Saturday, March 28, 2015

Is More Health Care Making You Feel Less Healthy?

Since I recently came across the study how Medical Expansion Has Led People Worldwide to Feel Less Healthy  I’ve been thinking a lot about “less is more” It didn’t help by reading another study this week, which shows that 97 percent of ER doctors admitted to ordering some advanced imaging scans that weren't medically necessary, mainly because they fear malpractice lawsuits.

 In 1999, several researchers noted, We now have good reason to believe that those who receive more "supply-sensitive" care have no improvement in survival and are unlikely to have better quality of life. The potential mechanisms whereby more medical care may lead to harms that counterbalance any benefits are summarized in our recent article "Avoiding the Unintended Consequences of Growth in Medical Care: How might more be worse?"

For an interesting discussion on this topic, check out The Atlantic’s You’re Getting too Much Healthcare.  As Richard Baron, president of the American Board of Internal Medicine, noted at the time of this article’s publication (12/13), “There were and are lots of things being done in healthcare that don’t reliably benefit patients.”

Do we really need to know so much? Is it making us crazy in the process? If you have a chronic condition, just how much testing, treatment and medication does one really need? The answers to questions 1 and 2 are simple-no, we don’t need to know so much and yes, it’s making people crazy, to say nothing of making them poorer.

Cut to the chase: How to avoid being over treated or tested:

• Ask Questions: Don’t assume more is better and ask about the real need for tests and treatments. What is the benefit of my being tested/treated? What’s the chance of something bad happening if I’m not tested/treated?

• Practice healthy living: The Power Nine of the Blue Zones is a good overall guide for living a life that promotes longevity and quality.

• Check out BE SAFER: Avoid Medical Errors 

Wednesday, March 25, 2015

Take a Break: Enjoy a Podcast or Something Like It

Jog your brain and learn something new by taking a “podcast break.” To help you get started, try one of the following sites:

The Splendid Table (food topics) 
• Marketplace (economics and business)
Speaking of Faith (religion),
Fresh Air (Interviews of general interest)
This American Life (quirky general interest stuff),
This Week in Tech (technology news)
Freakonomics (The Hidden Side of Everything) 
• Dharma Seed (Theravada Buddhism workshops) 

TED Talks are interesting and not very long. Lots of variety to choose from.

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

Saturday, March 21, 2015

Journal Watch March 2015

• British Scientists Spot Brain’s Pain Center: The University of Oxford team used a new imaging technique to observe how different levels of pain affected the brains of 17 volunteers. Activity in only one area of the brain -- the dorsal posterior insula -- matched the participants' self-reported pain ratings. This method could be used to help assess pain levels in people who have difficulty providing doctors with that information, such as those in a coma, small children or dementia patients, said the authors of the study published March 9 in the journal Nature Neuroscience. 

Early Scans for Back Pain May Do Little For Seniors: Older adults with back pain who seek care and get imaging within six weeks of their doctors visit for back pain do not have better outcomes than similar older adults who do not get early imaging. Although early imaging is not associated with better pain and function outcomes, it is associated with greater use of health care services, such as visits [and] injections, which translates into a nearly $1,500 per patient additional cost, for no measurable benefit." JAMA 

• Stepped Care Approach to Chronic Pain Improves Function: A two-step strategy to managing chronic pain in US military veterans was associated with improved function and decreased pain severity, yielding a 30% improvement in pain-related disability, a new study shows. Step 1 included 12 weeks of analgesic treatment and optimization according to an algorithm, coupled with pain self-management strategies. Step 2 comprised 12 weeks of cognitive-behavioral therapy. JAMA Internal Medicine 

• Belief in Acupuncture Key to Effect on Back Pain: The study included 485 people who received acupuncture for back pain and completed questionnaires before they began treatment, at two and three months into treatment, and then again at six months after treatment. Patients who had low expectations of acupuncture before they began the therapy gained less benefit than those who believed it would work, according to the researchers at the University of Southampton in England. Clinical Journal of Pain 

 • Homeopathy Doesn’t Work: Australia’s National Health and Medical Research Council considered 1,800 studies, narrowing them down to 225 that met certain criteria, and concluded that homeopathy didn't work better than a placebo. Even if a study claimed it was effective, the council found that that study was of poor quality. ABC News 

