Journal Watch October 2020

COVID

Statins reduce COVID-19 severity, likely by removing cholesterol that virus uses toinfect: Analyzing anonymized patient medical records, UC San Diego researchers discovered that cholesterol-lowering statins reduced risk of severe COVID-19 infection, while lab experiments uncovered a cellular mechanism that helps explain why. American Journal of Cardiology

 

Those Who Social Distance Have Fraction of COVID-19 Risk Compared to Those Who Don’t: People who said they frequently used public transportation were more than four times as likely to have tested positive for SARS-CoV-2.  Those who said they practiced strict outdoor social distancing were just a tenth as likely to have tested positive. The key to limiting exposure is to limit the amount of time in places where there is a high concentration of viral particles in the air. Clinical Infectious Diseases

 

Remdesivir Effective, Well-Tolerated in Final Trial Report: A final report from the multinational placebo-controlled ACTT-1 trial confirms that remdesivir is effective and well tolerated for shortening the time to recovery from COVID-19 infection. 

Remdesivir Does Not Reduce COVID-19 Mortality, Study Says: A large study sponsored by the World Health Organization found that remdesivir doesn't help hospitalized patients with COVID-19 survive and doesn't even shorten the recovery time of those who do survive. These findings contradict smaller studies which found remdesivir, an antiviral drug, helped hospitalized coronavirus patients recover faster than patients who received a placebo. Those earlier studies led the FDA to grant emergency use authorization for the drug, which has been given to thousands of COVID patients in the United States, including President Donald Trump. The WHO-sponsored study was conducted from March 22 to Oct. 4 and involved 11,330 patients from 405 hospitals in 30 countries. Patients were given remdesivir and three other drugs singly or in combination. "These remdesivir, hydroxychloroquine, lopinavir and interferon regimens appeared to have little or no effect on hospitalized COVID-19, as indicated by overall mortality, initiation of ventilation and duration of hospital stay," the study concluded.

 Obstructive Sleep Apnea (OSA) Linked With Worse COVID-19: Using Finnish national databases, researchers found that while the rates of infection with the new coronavirus were the same for people with and without OSA, among people who did become infected, those with OSA had a five-fold higher risk of hospitalization. 

 Report Finds KN95 Masks Not as Effective as N95 Masks: Researchers at ECRI found that up to 70 percent KN95 masks imported from China don’t meet U.S. standards for effectiveness as with N95 masks. The group issued a hazard warning in September

 

Total deaths recorded during the pandemic far exceed those attributed to COVID-19: For every two deaths attributed to COVID-19 in the U.S., a third American dies as a result of the pandemic, according to new data publishing Oct. 12 in the Journal of the American Medical Association. The study, led by researchers at Virginia Commonwealth University, shows that deaths between March 1 and Aug. 1 increased 20% compared to previous years -- maybe not surprising in a pandemic. But deaths attributed to COVID-19 only accounted for 67% of those deaths. "Contrary to skeptics who claim that COVID-19 deaths are fake or that the numbers are much smaller than we hear on the news, our research and many other studies on the same subject show quite the opposite." 

Johnson & Johnson pauses COVID-19 vaccine trial due to unexplained illness — the second US trial now on hold: Johnson & Johnson's COVID-19 vaccine trial has been paused due to an unexplained illness in a volunteer. Now two of the four vaccine trials in the United States are now on hold. The Phase 3 clinical trial was temporarily halted Monday, according to the company. It is not known if the unidentified illness is related to the vaccine, but clinical protocols require a pause while it is investigated.

COVID-19 Antibodies Last at Least 3 Months: People infected with COVID-19 develop antibodies targeting the new coronavirus that last for at least three months, according to two reports in Science Immunology.

How Long Does It Take for COVID-19 to Stop Being Contagious? There isn’t a test to determine how contagious a person might be, so doctors have to judge a person’s level based on their symptoms.  A polymerase chain reaction (PCR) test, which is used to diagnose COVID-19 by swabbing the throat or nose, can help determine if a person is still carrying the virus but it doesn’t always tell us if they’re still contagious.

Older People No More Susceptible to COVID-19, But Fare Worse: Countering reports that older people are more likely to contract COVID-19, researchers found that advanced age does not increase susceptibility to SARS-CoV-2 infection. However, when older people in Spain, Italy, and Japan did get COVID-19, they were at higher risk for severe outcomes and death compared with younger patients, new evidence reveals. Scientific Reports

 

Blood Group O Linked to Decreased Risk for SARS-CoV-2 Infection: Blood group O was associated with a decreased risk for contracting SARS-CoV-2 infection, according to the results of large retrospective analysis of the Danish population. Blood Adv. 2020 Oct 14. 

