Journal Watch April 2021

COVID

CDC Panel Leaves J&J Pause in Place for at Least a Week: On Tuesday, the CDC and the FDA recommended that Johnson & Johnson vaccinations be paused after reports of blood clots in six patients among the more than 7 million people who had received the Johnson & Johnson vaccine in the United States. The following day, the CDC’s Advisory Committee on Immunization Practices decided it did not have adequate information to change the current paused status of the J & J vaccine.

 

Several Vaccine Sites Pause Johnson & Johnson Shot After Adverse Reactions: Three vaccination sites in North Carolina closed temporarily after several people had immediate reactions. Sites in Colorado, Georgia, and Iowa also paused after multiple people reported adverse reactions. Nausea, fainting, dizziness, light headedness and rapid breathing. The CDC investigated the vaccine lots and hasn't found any reason for concern. The Associated Press.

 

 COVID-19 Can Cause Atypical Thyroid Inflammation: Individuals who experience inflammation of the thyroid gland during acute COVID-19 illness may still have subacute thyroiditis. months later even if thyroid function has normalized, new research suggests. Furthermore, the thyroiditis eems to be different from thyroid inflammation caused by other viruses. ENDO 2021 meeting

Progesterone Eases Severe COVID-19 in Hospitalized Men: Women hospitalized with severe COVID-19 generally do better than men, which led to the notion that perhaps men hospitalized for COVID-19 could be treated with female hormones. This concept has shown "very encouraging" results in a single-center, US pilot study that randomized 42 men hospitalized for severe COVID-19. Those who received up to 5 days of treatment with injected progesterone had significantly better outcomes than those who received standard of care, researchers report in Chest.

Flu Shot Associated With Fewer, Less Severe COVID Cases: People who received a flu shot last flu season were significantly less likely to test positive for a COVID-19 infection when the pandemic hit, according to a new study. And those who did test positive for COVID-19 had fewer complications if they received their flu shot. American Journal of Infection Control

 

Evidence supports COVID-19 hearing loss link: Hearing loss and other auditory problems are strongly associated with COVID-19, according to a systematic review of research evidence. International Journal of Audiology, 2021 

 

Clinical Trials Planned for Oral COVID Vaccine: A coronavirus vaccine that could be taken as a pill may enter clinical trials in the second quarter of 2021. The oral vaccine is being developed by Oravax Medical, a new joint venture of  the Israeli-American company Oramed and the Indian company Premas Biotech, Business Insider reported. 

 

Neurologic Symptoms Frequent in Nonhospitalized COVID Long-Haulers: Cognitive dysfunction tops the list of neurologic complaints in long-haul COVID-19 patients whose illness wasn't severe enough for them to be hospitalized, but it isn't the only problem, new research shows. Researchers who tracked 100 COVID-19 long-haul, nonhospitalized patients from May to November found 85% reported four or more neurologic symptoms. published online  Annals of Clinical and Translational Neurology.

 

Vitamin D May Protect Against COVID-19, Especially in Blacks: Higher levels of Vitamin D than traditionally considered sufficient may help prevent COVID-19 infection — particularly in Black patients, shows a new single-center, retrospective study looking at the role of vitamin D in prevention of infection. The study, published recently in JAMA Network Open, notes that expert opinion varies as to what "sufficient" levels of vitamin D are, some define this as 30 ng/mL, while others cite 40 ng/mL or greater. Results show: "Risk of positive COVID-19 test results decreased significantly with increased vitamin D level of 30 ng/mL or greater when measured as a continuous variable."

 

Women in 40s, 50s Who Survive COVID More Likely to Suffer Persistent Problems: UK Studies: Women in their 40s and 50s appear more at risk of long-term problems following discharge from hospital after COVID-19, with many suffering months of persistent symptoms such as fatigue, breathlessness and brain fog, two UK studies found. Medscape

 

COVID Vaccine Found Highly Effective in Real-World US Study: The U.S government's first look at the real-world use of COVID-19 vaccines found their effectiveness was nearly as robust as it was in controlled studies. The two vaccines available since December — Pfizer and Moderna — were 90% effective after two doses, the Centers for Disease Control and Prevention reported Monday. In testing, the vaccines were about 95% effective in preventing COVID-19. Medscape 

 

Pfizer Asks FDA to Extend Use of COVID Vaccine to Ages 12–15: The request follows the March 31 announcement of a successful phase 3 deescalation study involving 2260 children and adolescents aged 12 to 15.

