United States
I have been a medical reporter for more than 2 decades, and have written thousands of health-related articles for the websites WebMD, Physician's Weekly, MedPage Today and BreakingMED. My writing has also appeared in the Philadelphia Enquirer, the Atlanta Constitution, the Associated Press and other publications.
Since March of 2020, I have written almost exclusively about Covid-19. Prior to this my beat included vaping, EVALI, smoking, COPD, other pulmonary diseases and critical care medicine. I also cover medical conferences.
Weekly home-based, rapid antigen testing for Covid-19 combined with self-enforced isolation of people positive for SARS-CoV-2 infection could save thousands of lives at an acceptable cost, according to findings from a mathematical modeling study performed by researchers from Yale School of Public Health.
An analysis of real-world mRNA vaccine data from the Mayo Clinic adds to the evidence that vaccination prevents asymptomatic SARS-CoV-2 infection, greatly slowing the spread of Covid-19. The retrospective, cohort analysis, published in the journal Clinical Infectious Disease , involved data on over 39,000 patients who underwent pre-surgical molecular screening for Covid-19 between mid-December of last year and early February 2021.
The widely reported death of the founder of a nationwide chain of steak houses last week put the spotlight on prolonged neurological symptoms linked to Covid-19. After experiencing a mild case of the coronavirus last November, entrepreneur W.
People with SARS-CoV-2 antibodies had a 10-fold lower risk for active viral infection at 3 months, compared to people without evidence of antibodies in an observational study involving testing data from more than 3.2 million people.
ATLANTA -- In his 3 decades as the nation's top advisor on infectious diseases, Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), said that there has been one constant -- every presidential administration during his tenure navigated an unexpected outbreak of emerging or re-emerging infectious diseases.
Covid-19, February 2021
Johnson & Johnson's single-shot Covid-19 vaccine candidate was shown to be very effective overall, but significantly less effective against the highly contagious South African B.1.351 variant of the disease predicted by many to become the dominant form of SARS-CoV-2 infection in the United States by mid-spring.
Peer-reviewed, interim phase III data from a trial of a Covid-19 vaccine developed in Russia showed an overall efficacy of 91.6%, with protection shown across all age groups. The trial data for the Sputnik V Covid-19 vaccine, also known as the Gam-Covid-Vac, involved 20,000 participants vaccinated in Moscow last fall, with three-quarters randomized to receive the active adenovirus vector vaccine and one-forth receiving placebo vaccines.
Covid-19, January 2021
Early in the COVID-19 pandemic, both the CDC and the World Health Organization identified asthma patients as being at high risk for severe disease and hospitalization, but it soon became evident that this may not be the case when study after study showed little or no support for that conclusion.
SARS-CoV-2 seroprevalence during lockdown among children age 10 and younger in southwest Germany was 3-fold lower than observered in a paired parent, adding to the evidence that children do not play a key role in spreading Covid-19.
Health care workers with detectable antibodies to SARS-CoV-2 had very low rates of reinfection over 6 months of follow-up in a longitudinal study from the United Kingdom, indicating substantial post-infection immunity in the months after primary infection.
Reported anaphylactic reactions to the Pfizer-BioNTech Covid-19 vaccine, while rare, are approximately 10 times higher than those reported for long established vaccines, with such reactions occurring in roughly 1 in 100,000 early recipients. As of Dec.
Early administration of high-titer convalescent plasma was associated with reduced progression to severe Covid-19 in older adults treated within 72 hours of mild symptom onset in the INFANT-Covid-19 trial. Among older patients with SARS-CoV-2 infection and recent symptoms onset, treatment with high titer convalescent plasma was associated with a 48% reduction in the risk of progression to severe respiratory disease.
Peer-reviewed findings from the COVE trial showed the Moderna mRNA-1273 vaccine to have 94.1% efficacy for preventing Covid-19, with efficacy of 86.4% reported in older (≥65 years) study participants. No significant safety concerns were reported among recipients of the mRNA-1273 vaccine at a median of 2 months follow-up.
Covid-19, October - December, 2020
For the first time in its more than 200-year history, the New England Journal of Medicine is weighing in on a U.S. election, calling the Trump administration's response to the Covid-19 pandemic a national tragedy. An editorial published Wednesday signed by all 24 NEJM editors characterized the national response to Covid-19 as "consistently inadequate."
A 10-day course of the antiviral drug remdesivir was superior to placebo for shortening the time to recovery in adults hospitalized with Covid-19, according to the final report from the randomized, placebo-controlled Adaptive Covid-19 Treatment Trial (ACTT-1).
PETAL Network trial included nearly 500 hospitalized patients Yet another study - this one from the National Heart, Lung, and Blood Institute PETAL Clinical Trials Network - found no benefit for hydroxychloroquine in the treatment of patients hospitalized with Covid-19. PETAL researchers randomized nearly 500 patients with Covid-19 being treated at 34 U.S.