Widespread COVID-19 Vaccine Could Be Ready by April, Fauci Says: A "safe and effective" coronavirus vaccine may be widely available by April. "That would be predicated on the fact that all of the vaccines that are in clinical trials have been proven to be safe and effective,"  said Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases, told CBS Evening News.

COVID-19 Antibody Response Not Reduced With Diabetes: Neither diabetes per se nor hyperglycemia appear to impair the antibody response to SARS-CoV-2, suggesting that a COVID-19 vaccine would be just as effective in people with diabetes as in those without, new research finds.  published online October 8 in Diabetologia

 

Certain pre-existing conditions may double, triple mortality risk for COVID-19: A large, international study of COVID-19 patients confirmed that cardiovascular disease, hypertension, diabetes, congestive heart failure, chronic kidney disease, stroke and cancer can increase a patient's risk of dying from the virus. Plos One

 

Face masks: what the data say: The science supports that face coverings are saving lives during the coronavirus pandemic, and yet the debate trundles on. How much evidence is enough? Nature

 

 

PAIN

Gabapentin Does Not Lower Pain Scores in Chronic Pelvic Pain: For women with chronic pelvic pain, gabapentin treatment does not result in significantly lower pain scores and is associated with more side effects than placebo. Sept. 26 in The Lancet. 

 

Survey: Rheumatic Diseases Pose Routine Challenges: Many patients with rheumatic diseases face significant challenges in their daily lives, including affordability issues, lifestyle and activity limitations, and negative effects on mental and emotional health, according to the results of a survey released by the American College of Rheumatology (ACR). 

 

Botox for TMJ Disorder Does Not Affect Jaw Bone Density: Low-dose botulinum toxin injections for jaw, facial pain not linked to short-term bone changes. Journal of Oral Rehabilitation

 

Research Suggests That Rheumatoid Arthritis May Be 2 Different Diseases: Researchers say rheumatoid arthritis may actually be two diseases instead of just one. They recommend that the disease be divided into two types: people with autoantibodies and people without them. They say people with autoantibodies appear to have better long-term outcomes in the reduction of rheumatoid arthritis symptoms. PLOS Medicine research

 

Most effective drugs for common type of neuropathic pain: Clinical study tested four different types of medications for efficacy, tolerability and adverse effects use to treat cryptogenic sensory polyneuropathy (CSPN). Nortriptyline had the highest efficacious percentage (25%), and the second-lowest quit rate (38%), giving it the highest level of overall utility. Duloxetine had the second-highest efficacious rate (23%), and lowest drop-out rate (37%). Pregbalin had the lowest efficacy rate (15%) and Mexiletene had the highest quit rate (58%). "There was no clearly superior performing drug in the study," "However, of the four medications, nortriptyline and duloxetine performed better when efficacy and dropouts were both considered. Therefore, we recommend that either nortriptyline or duloxetine be considered before the other medications we tested." JAMA Neurology

 

Spinal cord stimulation reduces pain and motor symptoms in Parkinson's disease patients: A team of researchers reports that spinal cord stimulation (SCS) measurably decreased pain and reduced motor symptoms of Parkinson's disease, both as a singular therapy and as a 'salvage therapy' after deep brain stimulation (DBS) therapies were ineffective. Bioelectronic Medicine

 

Study Explores Relationship Between Pain and Cognitive Impairment: A recent study exploring the association between pain and cognitive impairment (CI) found that pain and CI each increase the severity of the other; that is, when pain progresses from acute pain to high impact chronic pain (HICP), the severity of CI increases, and as the severity of CI increases, the severity of pain increases. Further, the study found that people with comorbid chronic pain and CI are in a much higher state of self-reported disability than people with either alone. The Clinical Journal of Pain 

 

Comparing the Neural Effects of Placebo Pain Relief in Fibromyalgia Patients and Healthy Individuals: Although fibromyalgia is associated with changes in brain function and neural pathways, researchers saw no differences in responses to placebo pain relief between fibromyalgia patients and healthy volunteers in a new study. Pain 

 

Study Provides New Insights Into Changes in Brain Function in Fibromyalgia: Pain at the time of testing, rather than the presence of a chronic pain condition, is primarily responsible for changes in the functioning of the brain’s default mode network in patients with fibromyalgia NeuroImage.

 

COMPLEMENTARY & ALTERNATIVE MEDICINE

Why Some Experts Say Cannabis Can Be Effective in Treating Menopause Symptoms: A survey indicates that more women may be using cannabis to treat menopause symptoms. Some experts say cannabis can be effective in treating menopause while others express concerns about the drug’s side effects. One expert recommends using hemp-based products as an alternative. North American Menopause Society (NAMS).

 

Acupuncture Before Surgery May Help Reduce Opioid Use Afterward: According to a study presented at the ANESTHESIOLOGY® annual meeting, administering acupuncture, both traditional and “battlefield,” decreased postoperative opioid use by as much as half.

