Study: New bedside test means faster diagnosis, treatment of COVID-19

Oct. 8 (UPI) — A rapid, bedside test for COVID-19 delivers results in less than two hours, meaning that appropriate treatment can be initiated earlier for those already hospitalized because of their symptoms, according to a study published Thursday by The Lancet Respiratory Medicine.

The standard COVID-19 test uses polymerase chain reaction, or PCR, technology, which amplifies small samples of DNA in order to identify the presence of virus in samples taken from an infected person’s nose or throat.

The PCR test requires samples to be sent to a centralized lab within the hospital for processing, typically takes more than 20 hours to produce results, the researchers said.

The enhanced speed of the bedside, or “point-of-care” tests, also means patients infected with the new coronavirus can be isolated earlier, reducing the risk for transmission to other patients and healthcare workers.

“Our findings are the first to suggest the clinical benefits of molecular point-of-care COVID-19 testing in hospitals, demonstrating reduced delays, bed moves and time in assessment areas, which all lead to better infection control,” study co-author Dr. Tristan William Clark, of Southampton General Hospital in England, said in a statement.

“We believe that [these] molecular [tests] should be urgently integrated … to reduce coronavirus transmission within hospitals to prevent the next wave of the pandemic overwhelming health services around the world,” Clark said.

Since the start of the global pandemic in March, healthcare systems worldwide have relied on PCR testing of patient samples in centralized hospital laboratories, an approach that is accurate, but also lengthy and resource intensive, according to Clark and his colleagues.

The longer time it takes to generate results with PCR testing means that patients often wait in mixed assessment rooms to be admitted to the correct COVID-19 or non-COVID ward, increasing the possibility of transmission, the researchers said.

However, with point-of-care tests, nasal and throat swab samples are collected and placed into small cartridges for analysis. Unlike PCR tests, which require specially trained lab personnel, the bedside tests can be performed by healthcare workers in the emergency room or other assessment area, they said.

For this study, Clark and his colleagues evaluated the QIA-stat-Dx point-of-care testing platform, manufactured by Dutch firm Qiagen, in 1,054 adults with COVID-19 symptoms being assessed in the acute medical unit and emergency department of Southampton General Hospital between March 20 and April 29.

Nose and throat swabs were taken from all patients and tested for COVID-19 infection, with 499 patients evaluated using the QIA-stat-Dx, while the rest were assessed using only PCR testing. All test results were confirmed using the standard PCR approach as well, the researchers said.

Among those tested with QIA-stat-Dx, 197, or 39%, were found to be positive for COVID-19, while 155, or 28%, of those evaluated by only PCR were positive for the virus, the data showed.

The point-of-care test produced results in roughly 1.7 hours on average, while PCR evaluation took approximately 21.3 hours per patient, according to the researchers.

After testing, patients were transferred to

PTCE Announces September ‘Faces of Pharmacy’ Winners in Recognition of American Pharmacists Month

Yearlong campaign recognizes pharmacists for their dedication, and often overlooked contributions, to transforming healthcare

In support of American Pharmacists Month in October, PTCE, a leader in continuing education for multispecialty pharmacists and pharmacy professionals, is committed to recognizing pharmacists’ contributions to health care practices and all they do for their communities through its ‘Faces of Pharmacy’ recognition program.

In this transforming health care landscape, The Faces of Pharmacy nomination opportunity celebrates pharmacists, who navigate evolving health care practices and continue to make a difference in the lives of their patients.

