Let the naming begin

With the exception of the Spanish Flu,* we’re not supposed to use place names for diseases because something something offensive to entire nations. And the current system of Covid-19 variants (B.whatever) isn’t easy to remember.

Fear not! The WHO has a plan — one that is already doomed to be outdated, but shouldn’t offend anyone except antiquarians: The variants will be named using the letters of the Greek alphabet.

A country may be more willing to report it has found a new variant if it knows the new version of the virus will be identified as Rho or Sigma rather than with the country’s name.

We’re already at Kappa. To quote the 20th century philosopher Scooby-Doo, “Ruh-ro.”

WHO’s plan: “When the 24 letters of the Greek alphabet have been exhausted, another series like it will be announced.” (We suggest auctioning off naming rights.)

* Which has a really interesting reason for being called that.

Surprise plot development!

“China confirms first human case of H10N3 bird flu strain” — but don’t you worry, the risk of transmission is low … says the Chinese state health agency.

Sunscreen worries

Sure, SPF numbers are pretty straightforward, but the American Academy of Dermatology says that, in its poll, it found that a lot of people don’t know how to use sunscreen properly. It’s not just applying too little. Two-thirds of people don’t reapply sunscreen as often as they should.

• 42% either tend to not reapply sunscreen at all or reapply it only when they get wet.
• 30% apply sunscreen just to their face instead of also applying it to other areas of their body.

Yes, yes, your customers probably look quite good with a tan. But maybe you can convince them to use sunscreen properly and get their tan from a bottle. (We won’t tell.)

That said…

Be careful. Some brands of sunscreen contain too-high levels of benzene, according to analysis by Valisure — an independent lab that likes to test medications and healthcare products. The company is pushing the companies (or the FDA) to recall the products.

Which products, you ask? We’re talking some big-name brands, but General Counsel Greg Reybold scares me so I won’t list them here. The list is in Valisure’s petition to the FDA (PDF).

Your chromosomes are fat

British researchers, for reasons known only to themselves, decided to weigh human chromosomes. Well, “calculate the mass” is more accurate — they determined the number of electrons and figured the rest from there.

The result: “Our measurement suggests the 46 chromosomes in each of our cells weigh 242 picograms (trillionths of a gram).”

What’s interesting: That’s a lot more than they expected, “and, if replicated, points to unexplained excess mass in chromosomes.”

Coming soon: “Dark DNA.”

A minor auto-injector note

Autoinjectors are cool devices — let patients take meds that aren’t in a pill or capsule by automating the dosage. One downside, though, is that there can be a lot of waste if they’re used regularly. Manufacturers are taking notice. The latest: Phillips-Medisize has created the Aria Smart Autoinjector which “consists of a reusable drive and disposable cassette.”

Because it’s just got the meds and not the delivery guts, that syringe (1- or 2.25-ml) uses a lot less material.

Tomorrow’s skin tester

A team of Chinese and American researchers has developed a nifty device for identifying skin conditions. It uses a sensor about the size of a quarter (or a one-yuan coin) to vibrate the skin in a suspect area. The device measures the elasticity of the skin — it turns out that skin stiffness, measured very accurately, is a useful indicator of what condition might be present.

“The data produced can assist in diagnosis, treatment tracking and disease monitoring particularly for skin associated disorders, such as skin cancer, as well as in aspects of aesthetic dermatology and of the recovery from surface wounds.”

It could also be used by individuals: “In the near future, we believe this technology will allow people to monitor their skin health status anytime with a simple wearable device.”

Free as in beer

It seems an odd roadblock to overcome, but be aware: There are people who aren’t getting vaccinated because they don’t realize or believe it’s free. They’re afraid of unexpected medical bills. So if you meet one, remind them: They’ve bought and paid for it already.

So that’s how the trip works

What with psychedelics being in the medical news more and more, it seems important to learn, you know, how they work.

Neuroscience researchers at Cornell looked at fMRI scans of people on and off LSD, and made some interesting observations. In short, having an acid trip is having parts of your brain communicate that don’t usually talk to one another.

“If you think of our neural connections as like a series of roads and highways, LSD doesn’t change the roadways, but it does lower the energy you need to get from one to the other. It flattens the energy landscape between different parts of the brain, bringing them closer together.”

By doing that, it adds a bit of flexibility to the brain that it probably didn’t have since childhood — and that flexibility may be why psychedelics work for depression: They help the brain get out of whatever rut its dug itself into.

The Long(ish) Read: One shot to rule them all?

Why not a universal coronavirus vaccine? We have the technology. Well, a few reasons (and yes, money is one).

Out of bed you daisy head

Want to avoid depression? A group of physiologists did a monster study, and found a simple trick: Wake up an hour earlier. Or more.

But it’s not about cutting the amount of sleep you get — it’s about what time you wake up. Night owls tend to have greater risk of depression, even when they have a full eight hours of sleep.

What these researchers found is that…

Each one-hour earlier sleep midpoint (halfway between bedtime and wake time) corresponded with a 23% lower risk of major depressive disorder.

