Someday this will be a vending machine

Canadian scientists have 3D printed testicular cells — “and identified promising early signs of sperm-producing capabilities.”

[The researchers] hope the technique will one day offer a solution for people living with presently untreatable forms of male infertility.

Next up: Fine-tuning, and exposing the cells to “different nutrients and growth factors” to try to get them to produce sperm.

Press L2 for a tall blond boy

New Covid vaccines

From MIT: A yeast-based vaccine they say is “inexpensive, easy-to-store, and [an] effective alternative to RNA vaccines.” And because it can be produced by yeast, it can be made all over the world. Clinical trials are starting.

From Penn State: An inhalable aerogel that works in mice. Besides not needing a needle, this would (if it works in humans) prevent the virus from even gaining a foothold — it “would elicit local immunity at the primary site of infection.”

Rolling the dice

Congress declined to provide more money for the U.S. response to Covid-19, which hopefully won’t be an issue. But, as Forbes points out, if another wave of the virus starts sweeping the country … well, it won’t be pretty.

• Monoclonal antibody treatments will be severely limited, or left to the states to pay a large part of the price tag.
• People without health insurance — and remember, Georgia has the country’s third-highest rate of uninsured — “will no longer receive free Covid-19 tests and treatments as of March 25, and vaccination coverage for the uninsured will end April 5.” But they’ll still be walking around.
• Oh, and those anti-viral pills that so many people are counting on for treatment? Because they’re only authorized for emergency use, and the government won’t have the money for them … well, they simply won’t be available.

In unrelated news… worldwide, new Covid-19 infections rose for the first time since January, jumping 8 percent week to week.

Chocolate … with a grain of salt

The flavanols in cocoa might reduce cardiovascular risk … according to a study funded by Mars, Inc. (as in the M&M people).

Acid, SSRIs, and plasticity

The idea that small doses of LSD treats depression and anxiety is catching on, but the actual mechanism isn’t clear. But Canadian neurobiologists have made a solid step to figuring it out.

The short version: LSD seems to work like an SSRI on steroids. Wait, no. Bad analogy. Like an SSRI-Plus. It increases serotonin transmission just like an SSRI — by desensitizing the right receptors and getting them to produce more serotonin.

But it goes a step further by promoting the formation of more branches between neurons, i.e., dendritic spines. “LSD can rebuild these branches that are ‘dismantled’ due to stress. This is a sign of brain plasticity.”

But before you think about licking those Mickey Mouse stamps you got at the Dead show at the Fox Theater in 1980, remember, as always, “More studies are needed.”

Cloaking device

Bacteria can be used to carry drugs to tumors — that’s not a new idea. The problem is that the body tends to attack that bacteria, what with it being, you know, bacteria.

But what if you cloaked the bacteria and made it invisible to the body? It could get where it needed to go like slipping past the castle guards and do its thing without pesky interference.

And that’s what Columbia University engineers came up with — an ‘invisiblity cloak’ for bacteria that using “inducible capsular polysaccharides” to let them slip past the immune system and carry its payload to the tumor.

Even better, they can adjust how long that coating lasts — that is, how long the bacteria delivers drugs before the body says “Waaaaaaait a second” and destroys it.

What, you want more? Sheesh, fine. The coated bacteria can also migrate from one tumor to another, if the cancer has metastasized. It’s all about how the cloak is tweaked.

That’s not scary at all

Our artificially intelligent friends (please don’t call them “robot overlords”) are getting very good at coming up with new drug candidates. But what if, just for kicks, you asked them to come up with, oh, I dunno, chemical weapons? The result — found researchers in the US, UK, and Switzerland — is not comforting:

“AI suggested 40,000 new possible chemical weapons in just six hours.”

Said the lead author in an interview, “I’ll be a little vague with some details because we were told basically to withhold some of the specifics.” Well I sure feel much better.

The Long Read: ‘What Say You’ edition

Ever wish there was a decent option for communicating with people who don’t speak English? You’re not alone. Let’s face it, “Doctors often turn to Google Translate to talk to patients. They want a better option.”

Stay where you are

Everyone’s excited about the idea of permanent Daylight Saving Time — ending the twice-yearly nightmare of changing clocks backward and forward like some sort of animals.

Well, almost everyone. The American Academy of Sleep Medicine loves the idea of leaving the clocks alone, but it argues we should stick with standard time all year. Fall back and stay back.

[C]urrent evidence best supports the adoption of year-round standard time, which aligns best with human circadian biology and provides distinct benefits for public health and safety.

One good thing: The issue hasn’t become politicized … yet.

J&J vax makes a comeback

The Johnson & Johnson Covid-19 vaccine became the red-headed stepchild of the pandemic — it just didn’t provide the protection that mRNA vaccines did.

Or did it?

The latest data seem to show that the J&J vaccine actually works — and works well. As one South African health official said, “It punches above its weight for a single-dose vaccine.”

Punches hard, according to the latest CDC data, which found that “the Johnson & Johnson vaccine appeared to be somewhat more protective against infection than the two alternatives.” Why?

The J.&J. vaccine may produce antibodies that decline more slowly than those produced by the other vaccines, some research suggests. Or those antibodies may become more sophisticated over time, through a biological phenomenon called affinity maturation.

Keep waving, dear

As the Omicron BA.2 variant starts to spread through Europe and Asia, the spectre of Yet Another Covid Wave appears like a creepy uncle in the window. Sick of it all? Then I guess I shouldn’t mention Omicron BA.4, aka, “Omicron-Omicron recombination,” huh?

There have been four confirmed sequences of the strain in South Africa, one in the US, and one in Puerto Rico through March 16. […] The real number of infections by this recombinant could be much higher, especially as Omicron BA.1 and BA.2 continue to rage.