 

Fauci Thanks US Health Workers for Sacrifices but Admits PPE Shortages Drove Up Death Toll: Dr. Anthony Fauci thanked America's health care workers, who "every single day put themselves at risk" during the pandemic, even as he acknowledged that PPE shortages had contributed to the deaths of more than 3,600 of them. Medscape 

Clinical Trials Mix Vaccine Types to Boost COVID Protection: Combining different vaccine platforms — known as a heterologous prime-boost strategy — likely enhances immunity, according to Ross Kedl, PhD, from the University of Colorado in Aurora.The strategy has been used in animal studies for decades, "and it is well known that this promotes a much better immune response than when immunizing with the same vaccine twice," Medscape 

Skin Reactions to COVID Vaccines Aren't Dangerous, Study Says: The Pfizer/BioNTech and Moderna coronavirus vaccines can cause several kinds of skin reactions, but these reactions go away quickly and aren't dangerous, according to a study published in the Journal of the American Academy of Dermatology.

 

'Beyond a Reasonable Doubt': COVID-19 Brain Health Fallout Is Real, Severe: In what is purported to be the largest study of its kind to-date, results showed that among 236,379 COVID-19 patients, one third were diagnosed with at least one of 14 psychiatric or neurologic disorders within a 6-month span. published online April 6 in The Lancet Psychiatry.

 

UK Variant Now the Dominant COVID-19 Strain In US: The highly transmissible and deadly U.K. coronavirus strain, B.1.1.7, is now the most common form of COVID-19 in the United States, said Rochelle Walensky, MD, director of the Centers for Disease Control and Prevention. Medscape

 

Antibody Persistence through 6 Months after the Second Dose of Moderna: According to a study  in the New England Journal of Medicine, antibodies from the Moderna vaccine remained high among 33 adults of varying ages six months after the second dose. Although the study only looked at Moderna's vaccine, Fauci said "there's every reason to believe that similar results will be seen with the Pfizer as well as the J&J."

Pfizer COVID-19 Vaccine Protects for 6 Months or More: The Pfizer/BioNTech COVID-19 vaccine affords at least 6 months of protection after the second dose, the companies. Furthermore, data released today show that the vaccine affords 100% protection against severe COVID-19, as defined by the US Centers for Disease Control and Protection. The vaccine was likewise effective in preventing COVID-19 in South Africa, where the variant of concern B.1.351 was first identified. Medscape https://www.medscape.com/viewarticle/948575

Pfizer, Moderna Say Booster Shots Probably Needed: People who've received both doses of the Pfizer-BioNTech or Moderna coronavirus vaccines will probably need a booster shot this year, top executives for those two pharmaceutical companies said this week. Medscape 

 

COVID-19 Third Leading Cause of US Deaths in 2020 After Heart Disease, Cancer: COVID-19 was the primary or contributing cause of 378,048 deaths in the United States last year, with a particularly high toll among the elderly, according to two reports released in the U.S.

 

Risk for Erectile Dysfunction (ED) Sixfold Higher in Men With COVID-19: Covid increases the risk of developing ED and is also a marker of increased susceptibility to the infection. The study was published on 20 March in Andrology

 

The Pandemic is Making Periods Unbearable for Some Women: Following a recent article in The Guardian, the internet erupted with tales of periods gone awry. The stress and loss of normalcy over the last year appears to have altered cycles and amplified the premenstrual syndrome (PMS) symptoms many women experience. And after the piece published, many responded on social media with the same sentiment: "So, it's not just me?"

 

Post-COVID Wave Ahead of Death, Disability From Chronic Disease: As a result of the COVID-19 pandemic, the United States will likely face a tsunami of death and disability from common chronic diseases that will affect society for decades, Robert Califf, MD, former commissioner of the US Food and Drug Administration (FDA), writes in an article published today in Circulation.