The coronavirus pandemic has been a particularly scary time for children with asthma and their parents, but there is growing evidence that as a group kids with asthma are not only doing OK during COVID-19, but may actually be doing better.
In the late summer of 2019 -- months before COVID-19 was on anyone's radar -- another deadly, previously unseen respiratory illness dominated the headlines. By mid-December, the vaping-related lung disease named EVALI by the CDC had hospitalized 2,500 people across the U.S.
Covid-19, August-September
Since mid-June, four countries -- the U.S., Brazil, Mexico, and India -- have experienced the most COVID-19 deaths globally, and it is likely they will continue to have the highest mortality rates associated with the pandemic for several months to come.
Covid-19, May-July, 2020
Among an early cohort of Covid-19 patients from Italy with mild disease who experienced illness-related smell or taste loss, 9-in-10 had complete or partial resolution of these dysfunctions within 4 weeks of symptom onset, researchers report.
As many as 1 in 5 people worldwide - or 22% of the global population - are at risk for developing severe Covid-19 if they become infected, according to a newly published modeling study. Researchers estimated that 1.7 billion people have at least one underlying health condition that would make them more vulnerable to developing severe and possibly life-threatening symptoms of Covid-19.
Covid-19, March-April. 2020
It is a familiar public health message that has taken on new urgency in the time of the COVID-19 coronavirus pandemic: If you smoke, you need to quit. The sooner, the better. Tobacco users face an elevated risk for a long list of chronic diseases and malignancies, and there is growing evidence that smoking, and possibly vaping, also increase the risk for life-threatening complications and death from COVID-19.
Long-term exposure to even small increases in PM2.5 linked to more deaths in study
Small study suggests improved clinical status in patients receiving plasma from recovered patients
Fever may also be absent, Wuhan study finds.
Modeling study estimates impact of lockdown and timing of easing restrictions
Quarantine of those infected, plus home, school and work efforts had most impact
Covid-19, February-March, 2020
ORLANDO -- U.S. hospitals need to prepare now to deal with a possible influx of COVID-19 coronavirus cases by having a plan in place to identify patients, isolate them, and collect and report case data, infection control specialists said here.
The U.S. has more critical care hospital beds per capita (34.7 per 100,000 population) than most other countries -- almost 10 times as many as China (3.6) and about triple the rate in Italy (12.5). But the number of ICU beds and mechanical ventilators in U.S.
Vaping, E-Cigarette Illness
In January, we reported on a National Academies of Sciences, Engineering, and Medicine (NAS) report that essentially punted on the question of whether electronic cigarettes are, on balance, harmful, or helpful. In this follow-up, we review what has happened with this explosive topic since then.
This story was originally published Jan. 23, 2018. As part of MedPage Today's year-end review of 2018's top stories, we are republishing it along with an update on what has happened since with e-cigarette research and regulation.
Federal health officials on Friday said no single source has been identified for the outbreak of respiratory illnesses linked to vaping, although New York state health officials reported that vitamin E acetate found in cannabis vaping products may have caused at least some cases.
As FDA commissioner Scott Gottlieb, MD, prepares to leave office in about 2 weeks, he has expressed optimism that the ambitious policy initiatives aimed at protecting youth and adults from the harms of tobacco will move forward under new leadership.
The FDA said Wednesday that it had identified a potential seizure risk associated with electronic cigarettes, mostly in teens and young adults. In a statement released Wednesday morning, U.S. health officials disclosed that an agency review had identified 35 cases of seizures possibly linked to the use of e-cigarettes from 2010 through early 2019.
A second major survey confirms that e-cigarette use among teenagers is soaring, following a CDC report in November that said use among high school students had nearly doubled in just one year. Reported early Monday, findings from the annual Monitoring the Future survey indicated the percentage of high school seniors who reported current vaping increased from 11% in 2017 to 21% this year.
The parents of Texas teen Tryson Zohfeld had no idea their son was using vaping products when he became desperately ill with an unexplained, rapidly progressing respiratory disease earlier this summer. The 17-year-old presented at Fort Worth's Cook Children's Medical Center with abdominal pain, vomiting, and extreme difficulty breathing.
Misc Stories
As another so-called triple therapy for chronic obstructive pulmonary disease (COPD) hits the market, pulmonologists and primary care physicians are beginning to consider which patients are most appropriate for these treatments, and how much added benefit these products offer relative to more conventional -- and better understood -- two-drug combinations.
It was the post that blogger Jo-Lynne Shane says she almost didn't write. When the Pottstown-area woman and her three children got sick from raw milk early last year, she knew she owed it to her readers to write about it.