Greedy pharmacy techs make outlandish demands — ‘better working conditions’

“Hospitals and health systems,” found a survey from the American Society of Health-System Pharmacists, “are experiencing severe shortages of pharmacy technicians.” And they’re trying — really, really trying — to get them to stay.

But what will that take? Conveniently, ASHP asked the techs, and the answer is shocking. Shocking.

Three-quarters of technicians who responded to the survey said higher pay would help retain technicians, nearly a third would like to see employers offer retention bonuses, and 25% desire a career ladder with clear pathways to promotion.

Because “Even with that strong job satisfaction, technicians are often frustrated with heavy workloads, inadequate staffing, and inadequate compensation.”

Better working conditions, higher pay, and a career path — crazy, right?

An argument for staying home

Ticks carrying the Heartland virus are in Georgia, bringing the once-rare disease to a hospital near you.

The lone star tick that carries the virus isn’t new, according to Emory environmental scientist Gonzalo Vazquez-Prokopec, but the virus it’s carrying is rare … for now.

“We’re trying to get ahead of this virus by learning everything that we can about it before it potentially becomes a bigger problem.”

And to add to the thrill, similar viruses are carried by the Asian longhorned tick, which first appeared in Georgia last year.

Is that the best you can do?

Biogen has finally published the phase 3 results for aducanumab — aka Aduhelm, the Alzheimer’s treatment it originally priced at $56,000 a year … and that showed little if any effect (but still magically got (controversial) FDA approval).

This should settle things, right? Ha! Biogen published those results in a, shall we say, ‘not-exactly-first-rate journal,’ according to Endpoints News. But the kicker: The journal’s editor-in-chief “is a paid Biogen consultant and received almost $40,000 in payments from the company since 2014.”

The folate-dementia connection

It seems there’s a connection between dementia and serum folate (aka vitamin B9) deficiency, but it’s not clear which causes which.

While the headline from the BMJ reads, “Low blood folate may be linked to heightened dementia and death risks in older people,” the actual research explains that linked to doesn’t mean causes.

Sure, people with low folate “were 68% more likely to be diagnosed with dementia and nearly 3 times as likely to die from any cause,” but the American and Israeli researchers were clear that “reverse causation is likely.”

Testing folate levels is important regardless. Low levels either indicate existing dementia — or they portend a future risk.

Spray-on heart repair

What’s better than coronary bypass surgery? Coronary bypass surgery with gold nanoparticles.

Canadian medical researchers developed a spray — “a spritz of super-tiny particles of gold and peptides” — that can help repair a damaged heart* as either a stopgap before surgery or as part of a bypass operation.

[T]he custom-made nanogold modified with peptides […] was sprayed on the hearts of lab mice. The research found that the spray-on therapy not only resulted in an increase in cardiac function and heart electrical conductivity but that there was no off-target organ infiltration by the tiny gold particles.

“You spray, then you wait a couple of weeks, and the animals are doing just fine compared to the controls.”

* A literal damaged heart — not some kind of late-night Lifetime movie plot

The Long Read: An immune system in the palm of your hand

A bunch of our stories start off, “If you have a mouse with…” because studies often find treatments that work on mice (or zebrafish, or pangolins) but not on humans. Humans are different.

One solution is organs on a chip. They can be better than using critters to test drugs designed for humans. There are hearts on a chip, lungs, spleens, and even teeth — and Harvard biologists have now cracked one of the toughest nuts: They’ve created an immune system on a chip. It includes human B and T cells, and even the structures that control immune responses.

These “lymphoid follicle” chips…

…consist of different chambers that harbor “naïve” B cells and T cells, which together initiate the cascade of events that leads to a full immune response when they are exposed to a specific antigen.

All those opioid laws

Did … almost nothing. All those states passing prescription caps, anti-pill-mill laws, and even mandatory PDMPs, and the end result was bupkis.

That’s the conclusion of a new study out of Johns Hopkins (and Cornell and UMich) that found yes, there were some small, non–statistically significant changes, yes, but the laws they looked at …

…were each associated with a change of less than 1 percentage point in the proportion of patients receiving any opioid prescription [and] a change of less than 1 in days’ supply of opioid prescriptions […] per day per patient prescribed opioids.

We need 100 of you

Here’s the deal: The Georgia Pharmacy Foundation does great stuff, including funding scholarships for some of Georgia’s deserving student pharmacists.

This March, the foundation is looking for just 100 GPhA members to each donate $100 — it’s the $100 From 100 Campaign!

Be one of those 100 people.

If we had a dollar for everyone who said, “Someone else’ll do it,” we wouldn’t need to ask you. So we’re asking: Will you help tomorrow’s pharmacists? Give to the $100 From 100 Campaign!

Diabetics: Time your snacks

If you any diabetics who are interested in living longer, here’s a new tip: It’s not just what you eat, it’s when you eat it.

A salad and glass of milk before bedtime will help, and if you must eat those Slim Jims, don’t do it in the evening — that’s what Chinese endocrinologists found (and published in the Endocrine Society’s Journal of Clinical Endocrinology and Metabolism.) after analyzing the health data of more than 4,600 people.

“We observed that eating potatoes in the morning, whole grains in the afternoon, greens and milk in the evening and less processed meat in the evening was associated with better long-term survival in people with diabetes.”

Listening to their robot overlords

Sure, lots of people don’t listen to their doctor or pharmacist when told, “Look at your genetics, dude. You should think about a statin.” But you know who they will listen to? An app.

The good folks at Scripps Research designed one that calculates a person’s genetic risk for coronary artery disease. When it gave them the score and told them the dangers (“Remember how they found Uncle Mike?”) a lot more of the high-risk people went to get a prescription.

Big caveats, though: Right now, users have to take a 23andMe genetic test, deal with whatever horrible family secret it uncovered, link the data to the app, fill out a bunch of questions … you get the idea. But still, call it a proof of concept.

