The Update is a monthly digest of all that is interesting, exciting and new in the world of medicine and medical science, presented in a curated and convenient package.
1.Study Refutes The Idea of Using Vitamin C-Based Cocktail for Treatment of Sepsis
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In 2017 a paper was published asserting that intravenous vitamin C given to patients with sepsis was literally a life saver. Despite the study only looking at 47 subjects the results garnered international coverage and was adopted in many ICUs worldwide.
On January 17th, Monash researchers comprehensively refutes the idea that the combination of high dose intravenous vitamin C, thiamine (vitamin B1) and hydrocortisone is beneficial in the treatment of sepsis.
The study (the VITAMINS trial) was set up by the ANZIC-RC across ten intensive care units in Australia, New Zealand and Brazil, looking at 216 patients in septic shock between May, 2018 and July, 2019.
Divided into the control group which only uses the standard treatment of sepsis and the intervention group which uses the standard treatment with intravenous vitamin c.
The study found no improvement in the duration of support with blood pressure drugs for the treatment of shock or survival of those receiving vitamin C + thiamine + steroid therapy compared to steroid therapy alone.
2.Osteoporosis: Researchers Find Another Possible Risk Factor
New research points to a link between bone health and ambient air quality.
A new study led by the Barcelona Institute for Global Health — whose findings appear in JAMA Network Open, now suggests that poor air quality is associated with a lower bone density among aging populations.
Osteoporosis affects millions of people around the world, and it is not possible to change some of the primary risk factors, such as aging. However, more environmental risk factors are coming to light.
This condition tends to affect older individuals, particularly females, but some environmental factors such as a lack of vitamin D can also contribute to its development.
The investigators used estimates of outdoor exposure to air pollution, referring to the presence of carbon and fine particulate matter in the air. These are minuscule particles that come, for instance, from car exhausts. These particles remain airborne for a long time and infiltrate the human body through the lungs.
They found that individuals who frequently experienced ambient air pollution, especially by way of fine particles, also seemed to have a lower bone mass level. The link between poor air quality and poor bone health could be due to "the oxidative stress and inflammation caused by air pollution
Following the first reports of cases of acute respiratory syndrome in the Chinese Wuhan municipality at the end of December 2019, Chinese authorities have identified a novel coronavirus as the main causative agent. Cases have now been detected in several countries in Asia, but also in Australia, Europe and North America. The first cases in the EU/EEA were confirmed in France, with further global spread being likely.
Coronaviruses are zoonotic, meaning they are transmitted between animals and people. They have an incubation period of 1-14 days.
This new virus can, in more severe cases, cause pneumonia, severe acute respiratory syndrome, acute cardiac injury and kidney failure. Common signs of the infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. Diarrhea, generalized body weakness and fatigue are also manifestations of the disease.
There are currently no antiviral drugs used to treat the disease. The current management options include symptomatic treatment, vital organ care, with the possible administration of corticosteroids.
Prevention and control is necessary; and this includes maintaining basic hand and respiratory hygiene, avoiding close contact with anyone showing symptoms such as coughing and sneezing, avoiding contact with farm or wild animals such as bats, cleaning and disinfecting frequently touched objects and surfaces. Additionally, The consumption of raw or undercooked animal products should be avoided.
The Ministry of Health and Prevention (MoHAP) revealed on the 29th of January, 2020, that a four-member Chinese family infected with the new coronavirus are the first confirmed cases in the UAE. The statement clarified that "all family members are in stable condition and the situation was contained by following the most necessary precautionary measures adopted globally when dealing with infected cases”.
A Podcast episode from Radiolab, that talks about the expense of medical care.
Two years ago, a group of doctors did something unprecedented - they boycotted a cancer drug because, given the benefit, it cost too much. Following up on the story, Radiolab producer Molly Webster discovers this is far from your normal drug pricing story. It's long been taboo to talk about cost and care in the same breath. But we enter a space where economics and philosophy sit side-by-side, and raise a deeply uncomfortable question: what is a year of life worth?
