Saturday, April 18, 2015

Journal Watch April 2015

• The Problem with Opioids for chronic Pain: In addition to addiction, side effects from opioid medications include constipation, increased risk of birth defects, falls and fractures, heart attacks and a decrease in the production of testosterone. Opioids should be medications of last resort. Review article US News. 

 Mindfulness Program Beneficial for Chronic Pain: Researchers from a randomized trial to examine the effects of mindfulness meditation on chronic pain concluded, "A standardized mindfulness program contributes positively to pain management and can exert clinically relevant effects on several important dimensions in patients with long-lasting chronic pain," the authors write. Pain Medicine 

• Occult Infections may be the cause of chronic pain after spine surgery: Chronic pain after spine surgery can affect as many as 40% of patients, even after all surgical parameters are met and are normal. Occult spinal infections may be the cause of some of these cases of pain with unknown origin. “Occult infection is more prevalent than previously identified.” Lumbar Spine Research Society Annual Meeting 

• Chronic Pain meds misused by 20% to 25% of patients: Approximately 20 to 25 percent of patients using opioids for chronic pain have misused these drugs, according to a report published in the journal Pain.

• Nasal Bupivacaine Block of Sphenopalatine Ganglion Reduce Chronic Migraines: A nasal formulation of 0.5% bupivacaine effectively and safely reduces the frequency of headaches in patients with chronic migraine and reduces the average amount of pain associated with the headaches. 31st Annual Meeting of the American Academy of Pain Medicine (AAPM). 

Use of Antidepressants and Anticonvulsants Increase Ziconotide Side Effects: The common use of antidepressants and anticonvulsants among patients treated with intrathecal ziconotide for chronic pain is associated with increased side effects of cognitive impairment and alertness. 31st Annual Meeting of the American Academy of Pain Medicine (AAPM). 

Ketorolac Injections as Effective as Corticosteroids for Knee Osteoarthritis Pain: Ketorolac intra-articular knee injections provide pain relief from knee osteoarthritis that is equivalent to improvement with corticosteroids. American Academy of Pain Medicine (AAPM) 

• A Grateful Heart May be a Healthy Heart: Higher levels of gratitude were associated with better mood, better sleep, less fatigue and less inflammation, a factor that can worsen heart failure, according to the study. Spirituality in Clinical Practice.  

• Liquid Medical Marijuana Shows Promise Against Severe Epilepsy: A liquid form of medical marijuana may help people with severe epilepsy that does not respond to other treatments, according to a new report. Advanced Clinical Experience in Neurology, 

• Approved Afibercept for Diabetic Retinopathy for patients with Diabetic Macular Odema
Warned that serious slowing of the heart rate can occur when the antiarrhythmic drug amiodarone is taken together with either the hepatitis C drug Harvoni (ledipasvir/sofosbuvir) or with Sovaldi (sofosbuvir) taken in combination with another direct acting antiviral for the treatment of hepatitis C infection.
• Approved the Gastric Emptying Breath Test (GEBT), a new non-invasive test to aid in the diagnosis of delayed gastric emptying, known as gastroparesis.
• Warned against muscle growth product Tri-Methyl Xtreme
• Approved generic copaxone for  multiple sclerosis

• Exercise Might Help His Sex Life: Nearly 300 men provided information about their physical activity levels and their ability to have erections and orgasms, the quality and frequency of erections, and their overall sexual function. Better sex was reported by those who engaged in the equivalent of two hours of strenuous exercise, 3.5 hours of moderate exercise, or six hours of light exercise a week. Journal of Sexual Medicine

• Regular, Vigorous Exercise May Lengthen Your Life: Australian researchers found that middle-aged or older people who get at least some high-intensity exercise that makes them sweaty and winded may reduce their chances of dying early by up to 13 percent. The study involved more than 204,000 people aged 45 or older who were followed for more than six years. Researchers compared those who engaged in only moderate activities -- like gentle swimming, social tennis or household chores -- with people who got some amount of vigorous activity -- such as jogging, aerobics or competitive tennis. JAMA Internal Medicine 

