Journal Watch : October 2021

COVID

FDA panel endorses lower-dose Moderna COVID shot for booster 

and backs J&J COVID vaccine booster.  The final decision on both Moderna and J&J is up to the FDA, but in general they follow the recommendations of the expert panel. The half dose Moderna is recommended six months after the second dose, while J & J is recommended 2 months after the initial dose.

 

COVID-19 Hospitalisation '80% More Likely for Smokers' Thorax.

 

Merck says COVID-19 pill cuts risk of death, hospitalization: Merck & Co Inc's experimental oral drug for COVID-19, molnupiravir, reduced by around 50% the chance of hospitalization or death for patients at risk of severe disease, according to interim clinical trial results. AP 

 

Merck Says Research Shows Its COVID-19 Pill Works Against Variants: Laboratory studies show that Merck & Co's experimental oral COVID-19 antiviral drug, molnupiravir, is likely to be effective against known variants of the coronavirus, including the dominant, highly transmissible Delta. Medscape

 

FDA unlikely to rule on Merck's COVID pill before December: The FDA is asking outside experts to meet in late November to scrutinize Merck's pill to treat COVID-19. The Nov. 30 meeting means U.S. regulators almost certainly won't issue a decision on the drug until December, signaling that the agency will conduct a detailed review of the experimental treatment's safety and effectiveness.

 

Antibody Cocktail Reduces Chance of Developing COVID: A one-time dose of two long-acting monoclonal antibodies, tixagevimab and cilgavimab, reduced the risk of developing symptomatic COVID by 77% in comparison with placebo in a randomized, double-blind, placebo-controlled, phase 3 trial in adults. Infectious Disease Week 2021 Annual Meeting PROVENT trial

 

Having Flu and COVID Vaccines at Same Time Is Safe: Having flu and COVID jabs at the same time is safe, according to preprint research from the ComFluCOV study. Researchers concluded that concomitant vaccination did not raise safety concerns, and the immune response to both vaccines was preserved. Side effects were reported for some combinations but were found to be mainly mild to moderate, including fatigue, apart from one hospitalisation with severe headache related to the trial.

 

At Least One Long-Term Symptom Seen in 37% of COVID-19 Patients: The most common symptoms included breathing problems, fatigue, pain and anxiety, Oxford University said, after investigating symptoms in over 270,000 people recovering from COVID-19. The symptoms were more frequent among people who had been previously hospitalised with COVID-19 and were slightly more common among women, according to the study published in PLoS Medicine. PLOS Medicine

 

Yes, You’re Fully Vaccinated Even if You Haven’t Had a Booster Shot: People who have received the Johnson & Johnson shot or both doses of the Pfizer and Moderna shots are still considered fully vaccinated in the United States, even with the Food and Drug Administration’s (FDA) recent authorization of booster doses for select groups.

 

American Journal of Medicine commentary says COVID-19 vaccines should be shored up with a plant-based diet. “A solid vaccination program is lifesaving, essential, and insufficient,” begins the commentary “Shoring Up Vaccine Efficacy,” which appears today in the American Journal of Medicine. The authors say that in addition to vaccinations, health care workers should recommend plant-based diets to help patients improve their health and decrease vulnerability to COVID-19.

 

Poor oral health may impact COVID-19 severity, especially for cardiac patients: The correlation between poor oral health and COVID-19 severity, as well as the correlation between oral health and delayed recovery, demonstrates a potential need to consider oral health an additional risk factor for cardiac patients who may contract COVID-19. ACC Middle East 2021

 

Pfizer's Vaccine Protection May Wane After 2 Months: The protection from Pfizer's COVID-19 vaccine may begin to wane against infection after 2 months, but it still prevents hospitalization and death for at least 6 months, according to two new studies published Wednesday in The New England Journal of Medicine. 

 

Pfizer COVID Vaccine Antibodies May Disappear in 7 Months: Antibody levels may wane after 7 months for people who got the Pfizer-BioNTech vaccine, according to a new study published on the bioRxiv preprint server. In the study, which hasn't yet been peer-reviewed or formally published in a medical journal, researchers analyzed blood samples from 46 healthy young or middle-aged adults after receiving two doses, and then 6 months after the second dose. "Our study shows vaccination with the Pfizer-BioNTech vaccine induces high levels of neutralizing antibodies against the original vaccine strain, but these levels drop by nearly 10-fold by 7 months,"

 

HEPA Filters May Clean Sars-CoV-2 From the Air: High-efficiency particulate air (HEPA) filters and ultraviolet (UV) light sterilization effectively remove SARS-CoV-2 particles from the air — the first such evidence in a real-world test. The journal Nature reported this week that the research, which has not been peer-reviewed, suggests the filters may help reduce the risk of hospital-acquired SARS-CoV-2.

