Alternative to insulin

Scientists at the Salk Institute have found that insulin isn’t the only way to control diabetes. A hormone called FGF1, they discovered, also regulates blood glucose “potently and quickly”, but it does so in a different way.

Here comes the science: Treating diabetes involves (among other things), suppressing lipolysis. Insulin does this using a signalling pathway called PDE3B. On the other hand, FGF1 uses the PDE4 pathway instead — a ‘parallel road.’ This means FGF1 can work when insulin doesn’t.

Next up:

“Now that we’ve got a new pathway, we can figure out its role in energy homeostasis in the body and how to manipulate it.”

iPLEDGE problems? You’re not alone

If you or your patients are having trouble with the iPLEDGE program for isotretinoin, the FDA is working on it. Honest. But in the meantime, if you have issues with the system, contact the iPLEDGE call center at (866) 495-0654.

Off: the cuff

As much fun as it is to be able to say “sphygmomanometer,” University of Missouri engineers think they’ve built an alternative — one that kinda looks like a pulse-ox meter.

It uses a pair of pulse sensors that, together, measure how fast the person’s blood is traveling, which “has a strong correlation with blood pressure.” A computer does its magic and presto!, BP without the cuff. It takes about five seconds while also measuring temperature, blood ox, heart rate, and respiratory rate.

The prototype is about 90% accurate for systolic blood pressure and 63% accuracy rate for diastolic, but the latter should improve as the algorithm has more data to work with.

Plus or minus

The CDC now says the omicron variant accounts for 95.4% of new U.S. Covid-19 cases. But since the U.S. doesn’t do a lot of genetic sequencing, maybe it’s 34%. Could be 68%. But probably 95.4%.

New shingles vaccine in the works

GlaxoSmithKline’s Shingrix is the big name in shingles vaccines, but competition’s a-comin’. Fresh off their Covid-19 success with mRNA tech, Pfizer and BioNTech are now teaming up “to fast-track a vaccine for shingles based on the same technology platform.”

Trials are expected to start later this year, and if the speed of development of the Covid vaccine is any indication … well, you might not want to be holding onto any GSK stock next year*.

* Comment is for humor value only, and should not be construed as financial or investment advice.

Be careful with that Viagra

Let’s say you’ve got a mouse who you’ve been giving Viagra. (We don’t judge.) Something to keep in mind: Apparently sildenafil can weaken the artery supplying blood to the mouse’s abdomen and legs, leading to an “abdominal aortic aneurysm.”

In humans…

Abdominal aortic aneurysms occur more frequently in older men who have risk factors including emphysema, family history of abdominal aortic aneurysms, high blood pressure, high cholesterol, smoking and sometimes, obesity.

“Caution,” say the University of Rochester researchers who did the study, “may be appropriate.”

Medical shocker

“Smoking Cessation after Cancer Diagnosis Associated with Improved Survivial” (sic)

Patients with lung cancer who quit smoking after their diagnosis have a 29 percent improvement in their overall survival compared to patients who continue smoking after diagnosis.

Thinking about buying a pharmacy?

Really, who wouldn’t want to own one? Low stress, high reward, a lifestyle of leisure, being the envy of your peers … that’s why the good folks at NCPA are now offering their popular Pharmacy Ownership Workshop in a virtual format January 29 and 30.

It covers everything from developing a business plan and choosing a site, to finances and marketing and more. Check out the details and register here.

Captain Obvious is binge-watching “30 Rock” and staring into space

Polls show that Americans are worn out and frustrated by the pandemic.

“A Monmouth University poll taken two weeks after Omicron was first detected in the United States found that six in 10 Americans said they were ‘worn out’ by the pandemic, and nearly half said they were angry.”

Elsewhere: Big Cloudy Sky edition

Here’s an unexpected side effect of marijuana legalization: It could make it harder for people who use medical marijuana to get it.

In January 2020, when recreational marijuana became legal in Illinois, some dispensaries had to close their doors or impose limits on purchases. The same thing happened in Colorado and Washington when the recreational market opened in those states.

Why? Because pot is still illegal federally, so any cannabis sold in a state must be grown in the state — and that means shortages when it becomes legal recreationally.

The good news, though: “A state’s market usually takes six to 12 months to stabilize after recreational cannabis becomes legal.” Or, you know, we could just change federal law….

Big vaccine news

The nightmare is over.

Today’s Covid treatment

You might think of echinacea for colds, but of course it’s being researched for treating Covid-19, too. A group of European researchers looked at the existing studies and found that … well look at that, echinacea does have broad antiviral properties. (It appears to envelope a bunch of respiratory pathogens, including coronaviruses, lowering symptoms and reducing viral loads.)

As usual, of course, more testing is needed.

Don’t forget to nominate someone!

If you know someone who’s a bit extraordinary — at least in the field of pharmacy — it’s your sacred duty to nominate her, him, it, or them for a 2022 GPhA award.

The deadline is less than a month away: February 1. So it’s time to start choosing the best of the best in Georgia pharmacy, with awards presented in style at the 2022 Georgia Pharmacy Convention in (on?) Amelia Island, Fla.

