Journal Watch December 2020

COVID

Vaccines Authorized by the FDA: The Pfizer-BioNTech vaccine gained approval from the FDA on Dec. 11 for those 16 and older, which was followed by the Moderna Vaccine on Dec. 18.  President Trump has said vaccines will be free to all Americans, though some places may charge a fee for administering the shots. Initial supplies will be limited. Based on the U.K experience, it’s expected that  people with a history of serious allergic reactions will be warned about the vaccination. The FDA also said the vaccine might not be as strong in people with compromised immune systems, including those taking drugs that weaken the immune system. Both vaccines employ mRNA technology. It will be up to the states how the vaccine will be distributed thought the Centers for Disease Control (CDC) recommends that health-care workers and nursing home and other long-term care residents be the first to receive the vaccine.

 

CDC Warns That COVID-19 Vaccine Might Spur Transient Sickness: Experts attending a meeting of an advisory committee to the U.S. Centers for Disease Control and Prevention stressed that Americans who receive the vaccine should not be surprised if they feel under the weather for a few days afterward. 

 

FDA Give Guidance on Allergy, Pregnancy Concerns for Pfizer Vaccine: The US Food and Drug Administration (FDA) has clarified its guidance on administration of the Pfizer/BioNTech COVID-19 vaccine, stating that it is safe for people with any history of allergies, but not for those who might have a known history of severe allergic reaction to any component of the vaccine.

 

Researchers urge priority vaccination for individuals with diabetes: Researchers have discovered individuals with type 1 and type 2 diabetes infected with COVID-19 are three times more likely to have a severe illness or require hospitalization compared with people without diabetes. Diabetes Care

 

Interpol Warns Fake COVID-19 Vaccines May Pop Up Online: Interpol released a warning last week stating that organized crime networks may try to scam people into buying fraudulent COVID-19 vaccines. The real vaccine won’t be distributed online, so avoid circumventing the process for what may seem like early access to the shot.

 

Johnson & Johnson Hopes to Offer COVID Vaccine in February: Johnson & Johnson has fully enrolled 45,000 participants in phase III of its clinical trials for a coronavirus vaccine and hopes to apply for an emergency use authorization from the FDA in February. The Johnson & Johnson vaccine differs from the Pfizer and Moderna vaccines in that it doesn't need to be frozen and only requires one dose, not two.

 

New Home Test approved by the FDA: The U.S. Food and Drug Administration on Tuesday authorized the first coronavirus test that people will be able to buy at a local store without a prescription and use for immediate results at home to find out if they're positive or negative. The test will cost about $30 and be available by January. It takes about five minutes to collect the sample and produces results within 20 minutes. 

 

Plasma From Recovered Patients Shows Little Benefit in Those Hospitalized With COVID-19: The therapy know as convalescent plasma, which delivers antibodies from COVID-19 survivors to infected people, did not significantly improve patients' health status or reduce their risk of dying from the disease any better than a placebo.

 

Face masks slow spread of COVID-19; types of masks, length of use matter: "The results suggest that the consistent use of efficient face masks, such as surgical masks, could lead to the eradication of the pandemic if at least 70% of the residents use such masks in public consistently," said author Sanjay Kumar. "Even less efficient cloth masks could also slow the spread if worn consistently." Physics of Fluids

 

One-third of patients may experience ‘long COVID’: A study has found that 32% of people who tested positive for SARS-CoV-2 were still experiencing at least one symptom 6 weeks after their tests. The most common of these symptoms were fatigue, shortness of breath, and a loss of taste or smell. The phenomenon appears to be more common among people who experienced more severe infections. Among people with milder infections, however, the prevalence of long COVID has been unclear. Data from the COVID Symptom Study app suggest that 1 in 10 people with the illness experience symptoms for 3 weeks or more. Annals of Internal Medicine.