 

Interferon Treatment in COVID-19 Linked to Thyroid Changes: Treatment of COVID-19 with interferon beta-1b — even for just a few days, a much shorter period than is commonly used for maintenance in multiple sclerosis (MS), for example — is associated with potentially important adverse effects on thyroid function, according to research presented at the virtual 90th Annual Meeting of the American Thyroid Association (ATA). 

 

Convalescent plasma ‘futile’ for critically ill COVID-19 patients, study finds: Blood plasma from people who have recently recovered from an infection, which experts call convalescent plasma, contains antibodies that can potentially tackle the same infection in others. A large study has now concluded that the treatment does not provide any benefits for critically ill patients, with the possible exception of those with weakened immune systems. Proponents of the therapy argue that convalescent plasma can save lives if given early enough, before the onset of the inflammatory phase of the disease. JAMA

 

High-dose of readily available blood thinner reduces risk of death for moderately ill COVID-19 patients: A high dose of heparin medication reduces the risk of death in hospitalized patients who are moderately ill with COVID-19. British Medical Journal

 

Vaccinating against flu and COVID-19 at the same time is safe: It is safe to have an influenza vaccine at the same time as a second dose of a COVID-19 vaccine, according to a study. The coadministration of the two vaccines did not affect the immune response. Only a few people reported mild side effects, such as fatigue or soreness at the injection site. The Lancet

 

Statins linked to reduced risk of death from COVID-19 in major population study: Researchers at Karolinska Institutet in Sweden have now conducted the largest population study to date in the field. The study indicates that statin treatment slightly lowers COVID-19 mortality. PLoS Medicine

 

 

 

PAIN        

Psychological treatment shown to yield strong, lasting pain relief, alter brain networks: The study, published Sept. 29 in JAMA Psychiatry, found that two-thirds of chronic back pain patients who underwent a four-week psychological treatment called Pain Reprocessing Therapy (PRT) were pain-free or nearly pain-free post-treatment. And most maintained relief for one year. The findings provide some of the strongest evidence yet that a psychological treatment can provide potent and durable relief for chronic pain, which afflicts one in five Americans. 

 

Researchers’ novel mind-body program outperforms other forms of treatment for chronic back pain: In a new publication appearing in journal PAIN,  researchers found that the mind-body intervention based on John Sarno’s work was highly beneficial for treating back pain when compared to standard care, with 64 percent of research volunteers reporting being 100 percent pain free six months later. 

 

Corticosteroid injections of hip linked to 'rapidly destructive hip disease': A new study adds to concerns that hip steroid injections may lead to increased rates of a serious complication called rapidly destructive hip disease (RDHD), according to a paper in The Journal of Bone & Joint Surgery.

 

How do migraines affect the sleep cycle? Adults and children with migraines may get less quality, REM sleep time than people who don’t have migraines. That’s according to a meta-analysis published in the September 22, 2021, online issue of Neurology^®. Children with migraines were also found to get less total sleep time than their healthy peers but took less time to fall asleep.

 

History of migraines lead to more severe hot flashes for postmenopausal women: A new study links a history of migraines and hot flashes and highlights the fact that both could be associated with an increased risk of heart disease. The North American Menopause Society (NAMS) Annual Meeting 

 

Weather can affect pain tolerance: It may sound like an old superstition – but on some standard quantitative sensory tests, weather-related factors do indeed affect pain tolerance, suggests a study in PAIN®

 

Acupuncture reduces pain and opioid use for total knee replacement surgery patients: Patients who have acupuncture during total knee replacement surgery report less pain and need far fewer opioids to manage their discomfort, according to a study being presented at the ANESTHESIOLOGY^® 2021 annual meeting. Results of the study showed that 65% of patients who received acupuncture during surgery achieved a low-dose or opioid-free postoperative experience, compared to 9% of patients outside of the study.

 

COMPLEMENTARY & ALTERNATIVE MEDICINE

Meditation training reduces long-term stress Psychosomatic Medicine 

 

Nature-based activities can improve mood and reduce anxiety, new study shows: Outdoor nature-based activities are effective for improving mental health in adults, including those with pre-existing mental health problems, a new study has found. The research showed that taking part in outdoor, nature-based activities led to improved mood, less anxiety, and positive emotions. The study found that activities lasting for 20 to 90 minutes, sustained for over the course of 8 to 12 weeks, have the most positive outcomes for improving mood and reducing anxiety. Gardening and exercise were among the activities associated with mental health benefits. Engaging in conservation activities was also reported to make people feel better, as did ‘forest bathing’ (stopping in a forest to take in the atmosphere). SSM - Population Health.

