Journal Watch February 2021

COVID

Metformin Treatment Again Linked to Fewer Deaths From COVID-19: People with type 2 Diabetes who develop COVID-19 show a substantially reduced risk of dying if they are taking metformin, shows a new study that adds to prior research indicating the drug might somehow play a role in reducing the severity of infection. "Unlike several previous analyses, this was a study in a racially diverse population with a high proportion of Blacks/African Americans and...[it] revealed that metformin treatment of diabetes prior to diagnosis with COVID-19 was associated with a dramatic threefold reduced mortality in subjects with type 2 diabetes, even after correcting for multiple covariates.” The new study, published this month in Frontiers of Endocrinology, included 25,326 individuals who were tested for COVID-19 at the University of Alabama at Birmingham Hospital between February and June 2020.

 

CDC: Gap Between Vaccine Doses Could Be 6 Weeks: The CDC has updated its guidance on how long people can wait between the first and second doses of the Pfizer/BioNTech and Moderna COVID-19 vaccines. If the second dose can't be scheduled in the recommended timeframe — 21 days after the first dose for Pfizer and 28 days for Moderna — people can wait up to 6 weeks, the CDC said in an update.

 

Bamlanivimab+ Etesevimab Reduces SARS-CoV-2 Viral Load: Treatment with bamlanivimab and etesevimab, but not monotherapy with bamlanivimab, is associated with a reduction in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in patients with mild-to-moderate COVID-19, according to a study published online Jan. 21 in the Journal of the American Medical Association.

 

Common drug colchicine brings hope to COVID fight: A major clinical trial in Canada shows that an inexpensive anti-inflammatory drug called colchicine can significantly reduce the risk of complications and death from COVID-19.

 

J&J Vaccine 85% Efficacious Against Severe COVID Globally: The Janssen/Johnson & Johnson single-dose adenovirus vaccine provides 85% efficacy globally against severe COVID-19 illness, and it is 72% efficacious against moderate-to-severe illness in the US, according to highly anticipated interim Phase 3 results. The efficacy against severe disease provided by the Janssen/J&J vaccine held true regardless of age, race/ethnicity, absence or presence of comorbidities, and geography. The 44,000-participant ENSEMBLE study was conducted in the United States, South America, and South Africa.

 

Researchers propose that humidity from masks may lessen severity of COVID-19: Masks help protect the people wearing them from getting or spreading SARS-CoV-2, the virus that causes COVID-19, but now researchers from the National Institutes of Health have added evidence for yet another potential benefit for wearers: The humidity created inside the mask may help combat respiratory diseases such as COVID-19. Biophysical Journal

Guidelines in the Works as 'Long-Haul' Patterns Emerge in COVID: Until a clearer picture emerges from larger, prospective, and multicenter studies, experts shared what is known and what evidence remains elusive in a February 12 media briefing sponsored by the Infectious Diseases Society of America. To be considered post-COVID-19 syndrome, symptoms should persist for at least 4 weeks after acute SARS-CoV-2 infection. Many patients, however, experience symptoms lasting 2 to 6 months or longer. Fatigue appears to be most common, followed by dyspnea and other pulmonary complications. Neurologic symptoms, particularly "brain fog" and numbness or tingling throughout the body, as well as mental health challenges including PTSD.

Trump Sicker With COVID-19 Than Portrayed: Former President Donald Trump's condition after being diagnosed with COVID-19 in early October was more worrisome than portrayed for the public, The New York Times reports, citing four unnamed people familiar with his condition. The Times said Trump had lower blood oxygen levels than his doctor reported; that X-rays found lung infiltrates, which can be a sign of an acute case of the virus; and that officials considered putting Trump on a ventilator at one point.

J&J CEO Says People May Need Annual COVID-19 Vaccine Shots for Next Several Years: Johnson & Johnson Chief Executive Officer Alex Gorsky told CNBC that people may need to get vaccinated against COVID-19 annually over the next several years, like seasonal flu shots. "Unfortunately, as (the virus) spreads it can also mutate," he said in an interview "Every time it mutates, it's almost like another click of the dial so to speak where we can see another variant, another mutation that can have an impact on its ability to fend off antibodies or to have a different kind of response not only to a therapeutic but also to a vaccine," he added.