• Stress Reduction May Reduce Fasting Glucose in Overweight and Obese Women: A treatment known as mindfulness-based stress reduction may decrease fasting glucose and improve quality of life in overweight and obese women, new research suggests. ENDO 2015 

• Complementary Therapies Can  Boost Survival in Cancer Patients: A new review of evidence drawn from experimental and epidemiologic studies, as well as a few clinical trials, demonstrates that several of the integrative approaches and lifestyle changes might also influence cancer survivorship. Medscape 

• Approves new antibacterial drug ceftazidime-avibactam
• Approves Panobinostat for treatment of multiple myeloma
• Approves VenaSeal Varicose veins permanent treatment closure system
• Approves the ResQCPR Systema pair of CPR devices to help save those whose hearts have stopped beating

• Study Ties Saunas to Lower Risk of Death from Heart Disease: A study from Finland found that men who use saunas frequently are less likely to die from heart disease. Men's risk was even lower when they visited saunas more often in a week, and when they spent longer periods of time in a sauna each session, the researchers reported. Frequent use of sauna even appeared to lower a man's overall risk of death. Men who visited the sauna two to three times per week had a 24 percent lower risk of death, while those who went four to seven times per week had a 40 percent reduction compared to only one sauna session per week. JAMA Internal Medicine. 

• Exercise’s Effect on Brain May Boost Mobility in Old Age: A study of 167 patients, average age 80, found that staying physically active may ward off brain damage that can limit mobility. Neurology 

• Healthy Lifestyle May Guard Against Dementia: A healthy diet, physical activity and brain exercises can help slow mental decline in older people at risk for dementia, a new study suggests. On the other hand, a high body-mass index (BMI) and poor heart health are significant risk factors for age-related dementia, the researchers said. BMI is an estimate of body fat based on height and weight. The Lancet 

• Any Exercise is Good, But Higher-Intensity May Be Better: Researchers found that when they got middle-aged, obese adults regularly moving -- even with a half-hour of slow walking -- it helped them shed a little bit of weight and a couple of inches from their waistlines. However, it took higher-intensity exercise to lower people's blood sugar levels -- which, over the long term, might reduce their risk of type 2 diabetes. Annals of Internal Medicine 

• Stress, Depression “ a Perfect Storm” of Trouble for Heart Patients:Researchers looking at the effect of significant stress and deep depression on nearly 4,500 patients with heart disease called the pairing a "psychosocial perfect storm." "The combination of high stress and high depression symptoms may be particularly harmful for adults with heart disease during an early vulnerability period.” Circulation 

• A Sense of Purpose May Help Your Heart: Living your life with a strong sense of purpose may lower your risk for early death, heart attack or stroke, new research suggests. The finding is based on a broad review of past research involving more than 137,000 people in all. The research team reviewed 10 published studies. The average follow-up was 8.5 years. AHA Meeting 

• A Sense of Purpose May Benefit your Brain: Having a strong sense of purpose in life may lower the likelihood of brain tissue damage in older adults, new research suggests. Stroke 

• Loneliness Shortens Life: A meta analysis of data from dozens of studies involving more than 3 million people shows that social isolation may harm physical along with negatively impacting poor mental health. The research is in the area of people who feel lonely. Perspectives on Psychological Science 

Coffee Possibly Lowers Risk of MS: A study, of 5,600 Swedish and U.S. adults, found that those who drank four to six cups of coffee a day were about one-third less likely to develop multiple sclerosis (MS), compared with people who did not drink coffee. Researchers stressed that the findings do not prove that coffee fights MS. 

• Another Study Finds Mediterranean Diet May Cut Heart Disease: A study including more than 2,500 Greek adults, aged 18 to 89, whose diets and health were tracked for 10 years found that nearly 20 percent of men and 12 percent of women in the study developed or died from heart disease. People who most closely followed a Mediterranean diet were 47 percent less likely to develop heart disease than those who did not closely follow the diet. The researchers also found that sticking to a Mediterranean diet was more protective against heart disease than physical activity. Previous studies have shown that a Mediterranean diet -- which is high in fresh fruits and vegetables, whole grains, beans, nuts, fish, and olive oil -- is associated with weight loss, lower blood pressure and blood cholesterol levels, and a lower risk of diabetes and heart disease. American College of Cardiology 

