Journal Watch June 2021

COVID

IBS patients' symptoms improved under COVID-19 lockdown orders Patients' irritable bowel syndrome (IBS) symptoms unexpectedly improved when they were under COVID-19 stay-at-home orders, reaffirming the gut-brain connection in functional gastrointestinal disorders, according to research that was selected for presentation at Digestive Disease Week® (DDW) 2021.

 

Psoriasis Associated With an Increased Risk for COVID-19 in Real-World Study: People with psoriasis have a higher risk of infection with COVID-19 than the general population, but some systemic treatments appear to lower risk in patients, compared with those on topical therapy, a new study finds. American Academy of Dermatology Virtual Meeting Experience

 

COVID Vaccines Protect Against Top Variants, WHO Says; Currently approved vaccines offer protection against he four main coronavirus variants known to exist in the US and Europe. World Health Organization

COVID-19 Immunity Could Last for Years, Studies Say: Immunity to the novel coronavirus could last for a year — and possibly longer — particularly after COVID-19 vaccination, according to  The New York Times . Two recent studies indicate that most people who contracted COVID-19, recovered and then got vaccinated later may not need a booster shot. Those who were never infected and then got vaccinated may need a booster shot later, the newspaper reported. Both studies looked at people who were exposed to COVID-19 about a year ago. In a study published Monday in the journal Nature, scientists found that certain immune cells may survive in the bone marrow of people who were infected and later vaccinated. Those immune cells may create antibodies whenever needed.

Lower Testosterone in Men Tied to Severe COVID Cases: While men have been shown to have greater risk of COVID-19 illness compared with women, a new study shows that the lower the testosterone level in men, the higher the likelihood of severe COVID-19 disease. JAMA Network Open,

Unvaccinated Shouldn't Rely on General COVID-19 Protection: People who haven't received a COVID-19 vaccine shouldn't rely on general protection from those who have been inoculated, according to CNN. Although the U.S. is hitting major vaccination milestones and COVID-19 cases are dropping, those who aren't vaccinated still face high infection risks, medical experts told the news outlet. "The work ahead of us is going to be really challenging because while the people who are fully vaccinated are well protected, we still have to keep on convincing individuals who are not yet vaccinated that they are not safe," Leana Wen, MD, an emergency physician and CNN medical analyst, said this week.

The origin of COVID: Did people or nature open Pandora’s box at Wuhan? - Bulletin of the Atomic Scientists 

 

Vitamin D Supplements May Not Reduce COVID-19 Risk: A new genetic study suggests that giving people extra vitamin D may not protect against coronavirus infection or COVID-19. PLOS Medicine,

 

Getting a Pfizer or Moderna COVID-19 Vaccine Can Drop Your Risk for Infection by 91%: New research from the Centers for Disease Control and Prevention (CDC) has found that the messenger RNA (mRNA) vaccines used against the coronavirus reduce the risk of COVID-19 infection by 91 percent in people who are fully vaccinated. For people who are partially vaccinated, the reduced risk drops to 81 percent. The study, which was released this month as a preprint on MedRxiv, also shows that the vaccines reduce the severity of illness in both fully and partially vaccinated people who develop COVID-19.

 

New study highlights potential role of diet: Healthcare professionals, with heavy exposure to Covid,  eating a plant-based diet were 73% less likely to experience moderate to severe COVID-19, and those following a plant- or fish-based diet were 59% less likely to get seriously ill.

 

Antibody Combo 'Reduces Mortality in Most Vulnerable COVID Patients': An antibody combination has been found to reduce the risk of mortality by 20% when given to seronegative patients hospitalised with severe COVID-19, according to a study preprint. The treatment uses a combination of two monoclonal antibodies, casirivimab and imdevimab (REGEN-COV, Regeneron Pharmaceuticals), that bind specifically to two different sites on the coronavirus spike protein, neutralising the ability of the virus to infect cells.

 

CDC: Delta Variant From India a 'Variant of Concern': The CDC has officially classified the delta variant of the coronavirus as a "variant of concern" to monitor in the U.S. The variant, which was first identified in India and is also known as B.1.617.2, now accounts for 10% of cases in the U.S. and is spreading quickly. The variant led to a surge in cases in India and is prevalent across the U.K., which has led to a delay in reopening. "It's doubling every 2 weeks," Scott Gottlieb, MD, a former FDA commissioner, said on CBS News's Face the Nation on Sunday. The delta variant is more transmissible than other strains and appears to remain contagious for longer periods of time, he said. And I think the risk is really … that this could spike a new epidemic heading into the fall." The Pfizer and Moderna vaccines appear to be about 88% effective against the delta variant after two shots, Gottlieb said. The Johnson & Johnson and AstraZeneca vaccines seem to be about 60% effective, but more studies are needed.

