Saturday, December 9, 2017

Life With Chronic Conditions: Keep the December Blahs at Bay

Low serotonin levels in the brain increase risk of depression. December seems to be the “perfect storm”-the least sunlight of the year and our over compensation for it by eating and drinking all sorts of simple carbs, spending hours sitting inside and using the cold as an excuse not to go out and exercise – well who has time between the shopping and parties? In short, the December blahs, have begun to descend along with serotonin levels. 

Interestingly, I started writing this post and a Christmas package arrived from my brother. On the accompanying card, John, who is a doctor of the most scientific sort, said he was including a book by a neurosurgeon he had come in contact with regarding a patient with Parkinson’s Disease.

The book “Into the Magic Shop,” was authored by Dr. James Doty, whom I had heard on the podcast “On Being.” I relate this because it’s an insightful book that arrived at the perfect time, reminding me that it can be truly a magical time of  year. In fact, among the “things to consider” sections below are some exercises from the book.
 The good news is that there are things you can do to change that, and in turn, improve other aspects of your life.

One of my favorite comments about how to cope with the holidays, comes from the comedian Patton Oswalt, whose wife died unexpectedly a few years ago, Go see an early matinee and sip coffee from the only sandwich place open on the block. Pretend you’re the survivor of a weird plague that’s wiped out the population yet still leaves TV stations broadcasting, fast food joints cooking you delicious food and empty buses crawling up abandoned streets. When you look at a holiday spent alone at the right angle, it becomes a sun-lit film noir wonderland... People’s loneliness isn’t alleviated by tit-for-tat joy. That’s too easy. It’s other people being alive and present which spawns true joy, and makes the dead air particles shimmer and vibrate and warm the world. So go out and invade, in any way you can. If you have kids, make them part of your crew, let them join your mission. Be alive and aware and in motion on the Lonely Planet. It won’t stay lonely for long.

Things to consider & Try
• Increasing serotonin naturally: On going research shows that increasing serotonin in the brain decreases feelings of depression. There are a number of ways to do this without drugs including: exercise, sunlight, massage, and thinking happy thoughts. Check out Boosting Your Serotonin Activity. Be aware that before taking vitamins, which is often recommended to increase serotonin, check with your medical provider.

Ruth’s Tricks: Mindfulness Exercises-These are from the book Into the Magic Shop mentioned above.

Get moving: Not surprising a clear link has been established between lack of physical activity and depression. You don’t have to be a gym rat to enjoy the benefits of getting plenty of exercise. Build it into your life. Check out Take a Stand to Better Health.

Get outside and enjoy nature. Take a walk, sit in the park, ride a bike, feed the birds

Get plenty of sleep.

Cut back on sugar and simple carbs: Given that the “eating season” has already started, this can be a bit of a challenge but there are lots of ways to do this, such as drinking seltzer with a twist of lime instead of having an alcoholic beverage or soda.  Out of site out of mind-don’t have a sugar bowl, syrup, honey or other sweeteners sitting out where you will be tempted to use them. Reduce the amount of sugar you use-instead of two packets of sugar for coffee, use one. Eat half a cookie instead of a whole one. Substitute the simple carbs pastries, pretzels, and pasta, with more complex ones such as sweet potatoes, apples, blueberries, carrots, and garbanzo beans. Brain serotonin levels can also be raised by eating foods rich in L-tryptophan, such as chicken, turkey, salmon, beef, nut butter, eggs, and green peas.

Cut back on social media. Have face-to-face conversations. Power down too much texting, messaging, and scrolling through Facebook adds to anxiety and depression.

Declare Your Holiday Bill of Rights. You deserve to honor the holidays in a way that works best for you—and to take care of yourself in the process. Use this bill of rights to give yourself permission to make the holidays what you need them to be. Share it with loved ones so they can help support you.

Straighten Up hunching had a negative impact on mood vs. walking with back straight, chin up, and shoulders back put liveliness in steps and overall mood

Eliminate negative people from your life, or if you can’t eliminate them, reduce the amount of time you interact with them.

• Take a break: Hundreds of different ways are included at the Take a Break Pinterest site.