• Omega-3 Fatty Acids May Stem Further Damage After Heart Attack: High doses of omega-3 fatty acids may protect against further damage in heart attack patients, a preliminary study suggests. American College of Cardiology 

• Fried Foods Tied to Raised Heart Failure Risk: In this study, men who ate fried food one to three times a week had an average 18 percent increased risk of developing heart failure, researchers found. When fried food was eaten four to six times a week, heart failure risk was 25 percent higher, and at seven times or more weekly, 68 percent greater. American Heart Association meeting 

• Nuts May Lengthen Your Life: Eating nuts, including peanuts and peanut butter, may help you live longer, a new study suggests. Researchers looked at the diets of more than 200,000 people in both the United States and China, and found nut consumption was linked with a lower risk of premature death from heart disease and other causes. JAMA Internal Medicine 

• Nuts Linked to Better Heart Health for Teens: Eating a modest amount of nuts appears to lower the risk for teens of developing conditions that raise the chances of heart disease later in life, new research suggests. Endocrine Society 

• Vegetarian Diet May Lower Colon Cancer Risk: A vegetarian diet might cut your risk of colorectal cancer by 20 percent, a new study finds. For fish-eating vegetarians, the protective link was even stronger. JAMA Internal Medicine 

• Folic Acid May Help Ward Off Stroke: Folic acid -- the same nutrient women take in pregnancy to help ward off birth defects -- may also help lower stroke risk in people with high blood pressure, a new Chinese study finds. JAMA 

• Vitamin D Doesn’t Help with High BP: A meta study (over 70 combined studies) found no signs that boosting vitamin D levels had any effect on blood pressure readings. JAMA Internal Medicine 

• High Levels of Vitamin D is Suspected of Increasing Mortality: The level of vitamin D in our blood should neither be too high nor to low. Scientists from the University of Copenhagen are the first in the world to show that there is a connection between high levels of vitamin D and cardiovascular deaths. Journal of Endocrinology and Metabolism. 

• Recommendation for Vitamin D Intake,Some Experts Say is too low: Researchers at UC San Diego and Creighton University have challenged the intake of vitamin D recommended by the National Academy of Sciences (NAS) Institute of Medicine (IOM), stating that their Recommended Dietary Allowance (RDA) for vitamin D underestimates the need by a factor of ten. The recommended intake of vitamin D specified by the IOM is 600 IU/day through age 70 years, and 800 IU/day for older ages. Nutrients 

• Salt May Be Bad for More Than Your Blood Pressure: Even if you don't develop high blood pressure from eating too much salt, you may still be damaging your blood vessels, heart, kidneys and brain, a new study warns. Researchers reviewed available evidence and found that high levels of salt consumption have harmful effects on a number of organs and tissues, even in people who are "salt-resistant," which means their salt intake does not affect their blood pressure. Journal of the American College of Cardiology 

• Diet Soda Linked to Increases in Belly Fat: Increasing diet soda intake is directly linked to greater abdominal obesity in adults 65 years of age and older. Findings raise concerns about the safety of chronic diet soda consumption, which may increase belly fat and contribute to greater risk of metabolic syndrome and cardiovascular diseases. Journal of the American Geriatrics Society 

 High Dose Zinc Acetate Lozenges May Help Shorten Common Cold Symptoms: High dose zinc acetate lozenges shortened the duration of common-cold associated nasal discharge by 34%, nasal congestion by 37%, scratchy throat by 33%, and cough by 46%, according to a meta-analysis. BMC Family Practice 

• Epilepsy Surgery Gets High Marks from Patients: More than nine in 10 epilepsy patients who had brain surgery to try to control their seizures are happy they did so, a new survey reveals. Patients saw the number of debilitating seizures they experienced after surgery either drop significantly or disappear altogether. Epilepsy & Behavior 

• Poor Response to Statins May Mean Clogged Arteries: A new study found these people experienced little or no reduction in the "bad" cholesterol that contributes to artery-blocking plaque, making heart attack or stroke more likely. Arteriosclerosis, Thrombosis and Vascular Biology 