• Exercise Improves Non-Alcoholic Fatty Liver Disease: “The results from our study show that all exercise doses, irrespective of volume or intensity, were efficacious in reducing liver fat and visceral fat by an amount that was clinically significant, in previously inactive, overweight, or obese adults compared with placebo.” Journal of Hepatology

 Smoking May be Linked to prostate Cancer’s Return: Researchers followed nearly 7,200 men after they had their prostate gland removed because of cancer.  During the roughly 28-month follow-up, current smokers and patients who had only quit smoking within the previous 10 years were about twice as likely to have their cancer return as those who never smoked, the international team of researchers found. Former smokers had to have quit more than 10 years in order to have a significantly lower risk of cancer recurrence. European Association of Urology 

Arts and Crafts Activities May Stave Off Dementia: A study of 256 found that those who engaged in artistic activities such as painting or drawing, in both middle age and when they were 85 and older, were 73 percent less likely to develop mild cognitive impairment than those who did not engage in artistic activities. The people who engaged in craft activities such as woodworking or pottery were 45 percent less likely to develop mild cognitive impairment than those who did not participate in such activities, the researchers found. Neurology 

• To Protect Aging Brain,Start with Exercise: A new report from the Institute of Medicine also suggests that quitting smoking, managing health conditions and socializing can also help to preserve brain function. 

• Pesticide Exposure Contributes to Heightened Risk of Heart Disease: Pesticide exposure, not obesity alone, can contribute to increased cardiovascular disease risk and inflammation in premenopausal women, according to a new study. Journal of Clinical Endocrinology & Metabolism

• Heavy Snoring, Sleep Apnea May Signal Earlier Memory and Thinking Decline: Heavy snoring and sleep apnoea may be linked to memory and thinking decline at an earlier age, according to a study published in the April 15, 2015, online issue of the journal Neurology. The research also suggests that treating the disorders with a breathing machine may delay the decline. 

• E-Cigarettes May Not Help Smokers Quit: A study of 1,000 found that smokers who used e-cigarettes were less likely to quit regular cigarettes than those who hadn't tried the devices. American Journal of Public Health 

• Walking Boosts Outcomes for Prostate Cancer Survivors:  A study of 51,000 early stage prostate cancer survivors found that three hours of "casual" walking per week boosted the men's health-related quality of life by reducing fatigue, depression and weight issues. Walking at a faster pace for 90 minutes a week provided similar benefits, the team found. Journal of Cancer Survivorship: Research and Practice

Cardiorespiratory Fitness Reduces Disease Risk Among Smokers: Cardiorespiratory fitness is associated with reduced metabolic syndrome risk among smokers, according to researchers. American Journal of Preventive Medicine 

 More Whole Grains May Boost Life Span: A new study suggests that older people who eat a lot of whole grains may live longer than those who hardly ever eat them. BMC Medicine 

Exercise, but not Vitamin D, Cuts Injuries from Falls in Older Women: Neither routine exercise nor vitamin D supplementation does anything to lower the overall risk for accidental falls among older women, a new Finnish study says. However, the risk of serious injury as a result of falling was cut by more than half when elderly women engaged in regular exercise, according to the study. AMA Internal Medicine

• Weight Watchers, Jenny Craig Beat Other Commercial Diets: Only two out of 32 major commercial weight-loss programs marketed nationwide -- Weight Watchers and Jenny Craig -- can boast scientific evidence showing their clients maintain weight loss for at least a year, the researchers found. Annals of Internal Medicine 

• High-Fat Dairy Products Linked to Reduced Type 2 Diabetes Risk:  Consumption of high-fat yogurt and cheese are linked to a reduction in the risk of type 2 diabetes by as much as a fifth, according to new research. High meat consumption, on the other hand, is linked to a higher risk. Am J Clin Nutr

• Eating Out Equals High Blood Pressure: A recent study on university-going young adults is the first ever to show an association between meals eaten away from home and high blood pressure. These findings highlight lifestyle factors that can affect hypertension and emphasize the importance of being aware of the salt and calorie content in food, to facilitate better meal choices when eating out. Am J of Hypertension 

• Roseroot Herb Shows Promise as Potential Depression Treatment Option: Rhodiola rosea (R. rosea), or roseroot, may be a beneficial treatment option for major depressive disorder (MDD), according to results of a study. Phytomedicine 