Continuing its year-long campaign, PTCE is proud to announce its September winners:

  • Alisa Eibling, Pharm.D., Clinical Director, PFSP Specialty Pharmacy

  • Adam King, MPH, CPhT, PR, Executive Director and founder, CompassionRx

  • Jameika Stuckey, Pharm.D., Clinical Supervisor and medication safety manager, University of Mississippi Medical Center

  • Michael Lorenzo Tinglin, Pharm.D., Clinical Pharmacist, Premier Family Medical

“Congratulations to the four pharmacy professionals who were selected as the winners of our Faces of Pharmacy program,” said Jim Palatine, R.Ph., MBA, president of PTCE. “The number of nominations we have received for the month of September truly exemplifies the need and desire to acknowledge these healthcare professionals who make a difference in the lives of their patients. In honor of American Pharmacists Month, we are devoted to showing our appreciation for the care and commitment of pharmacy professionals in the industry, and we will continue to recognize these professionals every month with our inaugural yearlong campaign.”

Each month, PTCE will select four pharmacy professionals to feature on its website and social media platforms in recognition of their unwavering commitment to delivering exceptional care to patients.

Nominations can be submitted online by colleagues, patients, friends and family members of outstanding pharmacists, pharmacy technicians or anyone else working in the industry. Submissions should detail what the nominee has done to ensure access to treatment and care or describe how they go above and beyond to support their patients or community.

For more information about the September Faces of Pharmacy winners, click here.

About Pharmacy Times Continuing Education™

Pharmacy Times Continuing Education™ (PTCE) is a leader in continuing education for retail, health system, oncology, managed care and specialty pharmacists. PTCE is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education (CPE). PTCE’s print, online and live CPE activities are designed to help improve the knowledge, competence and skills of pharmacists so they are better prepared to provide the highest quality pharmacy care to the patients they serve and to the physicians they assist as part of a multidisciplinary treatment/management team. To learn more about the educational activities sponsored by PTCE, visit https://www.pharmacytimes.org.

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Contacts

PTCE
Alexandra Ventura, 609-716-7777
[email protected]

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COVID drug Trump touted as a “cure” was developed using cells derived from aborted fetal tissue

The antibody cocktail that President Trump received for his COVID-19 infection and touted on Wednesday evening as a “cure” for the deadly virus was developed using cells derived from aborted fetal tissue, a practice the White House and anti-abortion rights groups oppose.

Last week, Mr. Trump received Regeneron Pharmaceuticals’ cocktail of monoclonal antibodies, an experimental therapeutic for coronavirus that is still undergoing testing and is not FDA approved. In a nearly five-minute video posted to Twitter on Wednesday, the president lauded its effects, calling it “the key.”

“I think this was a blessing from God that I caught [the virus], I think it was a blessing in disguise,” Mr. Trump said in the video. “I caught it, I heard about this drug, I said, ‘Let me take it’ … and it was incredible the way it worked.”

But the way in which the antibody cocktail was developed is at odds with the Trump administration’s position on stem cell research. The drug’s potency was tested in a lab using HEK 293T cells, a cell line originally derived from the kidney tissue of a fetus aborted in the Netherlands in the 1970s, said a spokesperson for Regeneron in an email to CBS News on Thursday. The cells “were used in testing the antibody candidates’ ability to neutralize the virus” and helped researchers “determine the ‘best’ two antibodies, which now make up the REGN-COV2 cocktail,” the spokesperson said.  

There is no fetal tissue present in the final product.

Remdesivir, an antiviral drug Mr. Trump received, also was tested using the HEK 293T cells.

Last year, the Trump administration said it would no longer support long-standing funding for medical research by government scientists using human fetal tissue, a move that countered advice from physicians and researchers. The decision was seen as a major victory for anti-abortion rights groups.

Because the fetal cells used in developing Regeneron’s antibody cocktail were originally derived from an abortion prior to the funding ban, a White House official told CBS News on Thursday that the therapeutic wasn’t in violation of the administration’s new policy.

“The Administration’s policy on the use of human fetal tissue from elective abortions in research specifically excluded ‘already-established (as of June 5, 2019) human fetal cell lines,” the official said. “Thus, a product made using extant cell lines that existed before June 5, 2019 would not implicate the Administration’s policy.”

Anti-abortion groups, which generally oppose the use of fetal tissue in pharmaceutical research, did not raise issue with the therapeutics used and promoted by the president.

