中山大便浅血(中山大便出 血是什么原因) (今日更新中)

The excitement of two COVID-19 vaccines with more than 90 percent efficacy is undeniable.In November, both Pfizer and Moderna announced its scientists had developed vaccines with efficacy at or near 95 percent, but scientists are warning these vaccines are not the "silver bullet" to ending the pandemic.“We don’t want to give the public the impression that there’s an emergency use authorization and these vaccines become available in a small amount in December and we can go back to our pre-pandemic behavior,” said William Moss, executive director of the International Vaccine Access Center at Johns Hopkins.In June, the FDA released its vaccine guidelines, saying it would consider emergency use authorization for any vaccine testing with at least 50 percent effectiveness, so there is a reason for celebration, according to Moss, but only after certain questions about the vaccine are answered.Dr. Anthony Fauci has said the initial vaccines will prevent symptoms in those who become infected, rather than kill the virus itself. Moss says that means immunized people might be able to spread COVID-19 to others.He also wonders how long immunization will last. One year? Three years? Will booster doses be needed? They're all careful considerations that will only emerge once one is put into play, according to Moss.“It’s obviously tragic that the [COVID] cases are occurring that quickly, but it does help a vaccine trial because otherwise you just have to wait that much longer for samples to come in,” said Moss.The vaccine process has innovated how scientists and researchers approach these types of situations, however, according to Moss.In traditional vaccines, a small dose of the virus is injected into the body so the immune system can create antibodies. In the COVID-19 vaccine, though, both Moderna and Pfizer have used what is called messenger RNA (mRNA) where the virus’ genetic code is injected into the body so it can instruct cells on what antibodies to produce. Scientists say this way is faster, safer, and can create a stronger immune response as people are not exposed to the virus.“I suspect that if this all goes well and these vaccines are safe and continue to demonstrate 90 to 95 percent efficacy, we’re going to see other vaccines of a similar type,” said Moss. 2298