 

Giving Flu and COVID Shots at Same Time Appears Safe, Effective: the NVX-CoV2373 vaccine (Novavax) is showing 89.8% efficacy in an ongoing, placebo-controlled phase 3 study. When the researchers gave a smaller group of 431 volunteers from the same study an influenza shot at the same time, efficacy dropped slightly to 87.5%. The research was published online June 13 as a medRxiv preprint.

COVID May Cause Long-Term Brain Loss: According to the study, researchers in the United Kingdom had access to brain image testing on about 40,000 people that was done before the start of the coronavirus pandemic. In 2021, they asked hundreds of those people to come back for more brain scans. Almost 800 responded. Of those patients, 404 had tested positive for COVID-19, and 394 had usable brain scans that were taken before and after the pandemic. Comparison of the before-and-after brain scans found "significant effects of COVID-19 in the brain with a loss of grey matter" in parts of the brain connected to smell and taste.

More Than 300 Heart Inflammation Cases Reported After Vaccination: More than 20 million adolescents and young adults have been vaccinated in the U.S., the news outlet reported. Although rare, the 300 cases are higher than expected for the age group. Medscape

 

Smell training, not steroids, best treatment for COVID-19 smell loss: Corticosteroids - a class of drug that lowers inflammation in the body - are not recommended to treat smell loss due to Covid-19. Instead, 'smell training' - a process that involves sniffing at least four different odours twice a day for several months- is recommended. International Forum of Allergy & Rhinology

 

 

PAIN

Ibuprofen May Be Superior to Codeine to Manage Postsurgery Pain: According to research published today in the Canadian Medical Association Journal, it appears ibuprofen is more effective than codeine for managing pain after surgery. Ibuprofen also appears to have fewer side effects than codeine, which is an opioid, and it along with other nonsteroidal anti-inflammatory drugs (NSAIDs) do not pose the potential for dependence as codeine may. “We found high-quality evidence that outpatient postoperative adults taking NSAIDs reported less pain at 6 and 12 hours than those taking codeine in a meta-analysis of RCTs,” the researchers wrote.

 

Many surgery patients get opioid prescriptions, but many don't need to, study suggests: Effective pain control with equal short-term outcomes and patient satisfaction seen in patients who got non-opioid pain medication. The team behind the study has also produced a free, evidence-based guide for surgeons and other acute care providers, to help them treat patients' pain without the risk of persistent use that opioids carry. The new study is published in the Annals of Surgery by a team from Michigan Medicine

 

People with back pain miss far fewer workdays when they receive recommended treatments: People with lower back pain injury miss 11 more days of work in a year when they only receive treatments for lower back pain that are not recommended by medical guidelines compared to people treated according to guidelines. The findings publish in PLOS ONE on June 17. 

 

Study examines care received by patients with knee osteoarthritis: New research reveals that only a minority of U.S. Medicare beneficiaries with knee osteoarthritis in 2005-2010 used non-surgical care such as physical therapy and knee injections, and few were treated by rheumatologists, physiatrists, or pain specialists. The study, which is published in Arthritis & Rheumatology, also found that non-surgical care was more common in regions with low rates of knee replacement surgery.

 

Disparities in treatment persist for people with headache: Disparities exist in the treatment of people with headache disorders because of race and ethnicity, socioeconomic status and geography, according to a review article published in the June 9, 2021, online issue of Neurology 

 

Higher incidence of carpal tunnel syndrome after bilateral oophorectomy: New study suggests the risk of severe carpal tunnel syndrome increases for women after surgery to remove the fallopian tubes and ovaries. Menopause

The use of couple therapy to reduce pain during intercourse : Provoked vestibulodynia is a condition experienced by approximately 8% of women in North America. It is characterized by severe pain at the vaginal opening during sexual intercourse or when inserting tampons. To reduce the burning sensation, many women apply lidocaine, an anesthetic cream. A new study of 108 couples found cognitive-behavioural therapy (CBT) for couples to be more effective than lidocaine. 