What awards, you ask? The details are at GPhA.org/awards, but here’s the list:

• The Bowl of Hygeia: You know it or you don’t — it’s among the most prestigious awards in pharmacy and the only one with a Wikipedia page.
• Larry L. Braden Meritorious Service Award: GPhA’s highest honor
• Distinguished Young Pharmacist Award (“Young” meaning in the profession for less than a decade)
• Excellence in Innovation Award for Pharmacy Practice
• Faculty Member of the Year
• Jim Bartling Student Pharmacist of the Year*
• Pharmacy Technician of the Year

Yes, these are GPhA awards, but nominations come from you, the members. That’s what gives them meaning. And it starts now.

Visit our awards page at GPhA.org/awards for more information on award criteria, and to make your nominations. The deadline for submissions is February 1, 2022.

* Note that, by tradition, the winner of this award is expected to buy a round drinks for the other student pharmacists attending the convention.

A vaccine against dog allergies?

Instead of forcing people’s immune systems to tolerate dogs (as most dog-allergy treatments being researched do), some Japanese researchers are trying something different.

Fun fact: Dogs have seven allergans, “Can f 1” through “Can f 7,” but one — Can f 1 — is responsible for most allergic reactions.

The researcher’s plan is to look deep and determine Can f 1’s IgE epitopes (the parts recognized by the immune system). They want to design a drug that trains the immune system to attack that, ergo, a vaccine against Can f 1 … and therefore a vaccine against dog allergies.

M-m-m-my flurona

Israel has reported the world’s first case of ‘flurona’ — a flu-Covid double infection. No, the patient wasn’t vaccinated, but she was pregnant. Luckily her symptoms were mild.

The pay-attention supplement … for mom

Mom, if you want your seven year old to pay better attention … well, you may be almost eight years too late.

Choline. You needed to have taken choline while you were pregnant — and not just some choline. You needed twice the recommended amount. All this comes out of Cornell research that found “Seven-year-old children performed better on a challenging task requiring sustained attention if their mothers consumed twice the recommended amount of choline during their pregnancy.”

Most prenatal vitamins don’t include it, in part because it wasn’t considered all that important.

“Current recommendations for pregnant women were set in 1998 and are based on the amount of choline needed to prevent liver dysfunction in men, not on the more relevant outcome of offspring neurocognitive development.”

Captain Obvious turns his head

“Coughing Downward Reduces Spread of Respiratory Droplets”

Red means “Get that thing off me!”

Instead of vaccinating against Lyme disease, why not vaccinate people against ticks? Sort of. Yale researchers are developing an mRNA ‘vaccine’ that creates a reaction to a tick bite — a red rash that spreads quickly, so it’s noticeable before the tick has fed long enough to introduce the Lyme-causing B. burgdorferi bacteria.

“When you get early redness and early recognition, you pull the tick off. In our experience, when we pulled the tick off when redness occurred, protection against Lyme disease was very strong.”

Smells like metastases

If you woke up today not thinking the human body is amazingly complex, here’s a wake-up call: A gene responsible for the sense of smell is also apparently important for breast cancer metastasis, as it helps the tumor cells hijack the body’s signalling pathways.

Researchers at Mass General Hospital found that inhibiting the gene, OR5B21, “significantly decreased the metastasis of breast cancer cells.”

“The common perception is that the only role of olfactory receptors, which line the nasal cavity and relay sensory data to the brain, is to recognize odor and smell. Our work suggests that the olfactory receptor 5B21 is also a novel oncogene that may figure prominently in cancer progression by driving breast cancer cells to the brain and other sites in the body.”

Elsewhere: A Pound of Cure edition

Florida and Texas, two states with possibly the strongest anti-mask/anti-vaccine/anti-prevention stances when it comes to Covid-19 are now demanding federal help to deal with the shocking — shocking! — spread of the virus. Florida wants antibody doses*, Texas wants “testing and treatment.”

* Even though they don’t work against Omicron — according to Regeneron, the company that makes it.

Leave the dog’s hair alone

No matter what grandma, the guys in the back of that seedy bar, or your 10th grade gym teacher said, when it comes to hangover cures, there’s no good evidence that any of those ‘cures’ actually works.

Sure, there have been studies (say the British researchers who looked into it), but they aren’t very good:

Although some studies showed statistically significant improvements in hangover symptoms, all evidence was of very low quality.

If you’re skeptical, consider this: The first suggestion from Harvard University is literally “Hair of the dog” — drinking more to ease the symptoms of a hangover.

Covid notes

J&J STAYS IN THE GAME

If you got the J&J Covid-19 vaccine, first of all bless your heart. But good news: A study out of South Africa found that a two-dose regiment of the vaccine provides about 85 percent protection from severe Covid.

DELTA PROTECTS AGAINST OMICRON

A different South African study found that being infected with the omicron variant likely gives protection against the delta variant.

This is good for two reasons. First, with Omicron spreading much faster than Delta, it’ll soon be what you’re most likely to catch. Second, if you’re going to get Covid-19, Omicron is what you want — it’s less likely to kill you than Delta is.