For Covid Long-Haulers, a Little-Known Diagnosis Offers Possible Treatments—and New Challenges: a little-known syndrome called POTS: A  disorder of the autonomic nervous system that can have a variety of causes, and it existed before Covid. One common trigger is an infection, such as a virus. Now some doctors believe that the coronavirus is triggering the disorder in some people, providing an explanation for debilitating symptoms including dramatically elevated heart rates from small movements, dizziness and extreme fatigue after even minor physical activity. The good news, experts say, is there are protocols and treatments for POTS, which stands for postural orthostatic tachycardia syndrome. They include a guided, very gradual return to physical activity; compression stockings or abdominal compression to prevent blood pooling in the lower half of the body; increased salt and fluid intake if blood pressure is low; and sometimes medications to regulate blood pressure, heart rate and blood volume. The Wall Street Journal 

Long-Haul COVID-19 May Be a Public Health Crisis After the Pandemic: On Dec. 3 and 4, the National Institutes of Health sponsored a meeting to discuss the long-term symptoms of COVID-19. This shed light on the millions of people around the world who’ve been affected by lingering symptoms from the disease. Healthline

 

Large US study confirms COVID-19 complications: Lung, kidney and cardiovascular issues. Canadian Medical Association Journal (2020). DOI: 10.1503/cmaj.201686

 

Baricitinib Combo for COVID-19 Accelerates Recovery: Among people hospitalized with COVID-19, a combination of baricitinib and remdesivir reduces the median time to recovery compared with remdesivir plus placebo, according to trial results published December 11 in the New England Journal of Medicine.

 

Men Worldwide Doing Worse with COVID-19: Researchers pooled data from government websites and the medical literature on more than 3.1 million people infected with the new coronavirus in 46 countries. They found no difference in the proportion of male and female patients who contracted COVID-19. Men, however, were nearly three times more likely to be admitted to an intensive care unit and 39% more likely to die from COVID-19. Nature Communications

 

Vitamin D Deficiency in COVID-19 Quadrupled Death Rate: Vitamin D deficiency on admission to hospital was associated with a 3.7-fold increase in the odds of dying from COVID-19, according to an observational study looking back at data from the first wave of the pandemic. published online November 25 in the American Journal of Clinical Pathology.

 

Metformin Use May Reduce Mortality in Women With COVID-19: For women with type 2 diabetes or obesity who are admitted to the hospital with COVID-19, metformin use is associated with significantly reduced mortality, according to a study published online Dec. 3 in The Lancet Healthy Longevity. 

 

Study hints that supplements may reduce COVID-19 risk in females: The research found small but significant decreases in the risk of SARS-CoV-2 infection among females — but not males — who took multivitamins, vitamin D, omega-3 fatty acids, or probiotics. MedRxiv.

 

LED lights found to kill coronavirus: Researchers from Tel Aviv University (TAU) have proven that the coronavirus can be killed efficiently, quickly, and cheaply using ultraviolet (UV) light-emitting diodes (UV-LEDs). They believe that the UV-LED technology will soon be available for private and commercial use. ournal of Photochemistry and Photobiology B: Biology.

COVID-19 Neurologic Fallout Not Limited to the Severely Ill: A review of  medical records of 74 adults (mean age, 64 years) who were hospitalized with COVID-19 and evaluated for neurologic conditions at Boston Medical Center, a safety-net hospital caring primarily for underserved, low-income, racial and ethnic minority populations. "We found a range of neurologic diagnoses, including stroke and seizures, among hospitalized patients with COVID-19 and the majority were not critically ill, suggesting that these complications are not limited just to those patients who require ICU care or a ventilator," The study was published online December 9 in Neurology Clinical Practice.

COVID Ranks as Leading Cause of Death in the US. 

