Dealing with the amoxicillin shortage

The amoxicillin shortage is expected to last for months, so the American Academy of Pediatrics has released its guidelines for alternatives.

First, because physicians don’t seem to be getting the message, don’t prescribe antibiotics for viral illnesses.

Second, there are amoxicillin formulations that aren’t in shortage, where doses can be adjusted. Compounding is another option — even something basic: “they can open capsules and split chewable formulations and mix them with liquid or a semisolid such as applesauce.”

And, of course, there are other antibiotics. The AAP has a helpful page with the details, including a handy chart.

You have another target? An anti-Covid target?
Then name the protein!

European and British researchers have discovered a “pocket” on the SARS-CoV-2 virus that they say offers a new and better target than the spike protein for delivering medication.

The Nsp1 protein was ignored as a target because it didn’t seem to have any holes/cavities/doors to send a drug into. But that’s because no one used experimental screening and X-ray crystallography techniques. Until the Swiss.

[They] revealed the existence of a ‘‘hidden’’ cavity on the surface of Nsp1, which could be the target of future drugs against SARS-CoV-2.

Why is this better? Because the spike protein can change between variants, and this gives drug developers another target for a potential universal Covid vaccine.

Why diabetics go to hospital

People with type 2 diabetes tend to be hospitalized more than other folks, and there’s a surprise reason: anemia. That’s what Aussie researchers found when they decided to look into why type-2 diabetics were hospitalized more.

“While it’s known that diabetes can contribute to anaemia through reduced iron absorption, gastrointestinal bleeding and through complications that cause anaemia, it was unexpected to see the association between diabetes and iron deficiency anaemia feature so significantly as a complication.”

Another reason: Other hospitalizations are declining. “Because we now have better diabetes management, the proportion of those presenting to hospital with cardiovascular disease and kidney disease is reducing.”

Skin in the game

It puts the lotion on its skin…

…so your baby doesn’t get eczema.

Researchers in China analyzed data from 3,500 infants in 11 trials and found that “early application of skin emollients can effectively prevent atopic dermatitis development in infants.”

But which is best? In general, creams, emulsions, and combos all worked well, but if pressed they would say “emollient emulsion may be the best option.”

Antibiotics and acne

Treating severe acne with systemic antibiotics is a bad idea. Or at least an idea that needs to be weighed against the effects on a teen’s skeleton.

It’s the good ol’ gut biome at work again. Long-term use of, say, minocycline, obviously affects gut bacteria. What Medical University of South Carolina researchers found is that those sustained changes to the gut biome will “lead to reduced bone maturation.”

Which one had acne?

Oh, yeah, and once the treatment has been going on a while, there’s no turning back. “[T]he microbiome and the skeleton aren’t able to recover fully after antibiotic therapy.”

Artificial sweeteners — saving you a long read

The paper (in the journal Nutrients):

“No Association between Low-Calorie Sweetener (LCS) Use and Overall Cancer Risk in the Nationally Representative Database in the US: Analyses of NHANES 1988–2018 Data and 2019 Public-Use Linked Mortality Files”

The gist: Low-calorie sweeteners — including saccharin and aspartame — don’t increase cancer risk, but they do increase the risk of obesity and diabetes.

It’s called “investing”

Healthy people pay more taxes. They work more, produce more, and are generally nicer to be around. So investing in healthy neighbors makes sense.

Tree planting in Portland

They (a non-profit group called “Friends of Trees”) planted 50,000 trees in Portland, Ore., just to make neighborhoods look nicer. But they also kept careful records. A decade later, U.S. and Spanish researchers looked into this “natural experiment.” They found that the more trees were planted in an area, the lower the mortality rate, especially for cardiovascular and respiratory causes and “particularly for males and people over the age of 65.”

And even though it can cost thousands of dollars a year to maintain 140 trees (one in each of Portland’s areas). No matter. Those 140 trees give back “around $14.2 million annually in lives saved.”

Even better: The older the tree, the more it does; a10-year-old tree has double the effect of a new one.

Covid vaccinations in New York

What was the return on investment for the almost $30 billion New York City spent on its Covid-19 vaccination program? When you take into account how much was saved just on healthcare spending and productivity loss, a big big study published in JAMA Network Open found that the ROI was — wait for it — 1019 percent.

[E]very $1 invested in the New York City vaccination campaign yielded an estimated $10.19 in cost savings from lower infection and mortality rates, fewer productivity losses, and averted health care use.

And that’s direct effects. As the ripples spread — more police on the job, more airport workers, more sales people, more production — that savings is even more.