“The president was not given any medicines to treat COVID-19 that involved the destruction of human life,” wrote David Prentice, Ph.D., and Tara Sander Lee, Ph.D., of the Charlotte Lozier Institute, the research arm of the anti-abortion rights political group the Susan B. Anthony List, in a statement emailed to CBS News Wednesday afternoon. “No human embryonic stem cells or human fetal tissue were used to produce the treatments President Trump received – period.”

The researchers did not

Dentist’s COVID-19 Coverage Suit Sent Back to State Court


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Law360 (October 8, 2020, 6:44 PM EDT) —
A Texas federal judge remanded a dentist’s COVID-19 coverage suit against Allstate Insurance Co. back to state court, ruling that the insurer failed to show that a claims adjuster was wrongly joined, defeating the suit’s diversity of jurisdiction required in federal court.

U.S. District Judge Richard B. Farrer said Wednesday that Orsatti DDS PC, a dental office of Bexar County, Texas, sufficiently showed that it properly included an insurance claims adjuster in the suit, which lacks complete diversity of citizenship to stay in the district court.

Orsatti suspended business and could operate only for dental emergencies due to government closure orders amid the COVID-19 pandemic in March. The office claimed that it lost income and filed a coverage claim to Allstate. The Illinois-based carrier then assigned commercial property adjuster Blessing Sefofo Wonyaku — a Texas citizen — to investigate the claim.

Allstate subsequently denied coverage, asserting a virus exclusion and a lack of physical damage to Orsatti’s property. In June, the dental office sued the insurer in Bexar County state court before the insurer removed the case to federal court a month later.

Orsatti alleged that the insurer and its adjuster failed to conduct a proper investigation of its claim because they never asked for any documents or information relating to its claim. The office contended that both Allstate and Wonyaku “conspired to delay and deny or underpay its claim”

Allstate had argued that Wonyaku was improperly joined because Orsatti failed to show Wonyaku engaged in any conduct separate from the coverage denial. On Wednesday, Judge Farrer said Allstate’s arguments “lack merit.”

Orsatti “has properly stated a claim against [Wonyaku] for h[er] conduct as an individual adjuster,” and has plausibly alleged that she engaged in “an outcome-oriented investigation” and “unfair settlement,” the judge said.

Judge Farrer pointed out that Orsatti had adequately alleged that Wonyaku never asked “any questions upon learning [the dental practice] had to close business” due to government closure orders but “immediately” sent over a denial letter stating no coverage.

“Had Wonyaku requested additional information, as she was obliged to do, Orsatti’s amended petition suggests that Wonyaku would’ve found the virus exclusion provision inapplicable in this context,” the judge said.

Additionally, Judge Farrer said, although Allstate argued that it was not required to investigate the claim because the policy bars coverage for virus loss and mandates coverage denial, its argument “is more properly an attack on the merits of the claim, rather than an inquiry into the propriety of the joinder of the local party,” the judge said.

Allstate failed to demonstrate that

Gilead Sciences to sell Europe 500,000 doses of remdesivir

Oct. 8 (UPI) — Gilead Sciences announced Thursday that it’s selling 500,000 doses of remdesivir to European countries as many experience a spike in cases of COVID-19.

The company, which produces the antiviral under the name Veklury, said it reached a deal allowing the European Commission to purchase the drug for 36 countries over the next six months.

Gilead says it ramped up its production of remdesivir in recent months after studies indicated it showed shortened recovery times for some coronavirus patients. The U.S. Food and Drug Administration took control of the distribution of the drug in May after giving it emergency approval for COVID-19 treatment.

Gilead resumed control of distribution earlier this month. The company said it’s on track to produce more than 2 million treatment courses of the drug this year.

“Supply of Veklury is expected to meet global demand by the end of this month, enabling the purchase of Veklury both to treat patients and to support national stockpiling of the medicine for current and future surges of COVID-19,” the company said in a statement.