Put another way, if someone who normally goes to bed at 1:00 a.m. goes to bed at midnight instead and sleeps the same duration, they could cut their risk by 23%; if they go to bed at 11:00 p.m., they could cut it by about 40%.

But why? They don’t know yet, but the speculation is that it’s better to have more of your awake time during the day: “Keep your days bright and your nights dark.”

Convention stuff!

It’s big, it’s bold, and it’s where you need to be — the Georgia Pharmacy Convention, June 17-20 on Amelia Island!

Online registration closes this coming Tuesday, June 1! After that you’ll have to register at the convention, where people will “tsk tsk” at you under their breath. Register now!

On June 1 the convention app will be released! W00t! That’s when you can start chatting with other attendees and making plans for Amelia Island. It’s also when William Huang will crack his virtual knuckles and start sharing photos.

There’s plenty more, including the big Pharm-a-Seas sand-pharmacy building competition. So head over the GPhAconvention.com, find out more, and register before it’s too late!

Antibiotics against humans?

Bacteria (and other prokaryotes) have different ribosomes than, say, human cells. They make proteins in a different way, and antibiotics target those bacterial ribosomes. That’s why antibiotics can kill germs without killing our cells.

But pharmacy researchers at the University of Illinois Chicago had an idea. What if they could alter human ribosomes so antibiotics would work? Not all cells, though, just the troublesome ones. In other words, “Can antibiotics treat human diseases in addition to bacterial infections?”

“Because there are many human diseases caused by the expression of unwanted proteins — this is common in many types of cancer or neurodegenerative diseases, for example — we wanted to know if it would be possible to use an antibiotic to stop a human cell from making the unwanted proteins, and only the unwanted proteins.”

CVS facing lawsuit

Seven (at last count) insurance companies are suing CVS Health, claiming the company — via its PBM — overcharged them for generic drugs by hiding the real prices via a discount club.

“CVS intentionally told third-party payers, including Plaintiffs, that the prices charged to cash customers for these generic drugs were higher — often much higher,” the lawsuit states.

Consequently, the insurers paid CVS at rates that were much higher than the actual prices that CVS was offering its customers.

Of note: This is the second such suit against the company; a year ago a different group of insurers sued for the same reason.

To fight resistant bacteria, first find their defenses

One way bacteria become resistant is by creating enzymes “that basically chew up the antibiotics before they can do their job,” as a University of Texas chemist explained. So, while stopping those enzymes isn’t possible (yet), the UT folks have figured out a way to make them glow using a florescent chemical probe.

That can not only inform treatment, it can be used as other researchers look for ways to get past those enzymatic defenses.

“This allows us to work towards developing therapies and eventually understanding evolutionary characteristics of such proteins.”

Rodent news update

If you have a hamster with Covid, good news: University of Pittsburgh researchers have developed an inhalable nanobody that “can prevent and treat severe Covid-19 in hamsters.” Think monoclonal antibodies (which are already used as a Covid treatment) but smaller and — most importantly — inhalable. With Covid attacking the lungs first, inhalation therapy makes sense.

And it works:

[I]nhalation of aerosolized nanobodies at an ultra-low dose reduced the number of infectious virus particles in the lung tissue by 6-logs (or a million fold).

And if you’ve got a mouse, it’s the scientists at UPenn bringing the good news: The drug diABZI — normally considered something for cancer — “was highly effective in preventing severe COVID-19 in mice that were infected with SARS-CoV-2.” In fact, they think it might work for other coronaviruses, too.

Bonus: Includes the phrase “game-changer”!

Amazon getting physical?

The rumor is that Amazon is planning to take its nascent retail prescription drug business into the real world, possibly inside Whole Food stores.

Cue the panic, with CVS and Walgreens stock dropping on the news. But first, it’s only a rumor. Second, though, Axios gives a pretty solid reality check on what it means, at least for the short- to medium-term:

Amazon still isn’t disrupting the prescription drug industry. Amazon is maybe, possibly considering a way to capture a marginally bigger piece of the extremely small slice it has.

The right bacteria protects the good bacteria

Having the right bacteria in the guy can reduce chemotherapy side effects. According to environmental biologists at Northwestern University, certain types of gut bacteria — for example, Raoultella planticola — can break down chemotherapy drugs and protect the rest of the good bacteria in the gut. And having the good gut bacteria survive can make a tremendous difference in typical chemo side effects.

This is still in the lab, but “There are several eventual applications that would be great to help cancer patients — particularly pediatric patients.”

Future Watch

A new way to deliver vaccines could be with a wafer under the tongue. That type of delivery isn’t new (think nitroglycerin), but vaccine molecules are too large to work that way. Until now. Maybe.

Biomedical engineers at the University of Minnesota have developed a polymer ‘wafer’ that can deliver the large proteins of a vaccine while protecting and preserving them. They’ve tested it with HIV proteins and it worked, so it’s a successful proof of concept. As always, more research is needed.

“This is just a small step in this long journey. If we continue this line of work, it can bring us to a point where we will have vaccines—they could be based on DNA, RNA, proteins—that can be stored without refrigeration and easily delivered under the tongue at the sublingual site.”

