20-Week Study of Clinical Outcomes of Over-the-Counter COVID-19 Prophylaxis and Treatment

Objectives and Setting.

As the lethal COVID-19 pandemic enters its second year, the need for effective modalities of alleviation remains urgent. This includes modalities that can readily be used by the public to reduce disease spread and severity. Such preventive measures and early-stage treatments may temper the immediacy of demand for advanced anti-COVID measures (drugs, antibodies, vaccines) and help relieve strain also on other health system resources.

Design and Participants.

We present results of a clinical study with a multi-component OTC “core formulation” regimen used in a multiply exposed adult population. Analysis of clinical outcome data from our sample of over 100 subjects − comprised of roughly equal sized regimen-compliant (test) and non-compliant (control) groups meeting equivalent inclusion criteria − demonstrates a strong statistical significance in favor of use of the core formulations.

Results.

While both groups were moderate in size, the difference between them in outcomes over the 20-week study period was large and stark: Just under 4% of the compliant test group presented flu-like symptoms, but none of the test group was COVID-positive; whereas 20% of the non-compliant control group presented flu-like symptoms, three-quarters of whom (15% overall of the control group) were COVID-positive.

Conclusions.

Offering a low cost, readily implemented anti-viral approach, the study regimen may serve, at the least, as a stopgap modality and, perhaps, as a useful tool in combatting the pandemic.

Assessment of the antimicrobial properties of maggots

Chronic bacterial colonisation or infection of wound is one of the major factors interfering proper wound healing, especially in diabetic foot ulcers. This study assesses the potential antimicrobial properties of maggots in vitro. This is a prospective randomised experimental study. Complete lysis of methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, vancomycin-resistant Enterococcus and Candida albicans cultures in the area of maggot application was observed 24 hours after application of live maggots in all culture plates and was confirmed by Gram staining. This lysis persisted for more than 5 days after the maggot application. Complete lysis of the bacterial or fungal cultures in the area of maggot application provides convincing evidence for the antimicrobial property of maggots. This effect has a significant implication in management of diabetic foot ulcers and vascular ulcers.

The steroid withdrawal syndrome: a review of the implications, etiology, and treatments

Steroid therapy is frequently used for chronic pain, particularly inflammatory pain states. Steroid withdrawal syndrome can produce a broad array of signs and symptoms, some of which are not well recognized. High fever is among these. We describe several cases with this clinical scenario and review the syndrome in broader terms.

Parametric instability in the formation of plasma waveguides

Plasma waveguides generated by focusing a moderate intensity laser into neutral gas with an axicon lens can be unstable to the generation of axial modulations in the channel parameters. A model is proposed in which the modulations are due to the nonlinear coupling between the axicon field and a scattered mode in the evolving channel. Good agreement is found with experimental measurements of these modulations.

Andogsky syndrome variant: atopic dermatitis associated with bilateral cataracts and retinal degeneration with left retinal detachment

A 15-year-old girl had a new variation of Andogsky syndrome (unilateral cataract and atopic dermatitis) in which atopic dermatitis was associated with primary bilateral cataracts and retinal degeneration with primary left retinal detachment before cataract surgery. She had no history of systemic steroid treatment.

Recalcitrant psoriasis vulgaris associated with Laurence-Moon-Biedl syndrome

We report a 30-year-old European (Ashkenazi Jewish) male with Laurence-Moon-Biedl syndrome (Bardet-Biedl type) who was hospitalized because of severe recalcitrant plaque-type psoriasis. Laurence-Moon-Biedl syndrome has been shown to be linked to the chromosome 11q region in the majority of the patients of European descent. The same 11q region had increased frequency of aberrations in the study that included cytogenetic analysis of 477 psoriatic patients. The animal model of the syndrome (mice) showed abnormalities in hair growth and epidermal differentiation. This genetic association between Laurence-Moon-Biedl syndrome and psoriasis can contribute to the understanding of the factors involved in the initiation of psoriasis and factors that modulate its severity and resistance to therapy.

