Saturday, June 20, 2020

Journal Watch June 2020


There is now a heavy emphasis on journal articles pertaining to Covid-19. As a result, a Covid section has been added. Due to how rapidly information is changing, studies provided reflect the most current thinking.

COVID
How Exactly do you catch Covid-19? There is a growing consensus that surface contamination and fleeting encounters (less than 15 minutes) are less of a worry than close-up, person to person interactions for extended periods of time. Crowded events, poorly ventilated areas, places where people are talking loudly or singing are risky. Activities like speaking and breathing produce respiratory bits of varying sizes that can disperse along air currents and potentially infect people nearby Wall St. Journal

COVID-19 may trigger new diabetes, experts warn: Emerging evidence suggests that COVID-19 may actually trigger the onset of diabetes in healthy people and also cause severe complications of pre-existing diabetes. Letter to NEJM and signed by 17 leading diabetes experts 

FDA Pulls Emergency Approval of Hydroxychloroquine for Covid-19: The FDA has withdrawn its emergency authorization for the use of chloroquine phosphate and hydroxychloroquine sulfate in the fight against COVID-19. The agency said that the drugs are "unlikely to be effective" as treatments for COVID-19. The drugs should not be used outside of clinical trials. On Wednesday, the World Health Organization (WHO) halted hydroxychloroquine trials on COVID-19 patients, finding it did not reduce the mortality rate.


Blood Donors Will Get Results of Coronavirus Antibody Test, Red Cross Says: The American Red Cross will test all blood, platelet, and plasma donations for COVID-19 antibodies so donors can learn whether they have been exposed to the new coronavirus. A positive test result does not confirm immunity to the virus, and the test is not meant to diagnose illness

Coronavirus death rate is higher for those with chronic ills: Death rates are 12 times higher for coronavirus patients with chronic illnesses than for others who become infected, a new U.S. government report says.

 

Dexamethasone proves first life-saving drug: The low-dose steroid treatment dexamethasone is a major breakthrough in the fight against the deadly virus, UK experts say. The drug is part of the world's biggest trial testing existing treatments to see if they also work for coronavirus. It cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth.

Face-Mask Use by Public Can Mitigate Spread of COVID-19: Face-mask use by the public, in combination with physical distancing and periods of lockdown, can mitigate the spread of the new coronavirus. When lockdown periods are implemented in combination with 100 percent face-mask use, there is less disease spread, secondary and tertiary waves can be flattened, and the epidemic can be brought under control. Proceedings of the Royal Society A

No Covid-19 cases reported from two infected hair stylists with 140 contacts: The Springfield-Greene County Health Department in Missouri recently reported that the incubation period has passed from those potentially exposed from Great Clips, a salon where 140 people were put at risk when two hairstylists tested positive for Covid. No clients of either stylist nor additional coworkers contracted COVID-19 as a result. “This is exciting news about the value of masking to prevent COVID-19,” said Director of Health Clay Goddard. “We are studying more closely the details of these exposures, including what types of face coverings were worn and what other precautions were taken to lead to this encouraging result. We never want an exposure like this to happen, but this situation will greatly expand our understanding of how this novel coronavirus spreads.” Springfield-Green County Health Department News Release

Asthma isn’t a risk factor for worsening Covid 19: People with asthma can breathe a little easier: New research suggests the condition does not increase your risk of hospitalization due to COVID-19. Journal of Allergy and Clinical Immunology.

The right way to breathe during the coronavirus pandemic: Inhale through your nose and exhale through your mouth. It's not just something you do in yoga class—breathing this way actually provides a powerful medical benefit that can help the body fight viral infections. 

Early Data Show No Protest-Related Increases in COVID-19 Infections: Antiracism protests in the United States have not led to increases in new cases of the coronavirus that causes COVID-19, early data show. The findings from a handful of cities are encouraging, and the use of masks and the fact that protests are outdoors may have helped, public health experts say, The Wall Street Journal reported. However, the data are preliminary and protest-related infections could still rise, health officials caution. 

