Saturday, June 17, 2017

Journal Watch June 2017

• Half of adults with anxiety or depression report chronic pain: In a survey of adults with anxiety or a mood disorder like depression or bipolar disorder, about half reported experiencing chronic pain. Journal of Affective Disorders 

Chronic Pain Opioid Guidelines Updated for State Medical Boards: The Federation of State Medical Boards (FSMB) has updated its guidelines on the use of opioids in the treatment of chronic pain, with new policies underscoring the need for physicians to be proactive in helping to turn the tide of the nation's opioid epidemic. Medscape

• Acceptance and Commitment Therapy reduces depression, anxiety among chronic pain patients: The results of a study presented at the Annual European Congress of Rheumatology (EULAR) 2017 has shown that Acceptance and Commitment Therapy, a form of cognitive behavioral therapy (CBT) that focuses on psychological flexibility and behavior change, provided a significant reduction in self-reported depression and anxiety among patients participating in a pain rehabilitation program. This treatment also resulted in significant increases in self-efficacy, activity engagement and pain acceptance.


Womenwho focus negatively, magnify chronic pain, more likely to be taking prescribed opioids: Female chronic pain sufferers who catastrophize, a psychological condition in which pain is exaggerated or irrationally focused on, not only report greater pain intensity, but are more likely to be taking prescribed opioids than men with the same condition. Anesthesiology


Does Chronic Pain Cause Cognitive Decline? A study appearing in JAMA Internal Medicine links persistent pain with progressive cognitive decline and dementia. But the mechanism is quite unclear. There are actually a few possibilities.

Can Virtual Reality Sessions Treat Chronic Pain?Stanford Doctor Yes Dr. Kim Bullock, a neuropsychiatrist at Stanford University, says she made the remarkable discovery by accident. While studying virtual reality for conditions like severe anxiety, a welcome side benefit of that treatment: patients’ chronic pain disappeared. NBC 


• Cool’ New Knee Procedure Eases Arthritis Pain Without Surgery :A new, non-invasive knee procedure could bring some relief for patients suffering from debilitating chronic pain, for whom surgery is not an option. The treatment, recently approved by the Food and Drug Administration, is called “cooled radio frequency ablation” and is a less drastic option for people with moderate to severe osteoarthritis pain who are not ready to have knee replacement surgery, or who have health conditions that don’t make them a good candidate for surgery. NBC 

 Study Documents Range of Challenging Meditation Experiences: Though it has gained popularity in the West as medically and psychologically beneficial, meditation can produce a much wider variety of outcomes, not all of them calm and relaxing, according to a new study that analyzes meditation-related challenges. Plos One

Marijuana Increases Periodontal Disease: Of 2,000 Americans studied, 27 percent reported the use of cannabis (marijuana, hashish or hash oil) one or more times for at least 12 months. Frequent recreational cannabis users were more likely to have signs of moderate to severe gum disease than less-frequent users, the researchers found. ournal of Periodontology

Copaiba: Silver bullet or snake oil?: Sales of the essential oil copaiba [koh-pey-buh] are increasing, at least in part, because more than 54 million Americans suffer from arthritis. The traditional way to treat arthritis is using NSAIDs and COXIBs, which are not without adverse events. For arthritis sufferers, copaiba may turn out to be a silver bullet or, perhaps, snake oil. Integrative Medicine

• Tai chi significantly reduces depression symptoms in Chinese-Americans: A new study finds that a 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese-Americans not receiving any other treatments. The Journal of Clinical Psychiatry

• Asks Maker of Opioid Painkiller Opana ER to Pull Drug From Market
• Fast tracks Tanezumab for Treatment of Osteoarthritis and Chronic Low Back Pain

• Loneliness May Lead to Sleepless Nights: More than 2,200 18- and 19-year-olds in England and Wales provided information about their loneliness levels and sleeping patterns. Between 25 percent and 30 percent of the participants said they felt lonely sometimes, and another 5 percent said they frequently felt lonely. Lonelier people were 24 percent more likely to feel tired and have difficulty concentrating during the day. Psychological Medicine 

Specific long-term therapy may not prevent fractures in older women: Data from the Women’s Health Initiative Study found that women who took bisphosphonates for 10-13 years had higher fracture rates, compared with women who took the medication for 2 years. Taking bisphosphonates for 3-9 years was not linked to a higher fracture risk. "Our study and several others have found higher risk of fractures among very long-term bisphosphonate users, compared with short-term users. However, the ideal length of bisphosphonate use has not yet been studied in randomized clinical trials. Journal of the American Geriatrics Society 


• Excessive exercise may damage the gut: A review of published studies has found that people who exercise excessively may be prone to acute or chronic gut issues. Alimentary Pharmacology & Therapeutics

