Saturday, February 28, 2015

Vaccinations and Chronic Conditions

The recent measles outbreak is making vaccination a very popular topic, particularly where I live- Vermont is viewed as one of the states where people are least likely to vaccinate children. While my kids’ schools have close to 100% vaccination rates, there are places with rates of about 50%.

The anti vaccination movement centers on two prominent ideas. The first dates back to a 1998 English study linking the measles, mumps and rubella (MMR) vaccine to autism in young children. While the study was quickly discredited and repeatedly refuted, the damage was done. Vaccination rates plummeted below the “herd” immunity levels and as a result outbreaks of measles have not only reappeared in England but now in the United States.

Another popular idea is that by vaccinating children you are setting them up for chronic conditions such as asthma and diabetes. However, large scientific studies do not support these claims. "Anecdotal reports and uncontrolled studies have proposed that vaccines may cause particular allergic or autoimmune diseases, Such reports have led some parents to delay or withhold vaccinations for their children. This is very unfortunate, because the best available scientific evidence does not support the idea that vaccines cause chronic diseases. Scientific studies have shown, however, that reducing vaccination rates lead to increases in preventable infectious diseases." Pediatrics A second study, completed in 2014 found similar results The researchers found high-quality evidence that several different vaccines are not linked to childhood leukemia and that the measles, mumps and rubella (MMR) vaccine is not linked to autism. The DTaP vaccine is not linked to diabetes mellitus, and the Hepatitis B vaccine is not connected to multiple sclerosis - Scope 

Some parents opt out of a vaccine believing that since the “other kids” are vaccinated their child will be protected by the "herd." Not surprisingly Vermont had a major outbreak of pertussis (whooping cough) several years ago because many parents in the state refused the P in the DTP vaccine for their child.

We have become complacent in having a life expectancy of almost 80 years of age, with few reminders of what parents were dealing with as recently as 60 some years ago with polio. Keep in mind that without the array of vaccines that exist today, our life expectancy would be considerably lower.

Are there risks with vaccines? Yes, but they are very rare and easily treated. Pediatrics

There are risks with everything but the risk from an infectious disease is far greater than a vaccine. For a graphic display of that risk, watch Penn and Teller’s explanation. Better yet, ask an 80+ year old parent how they felt when they had the opportunity to vaccinate their child against polio.

Simply put, if you have a chronic condition, you really don’t want to run the risk of coming in contact with an infectious disease. So “cut to the chase”

• If you have kids, make sure they are vaccinated properly

• Discuss your need for vaccinations (pneumonia, shingles etc.) based on age and condition with your medical provider and act accordingly. For adult immunizations check out the following links:

Wednesday, February 25, 2015

Take a Break: Smile

Did you know that smiling changes your brain? In fact, the more you smile the more you break the brain’s natural tendency to think negatively. Do it often enough and you can actually rewire your brain to make positive patterns more often than negative ones.  Even better, don’t feel like smiling? That’s okay, just the act itself is enough to get results-“fake it till ya make it!”

If you need more convincing that a smile can definitely brighten your day, check out How Smiling Changes Your Brain. 

So take a break and do lots of smiling today and every day. In the words of  Bobby McFerrin-Don’t Worry Be Happy 

Not interested in today’s activity? Check out the Take a Break Pinterest for lots of Take a Break ideas. 

Saturday, February 21, 2015

Journal Watch February 2015

• Psychological Factors Play a Part in Acupuncture Treatment of Back Pain: People with back pain who have low expectations of acupuncture before they start a course of treatment will gain less benefit than those people who believe it will work, according to new research. Conversely, those people who have a positive view of back pain and who feel in control of their condition experience less back-related disability over the course of acupuncture treatment. The Clinical Journal of Pain 

• Women’s Pain: Common, Treatment and Often Overlooked or Mismanaged: Despite the variety of effective treatments, and physicians who specialize in treating pain, women often suffer unnecessarily from conditions ranging from backaches to pain after cancer surgery, and also treat their pain with medications that may be ineffective and possibly harmful, according to a review of research. Science Daily 

