Medical Bulletin 19/August/2022

Here is the top medical news for the day:

Covid out Clinical Trial

Published in the New England Journal of Medicine, researchers — led by the University of Minnesota Medical School and School of Public Health — have found that metformin, a commonly prescribed diabetes medication, lowers the odds of emergency department visits, hospitalizations, or death due to COVID-19 by over 40 percent; and over 50 percent if prescribed early in the onset of symptoms. The study also found no positive effect from treatment with either ivermectin or low-dose fluvoxamine.

The study design was simple — patients were randomly assigned to receive one of the three drugs individually, placebo, or a combination of metformin and fluvoxamine or metformin and ivermectin. Although the study was placebo-controlled with exact-matching placebo pills, Dr. Carolyn Bramante, the study's lead author says that 83% of volunteers received medications supported by existing data because of the six-arm design. Each participant received 2 types of pills to keep their treatment assignment masked, for 3 to 14 days of treatment. Each volunteer tracked their symptoms, and after 14 days, they completed a survey.

Ref: Dr. Carolyn Bramante, Randomized trial of metformin, ivermectin, and fluvoxamine for Covid- 19,New England Journal Medicine,10.1056/NEJMoa2201662

Identification of genes strongly linked to autism and neurodevelopmental disorders

A new study of genes underlying neurodevelopmental differences has uncovered more than 70 that are very strongly associated with autism and more than 250 with strong links to the condition. The analysis is the largest of its kind to date and includes more than 150,000 participants, 20,000 of whom have been diagnosed with autism.

The results offer the most comprehensive look yet at diverse forms of genetic variation in autism and in more broadly defined neurodevelopmental conditions. The insights shed light on the molecular roots of brain development and neurodiversity, and provide new avenues for future research on the biology of autism.

Ref: Joseph D. Buxbaum et. al, 'Rare coding variation provides insight into the genetic architecture and phenotypic context of autism, Nature Genetics,10.1038/s41588-022-01104-0

Successfully engineered Immune cell model way for new treatments amongst immunocompromised children

The research, led by the Murdoch Children's Research Institute and published in Stem Cell Reports, used cutting edge stem cell technology to better understand how the infection invades immune cells and causes health complications, such as lung and skin and soft tissue infections, in immunocompromised people, particularly those with cystic fibrosis.

Researcher Dr Shicheng Jacky Sun said the immune cell type the team created in the lab, known as a macrophage, played an important role in infection, inflammation and regeneration. But due to this function was also a natural host for germs. Murdoch Children's researcher Dr Shicheng Jacky Sun said the immune cell type the team created in the lab, known as a macrophage, played an important role in infection, inflammation and regeneration. But due to this function was also a natural host for germs.

Ref: Shicheng Sun, Michael See, Hieu T. Nim, Kathleen Strumila, Elizabeth Ng, Ale jandro Hidalgo,Mirana Ramialison, Philip Sutton, Andrew G. Elefanty, Sohinee Sarkar and Edouard G. Stanley. 'Human pluripotent stem cell-derived macrophages host Mycobacterium abscessus infection,' Stem Cell Reports. DOI: 10.1016/j.stemcr.2022.07.013

4. Routine depression screening which may capture underdiagnosed patient populations

Implementation Leads to Better Symptom Recognition in Older Adults, Minorities, Men, Non- English Speakers, UCSF-Led Study Shows.

Screening for depression at the primary care level could dramatically increase the likelihood of treatment for those who are traditionally undertreated — racial and ethnic minority individuals, older adults, those with limited English proficiency and men — according to a new study led by UC San Francisco.

Ref: Maria E. Garcia.et. al,JAMA Network Open