Report: Georgia’s health needs improvement

Georgia ranked 45th out of the 50 states and DC for the performance of its healthcare system in the latest annual report from the Commonwealth Fund.

The study considered a long list of factors, including “Avoidable deaths from preventable and treatable causes,” access to healthcare, maternal care and mortality, and mental health care. (Of note, this report included the pandemic years, so every state saw its overall score take a hit.)

What hurt Georgia a lot:

• Low primary care spending
• Low access to care (e.g., people who couldn’t afford it and the high uninsured rate)
• Children without all recommended vaccines

The good stuff: a low rate of alcohol- and drug-related deaths.

You can read the overview of the study here, and see the details of Georgia’s performance here (7-page PDF)

Take that, Darwin

A new tactic against antibiotic resistance can, it seems, keep bacteria from evolving that resistance in the first place. It’s called dequalinium chloride (DEQ), and right now it’s just “proof-of-concept for evolution-slowing drugs.”

Essentially, Baylor College of Medicine researchers found that when stressed (like, say, with impending destruction) certain of the bacteria’s genes can activate to “increase production of protective molecules.” Not only does that program protect the bacteria at the moment, it can also affect its genes for the long term — i.e., making it resistant to the antibiotic.

But DEQ, the Baylorites say, can “dial down the master bacterial stress response.” That not only makes the bacteria more susceptible to antibiotics, it prevents its children from inheriting that resistance.

Given together with cipro, DEQ reduced the development of mutations that confer antibiotic resistance, both in laboratory cultures and in animal models of infection, and bacteria did not develop resistance to DEQ.

A new depression subtype (and why antidepressants don’t always work)

Of patients with major depressive disorder, more than a quarter fit into what Stanford researchers say is a new subtype of depression they call the cognitive biotype.

Here’s the interesting part: First they tested to see how many fit into this category (which is indicated by “difficulty with the ability to plan ahead, display self-control, sustain focus despite distractions and suppress inappropriate behavior”). That was about 27% of patients. Then they tested to see how three common antidepressants affected them.

Result: Patients with this new subtype were less likely to be helped by typical drugs like escitalopram, sertraline, or venlafaxine.

[T]he overall remission rates — the absence of overall depression symptoms — were 38.8% for participants with the newly discovered biotype and 47.7% for those without it. This difference was most prominent for sertraline, for which the remission rates were 35.9% and 50% for those with the biotype and those without, respectively.

So what could help? They’re thinking guanfacine, aka Intuniv or Tenex, might do the trick; testing is ongoing.

Captain Obvious uses earplugs (and locks the door)

“Moms lose significant sleep and free time during kids’ school year, new study finds”.

Premature menopause is more complicated than we thought

The old thinking: Variants in any of more than 100 genes could lead to early menopause — i.e., before the age of 40.

But now British researchers have found that a whopping 98% of women carrying variations of those genes in fact had menopause after 40.

In other words, some women might be diagnosed with ‘premature ovarian insufficiency’ when it doesn’t apply at all. As the senior author put it (in, obviously, a lovely British accent), “It now seems likely that premature menopause is caused by a combination of variants in many genes, as well as non-genetic factors.”

Old drug, new heart treatment

Using a new type of biosensor, Johns Hopkins researcher found that ruxolitinib — already FDA approved for treating some cancers and skin conditions, can also treat cardiac arrhythmias by inhibiting the CaMKII protein.

A 10-minute application of the drug was enough to prevent catecholaminergic polymorphic ventricular tachycardia, a congenital source of pediatric cardiac arrest, and rescue atrial fibrillation, the most common clinical arrhythmia.

The finding could lead to new uses for the drug, including (they suggested) “the ‘pill in a pocket’ scenario” where patients could take a ruxolitinib-based medication occasionally as symptoms arise.

The Long Read: Why BMI is yesterday’s metric

For a long time, BMI (body mass index — the ratio of weight to height) was the go-to measurement for obesity. But as you might imagine for such a crude comparison, it’s on its way out as a reliable tool.

[P]eople with the same BMI may have substantially different body fat percentage based on a variety of factors such as age, muscle mass, sex and race. In an example from one large study, adults with a BMI of 25 had a body fat percentage ranging from 14% to 35% for men, and 26% to 42% for women.

Short Takes: On the legal fronts

GSK settles Zantac suit

GSK, the company formerly known as Glaxo Smith Kline, decided it needed to stop investors from freaking out over impending lawsuits over Zantac. You remember Zantac, right? The heartburn drug that ended up causing cancer?

Anyway, the company settled a lawsuit with a guy from California before it could go to trial, and that “could set a precedent for thousands of cases set to go to trial next year” and which gave investors jitters.

What did Merck know and when did it know it?

Merck is now facing a slew of lawsuits over Singulair, its asthma and allergy medicine. The FDA required a black-box warning because of psychiatric side effects. Now, the plaintiffs say, they have evidence that Merck knew about those dangerous side effects long before that warning was required — it just didn’t disclose them.