, but not “immune” to the next wave of Covid-19. He thinks Delta has inadvertently pushed back other variants in Japan, but has not been able to completely prevent new ones. A vaccine alone is not enough to tackle the pandemic.

Some people wonder if the Japanese people have a special gene that helps destroy Delta and nCoV in general. Professor Inoue refutes this theory.

“East Asians like South Korea also have similar characteristics to Japan. But their situation is different. I don’t know why the phenomenon of the virus disappearing on its own is only in Japan,” Mr. Inoue said.

Thuc Linh (Follow ABC, Japan Times)

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Antibody therapy to fight Covid-19


Monoclonal antibodies are the right treatment option for Covid-19 for people who are immunocompromised or are taking medications for underlying disease, unresponsive to vaccines.

Vaccines, which offer long-term protection against Covid-19, are the fastest and most effective way to reverse the pandemic to date. Many countries are racing to immunize the majority of the population as soon as possible. However, humans need a healthy immune system in place to respond and it takes several weeks to produce a virus-specific immune response.

Some people cannot be vaccinated or do not develop sufficient immunity after vaccination. This group includes blood cancer patients undergoing chemotherapy; people on dialysis; patients who are taking anti-rejection drugs after organ transplantation; people who are taking immunosuppressants for lupus erythematosus, multiple sclerosis, and rheumatoid arthritis.

They are the “gray zone” of vaccination programs in any country, easily left out without a more effective and rapid alternative treatment. One possible option is monoclonal antibody therapy, with many potential candidates from AstraZeneca, Regeneron, GlaxoSmithKline (GSK) or Brii Biosciences.

Basically, monoclonal antibodies are grown in the laboratory, similar to the immunity of people who have been infected with Covid-19. After being injected into the body, they are able to remember and destroy pathogens for a long time.

On November 18, AstraZeneca announced the results of a phase three clinical study showing antibody therapy AZD7442 reduces the risk of serious illness or death by 88%. The therapy also reduced the likelihood of symptomatic nCoV infection by 83%.

New data come from two independent studies: the PROVENT prevention trial and the TACKLE outpatient trial, which lasted 6 months. Both showed strong efficacy of AZD7442 after only one intramuscular injection.

AZD7442 contains two monoclonal antibodies: tixagevimab and cilgavimab, derived from patients who have recovered from nCoV infection. Once introduced into the body, tixagevimab and cilgavimab recognize the specific components of nCoV (thorn proteins), attack directly or bind to the virus, stop the virus from working, and announce their presence to the cell killer immunity.

After destroying the pathogen, the antibody remains in the human body for a period of time, forming part of the immune memory. If this person is exposed to nCoV again, they reactivate and repel the virus again.

Another type of antibody drug is REGEN-COV, Developed by the pharmaceutical company Regeneron, also significantly reduced the risk of death in some hospitalized Covid-19 patients. The drug targets the spike protein on the surface of nCoV to prevent the virus from entering human cells.

In June, Regeneron announced the results of a study in the UK on more than 9,700 volunteers showing that using therapy alongside conventional drugs can reduce the risk of death in people infected with nCoV by 20%.

Last year, former President Donald Trump was also treated for Covid-19 with this therapy. Previously, the drug was only used for patients in the early stages of Covid-19. However, trials have found the product to be effective in some more severe patients.






Nurse at Houston Methodist Hospital, Texas, treating a Covid-19 patient with monoclonal antibody therapy, September 2021. Photo: NY Times

GlaxoSmithKline (GSK) and Vir Biotechnology also cooperate to produce antibody drugs Sotrovimab. The drug has the same mechanism of action as REGEN-COV. A GSK study published in June found that the drug reduced the risk of death or hospitalization from Covid-19 by 79%. According to another study published in bioRxiv on July 26, Sotrovimab is effective against variants like Delta.

Europe on July 28 reached an agreement with GSK to purchase more than 220,000 doses of Sotrovimab. The contract helps GSK promote drug research, after the failure to develop a vaccine.

Sotrovimab has received urgent approval in the US, which is being evaluated by the EU Medicines Agency (EMA). In the United States, the drug is used to treat patients with mild to moderate disease who have underlying medical conditions and are often prone to severe disease. On November 17, the government of this country signed a contract worth nearly 1 billion USD to buy Sotrovimab. GSK did not specify how much the US ordered, but said the billion-dollar deal brought the total number of doses of Sotrovimab ordered globally to more than 750,000.

Chinese authorities are also expected to approve a monoclonal antibody developed jointly by researchers from Brii Biosciences (USA), 3 People’s Hospital Shenzhen and Tsinghua University (China). The drug contains two neutralizing monoclonal antibodies, BRII-196 and BRII-198. Scientists prepared by cloning and combining antibodies from recovered Covid-19 patients in China.

Preliminary data shows that the drug reduces the risk of hospitalization and death for Covid-19 patients by 78%, effective against nCoV variants such as Delta. 800 Chinese patients have been treated with the new drug.

Brii Biosciences last month filed a license application with Chinese and US regulators after completing a phase 3 clinical trial, interim results are promising. The company is looking forward to conditional approvals in China and emergency use approvals in the US, according to Summer Li, director of the public relations department. If licensed, the company will target these two markets, while prioritizing countries that were once clinical trial sites such as Brazil, South Africa, Mexico, Argentina and the Philippines.

China National Biotechnology Group (CNBG), a subsidiary of Sinopharm, is also developing two Covid-19 drugs. One monoclonal antibody and one immunoglobulin serum preparation.

Zhang Yuntao, CNBG’s vice president and chief scientific officer, said last week that the company would clinical trials of the drug and report results within a year.

China has spent 315 million yuan ($49.3 million) on 53 Covid-19 drug research and development projects since the outbreak two years ago.

Dr. Anthony Fauci, a medical adviser to the White House, in August once described monoclonal antibody drugs as “an underutilized measure” in the fight against Covid-19, and wanted everyone to receive it. advantages of this method.

The medication should be given early, ideally within three to four days of the first symptoms appearing. This is the time when the virus is multiplying rapidly in the body, taking the medicine in time makes a big difference.

Thuc Linh (Follow WSJ, USA Today, Conversation, SCMP)

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Signs of weak sperm


Doctor, sperm count more or less, solid or liquid related to physiological weakness? What to eat to improve sperm quality? (Male, 38 years old, Hanoi)

Reply:

Sperm are only a small part of semen and cannot be seen with the naked eye. However, some changes may suggest a decline in sperm quality such as low semen volume, dilute semen, lumps, solidification, or color change from milky white to red or blue.

To most accurately assess the quality of sperm, you should go to the hospital for a semen analysis when there are abnormal signs above or when the couple has regular sex for 6 months or more but still not pregnant.

To improve sperm quality, you can add some foods such as oysters and shellfish such as shrimp and crab; red meat and poultry; whole grains; yogurt and dairy foods; vegetable oil. Some green vegetables, spices such as broccoli, cabbage, asparagus, tomatoes, garlic, sweet peppers. Avoid stimulants such as alcohol, coffee, tobacco, processed foods…

In addition, you should visit a doctor for examination, treatment of the cause and change in living habits.

Men need to have a medical examination at a reputable facility when there are suspicions or a pre-marital examination to promptly detect male problems and treat them early.

Dr. Le Duy Thao
Department of Andrology, Hong Ngoc General Hospital

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