Tocilizumab Reduces Odds of Ventilation or Death in Mostly Non-White COVID-19 Patients: The interleukin-6 inhibitor tocilizumab reduced the combined likelihood of mechanical ventilation or death by 44% among mostly non-white patients hospitalized with COVID-19, according to a new international randomized test of 389 volunteers. The New England Journal of Medicine

 

We are over-cleaning in response to covid-19: We don’t have a single documented case of covid-19 transmission from surfaces. Not one. Covid is spread mainly through the air so there’s no need to constantly disinfect surfaces. Shared air is the problem, not shared surfaces. Washington Post 

Elevated biomarker for blood vessel damage found in all children with SARS-CoV-2: Researchers have found elevated levels of a biomarker related to blood vessel damage in children with SARS-CoV-2 infection, even if the children had minimal or no symptoms of COVID-19. They also found that a high proportion of children with SARS-CoV-2 infection met clinical and diagnostic criteria for thrombotic microangiopathy (TMA). Blood Advances

 

PAIN

Improving pain care through implementation of the Stepped Care Model for Pain Management: A new study published in the Journal of Pain Research provides evidence that implementation of a Stepped Care Model for Pain Management (SCM-PM) has the potential to more adequately treat chronic pain. The SCM-PM calls for an individualized approach to managing pain in three steps. In Step 1, the clinician identifies and discusses the patient's pain concerns, and develops a treatment plan focusing on self-management and primary care-based interventions. Step 2 involves additional resources and collaborative treatment, including behavioral health assessment and interventions, medication, and consultations with specialists. Step 3 focuses on patients with chronic pain requiring significantly more care and involvement from other members of a pain management team.

 

Exercise for low back pain beneficial but no one agrees on why: A new evidence review has found there is still no consensus between researchers about why exercise works for low back pain patients - despite decades of studies on the topic. Musculoskeletal Science and Practice recently 

 

 

 

COMPLEMENTARY & ALTERNATIVE MEDICINE

First meta-analysis shows promise for yoga, meditation, mindfulness in concussion: Data from 22 different studies, including both published and unpublished work, that included a total of 539 study participants, and looked at the impact of the three interventions on outcome categories -- including mental health, physical health, cognitive performance, quality of life, and social/occupational performance -- and on specific health outcomes, like depression, attention, anxiety, and fatigue. "The main results that we saw were significant reductions in depression and fatigue, Especially with fatigue, it was a large effect size, which is impressive in the sense that fatigue is a difficult symptom for patients to deal with." Applied Psychology: Health and Well-being 

 

Does CBD Impair Your Driving Abilities? Experts, Researchers Disagree: In a new studyTrusted Source, researchers say cannabidiol (CBD) without the intoxicating chemical tetrahydrocannabinol (THC) doesn’t impair driving. However, the researchers say that THC itself can produce mild driving impairment that can last up to 4 hours.

 

FDA ACTION

• Approved Xofluza for postexposure flu prevention

• Approved Tagrisso, the first adjuvant therapy for the most common type of lung cancer

• Approved the Osseoanchored Prostheses for the Rehabilitation of Amputees (OPRA) Implant System, the first implant system marketed in the U.S. for adults who have transfemoral—or above-the-knee—amputations and who have or are anticipated to have rehabilitation problems with, or cannot use, a conventional socket prosthesis. 

• Approved Orgovyx the first oral hormone therapy for treating advanced prostate cancer

• Warns consumers to avoid 50 male enhancement and Weight Loss Products Sold Through Amazon, eBay and Other Retailers Due to Hidden, Potentially Dangerous Drug Ingredients

• Granted marketing authorization  for an anterior cruciate ligament (ACL) implant intended to serve as an alternative to ACL reconstruction to treat ACL tears.

• Approved Gallium 68 PSMA-11 (Ga 68 PSMA-11) – the first drug for positron emission tomography (PET) imaging of prostate-specific membrane antigen (PSMA) positive lesions in men with prostate cancer.

• Approved Oxlumo (lumasiran) as the first treatment for primary hyperoxaluria type 1 (PH1), a rare genetic disorder

• Expanded the approved indication for Xofluza (baloxavir marboxil) to include post-exposure prevention of influenza (flu) for patients 12 years of age and older after contact with an individual who has the flu.