 

Yoga and meditation reduce chronic pain: A mindfulness-based stress reduction course was found to benefit patients with chronic pain and depression, leading to significant improvement in participant perceptions of pain, mood and functional capacity, according to a new study. Most of the study respondents (89%) reported the program helped them find ways to better cope with their pain while 11% remained neutral. Journal of the American Osteopathic Association.

 

Cannabinoid Use Tied to Adverse Outcomes With COPD: New cannabinoid use is associated with elevated rates of adverse outcomes among older adults with chronic obstructive pulmonary disease (COPD), according to a study published online Sept. 30 in Thorax. individuals receiving higher-dose cannabinoids had both increased rates of hospitalization for COPD and pneumonia and all-cause mortality.

 

FDA ACTION

• Approved Phexxi (lactic acid, citric acid, and potassium bitartrate) for the prevention of pregnancy in females of reproductive potential.

• Approved Nucala for Hypereosinophilic Syndrome

• Approved Emergency use authorization of Abbott’s new Covid-19 antibody test

• Approved Opdivo-Yervoy combination to treat adults with unresectable malignant pleural mesothelioma

• Approved first Ebola Virus Treatment

 

 

 

PREVENTION: Exercise

Exercise Intensity Seems Not to Impact Mortality Levels: Combined moderate- and high-intensity training has no effect on all-cause mortality compared with recommended physical activity levels, according to a study published online Oct. 7 in The BMJ. 

 

Is sitting always bad for your mind? A new study suggests maybe not: It's generally accepted health advice that adults of all ages should sit less, move more, and engage in regular exercise to feel better and reduce the risk of chronic diseases. However, when it comes to the brain and cognition, a new study of older adults suggests that some sedentariness isn't all bad, so long as basic physical activity benchmarks are being met. Psychology and Aging

 

PREVENTION: Diet/Nutrition

Experts Debate Whether Time-Restricted Diets Are More Effective Than Food-Restrictive Diets: New research indicates there’s no significant difference in weight loss between time-restricted diets and other diets. They say there’s no one-size-fits-all approach to weight loss and healthy living, and time-restricted eating works well for some people to control unnecessary eating. For weight loss and healthy living, the age-old advice still applies: Stick to mostly plant-based, unprocessed foods, don’t overeat, and drink lots of water. Healthline

 

As You Get Older, You Need to Drink More Water: Researchers say that as people age, they need to drink more water to compensate for changes in their body temperature regulation. Dehydration can cause a number of ailments, including muscle pain, fatigue, and heat exhaustion. Older adults are encouraged to drink water even when they aren’t thirsty and to limit beverages such as soda, coffee, and alcohol, which can cause dehydration. That’s the advice from a new study published in The Journal of Physiology.

 

Rapeseed instead of soy burgers: Researchers identify a new source of protein for humans: Rapeseed has the potential to replace soy as the best plant-based source of protein for humans. In a current study, nutrition scientists found that rapeseed protein consumption has comparable beneficial effects on human metabolism as soy protein. The glucose metabolism and satiety were even better. Another advantage: The proteins can be obtained from the by-products of rapeseed oil production. Nutrients

 

Dietary folate, magnesium, and dairy products may all help stave off bowel cancer, study finds: Folate, magnesium, and dairy products may all help stave off bowel cancer, but there's no evidence that garlic or onions, fish, tea or coffee protect against the disease, finds a new analysis. Gut

 

Drinking coffee may protect some people against Parkinson’s: A recent study found lower levels of caffeine in the blood of people with Parkinson’s disease. The study compared people with Parkinson’s who carry a particular genetic mutation known to increase Parkinson’s risk with people who carry the same mutation but do not have the disease. Neurology.

 

 Reducing Drinking May Improve Pain Interference Symptoms: For U.S. veterans with unhealthy alcohol use, reducing drinking may improve or resolve various conditions including pain interference symptoms and substance use, although most correlations are not significant, according to a study published online Oct. 8 in Alcoholism: Clinical & Experimental Research.

 

PREVENTION: Supplements

Omega-3s to Prevent Alzheimer's: Who Benefits? Studies suggest that people who do not consume omega-3s are the most likely to get benefit because a lower omega-3 level is associated with greater brain amyloid plaques. Medscape 

 

New research finds unapproved drugs in brain-boosting supplements: The study, published Wednesday in Neurology, found five unapproved pharmaceutical drugs — in potentially dangerous combinations and doses — in over-the-counter brain supplements.

