Pulse Oximetry Readings Overestimate Oxygen Levels in Non-White Patients
A study co-led by Johns Hopkins and Baylor College of Medicine has found that pulse oximetry overestimated the blood oxygen levels of non-white patients during the COVID-19 pandemic.
The researchers began their study by looking at more than 1,200 patients with COVID-19 who had their blood oxygen levels measured by pulse oximetry and arterial blood gases. Pulse oximetry overestimated blood oxygen levels by 1.2% for black patients, 1.1% for non-Black Hispanic patients, and 1.7% for Asian patients when compared to white patients.
From there, the investigators applied a statistical prediction model to more than 6,600 other patients, finding that more than a fourth of these patients, who were mainly members of racial or ethnic minorities, most likely qualified for additional COVID-19 therapy before the pulse oximeter identified it. Overall, black patients were 29% less likely than white patients to have their treatment eligibility recognized by pulse oximetry. In addition, non-black Hispanic patients were 23% less likely.
The team believes the disparities in COVID-19 outcomes between different races during the pandemic might be partially explained by the biases related to pulse oximetry readings.
The study was published by JAMA Internal Medicine. Read More
Vaccine Hesitancy in Health Care Workers
Why have some health care professionals refused to receive the COVID-19 vaccines? An international group of researchers asked that question in a study conducted among more than 23,000 adults in 23 countries, including the U.S.
The group included 3,295 people who identified themselves as health care providers.
Results showed that most health care workers had received one or more doses of the vaccines, but 494, or 15%, reported vaccine hesitancy. One hundred and thirty-two, or 4%, said they would refuse the vaccine outright.
Vaccine hesitancy was more common in those with lower than the median income and, to a lesser degree, a younger age. In addition, concerns about the efficacy of the vaccines were less prevalent than concerns about their safety and whether or not they would be equitably distributed.
“These findings are troubling since health care workers’ hesitancy may influence community perceptions negatively, especially among patients and family members, and can contribute to their refusal or delayed uptake of the COVID-19 vaccine,” said study author Dean El-Mohandes, from the CUNY Graduate School of Public Health and Health Policy.
The study was published by Vaccine. Read More
NSCLC Drug Shows Promise
About one in four people with non-small cell lung cancer (NSCLC) have the KRAS mutation, and about 13% of those tumors are driven by a specific KRAS mutation called G12C. Researchers from Dana-Farber Cancer Institute studying an experimental drug called adagrasib have found that nearly 43% of patients with the KRASG12C mutation respond to the drug.
The phase 2 trial, published in The New England Journal of Medicine, also showed a median overall survival rate of 12.6 months in the cohort of 112 patients who had previously received both chemotherapy and immunotherapy with a PD-1 immune checkpoint blocker.
Adagrasib achieved a 33.3% response rate in 33 patients who had stable metastatic lesions in the brain and central nervous system that had spread from the lung tumors as well.
“These data highlight that inhibiting KRASG12C can lead to clinically meaningful benefits to NSCLC patients with this form of lung cancer,” said study author Pasi Jänne, MD, PhD.
Previously, the only drug found to be effective against KRASG12C lung cancer was sotorasib, which showed a 36% response rate in patients who received chemotherapy and a PD-1 immune checkpoint blocker. Read More
Graphic Warning Labels Lead Smokers to Hide their Packs
Graphic warning labels on cigarette packages are intended to cast an unfavorable light on smoking.
A recent study out of the University of California San Diego suggests they may do just that. Researchers found those who were given packs with the warnings, which ranged from images of throat cancer and a diseased foot to a newborn with a breathing tube, were more likely to hide those packages from view.
Overall, people who received packs with graphic warnings hid their packs 38% more often than those who received packs with no warnings or standard commercially available packs. Once the people in the study went back to their usual packs, they quit hiding them.
“In a randomized clinical trial, we demonstrated that smokers in the U.S. who received cigarettes in packs with graphic warning labels were less willing to display the packs in public. It has been hypothesized that this behavior could reduce perceptions by teens that it is socially acceptable to smoke, perhaps explaining why mandated graphic warning label packs are associated with reductions in teen smoking,” said study author John P. Pierce.
The study was conducted among 357 smokers randomized to one of the three groups. The graphic warnings had no effect on smoking behavior among any of the participants.
The study was published by JAMA Network Open. Read More
Inhaled Vaccines Outperform Nasal Sprays
Canadian investigators publishing in Frontiers in Immunology have found that inhaled aerosol vaccines are far better at inducing an immune response against respiratory infections than nasal spray vaccines.
The researchers arrived at that finding after using a tuberculosis vaccine to compare the two delivery methods in animals. After measuring the distribution of droplets, immune responses, and potency for both methods, they concluded that delivering the vaccine directly into the lungs stimulated stronger immune responses.
“This study, for the first time, provides strong preclinical evidence to support the development of inhaled aerosol delivery over nasal spray for human vaccination against respiratory infections including TB, COVID-19, and influenza,” said study author Zhou Xing, a professor at the McMaster Immunology Research Centre.
Scientists at McMaster have developed an inhaled aerosol vaccine for COVID-19. They are currently testing it in a clinical trial involving people who have had two or three doses of an injected mRNA vaccine. Read Abstract
Restoring Zinc Could Help Reverse Lung Damage in IPF
Could zinc be a gamer changer for people with idiopathic pulmonary fibrosis (IPF)? According to researchers from the Women’s Guild Lung Institute at Cedars-Sinai, the answer may be yes.
They found that stem cells lining the air sacs in the lungs of people with IPF lose their ability to process zinc, impairing their ability to regenerate. Restoring zinc to the cells could help reverse fibrosis.
The discovery came after the investigators compared these cells, known as type 2 alveolar epithelial cells (AEC2s), in people with and without IPF.
Those with IPF were missing a protein called zinc transporter 8 (ZIP8) that draws zinc into the cell. Further laboratory studies showed that cells lacking the ZIP8 protein could not regenerate and form colonies.
They used medication and deletion of the ZIP8 gene in mouse AEC2s to induce IPF, then fed the mice a diet that included zinc supplements. Fibrosis in the mice improved.
The authors believe more study is needed to determine whether zinc supplements, alone or in combination with other key molecules that promote tissue regeneration, will be effective in reversing IPF in people.
The study appeared in the Journal of Clinical Investigation. Read More
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