Home Monitoring Can Improve Health, Ease Anxiety for COVID-19 Patient: Geisinger Health System launched a program whereby patients diagnosed with COVID-19 are given a package that includes a mask, pulse oximeter (which measures blood oxygen levels), a digital thermometer, and acetaminophen for pain. Patients report their symptoms, temperature, and oxygen levels twice a day via Geisinger’s mobile app. If patient’s condition worsens they are immediately brought to the hospital. As a result, healthcare workers have been able to intervene early if and when problematic oxygen levels or severe symptoms occur. Healthline

PAIN
Dextrose Injections Aid Knee Osteoarthritis Pain: Intra-articular dextrose prolotherapy (DPT) injections are a safe and effective treatment for knee osteoarthritis, according to a study published in the May/June issue of the Annals of Family Medicine.

 

Osteoarthritis: New trial drug has powerful anti-inflammatory effect: A new drug that researchers are currently trialing to treat osteoarthritis can dampen the harmful effects of an overactive immune system while protecting its beneficial functions. The drug could, therefore, potentially treat rheumatoid arthritis, as well as other conditions resulting from inflammation. Inflammopharmacology

Minimally-invasive treatment for 'frozen shoulder' improves patients' pain and function: A new nonsurgical treatment decreases errant blood flow in the shoulder to quickly reduce pain and improve function in patients with adhesive capsulitis, also known as "frozen shoulder.” Interventional radiologists inserted a catheter through a pinhole-sized incision in patients' wrists that was used to feed microsphere particles into as many as six arteries in the shoulder to reduce inflammation. The treatment was conducted on an outpatient basis and took approximately one hour.
Society of Interventional Radiology's 2020 Annual Scientific Meeting on June 13

 

Which surgery works best for lower back pain? Researchers at Hospital for Special Surgery in New York City compared 117 patients who had minimally invasive lumbar decompression surgery and 51 who had minimally invasive lumbar spine fusion surgery. All the procedures were performed by the same orthopedic surgeon. There was no statistical difference between the two in returning to work. American Academy of Orthopedic Surgeons 

Switching to regional anesthesia provides more effective pain relief and may cut greenhouse emissions: The evidence suggests that regional anesthesia provides more effective pain relief, has fewer unpleasant side effects than general anesthesia, shortens hospital stay, and may be preferred by patients. Switching from general to regional anesthesia may help cut greenhouse emissions and ultimately help reduce global warming, indicates a real life example at one US hospital over the course of a year, and reported in the journal Regional Anesthesia & Pain Medicine.

New therapy reduces chronic low back pain in large international study: A new study has found that tanezumab, a monoclonal antibody that inhibits nerve activity, provides relief in patients with chronic low back pain. This is the first study that shows long-term relief for chronic low back pain with a single dose of tanezumab delivered under the skin once every two months. The study was conducted in 191 sites across eight countries in North America, Europe, and Asia. Pain

COMPLEMENTARY & ALTERNATIVE MEDICINE
Mindfulness combined with hypnotherapy aids highly stressed people: "Combining mindfulness and hypnotherapy in a single session is a novel intervention that may be equal to or better than existing treatments, with the advantage of being more time-effective, less daunting and easier to use. This could be a valuable option for treating anxiety and stress reduction." International Journal of Clinical and Experimental Hypnosis

FDA ACTION
• Approved Recarbrio (combination of imipenem-cilastatin and relebactam) for treating hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP)
• Approved Tivicay for HIV Pediatric Patients
• Approved Oriahnn capsules for management of heavy menstrual bleeding associated with uterine leiomyomas in premenopausal women
• Approved Tauvid (flortaucipir F18), a radioactive diagnostic agent, to image tau pathology in patients with cognitive impairment being evaluated for Alzheimer disease
• Approved IV artesunate to treat adults and children with severe malaria
• Approved Uplizna (inebilizumab-cdon) injection to treat neuromyelitis optica spectrum disorder (NMOSD) in patients who are anti-aquaporin-4 (AQP4) antibody positive
• Approved EndeavorRx, a video game for treating attention deficit hyperactivity disorder in children

PREVENTION: Diet/Nutrition
Eating an Early Dinner Can Help You Burn Fat, Lower Your Blood Sugar: According to a study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, eating a late dinner is associated with weight gain and high blood sugar levels, regardless if the meal is the same that you would have eaten earlier.