The Food and Drug Administration released updated safety standards Tuesday for makers of COVID-19 vaccines despite efforts by the White House to block them, clearing the way for requirements that are widely expected to prevent the introduction of a vaccine before Election Day.In the new guidelines posted on its website, the FDA said vaccine makers should follow trial participants for at least two months to rule out any major side effects before seeking emergency approval. That standard had been a sticking point between the FDA and White House officials, who said it could unreasonably delay the availability of COVID-19 vaccines.President Donald Trump has repeatedly insisted a vaccine could be authorized before Nov. 3, even though top government scientists working on the effort have said that timeline is very unlikely. On Monday Trump said vaccines are coming “momentarily,” in a video recorded after he returned to the White House.Former FDA officials have warned that public perception that a vaccine was being rushed out for political reasons could derail efforts to vaccinate millions of Americans.A senior administration official confirmed Monday that the White House had blocked FDA’s plans to formally publish the safety guidelines based on the two-month data requirement, arguing there was “no clinical or medical reason” for it.But on Tuesday, the FDA posted the guidance on its website, making clear that regulators plan to impose the safety standards for any vaccine seeking an expedited path to market.FDA Commissioner Stephen Hahn said in a statement that he hoped the guidelines would help “the public understand our science-based decision-making process that assures vaccine quality, safety and efficacy.”The requirements are aimed at companies seeking rapid approval through the FDA’s emergency authorization pathway. That accelerated process, reserved for health emergencies, allows medical products onto the market based on a lower bar than traditional FDA approval. But FDA has made clear only vaccines that are shown to be safe and effective will be authorized for coronavirus.Former FDA acting commissioner Dr. Stephen Ostroff said the requirements seem reasonable given the agency is in largely “uncharted territory” in terms of considering emergency use of a vaccine. The agency has only previously cleared one vaccine through the method — a decades-old shot that was authorized to prevent anthrax poisoning in 2005.“There really is no margin for error here,” Ostroff said. “Even when you’re talking about limited use of a vaccine there has to be some level of assurance that there isn’t a risk here that would far outweigh the benefit.”Dr. Peter Marks, the head of FDA’s vaccine division, said Tuesday that the two-month follow-up requirement was chosen to be “something reasonably aggressive, but not too conservative — right in the middle.” He spoke at a symposium organized by Johns Hopkins University.Initial doses of vaccines for emergency use would likely be reserved for medical workers and people with health conditions that make them particularly vulnerable to coronavirus. Full FDA approval for the general population will require significantly more data and is not expected until mid-2021.The White House attempt to block the guidance followed a string of instances in which the Trump administration has undercut its own medical experts working to combat the pandemic. FDA’s Hahn has been attempting to shore up public confidence in the vaccine review process for weeks, vowing that career scientists, not politicians, will decide if the shots are safe and effective.Pfizer CEO Albert Bourla has stoked excitement by saying that he expects data on whether the company’s candidate works to be ready in late October. But a number of variables would still have to align for the company to submit, and the FDA to review and greenlight, a vaccine application before Nov. 3. Pfizer’s competitors Moderna, AstraZeneca and Johnson & Johnson are working on longer research timelines.Vaccine development typically takes years, but the U.S. government has invested billions in efforts to accelerate the process and help multiple drugmakers prepare multiple candidates. All the doses will be purchased by the federal government for use vaccinating the U.S. population.Beyond exposing the rift between the White House and FDA, the delay in releasing the guidelines may have had limited practical effect.FDA scientists have been discussing the guidelines publicly for weeks and have made clear that the recommendations have already been shared with each of the vaccine developers.Former FDA Commissioner Scott Gottlieb said Tuesday that drugmakers depend on the FDA’s science-based endorsement to vouch for the safety and effectiveness of their products.“I can’t imagine a circumstance where a sponsor would challenge or seek to undermine the FDA’s role here,” Gottlieb said at the COVID-19 symposium. “This is precisely the moment when we need an objective, neutral arbiter.”Last week, Gottlieb and six other former FDA commissioners blasted the Trump administration for “undermining the credibility” of the agency in a op-ed calling for the release of the then-stalled vaccine guidelines.“Scientists should make decisions based on data, unfettered by political pressure or the intrusions of ideology or vested interests,” the officials wrote.___AP Medical Writer Lauran Neergaard contributed to this report.___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. 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The COVID-19 pandemic has hit people of color particularly hard, and one new study says that may be because of racial disparities in treating high blood pressure.According to the American Heart Association's Scientific Sessions, one-third of disparities in treatment may be the result of racial inequalities in prescribing or increasing the dosage of new medications used in treating high blood pressure.The study found that blood pressure control rates are lower in Black patients compared to other racial groups. Black patients also had more missed opportunities for treatment and missed more clinic appointments."A doctor might think a patient is less likely less able to afford medications, and because of that, they choose to not prescribe a certain medication," said Dr. Valy Fontil, an assistant professor of medicine at UCSF and one of the researchers involved in the study. "Or, they might know this person doesn't have transportation to the clinic, and so sometimes it might even be well-intentioned."Fontil says more standardized treatment protocols would help eliminate the disparities and prevent missed opportunities to get someone the medication they need."Sometimes people present, and the main thing that they're there for is not for the blood pressure," he said. "So, the clinician just sort of kind of might ignore the blood pressure. So automating these sort of standardized treatments would tell the clinician that they — even if the patient's not here for blood pressure — you have to address it in some way."Previous studies have also shown Black patients have more apprehension about why someone is giving them more medication. Fontil says one solution is having the patient be part of the treatment decision making.Fontil adds that the increasing number of virtual visits for blood pressure issues could make the racial disparities even worse. 1876