 

Keep Your COVID-19 Vaccine Card Safe But Don’t Laminate It. Here’s Why. Healthline

Corticosteroid Budesonide 'Shortens COVID-19 Recovery Time': Treatment with the inhaled corticosteroid budesonide was found to shorten recovery time from COVID-19 in those at risk of adverse outcomes by a median of 3 days, preliminary trial results showed. The results come from the Platform Randomised Trial of Interventions against COVID-19 in Older People (PRINCIPLE) trial by the University of Oxford.

Public Health Approach of Ayurveda and Yoga for COVID-19 Prophylaxis Journal of Alternative and Complementary Medicine

 

More Exercise Linked to Lower Chance of Severe COVID-19: People who exercised regularly and then tested positive for SARS-CoV-2 were less likely to experience more severe COVID-19 outcomes, a new study shows. Compared with the most active people in the study — those who exercised 150 minutes or more every week — patients with COVID-19 who were "consistently inactive" were 226% more likely to be hospitalized, 173% more likely to be admitted to an intensive care unit (ICU), and 149% more likely to die in the study. The study was published online April 13 in the British Journal of Sports Medicine.

 

 

PAIN

Total knee replacement a cost-effective treatment for patients with knee osteoarthritis: Knee osteoarthritis is a painful condition that affects over 14 million U.S. adults, many of whom have extreme obesity, defined by body mass index (BMI) greater than 40kg/m2. Total knee replacement (TKR) is often recommended to treat advanced knee osteoarthritis, but surgeons may be hesitant to operate on patients with extreme obesity due to concerns about the increased risks of tissue infection, poor wound healing and higher risk of implant failure. Using an established, validated and widely published computer simulation called the Osteoarthritis Policy (OAPol) Model, researchers from Brigham and Women's Hospital, together with collaborators from Yale and Boston University Schools of Medicine, quantified the tradeoff between the benefits and adverse events, taking into consideration costs of forgoing versus pursuing TKR. They found that across older and younger age groups, TKR is a cost-effective treatment for these patients. Annals of Internal Medicine 

 

New proposal for the management of low back pain with a proprioceptive approach: Low back pain in the elderly is the result of poor 'proprioception,' or the body's ability to perceive its own position in space, caused by a deterioration of sensory receptors in their muscles called proprioceptors. In a new study, researchers demonstrate a protocol for the management of low back pain by diagnosing and activating impaired proprioceptors with localized vibratory stimulations, crowning an approach that can enable elderly people to lead better lives. Electronics, 2021

 

Doubling down on headache pain: It's not uncommon for people who experience a concussion to have moderate to severe headaches in the weeks after the injury. A new study has found a combination of two drugs, Metoclopramide and Diphenhydramine, both common anti-nausea medications, given intravenously in the emergency room may relieve those headaches better than a placebo. Neurology

 

COMPLEMENTARY & ALTERNATIVE MEDICINE

Transcendental Meditation effective in reducing PTSD, sleep problems, depression symptoms: Veterans with PTSD who practiced the Transcendental Meditation technique showed significant reductions in PTSD symptom severity, according to a new study published today in Journal of Traumatic Stress

 

Fighting dementia with play: A clinical study carried out in Belgium has now shown for the first time that cognitive motor training improves both the cognitive and physical skills of significantly impaired dementia patients. A fitness game, known as "Exergame," developed by the ETH spin-off Dividat was used in the study. Alzheimer's Research & Therapy,

 

Early cannabis use linked to heart disease: Smoking cannabis when you're young may increase your risk of developing heart disease later, according to a recent study. Journal of Applied Physiology

 

 

FDA ACTION

• Issued an emergency use authorization (EUA) for a screening device that identifies biomarkers that may indicate asymptomatic SARS-CoV-2 infection in people ages 5 and older.

• Authorized marketing of the GI Genius, the first device that uses artificial intelligence (AI) based on machine learning to assist clinicians in detecting lesions (such as polyps or suspected tumors) in the colon in real time during a colonoscopy.

• Issued an emergency authorization for the Symbiotica COVID-19 Self-Collected Antibody Test System, the first antibody test authorized for use with home collected dried blood spot samples.

• Approved Abecma (idecabtagene vicleucel), a cell-based gene therapy to treat adult patients with multiple myeloma who have not responded to, or whose disease has returned after, at least four prior lines (different types) of therapy.

