Insulin in a pill?

Good news for diabetic rats: Researchers in Abu Dhabi have found a way to make an insulin pill where the drug isn’t destroyed by their stomach acids.

They did it using nanoparticles (of course), but really cool nanoparticles: They do double duty — not only protecting the insulin from stomach acid, but also releasing that insulin in response to elevated glucose.

Covid aftereffects

Mental health issues

We’ve known for a while that it takes some people a long time to recover from Covid-19 — even if you aren’t a true “long-hauler,” symptoms can last months.

The latest: A huge study in the Lancet (230,000 patients!) reports that one out of three people who “recover” from Covid “suffer from a neurological or psychiatric diagnosis six months on.”

The most common conditions were anxiety (17 percent of patients) and mood disorders (14 percent). For 13 percent of patients the disorders were their first diagnosis of a mental health issue.

The kids aren’t all right

Even without Covid symptoms, kids are being struck by MIS-C, a nasty (and mysterious) respiratory syndrome about three weeks after their coronavirus infection. Every time there’s a spike in Covid cases, three weeks later there’s a spike in MIS-C.

The worst part: These kids may not even realize they’ve been sick until their immune system goes haywire.

“[M]ost MIS-C illnesses are believed to result from asymptomatic or mild Covid-19” followed by a hyper-inflammatory response that appears to occur when the patients’ bodies have produced their maximum level of antibodies to the virus.

Time to register “Covid229E.com”?

Bored of Covid-19? No one blames you. So what’s on deck? A new website called Spillover is where infectious-disease folks are tracking and ranking the next zoonotic viruses likely to jump to humans.

Currently at highest risk: Coronavirus 229E (Bat strain) based on the number of species it infects, how widespread potential hosts are, and a bunch of other factors (e.g., “Intimacy of interaction between domestic animals and humans in the host ecosystem”).

“Perverse financial incentives”

If you thought pharma companies were paying physicians, get ready for this surprise: “Medical device firms’ payments to doctors far outstripped those from pharma.”

Surgical specialists were the ones getting the most, er, thank-you gifts — they “received seven times more money from device firms than [from] drug vendors.”

If the relationship between the patient and physician is “contaminated by perverse financial incentives, then it does erode the public trust, which is a sacred value in our heritage, our great medical heritage.”

As one oncologist put it, “The companies know where their bread is buttered.”

Autism gut check

While you can’t say that “gut microbes cause autism,” University of Colorado microbiologists have discovered that changes in gut microbes can affect where someone appears on the spectrum.

Not only did they find that people with autism had different microbe compositions than those without, but when the microbes changed, so did behavior:

[D]ifference in levels of lethargy/social withdrawal measured in individuals at different time points correlated with the degree of change in gut microbiome composition.

Chronic pain? Keep calm and carry on

The British sort-of equivalent to the FDA — National Institute for Health and Care Excellence (NICE) — has issued new guidance for chronic pain: Maybe cut out the painkillers.

Not that patients aren’t in pain. Rather that chronic pains are unique, and painkillers (says NICE) don’t help when it’s chronic:

This is because there is little or no evidence that they make any difference to people’s quality of life, pain or psychological distress, but they can cause harm, including possible addiction.

Instead, other treatments — including antidepressants and good ol’ exercise — are more likely to help with quality of life.

More about itching than you expected

People with severe liver disease often have a “devastating” itching. Duke medical researchers have figured out why.

The short version: Patients with liver disease have too much of a particular fat in their blood (lysophosphatidylcholine (LPC), if you must know). And LPC, when it reaches the skin, opens an ion channel called TRPV4, letting calcium ions pour through.

Then … well then, science happens, with a signaling cascade, vesicle formation, and micro-RNA. And that causes an itch.

“That’s nice,” you say. “So what?”

It means a potential treatment for that itch — and other itches. And it shows that the skin is busier than you might think: “This current research is getting us into a more exciting territory of the skin actually moonlighting as a sensory organ.”

The wind in her pipes

Congrats to Sonia Sein of New York, the first person to ever undergo a trachea transplant. What’s noteworthy (besides the fact that this was a crazy-tricky operation): Doctors think that there may be more to come, thanks to Covid-19’s ability to damage our entire breathing apparatus.