The government of Puerto Rico has quietly admitted that the death toll from Hurricane Maria -- a subject of great controversy -- may be far higher than its official estimate of 64.In a report to Congress dated Wednesday, the US commonwealth's government says documents show that 1,427 more deaths occurred in the four months after the storm than "normal," compared with deaths that occurred the previous four years.The 1,427 figure also appeared in a draft of the report -- "Transformation and Innovation in the Wake of Devastation" -- which was published and opened for public comment July 9. The figure was first "revealed" by the Puerto Rico government, according to the final report, on June 13, one day after officials were forced by a judge to release death records that CNN and the Centro de Periodismo Investigativo in Puerto Rico had sued to make public.Officials stopped short of updating the official death toll for the September 20 storm."The official number is being reviewed as part of a study under way by George Washington University," the report says. Officials hired that university to review the toll after news reports, including those from CNN, called it into question.The George Washington University study "will have certainty" about the number of people the government believes died in Hurricane Maria and its aftermath, Pedro Cerame, a spokesman for the Puerto Rican government in Washington, told CNN. Officials initially said that report would be released in May. Now they expect it to publish this month."We understand that the number is higher," Carlos Mercader, executive director of the Puerto Rico Federal Affairs Administration, told CNN in an interview. "We didn't commission the study to prove there were 64 (deaths). We wanted a scientific and epidemiological study that would give us light, not only on the number -- we know the number is higher -- but the reasons why this happened."The 1,427 figure is "an estimate," Cerame said, and it may include deaths that weren't related to the storm.It's an estimate that follows many others like it.In November, CNN surveyed 112 funeral homes -- about half the total -- across the island, finding that funeral home directors and staff had identified at least 499 deaths they believed to be related to Hurricane Maria and its chaotic aftermath, which included months without power for many of the island's 3.3 million residents. In December, the New York Times estimated the "excess death" toll from the storm to be 1,052, based on comparisons with previous years.In May, a team that included researchers from Harvard University published a study in the New England Journal of Medicine estimating that 793 to 8,498 people died in Maria's wake, a range that some academics have criticized as overly broad. The study's midpoint estimate -- 4,645 deaths -- became a rallying cry for activists upset by what they see as a lack of accountability for the scale of the catastrophe by officials in Puerto Rico and the United States.The Harvard estimate was based on surveys of 3,299 households in Puerto Rico, in which residents were asked about deaths in their homes after Hurricane Maria.Mercader, the Puerto Rico official, criticized that study in an interview with CNN on Thursday. "We all know that's impossible, that that couldn't happen," he said of the estimate that 4,645 people may have died after Maria. "We have the data. You all know that is an exaggeration."Then last week, a research letter published in the medical journal JAMA estimated that between 1,006 and 1,272 people died in relation to the storm -- with a midpoint estimate of 1,139.An accurate death toll is important, according to officials and academics, because it can help Puerto Rico and other governments better prepare for future storms, which are expected to become worse in the era of climate change. The official count also matters a great deal to the families of the deceased. Not only are they eligible for certain federal aid if the deaths are officially counted, but some relatives of the dead simply want their loved ones to be remembered."They were not numbers; they were people," Lisa De Jesús, whose friend Reinaldo Ruiz Cintron died while working in hurricane cleanup, told CNN in June. "And the government thinks that just p

The coronavirus pandemic has been responsible for more police officer deaths in the line of duty than any other cause combined in 2020, according to a non-profit dedicated to fallen police officers.According to the Officer Down Memorial Page, 101 police officers across the country have died after contracting COVID-19 while on the job. Eighty-two other police officers have been killed by other causes in the line of duty in 2020.A second non-profit, the National Law Enforcement Officers Memorial Fund (NLEOMF), lists around 110 officer deaths linked to COVID-19.Both Officer Down and NLEOMF only count officers who were known to contract the virus while in the line of duty and review each case before adding it to their count. Officer Down says it is reviewing an additional 150 fatal cases of COVID-19 that may be added to the count in the future."By the end of this pandemic, it is very likely that COVID will surpass 9/11 as the single largest incident cause of death for law enforcement officers," Officer Down executive director Chris Cosgriff told The Washington Post.Officer Down reports that 73 police officers died on Sept. 11, 2001 in the terrorist attacks, and more than 300 have died of cancer linked to recovery efforts in the years since.According to NLEOMF, the state with the most police officer deaths linked to COVID-19 is Texas, where 24 officers have died since the pandemic began. Another 12 police have died after contracting the virus in nearby Louisiana. Officer Down also reports that non-coronavirus related police officer deaths in the line of duty are down in 2020, despite widespread civil unrest. Thirty-one police have died from gunfire this year, the second-leading cause of death among officers in the line of duty. Another four officers have died as a result of "inadvertent" gunfire.President Donald Trump has repeatedly pushed the narrative that police officers across the country are under "assault" by left-wing activists throughout the 2020 presidential campaign.Earlier this year, Trump signed the Safeguarding America's First Responders Act of 2020, which offers federal benefits to the families of police officers killed by COVID-19. 2187

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