• Authorized marketing of Portable Neuromodulation Stimulator (PoNS)

 a new device indicated for use as a short-term treatment of gait deficit due to mild to moderate symptoms from multiple sclerosis (MS).

• Approved the first in the world non-surgical heart valve to treat pediatric and adult patients with a native or surgically-repaired right ventricular outflow tract (RVOT), the part of the heart that carries blood out of the right ventricle to the lungs.

• Approved a new indication for Myrbetriq (mirabegron extended-release tablets) and Myrbetriq Granules (mirabegron for extended-release oral suspension) to treat neurogenic detrusor overactivity (NDO), a bladder dysfunction related to neurological impairment, in children ages three years and older.

• Issued warning letters to two companies for selling products labeled as containing cannabidiol (CBD) in ways that violate the Federal Food, Drug, and Cosmetic Act (FD&C Act).

 

PREVENTION: Exercise

Exercise boosts blood flow to the brain: The results add to growing evidence that exercise programs may help older adults slow the onset of memory loss and dementia. It's not just your legs and heart that get a workout when you walk briskly; exercise affects your brain as well. A new study shows that when older adults with mild memory loss followed an exercise program for a year, the blood flow to their brains increased. Journal of Alzheimer's Disease

 

A strong coffee half an hour before exercising increases fat-burning

Drinking a strong coffee half an hour before exercising increases fat-burning, new study finds In the afternoon, the effects of the caffeine are more marked than in the morning. Journal of the International Society of Sports Nutrition

 

Exercise can improve sleep quality even when you don't perceive a difference: In a study in Scientific Reports, researchers revealed that vigorous exercise was able to modulate various sleep parameters associated with improved sleep, without affecting subjective reports regarding sleep quality. "The results of the subjective evaluations of sleep quality indicate that regular moderate exercise may be more beneficial for perceived sleep quality than occasional vigorous exercise, which might not have a subjective effect despite objective improvements in sleep."

 

Leisure physical activity is linked with health benefits but work activity is not: The first large study showing that leisure time physical activity and occupational physical activity have opposite, and independent, associations with cardiovascular disease risk and longevity. "A brisk 30-minute walk will benefit your health by raising your heart rate and improving your cardiorespiratory fitness, while work activity often does not sufficiently increase heart rate to improve fitness. In addition, work involving lifting for several hours a day increases blood pressure for many hours, which is linked with heart disease risk, while short bursts of intense physical activity during leisure raises blood pressure only briefly." European Heart Journal, 2021

 

Major risk of injury for recreational runners: Almost half of all recreational runners incur injuries, mostly relating to knees, calves or Achilles tendons, and the level of risk is equally high whatever your age, gender or running experience. University of Gothenburg.

To combat gum disease, help oral bacteria evolve: For people with non-alcoholic fatty liver disease, exercise not only improves physiology, it may also improve their smile--by reducing gum disease. International Journal of Environmental Research and Public Health

 

Want to be robust at 40-plus? Meeting minimum exercise guidelines won't cut it: 5 hours of moderate activity a week may be required to avoid midlife hypertension, UCSF-led study shows American Journal of Preventive Medicine 

 

Heart patients advised to move more to avoid heart attacks and strokes: Elevated blood pressure, high cholesterol and diabetes increase the risk of heart disease. But a large study today reveals that in people with these conditions, increasing activity levels is associated with a reduced likelihood of heart events and mortality. ESC Preventive Cardiology 2021

 

PREVENTION: Diet/Nutrition

Eating processed meat could increase dementia risk: Scientists used data from 500,000 people, discovering that consuming a 25g serving of processed meat a day, the equivalent to one rasher of bacon, is associated with a 44% increased risk of developing the disease. But their findings also show eating some unprocessed red meat, such as beef, pork or veal, could be protective, as people who consumed 50g a day were 19% less likely to develop dementia. American Journal of Clinical Nutrition

 

Frequent consumption of meals prepared away from home associated with an increased risk of death: Investigators looked at the association between eating out and risk of death and concluded that eating out very frequently is significantly associated with an increased risk of all-cause death, which warrants further investigation. Journal of the Academy of Nutrition and Dietetics. 