Metalloproteinase inhibitor attenuates neointima formation and constrictive remodeling after angioplasty in rats: augmentative effect of alpha(v)beta(3) receptor blockade

Release of matrix metalloproteinases (MMP) from smooth muscle and foam cells following arterial injury facilitates cell migration, neointimal hyperplasia, and vessel wall remodeling. Inhibition of MMP activity using the hydroxamate, zinc-chelating mimicers of collagen, Batimastat and Marimastat, has shown efficacy in reducing constrictive vascular remodeling 6 weeks after experimental angioplasty but not intimal hyperplasia. Vitronectin receptor (alpha(v)beta(3)) blockade interferes with binding of this integrin to MMP-2 and proteolyzed collagen, thereby reducing cell invasion. This study tests the effect of MMP inhibition, with and without vitronectin receptor (alpha(v)beta(3)) blockade, on neointima formation and arterial remodeling in a long-term model (up to 212 months) of balloon injury in vivo. Male Sabra rats were treated with Batimastat (BB-94, British Biotech Pharmaceuticals Ltd., 30 mg/kg, intraperitoneally) and/or the alpha(v)beta(3) receptor inhibiting RGD peptide, G-Pen-GRGDSPCA (GIBCO BRL, 0.1 micromol), administered as a perivascular gel to the common carotid artery after balloon injury. Animals were sacrificed 3, 14, 25, and 75 days (n=21, 23, 22, and 21) after injury. Animals treated with BB-94, peptide, or both had markedly increased absolute luminal area with markedly reduced luminal cross-sectional-area narrowing by neointima and intima-to-media area ratio at all time points except for 3 days after balloon injury versus non-treated, ballooned animals. Combined treatment was significantly more effective than either one alone. Constrictive remodeling, most marked 212 months after balloon injury, was prevented at this time point in all treated animals. The pattern of reduction in luminal narrowing, neointimal formation, and constrictive remodeling across treatment groups correlated very significantly with the reduction in tissue MMP activity as determined by zymography at 3 days. Confirmation of the efficacy of this strategy in larger animals should be the next step toward testing the applicability of this novel approach to the interventional setting.

Child sexual abuse by uncles: a risk assessment

Using a sample of 982 mothers who reported on child care and living arrangements involving uncles, and case records documenting the sexual abuse of 171 children by 148 uncles, this study examined the ways uncles ordinarily become involved with children, the conditions under which that involvement becomes associated with sexual abuse, and the role gender plays in this dysfunction. Among the findings, it was noted that although aunts were responsible for 28 times more child care than uncles, uncles were responsible for 48 times more child sexual abuse. Although female children do not have more exposure to uncles than do males, they appeared four times more likely to be victimized. About 19% of the abusive uncles lived with the children they abused, and most of the remainder came into contact with them as child care providers or during overnight visits. Implications for practice are discussed.

New CNS-specific calcium antagonists

Ischemic insults to the brain in stroke or traumatic brain injury produce excessive release of glutamate from depolarized nerve terminals. This excessive glutamate release in turn stimulates massive calcium entry into nerve cells, activating a biochemical cascade that results in cell death. A major pathway of calcium entry into depolarized nerve cells is through voltage-sensitive, high threshold calcium channels. A large fraction of this calcium entry is mediated through "R-type" calcium channels, channels resistant to blockage by dihydropyridine calcium antagonists such as nimodipine. A newly discovered compound derived from spider venom, CNS 2103, antagonizes both R-type channels and dihydropyridine-sensitive ("L-type") calcium channels. This broad spectrum of action, coupled with selectivity for calcium channels over other classes of voltage-sensitive and ligand-gated ion channels, makes CNS 2103 an interesting lead for development of drugs to treat ischemic brain injury. Activation of presynaptic ("N-type") calcium channels in nerve terminals is a primary cause of excessive neurotransmitter release in brain ischemia. Prevention of glutamate release by blockade of N-type channels in glutamatergic nerve terminals may, at an early stage in the pathophysiological cascade, abort the process leading to nerve cell death. Cambridge NeuroScience has developed a novel rapid kinetic approach for monitoring glutamate release from brain nerve terminals in vitro, and this has led to CNS 1145, a substituted guanidine that selectively blocks a kinetic component of calcium-dependent glutamate release mediated by persistent depolarization. Additional evidence suggests that CNS 1145 antagonizes presynaptic N-type calcium channels, and this may account at least in part for its ability to block glutamate release.