 

Daily use of cannabidiol ('CBD') oil may be linked to lung cancer regression according to one case report of a woman in her 80s with a non-small cell lung cancer. BMJ Case Reports

 

 

FDA ACTION

• Warns against using at-home dermal filler pens

• Approved marketing of three products from the vaping company Vuse, along with one device. The authorization only relates to tobacco-flavored e-cigarettes and not the wider range of flavors that critics say are aimed at younger consumers.

• Issued guidelines for voluntary salt reduction in packaged goods

• Approved Rethymic for the treatment of pediatric patients with congenital athymia

• Issued an emergency use authorization (EUA) for the ACON Laboratories Flowflex COVID-19 Home Test, an over-the-counter (OTC) COVID-19 antigen test, which adds to the growing list of tests that can be used at home without a prescription.

• Warned consumers that using the Safe-T-Lite UV WAND, a handheld ultraviolet-C (UV-C) germicidal wand intended for sanitization, may put you or a nearby person at risk of exposure to unsafe levels of UV-C radiation, and may cause injury to the skin, eyes or both after just a few seconds of exposure.

• Approved Byooviz (ranibizumab-nuna) as the first biosimilar to Lucentis (ranibizumab injection) for the treatment of several eye diseases and conditions, including neovascular (wet) age-related macular degeneration (nAMD)

 

 

PREVENTION: Exercise

Moderate-Vigorous Exercise Boosts Fitness 3 Times More Than Walking: The study, published in the European Heart Journal, included about 2,070 people involved in the Framingham Heart Study. A new study finds that “moderate-vigorous” exercise can improve your fitness three times as much as walking. Moderate-vigorous exercise is activity that leaves you able to hold a conversation but sometimes having to catch your breath. It is recommended that you aim for 150-300 minutes a week of moderate-intensity activity or 75-150 minutes of vigorous activity.

 

Aerobic exercise after a sport-related concussion speeds recovery in adolescent athletes: Adolescents can speed their recovery after a sport-related concussion and reduce their risk of experiencing protracted recovery if they engage in aerobic exercise within 10 days of getting injured. The Lancet Child & Adolescent Health

 

Why ‘DryScooping’ Protein Powder Before Your Workout Is a Terrible Idea: Experts say the trend on TikTok and other social media platforms encouraging people to “dry scoop” fitness powder before exercising poses a number of health risks.Trying to swallow these powders can cause coughing, shortness of breath, and other more serious health issues.Instead have a smoothie or a single cup of coffee before working out. Healthline

 

Want a Better Night’s Sleep? Avoid Intense Workouts Less Than 2 Hours Before Bed: A literature review  study found that exercise completed 2 or more hours before bedtime aided sleep quality. Participants fell asleep faster and slept longer. Exercise that occurred closer to bedtime, however, had a negative impact, causing people to take longer to fall asleep and to sleep for a shorter amount of time.

 

Active Video games can have similar health benefits to jogging: Active video games have similar positive health effects on the body as traditional exercises, such as jogging on a treadmill, according to a new study. The researchers say these games could be used by type 1 diabetics as a more enjoyable way to stay active and manage their condition. Games for Health Journal

 

Exercise may stop cancer in its tracks: Forget bedrest, research from Edith Cowan University (ECU) has shown exercise may be a key weapon in cancer patients’ battle against the disease. The study focused on prostate cancer due it being the most common non-skin cancer among men and the high number of patient fatalities – however the findings could have a wider impact.   Medicine and Science in Sports and Exercise.

 

Data shows Americans need at least 5 hours per week of physical activity to prevent some cancers: A new report finds more than 46,000 cancer cases annually in the United States could be prevented if Americans met the 5 hours per week of moderate-intensity recommended physical activity guidelines. The latest data appearing in the journal Medicine & Science in Sports & Exercise show 3% of all cancer cases in adults in the U.S. aged 30 years and older during 2013 to 2016 were attributable to physical inactivity and the proportion was higher in women (average annual attributable cases 32,089) compared to men (14,277).  Medicine & Science in Sports & Exercis

 

Serious injury risk higher for horse riding than for football, motor racing, or skiing: While the most common site of injury was the chest, head and neck injuries were the most lethal, the findings show. Trauma Surgery & Acute Care Open https://medicalxpress.com/news/2021-10-injury-higher-horse-football-motor.html

 

PREVENTION: Vitamins/Supplements

Why Getting Enough Iron in Middle Age Can Lower Your Heart Disease Risk: Not getting enough iron in middle age can lead to about a 10 percent increase in heart attack risk within a decade That’s according to a study published in ESC Heart Failure. Experts say you can increase your iron levels through diet, either with meat or vegetarian items, as well as with supplementation.