• Take a coffee or tea break to protect your liver: New study indicates that drinking even a few cups a day may prevent hardening of the liver. Researchers found that drinking coffee and herbal tea may protect against liver fibrosis, estimated as the degree of liver stiffness, which is high in extensive scarring of the liver. Because these beverages are popular, widely available, and inexpensive, they could have the potential to become important in the prevention of advanced liver disease. Journal of Hepatology

Flu Shot Falls Short More Often for Obese: New research reveals the vaccine doesn't work as well for people who are obese. International Journal of Obesity


Couch Potatoes' May Face Higher Risk of Kidney, Bladder Cancers: Add greater risk of kidney and bladder cancer to the long list of why a lifetime of sitting on the sofa isn't good for your health, a new study suggests. Specifically, lifetime recreational inactivity was associated with a 73 percent increased risk of bladder cancer and a 77 percent increased risk of kidney cancer. Cancer Epidemiology


• Dairy products a good dietary source of some types of vitamin K: New study adds to knowledge about natural forms of vitamin K in dietary sources, their appreciable presence in commonly consumed foods. In the study, published June 1 in Current Developments in Nutrition, researchers quantified the activity of two natural forms of vitamin K in dairy products of various fat contents and found that common U.S. dairy items, including milks, yogurts and cheeses, contain appreciable amounts of multiple forms of vitamin K. Vitamin concentrations varied by fat content. Vitamin K helps blood to clot.

• Probiotic use linked to improved symptoms of depression: A new study is the first to show improved depression scores with a probiotic. It adds to the whole field of microbiota-gut-brain axis, providing evidence that bacteria affect behavior. Gastroenterology 

Flax: These sesame-seed lookalikes are considered a functional food -- a food that goes beyond basic nutrients to provide health benefits and/or reduce the risk of chronic diseases, according to a report in the Journal of Food Science and Technology. 

Low Fat Dairy Habit and Parkinson’s Risk: A 25 year study of 130,000 men and women found that those who consumed at least three servings of low-fat dairy a day had a 34 percent higher risk of getting the disorder than those who only consumed one serving a day. No such association was seen with the consumption of full-fat dairy products, such as whole milk. Experts who reviewed the study stressed that the findings are preliminary -- the effect was a modest one and the research wasn't designed to prove cause and effect. Neurology

Even Moderate Drinking May Dull the Aging Brain: Researchers found that those who regularly drank alcohol showed greater brain shrinkage than non-drinkers by old age. They also lost more of their language "fluency" -- a measure of memory and thinking skills. And, the effects were seen even among people who drank "moderately" -- roughly four to seven drinks a week, the researchers found. The findings do not prove that alcohol was to blame. BMJ 

• Excess Alcohol May Speed Muscle Loss in Women: A study of 2,400 postmenopausal women, average age 62. Of those, 8 percent had sarcopenia (condition of loss muscle mass and strength). Rates of sarcopenia were nearly four times higher among high-risk drinkers than among low-risk drinkers, the study found. Menopause

Dietary Supplements and Cognitive Function, Dementia and Alzheimer’s Disease: This issue of the NCCIH Clinical Digest summarizes current information on “what the science says” about several dietary supplements that have been studied for cognitive function, dementia, and Alzheimer’s disease. Although a few trials of natural products for the prevention of cognitive decline or dementia have shown some modest effects, direct evidence is lacking. In addition, research on some mind and body practices such as music therapy and mental imagery, which have shown promise in treating some symptoms related to dementia, as well as alleviating stress among caregivers, is ongoing.

Healthy Dietary Fats Help Beat High Cholesterol: Replacing saturated fats with healthier ones found in some vegetable oils can reduce cholesterol levels and heart disease risk as much as statins, a new American Heart Association (AHA) advisory says. Those healthier fats are poly-unsaturated fats and mono-unsaturated fats. Poly-unsaturated fats are found in corn, soybean and peanut oils. Mono-unsaturated fats are found in oils such as olive, canola, safflower and avocado. Saturated fats are found in meat, full-fat dairy products and tropical oils such as coconut and palm. In clinical trials, reducing use of saturated fat in favor of poly-unsaturated vegetable oil reduced heart disease by about 30 percent, similar to statin drugs, according to the advisory. Several studies found that coconut oil -- which is widely promoted as healthy -- increased LDL cholesterol levels in the same way as other saturated fats do.


• Online Treatment: new research suggests that online therapy programs can help some people with mild to moderate depression. The study found the results lasted at least three to six months after therapy ended, and the programs don't necessarily need to have a therapist directly involved to produce benefits "There was a significant effect in decreasing depressive symptoms after completing the programs," American Psychiatric Association meeting

New Combo Pill for HCV Offers Hope to those who fail other treatments: The pill -- which contains the antiviral drugs sofosbuvir (Sovaldi), velpatasvir and voxilaprevir -- was nearly 100 percent effective in curing hepatitis C in patients whose disease returned after treatment with other antiviral drugs.

