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Here are the stories of coronavirus that Medscape editors around the world think you need to know today:
Oleander extract for COVID-19? Expert says “No”
Oleandrin, a toxic cardiac glycoside found in the poisonous oleander plant, makes headlines as a potential treatment for COVID-19 infection, and causes uninformed people to eat the leaves of the plant and become ill or die.
Arrival of toxicity occurs several hours after consumption, and gastrointestinal symptoms such as nausea, vomiting, abdominal pain, diarrhea (which may include blood), and loss of appetite may be initial signs of oleandrine poisoning, Medscape Medical News reports.
Poisoning can affect the heart, as well as the central nervous system, as evidenced by sluggishness, tremors, seizures and coma leading to death.
According to Axios , President Donald J. Trump recently met with the director of Phoenix Biotechnology, whose company produces oleandrin. The president expressed “enthusiasm” about the extract. Although the product has been evaluated in in vitro studies, it is a far cry from red tube to human, one expert warns.
Pandemic can be triggered by younger adults
As the cumulative number of reported COVID-19 cases among children in the United States stands at more than 400,000, the World Health Organization (WHO) on Tuesday expressed concern that the spread of the new coronavirus could be driven by other age groups – people in their 20s, 30s and 40s, many of whom are unaware that they are infected.
WHO officials have said that the proportion of young people among the infected worldwide has increased, putting vulnerable sectors of the population at risk worldwide, including the elderly and sick people in densely populated areas with poor health care services.
An emergence in new cases has prompted some countries to reintroduce resistance. The virus has killed more than 770,000 people and infected nearly 22 million, Reuters reports.
Stop the PPI to lower COVID-19 risk?
A 60-year-old patient taking a proton pump inhibitor (PPI) hears that “these heartburn drugs can give you COVID-19” and requires an urgent telehealth visit. Although the patient acknowledges that the medication helped her symptoms of gastroesophageal reflux disease (GERD), she wants to stop if the medication may increase her risk for COVID-19, a possibility that one study suggested.
What is the best course of action in this scenario? Charles P. Vega, MD, describes the case, then examines readers on four treatment options and discusses his approach.
Sensitivity to deep throat lacks regret
Although convenient and easy to collect, deep-throat food vessels have no susceptibility to diagnose COVID-19 compared to other airway specimens, according to a prospective study.
“High-yield samples, such as sputum or naso / oropharyngeal swabs, should be used for high-risk individuals,” said one study author. Reuters Health.
The researchers evaluated the diagnostic performance of deep-throat search by comparing positive rates and viral RNA concentrations with those detected with conventional respiratory specimens collected from 50 patients with SARS-CoV-2 infection in Hong Kong.
The overall SARS-CoV-2 RT-PCR positive rate for all types of examinations was 79.2%, with the highest positive rates for sputum (89.4%), followed by pooled nasopharyngeal and laryngeal plexuses (80.9%) and species with deep throat (68.7%), according to the study, which was published in the Journal of Infectious Diseases.
COVID-19 Linked to Development of Myasthenia Gravis
Myasthenia gravis should be added to the growing list of potential neurological consequences associated with COVID-19, new research suggests.
Clinicians from Italy have described what they believe are the first three reported cases of acetylcholine receptor (AChR) antibody-positive myasthenia gravis following COVID-19 infection.
“I think it is possible that there could have been many more cases,” the lead author said Medscape Medical News .
Practitioners are still struggling to survive
As government aid programs expired or withdrew, medical practices across the country struggled to stay afloat, and some offices began to close. Despite a rebound in face-to-face office visits, lost business drags down many practices, reports reports from a variety of sources.
In a nationwide survey conducted from July 24 to July 27 by the Primary Care Collaborative and the Larry Green Center, 20% of primary care physicians were not sure they would have enough staff, billable work and money on hand for 4 weeks longer to remain open.
A pain medicine specialist in Sacramento, California, who was the incoming president of the California Medical Association (CMA), fired the post “to focus on his practice, which has been financially struggling since the pandemic,” according to a statement from the CMA on the decision.
In memoiriam
As frontline healthcare professionals care for patients with COVID-19, they commit to cumbersome, dehydrating work and also put themselves at risk for infection. Thousands all over the world have died.
Medscape has published a to-do list to remember them. We will continue to update this list as, sadly, necessary. Please help us ensure that this list is complete by submitting names with an age, occupation or specialty, and location via this form.
If you want to share other experiences, stories or concerns related to the pandemic, join the conversation here.
Jake Remaly is a staff journalist at Medscape Medical News and MDedge. He can be reached at [email protected].
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