Two ways to live forever*

Start by knocking three years off your biological age in just eight weeks with DNA methylation! Change your diet and lifestyle (including adding “supplemental probiotics and phytonutrients”) It must be real, because the study’s author has her own website where she sells some of those very supplements.

Then … add a tapeworm to your life. Yep, a German study found that “Life expectancy of tapeworm-infected worker ants is significantly higher than that of their uninfected nest-mates.” How? The infected worms get better care from the other ants. So maybe don’t go the tapeworm route.

(Bonus: The article contains this bit of wisdom: “The high life expectancy of [ant] queens is due to their low mortality rate.”)

* Don’t do either

After the infection: MIS-C news

Although kids are rarely affected by being infected with Covid-19, some of them have developed a set of serious symptoms after it clears — high fever, abdominal pain, vomiting, diarrhea, rash, extreme fatigue, and potential organ damage. It’s been named multisystem inflammatory syndrome in children (MIS-C), and it’s been a mystery.

Two big pieces of news have come out, though — good news for parents. And, of course, the kids.

First, a small study out of the U.K. found that “Severe Symptoms of MIS-C Typically Clear Within Six Months,” which is cause of at least cautious optimism, if not full-blown celebration.

Second, pediatric pulmonologists (and others) in Boston have figured out how MIS-C happens: The virus, stinker that it is, hides in the gut, and can hang out there before jumping into the bloodstream.

And that gives them an idea for treatment: larazotide acetate, which is used to treat celiac disease, can prevent the SARS-CoV-2 virus from jumping from the gut into the bloodstream. They got FDA approval for a compassionate-use case, and successfully treated a 17-month-old.

Testosterone and Covid

What they don’t know: Why.

What they do know: Men with higher testosterone levels do better when hospitalized with Covid-19.

What makes even less sense: Men with Covid-19 fare worse, on average, than women.

If a man had low testosterone when he first came to the hospital, his risk of having severe COVID-19 — meaning his risk of requiring intensive care or dying — was much higher compared with men who had more circulating testosterone. And if testosterone levels dropped further during hospitalization, the risk increased.”

Coked-up fruit flies

One way to make a fruit fly’s very short life more interesting (and meaningful) is to give it some cocaine.

Clemson University behavioral geneticists exposed fruit flies to coke to see what it did to their brains. A lot, it turns out. “[C]ocaine use elicits rapid, widespread changes in gene expression throughout the fruit fly brain,” they found, but more importantly, they also noticed that there were specific cell clusters that were most affected.

By noting which cells — and which genes — had the biggest reaction, they hope to lay the groundwork for potential addiction therapy.

“We built an atlas of sexually dimorphic cocaine-modulated gene expression in a model brain, which can serve as a resource for the research community.”

99.9 percent

Of the 101 million Americans who have been fully vaccinated, more than 10,000 have gotten Covid-19 anyway. (More than a quarter of those experienced no symptoms.)

This is, in a way, great news. That real-world number means that about one-tenth of one percent of recipients has gotten sick — making the vaccines 99.9% effective.

By the way

The CDC says we’ve passed the halfway point, with most American adults now fully vaccinated (and more than 60 percent have had at least their first shot).

Y’all got a labor shortage?

NCPA wants to know about it.

Recently, NCPA reported that many members have told them that they’re having problems finding and retaining workers. They would like to know whether the issue is widespread among community pharmacists. Please tell them if you’re having issues by completing this short survey. We’re sure they would appreciate your input.

When is a urologist like a geologist?

When they’re studying kidney stones. It’s not clear how exactly they form, so a research team brought together by the Mayo Clinic includes geologists, microbiologists, microscopy experts, and others is working to figure it out. They’ve just published a paper in Nature Reviews Urology.

“Ultimately, our vision is that every operating room would have a small geology lab attached. In that lab, you could do a very rapid diagnostic on a stone or stone fragment in a matter of minutes, and have informed and individualized treatment targets.”

Methotrexate might block the Covid-19 vaccine

That’s according to an NYU study that found up to one in three people who take it “failed to achieve an adequate immune response to the vaccines.” This isn’t entirely a surprise, as methotrexate has been shown to interfere with the flu vaccine.

A different kind of flu vaccine

Biomedical engineers at the University of Buffalo have a new kind of flu vaccine. Instead of the usual dead or inactive form of the virus, this one is “a recombinant protein nanoparticle* vaccine.”

In English, that means billions of tiny spherical sacs course through body, bringing specific proteins to immune cells, “and they provoke those immune cells to respond more vigorously to the flu.”

This same nanoparticle technology — a vaccine platform — is also being tested with different proteins as a Covid-19 vaccine.

* Always with the nanoparticles

Missing the treatments

Donald Trump’s Operation Warp Speed did a great job putting the creation of Covid-19 vaccines into high gear. (Yes, we know that Pfizer wasn’t part of OWS, but that doesn’t change the fact.) The downside, we’re learning, is that the singular focus on a vaccine means that treatment options remain limited.