“On the whole it looks like a significant effect, especially considering that we were giving respondents only appropriately contextualized information about their gene-based risk scores—we weren’t directly telling them to go out and start taking medications.”

Cancer drugs: Lots of hype, narrow hope

Maybe you’ve noticed a bunch of new cancer drugs appearing over the last few years. Progress! Yes, but not as much as you might hope.

But UC Irvine hematologist/oncologists found that the cancer drugs the FDA approved between 2016 and 2021 have done little to change the first-line standard of care. Most of them affect a smaller number of patients — the ones who don’t respond to those existing drugs.

Only 14 percent (28 drugs) were good enough to displace the existing first-line drugs. The others were either alternatives (i.e., not any better), add-on therapies, or for later-stage patients “with few alternatives.”

Captain Obvious stares out the window in silence

“Severe COVID-19 may lead to depression or anxiety, study finds”

The future is gummier

Today’s fun fact: In 2019, “non-pill supplement delivery” — gummies, shots, powders, etc. — first beat out capsules and tablets as the way most people take supplements.

Some people have trouble swallowing. Other are apparently just tired of the effort required to take pills and capsules (or the effort to get Junior to take them) — aka “pill fatigue.” Whatever the reason, it won’t be long before more meds come in more forms.

More pharma companies leave Russia

AbbVie, Eli Lilly, and Novartis have also pulled out of Russia.

Lilly’s response is particularly brutal: “An Eli Lilly spokesperson clarified that the suspension will target certain drugs like Cialis.”

A frustrated Russia could not be reached for comment.

Night lights OF DOOM

Even if you close your eyes while you sleep, having a light on can kill you. Eventually. Apparently (found Northwestern neurologists), a room with even “moderate ambient lighting” causes your heart rate to rise, makes your sleep worse, and increases risk for heart disease and diabetes.

And it doesn’t take long: “[J]ust a single night of exposure to moderate room lighting during sleep can impair glucose and cardiovascular regulation.”

“Even though you are asleep, your autonomic nervous system is activated. That’s bad. Usually, your heart rate together with other cardiovascular parameters are lower at night and higher during the day.”

And if you absolutely must have a light? Go with amber or red/orange, not white or blue. They do as good a job keeping the monster(s) under the bed at bay, but are less stimulating for the brain.

Should pharmacists be able to prescribe contraception?

UGA wants to know. UGA College of Pharmacy researchers are conducting an opinion survey (it’s quick) about that very subject, and they’d like licensed pharmacists to weigh in.

Let them know what you think, what you’re comfortable with, and what it would mean — and be quick: The first 500 licensed Georgia pharmacists who complete this 10 minute survey will receive a $15 Amazon gift card via email. (Even if you’re not in the first 500, you’ll still be helping get a handle on the issue.)

Go forth and opine!

Today is the early bird deadline

Please do not register for the Georgia Pharmacy Convention until tomorrow.

If you register today, March 15, you’ll save $50 on your convention registration. So please, wait until tomorrow and pay $50 more.

Ha ha — we kid! But today is the last day to register and save $50.

Don’t miss out on great convention education, networking, food, fun, and more — with or without the early bird rate. Because even if the early bird gets the worm, the second mouse gets the cheese.

The 2022 Georgia Pharmacy Convention
June 9-12, 2022
Early bird pricing ends today March 15.

Click here to register!

Announcing convention keynoter Kenyon Salo!

We’re thrilled to announce that keynoting the 2002 Georgia Pharmacy Convention will be Kenyon Salo — one of the top keynote speakers and trainers in the fields of inspiration, leadership, and adventure!

He’s determined to live life to the fullest and help others do the same — and through humor, awe-inspiring moments, prolific storytelling, and edge-of-the-seat content, he’ll share his passions for adventure, storytelling, and connecting with people. He found a simple process to guide others on a path to what most of us crave — living a more fulfilled life.

Kenyon will not only remind you how amazing life can be, he’ll share the steps that will help you — both personally and professionally — embark on a path to achieve anything you desire.

Check him out!

Pfizer pulls out … and gives out

Pfizer has said it will no longer invest in Russia, but will continue to sell medication there. Get this, though: The company said it will donate all profits from its Russian subsidiary to humanitarian efforts in Ukraine.

[E]very dollar of profit derived from Russia will strengthen Ukraine and its people as they continue to valiantly defend their nation and freedom.

It’s not alone. At least 27 other pharmaceutical companies are giving direct or indirect support to Ukraine.

Chutzpah

Some of the companies that agreed to pay $26 billion for their role in the opioid crisis may have a twist up their sleeves. They’re apparently trying to use provisions in the Covid-19 relief bill to claim that opioid-settlement money as a tax deduction. And that is not sitting well with the House Oversight Committee. It’s asking the Department of Justice to investigate.

A colon cancer prevention pill?

Emodin (aka 6-methyl-1,3,8-trihydroxyanthraquinone*) can prevent colon cancer. That’s been shown. Exactly how it works was unclear, and without that tidbit it’s hard to turn it from “compound in Chinese rhubarb” to “pill you can buy.”

University of South Carolina physiologists made a big step toward figuring it out. The found the mice they gave it to had fewer and smaller polyps — not news. But they found that the cause seemed to be a gut with fewer of the particular macrophages that cause the tumors.

To confirm, they exposed the macrophages to emodin directly, and bam! Dead macrophages. Thus the road is open to further study, and maybe a new supplement on your shelves.

* Also the name of Elon Musk’s third child

Covid makes a comeback

China, Australia, and Europe are beginning to see a new wave of Covid-19 infections, this one from the Omicron BA.2 variant (which hasn’t yet gotten its own Greek letter*).

Europe is reporting an upswing in case numbers and hospitalizations — about a month after most restrictions had been lifted. Which is exactly what happened with Delta. And Omicron.