Try Hygge: Pronounced “hue-gah,” the Danish (the Danes are considered the happiest people in the world) term “hygge” means creating a nice, warm atmosphere and enjoying the good things in life with people you most enjoy. It is an absence of anything annoying or emotionally overwhelming and the presence of comforting, gentle and soothing things. Originating in Norway, where it meant well being, the high season of hygge is Christmas. Candles, mulled wine, fire places, blankets and scarves make this long and cold winter season bearable and for many, quite enjoyable. 

Be nice to someone if for no other reason it will give you a boost. Same goes for volunteering

Wednesday, December 6, 2017

Take a Break: Celebrate Polish Christmas

 The theme for this December’s “take  a breaks” are Polish Christmas customs.

The Polish believe it is good luck to have a spider on your Christmas Tree. There are a variety of legends associated with it, such as the spider wove the blanket for the Christ child; the spiders, who had been chased out in an effort to clean the house, returned on Christmas Eve to enjoy the splendor and crept into the tree leaving behind the lace of their webs.

One popular custom is the pajaki (pie yanki), which some refer to as a deluxe spider condo. Paper chandeliers, or pajaki, are a traditional Polish folk craft designed to brighten up the home with bold spring blooms during the long winter. Traditionally made from reeds, tissue paper, and foil, these ornate decorations can be made from many different items and can be made large or small.

Try some of these links to create your own pajaki:

Pajaki Chandelier DIY

Not interested in today’s activity, go to the Take a Break Pinterest and pick out something else.

Saturday, December 2, 2017

How much do you excuse someone’s behavior because of their “condition/”

How often do you accept inappropriate behavior because you “understand” that the person is sick, dealing with a crisis, addiction or for some other reason? Is it healthy to do this? Is this the compassionate thing to do? Where do you draw the line?

We humans need to be liked, loved, accepted, wanted and needed to one degree or another. To that end, we often put up with a lot to have those needs met. But how helpful is it over looking inappropriate behavior particularly if it’s having a negative impact on you?

Different scenarios call for different things to consider. However, it is important to recognize that it’s not okay to be abused, be it physical, verbal or emotional. Secondly, put your needs first. It isn’t being selfish, but rather a tool to help you come from a place of strength to be compassionate and caring. Allowing yourself to be someone’s “whipping boy,” no matter how you rationalize it, takes a terrible toll on your mind, body and spirit. Finally, mental illness is not an excuse for seriously inappropriate behavior but it’s one very commonly used. If this is an underlying issue, read When Someone Close to You Has a Mental Health Issue .

Bottom line-Accepting unacceptable behavior makes it acceptable.

Below are some scenarios and ways to deal with them

Scenario I: The person has a dementing illness, e.g. Alzheimer’s, a brain tumor, or some other major illness that is negatively impacting cognition. Verbal abuse is very common with dementia patients, posing significant challenges for caregivers. The reason the person is acting out can be rooted in various triggers, which can be hard to determine, particularly if the person has lost the ability to communicate effectively. Remember you didn’t cause the disease so don’t blame yourself for something out of your control.
• Try to remember that this is not abuse or aggression toward you.
• Remain calm and don’t respond with anger, fear, alarm or anxiety if at all possible.
• Be clear about the person’s diagnosis and talk to their medical provider about what you are experiencing
• Try to determine what the triggers are and eliminate them
• Try various approaches to avoid the inappropriate behavior including: regular physical activity (short walk); social interaction; giving them an activity they can do such as caring for plants, washing dishes; music, art and pet therapy
• Don’t go it alone. Get help. If this is too damaging a situation, you are not a bad person if you need to stop being a caregiver.


Scenario II: A provider abused by a patient. Provider abuse is so common, particularly among nurses, it’s considered to be part of the job description. It’s not okay.
• Know what type of policies and procedures your medical facility has put in place to protect staff, If they have an “acceptable behavior agreement” contract, or a provider “bill of rights,” which the patient is required to sign, use it. These agreements outline inappropriate patient behaviors, how this impacts staff as well as delivery of care, and consequences if behavior continues. Patients often don’t understand how their negative behavior impacts those around them let alone their care. If your facility does not offer such an agreement, work with them to put one in place.
• Get help, particularly if the person becomes violent


Scenario III: Domestic Abuse- Chronic conditions are linked with domestic violence. Even while they are still in an abusive relationship, many do not make the connection between their health conditions and their past relationships, and even more alarmingly, neither do health professionals.