• New Scoring System Helps Predict Risk of Chronic Pain: A scoring system based on six predictive measures (type of surgery, age, physical and mental health status, preoperative pain in the surgical area and non surgical areas) can help to reduce the risk of post surgery chronic pain. Anesthesiology 

• NIH Complementary and Integrative Health Agency Name is Changed:The “Consolidated and Further Continuing Appropriations Act, 2015” (Public Law 113-235) changed the name of the Center to the National Center for Complementary and Integrative Health (NCCIH). Press Release 

• NCCIH Clinical Digest Stress and Relaxation Techniques: Relaxation techniques may be helpful in managing a variety of health conditions, including anxiety associated with illnesses or medical procedures, insomnia, labor pain, chemotherapy-induced nausea, and temporomandibular joint dysfunction. For some of these conditions, relaxation techniques are used as an adjunct to other forms of treatment. Relaxation techniques have also been studied for other conditions, but either they haven’t been shown to be useful, research results have been inconsistent, or the evidence is limited. 

• Mindfulness May Help Ease Sleep Problems for Seniors: Researchers found that among 49 older adults with sleep problems, those who learned mindfulness practices started sleeping better within six weeks. In fact, they did better than their counterparts who were given conventional lessons on good sleep habits, the study authors said. JAMA Internal Medicine 

 US Nationwide Survey Reveals Widespread Use of Mind and Body Practices: A large nationally representative survey shows that the number of Americans using mind and body approaches to improve health and well-being remains high. Of note is a significant increase in the use of yoga since 2002. In addition, almost as many Americans practice meditation or receive chiropractic or osteopathic manipulation. Science Daily 

• How Mindfulness Training Affects Health: Over the past decade, there have been many encouraging findings suggesting that mindfulness training can improve a broad range of mental and physical health problems. Yet, exactly how mindfulness positively impacts health is not clear. Researchers have developed a model suggesting that mindfulness influences health via stress reduction pathways. Science Daily 

• Approved Meningitis B Vaccine Bexsero
• Approved Secukinumab for psoriasis
• Approved Natpara to control low blood calcium in those with hypoparathyroidism
• Permitted the marketing of Apps for Continuous Glucose Monitoring
• Strengthen approval of accessories and other items relating to automated external defibrillators. Since 2005, the FDS has received 72,000 reports of devices failing. 
• Approved generic esomeprazole
• Expanded approval of Vyvanse to treat bing eating disorders in adults.
• Approved ENROUTE Transcarotid Neuroprotection System (TNS) A new technology designed to reduce stroke risk in certain patients
• Approved Lucentis for Diabetic Retinopathy

• Pneumonia Raises Heart Disease Risk for Years: Older patients hospitalized with pneumonia appear to have an increased risk of heart attack, stroke or death from heart disease for years afterward, a new study finds. This elevated risk was highest in the first month after pneumonia -- fourfold -- but remained 1.5 times higher over subsequent years, the researchers say. Journal of the American Medical Association. 

• Walking Group a Step Towards Better Health: Researchers reviewed 42 studies, involving nearly 2,000 adults in 14 countries, that examined the physical and mental health effects of joining an outdoor walking group. Some of the people in the studies had chronic health problems such as arthritis, diabetes, obesity, fibromyalgia, Parkinson's disease, dementia, and mental health disorders. Joining a walking group led to decreases in blood pressure, resting heart rate, body fat, weight and total cholesterol, the study found. In addition, walkers saw improvements in overall physical functioning and lung power, the researchers said in a journal news release. And symptoms of depression also seemed to be reduced by joining an outdoor walking group, they found. Three-quarters of the walking group participants stuck with the exercise program. The only negative side effects reported were a few falls on roots or wet ground, the findings showed. British Journal of Sports Medicine. 

