Monkey see, monkey do

And by “monkey” we mean “vaccine maker.” Both Novavax and Moderna report that they’re working on flu/Covid combo vaccines.

Novavax’s is already in human trials, and its Covid vaccine would be an actual vaccine, not a booster. It hasn’t been approved by the FDA, though.

Moderna is a bit behind — it’s about to start trials. The Covid half is a booster, while the flu side is a new mRNA vaccine.

Kids, Covid, and Georgia

Good and bad news.

Bad: Georgia is one of 11 states with more than 150,000 children with Covid-19. It’s also seeing one of the highest increases in kids’ cases over the past three weeks (likely because of the start of the school year).

Good: Kids represent a little more than 14% of cases in the state, which is below the national average of 15.1%.

Good: The case rate for kids (cases per 100,000) in Georgia is the 13th lowest of the states — about 6,200/100K, compared to 6,709/100K for the country as a whole.

All this from the latest “Children and COVID-19: State-Level Data Report” from the American Academy of Pediatrics, based on state-reported data.

Check them for iron

Got pregnant patients? Ask about their iron levels. A full half of pregnant women (in a study out of Toronto) had low iron levels, “and one in four had severe iron deficiency.”

[D]espite how common iron deficiency is, 40% of pregnant women in this large regional study never had their iron levels checked, and women of lower socioeconomic status were less likely to get tested.

The next miracle cure

And this one actually has science behind it. The paper: “Vitamin D and lumisterol novel metabolites can inhibit SARS-CoV-2 replication machinery enzymes”

The takeaway: The metabolites produced by Vitamin D3 (available in a bottle) and by lumisterol* (which you get from the sun) “were able to block two specific enzymes required for the SARS-CoV-2 life cycle.”

In other words, not only is vitamin D deficiency a risk factor for Covid-19, but taking enough of it can help treat an infection by fighting the virus.

To be clear, this isn’t much of a preventative — certainly not compared to a vaccine — but it might help reduce the infection. As always, “further study is needed.” In the meantime, get outside.

* Formerly called vitamin D1, but it’s not actually a vitamin

Migraine news

Aim high

Seattle-based Impel NeuroPharma received FDA approval for its Trudhesa anti-migraine dihydroergotamine mesylate nasal spray. The idea: It sprays the DHE into the upper nasal cavity, unlike other sprays that can have the meds dripping down the throat, where they’re pretty much useless.

Eat right

Turkish researchers found that the farther people strayed from “Mediterranean diet patterns,” the more severe and frequent were their migraines. (They recommend a diet with “higher vegetables, fruits, legumes, and oil seeds.”)

Go bland

People who ate more salt — that is, had a higher 24-hour urine sodium level — had migraines that lasted longer than those who preferred their meals to be tasteless and uninspiring, according to Iranian researchers.

Beats the alternative

Ferring Pharmaceuticals thinks it has a solution to C. diff infections — something that works better than antibiotics. (To be fair, that’s not a high bar. Antibiotics don’t work very well at all. By killing gut microbes, they often just enable existing C. diff to recur or spread.)

What does work? Fecal microbiota transplants. But even they are a bit of a crapshoot, because each transplant will be a different mix of microbes. Ferring’s product, RBX2660, though, “can be standardised and the manufacturing process subjected to proper quality controls.”

“In a patient who’s suffering C. diff, there’s a loss of diversity and an increased risk of infection. The purpose of RBX2660 is to restore that diverse microbiome, which helps the body itself fight recurrent C. diff.”

Even better, it’s just completed a successful phase 3 trial.

Speaking of gut bacteria

British researchers have found that gut bacteria are affected by drugs, and in ways that are unexpected — with effects that are unknown.

Some bacteria absorb drugs, some ignore them, some are changed by the meds, and some modify the meds themselves. It’s a mess in there, but it could explain why some drugs, notably antidepressants (especially duloxetine), work differently from patient to patient.

👨‍⚕️ 💬 😀

In a commentary in the Journal of the American Medical Association, several physicians argue that we need more medical emojis to enable better communication between providers and patients.

[E]moji possess the power of standardization, universality, and familiarity to users, with increasing usage in both informal and professional settings. Emoji can facilitate communication of patient symptoms and concerns or other clinically relevant information, can be used as annotations for patient instructions, and more.

They’re hoping to add emojis for “intestines, leg cast, stomach, spine, liver, kidney, pill pack, blood bag, IV bag, CT scan, weight scale, pill box, ECG, crutches, and white blood cell.”