Australia is also seeing an uptick, and is pushing people to get their boosters before hospitals are overwhelmed again. And China, which has a low vaccination rate and so-so medical infrastructure, is starting lockdowns amid another surge.

As Forbes’s Bruce Lee (no relation) put it:

Some politicians, TV personalities, and people have been asserting that they are done with the Covid-19 pandemic, which may be nice to hear. But looks like SARS-CoV-2 didn’t get the memo.

* It would be Pi, unless the WHO thinks that’s confusing — in which case it’ll be Rho.

Mentally prepare yourselves

A second booster shot looks like it’s coming. (No, it’s not a “fourth booster.” Sheesh.)

Flu tests: good to know

At-home flu tests are just as good as the kind sent to a lab — so finds a study out of the University of Washington. It compared results when a test was done by a lay user vs. the same test sent to a lab.

Considering the time to get to a pharmacy (or, worse, a doctor), get the test done, send it out, have it run, and have it returned — it makes a lot more sense to do it yourself and hopefully start treatment (or at least rest and fluids) sooner.

Maybe it’ll help

Senator Chuck Grassley, ranking member on the Judiciary Committee, is … displeased with the FTC. The agency, you may recall, declined to investigate just how insidious PBMs and their practices are.

“There is widespread bipartisan support for examining PBMs and looking into whether they are causing Americans to pay higher prices for prescription drugs,” he wrote, and encouraged the commissioners to rethink their choices.

An earlier version of this story quoted Sen. Grassley as saying, “The emperor is not as forgiving as I am,” which turns out to have been misattributed. We regret the error.

Sharing is caring … and depressing

During the third wave of Covid-19, about 27 percent of people reported feeling depressed. But here’s the kicker: For people who shared at least one photo a day on social media, that jumped to 45 percent.

Hungarian researchers, tracking depressing since the start of the pandemic, found that the depression gap between ‘daily sharers’ and normal people got larger the longer the pandemic continued.

[T]ime spent on social media and willingness to share self-representative content have both increased during the pandemic waves and are associated with a higher and growing risk of major depressive disorder among the most active sharers.

Sharing and depression — which is cause and which is effect? Not clear. But after a couple of weeks of seeing daily photos, you might want to reach out: “How you doing?”

Psychopaths are (sorta) like us

Being a psychopath may not be a disorder. It may be an adaptation.

Here’s the logic: One of the processes that causes mental disorders also causes left-handedness; that’s why so many lefties are a bit … off*. (No offense. It’s just a fact.) So if psychopathy was also a disorder, more psychopaths should be left-handed.

That’s what Canadian researchers figured, at least. So they checked — they did a meta-analysis of 16 studies that “investigated the association between psychopathy and handedness in various populations.” (Yes, 16 separate research teams all did the same study.) They found that nope, there was no connection — there are plenty of right-handed psychopaths, too.

Thus, our results fail to support the mental disorder model and partly support the adaptive strategy model. We discuss limitations of the meta-analysis and implications for theories of the origins of psychopathy.

* Mark Zuckerberg; Eminem; presidents Ford, Clinton, Bush, and Obama; Napoleon, Tina Fey….

The next new scourge

It’s about time for a new ‘drug on the street to worry about’ story. The drug: xylazine, added to fentanyl. Why would people want to use a veterinary tranquilizer with an opioid? Experts don’t know. But it’s dangerous (of course) because a sedative is a Bad Idea if you’re in respiratory distress.

And because labs don’t normally test for it, the actual usage might be higher. Said the author of the paper that described the trend, “[It’s an] especially noxious contaminant that is spreading through the drug supply.”

Clarificorrection

On Thursday we told you about how the American Medical Association is very much against expanding the Covid ‘test to treat’ program for Covid-19 to more pharmacy-based clinics. Our headline was “AMA to pharmacists: Stay in your lane.”

Reader C.A. pointed out an obvious problem with that headline: “GPhA is making the same mistake I’m seeing everywhere. The AMA is not insulting pharmacists. They are insulting the midlevel providers who work in clinics inside the same building as pharmacies (such as CVS Minute Clinics) i.e., NPs and PAs.”

No argument. We sacrificed accuracy for a titillating headline!

A vaccine from blood

Canadian scientists have come up with a new kind of vaccine — one that uses the empty husks of red blood cells. It took a team of physicists, chemists, and immunologists, and the gist is that they make the cells look like whatever virus they want to vaccinate against. To pick a disease totally at random, how about … Covid-19? In that case…

“We take red blood cells and remove everything from the inside. We then attach spike proteins to their outside to mimic a corona virus.”

The idea is that this method is flexible, doesn’t require genetic material, and reduces side effects. At the moment, though, it’s just proof-of-concept.

Watch those kids

If you have teen or young-adult patients who just started taking either a stimulant or a benzo, keep an eye out, at least metaphorically. A new study out of Rutgers found that there’s been a noticeable uptick in overdoses for first-time users of those drugs in particular.

They found that 29 percent of youth with overdoses involving [a benzodiazepine] had a doctor-written prescription dispensed in the prior month […] while 25 percent of youth with an overdose involving stimulants had a stimulant prescription dispensed in the prior month.

Today’s Covid-19 treatment is made from …

Human skin cells, specifically dermal fibroblasts. Normally they produce nanoparticles called extracellular vesicles (EVs) that allow communication between cells and tissue. In this case, Cedar-Sinai scientists* tweaked the skin cells (via science magic) so they made EVs that repaired tissue instead.

They tested this repair system on human lung epithelial cells — the very ones attacked by the SARS-CoV-2 virus. Not only did it stop a deadly inflammatory process, the lung cells also made less of the ACE protein, which SARS-CoV-2 needs to infect and replicate.