• Mushrooms Boost Immunity: A new University of Florida study shows increased immunity in people who ate a cooked shiitake mushroom every day for four weeks. Journal of the American College of Nutrition 

• Deep Brain Stimulation May Ease SomeParkinson’s Pain for Years to Come: People with Parkinson's disease who undergo deep brain stimulation may experience long-term pain relief, a small, new study from Korea suggests. However, three-quarters of the patients developed new pain in muscles and joints eight years after the procedure was performed, the researchers found. JAMA Neurology 

• Latest Diabetes Care Guideline Focus on Individual Approach: The American Diabetes Association has issued new guidelines, which includes screening Asian-Americans for diabetes at lower weight and giving statins to patients who are over 40 and have diabetes. Annals of Internal Medicine

 1 in 5 Medicare Patients Faces Delay in Melanoma Surgery:Researchers evaluated more than 32,000 melanoma patients covered by Medicare. “We found around one in five Medicare patients experience a delay greater than 1.5 months and that 8 percent had surgery after three months.” Delays were least common for patients whose melanoma was biopsied and excised by a dermatologist, compared to other physicians. JAMA Dermatology 

Americans Get too Many Tests Before Cataract surgery: Older Americans get a lot of unnecessary tests before they undergo cataract surgery, a new study suggests.Experts said the findings highlight an area of wasteful health care spending. Plus, they said, there is a risk for harm if the tests pick up a mild abnormality that prompts further tests, then turns out to be nothing. New England Journal of Medicine 

Blood Thinners Over prescribed for Low-Risk Irregular Heartbeat: The study included information from nearly 11,000 atrial fibrillation patients across the United States. They were all younger than 60. They were also all considered to have a low risk of stroke, according to the researchers. Still, the study found about 25 percent of them were prescribed blood thinners, contrary to current treatment guidelines. JAMA Internal Medicine 

• New Drug Holds Promise for MS: The second of three phases required for U.S. Food and Drug Administration approval of the drug, known as anti-LINGO-1 appears to repair nerve damage seen in multiple sclerosis (MS) patients, results of an early trial suggest. American Academy of Neurology Meeting 

Malpractice Fears Spurring Most ER Docs to Order Unnecessary Tests: Of 435 ER physicians who completed the survey, 97 percent admitted to ordering some advanced imaging scans that weren't medically necessary, mainly because they fear malpractice lawsuits. The ER docs surveyed also suspect they aren't the only staff doing this. More than 85 percent believe too many diagnostic tests are ordered in their own emergency departments, by themselves and others. Academic Emergency Medicine 

• Could Obesity Help Protect Against Dementia: A new study of nearly 2 million people suggests that those who are overweight or obese in middle age may be less likely to develop dementia than their normal and underweight peers. Overweight and obese people were about 30 percent less likely to develop dementia 15 years later than people of a healthy weight. Conversely, underweight people were 34 percent more likely to develop dementia than those whose weight was normal, according to the study authors. he Lancet Diabetes & Endocrinology 

• Work-Related Asthma Affects Millions of US Adults: Almost 16 percent of American adults with asthma either developed the condition on the job or have asthma symptoms made worse by conditions in their workplace, a according to a new U.S. health report. Morbidity and Mortality Weekly Report 

• Many Very Ill Patients Choose ‘Next of kin” Who Aren’t: Nearly one out of 10 veterans in Connecticut younger than 65 have chosen someone who is not part of their immediate family as their next of kin, a new study reports. Immediate -- or nuclear -- family generally includes a person's spouse, adult child, parent or sibling. However, state laws won't allow non-immediate family members to make medical decisions on behalf of the patients, unless the patients have specifically named them in a living will or other legal document. J "When difficult decisions arise, it can cause delays and adverse consequences if people aren't sure who should be making decisions," Cohen said. And, under current laws, it's possible that a family member with little to no participation in a person's day-to-day life could end up responsible for making life-and-death medical decisions on that person's behalf, according to the researchers AMA

 Uninsured May Face Much Higher Charges for Cancer Drugs: Doctors may charge uninsured patients anywhere from two to 43 times what private insurance plans or Medicare pay for chemotherapy drugs, a new study estimates. Health Affairs 

No comments:

Post a Comment