Worse, now, is that BARDA (the Biomedical Advanced Research and Development Authority) said it won’t review any more potential therapies because it doesn’t have the money, although the Biden Administration is starting to pivot to the hunt for treatments.

A drug’s got to know its limitations

Psychology researchers at Michigan State found that caffeine can only go far when you’ve been sleep deprived. Taking it after missing a night of sleep will help with simple tasks (e.g., rearing alpacas, writing a newsletter), but not so much on more complex ones (e.g., completing a list of tasks in order).

“Although people may feel as if they can combat sleep deprivation with caffeine, their performance on higher-level tasks will likely still be impaired. […] Caffeine may improve the ability to stay awake and attend to a task, but it doesn’t do much to prevent the sort of procedural errors that can cause things like medical mistakes and car accidents.”

Be careful with Ocaliva

The FDA is restricting the use of Ocaliva, aka obeticholic acid, because it can cause serious harm in patients with advanced cirrhosis of the liver. Read more.

We’re keeping an eye on this

The hunt for the origin of SARS-CoV-2 is getting interesting, with President Biden ordering a more-detailed look at where the virus came from. The genetics show that it wasn’t manmade, but — other than human contact with an infected animal — the other possibility is that Chinese scientists were working with the (naturally occurring) virus and it was released in a lab accident.

“As of today, the U.S. Intelligence Community has ‘coalesced around two likely scenarios’ but has not reached a definitive conclusion on this question.”

* For purely humanitarian reasons, of course.

Moderna’s vaccine looks good for teens

Assuming you consider 100% efficacy after two doses to be good. Expect the company to file for a teen authorization shortly — in time for back-to-school.

Help diabetics with their lifestyles

Why not prepare to be a Lifestyle Coach for people with diabetes?

The Diabetes Training and Technical Assistance Center’s* Virtual Lifestyle Coach Training — now offered to Georgians — prepares individuals to serve as Lifestyle Coaches to deliver the evidence-based National Diabetes Prevention Program.

It’s coming up starting June 2. Click here for the flyer with the details, and learn how to register (PDF).

* From Emory University’s Rollins School of Public Health

Mild Covid: Once and done

Mild cases of Covid-19 appear to give patients long-lasting immunity from the disease, according to researchers at Washington University.

They found that yes, antibody levels drop soon after the infection clears, but that doesn’t mean immunity is gone.

“It’s normal for antibody levels to go down after acute infection, but they don’t go down to zero; they plateau. Here, we found antibody-producing cells in people 11 months after first symptoms. These cells will live and produce antibodies for the rest of people’s lives. That’s strong evidence for long-lasting immunity.”

But what about severe cases? There the jury’s still out, because the inflammation it causes might interfere with immune response. Or might not. “Further study is required.”

Captain Obvious knows where the state line is

A study from the Oregon Public Health Division found that, in states where marijuana is legal, more people are exposed to cannabis, “suggesting that exposures may be expected to increase with expanded legalization in more states.”

It’s almost as if, crazy as it sounds, when something is legal, more people have access to it. Further study may be needed.

Up your nose with … a Parkinson’s treatment

Levodopa can help treat Parkinson’s, but patients eventually build up tolerance to it and have to go from pills to injections. Now chemists at the University of York have a potentially better idea: A nasal gel.

Nasal, because of the direct connection to the brain (where levodopa is converted to dopamine). Gel because it adheres better to the inside “which allowed for better levels of uptake into both the blood and brain.”

The drug is already approved, so it’s a matter of finalizing the design of the delivery system for human trials.

Duke flushes

If the artificial intelligence being developed at Duke University ever achieves consciousness, it’s going to be very disappointed. Its job: analyzing stool samples for signs of inflammatory bowel disease, irritable bowel syndrome, and other conditions. What’s notable is that it can be added to a standard toilet, and deliver information to patients or practitioners.

“Patients often can’t remember what their stool looks like or how often they have a bowel movement, which is part of the standard monitoring process. The Smart Toilet technology will allow us to gather the long-term information needed to make a more accurate and timely diagnosis of chronic gastrointestinal problems.”

Updated supplement caution

The U.S. Preventive Services Task Force is once again planning to recommend “against the use of beta-carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer.”

This is notable because it’s not saying “these might not help” — it’s saying the potential harm outweighs the benefits, which it said in 2014. New research has apparently not changed its mind. (There are other supplements — e.g., multivitamins — where the USPSTF said there’s not enough evidence either way to make a recommendation.)

Bone density and deafness

If you have female patients with osteoporosis or low bone density, they’re also at much higher risk for hearing loss.

A 34-year study (!) of nearly 144,000 women (!) by researchers from Brigham and Women’s Hospital found that women with either of those conditions had up to a 40 percent greater chance of hearing loss. And the worse news: Taking bisphosphonates didn’t change that, despite a study that found it worked in mice.

Yes, you can drink milk

If you woke up this morning and thought, “Will drinking milk increase my cholesterol?” Good news: No, no it won’t (according to nutrigenetics researchers at the University of Reading).