CDC MAY DO A 360 ON ISOLATION

First it said that people who tested positive for Covid-19 but were asymptomatic needed to isolate for 10 days. Then, at the end of December, it cut that to just five days (in part at the request of employers like Delta Airlines, who wanted their employees back sooner).

Cue the backlash. And, you know, skyrocketing cases.

So … now the CDC is considering reversing its decision — maybe going back to a 10-day isolation, or adding a testing requirement, or … sheesh, at this point who knows? Mandatory double-masking? Wearing underwear backwards? Sacrificing a goat?

BOOSTERS FOR YOUNG TEENS ARE COMING

The FDA approved mRNA vaccine boosters for 12- to 15-year-olds; once the CDC approves them as well, high schoolers can get their third shot.

(Side note: There is some evidence that getting a different booster than the first shots may provide more protection — i.e., a Moderna booster if you had two Pfizer shots — but it probably doesn’t make much difference.)

Could the feds override Xtandi’s patent?

The awesome* prostate cancer drug Xtandi was discovered by scientists at the (public) University of California, funded by the National Institutes of Health (NIH) and the U.S. Army — i.e., U.S. taxpayers.

Still Japan-based Astellas Pharma is selling it to U.S. patients $156,000 a year for it — three to five times the price in the rest of the world.

HHS can fix this by exercising “march-in” rights.

The term “march-in rights” refers to the government’s authority, under Section 203 of the Bayh-Dole Act, to authorize third-party licenses to federally funded patents if the original patent holder fails to make the invention “available to the public on reasonable terms.”

In short, it could allow cheaper generic versions to be produced. So far, despite several petitions, it has declined. (Lobbying by the pharmaceutical industry couldn’t possibly have anything to do with that.)

But now there’s a new administration, and the petitioners have been told that their latest attempt is under review.

* Full disclosure: Xtandi, paid for by Medicare, gave me five more years with my Dad.

If you take digital payments, listen up

New for 2022: If you’re a small-business owners who uses services like PayPal, Venmo, or Cash App to accept money, not only are you supposed to report more than $600 to the IRS, now those services will be required to as well. So expect a 1099-K to be added to your paperwork.

What does this mean? Once again: Don’t take financial advice from a snarky blog. Ask your tax advisor.

Lupus and depression

If you’ve got patients with lupus, there’s a good chance they’re also suffering from depression — even when their disease is controlled and they’re on the right meds. And if they’re Black, the Washington University researchers found, there’s an even greater chance of depression.

This sounds like it might be important

“Rivaroxaban as thromboprophylaxis improves clinical outcomes after COVID-19 hospitalization”

Or maybe not. Them words are too bigly for me.

To-may-to, to-mah-to

Interesting non-medical story of the day: Japanese researchers have used CRISPR/Cas9 to genetically modify tomatoes so they contain high amounts of GABA (γ-aminobutyric acid) — which, the company that makes them claims, can help relax you and lower your blood pressure.

They aren’t in it to help people

Statins are pretty good (and cheap) for at lowering LDL-c levels. Even better, though, are PCSK9 antibodies — but they have to be injected twice a month, and they’re expensive.

But also out there is inclisiran, which lowers LDL-c as much as PCSK9 antibodies and only needs to be injected twice a year. The company that developed it, The Medicines Company, and CEO Clive Meanwell planned to keep the price much lower than, say, Repatha.

Then Novartis bought The Medicines Company, got approval for inclisiran (branded as Leqvio) … and priced it higher than existing PCSK9 antibodies.

[I]t would have been interesting had Novartis followed the plan initially outlined by Meanwell which would likely have benefited millions more patients. The high price of Leqvio won’t allow for that.

The new antivirals are here! The new antivirals are here!

The Georgia DPH says it’s received the first (limited!) shipment of Merck’s molnupiravir and Pfizer’s Paxlovid oral antiviral treatments for Covid-19, and it will distribute them to “select retail pharmacies” — translation: Walmart, Walgreens, and members of the Good Neighbor Pharmacy Group.

Stay away from the ER

In the name of all that’s holy, says the Georgia DPH, if you need a Covid test, don’t go to the emergency room. Register for a test through the DPH’s ‘register for a test’ site.

Stay off the floating Petri dishes

In the name of all that’s holy, says the CDC, if you need a vacation, don’t go on a cruise ship.

The agency has raised its travel health warning level for cruise ships to “Vantablack” because of repeated outbreaks on cruise ships, even among vaccinated passengers.

Speaking of testing

The headlines: “Antigen tests may have reduced sensitivity detecting Omicron!” (all because of an FDA release).

The reality about those at-home antigen tests:

• The study was based on lab results, not real-world ones.
• It found that some antigen tests weren’t as good at detecting Omicron as molecular ones were.
• Heck, antigen tests in general are “less sensitive and less likely to pick up very early infections.”

Go for the throat:

• Because Omicron tends to replicate faster in the throat than in the nose, saliva tests work better; South African microbiologists are publishing a paper about that, in fact.
• You can do a throat swab and a nasal swab with those OTC antigen tests. (In fact, that’s the protocol in some places.)