 

Cocoa may protect males' hearts from the effects of mental stress: New research suggests a cup of cocoa can have cardiovascular benefits for males. Nutrients.

 

Study strengthens links between red meat and heart disease: An observational study in nearly 20,000 individuals has found that greater intake of red and processed meat is associated with worse heart function. ESC Preventive Cardiology 2021

 

Mediterranean diet with lean beef may lower risk factors for heart disease

In a randomized controlled study, researchers found that a Mediterranean diet combined with small portions of lean beef helped lower risk factors for developing heart disease, such as LDL cholesterol. American Journal of Clinical Nutrition 

 

PREVENTION

Stress from work and social interactions put women at higher coronary heart disease risk: Psychosocial stress - typically resulting from difficulty coping with challenging environments - may work synergistically to put women at significantly higher risk of developing coronary heart disease, according to a new study. Journal of the American Heart Association

 

Carcinogen Reportedly Found in Hand Sanitizer: How to Avoid It: Healthline

 

 

 

TREATMENT

Weekly insulin helps patients with type 2 diabetes achieve similar blood sugar control to daily insulin: A new once-weekly basal insulin injection demonstrated similar efficacy and safety and a lower rate of low blood sugar episodes compared with a daily basal insulin, according to a phase 2 clinical trial. The study results compared an investigational drug called basal insulin Fc (BIF) with insulin degludec, a commercially available long-lasting daily insulin, in patients with type 2 diabetes. Endocrine Society

 

Viagra May Help Men with Coronary Artery Disease Live Longer: New research from Sweden finds that the impotence drug sildenafil (Viagra) can significantly reduce the risk of another heart attack and increase the life span in men already diagnosed with cardiovascular disease. Experts also say the heart benefit that was observed might be because drugs like sildenafil reduce blood pressure, a strong risk factor for heart disease.

More research is needed to verify the findings. published in the Journal of the American College of Cardiology (ACC).

 

Treating Sleep Apnea May Reduce Dementia Risk: People with obstructive sleep apnea who treat their apnea with the commonly-prescribed positive airway pressure therapy were less likely to be diagnosed with dementia. Sleep

 

Exercise training for bronchiectasis: A meta analysis found that For people with stable bronchiectasis, evidence suggests that exercise training compared to usual care improves functional exercise tolerance as measured by the incremental shuttle walk distance. Chochrane Library

 

Systemic pharmacological treatments for chronic plaque psoriasis: A network meta‐analysis: review shows that compared to placebo, the biologics infliximab, ixekizumab, risankizumab, bimekizumab, guselkumab, secukinumab and brodalumab were the best choices for achieving PASI 90 in people with moderate‐to‐severe psoriasis on the basis of moderate‐ to high‐certainty evidence (low‐certainty evidence for bimekizumab). Cochrane Library

 

Antidepressants for people with epilepsy and depression: Existing evidence on the effectiveness of antidepressants in treating depressive symptoms associated with epilepsy is still very limited. Rates of response to antidepressants were highly variable. Cochrane Library 

 

Do peoplewith asthma have fewer serious adverse events when taking formoterol and inhaled corticosteroids compared to salmeterol and inhaled corticosteroids? Meta-analysis found no safety issues that would affect the choice between salmeterol and formoterol combination inhalers used for regular maintenance therapy in adults and children with asthma. Cochrane Library

 

There is no 'one size fits all' approach to treat severe asthma: Despite a similar clinical presentation, people with severe asthma have strikingly distinct immune profiles, research shows. These findings can be used to develop new therapeutics and enhance precision medicine approaches to treating these patients. Cell Reports

 

OTHER

Can Biden’s Push for a Public Option Lower Your Healthcare Costs? In Biden’s campaign he proposed a new public option that would provide an alternative to private insurance for Americans who are not eligible for Medicare or Medicaid. The effects of a public option would depend on the details of the plan. In general, payment rates are expected to be lower under a public option than most commercial insurers.Healthline 

 

Why some of us are hungry all the time: New research shows that people who experience big dips in blood sugar levels, several hours after eating, end up feeling hungrier and consuming hundreds more calories during the day than others. Nature Metabolism