Saturday, November 18, 2017

Journal Watch November 2017




CHRONIC PAIN
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


COMPLEMENTARY & ALTERNATIVE MEDICINE
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

 FDA ACTION
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.



PREVENTION
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

NUTRITION/SUPPLEMENTS/VITAMINS
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

TREATMENT
• 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

OTHER
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

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