Peginterferon Lambda May Prevent Clinical Deterioration, Shorten Viral Shedding: In outpatients with COVID-19, peginterferon lambda has the potential to prevent clinical deterioration and shorten the duration of viral shedding, according to results of a double-blind, placebo-controlled trial. Reductions in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA were greater with peginterferon lambda than with placebo from day 3 onward in the phase 2 study. The Lancet Respiratory Medicine.

 

Preventive blood thinning drugs linked to reduced risk of death in COVID-19 patients: Patients given preventive blood thinning drugs (prophylactic anticoagulants) within 24 hours of admission to hospital with COVID-19 are less likely to die compared with those who do not receive them, a new study finds. BMJ

 

Do Zinc and Vitamin C Reduce COVID Symptoms?: In this randomized clinical trial of 214 patients with confirmed SARS-CoV-2 infection receiving outpatient care, there was no significant difference in the duration of symptoms among the 4 groups. These findings suggest that treatment with zinc, ascorbic acid, or both does not affect SARS-CoV-2 symptoms. JAMA Network Open

 

Feds to Boost Vaccines Sent to States, Pharmacies: The U.S. government will increase the number of coronavirus vaccine doses sent to the states weekly to 13.5 million while also doubling the number of doses going to pharmacies. "This program will expand access in neighborhoods across the country so that people can call and make an appointment and get their shot conveniently and quickly. Eventually, as supply increases, more than 40,000 pharmacy locations nationwide will be providing COVID vaccines through this program." Medscape

 

Metformin for Diabetes Has No Effect on COVID-19 Infection, Death: Findings were published online February 9 in the Journal of Clinical Endocrinology and Metabolism

 

Asthmatics no higher risk dying from COVID: Review of 57 studies shows people with asthma had a 14% lower risk of getting COVID-19 and were significantly less likely to be hospitalized with the virus. Journal of Asthma

 

Damage to the heart found in more than half of COVID-19 patients discharged from hospital: Around 50 percent of patients who have been hospitalized with severe COVID-19 and who show raised levels of a protein called troponin have damage to their hearts. The injury was detected by magnetic resonance imaging (MRI) scans at least a month after discharge, according to new findings.  European Heart Journal 

 

COVID-19 Not Transmitted by Food or Packaging: There is no evidence you can catch coronavirus through food or food packaging, the FDA and other government agencies said Thursday.

New Data Boost Calls for Single COVID-19 Vaccine Dose: A single dose of the Pfizer/BioNTech vaccine offers 92.6% efficacy in new calculations based on data submitted to the US Food and Drug Administration (FDA), researchers report. Together with previous findings that a single Moderna vaccine dose provides 92.1% efficacy against SARS-CoV-2 infection, investigators propose it is time to defer the second dose to extend protection to more people through single-dose mRNA vaccinations. While some scientists recommend wider vaccination using one dose, other experts disagree, citing that the emergency approval was given based on two doses. Medscape

PAIN

 Pain Patients Who Take Opioids Can’t Get in the Door at Half of Primary CareClinics: People who take opioid medications for chronic pain may have a hard time finding a new primary care clinic that will take them on as a patient if they need one, according to a new “secret shopper” study of hundreds of clinics in nine states across the country. Pain

 

Controlling Pain After Surgery Doesn’t Have to Mean Opioids, Study Shows: Comparison of opioid-sparing approach with standard care shows no difference in patient satisfaction, but less pain among those counseled to use opioids only as backup. JAMA Surgery

 

Alternate type of surgery may prevent total knee replacement: An underused type of knee surgery in younger patients, called high tibial osteotomy, shows considerable success in reducing the need for total knee replacement, according to new research in CMAJ (Canadian Medical Association Journal). "High tibial osteotomy is a knee surgery aimed at younger patients in the earlier stages of knee osteoarthritis. One of its goals is to prevent or delay the need for knee replacement," says coauthor Dr. Trevor Birmingham, Canada Research Chair in the Faculty of Health Sciences and the Bone and Joint Institute at Western University, London, Ontario. "In some ways, it's like performing a front-end alignment on your car to stop asymmetric wear on your tires and increase their longevity."

 

Anti depressants largely ineffective for back pain and osteoarthritis: Antidepressant drugs are largely ineffective for back and osteoarthritis pain, despite being widely used for these conditions, suggests a review of the evidence published by The BMJ.