“This potential anti-COVID-19 biological therapy is novel in that it has two facets: It protects infected cells, which remdesivir does not do, and also inhibits viral replication.”

* Try saying “Cedar-Sinai scientists” five times fast.

One-a-Week pill tech

The technology for a pig contraceptive — that allows it to be given weekly instead of daily — is coming to other meds. After all, why carry around all those old-style pills when you can take something that opens up like a snowflake?

Human trials of the pill itself are beginning soon, with phase-1 trials for a risperidone version “expected to be submitted for approval by the [FDA] by the end of next year,” and versions for levomethadone and rosuvastatin in the works.

The technology is opposed by the Alliance for Larger Pill Bottles because of something-something safety, terrorism, jobs, etc.

There is no Daylight Saving Time story here

Because 42 gazillion articles about the dangers of changing the clock are more than enough. Have a great weekend.

(Fun fact: The correct term is Daylight Saving Time — there’s no extra “s” in Saving.) (You’re gonna check that, I know.)

Et tu, antiviral?

Covid is on the decline, and now we can all breathe a sigh of relief, knowing th—

Oh, you have got to be kidding.

In an unexpected twist from this season’s writers, it seems that sotrovimab, the antiviral used to treat Covid-19, is causing treatment-resistant mutations of the virus to emerge.

“We discovered that the virus that causes COVID-19 can develop mutations within the patient several days after sotrovimab treatment, which reduces the effectiveness of this treatment by greater than 100-fold.”

So far the mutated versions haven’t spread beyond the treatment clinics, but heck, it’s only March.

Caring in your heart, certificate on your wall

Medication therapy management — it’s one of the best ways you can care for your patients (and it’s a potential revenue stream, too).

A big step to providing MTM, though, is making sure you’re giving— and getting — the most you can. Patients will appreciate that, not to mention the lovely certificate on your wall.

Learn how to provide the best MTM you can when GPhA presents, “APhA’s Delivering Medication Therapy Management Services: A Certificate Training Program for Pharmacists.” There are even two dates available!

Sunday, March 27, 2022 8:00 a.m. – 5:00 p.m.

=or=

Sunday, September 18, 2022 8:00 a.m. – 5:00 p.m.

Live via Zoom

Click here to get the details, see the instructors, and register!

Making quitting easier

Smoking and heavy drinking often go together, and when they do it’s even harder to get someone to quit cigarettes. (For one, alcohol makes the ‘reward’ from smoking even more acute.)

A treatment that works, it seems, is a one-two punch: nicotine replacement and varenicline (aka Chantix). A University of Chicago neuroscientist and team found that adding the varenicline worked much better than nicotine replacement alone.

• Nicotine replacement alone: 27.9% of the participants quit after 12 weeks
• Nicotine replacement plus varenicline: 44.3% of participants had quit

And a bonus side effect: reduced drinking — to the tune of 25-whopping-percent. (Weirdly, this was true with an without the varenicline.)

A better UTI treatment

Treating recurring urinary tract infections is simple: low-dose maintenance antibiotics. But Australian researchers think they’ve found a better alternative, and one that won’t contribute to antibiotic resistance: Koala dung. No, no — it’s methenamine hippurate, the urinary antiseptic.

Testing over a year on 240 women with recurrent, uncomplicated UTIs found that methenamine hippurate treatment was statistically “non-inferior” to using antibiotics. The researchers’ main caveat: They didn’t compare the treatment to specific antibiotics. Yet.

Nail in that coffin

A federal bankruptcy judge has approved the now-it’s-$6 billion settlement between the Sackler family and a long list of states, cities, tribes, and towns that suffered from the opioid crisis — a crisis that the family had absolutely nothing to do with, no sirree.

While they’re shielded from further civil liability, criminal cases are not off the table.

And the Sackler’s victims got their day in court — two dozen were allowed to speak in front of three members of the family. Per the AP:

“I hope you hear our names in your dreams. I hope you hear the screams of the families who find their loved ones dead on the bathroom floor. I hope you hear the sirens. I hope you hear the heart monitor as it beats along with a failing pulse.”

Flu news

Early data shows that this year’s flu vaccine is barely effective — just 16%, which falls within the margin of error. (The H3N2 strain is notorious for evading vaccines.) On the other hand, all that mask wearing has once again kept the season mild, and the peak is behind us … hopefully.

Bad chemical, worse virus

PFAS — nasty chemicals in a lot of consumer products and manufacturing processes — can interfere with the immune system (not to mention cause cancer and kidney disease). There are thousands of PFAS chemicals, and they’re slowly being restricted, phased out, or banned. And now the first studies have shown that, not surprisingly…

Higher levels of exposure to toxic PFAS “forever chemicals” may increase the likelihood of Covid-19 infection, more serious symptoms and death.

Fun fact: They last forever and “are estimated to be in about 97% of Americans’ blood.”

Midgely’s legacy

Do you know an idiot? Maybe you can blame Thomas Midgely. Because it seems that almost half of Americans alive today had enough childhood exposure to exhaust from the leaded gasoline he invented to lose “a collective 824 million IQ points.”

Duke and Florida State researchers found that…

As of 2015, more than 170 million Americans (more than half of the U.S. population) had clinically concerning levels of lead in their blood when they were children, likely resulting in lower IQs and putting them at higher risk for other long-term health impairments.

And if you think losing a few IQ points isn’t a big deal, the authors note that it’s enough to shift someone from ‘below average’ to ‘intellectual disability.’

* And also the genius who gave us CFCs and the ozone hole — a “one-man environmental disaster”

Captain Obvious is keeping his on in public for now

“Masking In K-12 Schools Significantly Reduces Covid-19 Among Staff And Students”

[In Arkansas], Districts that had “full” mask requirements […] had an estimated 23% reduction in cases compared with districts without mask requirements, a benefit that was observed for both students and staff members.

