Journal Watch February 2017

CHRONIC PAIN

• Common Pain killers Don’t Ease Back Pain: Commonly used non-steroidal anti-inflammatory drugs, such as aspirin and ibuprofen, used to treat back pain provide little benefit, but cause side effects, according to new research. The findings of the systematic review reveal only one in six patients treated with the pills, also known as NSAIDs, achieve any significant reduction in pain. Annals of the Rheumatic Diseases 

• Quicker treatment of low back pain leads to faster improvement and lower healthcare costs andutilization: Researchers have created a new protocol that gives patients with low back pain quicker access to treatment, and this protocol is showing signs of better patient outcomes and lower healthcare costs and utilization, according to new research. The rapid access protocol (RAP) created by the researchers allows patients whose insurance covers physical therapy without a physician referral to undergo screening with a physical therapist and begin treatment as quickly as possible. Science Daily 

• Try Drug-Free Options First for Low Back Pain,New Guidelines Say: People with low back pain should try drug-free remedies -- from simple heat wraps to physical therapy -- before resorting to medication, according to new treatment guidelines, released by the American College of Physicians (ACP). The recommendations put more emphasis on nondrug therapies than previous ones have. They stress that powerful opioid painkillers -- such as OxyContin and Vicodin -- should be used only as a last resort in some cases of long-lasting back pain. Another change: When medication is needed, acetaminophen (Tylenol) is no longer recommended. Annals of Internal Medicine 

• Personalized physical therapy brings relief for lower back pain: Impaired movement control may result in chronic lower back pain. A new study shows that the combination of manual therapy and exercise is an excellent way to combat movement control impairment in the lower back. This combination reduced the disability experienced by patients and significantly improved their functional ability. A personally tailored exercise program was more beneficial for patients than a generic one, and the treatment results also persisted at a 12-month follow-up. BMC Musculoskeletal Disorders 

• Rotator Cuff Pain?Genetics Might Be to Blame: A new study shows rotator cuff disease might be a heritable trait. Rotator cuff disease is a common disorder that affects 30 to 50 percent of people over the age of 50. The disease often leads to shoulder pain and loss of function. While many think of this as a ‘tear’ due to an injury or sustained over/misuse, some studies suggest genetics might play a role. Science Daily 

• Is the pain coming from your hip, spine or both?: Many patients live with low back pain that radiates to the buttock, groin, thigh, and even knees. The challenge for patients, and often their doctors, is determining the origin of the pain -- the hip, the spine or both. A new article outlines the identical symptoms associated with hip and spine pain and discusses the diagnostic steps and tests required to treat them appropriately. American Academy of Orthopaedic Surgeons 

• Acupuncture boosts effectiveness of standard medical care for chronic pain, depression: Acupuncture treatment can boost the effectiveness of standard medical care, lessening the severity of chronic pain and depression, health specialists have found. National Institute for Health Research (NIHR) Journals Library 

• Bacteria links Crohn's disease to arthritis: Patients with Crohn's disease, a type of inflammatory bowel disease (IBD) that causes abdominal pain and diarrhea, can also experience joint pain. In Crohn's disease, which affects about 800,000 Americans, the immune system can attack not only the bowels, but the musculoskeletal system as well, leading to spondyloarthritis, a painful condition that affects the spine and joints. Science Translational Medicine 

• Pain during alcohol withdrawal Electroacupuncture may help: Hyperalgesia refers to an increased sensitivity to pain. It can occur during alcohol withdrawal, and may contribute to a relapse to drinking. Alternative therapies such as acupuncture and electroacupuncture (EA; which combines acupuncture with electrical stimulation) are effective in reducing pain and, possibly, alcohol-withdrawal symptoms. This rodent study investigated whether EA can alleviate hyperalgesia during alcohol withdrawal, potentially reducing the risk of a relapse to drinking, and whether it achieves this effect via action at mu opioid receptors (MORs) located in a brain region called the lateral habenula. Alcoholism: Clinical and Experimental Research 

COMPLEMENTARY & ALTERNATIVE MEDICINE

• Brain-Training May Help Ease Ringing in the Ears: An online program that "trains" the brain may help people cope with the constant ringing in the ears called tinnitus, a small study suggests. AMA Otolaryngology-Head & Neck Surgery 

• Drinking Peroxide as ‘Natural’ Leads to Dangerous Blood Clots: Alternative drinking "therapies" that proactively promote the health benefits of potent peroxide. These so-called "super water" cures are anything but curative, researchers said, with ingestion leading to heart attack, stroke, and in some cases, death. Annals of Emergency Medicine 

• Low Back Pain? Relax, Breathe and Try Yoga: For people experiencing low back pain, yoga may be a natural fit in the quest to relieve an aching back, a new review indicates. The findings come from an analysis of 12 studies that included more than 1,000 participants with lower back pain. The studies compared yoga to physical therapy or patient education. There was some evidence that yoga led to small improvements in pain, and small to moderate improvements in back function at three and six months. Cochrane Library 

FDA ACTION

• Trulance Approved for Chronic Constipation

• Reports 5 dog deaths due to ingesting small amounts of fluorouracil, a skin cancer cream.