 

Can ketone supplements improve brain function in obesity? People with obesity may have a higher risk of cognitive impairment, such as difficulty making decisions or remembering. A small study involving oral ketone supplementation for 14 days suggests an improvement in brain blood flow and function in people with obesity. Scientists will need to carry out larger studies with a more diverse population to understand the underlying mechanism and confirm whether this approach could have real-world application. The Journal of PhysiologyTrusted Source.

 

Omega-3 supplements could elevate risk of atrial fibrillation: A meta analysis found that the risk of developing atrial fibrillation is dependent on the dose of omega-3 fatty acids. Although there's strong evidence that omega-3 fatty acids can significantly reduce blood triglyceride levels and arthritis pain, most experts agree it's best to get omega-3 fatty acids from eating fish several times a week. Circulation

 

PREVENTION: Diet/Nutrition

MIND Diet Preserves Cognition Even in the Presence of Alzheimer's Pathology: Adherence to the MIND diet can improve memory and thinking skills of older adults, even in the presence of Alzheimer's disease pathology, new data from the Rush Memory and Aging Project (MAP) show. A hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, the MIND diet includes green leafy vegetables, fish, nuts, berries, beans, and whole grains and limits consumption of fried and fast foods, sweets, and pastries. The study was published online in the Journal of Alzheimer's Disease

 

Peanut consumption: Potential benefits in young and healthy people: A study published in the journal Clinical Nutrition provides new knowledge on the health effects of a diet rich in nuts. According to the study, focused on the consumption of peanuts, the daily intake of products from this nut could have beneficial effects on the cognitive function and stress response in young and healthy individuals.

 

In tightly controlled study, low-carb diet improves cardiometabolic risk profile: A clinical trial led by Boston Children’s Hospital demonstrates that low-carb diets — even though higher in saturated fat — produce better cardiovascular and metabolic profiles than low-fat, higher-carb diets. online September 28 by the American Journal of Clinical Nutrition.

 

Diet may help alleviate some symptoms of bipolar disorder: A study in the journal Bipolar DisordersTrusted Source suggests that individuals with bipolar disorder who adjust their intake of specific fatty acids may experience less variability in their moods. The researchers decreased the experimental group’s consumption of omega-6 fatty acids by limiting red meat, eggs, and certain oils and increased their consumption of omega-3 fatty acids by adding flaxseed and fatty fish.

 

Research review shows intermittent fasting works for weight loss, health changes: Intermittent fasting can produce clinically significant weight loss as well as improve metabolic health in individuals with obesity, according to a new study review led by University of Illinois Chicago researchers. Annual Review of Nutrition

Rye a better choice than wheat for weight loss: Researchers recently published a study showing that people who ate high-fiber products made from whole grain rye lost more body fat and overall weight than those who ate corresponding products made from refined wheat. Clinical Nutrition 

 

Moderate carbohydrate intake is a cardiovascular benefit for women: Research found that in middle-aged Australian women, increasing the percentage of carbohydrate intake was significantly associated with reduced odds of CVD, hypertension, diabetes mellitus, and obesity. A  moderate carbohydrate intake between 41.0 percent—44.3 percent of total energy intake was associated with the lowest risk of CVD compared to women who consumed less than 37 percent energy as carbohydrates. No significant relationship was demonstrated between proportional carbohydrate intake and all-cause mortality. British Medical Journal

 

Mushroom consumption may lower risk of depression: Penn State researchers used data on diet and mental health collected from more than 24,000 U.S. adults between 2005 and 2016. They found that people who ate mushrooms had lower odds of having depression.

Journal of Affective Disorders.

 

Switching to reduced-sodium salt may reduce stroke risk: There is good evidence that limiting sodium in the diet and taking potassium supplements can lower blood pressure. People can achieve both of these ends by replacing the ordinary salt that they add to food with reduced-sodium salt. Regular salt is sodium chloride, while the reduced-sodium variety is a mixture of sodium chloride and potassium chloride. The New England Journal of Medicine.

 

PREVENTION

Why flu vaccination is more important this year: The National Foundation for Infectious Diseases (NFID) hosted a news conference thighlighting the need to get vaccinated against influenza and pneumococcal disease before a potentially severe 2021-22 influenza season. The flu is unpredictable. The best way to protect yourself and others in your community is to get vaccinated. Last flu season, very few people became sick with the flu due to masking and physical distancing.  This means fewer people will have immunity to flu strains this flu season.  Experts are warning that this flu season could be a bad one.