• Dangerous C. Difficile Germ Infects 500,000 Americans a Year: Almost half a million Americans were infected with the bacteria Clostridium difficile in 2011, and 29,000 died within a month of diagnosis, U.S. health officials report. C. difficile, which causes inflammation of the colon and deadly diarrhea, is often linked to antibiotic use. New England Journal of Medicine 

• Digoxin Tied to Worse Outcomes: Patients who take the heart rhythm drug digoxin may face a nearly 30 percent greater risk of death than patients not taking the drug, a review of prior research suggests. The analysis also suggests that digoxin may increase the risk for death by 60 to 70 percent among patients with both the heart rhythm disorder known as atrial fibrillation and kidney failure. American College of Cardiology annual meeting 

• Statins Lined to Raised Risk of Type 2 Diabetes: Cholesterol-lowering statin drugs may significantly increase a person's risk of developing type 2 diabetes, a new study from Finland suggests. Diabetes, Obesity and Metabolism 

 StatinsMay Help Improve Prostate Cancer Survival: Cholesterol-lowering statin drugs may slow down prostate cancer in men who are also taking medication to reduce their levels of male hormones, according to new research. American Society of Clinical Oncology 

• More Evidence That Hormone Therapy Might Not Help Women’s Hearts:The research, a review of collected data on the issue, found that hormone replacement therapy (HRT) does not protect most postmenopausal women against heart disease and may even increase their risk of stroke. Cochrane Library 

 Medications Used to Treat Diabetes May Trigger Heart Failure: A comprehensive study examining clinical trials of more than 95,000 patients has found that glucose or sugar-lowering medications prescribed to patients with diabetes may pose an increased risk for the development of heart failure in these patients. The Lancet Diabetes and Endocrinology 

• Fewer Americans Burdened by Medical Bills: The number of Americans struggling to pay medical bills has declined every year since 2011 and particularly since 2013, a new government report shows. Health policy and medical bill experts believe the new patient protections and coverage offered under the Affordable Care Act, as well as the steadily improving national economy, may have contributed to families' financial relief. U.S. National Center for Health Statistics 

• Seasonal Flu Vaccine Even Less Effective Than Thought: This year's flu vaccine is even more disappointing than previously reported, showing just 18 percent effectiveness against the dominant H3N2 strain of flu, health officials reported. The situation for children was even worse. The CDC panel pegged the effectiveness of the injected vaccine for kids aged 2 to 8 to be just 15 percent. And the nasal-spray version of the vaccine may not protect young children at all, health officials said. 

• Typical Adult Over 30 Gets Flu Twice Every 10 Years: Most people dread the flu, and many work hard to avoid it. However, a new British study finds that the typical person over 30 only gets the illness about twice every decade. In childhood and adolescence, flu is much more common, possibly because we mix more with other people Plos Biology 

 Study Links Family History of Prostate Cancer to Breast Cancer Risk: Women whose father, brother or son have had prostate cancer may have a 14 percent higher risk of developing breast cancer. Those women with a family history of both prostate and breast cancer were at a 78 percent greater risk of developing breast cancer. Cancer 

Be Wary of Websites Selling Genetic Cancer Tests: Websites that offer personalized genetic cancer tests tend to overstate their supposed benefits and downplay their limitations, a new study says. And many sites offer tests that have not been proven to be useful in guiding cancer treatment, according to the Dana-Farber Cancer Institute team that analyzed 55 such websites. Journal of the National Cancer Institute 

• Gout’sSilver Lining: A Lower Risk for Alzheimer’s? A new study finds that gout -- or the high uric acid level that drives the inflammatory condition -- may shield against the dementia. The study comes after prior research that had suggested that people with gout might also have a lower risk for other neurodegenerative conditions such as Parkinson's disease. Annals of the Rheumatic Diseases 

• Medical Expansion Has Led People Worldwide to Feel Less Healthy: A researcher at The Ohio State University used several large multinational data sets to examine changes in how people rated their health between 1981 and 2007 and compared that to medical expansion in 28 countries. During that time, the medical industry expanded dramatically in many of those countries, which you might expect would lead to people who felt healthier. "Access to more medicine and medical care doesn't really improve our subjective health. For example, in the United States, the percentage of Americans reporting very good health decreased from 39 percent to 28 percent from 1982 to 2006," Zheng said. Social Science Research