Health advocacy groups blasted the Environmental Protection Agency's plan to roll back Obama-era limits on coal-fired power plant emissions, with one group arguing the changes could result in more than 1,000 avoidable deaths a year in the U.S. while doing nothing to address climate change.
The recent FDA decision to put the metered-dose epinephrine inhaler Primatene Mist™ back on drugstore shelves was met with alarm by asthma specialists and respiratory health groups who warned that the move will place asthma patients at risk.
Meeting Coverage, ERS 2020 International Congress
Social smokers were more than eight times as likely to die of lung cancer than lifetime non-smokers, and their lung cancer risk was not substantially lower than that of heavier smokers in an analysis involving close to 19,000 people. In a study of pooled data from four U.S.
Fixed-dose triple therapy with fluticasone furoate/umeclidinium/vilanterol (Trelegy Ellipta) improved lung function in adults whose asthma was uncontrolled with an inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA), the CAPTAIN study showed. On Wednesday, based on findings from the trial, the FDA approved the chronic obstructive pulmonary disease treatment at two different doses for adults 18 and over with uncontrolled asthma, GlaxoSmithKline announced.
Persistent lung issues are common following hospital discharge for COVID-19, but recovery is more the rule than the exception, according to two studies presented at the virtual European Respiratory Society International Congress.
In patients with chronic rhinosinusitis with nasal polyps, add-on mepolizumab (Nucala) reduced both polyp size and the need for surgery in the SYNAPSE study, a researcher reported.
Higher doses of the investigational oral drug gefapixant significantly decreased cough frequency compared to placebo in two highly anticipated phase III studies, but well over half of patients in both trials reported taste-related adverse events.
Treatment with the novel reversible dipeptidyl peptidase 1 (DPP1) inhibitor brensocatib prolonged time to first exacerbation for patients with non-cystic fibrosis bronchiectasis, and led to fewer exacerbations overall, a randomized phase II study found.
Daily treatment with molgramostim, an inhaled granulocyte-macrophage colony-stimulating factor (GM-CSF), in patients with autoimmune pulmonary alveolar proteinosis (PAP) was associated with improvements in pulmonary gas transfer and functional health status, a randomized trial found.
Specific genetic alterations in children and teens with asthma may identify those who will not benefit from treatment with the long-acting β2-adrenergic receptor agonist (LABA) salmeterol, a researcher reported.
Meeting Coverage, ATS 2020 Virtual Meeting
There is new evidence that biomarker-directed treatment may improve therapeutic outcomes in patients whose asthma is uncontrolled despite therapy with an inhaled corticosteroid and long-acting β-2-agonist (ICS/LABA).
Since mid-June, four countries -- the U.S., Brazil, Mexico, and India -- have experienced the most COVID-19 deaths globally, and it is likely they will continue to have the highest mortality rates associated with the pandemic for several months to come.
Hospitalizations due to e-cigarette and vaping-associated lung injury (EVALI) likely occurred years before last summer's widely reported outbreak, new research suggests. A look-back analysis of hospital registry data from 2016 using ICD-10-CM coding guidance for EVALI enacted by the CDC this April, identified six cases that met the definition for the lung disorder, reported Kam S.
In a subset of patients presenting to emergency departments with suspected sepsis, early administration of antibiotics might have done more harm than good, researchers found.
Meeting Coverage -SCCM 2020
ORLANDO -- Treatment with IV interferon beta 1a (IFN-β-1a) for 6 days did not lead to improved mortality or fewer ventilator-free days among patients with moderate- to severe acute respiratory distress syndrome (ARDS) in the INTEREST trial.
ORLANDO -- The Surviving Sepsis Campaign is expanding its focus to include children, with its first evidence-based guidelines for managing sepsis- and septic shock-related organ dysfunction in pediatric populations. Sepsis is far more common in adults than children, but an estimated 1.2 million children each year develop the condition, and it is responsible for around 7,000 deaths among children annually in the U.S.
ORLANDO -- Early findings from the single-center HYPE study reported here suggest a role for machine learning in alerting clinicians to impending intraoperative hypotension in patients undergoing noncardiac surgery. The unblinded randomized trial was performed at a tertiary care center in Amsterdam, and compared intraoperative hypotension outcomes among patients undergoing elective, noncardiac surgery randomized to the early warning system or standard care.
ORLANDO -- Early findings from the single-center HYPE study reported here suggest a role for machine learning in alerting clinicians to impending intraoperative hypotension in patients undergoing noncardiac surgery. The unblinded randomized trial was performed at a tertiary care center in Amsterdam, and compared intraoperative hypotension outcomes among patients undergoing elective, noncardiac surgery randomized to the early warning system or standard care.
