All Sauce from Weekly Gravy:

In a surprising move, the U.S. Food and Drug Administration (FDA) has opted not to approve a needle-free alternative to the EpiPen for emergency treatment of severe allergic reactions. Approval of the Neffy nasal spray was widely anticipated. An FDA advisory panel voted to recommend approval of the drug for children and adults in May. While the FDA is not obligated to follow the advice of their advisory panels, it usually does. Instead, the FDA told the drug’s maker, ARS Pharmaceuticals, that it needed to conduct another study on the drug before it is approved, the company said in a statement late Tuesday night. “We are deeply disappointed that this action further delays the availability of Neffy for the millions of people who are at risk of a potentially life-threatening severe allergic reaction,” said Richard Lowenthal, co-founder, president and CEO of ARS Pharma. “We stand by the totality of the Neffy data package in a comprehensive registration program that was aligned upon with FDA and believe strongly in the value Neffy can provide for patients, families and caregivers living daily with severe allergic reactions,” he said in a company statement, adding that his firm will aim to complete the requested trial as soon as possible. The news was unwelcome on the front lines of health care. “It’s certainly disappointing as we were hoping to have…  read on >  read on >

Brown rats found and analyzed near Atlanta now carry rat lungworm, researchers report. It’s a parasite that can trigger a dangerous brain encephalitis in both people and pets, and which now threatens a wide area of the U.S. Southeast. Researchers in Georgia say the microscopic rat lungworm, known scientifically as Angiostrongylus cantonensis, typically begins its life cycle in native and exotic snails — rats probably contract the parasite after eating snails. A. cantonensis was first identified in Asia and was for many years not endemic to the United States. It first appeared in Hawaii before being spotted in Texas, Louisiana, Alabama and Florida, “likely introduced by infected rats and gastropods [snails] through trade routes, such as on merchant ships,” explained a team led by Nicole Gottdenker. She’s associate professor of anatomic pathology at the University of Georgia in Athens. Infected rats excrete the parasite in their feces. In rare cases, people who accidentally come into contact with A. cantonensis can also become infected. The worm can trigger a dangerous inflammation of the brain or its surrounding membrane, the meninges — a condition called meningoencephalitis. Concerned that rat lungworm might have continued its spread throughout the Southeast, Gottdenker’s team collected samples of tissues “from 33 wild brown rats found dead during 2019-2022 on the grounds of a zoological facility located in Atlanta,” they reported. About one-fifth…  read on >  read on >

Nearly one in five counties across the United States lack psychiatrists or internet service, making it difficult for around 10.5 million Americans to find mental health care, a new study shows. The counties examined in the study were more likely to be in rural areas, have higher unemployment rates, and have populations that were more likely to be uninsured and lack a bachelor’s degree. What’s worse, individuals who fall into any one of these categories are also more likely to suffer from depression and anxiety. So, the need for mental health services is especially critical in areas with the greatest barriers to access, the researchers noted. And while the pandemic created a rapid demand for telehealth, the medium has yet to reach the areas that need it most. “Telehealth was originally developed to mitigate the adverse effects of physician shortage. But unfortunately for many people in shortage areas, they don’t have access to broadband coverage,” said study author Dr. Hao Yu, an associate professor of health care policy at Harvard Medical School, in Boston. “We found those counties have negative health effects, like higher overdose mortality, higher suicide mortality. That’s kind of staggering,” he added. In July, the Bipartisan Infrastructure Law was passed by federal legislators and included a $65 billion investment to expand affordable and reliable high-speed internet access across the United States. While…  read on >  read on >