• More Evidence that Boxing Can Lead to Brain Damage: The study included professional fighters -- 93 boxers and 131 mixed martial arts experts. They ranged in age from 18 to 44, and were compared against 22 people of similar age with no history of head injuries. MRI brain scans and tests of memory, reaction time and other intellectual abilities showed that the fighters who had suffered repeated blows to the head had smaller brain volume and slower processing speeds, compared to non-fighters. British Journal of Sports Medicine 

• Weight Gain or Loss Linked to Fracture Risk in Older Women: The risk of broken bones increases with both weight gain and loss in older women, according to a new study. These findings challenge the widely held belief that weight gain protects older women against fractures, the researchers said. The study included data from more than 120,000 healthy postmenopausal women in the United States. The women were between the ages of 50 and 79 years old. Their health status was followed for an average of 11 years. BMJ 

• Seniors Need 2 Pneumonia Vaccines: Adults 65 and older need two vaccines to better protect them from bacterial infection in the blood (called sepsis), meningitis and pneumonia, according to a revised vaccination schedule from the 2015 Advisory Committee on Immunization Practices (ACIP). 

 When it Comes to Jogging, Easy Does It: Out of a pool of about 5,000 healthy Danish adults, researchers followed nearly 1,100 healthy joggers and 413 sedentary people for more than 12 years. The strenuous joggers, the investigators found, were as likely to die during that time period as the sedentary non-joggers. Light joggers and moderate joggers fared better, in that order. The dose of running that was most favorable for reducing mortality was jogging 1 to 2.4 hours per week, with no more than three running days per week. Journal of the American College of Cardiology 

• Small Study Links Lack of Sleep to Diabetes Type 2: Researchers say lack of sleep can lead to increased levels of substances called free fatty acids in the blood. These substances interfere with the ability of the hormone insulin to regulate blood sugar levels. The researchers said these findings suggest that high rates of obesity and diabetes could be reduced by something as simple as having people get more sleep. Diabetologia 

• Light Activity a Boost to Seniors Hearts: Light physical activity may benefit older adults' hearts -- even if they have mobility issues, a new study suggests. Journal of the American Heart Association 

• Study Questions Benefits of Treadmill Desk: Researchers found that the desks are expensive, challenging to incorporate into an office setting, and may do little to boost meaningful activity levels. Journal of Occupational and Environmental Medicine 

• More Evidence That Even Moderate Exercise Helps Women’s Hearts: Even a few bouts of moderate exercise each week can cut a middle-aged woman's odds for heart disease, blood clots and stroke, a new study finds. The British study also found that exercising more frequently didn't lead to greater reductions in heart risk. Circulation 

• Coffee May Protect Against Some Skin Cancers: People in a study who drank four or more cups of coffee daily were 20 percent less likely to develop malignant melanoma than non coffee drinkers, according to the study published (Jan. 20) in JNCI: Journal of the National Cancer Institute. 

• Coffee Linked to Possible Lower Endometrial Cancer Risk: Using data on more than 456,000 women from two large ongoing studies, researchers evaluated the dietary habits of more than 2,800 women diagnosed with cancer of the endometrium, the lining of the uterus. Compared to women who drank less than a cup a day, those who drank about four cups daily had an 18 percent lower risk of getting this cancer, they found. Cancer Epidemiology, Biomarkers & Prevention 

• Could a Drink a Day Lower Risk for Heart Failure: Having a drink each day might help lower a middle-aged person's odds for heart failure, a new study reveals. The investigation suggests that men in their 40s, 50s and 60s who drink as much as seven comparably sized glasses of wine, beer and/or spirits per week will see their risk for heart failure drop by 20 percent. For women the associated drop in risk amounted to roughly 16 percent, according to the study published online Jan. 20 in the European Heart Journal.

• Daily Drinking May Raise Risk of Liver Cirrhosis: In men, drinking every day raised the risk for cirrhosis more than less frequent drinking. And recent drinking, not lifetime alcohol consumption, was the strongest predictor of alcohol-related cirrhosis. Hepatology 

• Too Much Alcohol at Midlife Raises Stroke Risk: People who average more than two drinks a day have a 34 percent higher risk of stroke compared to those whose daily average amounts to less than half a drink, according to findings published Jan. 29 in the journal Stroke. Researchers also found that people who drink heavily in their 50s and 60s tend to suffer strokes earlier in life than light drinkers or non-imbibers. 