• Approved Zokinvy (lonafarnib) capsules to reduce the risk of death due to Hutchinson-Gilford progeria syndrome and for the treatment of certain processing-deficient progeroid laminopathies in patients one year of age and older

 

 

PREVENTION: Exercise

Aim to exceed weekly recommended physical activity level to offset health harms of prolonged sitting: The health harms associated with prolonged sitting can be offset by exceeding weekly recommended physical activity levels, says the World Health Organization (WHO) in new global guidelines on physical activity and sedentary behaviour, published in a special dedicated issue of the British Journal of Sports Medicine. But all physical activity counts and is good for long term health, say the new guidelines.

 

Everyday activities enhance personal well-being: Physical activity makes happy and is important to maintain psychic health. Researchers studied the brain regions which play a central role in this process. Their findings reveal that even everyday activities, such as climbing stairs, significantly enhance well-being, in particular of persons susceptible to psychiatric disorders. Science Advances

 

Large study finds clear association between fitness and mental health: New research from a large study demonstrates that low cardiorespiratory fitness and muscle strength have a significant association with worse mental health. BMC Medicine

 

PREVENTION: Diet/Nutrition

New ‘Green’ Mediterranean Diet May Be Even Healthier for You: According to a new study published online in the journal Heart,  researchers found that people who consumed higher amounts of plant-based proteins and less red meat and poultry experienced increased cardiovascular and metabolic benefits.

 

Following A Mediterranean Diet Helps Lower The Risk Of Diabetes In Women, New Study Finds. The health harms associated with prolonged sitting can be offset by exceeding weekly recommended physical activity levels, says the World Health Organization (WHO) in new global guidelines on physical activity and sedentary behaviour, published in a special dedicated issue of the British Journal of Sports Medicine. All physical activity counts and is good for long term health, say the new guidelines.

 

Patients with heart rhythm disorder warned against heavy alcohol consumption: Fourteen drinks a week is linked with a higher risk of health problems including stroke and embolism in patients with atrial fibrillation, according to research published in EP Europace, a journal of the European Society of Cardiology (ESC).

 

New Study Blood Type Diet A study published in the Journal of the Academy of Nutrition and Dietetics by researchers with the Physicians Committee for Responsible Medicine—a nonprofit of 12,000 doctors—debunks the 'blood type diet' by finding that blood type was not associated with the effects of a plant-based diet on body weight, body fat, plasma lipid concentrations, or glycemic control. This new study is based on a randomized control trial whose main findings were published in JAMA Network Open on Nov. 30. That trial randomly assigned overweight participants with no history of diabetes to an intervention or control group on a 1:1 ratio for 16 weeks. Participants in the intervention group followed a low-fat, plant-based diet. The control group made no diet changes. The key finding is that a plant-based diet ramps up metabolism as measured by an increase in after-meal calorie burn of 18.7%, on average, for the intervention group over the control. 

 

Diet modifications -- including more wine and cheese -- may help reduce cognitive decline, study suggests: The foods we eat may have a direct impact on our cognitive acuity in our later years. This is the key finding of an Iowa State University research study spotlighted in an article published in the November 2020 issue of the Journal of Alzheimer's Disease. Key findings included: Cheese, by far, was shown to be the most protective food against age-related cognitive problems, even late into life; The daily consumption of alcohol, particularly red wine, was related to improvements in cognitive function; Weekly consumption of lamb, but not other red meats, was shown to improve long-term cognitive prowess; and Excessive consumption of salt is bad, but only individuals already at risk for Alzheimer's Disease may need to watch their intake to avoid cognitive problems over time.

 

Is the sugar substitute stevia bad for our health?: New research into the plant-based sweetener stevia indicates that the sugar substitute may have negative implications for gut health. Molecules.