Another diabetes drug maker is taking legal action against businesses in several states, alleging that they’re “fraudulently claiming” that their compounded products are the same as its medication. This time, it’s Eli Lilly suing certain medical spas, wellness centers and compounding pharmacies over its medication Mounjaro. Mounjaro contains the active ingredient tirzepatide and is approved by the U.S. Food and Drug Administration to treat type 2 diabetes. The lawsuits, filed Tuesday, are meant to stop the other companies from “the unlawful marketing and sale of non-FDA approved compounded products.” “Lilly filed this lawsuit to protect patients,” the company said in a statement issued Tuesday. “Lilly cannot validate the safety or effectiveness of products claiming to contain tirzepatide that are not our own branded product.” The company sells Mounjaro only in prefilled single-dose pens. “These entities should be stopped from providing drug products in violation of consumer protection laws, particularly where they promise their patients that their drugs offer the same safety profile and clinical benefits as Mounjaro,” the statement added. In June, Novo Nordisk sued businesses for making compounded versions of semaglutide, which is used in its type 2 diabetes drugs Ozempic and Rybelsus. The medication is also used to treat obesity under the brand name Wegovy. In its cases, Novo Nordisk has asked the companies “to cease and desist from false advertising, trademark infringement…  read on >  read on >

How big is a hospital bed’s carbon footprint? Pretty big, new research shows. One hospital bed alone was roughly equivalent to the carbon footprint of five Canadian households, according to researchers studying a British Columbia hospital during 2019. They identified energy and water use and the purchasing of medical products as the hospital’s primary energy hotspots, accounting for over half of the hospital’s yearly carbon footprint. “In our work, we often find that the biggest environmental footprints are where you least expect them to be. As the adage goes: ‘Out of sight, out of mind,’” said researcher Alex Cimprich. He is a postdoctoral fellow in the School of Environment, Enterprise and Development at the University of Waterloo. “The goal is to make hidden environmental footprints more visible so that we can start to manage them.” For the study, the researchers assessed thousands of products purchased by hospitals, using a combination of statistical sampling and calculations of carbon intensity — CO2 equivalent per dollar spent — to calculate carbon footprints. “The results suggest that hospital sustainability initiatives need to look further to achieve deeper emissions reductions,” Cimprich said in a university news release. “While transportation of patients and products supplied to hospitals and hospital waste are visible areas of environmental concern, other more hidden areas like the supply-chains of medical products could have much bigger environmental…  read on >  read on >

A job that’s demanding but less than rewarding may take a big toll on a man’s heart health, a large new study suggests. The study, of nearly 6,500 white-collar workers, found that men who habitually felt stressed on the job had up to double the risk of developing heart disease as their peers who were more content at work. In some cases, that stress took the form of “job strain,” which meant that workers felt pressure to perform but had little power over how to get their work done. In other cases, the central problem was “effort-reward imbalance.” That’s when employees feel their diligence is not winning adequate returns — whether through pay, promotion, recognition or a sense of fulfillment. Men who reported either kind of job stress were about 50% more likely to develop coronary heart disease over the next 18 years, versus men who were happier on the job. Then there were the men who cited both types of job stress: Their risk of heart disease was double that of their male counterparts who reported neither work issue. There was no similar effect, however, seen among women. Researchers said the findings do not prove that job stress exacts a toll on men’s hearts, or that it doesn’t harm women. But there are plenty of reasons that stress at work — where adults spend…  read on >  read on >

Patients with Parkinson’s disease already face poorer mental and physical health, but now a new study shows they also suffer from decreased levels of hope and self-esteem due to the stigma associated with their disease. “There are patients who don’t even disclose the disease to family members because they’re afraid that the children may change their opinion of them or start making plans to put them in a nursing home or take over their finances or freedom to some degree,” said Dr. Alessandro Di Rocco, a professor of neurology at the Zucker School of Medicine at Hofstra/Northwell in Hempstead, N.Y. The study found that when most people think of Parkinson’s, they imagine older white men who are drooling, shaking and hunched over. This singular image can be damaging to people with Parkinson’s who differ in race, gender or age, and can lead to misdiagnosis or a delay in diagnosis. Furthermore, those who have several visible, physical symptoms of the disease can face greater stigma and even discrimination. And those fears are illustrated in the research, which found that more than half of people with Parkinson’s conceal their diagnosis for fear of stigma. For example, actor Michael J. Fox, who has Parkinson’s and spearheads The Michael J. Fox Foundation for Parkinson’s Research, kept his illness hidden for years before coming out to the public. Having symptoms…  read on >  read on >