Metformin recall

Yes, another one. Viona Pharmaceuticals is recalling its metformin extended-release tablets (750 mg) due to impurities that could cause cancer. Check the FDA site for instructions and the list of lot numbers.

A step to understanding OCD

Obsessive-compulsive disorder shows up in all sorts of ways, from the mild to the severe. And there’s no timetable, either. That makes treatment tough.

So Brown University researchers came up with an experiment. They wired the brains of five people with severe OCD. They gave them smart watches to track biometrics. They tracked them in the lab and at home, and also used computer vision — i.e., artificial intelligence that watches video — to monitor their behavior.

Then they compared ‘episodes’ of OCD with the brain scans. Result: They found patterns of brain activity that correlated with OCD symptoms.

So what? This means that there are distinct signals in the brain that either cause or are caused by OCD — and that’s a big step to being able to treat it, even with existing deep brain stimulation therapy. As always, of course, “Work on this line of research is ongoing.“

Good vaccine news

Forget Pfizer’s test data. Now real-world data shows that the mRNA vaccine is safe for kids.

During a six-week period after the shots’ approval (Nov. 3 through Dec. 19), VAERS [CDC’s Vaccine Adverse Reporting System] received 4,249 reports of adverse events after Pfizer vaccination in kids ages 5-11. The vast majority — 97.6% — […] consisted largely of reactions often seen after routine immunizations, such arm pain at the site of injection, or some transient fatigue or headache.

Weight, weight

On the one hand, losing weight can cut your risk of severe Covid-19 complications significantly. (If you take it to the extreme, a Cleveland Clinic study found that bariatric surgery “was associated with a 60% lower risk of developing severe complications from COVID-19 infection.”)

On the other hand, semaglutide, Novo Nordisk’s injected weight loss drug, is in short supply for at least the next several months. One of its contractors had to stop manufacturing the injector pens.

Captain Obvious is slipping notes under the desk

“Schools play role in adolescent mental health, study finds”

Picture of the day: 1918 flu

They all didn’t know how to wear masks then, either.

Think of the children

The number of kids being hospitalized with Covid-19 has jumped 30% in a week nationwide; most were unvaccinated.

=BUT=

If they have the omicron variant, at least, it tends to be less severe. (Although “It remains unclear to what degree the Omicron variant is responsible for rising hospitalizations.”)

=BUT=

About 1,200 kids a day are still in bad enough shape to end up in the hospital with Covid.

Getting paid for dispensing Covid antiviral pills

Strange but true: Some of you are expecting to be paid when you give patients those coming-soon Covid antiviral pills. (The pills will be given to you free, but you can still receive a “dispensing fee.”)

CMS has a two-page memo/guide that explains it.

We would call it “Getting Paid for Dispensing Covid Antiviral Pills,” but government writers are paid by the word, so it’s “Permissible Flexibilities Related to Oral Antiviral Drugs for Treatment of COVID-19 that May Receive U.S. Food and Drug Administration Emergency Use Authorization and are Procured by the U.S. Government.”

[Insert “Scarborough Fair” reference here]

Good news: A compound in both oregano and thyme seems to have anti-cancer properties. Even better, they (carvacrol, thymohydroquinone, and thymol) “also have antibacterial, anti-inflammatory, antioxidant and other properties beneficial to human health,” according to biochemists at Purdue.

The bad news: You need a lot of the herbs. A lot. Like, setting up a home distillery to extract the oil won’t even do it.

The eventual good news: Learning this means “we open a path to engineering plants with higher levels of [the compounds]” or simply finding an efficient way to synthesize them.

It’s certainly something

CDC (projecting an air of confidence and certainty): Omicron accounted for 73% of Covid-19 cases.

The press: Oooh, that’s scary!

CDC (mumbling quietly): Actually, that’s just a rough estimate because the U.S. doesn’t do a lot of genetic sequencing….”

The press: [Leaves room]

FDA: Forget bamlanivimab and etesevimab! Forget REGEN-COV! They don’t work against Omicron!

CDC: Oopsie! That 73%? Well, it was actually more like 23%. And this week it’s about 59%. There’s still a lot of Delta going around.

The People: What the heck?!

CDC: Well, we wanted to sound confident. We knew all along it was a guess. See, there are these things called ‘confidence intervals’—

The People: Oh, shut up.

CDC: But there’s good news! Now, um, you only have to isolate for five days if you test positive but don’t have symptoms!

Former Surgeon General Jerome Adams: No. No no no.

An underused Parkinson’s treatment?

Keep this in the back of your mind if you have patients with Parkinson’s: Taking dopamine agonists or dopamine reuptake inhibitors gives similar quality of life, according to British researchers.

That said, among those DRIs, patients seem to do better on MAO-B inhibitors, rather than COMT inhibitors.

Bottom line: “MAO-B inhibitors might be underused as adjuvant therapy for the treatment of people with Parkinson disease.”

Smoking news

Here’s an odd one: E-cigarettes seem to help certain people quit smoking? Which people? Heavy smokers who weren’t planning to quit. So if you know a smoker, slip ‘em some vapes once in a while, because….

… if they’re under 40 and quit, it can cut their chances of dying from cancer by 90 percent. (In general, Captain Obvious would point out, the younger you are when you quit, the better your odds.)

