A smell test for depression

A test to evaluate someone’s sense of smell might also indicate whether they’ve got depression.

Indian researchers, presenting at the American Physiological Society meeting, found that people who did poorly identifying smells (via the standard sniff tool called the Brief Smell Identification Test or BSIT) were more likely to have been diagnosed with depression.

In fact, “All the members of the depression group identified fewer smells than the control group.” The test has 12 scents; identifying fewer than 9 is abnormal; people with “recurrent depressive episodes” averaged 5.2 scents.

Our number 2 story: counterattacking Montezuma’s Revenge

Boston University researchers have made an important step to controlling traveller’s diarrhea without using antibiotics that can mess with the good gut bacteria. They’ve figured out how the troublesome E. coli. bacteria attaches itself in the gut.

The bacteria, it seems, “use long, thin filaments called ‘pili’ to bind to cells in the gut, allowing an infection to start.” In fact, they found, the pili will change depending on the environment. This is important because finding a way to keep the bacteria from attaching would be better than killing them.

“Therapeutics that disrupt pili and allow bacteria to be washed away have advantages over current antibiotics, as physical removal would not lead to the evolution of resistant strains and only the pathogens would be targeted.”

Don’t miss the GPhA annual survey!

Who are you? What’s your practice area?

What do you like about what GPhA is doing, and what do you wish would change?

Now’s the time to let us know. GPhA’s annual member survey is online and waiting for your input!

Trust me on this: Your answers are read and discussed across the association, and they really do make a difference in GPhA’s priorities over the next year.

One Senate, two insulin-price proposals

There are now two bipartisan proposals in the Senate for lowering insulin prices (“and for other purposes”).

The existing one comes from Georgia’s own Sen. Raphael Warnock (and John Kennedy of Louisiana), and it “would ensure maximum costs of $35 per month for all insulin products, and would also lower costs for uninsured patients.”

The new proposal, though, takes into account that pharma companies have already said they’ll lower insulin prices, and it takes that a bit further:

[It] would cap insured patients’ insulin costs at $35 per month for at least one insulin of each type and dosage form, and require pharmacy benefit managers to pass through rebates they collect from insulin manufacturers to the insurance plans that employ them.

It would also make it faster and easier for the FDA to consider biosimilars and for Medicare plans to get them into the hands of patients.

The good news is that the proposals are similar enough that it seems they could be merged, and they both have blue and red support. For now, at least.

Speaking of insulin prices…

When drug companies suddenly lowered some of their insulin prices earlier this year, the conventional wisdom was that they did it because they knew they’d have to, with new regs coming down the pike. Might as well make it sound like it was their own idea.

But the reality, it seems was more complicated, as a new analysis in the New England Journal of Medicine explains. We don’t have access to the journal itself, but the folks at Fierce Pharma have done a great write-up of how “The price cuts can be explained by a mix of factors.”

In case you’re curious, here’s some supplement-use data

A CDC study — part of the National Health Statistics Reports — gives some detail about who’s using dietary supplements these days. The basics:

  • 35% of children and adolescents and 59% of adults used at least one supplement in the past 30 days (from 2017 to 2020, which the survey covered).
  • Multivitamin use: 24% of kids and 32% of adults
  • Vitamin D use: 3% of kids and 19% of adults
  • Use of multiple supplements increased with age.
  • Except for little kids, use was higher among females than males.
  • Supplement use increased with income and education.

For all the detailed details, check out the paper itself (14-page PDF).

It seems cranberries work after all

Apparently it’s not a myth — according to Aussie epidemiologists, cranberry juice really can prevent urinary tract infections. They did a meta-analysis of existing research, so Big Cranberry probably* wasn’t involved.

Now, they say, there are 50 studies on the effects of cranberry products on recurring UTIs, and they point the same way:

These data support the use of cranberry products to reduce the risk of symptomatic, culture‐verified UTIs in women with recurrent UTIs, in children, and in people susceptible to UTIs following interventions.

Caveats: 1) They didn’t test whether cranberries were better than antibiotics or probiotics for prevention, and 2) “The data also doesn’t show any benefit for elderly people, pregnant women or in people with bladder emptying problems.”

* The paper doesn’t list the source of funding, but that may not really matter for this kind of analysis.

The Long Read: xylazine balancing act

The latest drug to Plague America’s Streets is (in case you missed it), xylazine — the common animal tranquilizer that’s being used to cut heroin … and ends up killing users.

The problem: As we learned from the knee-jerk reactions to the opioid crisis, knee-jerk reactions cause as many problems as they solve. As the government ponders xylazine limitations, legit users, i.e., veterinarians, are legit concerned:

[A]ddressing the threat is proving to be a tricky balancing act involving stakeholders in areas as disparate as addiction medicine, commercial livestock and law enforcement. The challenge is to walk a careful line by managing a drug that is essential for veterinarians but is fueling a public health crisis.