This type of abuse knows no gender but women are more apt to report it while men are far more ashamed about it and are less likely to do so. It’s important to understand that abusive behavior and violence is a deliberate choice made by the abuser. It’s about power and control and they will use a wide array of means to get or exert it-humiliation, violence, isolation, threats, intimidation, denial, blame etc. This is not a sign of love or respect and the sooner one is out of such a relationship the better for all.

It’s also important to recognize that many assume that domestic abuse and violence is associated with a mental illness. As it turns out, there are a few mental illnesses or disorders that can increase the risk of abusive patterns. Overall though, abuse and mental illness are very separate. Even if they do have a mental health issue, abuse is never okay.

• Learn more about Domestic Violence and Abuse and what can be done about it.
• Call or log onto the National Domestic Violence Hotline  at 1-800-799-7233
• Check out other resources: Domestic or Intimate Partner Violence from Women’s Health  Does Mental Illness Cause Abuse

Scenario IV: The person is using drugs/alcohol Abusive behavior is very common by those who are addicted. The spouse of an addict very often bears the brunt of both the blame and the abuse. It’s hard to do anything right. He or she is not supportive. Mental and emotional abuse may be directed at the spouse to completely shut down any ability to effectively fight the real problem—the addiction. It’s very common for spouses and significant others to be browbeaten into submission, often for years. Of course, physical violence is a very real possibility, especially toward spouses, children, elderly parents—particularly those people who can’t fight back. Narcon 
Don’t be an enabler and put up with inappropriate behavior,  Check out the

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They Ask for Help, You Try, But Nothing is Right 

Wednesday, November 29, 2017

7 Ways to Protect Yourself from Outrageous Medical Bills

7 Ways You Can Protect Yourself From Outrageous Medical Bills

Make sure the proposed test or treatment is necessary. Ask what might happen if you don't get the service right away.
Eva Bee/Ikon Images/Getty Images
A doctor offers a surgical add-on that leads to a $1,877 bill for a young girl's ear piercing. A patient protests unnecessary scans to identify and treat her breast cysts. A study shows intensive care-level treatment is overused.
ProPublica has been documenting the myriad ways the health system wastes money on unnecessary services, often shifting the costs to consumers. But there are ways patients can protect themselves.
We consulted the bill-wrangling professionals at Medliminal, one of a number of companies that negotiate to reduce charges for a share of the savings. After years of jousting with hospitals, medical providers and insurers, their key advice for patients and their families is to be assertive and proactive.
Here are seven steps patients can take to protect themselves:
  1. Make sure the proposed test or treatment is necessary. Ask what might happen if you don't get the service right away.
  2. Ask the price before the test or treatment. (Prices may not be negotiable if they're set by an insurance company contract.)
  3. Write on your financial agreement that you agree to pay for all treatment by providers who are in-network, which means they have set rates with your insurance company. (The medical providers may not accept the altered form.)
  4. If possible, get the billing codes the medical provider will use to charge you and contact your insurance provider to make sure that each code is covered.
  5. If you are having a procedure, try to get the National Provider Identifier and/or Tax ID number of the surgeons, anesthesiologists and their assistants. Contact your insurance company to see whether the providers are in-network, which results in the negotiated rates.
  6. Demand an itemized bill and then look at each specific charge. Medical bills are often riddled with errors.
  7. Ask whether the provider has a financial assistance policy, which could result in a sliding scale discount. Many people qualify, and discounts can range from 20 percent to 70 percent.

ProPublica is a nonprofit newsroom based in New York. You can follow Marshall Allen on Twitter:@marshall_allen. Have you seen examples of wasted health care spending? Share them with Marshallhere.