When it comes to staying trim, timing may be everything. That’s according to new research that found adults who routinely engaged in moderate-to-vigorous exercise early in the morning were less likely to be overweight or obese than those who worked out later in the day. “For individuals who exercise regularly, their body mass index [BMI] is 2 units lower and waist circumference is 1.5 inches shorter if they exercise in the early morning than in other times of day,” said study author Tongyu Ma, an assistant professor of exercise physiology at Franklin Pierce University in Rindge, N.H. BMI and waist circumference are considered two key measures of obesity risk. The upshot, said Ma, is that a “morning workout is a promising tool for weight management.” To explore the question, investigators tracked obesity status among nearly 5,300 adult men and women. All were enrolled in the ongoing U.S. National Health and Nutrition Examination Survey, either between 2003 to 2004 or between 2005 to 2006. Each of the participants wore a hip accelerometer whenever they were awake for somewhere between four to seven consecutive days, including at least one day over the weekend. Based on activity routines, they were then categorized into one of three exercise groups: morning (642 participants), midday (2,456) or evening (2,187). In turn, waist circumferences were measured and BMI scores were calculated. BMI…  read on >  read on >

Millions of Americans suffer from arthritis, and many reach for medication to ease their joint pain and inflammation. The options might seem overwhelming, though. Here, the Arthritis Foundation offers some suggestions for meds that can be purchased at a local drug store or filled with a doctor’s prescription, whether your pain is caused by normal wear and tear (osteoarthritis) or inflammatory disease. Over-the-counter meds Some of the best over-the-counter (OTC) medications for controlling arthritis pain are acetaminophen, ibuprofen, naproxen and acetylsalicyclic acid (aspirin), better known by brand names like Tylenol, Advil, Motrin, Aleve or Anacin. Ibuprofen, naproxen and aspirin are nonsteroidal anti-inflammatory drugs (NSAIDs). While those are pills, it’s also possible to get an NSAID in topical form, like diclofenac gel (Voltaren). Other OTC creams for arthritis contain salicylate, capsaicin, camphor or menthol as the active ingredient. While acetaminophen (Tylenol) is often used to treat osteoarthritis, NSAIDs are typically used for both inflammatory arthritis and osteoarthritis, according to the foundation. Acetaminophen offers only limited help with inflammatory arthritis because it doesn’t control the disease or prevent joint damage, the foundation says. Diclofenac gel and topical capsaicin might also be used in combination with oral medications to relieve pain. Only limited evidence supports using topical salicylate, camphor or menthol to treat osteoarthritis pain. A doctor or pharmacist can offer more information on these medications. How long…  read on >  read on >

Playing sports can offer a lot of benefits for kids, but it’s also important to help protect them from injuries. Parents and coaches can make a big difference in helping kids play safely, according to Nemours Kids Health. The medical organization suggests starting with proper equipment. Use it, but also make sure the safety gear is the right size, fits well and is right for the sport. That includes helmets for baseball, softball, bike riding and hockey, as well as for inline skating or riding scooters and skateboards. Ask your child’s coach about the appropriate helmets, shoes, mouth guards, athletic cups and supporters, and padding, Nemours advised. Also ask about protective eyewear for racquet sports, field hockey, lacrosse, basketball, softball and baseball. This might include shatterproof glasses. Make sure protective equipment is approved by the organizations that oversee the sports. That means bike helmets with safety certification from the Consumer Product Safety Commission (CPSC), and hockey masks approved by the Hockey Equipment Certification Council (HECC) or the Canadian Standards Association (CSA), for example. Take good care of this equipment so it holds up and continues working. Kids also need safe playing surfaces, including playing fields that are not full of holes and ruts that are a tripping hazard. High-impact sports, like basketball and running, should be done on surfaces like tracks and wooden basketball courts,…  read on >  read on >