Saturday, May 16, 2015

Journal Watch May 2015

CHRONIC PAIN
• Practicing Yoga May Reverse Effects Chronic Pain Has on the Brain: “Studies of people with depression show they also have reduced gray matter, and this could contribute to the gray matter changes in pain patients who are depressed. For yogis, however, there seem to be more gray matter in multiple brain regions, including those responsible for pain modulation. Modulation refers to how the brain interprets and perceives pain. The more yogis practiced this mind-body technique, the more gray matter they had. American Pain Society 

 Insomniacs May be More Sensitive to Pain: The more frequent and severe the insomnia, the greater the sensitivity to pain, a Norwegian study showed. Additionally, people with insomnia who also suffer from chronic pain have an even lower threshold for physical discomfort. Wolters Kluwer Health 

COMPLEMENTARY AND ALTERNATIVE MEDICINE
 Mindfulness Based Therapy as Good as Meds for Depression: Mindfulness Based Cognitive Therapy was found to be was as effective as antidepressant drugs in preventing a recurrence of depression over a two-year period. Mindfulness-based cognitive therapy brings together two treatment approaches. Guided mindfulness practices, which aim to increase awareness of negative spirals, are combined with aspects of cognitive behavioral training, a short-term therapy that teaches skills to help resist or counter damaging thoughts or moods. The Lancet 

• Nurses Cut Stress 40 percent with relaxation steps at Work: It's estimated that one million people a day miss work in the United States because they're too stressed out. To help lower stress in the workplace, researchers conducted a study with staff members in a surgical intensive care unit. They found that a mindfulness based stress reduction (MBSR) cut stress levels by 40 percent and lowered the risk of burnout. Ohio State University 

FDA Weighs Tighter Regulation of Homeopathic Medicines: Critics say these natural remedies are ineffective, potentially dangerous; backers contend current oversight is sufficient. The agency last reviewed its regulation of homeopathic products in 1988, when it issued a policy guide that allowed the natural remedies to be placed on shelves without any pre-market approval, said Cynthia Schnedar, director of the Office of Compliance in the FDA's Center for Drug Evaluation and Research. 

How Relaxation Response May Help Treat Two Gastrointestinal Disorders: Participating in a nine-week training program including elicitation of the relaxation response had a significant impact on clinical symptoms of the gastrointestinal disorders irritable bowel syndrome and inflammatory bowel disease and on the expression of genes related to inflammation and the body's response to stress. PLOS ONE 

• Medical Marijuana Pill Falls Short in Dementia Study: In a trial of 50 dementia patients, researchers found that pills containing the main active ingredient in marijuana were no better than placebo pills in easing agitation, aggression and wandering.
However, that doesn't mean the approach is a failure, the investigators report in the May 13 online edition of Neurology. The researchers say the medical marijuana pills were well-tolerated, so it seems safe to test a higher dose in future studies.

FDA ACTION
• Warning about bogus botox
• Recommended that bottled water manufacturers, distributors and importers limit the amount of fluoride they add to bottled water so that it contains no more than 0.7 milligrams per liter (mg/L).
• Approved KAMRA inlay, a device implanted in the cornea of one eye (the clear, front surface) to improve near vision in certain patients with presbyopia.
• Approved treatment for fat below the chin
• Approved first generic aripiprazole to treat mental illness
• Approved fibrin sealant  to help control bleeding during surgery

PREVENTION
Another Study Finds No Vaccine-Autism Link: Yet another study finds no evidence that the measles-mumps-rubella (MMR) vaccine raises the risk of autism -- even among children who are at increased genetic risk. JAMA 

• Study Supports HPV Vaccination: New research finds that young women who get the HPV vaccine gain significant protection against infection in three parts of the body if they haven't already been exposed to the human papillomavirus (HPV).  HPV can separately infect the cervical, anal, or oral sites, which can occasionally lead to cancer. The study involved more than 4,100 women in Costa Rica, aged 18 to 25. American Association for Cancer Research 

• Aspirin May Help Ward off Gastro Cancers: There was a 20 percent lower risk of cancers of the gastrointestinal tract, especially in the colon and rectum in people taking aspirin regularly for several years. "If considered alongside the known benefits of aspirin in the prevention of heart attacks and strokes, our data suggest the possibility that long-term regular aspirin use may have a significant benefit in prevention of the two leading causes of sickness and death in the U.S. and much of the world.” American Association for Cancer Research meeting 