Autologous adipose injection for shoulder pain in wheelchair users with spinal cord injury: Pilot study of micro-fragmented adipose tissue injection suggests that the biologic is an effective treatment option for wheelchair users with chronic shoulder pain 

 

 

COMPLEMENTARY & ALTERNATIVE MEDICINE

Complementary Health Approaches for Hypertension: NCCIH Clinical Digest

 

Tai chi shows promise for relief of depression and anxiety in stroke survivors: A small feasibility study has suggested that tai chi has the potential to reduce depression, anxiety and stress plus improve sleep in people who have had a stroke. EuroHeartCare - ACNAP Congress 2021

 

Olfactory virtual realities show promise for mental health practices and integrative care  Study shows that scent-enhanced virtual reality technologies, or OVR, can be a safe and effective integrative approach to target anxiety, stress, and pain when combined with standard inpatient psychiatric care Journal of Medical Research and Health Sciences

 

Team describes science-based hiccups intervention: The forced inspiratory suction and swallow tool was found to be 92% effective. FISST is a rigid drinking tube with an inlet valve that requires forceful suction to draw water from a cup into the mouth. The suction and swallow simultaneously stimulate two nerves, the phrenic and vagus nerves, to relieve hiccups. JAMA Network Open 

 

The 'Mozart effect' shown to reduce epileptic brain activity, new research reveals: Music by Mozart has been shown to have an anti-epileptic effect on the brain and may be a possible treatment to prevent epileptic seizures, according to new research presented today at the 7th Congress of the European Academy of Neurology (EAN) 

 

Commercial video games could help treat mental illness: Playing video games may provide low-cost, easy access, effective and stigma-free support JMIR Serious Games

 

Tick for insomnia treatment: If insomnia keeps you awake at night, Flinders University researchers recommend a trip to the doctor - not for a sleeping pill prescription but for a short course of intensive cognitive behavioral therapy (CBT). CBT improves insomnia, mental health and quality of life, and can be more successful than sleeping pills. Australian Journal of General Practice

 

Earlier sleep timing associated with lower depression risk, new study suggests: People who tend to go to bed and wake up earlier have significantly lower risk of major depression, according to a sweeping new genetic study. JAMA Psychiatry

 

FDA ACTION

• Approved a nasal antihistamine, Astepro, for nonprescription use through a process called a partial prescription to nonprescription switch.

• Approved StrataGraft for the treatment of adult patients with thermal burns

• Approved Ryplazim (plasminogen, human-tvmh) for the treatment of patients with plasminogen deficiency type 1, also referred to as hypoplasminogenemia

• Approved Wegovy (semaglutide) injection (2.4 mg once weekly) for chronic weight management in adults with obesity or overweight

• Approved Lumakras (sotorasib) as the first treatment for adult patients with non-small cell lung cancer

• Approved Rybrevant (amivantamab-vmjw) as the first treatment for adult patients with non-small cell lung cancer

• Approves Nivolumab after surgery for esophageal or GEJ cancer

• Approved emergency use for Sotrovimab for patients 12+ hospitalized with COVID-19 or require oxygen therapy

• Approved Aducanumab for Alzheimer’s Disease

 

PREVENTION: Exercise

Walking an Extra 1,000 Steps May Increase Your Life Span: A study presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Conference, found that people who took more steps each day had a significantly lower risk of death than those who were less active. The health benefits were consistent among people who walked in uninterrupted sessions and those who walked in short spurts. You don’t need to commit to lengthy strolls each day to improve your health. Squeezing in spurts of steps through everyday activities has the same health benefits. They identified a 32 percent decrease in death among those who took at least 2,000 steps a day. The health benefits plateaued around 4,500 daily steps

 

Exercise likely to be best treatment for depression in coronary heart disease: A study by RCSI indicates that exercise is probably the most effective short-term treatment for depression in people with coronary heart disease, when compared to antidepressants and psychotherapy or more complex care. Psychosomatic Medicine

 

Study finds association between head impacts and imaging changes in youth football players: Study finds association between head impacts and imaging changes in youth football players. Journal of Neurosurgery: Pediatrics

 

High-intensitystrength and impact training attenuates skeletal aging: Regular strength and impact-type training may decrease or even prevent age-related bone deterioration in men.