 

New hope for treating chronic pain without opioids: A new study from the University of Michigan School of Dentistry confirms that a low dose of a drug called naltrexone is a good option for patients with orofacial and chronic pain, without the risk of addiction. The Journal of the American Dental Association

 

COMPLEMENTARY & ALTERNATIVE MEDICINE

Legal cannabis stores linked to fewer opioid deaths in the United States: Access to legal cannabis stores is associated with a reduction in opioid related deaths in the United States, particularly those linked to synthetic opioids such as fentanyl, finds a new study. BMJ

 

 

FDA ACTION

• Approved the first monthly injectable, complete regimen for HIV-infected adults. Cabenuva (cabotegravir and rilpivirine, injectable formulation) is a complete regimen for treatment of HIV-1 and offers an alternative to the current daily oral antiretroviral regimen.

• Warned 10 companies for illegally selling dietary supplements that claim to cure, treat, mitigate, or prevent depression and other mental health disorders, in violation of the Federal Food, Drug, and Cosmetic Act (FD&C Act).

• Approved the Patient Specific Talus Spacer 3D-printed talus implant for humanitarian use. The Patient Specific Talus Spacer is the first in the world and first-of-its-kind implant to replace the talus—the bone in the ankle joint that connects the leg and the foot—for the treatment of avascular necrosis (AVN) of the ankle joint.

• Approved Cosela (trilaciclib) as the first therapy in its class to reduce the frequency of chemotherapy-induced bone marrow suppression in adults receiving certain types of chemotherapy for extensive-stage (when the cancer has spread beyond the lungs) small cell lung cancer.

• Issued emergency authorization of bamlanivimab and etesevimab administered together for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age or older weighing at least 40 kilograms [about 88 pounds]) who test positive for SARS-CoV-2 and who are at high risk for progressing to severe COVID-19.

• Approved Breyanzi (lisocabtagene maraleucel), a cell-based gene therapy to treat adult patients with certain types of large B-cell lymphoma who have not responded to, or who have relapsed after, at least two other types of systemic treatment.

• Authorized marketing of a new prescription only device intended to reduce snoring and mild obstructive sleep apnea. Unlike devices used while patients sleep, this is the first device used while awake that is intended to improve tongue muscle function, which in time can help prevent the tongue from collapsing backwards and obstructing the airway during sleep.

• Placed all alcohol-based hand sanitizers from Mexico on a countrywide import alert to help stop products that appear to be in violation from entering the U.S. until the agency is able to review the products’ safety.

 

PREVENTION: Exercise

Is stretching better than walking for reducing blood pressure? Regular stretching exercises may be more effective than brisk walks for combating hypertension, according to a new study.  The researchers found that 30 minutes of stretching on 5 days of the week led to greater improvements in blood pressure than a 30-minute walk on 5 days of the week. They also stress that people should still do aerobic exercise as it has many health benefits. Journal of Physical Activity and Health.

 

 

PREVENTION: Diet/Nutrition

Study compares low-fat, plant-based diet to low-carb, animal-based diet: People on a low-fat, plant-based diet ate fewer daily calories but had higher insulin and blood glucose levels, compared to when they ate a low-carbohydrate, animal-based diet, according to a small but highly controlled study. The study compared the effects of the two diets on calorie intake, hormone levels, body weight, and more. Nature Medicine

 

Moderate Alcohol Consumption Does Not Up Stroke Risk in A-Fib: For patients with atrial fibrillation (AF), low-to-moderate alcohol intake is not associated with an increased risk for stroke or other cardiovascular events, according to a study published online Jan. 25 in CMAJ .

 

Green Mediterranean diet may reduce risk of fatty liver disease: A form of the Mediterranean diet including more green plant matter may reduce the risk of non-alcoholic fatty liver disease by half, according to a new study The so-called green Mediterranean diet—which includes daily consumption of green tea and an aquatic plant called Mankai, both of which contain beneficial compounds known as polyphenols—was also found to reduce liver fat more than the other two healthy diets tested during the study. Gut

 

Does Intermittent Fasting Work? A new study conducted in the United Kingdom found that restricted eating plans, otherwise known as intermittent fasting, can be just as effective at helping people lose weight compared to other more complicated diets. PLOS One on Jan. 28Trusted Source,

 

Just add mushrooms: Making meals more nutritious: New research , published in Food Science & Nutrition (January 2021) found that adding a mushroom serving to the diet increased the intake of several micronutrients, including shortfall nutrients such as vitamin D, without any increase in calories, sodium or fat.