ICYMI

Chiquita Brooks-LaSure has been confirmed to head CMS.

Captain Obvious knows his ABCs

A CDC review of Georgia elementary schools found that upgrading the ventilation systems and requiring masks dramatically cut the incidence of Covid-19 infection.

In fact, just “opening windows and doors and using fans lowered the incidence by 35%.” Add better filters and it drops to almost half.

The researchers found that the incidence was 37% lower in schools that required mask use among teachers and staff members.

A reader’s asthma follow-up

After Saturday’s story on three-med asthma inhalers (“3>2”), reader Stephen Shearer, RPh, MS, dropped us note about the current Global Initiative for Asthma guidelines.

For safety, GINA no longer recommends treatment with short-acting beta2-agonists (SABA) alone. There is strong evidence that SABA-only treatment, although providing short-term relief of asthma symptoms, does not protect patients from severe exacerbations, and that regular or frequent use of SABAs increases the risk of exacerbations.

“The combination they [GINA] recommends is budesonide and formoterol (Symbicort),” Steve wrote, “But none of of the pharmaceutical companies have an FDA indication for this use.”

STOP RIGHT THERE! Just to be clear, you don’t get medical advice from a snarky blog, even this one. But it’s worth checking out the details of what GINA has to say at the GINA site.

Faster, puppydog, smell smell

Last week we told you about Covid tests that detected the virus in 30 minutes and one second, respectively. Well if waiting a full second is too long, there’s good news: British researchers have trained dogs to detect it in less than a second. The pups are about 94 percent accurate — almost as good as the 97.2 percent level of PCR tests. (And get this: “It takes eight to 10 weeks to train a Covid-19 detection dog.”)

About the variant in India

The Pfizer (and AstraZeneca) vaccines work against the nasty Indian variant (B.1.617) that’s ravaging the subcontinent and starting to spread in Britain — but only after two doses.

U.S. cases of B.1.617 are at about one percent, if you’re curious.

Contraception update

The CDC is recommending that women be allowed to self-administer subcutaneous DMPA birth control, following a similar recommendation from the WHO earlier this year. The idea is that it has “higher continuation rates than provider-administered DMPA.”

The agency was clear that self-administered DMPA should be an alternative to having it injected (inserted?) by a provider.

Proof we’re living in a Star Trek episode

When it comes do delivering controlled-release drugs, you need to forget about pills, capsules, or external devices. UC Riverside a researchers have made a piezoelectric nanofiber-based drug delivery system.

It’s essentially a tiny piece of fabric with the drug molecules woven in. But here’s the trick: It’s a piezoelectric fabric, meaning it creates electricity when it’s moved or squeezed — just enough electricity to release some drug molecules. “The researchers could tune the drug release quantity by varying the applied pressure and duration.”

If you aren’t astounded by the idea of an implanted nanoweave cloth with electrostatically charged drug molecules that are released based on micro-pascal-level pressure … well, you’re just all dried up inside.

Pfizer mixes it up

The company is testing what happens when it gives patients its pneumococcal vaccine, then follows up with a booster of its Covid-19 vaccine. Will the Covid shot boost the pneumococcal protection? Will it protect against both? Will it turn them into raging face-eating zombie abominations? We’ll know in six months.

(Why are they doing this? It’s looking for an edge over Merck in the pneumococcal vaccine market.)

DIY insulin pumps get a thumbs-up

Way back in 2019 we told you about people who were hacking old insulin pumps to create DIY artificial pancreases — “Loops” they’re called. They’re off-label (duh) and unregulated, but now a new study confirms … yes, they work.

“[A]dults and children with type 1 diabetes can successfully initiate the system, use it safely, and improve their glucose control with it.”

“[P]ositive results were seen in spite of the fact that most users relied primarily on community-developed resources to build and operate the system, with limited informal digital resources and support.”

To be clear, this is a study showing they work, not any kind of official approval.

Where does Georgia stand?

A state-by-state vaccine tracker ranks Georgia #48 out of 54 U.S. states and territories for percentage of people vaccinated against Covid-19. About 37.7% of people in Georgia have had at least one shot, compared to about 47.9% in the country overall.

The New England states (CT, MA, ME, NH, VT) lead the pack (along with Hawai’i) at more than 60% coverage, while Mississippi, Louisiana, the Virgin Islands, and Alabama are at the bottom, in the 33-34% range.

Viral birth control

More over mRNA, here comes siRNA. Aussie researchers think they’ve gone a step beyond today’s antivirals with a new kind of drug: small-interfering RNA. Rather than just reduce the symptoms of a coronavirus, siRNA can be tuned to a specific virus and attack its genome directly, stopping it from replicating, period. “Treatment with virus-specific siRNA,” they said, “reduces viral load by 99.9%.”

“This treatment is designed to work on all betacoronaviruses such as the original SARS virus (SARS-CoV-1) as well as SARS-CoV-2 and any new variants that may arise in the future because it targets ultra-conserved regions in the virus’ genome.”