I actually thought this was a joke

But it’s not — it’s a real study in a respected journal. “Lower cognition was robustly associated with Covid-19 vaccination hesitancy.”

Erroneous social media reports might have complicated personal decision-making, leading to people with lower cognitive ability being vaccine-hesitant.

Feds shipping the one antibody that still works

We told you last week that the omicron variant of Covid-19 is resistant to two of the three monoclonal antibody treatments used for treatment.

In short:

• Bamlanivimab and etesevimab (administered together) do not work against Omicron
• REGEN-COV does not work against Omicron
• Sotrovimab does appear to work against Omicron

Now the feds (FDA and HHS) released a statement saying that, for the time being, they’ll only be shipping sotrovimab.

Based on this information, ASPR [Assistant Secretary for Preparedness and Response] will pause any further allocations of bamlanivimab and etesevimab together, etesevimab alone, and REGEN-COV pending updated data from the CDC.

Shipments of sotrovimab did resume this week, and delivery of 55,000 doses of product has begun. An additional 300,000 doses of sotrovimab will be available for distribution in January.

Quickie info on pharmacy patient portals

Does your pharmacy have a Web portal for patients? Annnnnnnnd, do you meet both these criteria?

• You’re curious about other pharmacies’ use of a portal, including how many of their patients use it, what security they use, what info they store, and so on.
• You don’t want a ton of info — just, say, a two-page overview with a few charts.

If so, the Drug Topics survey results on “Patient Portal Trends in Pharmacy” sounds like it might be for you. Click right here (2-page PDF)!

Can a nasal spray fight dementia?

Maybe. Japanese researchers found that giving mice with dementia a spray of rifampicin “removes oligomers from the brain and improves cognitive function,” in part because of an “increase[d] drug transferability to the brain.” Good news!

Unfortunately, one of rifampicin’s side effects is liver damage. Their solution: Combine it with resveratrol. And what d’ya know…

[T]he research group administered a fixed dose combination of rifampicin and resveratrol intranasally five days a week for a total of four weeks to mice models of Alzheimer’s disease, frontotemporal dementia, and dementia with Lewy bodies, and observed their cognitive functions and brain pathology.

The results showed that the combination significantly improved the cognitive function of the mice, inhibited the accumulation of oligomers, and restored synaptophysin levels.

And because both rifampicin and resveratrol are existing, approved drugs, human trials can begin soon.

In shortage: pharmacy techs

“The latest worker shortage may affect your health,” reads the headline. “Pharmacies don’t have enough staff to keep up with prescriptions.”

The actual story: Pharmacy technicians “are quitting in waves” from retail pharmacies due to low pay, high stress, and what they say are unsafe working environments.

Al Carter, the executive director of the National Association of Boards of Pharmacy, a nonprofit organization that represents state pharmacy regulators. “In some states you have 60 or 70 pharmacies that are closing for days on end, because they don’t have the appropriate staff.”

Why the stress? And why do they feel it’s unsafe? Because of [insert drumroll here] … lack of staffing.

So what’s behind the lack of staffing?

The 22 technicians NBC News spoke to made $11.90 to $23 an hour, even though some […] had more than a decade of experience.

Said APhA CEO Scott Knoer, “We have to pay pharmacy technicians more. It’s a rewarding job, but it’s not an easy job. So it’s not shocking that we have a shortage.”

The Long Read™: Smoking and weight gain

People quit smoking, they gain weight — cliché but true. Conventional wisdom said it was because they substituted one habit for another.

But maybe not. The weight gain might be due to changes in (wait for it) … the gut biome. Read on.

It’s still coming

It’s been months since we’ve seen a story about a universal flu vaccine coming Any Day Now. So … a high-five to the big group of researchers* who give us today’s story.

Their vaccine would target a “long-ignored section of the virus” that they call the “anchor” (as opposed to the head or stalk of the virus, which mutate more).

The anchor, they believe, is common among flu strains and a perfect target for antibodies.

The antibodies, they discovered, recognized a variety of H1 influenza viruses, which account for many seasonal flu strains. Some of the antibodies were also able to recognize pandemic H2 and H5 strains of influenza in lab tests.

Humans can already make these antibodies, in fact, “so it’s just a matter of applying modern protein engineering methods to make a vaccine that can induce those antibodies in sufficient numbers.”

* From the Icahn School of Medicine, Scripps Research, and the University of Chicago

DPH: Covid pills are on their way

As we’ve covered last week, both Pfizer’s Paxlovid and Merck’s molnupiravir can now be used to treat patients with early, mild Covid-19.

According to the Georgia Department of Public Health:

Initial orders for Paxlovid and Molnupiravir will be placed at the beginning of next week [the week of December 26] with shipment occurring shortly after ordering. Initial supplies of these products will be extremely limited.

Per guidance from the Department of Health and Human Services (HHS), initial allocations will be made to federal pharmacy partners to ensure coverage across all areas of the state. As allocations increase, an ordering process will be made available to our therapeutics partners interested in ordering and dispensing these products.