Mammograms a Personal Decision for Women in Their 40s: Women in their 40s should talk with their doctors and then decide for themselves whether they need regular mammograms to screen for breast cancer before age 50, according to draft U.S. federal health guidelines. The draft mammography guidelines issued April 20 by the U.S. Preventive Services Task Force (USPSTF) largely reiterate those that have been in place since 2009, the last time they were updated. The guidelines still recommend mammograms to screen for breast cancer every two years for women ages 50 to 74.
However, those recommendations are still at odds with the American Cancer Society and the American College of Obstetricians and Gynecologists. Both of those groups recommend annual screening beginning at age 40. US Preventive Services Task Force 

• Orthopedist Offers Tips for Preventing Shoulder Injuries: Shoulder muscles, ligaments and tendons can be injured by sports, household chores and heavy lifting. These injuries sometimes take months to heal and can interfere with everyday task. Exercises recommended include wall push ups and using a stretch band attached to a door knob. American Academy of Orthopaedic Surgeons 

• Breast-Feeding May Lower Breast Cancer Recurrence, Death: Women who breast-feed their babies and later develop breast cancer are less likely to have the cancer return or to die from it than women who do not breast-feed, new research shows. Journal of the National Cancer Institute 

• Daily Aspirin Taken by More Than Half of Older US Adults: Leading medical associations recommend use of low-dose aspirin mainly to prevent a second heart attack or stroke. But many others who haven't had a heart problem also take aspirin regularly, researchers found. Slightly more than half of middle-aged adults and seniors in the United States take aspirin daily to prevent heart attack, stroke or other serious illnesses, a new survey has found. American Journal of Preventive Medicine 

 Fitness May Help Lower Odds of Non Hodgkin’s Lymphoma: A lifetime of vigorous exercise may lower the risk of non-Hodgkin's lymphoma -- a form of cancer that affects the lymph nodes, according to a new study. Activities that significantly increase breathing and heart rate appear to have the most benefit, the researchers said. American Association for Cancer Research 

• 2-Minute Walk Every Hour May Help Offset Effects of Sitting: Getting up and walking for two minutes every hour could help reverse the negative health effects from prolonged sitting, new research suggests. Trading two minutes of sitting for two minutes of light-intensity activity each hour lowered the risk of premature death by 33 percent, the study revealed. Clinical Journal of the American Society of Nephrology 

• Even in Later Life, Exercise Seems to Pay Off: In a study of 6,000 Norwegian men born from 1923 to 1932 and followed for 12 years, just 30 minutes of moderate activity six days a week was associated with 40 percent lower risk of death. More exercise reaped even greater benefits, decreasing the odds of death from both heart disease or any cause, the researchers said. Looking back further, men who were sedentary in their 40s lived five fewer years on average than those who were the most active. British Journal of Sports Medicine 

• Staying Fit May Delay Onset of High Cholesterol: Men who keep fit may find they delay normal age-related increases in blood cholesterol levels by up to 15 years, a new study suggests. Journal of the American College of Cardiology 

• Money May Convince Smokers to Quit: Paying smokers to quit seems to work better than offering them free counseling and nicotine replacement therapy, new research suggests. NEJM 

 SUPPLEMENTS/VITAMINS/NUTRITION
Dietary Supplements Linked to Increased Cancer: A meta-analysis of two decades worth of research -- 12 trials that involved more than 300,000 people -- and found that a number of supplements may actually increase risk. People who took high doses beta carotene supplements had an increased risk for lung cancer. Selenium supplements were associated with skin cancer. Men who took vitamin E had an elevated risk for prostate cancer. Folic acid, a B vitamin, taken in excess could lead to an increased risk for colon cancer. American Association for Cancer Research Meeting 

• A Diet Might Cut the Risk of Developing Alzheimer’s: A study comparing the MIND diet with the Mediterranean and DASH diets found that while strict adherence to any of the diets lessened the chance of Alzhemer’s, the MIND seemed to help counter the disease even when people followed only some of the diet’s recommendations. The research was observational, not randomized or controlled, and therefore isn’t evidence the MIND diet caused a reduced risk for Alzheimer’s. Instead, the research shows there is an association between the two. Alzheimer’s & Dementia. 

