First-of-its-kind pertussis vax

The FDA has just approved a whooping cough vaccine. What’s so special about that? It’s meant to be given to pregnant mothers to protect their kids — “the first vaccine approved specifically for use during pregnancy to prevent a disease in young infants whose mothers are vaccinated during pregnancy.”

A drug for sleep apnea

The only reliable ways to treat sleep apnea are with a CPAP machine or hit-or-miss surgery.

In Australia, getting a good night sleep is critical, and can make the difference between avoiding a drop-bear* attack or ending up in hospital. Thus Flinders University researchers are excited to have found a (possible) pharmaceutical treatment: reboxetine.

First they tried a reboxetine/oxybutynin combo, but soon figured that reboxetine alone did the trick. And that trick: stabilizing breathing, reducing the number of sleep apnea events per hour, and improving oxygen levels.

It’s not a cure, but it’s another potential treatment — and it offers a chance for more research into how norepinephrine reuptake inhibitors might work in the upper airway.

* Or spider, or kangaroo, or jellyfish, or gympie-gympie…

Pharmacists more than worth their weight

Check this out: Facing a lot of insurance-company claim denials, UNC Medical Center created a program it calls a “full-fledged pharmacy revenue integrity team.”

At first, the team’s job was to speed up prior authorizations so critical treatment could begin ASAP. But “From there, the work spiraled upward,” with pharmacists and pharmacy techs added to the team with the goal of reversing insurance company denials.

And it worked. The six-member team was able to cut denials and terminal write-offs drastically. How much is “drastically”? How about $6.4 million in one year for a single medical center?

“If you look at the full-time employees we have, even just for denials, it more than pays for this team. That $6.4 million is hard revenue. You would not have gotten it if this team had not been involved.”

Medicine down south

If you get sick, you probably don’t want to be treated by Florida’s surgeon general.

Joseph Ladapo released “guidance” (“a pdf of a word document”) saying men aged 18 to 39 should not receive Covid-19 vaccines — going against, you know, the entire world of medicine. Because Florida apparently has some secret information.

What’s that secret information? I kid you not: It’s an unauthored, unlabeled, unreviewed, unpublished “analysis” so deeply flawed as to cross the line into parody (and that would probably get a D in a high school statistics class).

As one epidemiologist points out in a deep dive into the flaws, the study doesn’t even use accurate math — it ‘resurrects’ people for one comparison, making it useless.

[I]f someone dies within 28 days of any dose, that’s counted as a death in the post-vaccine period, and compared with the subsequent period after. Of course, since the people have died in the 1st 28 days can’t really die again, this comparison is also quite skewed!

Another doctor with actual qualifications also debunked the ‘analysis’, pointing out, among other issues, the fast and loose use of ICD-10 codes, i.e., “lumping a hodge podge of unverified cardiac diagnoses together.”

As Forbes’s Bruce Lee point out, “Anyone can post something on a web site and call it an ‘analysis’ just like anyone can upload a video of themselves interviewing their cats on to YouTube and call themselves a talk show host.”

Covid antiviral fails in larger study

One of the two main drugs authorized for treating mild to moderate Covid-19 (to keep it from becoming severe Covid-19) apparently doesn’t work.

Merck’s molnupiravir was approved by the FDA (under an EUA) based on early data. But the later, more thorough studies have found that’s it’s no better than placebo.

Actually, so did Merck’s first study — they just didn’t realize it at the time. The trial was stopped early because the people getting molnupiravir did so well …

But when data from the remaining half of patients in the trial was published a month later, it told a different story. The second group had done far worse than the first. In fact, the data suggested molnupiravir did not improve their outcomes.

(Pfizer’s Paxlovid, on the other hand, continues to work a treat. The occasional “rebound” infections seem to be in people with robust but over-enthusiastic immune systems.)

Better than a bandage

Diabetic foot ulcers are double-plus ungood — you know this. And you probably know that treatment often isn’t simple.

Engineers at Queen’s University Belfast, though, have a nifty breakthrough. It’s a 3D printed bandage (a scaffold) that not only protects the foot, but delivers drugs antibiotics at the same time. Even better, it includes a ‘window’ that lets doctors monitor the healing without removing the bandage, plus that window does double duty by delivering a cell-growth factor to help.

Colonoscopy loses some luster

A surprise in the world of colon cancer screen: A new study out of Norway found that colonoscopies — the best way to detect colon cancer early — aren’t all they’re cracked up to be. Not that one isn’t a good tool, but rather “that colonoscopy only cut colon cancer risk by roughly a fifth, far below past estimates of the test’s efficacy, and didn’t provide any significant reduction in colon cancer mortality.”

As one study author put it:

“It’s not the magic bullet we thought it was. I think we may have oversold colonoscopy. If you look at what the gastroenterology societies say […] we talked about 70, 80, or even 90% reduction in colon cancer if everyone went for colonoscopy. That’s not what these data show.”

If their results hold up, it means that a colonoscopy might reduce the risk of colorectal cancer by 20 to 30%. That sounds great, but it puts the rather invasive procedure in line with other tests — the kind that can be taken at home.