CBD vs brain tumors

Mice with glioblastoma, like humans, don’t have a great prognosis. But, found immunologists at Augusta University and the Medical College of Georgia, when they (the mice) inhaled CBD, the tumors shrunk — and in only seven days.

So what’s going on? The CBD, apparently, interferes with the microenvironment the tumor creates for itself. But it does more — “reducing the tumor’s coopting of glial cells,” suppressing the P-selectin protein, inhibiting apelin, and more.

Best part: “[T]he approach is likely easily applicable to humans.”

At least people’s lives aren’t hanging in the balance

The Biden administration has accepted Georgia’s Medicaid waiver plan — an slimmer alternative to Medicaid expansion under the Affordable Care Act … but with one caveat: It would not permit the state’s proposed work requirements.

With that caveat, though, state leaders said they won’t accept it. (Instead, Georgia Health News reported, the response “could include pursuing such a court challenge, or just letting the waiver idea die.”)

Better guts, better treatment

People being treated for melanoma should add some more fiber* to their diet. It can improve their immunotherapy treatment (according to National Cancer Institute and University of Texas researchers) by improving their gut biome.

[A]mong patients with advanced melanoma who underwent immune checkpoint blockade (ICB) immunotherapy, those who consumed at least 20 g a day of dietary fiber survived the longest without their disease progressing.

But if you think you can get that same effect in a pill, think again:

[T]he use of probiotic supplements appeared to lessen the effectiveness of immune checkpoint blocker regimens.

* Older folks can add roughage.

Deuterium upgrade

Germans have always had a thing for deuterium, and now organic chemists at the University of Bonn have found a way to use it in pharmacy. Deuterium, you see, can keep drugs stable up to 50 times longer by inhibiting the enzymes that break the drugs down.

Deuterium to keep drugs stable isn’t new. What is new is a way to insert it in specific molecular locations. That’s important, because deuterium ain’t cheap, so being able to use it carefully can keep costs way down.

That’s what the Germans have cracked, using a new kind of substrates called “epoxides” to “introduce a deuterium atom at a single location and with a very specific and desired spatial orientation.”

They’ve tested the technique with precursors of ibuprofen and venlafaxine, and expect it can be expanded to a lot of drugs. More testing, of course, is required.

First-world problem (no, really)

Kids from wealthy backgrounds — whether personally rich or just doing well in a first-world country — are more likely to have worn out teeth than poorer kids.

The culprit: “easy access to soft drinks, energy drinks, and packaged juices” that increased their risk of tooth decay. (And it’s not just sugar, the Aussie researchers who did the study point out. A lot of these junk drinks have acid that helps the erosion.)

Cognitive decline declines

From 2008 to 2017, the percentage of older Americans experiencing cognitive decline dropped, big time: down 23% for women and 13% for men.

That, say the Canadian researchers who studied a survey of 5.4 million older Americans, means 1.13 million fewer Americans experienced cognitive impairment than expected.

What was the reason? Education played a big role. Since the 1920s, every generation has had “much greater opportunities to pursue post-secondary education.” And research has already shown that every year of school reduces the risk of dementia.

“It appears that these increasing educational opportunities continue to pay dividends more than half a century later. The short-term benefits of increasing educational attainment […] are well documented, but our research suggests the long-term benefits on later-life cognitive functioning are substantial.”

Don’t plan any surgery

Good news: Georgia is not one of the 13 states facing an emergency-level hospital-worker shortage. (Meaning more than 25% of the hospitals in the state report a critical staff shortage.)

Bad news: We’re on the cusp. Between the post-Thanksgiving and post-Christmas surges, Georgia is expected to cross that threshold within a week.

(States in the worst shape right now: Vermont, New Mexico, South Carolina, North Dakota, West Virginia, and Rhode Island.)

Saving you a click

Can omega-3 fatty acid supplements prevent depression? No.

What if we’ve got it wrong?

…about Down Syndrome? Granted, this is a bit out there, but then again, ‘crazy idea turns out to be true’ isn’t unheard of in science. (Helicobacter pylori, anyone?) In this case, there’s this doctor in Florida, Leslie Norins, who is convinced that not only are both Alzheimer’s and Down Syndrome actually infectious diseases, but both are caused by the same bacteria.

Dr. Norins knows he will have to cope with the pediatricians and parents of Down syndrome children who assert that the “cause” of Down syndrome is already known; it’s an extra “X” chromosome found in all or most cells of the child’s body.

“Poppycock and not proven” replies Dr. Norins.

…about prescribing antidepressants? There’s little evidence that SSRIs and SNRIs work well in the long term, argue a pair of British psychiatric researchers after conducting a meta-analysis of papers, but there’s plenty of evidence that coming off antidepressants is No Fun At All. Prescribing them for the long term, they say, does more harm than good.

Not only do the positive studies show only a slight improvement, but…

Much of the evidence of their efficacy comes from short-term placebo-controlled trials which tend not to include outcomes that are of greatest relevance to patients, such as social functioning or quality of life, but rather restrict outcomes narrowly to symptom measures.

Previous link is to the news story; click here for the paper itself.