Take a Break: Try Processing Speed Training

New research indicates that a type of brain exercise-processing speed training-could reduce the risk of dementia risk by 30%.  While a lot more research is going to be needed to confirm that, in the mean have some fun by trying some processing speed training.

Not interested in today’s activity, go to the Take a Break Pinterest and pick out something else.

Tuesday, November 21, 2017

Take a Break: Repurpose Candle Odds and Ends

As tomorrow begins the holiday season, there are often lots of candles that will be burned, leaving behind stubs, broken ones and the dregs of wax in candle jars. Here are a variety of ways to repurpose those odd bits.

Some suggestions for getting wax out of jars:
-       Pour boiling water in the jar and let sit over night. The wax will move to the top and makes it easier to take out. Don't dump water down the drain! Dump it outside or in the dumpster.
-       Place the candle jar in the freezer for a few hours or overnight. This will loosen the wax from the jar. Break up wax with a butter knife
-       See if the label will just peel off. If it doesn’t come off easily, soak it in hot water and try again. If there is goo left on it, a combination of baking soda and dish cleaner should do the trick. Wash the jar and lid with soap and water.

• Melt candles and create new ones. There are a variety of ways to melt wax-hot plate, microwave and even an oven. Because candles can have scents and can be made of various ingredients, I stay away from using a microwave or oven, simply because I use these appliances for cooking. A double boiler works well. If you don’t have a dedicated double boiler you can make one by using an old pot and placing a tin can or smaller pot that holds the candle dregs inside. Pour water around the sides so it creates a water bath. Boil
Double boiler method
away. If you want to learn more on different ways to melt candles check out How to Easily Melt Candle Wax Fast

 I make my own wicks by dipping 100% cotton butcher's string into the wax and let harden on wax paper. You can turn all sorts of items into candle holders-old tea cups, glass jars, tin cans. Just don’t use plastic. If you have access to sand, fill up a bucket or bowl and make sand candles.

Fill mason jar with solid candle wax. Insert a left over peeled crayon. Place in slow cooker and pour water around the jars. Cover and “cook” on high for 3 hours. Once it’s melted, put a candlewick in the jar, keep it in place by wrapping the top with a stick. Let dry/cool and enjoy!

• Seal your holiday cards by dripping hot wax on the back of the envelope. I’ve used this method to decorate a gift box.

Repair shoelace ends that are frayed, dip them into the hot wax and roll between your fingers to make sure they stick together

Fire starters: My friends with wood stoves, fire pits, and fireplaces love them. In fact we have a party at the beginning of December where we make fire starters, wreaths and swags. Collect pine cones and let dry for a few days so they open up and will crumble a bit when you crush them. Pick up pine needles, small berries or other small woodsie items.
• Purchase a tube of cotton pads from the Dollar Store. These will be in the cosmetic section as they are used for removing make up.
• Melt the wax (see above). If you have Scentsy warmer that will also work.
• Lay out wax paper, foil or parchment paper and scatter it with pieces of pine cone, needles,  bark, dried berries, herb pieces etc.
• Immerse the pad into the melted max for a few seconds until it is covered in wax and remove with tweezers or another tool. Lay on the prepared wax paper. Fip it over so both sides are evenly coated and then set aside to dry and cool.
• When cool, place as many as you want into a cellophane bag, along with a note that explains that these are fire starters.

An alternative method is take egg cartons (not plastic ones) and fill them with a mixture of pine cones, dried leaves, lint, sawdust etc. and then pour a little wax into each holder. Let dry and separate.

If you come across small pine cones, you can always make pine cone fire starters, which will look very attractive in a gift box.

Fix that drawer that’s being annoying you for months. Try rubbing your leftover candle wax wherever the wood slides. You’ll be surprised how easily the drawers move around afterwards.

Not interested in today’s activity, go to the Take a Break Pinterest and pick out something else.