• Healthy Diet Linked to Lower Risk of Memory, Thinking Decline: People who eat a healthy diet with lots of fruits and vegetables, nuts, fish, moderate alcohol use, and not much red meat may be less likely to experience declines in their memory and thinking skills. Neurology 

Mediterranean Diet Plus Olive Oil or Nuts May Boosting Thinking and Memory: Adding more olive oil or nuts to a Mediterranean diet -- one rich in fruits, vegetables, fish and whole grains and low in red meat -- may help keep your mind sharper as you age, a new study suggests. The Spanish researchers found that seniors following such diets had greater improvements in thinking and memory than people who were simply advised to eat a lower-fat diet. JAMA 

• Sugary Drinks Boost Risk Factors for Heart Disease: Consumption of sugary drinks increases risk factors for cardiovascular disease in a dose-dependent manner -- the more you drink, the greater the risk. The study is the first to demonstrate such a direct, dose-dependent relationship. Am J Clin Nutr 

• Moderate Drinking May Be Less Beneficial for Blacks: Moderate drinking appears to offer greater health benefits to whites than to blacks, a new study suggests. Previous research found a link between moderate drinking and a lower risk of type 2 diabetes, heart disease and premature death, but the participants in those studies were mostly white. American Journal of Public Health 

• The Downside of Gluten Free Eating: A recent Consumer Reports survey of 1,000 Americans found that 63 percent believed that following a gluten-free diet would be good for them, resulting in better digestion, healthy weight loss, increased energy, lower cholesterol and a stronger immune system. But the magazine's research of the scientific evidence suggested otherwise. The investigation found that many products touted as gluten-free aren't enriched or fortified with micro-nutrients such as folic acid and iron, which are common additions to wheat flour. What's more, these gluten-free products may be higher in fat and sugar than regular versions, contain rice or rice flour, which in turn may expose you to more inorganic arsenic than considered safe. 

 Switching from US to African Diet May Lower Colon Cancer Risks in Blacks: When a group of black Americans switched their diet from a typical American one (high-protein, low-fiber) to that of South Africans (high-fiber, low-fat), certain risk factors for colon cancer began to fade away, a small study found. The change was rapid, the researchers noted, suggesting the power of diet to alter colon cancer risk. Imperial College London 

 Dropping One Sugary Soda a Day Decreases Diabetes Risk: People who love sugary sodas and flavored milk may have a heightened risk of type 2 diabetes, regardless of their body weight, a large new study finds. Swapping just one of those drinks each day -- for water or unsweetened coffee or tea -- could lower diabetes risk by up to 25 percent. Diabetologia 

Foods that Help Keep the Pounds off as you age: While men and women who ate lots of nuts, peanut butter, fish, yogurt and low-fat cheese tended to lose weight, other foods commonly seen as "unhealthy" -- such as eggs, full-fat cheese and whole milk -- did not seem to make a difference in weight. On the other hand, sugary drinks and refined or starchy carbohydrates -- including white bread, potatoes and white rice -- had the opposite effect. Red and processed meats, meanwhile, were also tied to weight gain. Again, though, some of the harm was reduced if a person's glycemic load was kept in check. American Journal of Clinical Nutrition 

 High Protein Diet May be Dangerous for those at Risk of Heart Disease: Replacing carbohydrates and fats with protein is touted as a quick way to weight loss. But this long-term Spanish study of older adults found these high-protein diets -- think Atkins and South Beach, for example -- may be harmful. When protein replaced carbohydrates, for instance, the eating plan was linked to a 90 percent greater risk of gaining more than 10 percent of body weight. It was also linked to a 59 percent higher risk of death from any cause. When protein replaced fat, risk of death rose 66 percent. European Congress on Obesity 

Nicotinamide Linked to Reduced Risk of Skin Cancer: A form of vitamin B3 called nicotinamide is linked to a reduction of non-melanoma skin cancers by 23 percent when taken twice daily, according to Australian researchers. American Society of Clinical Oncology 

• Vitamin D Supplements Might Help Some Lose Weight: For obese Americans who are low on vitamin D, taking a supplement of the nutrient might help them lose weight, a new study suggests. European Congress on Obesity 

TREATMENT
•  Immune-Focused Drugs Show Promise Against Melanoma: Drugs that supercharge the body's immune system show promise in treating advanced melanoma, according to a pair of clinical trials. New England Journal of Medicine 

 Treating Sleep Apnea May Help Those with Heart Rhythm Disorder: People with both atrial fibrillation and obstructive sleep apnea are less likely to have a recurrence of the heart rhythm disorder if they use continuous positive airway pressure (CPAP) therapy, a new report says. Journal of the American College of Cardiology: Clinical Electrophysiology. 