• Health Diet may be linked to lower risk of lung disease: A healthy diet low in red meat and rich in whole grains might reduce the risk of developing the crippling chronic lung disease known as COPD, new research suggests. BMJ 

• Many Americans Don’t Handle Poultry Safely: Many Americans do not follow recommended safety practices when handling and cooking poultry, a new study finds. Fewer than two-thirds of consumers have a food thermometer, and less than 10 percent of those who have the devices use them to check if poultry is cooked to a safe temperature. Journal of Food Protection 

• Eating More Fiber Helped People Lose Weight: People who only added more fiber to their otherwise normal diet were able to lose weight, lower their blood pressure and reduce blood sugar levels -- all key to staving off diabetes and improving overall health. Annals of Internal Medicine 

• New Dietary Guidelines Put Strict Limits on Added Sugar: The U.S. government is recommending that Americans limit their intake of foods and drinks with added sugar to less than 10 percent of their daily calories, while easing some of its previous restrictions on cholesterol and sodium, according to a report from an advisory committee on the nation’s dietary guidelines released Thursday. The guidelines call for an “environmentally friendly” diet that limits processed and red meats, is “lower in calories and animal-based foods” and focuses on “plant-based foods” such as vegetables, fruits and whole grains.

• Highly Processed Foods Linked to Addictive Eating: A new study confirms what has long been suspected: highly processed foods like chocolate, pizza and French fries are among the most addictive. PLOS One 

• Drinking Green Tea Before Taking Supplements May Offer Protection from Toxicity: As high doses of green tea extract supplements for weight loss become more popular, potential liver toxicity becomes a concern. In the last decade, dozens of people have been diagnosed with the condition. However, drinking green tea in the weeks before taking supplements likely reduces risk, according to researchers. Food and Chemical Toxicology 

• Stem Cells May Reverse MS Disability: A therapy that uses patients' own primitive blood cells may be able to reverse some of the effects of multiple sclerosis, a preliminary study suggests. The findings, published in the Journal of the American Medical Association, had experts cautiously optimistic. But they also stressed that the study was small -- with around 150 patients -- and the benefits were limited to people who were in the earlier courses of multiple sclerosis (MS). 

• Tamiflu Cuts One Day off Average Flu Bout: A review of the data suggests that the antiviral drug Tamiflu shortens the length of flu symptoms by about a day, and reduces the risk of flu-related complications such as pneumonia. The Lancet 

• Safety,Life-Saving Efficacy of Statins Have Been Exaggerated Says Scientist; Statins, the cholesterol-lowering drugs prescribed to prevent heart attacks, are not as effective nor as safe as we have been led to believe, researchers say. Statins produce a dramatic reduction in cholesterol levels, but have failed to substantially improve cardiovascular outcomes, they add, stating that 'statistical deception' has been used to inflate claims about their effectiveness. Expert Review of Clinical Pharmacology 

• Statins May Not Lower Parkinson’s Risk: The use of statins may not be associated with lowering risk for Parkinson's disease, according to a new study. The findings cast doubts on reports suggesting that the cholesterol-lowering medications may protect against this neurodegenerative brain disorder. Movement Disorders 

• HRT Increases Ovarian Cancer Risk: Women who use hormone therapy after menopause -- even for just a few years -- may have an increased risk of ovarian cancer, according to new research. The new study found that when women used hormone replacement therapy for less than five years after menopause, the risk of ovarian cancer increased by about 40 percent. The Lancet 

• New Guidelines for People with Nasal Allergies: The recommendations for those ages 2 and up appear in the Feb. 2 issue of Otolaryngology-Head and Neck Surgery 