Saturday, November 18, 2017

Journal Watch November 2017

Foods That May Ease Rheumatoid Arthritis: Blueberries and a cup of green tea
are among the foods that could ease the pain, swelling and stiffness in your joints and even slow progression of the disease, researchers say. Dried plums, pomegranates, whole grains, the spices ginger and turmeric, and olive oil may also help. These foods appear to reduce inflammation, as well as joint stiffness and pain, according to the authors of a paper published Nov. 8 in the journal Frontiers in Nutrition

Options to Opioids in the ER: As the opioid epidemic continues to sweep across the United States, a new study suggests that a combination of Motrin and Tylenol may work as well as narcotic painkillers for ER patients who suffer sprains or fractures. JAMA

Stem Cell Injection better than Placebo for Back Pain: A SINGLE injection of six million stem cells into a degenerative spinal disc can reduce back pain, opioid reliance and the need for invasive spinal surgery for at least two years, early trial results show. The Melbourne-developed treatment, an off-the-shelf stem cell product that can treat 20,000 patients from cells grown from one healthy young person, is being tested as part of an international trial. The 100-patient, double-blinded phase II trial found a greater proportion of those treated halved their pain level compared to a placebo a year after treatment. It also reduced the need for pain relief and other surgical interventions. 

Why head and face pain causes more suffering: Sensory neurons in the head and face tap directly into the brain's emotional pathways. Nature Neuroscience 

Cognitive behavioral therapy for chronic pain By teaching patients better strategies for coping with chronic pain, cognitive behavioral therapy (CBT) is a valuable treatment alternative for the millions of Americans taking opioids for noncancer pain. Journal of Psychiatric Practice 

Noninvasive procedure is superior to steroid injection for painful knee osteoarthritis: For patients with osteoarthritis of the knee, a minimally invasive procedure called cooled radiofrequency ablation (CRFA) provides better pain reduction and functional improvement compared to steroid injection of the knee, concludes a study. Regional Anesthesia and Pain Medicine 

White matter damage linked to chronic musculoskeletal pain in Gulf War veterans: A new study has linked structural damage in the white matter of the brain to chronic musculoskeletal pain in Gulf War veterans. PAIN

Clinical study shows positive results for two yoga poses to decrease scoliosis curves: In a 74-person peer-reviewed study, patients averaged 25% -35% reduction in scoliosis curves over 10 months (adults) and 6 months (adolescents).The curves of younger patients were more responsive to the treatment. 

• Yoga May Boost Lung Cancer Patients, Caregivers: For advanced lung cancer patients, yoga appears to help improve their overall physical function, stamina and mental health. And it appears to give their caregivers a boost, as well. The findings stem from a small study of 26 patients and caregivers. The study participants, most of whom were in their 60s, took part in an average of 12 yoga sessions. The focus was on breathing exercises, physical postures and meditation. Palliative and Supportive Care Oncology Symposium

Issued an advisory about harms tied to kratom -- an imported herbal supplement with opioid-like effects that is increasing in popularity.
• Approved new treatment to prevent bleeding in certain patients with hemophilia A
• Announced comprehensive regenerative medicine policy framework to spur innovation, efficient access to potentially transformative products, while ensuring safety & efficacy
• Approves treatment for rare genetic enzyme disorder
• Permits marketing of the first device for use in helping to reduce the symptoms of opioid withdrawal. The NSS-2 Bridge device is a small electrical nerve stimulator placed behind the patient’s ear.
• Warns about illegal use of injectable silicone for body countouring and associated health risks
• Approves pill with sensor that digitally tracks if patients have ingested their medication.
• Clears common blood cell count test that offers faster results
• Approves first treatment for certain patients with Erdheim-Chester Disease, a rare blood cancer
• Warns companies marketing unproven products, derived from marijuana, that claim to treat or cure cancer
• Approves new treatment for adults with mantle cell lymphoma
• Issued statement on the proposal to revoke health claim that soy protein reduces risk of heart disease.
• Seeks to speed development of “regenerated” organs for medical use.