…about psilocybin and depression? We’ve written a few times how microdoses of psilocybin fight depression (most recently earlier this month). But now a new Dutch study in the Journal of Psychopharmacology says it ain’t so.

Our confirmatory analyses revealed that psilocybin microdosing did not affect emotion processing or symptoms of anxiety and depression compared with placebo.

You know what’s next: ‘More studies are needed.’

Covid quickies

One more pill: Hot on the heels of its approval of Pfizer’s Covid-treatment pill, the FDA has approved Merck’s molnupiravir (which does the same thing — treat someone who’s sick to keep ‘em out of the hospital).

Good news and bad: Three more studies confirm that Omicron is more virulent but less deadly than other variants.

Those other vaccines: AstraZeneca and Novavax each said that their vaccine is effective against Omicron. It’s unclear if anyone heard.

ACA coverage sets record

More Americans than ever have signed up for health coverage via the Obamacare marketplace, thanks in large part to “enhanced personal assistance and outreach” (not to mention more subsidies to keep patients’ costs down).

Georgia is one of the states with the biggest jumps, with 653,990 signups already for 2022 via healthcare.gov, compared to only about 514,000 for 2021.

Move over, Gatorade

Want to avoid heatstroke before a run? Drink some baking soda and water. Really. Japanese researchers had test subjects guzzle some an hour and a half before making them exercise. (As a control, they had half the participants drink salt water instead; then, to add to the ick factor, both solutions were grape flavored.)

Participants showed reduced measures of hyperventilation, improved ratios of carbon dioxide in the blood and greater blood flow in the brain. Perhaps most telling, the participants reported lower perceived exertion.

Want to try this at home? The solution was 300 mg sodium bicarbonate per kilogram of body weight, mixed with 4.5 mL of water per kilogram of body weight.

Hope for autistic mice

Oxytocin, it seems, may have an unexpected use: as a treatment for autism in mice.

How do you diagnose an autistic mouse? If it doesn’t sniff other mice enough. (Note: This is not a reliable method for humans.) In some cases, that’s because they’re missing a particular gene (CNTNAP2), meaning some of the connections in their brains were … different.

An international team of neuroscience researchers, though, led by a Canadian, found that injecting the mice with oxytocin rewired those brain regions.

“The injection robustly activated many brain regions of the modified mice and essentially normalized the brain connectivity differences we previously found.”

So, autism cured? Not quite, but it confirms the role of both oxytocin and CNTNAP2 in brain circuitry. Next up: Testing oxytocin on mice missing different autism-related genes.

Three more months

Students, take note: President Biden has extended the pause on federal student-loan repayments from January 31 to May 1, 2022.

At least you can trust your Roomba

If you’re going to be infected with a parasitic worm, what kind is most likely to get under your skin? The kind carried by your pet dog, cat, or fish. And you can thank the good folks at UGA for that info.

Researchers at UGA’s Center for the Ecology of Infectious Diseases found that of 737 parasitic worm species, 137 can infect people. And of those, the ones that first infect Fido, Fluffy, or Bubbles are also the ones most likely to jump to you.

Is there anything you can do? Well, keep this in mind: “Everyday behaviors like playing with and feeding our pets increase opportunities for those parasites to infect people.” So your only option is apparently to lock your pet away like Weird Uncle Harold and interact as little as possible.

Easier HIV PrEP

The FDA has approved the Apretude injection for HIV pre-exposure prophylaxis. It’s given once every two months, as opposed to a daily pill.

Covid-vaccine quickies

Oxford and AstraZeneca announced that they’re working on an Omicron-specific version of their adenovirus-based Covid-19 vaccine. Their first Covid vaccine was pretty much sidelined in favor of mRNA vaccines, but no one every called an Oxfordian a quitter. As one of them bragged, “Adenovirus-based vaccines could in principle be used to respond to any new variant more rapidly than some may previously have realised.”

Sure, why not: Israel — which to be fair has been kinda leading the world in Covid-vaccine info — announced that it’s authorizing a fourth dose of mRNA vaccines for adults ages 60 and up and medical personnel. (Side note: Two months after William Shatner rode into space on a Blue Origin rocket, Pfizer CEO Albert Bourla said a fourth dose of his company’s vaccine may be needed to fight Omicron.

The army gets into it: Scientists at the Walter Reed Army Institute of Research say they’ve got a vaccine that works against all the Covid-19 variants, including Omicron — and any potential strains. It’s just finished phase 1 human trials. Instead of mRNA, this one uses (wait for it) nanoparticles.

Pfizer’s pill gets the nod

Now there’s an at-home treatment for Covid-19 … if you catch it in time, and if you can get your hands on the Paxlovid pills.

The Food and Drug Administration authorized Pfizer’s drug for adults and children ages 12 and older with a positive COVID-19 test and early symptoms who face the highest risks of hospitalization.

Western guts weaken diabetes med

Got patients taking acarbose for diabetes? It may not work, or work well. Why not? Gut bacteria. It turns out (per Princeton molecular biologists) “that some bacteria in the mouth and gut can inactivate acarbose and potentially affect the clinical performance of the drug.”