Daily coffee may lower risk for developing arrhythmia: Regular coffee consumption is associated with a significantly lower risk for arrhythmias, according to a study presented recently as part of the Heart Rhythm Society online meeting: HRS 2020 Science.

PREVENTION: Supplements
There’s Little Evidence That Probiotics Help Most GI Symptoms: A new guideline by the American Gastroenterological Association cautions that there’s not enough scientific evidence to recommend using these so-called good bacteria and yeasts to treat most digestive diseases. The guideline recommends using probiotics for only a limited number of gastrointestinal (GI) conditions. Specific probiotics may also reduce the risk of Clostridium difficile infection in adults and children taking antibiotics and for the management of pouchitis, a complication of ulcerative colitis that has been treated surgically. “Patients taking probiotics for Crohn’s, ulcerative colitis or [irritable bowel syndrome] should consider stopping. The supplements can be costly and there isn’t enough evidence to prove a benefit or confirm lack of harm.”

A good vitamin D status can protect against cancer: A good vitamin D status is beneficial both in cancer prevention and in the prognosis of several cancers, according to a new research review. The anti-cancer effects of vitamin D are especially pronounced in the prevention and treatment of colon cancer and blood cancers. In addition, high vitamin D responsiveness can be linked to a smaller cancer risk. Vitamin D responsiveness varies between individuals, affecting their need for vitamin D supplementation. Seminars in Cancer Biology 

Vitamin B3 revitalizes energy metabolism in muscle disease: An international team of scientists reported that vitamin B3, niacin, has therapeutic effect in progressive muscle disease. Niacin delayed disease progression in patients with mitochondrial myopathy, a progressive disease with no previous curative treatments. Cell Metabolism 

Multi-ethnic study suggests vitamin K may offer protective health benefits in older age: A new, multi-ethnic study found adults aged 54-76 with low circulating vitamin K levels were more likely to die within 13 years compared to those with adequate levels, suggesting vitamin K may offer protective health benefits as we age. The American Journal of Clinical Nutrition

PREVENTION: Other
Negative Thinking Can Harm Your Brain and Increase Your Dementia Risk: In a new study, researchers at University College London have found repetitive negative thinking is linked to cognitive decline, a higher number of harmful tau protein and amyloid deposits in the brain, and increasing a greater risk of dementia.

 

Exercise, Diet, Alcohol: New Guidelines Detail Best Ways to Reduce Cancer Risk: The American Cancer Society released new guidelines  for reducing the risk of cancer. Among the recommendations include: exercise more per week; reduce red and eat more colorful fruits and vegetables; strictly limit alcohol

 

What People with Type 2 Diabetes Can Do to Lower Their Risk for Cancer, Dementia: Now recent research from Australia has concluded that people with type 2 diabetes are up to three times more likely to develop several types of cancer and 60 percent more likely to develop dementia compared to the general population. Experts advise people to eat a healthy diet, exercise regularly, and get plenty of sleep to lower their risk for disease.

Sedentary? Feel happier with sleep or light activity instead: Lockdowns have made it more difficult for many to stay active. A new study suggests better and perhaps surprising ways to spend our spare time — that might benefit our health, as well. The research appears now in the American Journal of Preventive Medicine.

Combination of healthy lifestyle traits may substantially reduce Alzheimer's disease risk: Combining more healthy lifestyle behaviors was associated with substantially lower risk for Alzheimer's disease in a study that included data from nearly 3,000 research participants. Those who adhered to four or all of the five specified healthy behaviors were found to have a 60% lower risk of Alzheimer's. The behaviors were physical activity, not smoking, light-to-moderate alcohol consumption, a high-quality diet, and cognitive activities. Funded by the National Institute on Aging (NIA), part of the National Institutes of Health, this research was published in the June 17, 2020, online issue of Neurology, the medical journal of the American Academy of Neurology. 