Test me like one of your French ants, Jack

Dogs can detect cancer, Covid, and who-knows-what other diseases. But they’re so big. French researchers have an alternative: ants.

Yep, they’ve trained ants to detect cancer cells by smell. “[I]ndividual ants need only a few training trials to learn, memorize, and reliably detect the odor of human cancer cells,” they wrote.

Our findings suggest that using ants as living tools to detect biomarkers of human cancer is feasible, fast, and less laborious than using other animals.

Breaking news: Georgia house passes HB1351!

The bill, sponsored by Representative David Knight, would “carv[e] out the drug benefit from Medicaid managed care plans,” as Georgia Health News put it. More details to come shortly!

Today’s interesting antibiotic fact

When it comes to telehealth, physicians who are affiliated with a hospital prescribe fewer antibiotics than contractor-supplied or “vendor” docs.

Of 257 telemedicine encounters related to acute respiratory infection, affiliated physicians prescribed antibiotics in 18% of visits, compared to 37% of visits by vendor physicians.

Spring, when pharmacists’ fancy turn to thoughts of GPhA Region Meetings

It’s that time! Time to register for your GPhA Spring Region meeting, coming to your area in April. Hang out with your fellow pharmacists, have a great meal, hear some important updates, and, of course, score an hour of that sweet CE credit.

Click here, see your meeting’s details, and register today! (Note: A few locations are still being nailed down and will be announced soon.)

AMA to pharmacists: Stay in your lane

The White House is launching a ‘test to treat’ program for Covid-19 — pharmacy-based clinics across the country would be “‘one-stop shops’ where people who receive a positive COVID-19 test result can be seen by a clinician and receive antiviral therapy, all in one visit.”

APhA is on board, although it would like to see more pharmacies included. But physicians? Not so much. The American Medical Association likes the idea of one-stop shops, but says they should be in doctors’ offices because “pharmacy-based clinics usually treat simple illnesses.”

“COVID-19 is a complex disease, and there are many issues to consider when prescribing COVID-19 antiviral medications,” the AMA said. “Leaving prescribing decisions this complex in the hands of people without knowledge of a patient’s medical history is dangerous in practice and precedent.”

Patients who test positive, the AMA said, should consult their physicians.

RIP David Bennett

The first person to receive a heart transplant from a genetically-modified pig has died, two months after receiving the organ. “He proved to be a brave and noble patient who fought all the way to the end.”

The cold and Covid

Back in January there was a hint that having the common cold might offer some protection from Covid-19. Now, though, it seems the opposite may be true.

A new study out of the University of Rochester found that people who had been infected with a common cold would release a lot more antibodies against SARS-CoV-2 — but they were targeting the wrong part of the virus, and they were keeping the ‘right’ antibodies from working.

[T]hese antibodies were targeting parts of the spike protein […] that were similar to common cold coronaviruses the immune system remembered from previous infections. Unfortunately, targeting those areas meant the antibodies could not neutralize the new SARS-CoV-2 virus. When levels of these antibodies rose faster than levels of SARS-CoV-2 neutralizing antibodies, patients had worse disease and a higher chance of death.

Omicron shift

The BA.2 sub-variant of Omicron now accounts for an estimated 11.6% of what’s circulating in the U.S., according to the CDC. The latest info suggests BA.2 is even more virulent than original Omicron, but having made it through the first Omicron wave means it’s not actually hospitalizing as many people.

Forever young

We’ve talked a lot about ways to keep mice healthier, but you may have thought, “What’s the point? They only live a few years anyway.”

Not anymore (maybe). Scientists at the Salk Institute — tired of trying to convince Suzie that it really is still Nibbles in the cage — have “shown they can safely and effectively reverse the ageing process in middle-aged and elderly mice by partially resetting their cells to more youthful states.”

They do this with a mixture of four reprogramming molecules that reset the epigenetic marks on the mice’s cells from old mouse to new mouse — thus “the treatment does not simply pause ageing, but actively turns it backwards.”

The Salk team members soon after announcing their discovery

“Europe is mad. The world is mad.”

Feeling anxious? The Brits have got your back with a next-generation body pillow. It’s “a huggable, cushion-like device that mechanically simulates breathing, and preliminary evidence suggests it could help reduce students’ pre-test anxiety.”

Considering school tests are the subject of many a nightmare decades later, that’s some pillow.

Fun fact: The ‘breathing’ pillow was one of five they tested, and the one with the best results. The others were one with a heartbeat, one that purred, one that purred and breathed, and one with colored lights.

Their work is published in PLOS One.

Today’s Covid treatment comes from …

Mushrooms. Specifically the C. militaris shroom and the cordycepin it contains.

Korean researchers figured that since mushrooms are known to have anti-inflammatory, antibacterial, and antiviral effects, there’s a good chance one of the chemicals in the fungi could have an effect on Covid-19. Lo and behold, cordycepin did — in fact, some of its effects “[were] equivalent to the most used reference medicines like lopinavir and remdesivir.” Well, in the lab, anyway.

Next up, animal tests.

Accelerated doesn’t mean unlimited

Right now, if the FDA gives a drug accelerated approval, there’s kind of a big flaw: It’s hard to revoke that approval if negative data shows up.

Accelerated approval means the agency is pretty sure the drug works, and getting it to people is important — think pandemic. So the drug is approved with the understanding that the drug maker will soon provide detailed proof that the drug works.

And if they don’t? Nada. So drug makers often don’t bother. Why should they? They’ve got (conditional) approval, so why take a chance on running a study that shows their product doesn’t work?

And thus Frank Pallone, chair of the House Energy & Commerce Committee, is introducing a bill that would…

… set time limits around accelerated approvals, such as requiring the approvals to expire one year after post-approval studies are scheduled to be complete, and never later than five years after an accelerated approval.