Even better, the nanoparticles* they use are cheap and easy to make.

* There are always nanoparticles.

Vaccine interference

We know that people with immunosuppressing conditions are (obviously) more vulnerable to SARS-CoV-2. But a new study out of the University of Michigan found that about three percent of American adults under 65 take meds that compromise their immune systems — notably steroids — and might prevent the Covid vaccine from working.

“We’re starting to realize that people taking immunosuppressive drugs may have a slower, weaker response to COVID vaccination, and, in some cases, might not respond at all.”

3 > 2

There are two-drug inhalers for asthma because, well, two is better than one. Start with a corticosteroid, add a bronchodilator, and patients breathe easier.

But then, despite being hobbled by the metric system, Canadian researchers figured out that if two is better than one, three might be better than two. And they were right. Adding a third drug — one to reduce mucus buildup — “reduced severe asthma exacerbations and slightly improved asthma control without an increase in adverse events.”

The third drug is a “long-acting muscarinic antagonist” making the triple-combo “LAMA add-on therapy.”

“If we can reach optimal control of patients’ asthma and reduce asthma exacerbation rates through the LAMA add-on therapy, patients may be able to avoid other treatments that carry a higher risk of adverse events, such as oral corticosteroids, or therapies that are substantially more expensive, such as biologics.”

One-upmanship

Engineers from the University of Illinois have created a Covid-19 test that can give a result in fewer than 30 minutes.

But a team from the University of Florida and Taiwan’s National Chiao Tung University have one they say can detect the virus within one second.

Making cancer kill itself

Swiss researchers have a new kind of Trojan horse to fight cancer. In this case, though it’s as if the horse was filled with pamphlets convincing the Trojan people to kill each other*.

Essentially, they’ve built an adenovirus that delivers some specific genes, but only to tumor cells. Those genes get the cancer itself to start producing antibodies (and more) that “act to eliminate tumors from the inside out.” Oh so satisfying.

Oh, and not only does the therapy only work on tumors — so healthy cells aren’t damaged — it produces more antibodies than when a drug was injected directly. The technique might also be used to deliver other drugs the same way, getting infections or viruses to do themselves in.

* My gosh, that metaphor is a stretch.

A kindler, gentler soap

Surfactants — the main ingredient in soaps and detergents — are usually made from petroleum. They can also be made from bacteria, and biosurfactants are better for a lot of reasons.

Problem: The bacteria than can make biosurfactant molecules (Pseudomonas aeruginosa) is a nasty, disease-causing little bugger.

But now researchers in Quebec have found a friendly bacteria (Pantoea ananatis) that makes a similar molecule while not being toxic to us humans. If they can synthesize it on a large scale, it could make the whole process of cleaning and disinfecting a lot less toxic.

Algae in the brain

I take most news out of the ACS with a grain of salt, but this one is cool enough that I hope it’s legit.

Researchers at Huazhong University of Science and Technology in Wuhan-yes-that-Wuhan, China, have a stroke treatment so crazy it just … might … work: They’re using blue-green algae and nanoparticles to create photosynthesis in the brains of stroke victims. Well, assuming the victims are mice. (It’s proof-of-concept at the moment.)

The logic is … well, logical. Blocked blood vessels prevent oxygen reaching the brain, and algae photosynthesize oxygen, so why not implant that algae in the brain?

I know what you’re thinking: “But it’s dark in there!” That’s where the nanoparticles come in: They convert near-infrared light, which can penetrate the skull, into visible light for the algae. Holy moly.

* There are always nanoparticles.

And then there were … nine?

There are seven coronaviruses that can infect people, plus an eighth that might. But now, researchers looking at kids who had pneumonia in Malaysia have found number nine. So far only those kids had it, and it could just be a one-off and not reappear.

It’s an odd chimera — it could have come from “a cat, pig, dog, ‘or some wild carnivores’,” say the people who looked at it. But that’s not a wild guess — different parts of the spike protein resemble different animals’ coronaviruses: canine coronavirus type I, transmissible gastroenteritis virus (from pigs), and a feline coronavirus.

This chimera is unlikely to have arisen at once, but instead involved repeat genetic reshuffles between different coronaviruses over time. “This is a mosaic of several different recombinations, happening over and over, when nobody’s watching. And then boom, you get this monstrosity.”

The goodest of bois

Dogs aren’t just good at sniffing out Covid-19 infections, they’re better than lateral-flow tests and on par with PCR testing.

The dogs detected 97% of the 109 people whose PCR test subsequently proved positive, and 91% of those whose PCR test was negative.

Skipping their meds

A study out of Britain found that “Nearly half of people with bipolar disorder do not take their medication as prescribed” — and also found the biggest reasons why. They’re just about all issues that pharmacists can help with.

Topping the list were side effects (either real or fear of what those effects might be). Also up there: not realizing how important the medications were, and lack of encouragement from family or clinicians. (Forgetting to take them, fear of addiction, and preferring “alternative” treatment were less common.)

Low D might be OK, at least for Covid

Early in the pandemic, some study or other (they’re all a blur at this point) indicated that low levels of vitamin D might be associated with higher coronavirus risk. That was then.