 

An avocado a day keeps your gut microbes happy: Eating avocado as part of your daily diet can help improve gut health. Researchers found that people who ate avocado every day as part of a meal had a greater abundance of gut microbes that break down fiber and produce metabolites that support gut health. They also had greater microbial diversity compared to people who did not receive the avocado meals in the study. Journal of Nutrition

 

PREVENTION: VITAMINS/SUPPLEMENTS

Dietary Supplements and Cognitive Function, Dementia, and Alzheimer’s Disease: What the Science Says: From the National Center for Complementary and Integrative Health. This issue of the digest summarizes current information on what the science says about several dietary supplements that have been studied for cognitive function, dementia, and Alzheimer’s disease. Although a few trials of natural products for the prevention of cognitive decline or dementia have shown some modest effects, direct evidence is lacking. In addition, research on some mind and body practices such as music therapy and mental imagery, which have shown promise in treating some symptoms related to dementia, as well as alleviating stress among caregivers, is ongoing.

 

Study Finds Fish Oil May Not Help Your Heart: A studyTrusted Source, published in the Journal of the American Medical Associationon November 15, found that a high dose of omega-3 fatty acids did not reduce people’s chances of experiencing a major cardiovascular event.

 

Eating driedfruit linked to better overall diet and health: Encouraging people to eat more dried fruit — without added sugar — could be an effective way to boost their intake of vital nutrients, researchers have concluded. Even after adjusting for demographic and lifestyle factors, the participants who ate significant amounts of dried fruit tended to have better diets, a lower BMI, a smaller waist circumference, and lower systolic blood pressure compared with those who did not. Medical News Today

 

Higher doses of vitamin D did not reduce falls in at risk older adults: A randomized trial found that, compared with a lower dose, higher doses of vitamin D supplementation did not reduce falls in older persons at high risk for falls. In addition, several analyses raised safety concerns about vitamin D3 doses of 1000 IU/d or higher. Annals of Internal Medicine.

 

PREVENTION

Anxiety associated with faster Alzheimer's disease onset: Anxiety is associated with an increased rate of progression from mild cognitive impairment to Alzheimer's disease, according to a new study. Radiological Society of North America

 

Testosterone can prevent type 2 diabetes in men: The largest investigation of testosterone treatment ever undertaken has shown that, over and above the effect of a lifestyle program, treatment with testosterone prevents or reverses newly diagnosed type 2 diabetes in men. The Lancet Diabetes & Endocrinology

 

TREATMENT

Drug for rare disorder shows promise for treating herpes viruses: A drug currently prescribed to treat a rare enzyme deficiency can help cells clear the herpes simplex 1 and herpes simplex 2 viruses, according to a new study. Science Advances 

 

New guideline supports behavioral, psychological treatments for insomnia: A new clinical practice guideline establishing recommendations for the use of behavioral and psychological treatments for chronic insomnia disorder in adults has been published. The guideline includes one strong recommendation -- which is one that clinicians should follow under most circumstances -- for the use of cognitive behavioral therapy for insomnia. CBT-I combines one or more cognitive therapy strategies with education about sleep regulation plus behavioral strategies such as stimulus control instructions and sleep restriction therapy. Treatment typically involves four to eight sessions. Journal of Clinical Sleep Medicine

 

 

OTHER

Amazon Pharmacy Boasts Big Discounts for Prescription Meds, but Probably Isn’t the Best Deal: Amazon launched Amazon Pharmacy, a delivery service for prescription medications.  The service allows customers to purchase prescription medications with or without insurance. It boasts that Amazon Prime members can save up to “80 percent off generic and 40 percent off brand name medications when paying without insurance.”

Experts say Amazon Pharmacy has the potential to improve drug pricing in the United States, but it likely won’t be a game-changer since it will work within the same system as other online pharmacies. Despite its boasting, Amazon Pharmacy pricing doesn’t really offer much of a discount. Healthline