ORLANDO -- Users of vaping products who are at moderate risk of developing e-cigarette/vaping-related lung injury (EVALI) -- i.e., those already showing signs of lung damage -- should be strongly encouraged to stop, an expert said here. "For these patients, we think that vaping cessation is absolutely mandatory," said Craig M.
Meeting Coverage, SLEEP 2019
SAN ANTONIO -- Morning blue wavelength light exposure was associated with increased sleep duration and greater retention of fear extinction learning in people with post-traumatic stress disorder (PTSD) in a pilot study.
SAN ANTONIO -- Very brief exposure to light flashes while sleeping can help reset the body's circadian clock and may prove to be an effective strategy for managing phase shift sleeping disorders.
SAN ANTONIO -- Having obstructive sleep apnea or other sleep-disordered breathing (SDB) conditions may speed up aging, especially among women, according to preliminary study data presented here. SDB was found to be associated with accelerated epigenetic aging in a dose-dependent manner, said Xiaoyu Li, ScD, a postdoctoral fellow at Harvard T.H.
SAN ANTONIO -- College students who didn't get enough sleep had more depression, anxiety, and other mental health issues, a researcher reported here. In adjusted models, a dose-response relationship was seen between lack of sleep and all mental health variables examined in an analysis of data from the National College Health Assessment (NCHA), according to Thea Ramsey, a research assistant at the UA Sleep & Health Research Program at the University of Arizona in Tucson.
SAN ANTONIO -- Although one state has authorized medical cannabis as a treatment for obstructive sleep apnea (OSA), the science supporting it remains shaky and physicians should be very cautious about recommending it, a sleep medicine specialist said here.
SAN ANTONIO -- Early results from an ongoing randomized controlled trial indicated that cognitive behavioral therapy (CBT) delivered via telemedicine was just as effective as face-to-face CBT for insomnia. Findings from the non-inferiority study showed the two CBT delivery methods to be equally effective for improving secondary sleep outcomes, as measured by sleep diaries, including time to sleep onset and incidence of wake episodes after sleep onset.
SAN ANTONIO -- Preliminary findings from a study of survivors of the 2010 earthquake in Haiti suggest that sleep issues related to the disaster persist and are associated with ongoing mental health problems, a researcher said here.
SAN ANTONIO -- High school students in a metro Denver school district increased their nightly sleep times by an average of 48 minutes per night after school start times were delayed by roughly an hour, to 8:20 a.m., researchers reported here.
SAN ANTONIO -- Since its FDA approval in 2014, upper airway stimulation (UAS) has proven to be an effective alternative to continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea (OSA) in patients who are CPAP intolerant. But research presented here suggested that, like CPAP, adherence with UAS may be poorer in patients with comorbid insomnia.
Meeting Coverage, AAAAI 2019
SAN FRANCISCO -- Allergic reactions to red meat are on the rise, and the spread of the antigen that causes meat allergies may be easier than previously thought, researchers reported here. Alpha gal syndrome (AGS) describes an allergic immune response to the alpha gal sugar found in the blood of nearly all mammals except humans, which manifests as a sudden allergic reaction to red meat.
SAN FRANCISCO -- Egg allergies in infants only rarely lasted till age 6 in an Australian longitudinal study, and peanut allergies resolved in nearly a third, researchers said here. Among children whose allergies were confirmed at age 1 through challenge testing, peanut allergy was no longer present in 31% (95% CI 24%-40%) and egg allergy resolved in 89% (95% CI 85%-92%) when they were examined 5 years later.
SAN FRANCISCO -- A novel peptide-based immunotherapy for peanut allergy designed to be given as a monthly injection showed a highly favorable safety profile in phase I trial data, researchers said here at the American Academy of Allergy, Asthma & Immunology annual meeting.
SAN FRANCISCO -- Most patients with aspirin-exacerbated respiratory disease (AERD) can be safely desensitized to aspirin in a single day with a four-step dose escalation protocol, researchers reported here.
SAN FRANCISCO -- The biologic therapy dupilumab (Dupixent) showed significant efficacy with a good safety profile in a phase III study involving patients with chronic rhinosinusitis with multiple nasal polyps, researchers reported here. Compared to dupilumab-treated patients, patients in the placebo group of the randomized trial were three times more likely to require nasal polyp surgery or treatment with systemic steroids after week 24, said Joseph K.
SAN FRANCISCO -- The prevalence of asthma was more than twice as high as the national average in a cohort of opioid-dependent patients receiving acute care at an inner city hospital in a New York City borough, with female sex more closely linked to higher asthma risk than male sex, researchers reported here.
SAN FRANCISCO -- More than half of patients being treated with omalizumab (Xolair) for chronic idiopathic urticaria (CIU) relapsed after the biologic therapy was discontinued, according to the first large analysis of prescribing practices and patient outcomes in the real-world setting.