• Effective Sleep Apnoea Treatment Lowers Diabetes Risk: Using continuous positive airway pressure (CPAP) therapy for 8 hours a night to treat sleep apnoea can help people with pre-diabetes improve their blood sugar levels and may reduce the risk of progressing to diabetes, according to a study published in the April 21 online edition of the American Journal of Respiratory and Critical Care Medicine. 

• Antibiotic Commonly Prescribed for UTIs Less Effective Than Others: Older women with urinary tract infections (UTIs) who are taking the commonly prescribed antibiotic nitrofurantoin are more likely to experience treatment failure, resulting in a second antibiotic prescription or a hospital visit, than if they received another antibiotic. Canadian Medical Association Journal. 

• Routine Health Care Similar from Nurse Practitioners, Doctors: Many patients with chronic heart disease will receive the same quality of care from a nurse practitioner or physician assistant as they would from a doctor, a new study suggests. Circulation: Cardiovascular Quality and Outcomes 

Good Bacteria Might Fight Common Hospital Infection: Researchers may have found a new way to combat a stubborn and potentially deadly gut infection Clostridium difficile a friendly version of the culprit bacteria itself. Prolonged antibiotic use is often to blame because it can knock out "good" gut bacteria that would normally keep toxin-producing strains of C. difficile in check. Despite that, treatment with specific antibiotics, like vancomycin, usually beats back the infection at first. With a 30% repeat illness rate, it’s welcome news that in a study of 125 patients who received additional therapy treatment of a non toxic strain of C.difficile, only 11 had a recurrent infection and a subgroup given a relatively high dose of the good bug only had a recurrence of 5%. JAMA 

• Contraceptive, cholesterol-lowering medications used to treat cancer: The combination of a cholesterol-lowering drug, Bezafibrate, and a contraceptive steroid, Medroxyprogesterone Acetate, could be an effective, non-toxic treatment for a range of cancers, researchers have found. Early stage clinical trials of the drugs in elderly patients with acute myeloid leukemia (AML) have shown promising results, with survival three months longer on average than standard palliative care. The combination, known as BaP, has also been used alongside chemotherapy to successfully treat children with Burkitt's lymphoma (BL), Cancer Research 

OTHER
 Some Arthritis Meds Cost Seniors Thousands Annually: Arthritis medications known as biologic disease-modifying drugs can cost Medicare patients more than $2,700 in co-payments a year, a new report finds. Biologic anti-rheumatic medications, e.g. adalimumab (Humira), anakinra (Kineret) and etanercept (Enbrel), have allowed patients to gain better control of rheumatoid arthritis when taken early in the course of disease. Arthritis & Rheumatology 

Antibiotic Shortage On the Rise: Shortages of antibiotics, including those used to treat drug-resistant infections, may be putting patients at risk for sickness and death, according to a new report. Clinical Infectious Diseases

• Smog May Be Harming Your Brain: Tiny particles of pollution might shrink the brain and increase risk of 'silent' strokes, study contends. Stroke 

• Weak Bones and Sudden Hearing Loss: In a Taiwanese study, people with osteoporosis had a 76 percent higher risk of developing sudden deafness -- an unexplained, rapid loss of hearing that typically occurs in one ear. Journal of Clinical Endocrinology & Metabolism 

• Traumatic Life Events May Harm Women’s Hearts: Middle-aged and older women who experience a life-threatening illness or the death of a loved one may face a 65 percent increased risk of heart attack, a new study suggests. And having a history of money problems might double the heart attack risk, the study authors added. Such traumatic events can increase a woman's stress levels to the point where her heart health may be harmed. Circulation: Cardiovascular Quality and Outcome 

Viewing Violent News on Social Media Can Cause Trauma: Viewing violent news events via social media can cause people to experience symptoms similar to post-traumatic stress disorder (PTSD). British Psychological Society 

 Immune System Genes May Change with the Season: Researchers analyzed genes from more than 16,000 people worldwide, including those from both the Northern and Southern hemispheres. They found that the activity of nearly one-quarter of the genes differed according to the time of the year. Some are more active in winter and some are more active in summer, the research revealed. These findings might explain why conditions such as rheumatoid arthritis and heart disease are worse in the winter than in the summer. Nature Communications 


• Lower Depression, Better Mental Health During the Great Recession: Americans had fewer depression diagnoses and better mental health during the Great Recession (2007-09) compared to pre-recession, according to a study. This large, American study also showed that post-recession, women were more likely to be diagnosed with anxiety disorders, while men were less likely to suffer from psychological distress. University of Maryland 

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