• Offers Guidance on Fish Intake for kids pregnant women 

PREVENTION

• Link between weight and certain brain functions: Memory training is far less effective in older adults who are obese than those who aren't, a new study finds. The research included about 2,800 people, average age 74, who were followed for more than 10 years. Obese participants gained only one-third of the benefit of memory training compared with those who weren't obese, the study authors said. However, the study didn't find any differences by weight in the benefits from training in reasoning and problem-solving, or in thought-processing speed. Obesity 

• Nearly Half of US Men Infected with HPV: About 45 percent of U.S. men are infected with the sexually transmitted disease, as are 45 percent of women. Among women, the prevalence of HPV infection drops to about 22 percent as they age, but it remains high among men. Most people infected with HPV don't know they have it and don't develop health problems from it, according to the U.S. Centers for Disease Control and Prevention. But HPV is not a benign infection. More than 9,000 cases of HPV-related cancers occur in men each year. HPV is the cause of 63 percent of penile, 91 percent of anal, and 72 percent of oral and throat cancers, the researchers noted. JAMA Oncology 

• Short Stretches of Exercise May Have Anti-Inflammatory Effect: Just 20 minutes of moderate exercise may dampen inflammation in the body, researchers say. The study findings suggest that "exercise doesn't have to be tremendously hard for you to see health benefits from it. Brain, Behavior, and Immunity 

• Too Much Sitting Ages you Faster: Researchers who assessed nearly 1,500 older women found those who sat most of the day and got little exercise had cells that were biologically older by eight years than the women's actual age. American Journal of Epidemiology 

• Sitting not linked to incident diabetes, new research suggests: Sitting may not be as deadly as previously thought, with new research ruling out sitting as a direct cause of diabetes. British Journal of Sports Medicine 

• E-Cigarettes May Be Less Toxic Than Tobacco: "Our study shows that bodily level exposure to established and important smoking-related carcinogens and toxicants is reduced by between 56 percent to 97 percent in long-term e-cigarette users who have stopped smoking completely, compared with tobacco cigarette smokers.” Annals of Internal Medicine

NUTRITION/SUPPLEMENTS/VITAMINS

• Diets High in Barbecued, grilled and smoked meats lowers survival after breast cancer: The study involved more than 1,500 women who had been diagnosed with the cancer in 1996 and 1997. The study participants were followed for nearly 20 years. Eating lots of grilled, barbecued or smoked meat before their cancer diagnosis was linked with a 23 percent increased risk of dying from any cause during the follow-up period compared with low intake, the researchers said. And continuing to eat lots of meat cooked in this fashion after breast cancer seemed to increase those odds, the findings suggested. Beef, pork and lamb, in particular, were singled out as potentially troublesome. Journal of the National Cancer Institute 

• Whole Grain Goods May Help You Stay Slim: Switching to whole-grain foods might help keep your weight in check as much as a brisk 30-minute daily walk would, a new study suggests. American Journal of Clinical Nutrition 

• Evidence Points to Fish Oil to Fight Asthma: Omega-3 fatty acid products

can reduce the production of IgE, the antibodies that cause allergic reactions and asthma symptoms in people with milder cases of asthma. But in patients with severe asthma who use high doses of oral steroids, the omega-3 fatty acids are less effective because the

corticosteroids block the beneficial effects. Journal of Clinical Investigation 

• Scientifically-designedfasting diet lowers risks for major diseases: Results of a randomized clinical trial shows a periodic, five-day fasting diet designed by a researcher safely reduced the risk factors for heart disease, cancer, diabetes and other age-related diseases. Science Translational Medicine, 

• Cutting Salt a Health Boost for Kidney Patients: Encouraging people with kidney disease to reduce their salt intake may help improve blood pressure and cut excess fluid retention, at least for a while, a new study suggests. Clinical Journal of the American Society of Nephrology 

• Possible Drawback to Gluten-Free: America's love affair with gluten-free foods may come at a cost: greater intake of the toxic metals arsenic and mercury, a new study contends. Gluten-free products often contain rice flour as a substitute for wheat, rye and barley. And rice is known to accumulate arsenic and mercury from fertilizers, soil and water. Epidemiology 

• Mediterranean Diet Plus Olive Oil a Boost to Heart Health? A Mediterranean diet high in virgin olive oil may boost the protective effects of "good" cholesterol, a new study suggests. Circulation 