 

PREVENTION

Study shows weighted blankets can decrease insomnia severity: Weighted blankets are a safe and effective intervention in the treatment of insomnia, according to Swedish researchers who found that insomnia patients with psychiatric disorders experienced reduced insomnia severity, improved sleep and less daytime sleepiness when sleeping with a weighted chain blanket. Journal of Clinical Sleep Medicine

 

Heart Disease Is the Top Cause of Death in Women, but Few Know Warning Signs: Heart disease remains the top cause of death for women in the United States. About 1 in every 5 female deaths are linked to heart disease. A recent national survey from the American Heart Association found that despite the risk, many women are unaware of the signs of heart attack and stroke or the risk heart disease poses to women. national survey Circulation

 

Watching nature on TV can boost well being, finds new study: Watching high quality nature programmes on TV can uplift people's moods, reduce negative emotions, and help alleviate the kind of boredom associated with being isolated indoors, according to a new study published today in the Journal of Environmental Psychology.

 

TREATMENT

Persons with Parkinson's disease can have a brighter future: In this special supplement to the Journal of Parkinson's Disease experts review common and vexing issues affecting people with Parkinson's disease as well as emerging concerns such as the importance of personalized care management. Experts review management strategies that can help improve quality of life of patients living with Parkinson's disease and highlight the importance of personalized, optimal care management. 

 

Parkinson's: Study examines the potential of spinal cord stimulation: A new study finds that spinal cord stimulation could represent an alternate therapy for people with Parkinson’s disease that is resistant to conventional treatments. The researchers claim that this emerging technology may help decrease pain and improve mobility. Bioelectronic Medicine.

 

Plasma Exchange 'Encouraging' as Novel Alzheimer's Treatment: Plasma exchange (PE) with albumin replacement may be effective for slowing down symptoms of Alzheimer's disease (AD), new research suggests. Results from the phase 2b/3 AMBAR study showed that the treatment, which aims to remove amyloid beta (Aβ) from plasma, was associated with a 60% decrease in functional and cognitive decline in patients with moderate AD. AAIC 202 https://www.medscape.com/viewarticle/934937

 

Manufacturer Prices for Insulin Substantially Higher in the U.S.: Manufacturer prices more than eight times higher in the U.S. than in other high-income countries. Rand Corp

 New Procedure Could Eliminate the Need for Insulin for Some with Type 2 Diabetes: A new procedure could help eliminate the need for insulin for some people with type 2 diabetes. The outpatient procedure involves inserting a catheter into a part of the intestine to destroy mucosal cells that have changed as a result of diabetes. The procedure is called duodenal mucosal resurfacing, or DMR. UEG Week 2020 Virtual

 

Antibiotics Can Be as Effective as Surgery in Some Appendicitis Cases: Antibiotics can eliminate or delay the need for appendectomy, at least in some cases, according to research published in the New England Journal of Medicine (NEJM).

 

Bariatric Surgery Linked to Longer Life Expectancy in Obesity: Adjusted median life expectancy three years longer with bariatric surgery than with usual obesity care. NEJM 

 

Treating ringing in the ears with Sound and electrical stimulation of the tongue: In the largest clinical trial of its kind, researchers show that combining sound and electrical stimulation of the tongue can significantly reduce tinnitus, commonly described as 'ringing in the ears.' They also found that therapeutic effects can be sustained for up to 12 months post-treatment.  Science Translational Medicine, 2020 

 

Regular use of acid reflux drugs linked to heightened risk of type 2 diabetes Blood glucose check-ups advised for long term users, advise researchers. Regular use of acid reflux drugs, known as proton pump inhibitors, or PPIs for short, is linked to a heightened risk of developing type 2 diabetes, finds new research. Gut 

 

Psoriasis Guidelines Focus on Treatment of Adults: Topical agents, alternative medicine, and disease severity assessment are the subjects of the latest updated set of guidelines for the management and treatment of psoriasis issued jointly by the American Academy of Dermatology and the National Psoriasis Foundation. https://www.medscape.com/viewarticle/935399

 

 

OTHER

Experts Uncertain If the President’s Drug Import Plan Will Save Consumers Money: An executive order that’s expected to take effect in late November would allow six states to import prescription drugs from Canada. Experts say they’re not sure whether this new program would actually lower drug prices for U.S. consumers. They note that insulin isn’t one of the drugs approved for importation. Healthline 

Why Trump’s Executive Order Doesn’t Protect People With Preexisting Conditions: President Trump signed an executive order that claims to help protect Americans with preexisting conditions like cancer, asthma, or diabetes.  Trump also outlined a potential healthcare plan that aims to protect people from surprise billing, ensure better care, and invest in critical areas. “This includes a steadfast commitment to always protecting individuals with preexisting conditions and ensuring they have access to the high-quality healthcare they deserve,” the order states.  But experts point out that the administration is trying to overturn the Affordable Care Act (ACA), which already offers protections for preexisting conditions. Additionally, the executive order cannot be enforced unless other laws are passed. Healthline https://www.healthline.com/health-news/why-trumps-executive-order-doesnt-protect-people-with-preexisting-conditions