Clinical results for the antiviral have been mixed. A new National Institute of Allergy and Infectious Diseases study published Thursday in the New England Journal of Medicine said treatment with remdesivir shortened recovery time by five days compared to a placebo, and reduced mortality by 70% at Day 29 in patients with low-flow oxygen.

Another study in August showed the drug doesn’t improve outcomes in people hospitalized with moderate pneumonia caused by COVID-19.

Researched published last month showed that remdesivir administered in combination with baricitinib — treatment for rheumatoid arthritis — can reduce the recovery time for people with COVID-19 when compared to people treated with just the antiviral.

Originally developed to treat Ebola virus, remdesivir works by slowing the production of enzymes that play a key role in the replication of viruses, including coronaviruses, according to Gilead Sciences.

President Donald Trump received remdesivir as part of his own treatment for COVID-19.

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This Is How Much Toothpaste You Really Need

Updated 1 minute ago. Posted 1 minute ago

Why did I not know this earlier?!

Dr. Gao Jye Teh is a Malaysian-based dentist who — like a lot of people — decided to download TikTok during the COVID-19 lockdown earlier this year. “I found myself retaining information I learned from watching TikToks easily because it was often conveyed in short, digestible, and entertaining ways. It got me thinking, ‘What if I could spread dental awareness in this memorable way, too?’ So, I gave it a shot,” Dr. Gao told BuzzFeed.

And, he has been very successful at doing just that! In his latest TikTok — which went viral with over six million views — Dr. Gao demonstrated what the proper amount of toothpaste looks like:

So, how much do you actually need? People over three years of age only need the amount of a SINGLE PEA!


Evgenyatamanenko / Getty Images

That’s right! Although this toothpaste swish is perfection, it is FAR TOO MUCH.


Malerapaso / Getty Images

Dr. Gao said his information is backed in this document — and by the easily overlooked directions on toothpaste packaging.

“Kids under age three only need a smear of toothpaste. The ‘little’ amount is attributed to the fact that they might have trouble not swallowing the excess fluoride toothpaste,” explained Dr. Gao.

Dr. Gao emphasized that using more than the recommended amount of toothpaste is most detrimental to children whose adult teeth are still developing under their gums. “This is because fluoride, when ingested in large amounts, can cause a cosmetic condition known as dental fluorosis on the developing teeth. The cosmetic implications range from mild discoloration to yellow and brown stains to obvious pits in the teeth,” he said.

However, if too little toothpaste is used, your teeth will not benefit from the full protective properties of the fluoride. “Once you brush your teeth, you should spit out the excess and not rinse your mouth with water. This is because the fluoride in the toothpaste takes time to act on your teeth,” explained Dr. Gao.

@doctorgao

Spit… you’ll get used to it 😄 #dentist #dental #dentistry #tiktokguru #youngcreators #learnontiktok #edutok #teeth #foryou

♬ Hell 2 da Naw – Bullwinkle Boyz

Dr. Gao said when it comes to mouthwash, he recommends using one that contains fluoride at a time separate from brushing. “Doing this will increase the amount of fluoride exposure, helping with the remineralization of your teeth. There are many variations of mouthwash out there – some specialized for treating gum disease, some for dealing with dry mouths, and some that contain alcohol. Seek advice from your dentist to decide which type you are most suited for.”

We also asked Dr. Gao if all toothpastes were essentially the same or if there is a certain type he recommends. “Toothpaste is like shampoo. If you think about it as a product to clean your teeth — just as shampoo cleans your hair — then, yes, all toothpaste serves this purpose.

Depressed teens may struggle in school

By about age 16, teens diagnosed with depression have substantially lower educational attainment, a new British study finds.

Targeted educational support might be of particular benefit to teens from poor backgrounds and boys, but all children with depression can benefit from such help, the study authors suggested.