Drug Xeloda Prolongs Survival for Some Breast Cancer Patients It cut risk of relapse, death by 30 percent over 5 years, trial found. NEJM 

• Adding abiraterone to standard treatment improves prostate cancer survival by 40 percent: Adding abiraterone to hormone therapy at the start of treatment for prostate cancer improves survival by 37 percent, according to the results of one of the largest ever clinical trials for prostate cancer. Science Daily

For older adults, antibiotics may not be appropriate treatment for some UTIs: Prescribing antibiotics for urinary tract infections (or 'UTIs') may often be avoided among older adults, suggests new research. Journal of the American Geriatrics Society

Drug for refractory psoriatic arthritis shows promise in clinical trial: Patients with psoriatic arthritis for whom standard-of-care pharmaceutical treatments have provided no lasting relief experienced a significant reduction in symptoms, including joint tenderness and swelling, have reported promising results when they were given a new drug-SPIRIT-P2 The Lancet 

Patients’ Own Fat Tissue Can Help Treat Joint Problems: Body fat now can help treat bone joint conditions, including injuries and osteoarthritis -- the type of arthritis caused by wear and tear in tissue between joints, which affects 27 million people. A new device gently suctions, processes and uses a patient's own fat tissue to provide a potential source of stem cells and growth factors to promote healing. The FDA approved Lipogems for widespread use in November of 2016. 

Is the finger-stick blood test necessary for type 2 diabetes treatment? In the first large pragmatic trial of its kind in the United States, results from a UNC School of Medicine study show that checking finger-stick blood sugars may not help diabetes patients who do not use insulin. JAMA Internal Medicine

For Diabetics, Nasal Powder Fixed Severe Low Blood Sugar: New product much easier to use than rescue injections. For many people with diabetes, low blood sugar levels are a serious health risk, but researchers report that a new nasal powder quickly reverses the effects of this dangerous condition. Better yet, it can be administered even when someone is unconscious. American Diabetes Association meeting

Study Confirms Link Between Diabetes Med and Rare But Dangerous Complication: A new class of type 2 diabetes drugs called SGLT2 inhibitors (Invokana, Invokamet, Farxiga, Xigduo XR, Jardiance and Glyxambi) could increase the risk of a rare, life-threatening complication of the disease called ketoacidosis, a new study warns. NEJM

Online cognitive behavioral therapy for insomnia is effective for military: A new study focused on soldiers at Fort Hood who had chronic insomnia. Some received therapy from clinicians for six weeks and some received online therapy for six weeks. For military personnel, internet-delivered cognitive behavioral therapy appears to be an effective alternative to meeting regularly with a therapist, although it is about half as effective as traditional methods, according to results of a study. Sleep 

Major Study Heralds New Era in Treatment of Type 2 Diabetes The findings published in the New England Journal of Medicine found the drug canagliflozin reduced the overall risk of cardiovascular disease by 14 per cent and reduced the risk of heart failure hospitalisation by 33 per cent. It was also shown to have a significant impact on the progression of renal disease.

• MS Related Brain Changes May Affect Social Skills: Subtle brain changes may explain why some people with multiple sclerosis (MS) lose their ability to interpret clues about what other people are thinking and feeling, a new study suggests. It doesn't happen to everyone with MS, but experts agree that it's a big deal for those who experience it. Neurology

• Nearly 10 Million U.S. Adults Suffer From Mental Illness: Nearly 10 million American adults have a serious mental illness, and a similar number have considered suicide during the past year, according to a new government report on the nation's behavioral ills. The report also said that 15.7 million Americans abuse alcohol and 7.7 million abuse illicit drugs. he researchers found that 12.5 million people are estimated to have misused prescription painkillers such as oxycodone (OxyContin, Percocet) or hydrocodone (Vicoprofen).. Behavioral Health Barometer -- United States, 2016 

Depression Can Slow Hospital Patients' Recovery: A review of 20 studies on depression screening in hospitals showed that 33 percent of patients had symptoms of depression. Patients with depression are less likely to take their medications and keep all recommended appointments after leaving the hospital, potentially leading to longer hospital stays and an increased risk of readmission. Journal of Hospital Medicine

• Home Blood Pressure Monitors Wrong 7 of 10 Times:  Checking your device against ones used at your doctor's office may be advised, experts say. A small, new Canadian study suggests that readings from the devices are wrong most of the time and could put patients at risk. American Journal of Hypertension

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