Now it seems that low levels of vitamin D might not increase your risk for contracting Covid-19. At least not by much, overall. That comes from Quest Diagnostics (the laboratory chain) which looked at the Covid antibody and vitamin D levels of more than 18,000 patients.

Participants with extremely low levels of vitamin D were 4% more likely to test positive for coronavirus antibodies. Those with moderately low levels, however, actually were 7% less likely to test positive, the researchers said.

Alcohol and the “important bits”

The latest on the question of whether alcohol is good or bad comes courtesy of Oxford University researchers. And the answer is [shakes Magic 8-Ball] … “Drinking any amount of alcohol causes damage to the brain.”

The researchers noted that drinking had an effect on the brain’s gray matter — regions in the brain that make up “important bits where information is processed,” according to lead author Anya Topiwala, a senior clinical researcher at Oxford. “The more people drank, the less the volume of their gray matter.”

A year’s head start on TB

A new blood test can predict tuberculosis in infants a year before it develops, by finding teeny-tiny* traces of a protein secreted by the Mycobacterium tuberculosis bacteria. It only uses a drop of blood, which is a lot easier to get than a respiratory sample.

Tulane University biotechnology researchers developed the test, which is not only better than the “gold standard” breath test, it can detect the infection long before any symptoms develop.

Next up: “The researchers are working to develop an inexpensive, portable instrument to read the test to allow it to be more easily used in resource-limited settings.”

* aka “itsy-bitsy”

The Rasputin of infections

Lyme disease just won’t die — that’s what Tulane University primatologists discovered. Even after a full course (28 days!) of doxycycline, rhesus macaques exposed to Borrelia burgdorferi “were found to have some level of infection 7 – 12 months post treatment.” Even worse, some of them still had negative antibody tests.

They’re so cute, we’ll have to give them lifelong infections

Today’s booster-shot news

Yesterday we probably wouldn’t need boosters. Today, Peter Marks (director of the FDA’s Center for Biologics Evaluation and Research) said don’t hold your breath — we don’t know yet if we’ll need them or not.

The UK is testing a third dose of seven different Covid vaccines on 2,886 participants “to investigate which ones could be used as ‘booster’ doses to protect against new variants.”

‘Universal booster’ cage match

Sanofi, which missed out on the big vaccine rollout, is still in the game. It says that its vaccine (which it’s making with GSK) could be the “universal booster.”

Now “waaaaaaaait a minute,” says Astra-whoops-we-had-another-problem-Zeneca. “Actually, our vaccine could be a universal booster and ‘elicits an immune response ‘capable against any variant.”

So, with boosters potentially on the horizon…

Now would be the smart time to get that official immunization training.

It’s this coming weekend — Saturday for technicians, Sunday for pharmacists — and there is still time to register! They’re both being held at GPhA’s North American Headquarters facility in Sandy Springs.

• Pharmacists, click here for info on “APhA’s Pharmacy-Based Immunization Delivery: A Certificate Program for Pharmacists.”
• Technicians, click here for info on “GPhA’s Immunization Delivery Training for Pharmacy Technicians.”

It’s the government and it’s here to help

…with posts and images to share on social media promoting vaccine safety. (It’s a web page that links to a PDF that has links to the images. Go figure.)

Birthmark or mole? Ask Dr Google

The company calls it an AI-powered dermatology assist tool. Just upload a few images of a spot or nail, answer some questions, and you’ll know what’s the most likely condition. Well, unless you’re in the United States. It’s launching in Europe later this year (as a Class I medical device) but hasn’t been approved here.

And in case you’re wondering if you’ll suddenly start seeing sunscreen commercials: “Google doesn’t use the data to target ads.” Trust them.

Legacy of the plague

You might think that, after the waves of bubonic plague ravaged Europe, evolution would have a say in the genes of survivors. And yep, you’d be right.

A team of U.S. and German researchers took DNA samples from 36 plague victims from a 16th century mass grave, then compared them to samples from people living in the same city (Ellwangen — try Weinstrube Kanne on Obere Strasse for the amazing Schweineschnitzel*).

What they found is evidence — “innate immune markers” — that plague survivors passed gene variants down to their descendants.

“It sheds light on our own evolution. There will always be people who have some resistance. They just don’t get sick and die, and the human population bounces back.” [But] “I wouldn’t want to discourage anyone from taking a vaccine for the current pandemic. It’s a much safer bet than counting on your genes to save you.”

* If you’re vaccinated, you’ll soon be allowed back into the EU

Interesting medical news

Brains, like history, are always more complicated than you think. In this case, the idea that nerve signals travel one way (axon to dendrite) turns out to be wrong. Austrian researchers found that “At a key connection, or synapse, messages are sent against the usual stream of information.”

In other words, one neuron ‘teaches’ another, but can then ‘learn’ from the interaction as well.