Variables affecting disc size in the lumbar spine of rabbits: anesthesia, paralysis, and disc injury

Methods have been developed that permit repetitive radiographic measurement of the lumbar intervertebral disc space in a rostral-caudal direction (width) in the anesthetized laboratory rabbit. Using isolated control discs and injured discs in which narrowing has been induced for chronic and acute periods, the widths of the lumbar intervertebral disc spaces determined ratio-graphically correlate with widths determined histologically (p less than 0.000, r = 0.75). Both an increase (widening) and a decrease (narrowing) in disc width were observed using radiography after different experimental treatments. Anesthesia and lower-body paralysis (an experimentally induced inability to bear weight on and to perceive a pinch stimulus in hind limbs) caused widening of the discs: anesthesia causing a general widening throughout the lumbar spine and lower-body paralysis causing a specific widening low in the lumbar spine. Both disc injection and piercing the disc with needles to recover nucleus pulposus material caused narrowing of the discs. Acridine-orange injection induced a narrowing accompanied by osteophytosis. Experimentally induced narrowing at L4-5 (the result of injury to the disc) resulted in narrowing also at L2-3. These findings are consistent with the hypothesis that in vivo disc-width size in the young rabbit depends on both the quantity of nucleus pulposus material and the force-generating activities of the adjacent spinal muscles, and that disc injury at one level stimulates narrowing at other levels.

Social approval for violations of sexual consent in marriage and dating

This study compares approval for minor violations of sexual consent in three contexts: marriage, long-term dating, and a first date. Quantitative and qualitative data from a vignette experiment show that as couples progress from a first date to marriage, men gain support to violate their partner's consent, and, to a lesser degree, women lose support to assert their rights. Evidence is presented that men are more approving of male dominance and female passivity in dating and marriage than are women.

Growth related increase in an intervertebral disc space in rats

Methods have been developed that permit repetitive radiographic measurement of the lumbar L4-5 intervertebral disc space area in the laboratory rat. In using this approach, the coefficient of variation in repetitive determinations was 7.6 +/- 0.7%. Normal rats have been shown to manifest statistically significant increase in disc space area size between 2.5 and 5 months of age.

Microwaves: effect on thermoregulatory behavior in rats

Rats, with their fur clipped, pressed a lever to turn on an infrared lamp while in a cold chamber. When they were exposed to continuous-wave microwaves at 2450 megahertz for 15-minute periods, the rate at which they turned on the infrared lamp decreased as a function of the microwave power density, which ranged between 5 and 20 milliwatts per square centimeter. This result indicates that behaviorally significant levels of heating may occur at an exposure duration and intensities that do not produce measurable changes in many other behavioral measures or in colonic temperature. Further study of how microwaves affect thermoregulatory behavior may help us understand such phenomena as the reported "nonthermal" behavioral effects of microwaves.

Equivocal neurological signs, child development, and learned behavior

Ten children were tested repeatedly for five motor tasks commonly labeled "soft signs." Finger approximation, walking hell to toe, and the equivocal Babinski improved significantly with practice. These results are interpreted as eliminating these tasks from evidence of "minimal brain damage" and questioning the validity of their inclusion in developmental tests.

Oral lignocaine: its absorption and effectiveness in ventricular arrhythmia control

A preliminary study suggests that the gastrointestinal absorption of lignocaine is predictable and that adequate antiarrhythmic blood concentrations are maintained for four to five hours when 500 mg. is taken with food and for two hours if the drug is taken without food. Ventricular arrhythmias were successfully treated with oral lignocaine in four patients.