Older Women Can “Walk Away”from the grim reaper: In a new study, women who logged an average of nearly 70 minutes walking daily had up to a 70 percent lower risk of death compared to the least active women, who moved just eight minutes a day. The study also found that the benefits were significant mainly for women who participated in moderate to vigorous exercise. The study included data from nearly 17,000 women. Their average age was 72, and most were white. Circulation

Cross off that 'to do' list, study shows all daily activity can prolong life: For women over age 65, adding 30 minutes per day of light physical activity may lower mortality risk. The 6,000 women in the study, ages 65 to 99, were followed for up to four and a half years. They wore a measuring device called an accelerometer on their hip around-the-clock for seven days while going about their daily activities. The study found that 30 minutes of light physical activity per day lowered mortality risk by 12 percent while an additional 30 minutes of moderate activity, such as bicycling at a leisurely pace or brisk walking, exhibited a 39 percent lower risk.Journal of the American Geriatrics Society

Group exercise improves quality of life, reduces stress far more than individual work outs: Group exercise participants showed significant improvements in all three quality of life measures: mental (12.6 percent), physical (24.8 percent) and emotional (26 percent). They also reported a 26.2 percent reduction in perceived stress levels. By comparison, individual fitness participants on average worked out twice as long, and saw no significant changes in any measure, except in mental quality of life (11 percent increase). The Journal of the American Osteopathic Association

Commitment Is Key for Online Quit-Smoking Groups: An online social network designed to help you quit smoking can do just that, a new study finds. But the odds of quitting rise along with the level of active involvement, the researchers said. Plos One 

Definition of High Blood Pressure Drops: Nearly half of all adult Americans will be considered to have high blood pressure under new guidelines issued Monday by the nation's top heart health organizations. The new guidelines lower the diagnostic threshold for stage 1 high blood pressure to 130/80, down from the previous level of 140/90, according to a joint statement from the American Heart Association and the American College of Cardiology. 

• Does Sex Really Trigger Cardiac Arrest: It's a common Hollywood trope -- an older guy is having enthusiastic sex with a gal half his age when he suddenly flops over dead.
But in real life, sexual activity very rarely causes cardiac arrest, a new study reassuringly reports. Sex was linked to only 34 out of more than 4,500 cardiac arrests that occurred in the Portland, Ore., metropolitan area between 2002 and 2015. That's a rate of just 0.7 percent, the researchers noted. Journal of the American College of Cardiology 

 Friends Key to a Health Aging Brain: Getting along well with others may do more than just make life less stressful for seniors. A new study suggests that warm, supportive relationships might give a big memory boost to the aging brain.  Researchers found that so-called SuperAgers -- people 80 or older with the memory powers of those 50 to 65 -- were more likely than those with average memory to report positive relationships in their lives. Plos One 

• IUD May Lower Cervical Cancer Risk: IUD contraceptive devices may reduce a woman's risk of cervical cancer by about a third, a new review concludes. Researchers think IUDs might promote an immune response that kills off human papillomavirus (HPV), the virus that causes virtually all cases of cervical cancer. "The data say the presence of the IUD in the uterus stimulates an immune response, and that immune response very, very substantially destroys sperm and keeps sperm from reaching the egg," explained lead researcher Victoria Cortessis. "It stands to reason the IUD might influence other immune phenomenon." Obstetrics & Gynecology

Eat Well Age Well: The scientists followed close to 1,000 men and women in England, who were born in March 1946, throughout their adulthood. Those who ate more fruits, vegetables and whole-grain cereals -- and fewer highly processed foods -- throughout adulthood did better on three tests of physical function in their early 60s than those with less healthy eating habits. The study also found that those whose eating habits improved during adulthood did better on two of the tests, chair rise speed and standing balance time. The third test was timed up-and-go speeds. The Journals of Gerontology: Series A

  Healthier Diet, Less Salt: The Recipe to Beat High Blood Pressure: Cutting back on salt, along with following the highly recommended "DASH" diet, can beat back high blood pressure in adults, new research shows. After just a month, the results for people adopting this strategy were "striking and reinforce the importance of dietary changes" for those with problematic blood pressure. American Heart Association's annual meeting