Or, if you want real science-y terms (courtesy of Science Alert):

This means there’s a reverse-traveling signal from the dendrites of the pyramidal cell that in a complex way can modify the sending signal strength of the mossy neuron’s axons. Challenging some long-standing assumptions, this confirms that the firing of synapses depends on both pre- and postsynaptic activity.

Elsewhere

To encourage Covid vaccinations, Ohio is offering vaccinated folks a chance to be one of five $1 million lottery winners. (Which means, statistically, it’s better to get vaccinated but convince your neighbors not to. Just sayin’.)

Missouri will finally have a prescription drug monitoring program for opioids — the last state to do so.

An asthma vaccine?

If you have mice with asthma, good news: Scientists at Paris’s Pasteur Institute have developed a potential vaccine.

Right now, treating the worst asthma usually means using dupilumab to block those nasty IL-4 and IL-13 molecules. But dupilumab ain’t cheap, especially when you’re talking about a chronic illness. So the Parisians came up with a way to get the body to produce an immune response itself — a treatment that “induces the sustained production of antibodies specifically directed against IL-4 and IL-13.”

Inflammation and depression

The interesting news: A huge British study (85,895 individuals) found that there is definitely a connection between depression and inflammation.

“Our study provides the most conclusive evidence to date that people with depression have proteins in their blood indicating activation of the inflammatory system.”

The frustrating news: They don’t know which causes which. (Although it’s possible that depression leads to behaviors such as overeating or smoking that lead to inflammation, but that’s far from clear-cut.)

While the evidence here isn’t enough to show that one directly causes the other, the researchers say that it suggests that there could be a direct biological link somewhere that’s yet to be discovered.

One is too many

New research out of the American College of Cardiology finds that alcohol has an immediate effect on heart rhythm. In fact…

The data revealed that just one glass of wine, beer or other alcoholic beverage was associated with twofold greater odds of an episode of [atrial fibrillation] occurring within the next four hours.

That’s not a big deal for most people, but if your heart isn’t in the best shape, that “rapid, chaotic and fluttery heartbeat” could end up being a free* ticket to the ER

* Not free

Drugmaker behaving badly

A congressional committee report found that AbbVie has raised the price of Humira over and over and over, in part because it blocked biosimilar competition by paying competitors to delay entering the market. AbbVie’s largest customer is the U.S. government — Medicare — but current law keeps capitalism at bay:

The U.S. is unable to negotiate directly with companies for lower prices for Medicare beneficiaries, making American taxpayers a cash cow for the drugmaker, the committee said.

Oh, and if you’re thinking, “The company needs that money for, like, research!” Wrong:

Most of those increases were aimed at reaching revenue targets, which led to big payouts for AbbVie’s top executives, according to the probe.

Smell test, Covid style

In the race to the fastest Covid-19 test, the Dutch may have taken the lead with the SpiroNose by a company called Breathomix. (No one said they were great at the whole naming thing.) Rather than look for the virus itself, the SpiroNose tests for a variety of exhaled organic compounds that — for unknown reasons — change when someone is infected.

The idea isn’t a clear Yes/No. Instead, it can give a fairly confident “No” and flag the rest for further testing, reducing the number of tests needed.

SpiroNose isn’t meant to definitively diagnose infection; instead it aims to rule it out in as many cases as possible. For the remainder, the test yields an “inconclusive,” and those people receive a polymerase chain reaction (PCR) or antigen test.

Mix and match

A study out of Spain has answered the question (for the moment) “Can you mix the Pfizer and AstraZeneca vaccines?” The answer: Yep. “[G]iving a dose of Pfizer’s drug to people who already received a first shot of AstraZeneca vaccine is highly safe and effective.”

A 20-year head start

Back in 1993 or so, researchers collected and stored thousands of blood samples. And now Johns Hopkins researchers looked at those samples and the patients they came from and discovered that there are 16 proteins that, if elevated, can indicate a high risk for developing Alzheimer’s two decades in advance. (Another 22 proteins can indicate that risk five years before symptoms appear.)

Oh, and one of those proteins, SVEP1, “is not just an incidental marker of Alzheimer’s risk but is involved in triggering or driving the disease.”

A pessimist might point out that, as there’s no treatment for Alzheimer’s, this is just a 20-year countdown clock. But the researchers are more optimistic:

“Some of these proteins we uncovered are just indicators that disease might occur, but a subset may be causally relevant, which is exciting because it raises the possibility of targeting these proteins with future treatments.”

Some will need boosters

The evidence is mixed on whether most people will need a Covid-vaccine booster shot. (Health experts say probably not, vaccine makers say probably so. Go figure.) But one group that likely will need a booster is people who are immunosuppressed, at least according to the chair of the American College of Rheumatology Covid-19 Vaccine Clinical Guidance Task Force.

“I personally think that it is likely that people will need a booster,” said Jeffrey R. Curtis. “That may not be everybody, but I think that getting a booster dose and then having some periodicity to this is likely to be quite common.”

But he did add this rather broad caveat:

“Of course, there is a lot of science and the science is very much in evolution. Whatever you think you know this month, may well be different next month, so for that reason I think everything we say or talk about tonight is subject to change.”