Get yer legislative update!

Stay up to date with what’s happening in Atlanta — Melissa Reybold’s latest legislative update is live, with all the details on the bills we’re following. Think PBMs and Medicaid, insurance participation contracts, being allowed to carry controlleds in a compartmentalized container, and more.

A new weight loss drug?

We’ve all dealt with fat mice — sometimes it’s hard to get them to lose weight. But now it seems a drug intended for cancer — camptothecin — might help them lose weight.

Camptothecin can treat gastrointestinal tumors, but it’s got some awful side effects at useful doses*. But at smaller doses, Chinese geneticists found, it stimulates the release of growth differentiation factor 15. And GDF15 suppresses appetite and causes weight loss “without ill effects” in those mice.

As always, of course, “Further study is needed to evaluate its efficacy and safety.”

* But analogs of camptothecin work: belotecan, irinotecan, topotecan, and trastuzumab deruxtecan.

Tick spit, continued

Last month we told you how Aussie researchers found that tick saliva can reduce inflammation. But it seems they’re not the only ones researching it.

Researchers at Britain’s Durham and Newcastle universities found that a protein in tick spit — votucalis — “provided pain and itch relief” by binding to histamine molecules without getting to the brain.

The anti-itch and pain relief potential of Votucalis means we could be on the brink of discovering a viable alternative to opioid and gabapentinoid drugs.

Immunization training down under

Technicians down south — we haven’t forgotten you! GPhA’s got it’s hot hot hot immunization training session, coming to Douglas, Ga.*, live on Saturday, April 2.

Be ready for Rho, Upsilon, and the eventual Andromeda strain: Get your vaccine training, bragging rights, and a spiffy certificate with GPhA’s Immunization Delivery Training for Pharmacy Technicians. It’s a total of 5½ hours of CE, including home-study and live training.

Space is limited, so don’t wait — click here for all of the details and to register now!

* At the Grace Pointe Church, kitty-corner from Space Cow Creamery

Totally objective research

Which is better for your heart, almonds or French fries? Yes, it’s a trick question; we all know that almonds must be better for you.

‘Now waaaaaaaait a minute,” says a research team out of the University of Alabama and Indiana University. Their study finds that — wowzers! — despite what you might have heard…

There were no significant differences in [fat mass] or in glucoregulatory biomarkers after 30 days of potato consumption versus almonds.

And thus, “Results do not support a causal relationship between increased French fried potato consumption and the negative health outcomes studied.” (Those “negative health outcomes” were weight gain, adiposity, and diabetes risk.)

Pssst: If you listen very carefully you’ll hear the researchers say, “Funding provided by the Alliance for Potato Research and Education.”

The Long Read: Changing Colors edition

If you noticed that a lot of pharmaceutical brands tend toward blue, you’re right — it’s pretty common. But lately companies are expanding their palettes, and now purple isn’t quite as much a standout as it once was. (But brown? No, you won’t see a lot of brown.)

Even the wrong flu vax works

Each year’s U.S. flu vaccines are based on the strain that appears in Australia during our summer — it’s our best guess at what strain will appear here. Usually it’s a partial match, which gives reporters something to write about: “Flu vaccine only 60% effective!”

But we’ve learned from Covid-19 that effective against disease and effective against severe illness are two different things.

So CDC wondered about the “wrong” flu vaccine. It turns out, they found (based on the awful 2019-20 flu season) that even a “mismatched” vaccine can cut a kid’s risk of hospitalization by almost half.

Vaccination was estimated to reduce the risk of critical influenza in children by 78% against [matched strains] and 47% against mismatched viruses. (Emphasis ours.)

Flumidity?

When will flu hit? It’s all about the humidity, says NASA, and it varies by state. When the humidity gets below a certain point each year, two weeks later the flu breaks out. For Georgia, that’s about 7g/kg.

That’s an absolute humidity. Based on this calculator, if it’s 50°F outside (10°C), Georgia crosses into flu season when (tap tap tap) … when the relative humidity drops below about 90 percent.

When it comes to chemo, women are different

People undergoing chemotherapy often have side effects — some severe. But women are much more likely to have them, especially with immunotherapy. What’s up with that?

One big problem (found a group of cancer researchers from across the country —with one Canadian for good luck) is that testing and development of treatments are all based on men and male cells.

That results in dosages that are “very well-tolerated” … for men. Women, though, metabolize drugs more slowly, and they’re also more prone to autoimmune diseases. But a physician consulting a chart for maximum tolerated dose isn’t taking into account a patient’s gender.

Result:

Overall, women were 34% more likely than men to experience severe adverse effects in response to their cancer treatments, a figure that increased to 49% for women receiving immunotherapies, according to a recent study in the Journal of Clinical Oncology.

Covid numbers

Cases, hospitalizations, deaths — all dropping, dropping, dropping.

• Only about 1,100 Georgians a day are testing positive now.
• Only 2,600 Covid cases are in the hospitals.
• Only about 64 Georgians a day are dying from Covid.

Worldwide, a minimum of 60 million people have died from Covid-19. (The reality is probably a lot higher, because of lack of testing.)

Good news, guys

Sure, The latest studies out of Canada and China show that Covid can do a lot of damage to the male reproductive system — causing erectile dysfunction, testicular pain and atrophy (!), lower testosterone, Peyronie’s* disease, and more.

The good news: They also found that “the effects may be transient” — decreased male fertility, for example, lasts only a few months — “and may be at least partially mitigated by vaccination.”

* Do. Not. Google.

Azithromycin, kids, and asthma

Keep this in the back of your mind: If you’ve got kids with bad asthma as patients, and they’re having trouble keeping it under control, azithromycin is your huckleberry.

A study out of India found that adding a bit of azithromycin (10 mg/kg, three times a week) to the therapy of 5 to 15 year-olds significantly improved control of their asthma, and cut their ER visits and steroid use.