 Higher Dementia Risk Linked to More Use of Common Drugs: A large study links a significantly increased risk for developing dementia, including Alzheimer's disease, to taking commonly used medications with anticholinergic effects at higher doses or for a longer time. Many older people take these medications, which include nonprescription diphenhydramine (Benadryl). The most commonly used medications in the study were tricyclic antidepressants like doxepin (Sinequan), first-generation antihistamines like chlorpheniramine (Chlor-Trimeton), and antimuscarinics for bladder control like oxybutynin (Ditropan). The study estimated that people taking at least 10 mg/day of doxepin, 4 mg/day of chlorpheniramine, or 5 mg/day of oxybutynin for more than three years would be at greater risk for developing dementia. JAMA Internal Medicine 

• Nearly1 in 10 Adults Skips Meds Due to Costs: High drug costs in the United States may be hurting the very people the medications are meant to help, the new report from the U.S. Centers for Disease Control and Prevention suggests. About 15 percent of U.S. adults have asked their doctor for a lower-cost alternative, the researchers found. The U.S. Centers for Medicare and Medicaid Services suggests the following ways patients can save money on drugs:
    Take generic or other lower-cost medications,
    Choose an insurance plan that has additional drug coverage,
    Consider drug assistance plans offered by pharmacies and states,
    Apply to Medicare and Social Security for help reducing costs,
• Apply to community-based charities for help with medication costs. NCHS News Brief 

 E Cigarettes Can Churn Out High Levels of Formaldehyde: Vapor produced by electronic cigarettes can contain a surprisingly high concentration of formaldehyde — a known carcinogen — researchers reported Wednesday. The findings, described in a letter in the New England Journal of Medicine, intensify concern about the safety of electronic cigarettes, which have become increasingly popular. 

• Diabetes-Related Foot Condition Often Missed: A debilitating condition called Charcot foot is often missed among the nearly 30 million Americans with diabetes, doctors say. The condition is highly treatable, but if left alone it can lead to permanent deformity, disability, surgery and even amputation, according to the American College of Foot and Ankle Surgeons (ACFAS).

 • Eczema Linked to Other Health Problems; Adults with eczema -- a chronic, itchy skin disease that often starts in childhood -- may also have an increased risk of heart disease and stroke, according to a new study. This increased risk may be the result of bad lifestyle habits or the disease itself. The researchers found that people with eczema smoke and drink more, are more likely to be obese and are less likely to exercise than adults who don't have the disease. Journal of Allergy and Clinical Immunology 

• Stroke Survivors who live alone face higher risk of early death: Stroke survivors -- especially men -- who live alone are at increased risk for premature death, a new study suggests. 

• Those who care for Brain Injured at Risk for Chronic Disease: Some loved ones who care for veterans with brain injuries may be at increased risk for chronic health problems, a new study indicates. Traumatic brain injuries can result in devastating physical and cognitive [mental] impairments. "Grief, anger and blame are common among caregivers who are left to cope with these profound disabilities and the loss of the person they once knew. These feelings may put these individuals at risk for inflammatory-related disease.” Biological Research for Nursing. 

• New name for Chronic Fatigue Syndrome: Chronic fatigue syndrome is about to get a new clinical definition, with the hope that it will help physicians better diagnose people afflicted with the mysterious and complex disorder. The Institute of Medicine has released a long-awaited report that defines diagnostic criteria for chronic fatigue syndrome and examine whether a new name for the disease is warranted. 

 Lyme Disease More Serious and Costly Than Believed: Prolonged illness in Americans with Lyme disease is more widespread, serious and costly than previously believed, a new study suggests.
Researchers found that Lyme disease has a much greater impact on patients and the health system, costing up to $1.3 billion a year to treat. Plos One 

• More Americans Surviving Cancer: Survival rates are improving for many people with cancers of the breast, prostate, lung, liver and colon or rectum, especially for those diagnosed at younger ages, a new study reports. Cancer is still a leading cause of death in the United States, but advances in radiation, chemotherapy and targeted treatments have improved survival, the researchers said. JAMA Oncology

• Chronic Illness, Loneliness May Go Hand-in-Hand for Elderly: For people age 70 or older who struggle with a chronic illness, loneliness is often a complicating factor, a new study finds. Health Psychology