• Vitamin D Linked to Lower Risk of Respiratory Infections: There's preliminary evidence that adequate amounts of vitamin D might help lower rates of respiratory infections, such as colds, bronchitis and pneumonia, the researchers said.In a review of past trials of people taking vitamin D supplements, researchers found that supplementation was linked to a 12 percent reduction in the proportion of people having an "acute respiratory infection." BMJ 

• Increased levels of active vitamin D can help to optimize muscle strength: Researchers have shown that increasing the levels of active vitamin D can help to optimize muscle strength in humans. PLOS One 

TREATMENT

• Think You’re Allergic to Penicillin? Check Again: According to UT Southwestern researchers, 90 percent of people who have a penicillin allergy listed in their medical records didn't actually have a reaction when exposed to the medication during an allergy test. Doctors can test for a penicillin allergy in a two-step process. First, they do a skin test. If that result is negative, patients are given an oral penicillin challenge to verify the result. HealthDay 

• Common pain relievers may increase heart attack risk during respiratory infections: Widely used pain relievers may increase the risk of a heart attack when used during a cold or flu-like illness, according to a new study. The findings suggest physicians and patients should use caution when prescribing or taking the medications, known as nonsteroidal anti-inflammatory drugs, or NSAIDs, to ease symptoms of acute respiratory infections. Journal of Infectious Diseases 

• Blood test may help differentiate Parkinson's from similar diseases: A simple blood test may be as accurate as a spinal fluid test when trying to determine whether symptoms are caused by Parkinson's disease or another atypical parkinsonism disorder, according to a new study. Neurology 

• Removal of ovaries during hysterectomy linked to increase in heart disease, cancer and premature death: A link has been found between removal of both ovaries at the time of hysterectomy and premature death. Increase in incidence of heart disease and cancer, and of deaths from heart disease and cancer when ovaries were removed. More than 113,000 hysterectomy cases were studied and the ovaries were removed in about a third of these. BMJ 

• New guideline provides clinical recommendations for specific insomnia drugs: A new clinical practice guideline is the first from the American Academy of Sleep Medicine to provide comprehensive, evidence-based analyses of individual agents commonly used in the treatment of chronic insomnia disorder. The clinical practice guideline includes 14 specific recommendations for individual agents, including prescription medications such as zolpidem and eszopiclone; over-the-counter medications such as diphenhydramine; and dietary supplements such as melatonin and valerian. Each recommendation suggests whether clinicians should or should not use the individual drug for sleep onset insomnia or sleep maintenance insomnia, versus no treatment. However, the guideline does not recommend one drug over another since few comparative efficacy studies have been conducted among these agents. Journal of Clinical Sleep Medicine 

• B vitamins reduce schizophrenia symptoms, study finds: A review of worldwide studies has found that add-on treatment with high-dose B vitamins -- including B6, B8 and B12 -- can significantly reduce symptoms of schizophrenia more than standard treatments alone. Psychological Medicine 

CAREGIVERS

• Partners Of Breast Cancer Patients Suffers too: The stress of managing breast cancer care provokes symptoms of anxiety in more than 42 percent of partners and caregivers. And this stress-induced anxiety can last years after their loved one's illness, researchers found. American Society for Clinical Oncology 

• Caregivers should be screened early, often to prevent depression, anxiety: Currently, more than 34 million people in the U.S. care for terminally ill love ones, but few resources are available to help them navigate the challenges they encounter. A study has found that nearly one-quarter of caregivers were moderately or severely depressed and nearly one-third had moderate or severe anxiety. The researchers recommend that health providers remember to treat the whole family, providing ongoing screening to family caregivers to identify early signs of depression and anxiety. Journal of Palliative Medicine 

OTHER

• Screen Time May Not Be So Bad for Teens: Teens who log hours of screen time every day -- on video games, smartphones, computers, TV and the like -- may not be doing themselves any harm, a new study suggests. A digital "sweet spot" of screen time might even benefit teens' well-being by allowing them to develop social connections and personal skills, according to the findings. The study authors said the teens' mental well-being tended to peak in one of these daily scenarios: Playing video games for about 1 hour and 40 minutes; Fooling with their smartphone for about 1 hour and 57 minutes; Watching videos for about 3 hours and 41 minutes; Using computers for about 4 hours and 17 minutes. Psychological Science 

• Scientists develop game-changing blood test for concussions: A new blood test can now accurately diagnose a concussion using a form of blood profiling known as metabolomics.that identifies with greater than 90 per cent certainty whether or not an adolescent athlete has suffered a concussion. blood is drawn from an individual that may have suffered a concussion as the result of a sudden blow to the head (or from transmitted forces from a sudden blow to the body) within 72 hours of the incident. The scientists measure a panel of metabolites -- small molecules that are the products of the body's metabolism -- in the blood to search for distinct patterns that indicate a concussion has occurred. Metabolomics