Even without concussion, athletes in contact sports may have brain changes: Female college rugby players may have subtle brain changes even if they haven't had a recent concussion, according to a new study published in the June 17, 2020, online issue of Neurology, the medical journal of the American Academy of Neurology. The study compared rugby players to other female college athletes competing in the non-contact sports of swimming and rowing. "There's no longer a debate that when an athlete is diagnosed with a concussion caused by a sharp blow or a fall, there is a chance it may contribute to brain changes that could either be temporary or permanent," said study author Ravi S. Menon, Ph.D., FRSC, of Western University in London, Canada. "But what are the effects of the smaller jolts and impacts that come with playing a contact sport? Our study found they may lead to subtle changes in the brains of otherwise healthy, symptom-free athletes."

Study shows sedentary behavior independently predicts cancer mortality: In the first study to look at objective measures of sedentary behavior and cancer mortality, researchers from The University of Texas MD Anderson Cancer Center found that greater inactivity was independently associated with a higher risk of dying from cancer. The most sedentary individuals had an 82% higher risk of cancer mortality compared to the least sedentary individuals. An accelerometer was used to measure physical activity, rather than relying on participants to self-report their activity levels. Researchers also found that replacing 30 minutes of sedentary time with physical activity was associated with a 31% lower risk of cancer death for moderate-intensity activity, such as cycling, and an 8% lower risk of cancer death for light-intensity activity, such as walking.

Centenarian study suggests living environment may be key to longevity: Where you live has a significant impact on the likelihood that you will reach centenarian age, suggests a new study. People who live in highly walkable, mixed-age communities may be more likely to live to their 100th birthday. The probability of reaching centenarian age is high are located in urban areas and smaller towns with higher socioeconomic status
 Journal of Environmental Research and Public Health

Volunteerism:Doing good does you good: A new study takes a closer look at the benefits of volunteering to the health and well-being of volunteers, both validating and refuting findings from previous research. The results verify that adults over 50 who volunteer for at least 100 hours a year (about two hours per week) have a substantially reduced risk of mortality and developing physical limitations, higher levels of subsequent physical activity, and improved sense of well-being later on. American Journal of Preventive Medicine

 

TREATMENT
Advanced MRI scans may improve treatment of tremor, Parkinson's disease: Recently developed MRI techniques used to more precisely target a small area in the brain linked to Parkinson's disease and essential tremor may lead to better outcomes without surgery and with less risk of negative effects, a new study led by UT Southwestern researchers suggests. Brain

Cancer patients less likely to be prescribed cardioprotective medications: As cancer survivor rates increase with modern treatments, cardiovascular disease (CVD) rates are rising in cancer patients and survivors and CVD has emerged as a leading cause of long-term preventable death in this population. Even though cardioprotective medications—including statins, ACE inhibitors and antiplatelet therapies—are frontline primary and secondary CVD prevention, patients with a prior or current history of cancer had lower rates of utilization compared to those without cancer, according to a research letter published in JACC: Cardio Oncology.

Continuous glucose monitoring reduces hypoglycemia in older adults with type 1 diabetes: Results from a six-month, multi-site clinical trial called the Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) Study Group. Older adults who use continuous glucose monitoring (CGM) devices can significantly reduce the occurrence of hypoglycemia and severe hypoglycemic events while also reducing hemoglobin A1c. JAMA

Novel antisense drug shows promise in slowing fatty liver disease: Using a first-of-its-class drug in a clinical trial, an international research effort reports that inhibition of a key enzyme safely and effectively improved the health of persons with non-alcoholic fatty liver disease (NAFLD), a chronic metabolic disorder that affects hundreds of millions of people worldwide. The Lancet Gastroenterology and Hepatology

OTHER
Past stressful experiences do not create resilience to future trauma: The adage “What doesn't kill you makes you stronger,” is not true and in fact, new research finds just the opposite. Past stressors sensitize people to future traumas, thereby increasing their chances of developing a mental health disorder. British Journal of Psychiatry

'Trigger warnings' may do more harm than good, study finds: Trigger warnings are meant to alert trauma survivors about unsettling text or content that they might find potentially distressing. But these words of caution at the start of films or books may provide no help at all—and might even hamper a traumatized person's ability to grapple with deep psychological scars, a new study reports. Clinical Psychological Science

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