• Nuts Prevent Heart Disease: Avoiding heart disease may be a nutty idea. That's the conclusion of a new study of more than 210,000 U.S. adults tracked for 32 years. Researchers found that those who regularly ate peanuts, walnuts, cashews and other nuts had a lower risk of heart disease. The research was funded by the U.S. National Institutes of Health. It found that -- compared to people who never ate nuts -- people who ate walnuts one or more times a week had about a 20 percent lower risk of heart disease. Those who ate peanuts two or more times per week had about 14 percent lower risk, and those who ate tree nuts -- such as almonds, cashews, pistachios or macadamia nuts -- had a 15 to 23 percent lower risk.The investigators found no link between total nut consumption and stroke risk, but they did find that people who ate peanuts and walnuts, in particular, had a lower risk of stroke. Journal of the American College of Cardiology

• Proton Pump Inhibitors Linked to Risk of Chronic Kidney Disease: A total of 5 studies with 536,902 participants met the eligibility criteria and were included in the meta-analysis that showed a link between proton pump inhibitors and the development of kidney disease. Annual Meeting of the American Society of Nephrology (ASN)

Two Years of Teriparatide Significantly Decreases Risk of New Fractures in Women With Severe Osteoporosis: Two years of teriparatide significantly decreases the risk of a new clinical vertebral fracture in postmenopausal women with severe osteoporosis, compared with risedronate, according to a study presented here at the 2017 Annual Meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP). 

• Romosozumab Followed by Alendronate Bests Alendronate Alone for Fracture Prevention: In postmenopausal women with osteoporosis who are a high risk for fracture, romosozumab treatment for 12 months followed by alendronate resulted in a significantly lower fracture risk than alendronate alone, according to a study presented here at the 2017 Annual Meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP). 

Aspirin can prevent heart attacks after noncardiac surgery in patients with prior PCI: The results of the largest randomized trial of patients with PCI will inform clinical practice. A new study has found that perioperative aspirin can prevent heart-related complications after major noncardiac surgery in patients with previous percutaneous coronary intervention (PCI) such as an angioplasty or stent. The study found that for every 1,000 patients with PCI, giving them aspirin at the time of noncardiac surgery would prevent 59 heart attacks and cause eight major bleeding events. Annals of Internal Medicine 

Depressed with a chronic disease? Many find antidepressants are not working: Scientists are finding more evidence that commonly prescribed antidepressants aren't effective in people battling both depression and a chronic medical disease, raising a critical question of whether doctors should enact widespread changes in how they treat millions of depressed Americans. JAMA

Virtual Reality Training After a Stroke: Using virtual reality therapy to improve arm and hand movement after a stroke is equally as effective as regular therapy, according to a study published in the November 15, 2017, online issue of Neurology®, the medical journal of the American Academy of Neurology.

• Peanut Patch Found Safe, Effective for treating allergies: A 250-μg peanut patch produces a significant treatment response in peanut-allergic patients treated for a year, according to a study published online Nov. 14 in the Journal of the American Medical Association.

Statins Cut Risk: For patients who have experienced an atherosclerotic cardiovascular disease (ASCVD) event, receipt of statins, especially high-intensity statins, is associated with reduced risk of major adverse cardiac events (MACE), according to a study presented at the American Heart Association's Scientific Sessions.

Older people with bowel disease receiveolder medicines: Inflammatory bowel disease is common amongst older people and there are big differences in the choice of treatment for different age groups. Patients over the age of 60 often receive cortisone drugs instead of more modern medicines that target the immune system. Gastroenterology

Doctor Burnout: A Big Threat to Health Care: Complaining of burnout and job dissatisfaction, many U.S. doctors plan to reduce their work hours or leave medicine altogether, a new study reveals. The study found that about one in five doctors intends to reduce work hours in the next year. And about one in 50 intends to leave medicine for a different career within the next two years. The demands of electronic health records were among the challenges leading to job dissatisfaction. Mayo Clinic Proceedings. 

Psoriasis severity linked to increased risk of type 2 diabetes People with psoriasis are at a higher risk to develop type 2 diabetes than those without psoriasis, and the risk increases dramatically based on the severity of the disease. Researchers found people with psoriasis that covers 10 percent of their body or more are 64 percent more likely to develop diabetes than those without psoriasis, independent of traditional risk factors such as body weight. Journal of the American College of Dermatology