For the study, the researchers used British health and education records to identify nearly 1,500 kids under 18 years of age with depression. Typically, their depression was diagnosed around age 15. Their educational attainment was compared with a group of young people who were not depressed.

Among students with a diagnosis of depression, 83% reached expected educational attainment at ages 6 to 7, but only 45% hit more advanced thresholds in English and math by age 15 to 16. Researchers said that’s much lower than the 53% who met the threshold locally and nationwide.

“Previous research has found that, in general, depression in childhood is linked to lower school performance,” said researcher Alice Wickersham, a doctoral student at NIHR Maudsley Biomedical Research Centre of King’s College London.

But young people who developed depression in secondary school typically showed a performance decline on the General Certificate of Secondary Education (GCSE) exams. The exams — taken by most pupils at about age 15 to 16 in England, Wales and Northern Ireland — dovetailed with the time of diagnosis for many young people.

The pattern appeared to be consistent across different genders, ethnicities and economic groups, Wickersham said in a research center news release.

“While it’s important to emphasize that this won’t be the case for all teenagers with depression, it does mean that many may find themselves at a disadvantage for this pivotal educational milestone,” Wickersham said.

“It highlights the need to pay close attention to teenagers who are showing early signs of depression. For example, by offering them extra educational support in the lead up to their GCSEs, and working with them to develop a plan for completing their compulsory education,” she added.

Researcher Dr. Johnny Downs, senior lecturer in child and adolescent psychiatry at King’s College London, said the findings have two key policy implications.

“It demonstrates just how powerful depression can be in reducing young people’s chances at fulfilling their potential, and provides a strong justification for how mental health and educational services need to work to detect and support young people prior to critical academic milestones,” he said.

The findings were published online Oct. 8 in the British Journal of Psychiatry.

More information

For more about teens and depression, head to the U.S. National Institute of Mental Health.

Copyright 2020 HealthDay. All rights reserved.

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Trump politicizes promising coronavirus antibody treatments, erroneously calling them a ‘cure’

Trump also claimed in the videos he had granted the drugs an emergency use authorization (EUA), a designation that would make the medicines more broadly available. But the companies said they have submitted the requests to the Food and Drug Administration — a process that the agency has repeatedly tried to assure the public is based on science and free of political interference.

“We’re going to make them available immediately, we have an emergency use authorization that I want to get signed immediately,” Trump said in the video posted Thursday afternoon.

Experts said that by inserting himself and his own recovery story into an area of ongoing medical research, Trump risks disappointing and confusing the American public with a hopeful anecdote that may not reflect how the drug works for others or how broadly it will become available when it is approved, which he also promised would be free.

“The fundamental problem with monoclonal antibodies is there’s not enough worldwide capacity to produce enough of them to have a real impact on the disease,” said Ezekiel Emanuel, a health policy expert who is advising the campaign of Joe Biden. “Yes, they might be great, but for a small number of patients.”

The president also said in the video that people in hospitals should receive the drugs, but the data so far supports using them in people with mild or moderate illness who are recently diagnosed. Early data from ongoing studies have shown evidence the drugs reduce symptoms over days, knock back the virus by reducing levels in the body and may cut down the need for further medical visits. That data is considered very promising, but not definite evidence of a cure.

Trump’s endorsement of monoclonal antibodies comes as the authorization of a coronavirus vaccine before Election Day appears increasingly unlikely. Such an okay had loomed as a potential “October surprise” that some believed could alter the course of the election with the prospect of a quick return to normalcy. An influential medical journal argued in an editorial Wednesday that the Trump administration’s handling of the pandemic took “a crisis and turned it into a tragedy,” so the antibody drugs could offer a rare victory.

Trump said in one video that the therapies were “more important” than the vaccine, the same day that both companies disclosed that they had filed with regulators for emergency authorization to use the drugs in some patients. On Fox Business on Thursday morning, he called the Regeneron drug “a gift from heaven.”