 

Long-term, heavy coffee consumption and CVD risk: In a world first genetic study, researchers found that that long-term, heavy coffee consumption - six or more cups a day - can increase the amount of lipids (fats) in your blood to significantly heighten your risk of cardiovascular disease (CVD). Clinical Nutrition

 

Eating more refined grains increases risk of heart attack & death: A new study published in The British Medical Journal found consuming a high number of refined grains, such as croissants and white bread, is associated with a higher risk of major cardiovascular disease, stroke and death.

 

Researchers discover energy drinks' harmful effects on heart: Popular energy drinks may give you a boost, but they may also contribute to possible serious heart conditions, findings show. Food and Chemical Toxicology

 

New evidence linking eggs, cholesterol to cardiovascular death: A person's intake of whole eggs and cholesterol was positively associated with their risk of death, while intake of egg whites or egg substitutes was negatively associated with death in a new study. PLOS Medicine

 

Grape consumption may protect against UV damage to skin: A recent human study published in the Journal of the American Academy of Dermatology found that consuming grapes protected against ultraviolet (UV) skin damage.¹ Study subjects showed increased resistance to sunburn and a reduction in markers of UV damage at the cellular level. ² Natural components found in grapes known as polyphenols are thought to be responsible for these beneficial effects.

 

Vegan diet better for weight loss and cholesterol control than Mediterranean diet: A vegan diet is more effective for weight loss than a Mediterranean diet, according to a groundbreaking new study that compared the diets head to head. The randomized crossover trial, which was published in the Journal of the American College of Nutrition, found that a low-fat vegan diet has better outcomes for weight, body composition, insulin sensitivity, and cholesterol levels, compared with a Mediterranean diet.

 

Nanotech plastic packaging could leach silver into some types of foods and beverages: Antimicrobial packaging is being developed to extend the shelf life and safety of foods and beverages. However, there is concern about the transfer of potentially harmful materials, such as silver nanoparticles, from these types of containers to consumables. Now, researchers reporting in ACS Applied Materials & Interfaces illustrate that silver embedded in an antimicrobial plastic can leave the material and form nanoparticles in foods and beverages, particularly in sweet and sugary ones.

 

Experiences of post-traumatic stress disorder (PTSD) linked to nutritional health: A study of factors associated with Post-Traumatic Stress Disorder (PTSD) has led to a number of novel findings linking nutrition to experiences of PTSD. Notable among them is the discovery that Canadians, between the ages of 45 and 85, were less likely to exhibit PTSD if they consumed an average of two to three fiber sources daily. Social Psychiatry and Psychiatric Epidemiology 

 

Role of diet in risk of colorectal cancer: Strong scientific evidence shows that limiting red meat and alcohol consumption, eating foods containing fiber and calcium, consumption of dairy products especially yogurt can help prevent colorectal cancer.  AMA Network Open.

 

PREVENTION: VITAMINS/SUPPLEMENTS

Consuming omega-3 fatty acids could prevent asthma, study suggests: New research suggests that a higher dietary intake of long chain omega-3 fatty acids in childhood may reduce the risk of developing subsequent asthma, but only in children carrying a common gene variant. European Respiratory Journal

 

Vitamin D supplementation: Possible gain in life years combined with cost savings: I n recent years, three meta-analyses of clinical studies have come to the conclusion that vitamin D supplementation was associated with a reduction in the mortality rate from cancer of around 13 percent. Scientists at the German Cancer Research Center (DKFZ) have now transferred these results to the situation in Germany and calculated: If all Germans over the age of 50 were to take vitamin D supplements, up to 30,000 cancer deaths per year could possibly be avoided and more than 300,000 years of life could be gained -- in addition, health care costs could be saved.

 

Use of goldenseal may compromise glucose control in diabetics on metformin: Diabetic patients taking the natural product goldenseal while taking the prescription drug metformin may be unwittingly sabotaging their efforts to maintain healthy blood glucose levels. This concern arose from a recent study published in the journal Clinical Pharmacology & Therapeutics.

 

 

PREVENTION

Opioid Use May Contribute to Risk for Pancreatic Cancer: Opioid use seems to contribute to the increasing incidence of pancreatic cancer (PC) in the United States, according to a study published online Jan. 6 in PLOS ONE.

 

Mental health is important to overall health, and heart disease prevention and treatment: Psychological health can positively or negatively impact a person's health and risk factors for heart disease and stroke, according to "Psychological Health, Well-Being, and the Mind-Heart-Body Connection," a new American Heart Association Scientific Statement, published in Circulation.