 

Combined treatments are the most effective to stop smoking: Combination therapies, particularly varenicline and nicotine replacement therapy (NRT) combined, are the most effective tobacco cessation pharmacotherapies, the largest review to examine the effectiveness and safety of electronic cigarettes (e-cigarettes) and medicines that people use to quit tobacco has found. Addiction

 

Natural light may be key to improving mood and reducing insomnia: The cross-sectional and longitudinal study of more than 400,000 participants in the UK Biobank program found that a lack of daytime light exposure was a risk factor for depressive symptoms, poor mood, and insomnia. The greater time spent in outdoor light during the day was associated with fewer depressive symptoms, lower odds of using antidepressant medication, better sleep and fewer symptoms of insomnia," Journal of Affective Disorders

 

Advice shifting on aspirin use for preventing heart attacks: Older adults without heart disease shouldn't take daily low-dose aspirin to prevent a first heart attack or stroke. Bleeding risks for adults in their 60s and up who haven't had a heart attack or stroke outweigh any potential benefits from aspirin, the U.S. Preventive Services Task Force said in its draft guidance. There may be a small benefit for adults in their 40s who have no bleeding risks. For those in their 50s, the panel softened advice and said evidence of benefit is less clear.

 

Some sunscreen mixtures lose effectiveness and become harmful during sun exposure: Chemical reactions involving a main ingredient-zinc oxide- mean many sunscreens become ineffective after just two hours of sun exposure, according to a new collaborative study  "Once exposed to sunlight for two hours, zinc oxide destroys the UVA protection provided by other ingredients. In this context, putting on sunscreen could actually make things worse because people believe they are being protected from harmful UV rays and may stay in the sun longer." Photochemical & Photobiological Sciences

 

2021 USPSTF guidance expands eligibility for lung cancer screening: Adopting the 2021 U.S. Preventive Services Task Force (USPSTF) recommendations for lung cancer screening will increase the number of eligible people, including more women and racial and ethnic-minority groups, according to a study published online Oct. 12 in JAMA Network Open.  JAMA Network Open

 

Pesticide linked to chronic kidney disease: A commonly available pesticide has been associated with an increased risk of chronic kidney disease (CKD). "The findings suggest we should limit our exposure to pesticides, even in very small doses, as chronic exposure may lead to negative health outcomes." International Journal of Environmental Research and Public Health

 

 

TREATMENT

Stopping Antidepressants Too Early Can Increase the Risk of Relapse: A majority of people who stop taking long-term antidepressant medication relapse to depression within a year, a new study finds. Researchers from University College London found that 56 percent of people who stopped taking long-term antidepressants such as citalopram, sertraline, fluoxetine, and mirtazapine experienced a relapse within 12 months. That compared to a 39 percent relapse rate among people who kept taking their medication. Conversely, the study found that 44 percent of participants who quit taking antidepressants did not relapse.

 

Statin use associated with type 2 diabetes progression: Researchers have found associations between statins and decreased insulin sensitivity, which can lead to type 2 diabetes. In the present study, the team found people with type 2 diabetes who took statins were more likely to have greater disease progression. JAMA Internal MedicineTrusted Source,

 

Promising results for Parkinson's disease treatment: Researchers have found a way to make deep brain stimulation (DBS) more precise, resulting in therapeutic effects that outlast what is currently available. The work will significantly advance the study of Parkinson's disease. Science

 

GI bleeding up for new users of rivaroxaban: Rivaroxaban is associated with increased rates of gastrointestinal bleeding (GIB) compared with other direct oral anticoagulants. Annals of Internal Medicine

 

Contraceptive pill can reduce type 2 diabetes risk in women with polycystic ovary syndrome Diabetes Care

 

Possible alternative treatment for Lyme disease: Researchers have described a new antibiotic that appears to have the potential to cure Lyme disease.

 

OTHER

Gas-related intestinal symptoms affect nearly all adults on a daily basis: Gas-related symptoms are associated with poorer quality of life, and higher stress, anxiety, and depression, with breaking wind being the most frequently reported gas issue, affecting eight out of 10 adults in the general population (81.3 %) in a 24-hour period, according to a new survey1 being presented today at UEG Week Virtual 2021. Other gas-related symptoms included stomach rumbling, which affected 60.5% of respondents, closely followed by belching (58%), and bad breath (48.1%). Trapped wind (47.2%), abdominal distension/swollen tummy (39.6%) and bloating/abdominal pressure (38.5%) also had a noticeable impact, while only 11.1% of respondents reported having no gas symptoms. On average survey participants had been affected by three different gas symptoms within the previous 24-hour period.