The more you know.

Peanut needles

If you have a mouse with a peanut allergy, you might have heard of some big advancements lately that might reduce those allergies by using early, mild exposure.

Right now, the only way to do that is a strict oral therapy — pills. Up and coming are skin patches, which are worn 24 hours a day for two months. But University of Michigan allergy researchers think they’ve found a better delivery system: microneedles.

By delivering the allergen to the skin, a microneedle, um, device “significantly improve[s] desensitization” — better yet, it only has to be worn a few minutes a day for several weeks, and the dosage can be tweaked for the patient.

Walk this much

Older folks! If you’ve been doing your 10,000 steps a day, good news: You don’t have to!

A study meta-analysis out of UMass Amherst found that you really only need to do 6,000 to 8,000 — after that, the benefit levels off. That gives you time to hurry home and get those whippersnappers off your lawn.

(Young folks, keep walking. Your benefits level off at 8,000 to 10,000 steps.)

Weird Science: Shopping Cart edition

The horizontal handle of most shopping carts causes you to use your triceps. And using your triceps has a strange psychological effect: Because we use them when pushing something away from us, “triceps activation is associated with rejecting things we don’t like.”

Ergo, using a shopping cart is, subconsciously, a negative experience. And British scientists proved it. Shoppers who used a specially designed shopping cart with parallel handles (see below) “bought more products and spent 25 per cent more money than those using the standard trolley.”

Today’s Covid treatment…

…is baricitinib, the arthritis drug, which “reduced hospitalized Covid-19 patients’ risk of dying by 13%,” in what’s billed as the world’s largest trial of coronavirus treatments.

Specifically, it works for people hospitalized with Covid and already on other medications. In those cases, it can reduce the chance of death even further.

Jocularity! Jocularity!

Come let your metaphorical hair down for a few hours with the Academy of Employee Pharmacists! It’s an afternoon of merriment, joviality, and — dare we say it — verve at the Scofflaw Brewing Company in Atlanta, April 23 from 2:00 to 7:00pm.

The whole time costs a mere $10, and that includes two drink tickets. You won’t find a better time for that price without breaking a few laws. And yes, student pharmacists are invited … as long as they promise to keep the hooliganism to a minimum. You know who you are.

All you need to do is register so they know how many to expect — click here to do just that.

Benzos can turn the brain against itself

Taking benzos for a long time eventually affects the brain, and not in a good way. Eventually, found German researchers, long-term use “leads to the loss of neural connections in the brain” by binding to and activating the brain’s microglia.

Instead of their normal clean-up job, those microglia start acting like over-achieving janitors, throwing out the good with the bad — in this case, they attack perfectly good synapses. End result: cognitive impairment.

Veggie tales

Eating more vegetables is good for your heart. Everyone knows that. But what if everyone was wrong? (Cue the dramatic music.)

A group of British and Chinese public health researchers decided to look into it via the health data of almost 400,000 people. What they found was … interesting.

First, “Higher intakes of raw, but not cooked, vegetables were associated with lower cardiovascular disease risk.”

But here’s the kicker. When they looked into the confounding variables — i.e., what else in the lifestyle of those those raw-vegetable-eaters might be a factor — the beneficial effect dropped by more than 80 percent.

In other words, it wasn’t the vegetables that reduced the risk, it was the overall lifestyle of people who ate more of them.

Rare disease slips into Georgia

Georgia is one of four states that experienced an outbreak of melioidosis according to a CDC report published in the New England Journal of Medicine. The source? Bacteria in Better Homes and Gardens-brand aromatherapy spray (“lavender and chamomile” scent) imported from India.

The bacteria that causes melioidosis — B. pseudomallei — occurs naturally in soil and water — just rarely in the U.S. And when it comes here, it’s usually because someone travelled to a tropical country and brought it home. In these cases, it hitched a ride in the worst possible product: an indoor aerosol.

(The Georgia patient, a 12-year-old boy, died in the hospital from a combination of melioidosis and Covid-19.)

Insulin challenge

President Biden: Let’s make insulin only $35 a month.

Congress: Yeah!*

Civica: Heck, approve our biologics applications and we’ll do it for $30. Insured or not.

The company “plans to manufacture and market three of the most common forms of insulin: glargine, lispro and aspart” at the Virginia factory it’s building starting (hopefully) in 2024. It should be able to produce enough vials and pre-filled syringes for about 50 million patients per year.

* Unless drug companies ‘lobby’ us more, or it becomes too political, or people forget about this after the elections….

His brain shrank three sizes that day

Another month, another alcohol study. This one, out of the University of Pennsylvania, finds that [stirs tea leaves] even light drinking shrinks your brain.

Alcohol has never been great for the brain, but moderate drinking has been thought to be okay, or even (depending on the study) good for you. Not so, says this group. It doesn’t take much booze at all:

[N]egative associations between alcohol intake and brain macrostructure and microstructure are already apparent in individuals consuming an average of only one to two daily alcohol units. (Emphasis ours.)

And by “brain macrostructure and microstructure” they mean shrinking your gray matter and messing with the structure of your white matter. According to the press release, in fact, going from “alcohol unit” a day (i.e., half a beer) to two units is like aging your brain two years.

On the other hand…

Drinking wine with dinner cuts your risk of type 2 diabetes, according to an American Heart Association study out of Tulane, based on data of more than 300,000 adults taken from the venerable UK Biobank.

The caveats: It should only be one glass (for women) or two (for men), and it has to be with a meal. In that case, it “was associated with a 14% lower risk of type 2 diabetes compared to consuming alcohol without eating food.”

Oh, and forget beer or liquor — those can raise your diabetes risk.

Shake it till you make it

Why get out and walk or run for exercise when you can just … vibrate?