 

PREVENTION: Vitamins/Supplements

Nutritional supplement proves 92% effective in boosting brain function: An international subject pool was studied to confirm the effectiveness of a whole food complete vitamin and meal replacement product, IQed. The findings indicate that the carefully developed nutritional supplement, IQed Smart Nutrition, can help bolster key functions for people with a wide range of prevalent diagnoses including Autism, Apraxia, and ADHD, and other obscure, but equally challenging, diagnoses encompassing speech and motor processing disorders.   Alternative Therapies

 

Vitamin D and Breast Cancer Survival: Having enough vitamin D at the time of diagnosis is associated with better breast cancer outcomes according to a new study highlighted at the American Society of Clinical Oncology 2021 virtual annual meeting. Experts say most people in the United States don’t have sufficient vitamin D levels because only a few foods contain the mineral naturally. They add that vitamin D supplementation is necessary for only certain groups of people, including post-menopausal women, those on long-term steroids, older adults, expectant and breastfeeding women, those with chronic kidney disease, parathyroid disease or obesity.

 

Could Fish Oil Supplements Help Fight Depression? In a study of 22 people with major depression, Treatment with both omega-3s was associated with a significant improvement in depression, with an average 64% drop in symptoms for the EPA group and 71% in the DHA group. It does not prove cause-and-effect, however. Molecular Psychiatry

 

 

PREVENTION: Diet/Nutrition

There’s No Safe Dose of Alcohol: According to a recent study by a group of scientists at Oxford University in England, there’s no safe dose for alcohol consumption.  The observational study looked at data from more than 25,000 middle-aged adults. The study found that moderate consumption is more closely associated with adverse effects on the brain than was previously known. They found that alcohol was negatively associated with global brain gray matter volume. Also, individuals with comorbidities like high blood pressure and a high BMI, or those who binge drink, may be more susceptible to these adverse effects.

 

Caffeine Can Only Help So Much If You Don’t Get Enough Sleep: Experts say caffeine can help you stay awake if you’re sleep deprived, but it probably won’t improve your performance on tasks. They say caffeine is not a substitute for a good night’s sleep, which helps repair tissue and cleanse the brain. They note that too much caffeine can also disrupt sleep patterns.  studyTrusted Source Journal of Experimental Psychology: Learning, Memory, & Cognition

 

Spice Up Your Diet. It’s Good for Your Heart: Two new studies have found that consuming herbs and spices can help promote better cardiovascular health. One study found that adding herbs and spices to meals may help reduce blood pressure in people at risk of heart disease.  The other study linked spice supplements (ginger, cinnamon, turmeric, curcumin, or curcuminoid supplements)  to lower cholesterol levels in people with type 2 diabetes. NUTRITION 2021 Live Online

 

2 Servings of Fruit a Day Can Lower Your Risk of Type 2 Diabetes: Researchers say you can lower your risk of type 2 diabetes by eating two servings of fruit per day.People who eat fruit can lower their blood glucose levels without producing as much insulin. Fruit juice doesn’t produce as many benefits as consuming whole fruits. Journal of Clinical Endocrinology & Metabolism

 

Case study shows patient on ketogenic diet living fully with IDH1-mutant glioblastoma: A British man who rejected the standard of care to treat his brain cancer has lived with the typically fatal glioblastoma tumor growing very slowly after adopting a ketogenic diet, providing a case study that researchers say reflects the benefits of using the body's own metabolism to fight this particularly aggressive cancer instead of chemo and radiation therapy. Frontiers in Nutrition 

 

High caffeine consumption may be associated with increased risk of blinding eyedisease: Consuming large amounts of daily caffeine may increase the risk of glaucoma more than three-fold for those with a genetic predisposition to higher eye pressure according to an international, multi-center study. Ophthalmology

 

People Who Skip Breakfast Miss Vital Nutrients, Snack More: A new study from researchers at The Ohio State University shows that regularly skipping breakfast may be a bad idea. Foods that are commonly eaten for breakfast don’t tend to be eaten at other times of the day. This can lead to underconsumption of the nutrients that they contain.  In addition, people who skip breakfast tend to snack more, especially on sugars, carbohydrates, and fat. Experts say that it’s important to start your day with good nutritional choices, regardless of what you eat.

 

Traditional Diet Gets Rid of More Fat Tissue Than Intermittent Fasting, Study Finds

 

'MIND' Diet Can Help Preserve Brain in People With MS: Those who ate more of the "good" foods from a brain-health eating regimen known as the MIND diet and fewer "bad" ones tended to have more preserved tissue in a critical relay station in the brain called the thalamus. The study also found a link between eating more full-fat dairy products and fewer MS brain lesions. Eating omega-3 fatty acids from fish also had brain benefits. The MIND diet combines aspects of the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet. Foods considered "good" include leafy vegetables, berries, nuts and fish, and those considered "bad" include fried foods, butter, cheese, red and processed meats and sweets. MS and Related Disorders.