 

Long-term stress linked to increased risk of heart attack: A new study reveals that the levels of the stress hormone cortisol were increased in the months preceding a heart attack. The results suggest that long-term stress is a risk factor for heart attacks. Scientific Reports

 

Male sex,BMI, smoking and depression all increase biological age: A combined score of biological aging shows stronger links with physical and mental health than individual indicators. eLife

 

Drinking, smoking, and drug use linked to premature heart disease in the young: Recreational drinking, smoking, and drug use is linked to premature heart disease in young people, particularly younger women, finds research published online in the journal Heart.

 

Working outdoors linked to lower risk of breast cancer among older women: Working outdoors over many years is linked to a lower risk of breast cancer in women after the age of 50, finds research published online in the journal Occupational & Environmental Medicine.

 

Certain factors are linked with an elevated risk of bone fractures: Older age, female sex, higher body mass index, a previous fracture, a family history of fracture after the age of 50 years, low leisure-time physical activity, heavy work, living alone, smoking, and no or high alcohol consumption were factors independently associated with a greater likelihood of experiencing a fracture. Journal of Bone and Mineral Research

 

TREATMENT

Gastrointestinal surgery can be a 'cure' for type 2 diabetes finds new long-term study: The results of a randomized clinical trial with the longest follow up to date show that metabolic surgery is more effective than medications and lifestyle interventions in the long-term control of severe type 2 diabetes. The Lancet

 

Nivolumab effective treatment for malignant mesothelioma: Nivolumab monotherapy is an effective treatment option for relapsed malignant mesothelioma (MM), according to research presented at the International Association for the Study of Lung Cancer World Conference on Lung Cancer.

 

Fecal transplant turns cancer immunotherapy non-responders into responders: Researchers at UPMC Hillman Cancer Center and the National Cancer Institute (NCI) demonstrate that changing the gut microbiome can transform patients with advanced melanoma who never responded to immunotherapy--which has a failure rate of 40% for this type of cancer--into patients who do.

 

'Gamechanger' drug for treating obesity cuts body weight by 20 percent: One third (35%) of people who took a new drug for treating obesity, semaglutide 2.4mg  lost more than one-fifth (greater than or equal to 20%) of their total body weight, according to a major global study involving UCL researchers. NEJM

 

Prostate drug associated with lower risk of Parkinson's disease: Taking a particular type of medication to treat enlarged prostate is associated with a reduced risk of developing Parkinson's disease, according to a large observational study by researchers at the University of Iowa, and colleagues in Denmark and China. The findings, published in JAMA Neurology, suggest that terazosin, and similar medications, might have potential to prevent or delay the development of Parkinson's disease. JAMA Neurology

 

New realm of personalized medicine with brain stimulation: Millions of patients suffering from neurological and mental disorders such as depression, addiction, and chronic pain are treatment-resistant. New research paves the way for a promising alternative: personalized deep brain stimulation. Researchers have found a way to predict what effect electrical stimulation will have on an individual's brain activity across multiple brain regions. The work represents a major step forward in achieving new therapies for a whole host of neurological and mental disorders. Nature Biomedical Engineering

 

Research Finds Link Between Hair Loss Drug Finasteride and Depression: Recent reports suggest a link between use of the anti-baldness medication finasteride (Propecia) and the incidence of depression, including suicidal ideation and other negative health effects among users. Healthline

 

CPAP treatment increases physical activity in adults with sleep apnea, heart disease: A new study found that treating obstructive sleep apnea with CPAP therapy increased self-reported physical activity in adults with a history of heart disease. Journal of Clinical Sleep Medicine

 

Smartwatch sensors enable remote monitoring & treatment guidance for Parkinson's patients: Scientists have developed a monitoring system based on commercial smartwatches that can detect movement issues and tremors in patients with Parkinson's disease. The system gave evaluations that matched a clinician's estimates in 94% of the subjects. The findings suggest the platform could allow clinicians to remotely monitor the progression of a patient's condition and adjust medication plans accordingly to improve outcomes. American Assoc. for the Advancement of Science

 

OTHER

"Prediabetes" diagnosis less useful in older patients: Older adults who are classified as having "prediabetes" due to moderately elevated measures of blood sugar usually don't go on to develop full-blown diabetes. Doctors still consider prediabetes a useful indicator of future diabetes risk in young and middle-aged adults. However, the study, which followed nearly 3,500 older adults, of median age 76, for about six and a half years, suggests that prediabetes is not a useful marker of diabetes risk in people of more advanced age. JAMA Internal Medicine