Here comes the science: Some bacteria — including the kind that produce acarbose — produce an antidote to acarbose. If any of those bacteria are in the gut … well, you see the problem.

Yet more science: Acarbose isn’t used much in the U.S., but it’s more popular in Asia. Turns out (per a 2013 paper), that it works better for patients on an Eastern diet. Now we know why.

I can’t smile, but I’m much more relaxed

If you’re feeling anxious, here’s an idea: Inject yourself with botulinum toxin in your face, head, limbs, or neck. No matter what it does for your looks, it seems it can reduce your anxiety.

That’s what researchers from UC San Diego and Germany’s Hannover Medical School report, based on their mathematical analysis of the FDA’s Adverse Effect Reporting System. They scoured the reports of 40,000 people, but instead of looking for negative side effects, they looked for positive ones.

What they found was that the reported anxiety risk was 22 to 72 percent lower in Botox-treated patients for four of eight conditions and injection sites: facial muscles for cosmetic use; facial and head muscles for migraine; upper and lower limbs for spasm and spasticity; and neck muscles for torticollis.

Do your labels talk?

Hy-Vee’s do. Sort of. The pharmacy chain is rolling out ‘talking prescription labels’ free to visually-impaired patients, via a partnership with En-Vision America.

It’s actually an RFID chip (like what libraries use to check books in and out) in the cap that identifies the meds to either a small desktop ‘reader’ or a smartphone app, which then reads it aloud. Right now it reads prescription information, but there’s no reason it couldn’t include advertisements as well. “Are you still taking Zorbagen for your arthritis? Why not ask for Blurbamax instead?”

Lab-grown brain plays Pong

If you thought there were philosophical and ethical questions when scientists grew brain cells in a dish, it just got a lot more complicated.

A group of Australian and British researchers have taken human stem cells, coaxed them into becoming brain cells, and taught them to play Pong. The video game.

Of course, the article points out that “Pong is a first-generation video game,” so it’s not as if the clump (which — no joke — the scientists dubbed a “cyborg”) is learning to level a dragonknight in Elder Scrolls Online*. But still. (For you younger folks, the article explains how Pong is played.)

Other fun facts:

• They named it “DishBrain”.
• It learned to play “significantly faster than artificial intelligence machines”.

No, it doesn’t have its own Twitch stream yet. On the other hand…

* Or even a lowly sorcerer

Anthrax and pain

Giving someone anthrax will, to be accurate, stop their pain. But Harvard scientists and colleagues have found that a particular toxin from the anthrax bacterium can treat pain without killing the patient.

In fact, that anthrax toxin can also be used to carry other drugs to the pain-sensing neurons. Even better, while the pain-blocking was potent, the side effects were nil.

Additionally, the researchers observed that as the pain diminished, the treated nerve cells remained physiologically intact—a finding that indicates the pain-blocking effects were not due to injury of the nerve cells but rather stemmed from the altered signaling inside them.

Obviously experiments are ongoing, but at the moment, they think they’ve got a good foundation: “[U]sing a bacterial toxin to deliver substances into neurons and modulate their function represents a new way to target pain-mediating neurons.”

Hairspray recall

Proctor & Gamble is recalling several aerosol dry conditioner and dry shampoo spray products because it detected benzene in some of them. Brands include Aussie, Hair Food, Herbal Essences, Old Spice, Pantene, and Waterl<ss. See the details and product codes on the FDA recall page.

(And you thought those were all different brands. Ha!)

IBD treatment: taking one edge off the sword

Current treatment for inflammatory bowel disease involves blocking an inflammatory molecule (TNF-alpha) from binding to two receptors, TNFR1 and TNFR2.

What’s interesting, UC Riverside biomed researchers found, is that blocking both those receptors may not be a good idea. TNF-alpha, it seems, both promotes inflammation (when it interacts with TNFR1) and suppresses it (when it interacts with TNFR2) — “a double-edged sword.”

“If you block both the receptors, you block the destructive effects and the recovery. To circumvent this, in our work we opted to do selective targeting of TNFR1.”

Narrowing the target is already showing results (good ones, even). And as TNFR1 plays a part in diseases like rheumatoid arthritis, multiple sclerosis, and psoriasis, this is a breakthrough that could have some wind-ranging results.

Rite Aid closing 63 stores

The goal, of course is “to reduce costs [and] drive improved profitability.” It’s been losing money lately, but at least the losses have been slowing.

Prebiotics make for better eating

Women who took a particular prebiotic — galacto-oligosaccharides (GOS) — ate less sugar. In fact, they ate healthier in general, according to British researchers.

The research team found that participants who used the GOS supplements consumed 4.1% less sugar and 4.3% fewer calories from carbohydrates overall than women from the placebo group. Interestingly, the study also found that those who took the GOS supplements consumed around 4.2% more energy from fats.

Their working hypothesis: The gut bacteria reduce the patients’ stress, and thus they reduce their stress eating. So it’s all about the brain. But, as always, “more work needs to be done to confirm and help us understand the mechanisms.”

Captain Obvious cries into his eggnog

“Could holiday stress be affecting your child’s holiday joy?“

Bonus: “[m]others are twice as likely to be stressed by preparations.”