 

PREVENTION

SPRINT studyconfirms controlled blood pressure important in preventing heart disease and stroke: Follow-up data from the landmark SPRINT study of the effect of high blood pressure on cardiovascular disease have confirmed that aggressive blood pressure management -- lowering systolic blood pressure to less than 120 mm Hg -- dramatically reduces the risk of heart disease, stroke, and death from these diseases, as well as death from all causes, compared to lowering systolic blood pressure to less than 140 mm Hg. NEJM

 

Can Too Much Work Increase Your Risk of Death? a recent reportTrusted Source released by the World Health Organization and the International Labour Organization says that overwork led to 745,000 deaths from stroke and heart disease in 2016. To make matters worse, that’s an increase of 29 percent since the year 2000.  Working over 55 hours is associated with an increased risk of death. But experts say that a certain number of hours worked doesn’t always mean someone is overworked. Instead, they say to look for signs that work is exhausting you and affecting your health.  If you’re in a job that is negatively impacting your health, there are ways to improve your mental health even if you don’t switch jobs.

 

Poor oral health linked to muscle loss and diabetes: A longitudinal study found that “oral frailty,” a measure that includes the number of remaining teeth, chewing ability, and difficulties eating and swallowing, was a risk factor for physical frailty, disability, and mortality from all causes. PLOS ONETrusted Source.

 

Study Finds ‘Forever Chemicals’ Common in Cosmetics: A new study found that almost half of the cosmetic products tested in contain potentially harmful chemicals. These chemicals, called per- and polyfluoroalkyl substances (PFAS), have been linked in early research to cancer, reproductive harm, and damage to the immune system. PFAS are often used to increase a product’s durability, spreadability, and wear. The study, published by the American Chemical Society, looked at more than 200 products in the United States and Canada and found the highest levels of these chemicals in everyday personal care products, including lipstick, mascara, and foundation.

 

Have trouble sleeping? You're at higher risk of dying, especially if you have diabetes: Having trouble falling or staying asleep may leave you feeling tired and frustrated. It also could subtract years from your life expectancy, according to a new study from Northwestern Medicine and the University of Surrey in the United Kingdom (UK).  The effect was even greater for people with diabetes who experienced sleep disturbances, the study found. Journal of Sleep Research

 

TREATMENT

Personalized medicine, not X-rays, should guide forearm fracture treatment in older adults: A decade-long study of the most common forearm fracture in older adults revealed that personalized medicine catering to a patient's individual needs and environment, not age or X-rays, should guide treatment options. JAMA Network Open

New drug to halt dementia after multiple head injuries: A world-first international study led by the University of South Australia has identified a new drug to stop athletes developing dementia after sustaining repeated head injuries in their career. Scientific Reports

 

Treating sleep apnea with CPAP therapy is associated with lower risk of heart problems: Findings from a recent study show that patients with untreated, moderate to severe obstructive sleep apnea had a higher risk of experiencing a cardiovascular event, but the risk of incident heart problems was decreased in those who used CPAP therapy.

 

 

OTHER

Routine Testing Before Surgery Remains Common Despite Low Value: A wealth of evidence suggests these tests are often unnecessary, costly, and can lead to adverse effects. Before undergoing surgery, patients often go through a number of tests: blood work, sometimes a chest X-ray, perhaps tests to measure heart and lung function. plenty of evidence suggests that preoperative testing is often unnecessary for low-risk surgeries.  At best, it’s costly and doesn’t usually improve outcomes for patients. At worst, it can lead to more invasive testing and delay surgery, which can create complications that could have been avoided if the tests weren’t done. JAMA Internal Medicine

 

Human health 'intricately linked' to ocean health: In a new report, a team of researchers argues that the world’s ocean is “intricately linked” to human health. As a consequence, repairing the human-influenced damage done to the ocean will also benefit human health. In the paper, which appears in the American Journal of Public Health, the authors say that restoring the health of oceans should not just be the priority of marine scientists but also the medical community and the public more broadly.

 

Supreme Court Upholds Affordable Care Act: On Thursday, in a 7-2 vote, the US Supreme court upheld the Affordable Care Act.