Both the Regeneron and Eli Lilly drugs are being tested in clinical trials, and no one knows if the former helped Trump recover, whether it did so in addition to all the other treatments he received or whether he would have recovered on his own as part of the natural course of the disease.

Several experts said that Trump touting a drug as a cure will make it even harder to persuade patients to participate in ongoing clinical trials where they will have

Pandemic Delays Treatment, Threatening Patients and Research

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The COVID-19 pandemic has taken a severe toll on patients with retina diseases, according to leading European specialists who took stock and exchanged tips on innovative responses to the crisis at the virtual European Society of Retina Specialists 2020 Congress.

The number of new patients with neovascular age-related macular degeneration decreased by an average of 72% after the onset of the pandemic, said Adnan Tufail, MBBS, MD, from Moorfields Eye Hospital in London, citing findings from a survey he and his colleagues conducted at three treatment centers in the United Kingdom.

A delay in treatment initiation of 3 months could cause an increase of more than 50% in the number of eyes with age-related macular degeneration with 6/60 vision or worse, the survey team estimates, and a 25% decrease in the number of eyes with driving vision over a year.

Significant declines in the number of patients presenting to the hospital for retina treatments were also reported in France and Spain.

“The problem was that patients were afraid to go to the hospital for the injections in their eyes,” said Cesare Mariotti, MD, PhD, from the University of Ancona in Italy.

The overall drop in patients going to the hospital for treatment — roughly 80% across Asia, Europe, and the United States — posed challenges for research, as well as for patients, said Susanne Diehl, PhD, from Novartis in Bavaria, Germany. “Trials will be delayed, approvals will be delayed, and innovation will come to the market delayed.”

Mobile Injection Units

One inventive response to the crisis was to form a mobile intravitreal injection clinic so patients, particularly seniors, could receive treatments in their homes, said Anat Loewenstein, MD, MHA, from Tel Aviv University in Israel.

That service required a lot of infrastructure to set up, and a physician was delegated to review all patient charts to identify those who did not need to be examined before an injection was administered.

It would not be feasible to continue over the long term, but patients loved it, she told Medscape Medical News. “You can’t imagine how people were grateful and happy and were begging us to do that.”

Crews on the mobile units wore masks, face shields, gowns, and gloves, and were tested periodically for COVID-19, Loewenstein reported.

And an entire floor of an office building that wasn’t being used during the pandemic was donated by WeWork, the coworking company, so that Loewenstein and her colleagues could set up a satellite injection clinic, complete with an optical coherence tomography (OCT) machine, for patients not comfortable visiting the hospital.

The strategy in France was to issue a press release and information sheets to reassure patients that they could safely come to the hospital for treatment, said Laurent Kodjikian, MD, PhD, president of the French Society of Ophthalmology.

“Despite that, about 20% to 30% of the patients didn’t come,” said Jean-Francois Korobelnik, MD, from the University Hospital of Bordeaux

10 states with the rudest drivers

For many, the experience of driving creates a feeling of anonymity. Protected inside the pod-like confines of our car, we may begin viewing the world outside as an observer, rather than as a participant. This detachment can embolden drivers to behave more aggressively or impolitely towards other drivers than they would in another social situation. 

Unfortunately, rude driving behavior and aggression towards other drivers are ubiquitous in America. In fact, more than half of all drivers in the United States reported at least one incident of significant aggression, anger, or road rage towards another driver over a one-year period. 

While drivers may not feel particularly accountable for behaving impolitely towards others, some forms of rude driving behavior can be extremely dangerous. Honking to express annoyance may be one thing, but it’s quite another to angrily tailgate a car, truck, or motorcycle, or to run a red light in utter disregard of oncoming traffic. 

The data scientists at Insurify, an insurance quotes comparison website, were eager to investigate patterns in rude driving behavior that are on the more dangerous (and illegal) end of the spectrum. Curious to find whether there are regional differences in these extreme behaviors, Insurify’s data scientists turned to their database and ranked each state based on its share of ill-behaved drivers. 

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