Journal Watch December 2017

CHRONIC PAIN

• Popular Shoulder Surgery to Ease Chronic Pain Questionable: A placebo-controlled study found that arthroscopic procedure, subacromial decompression, proved no difference in relieving shoulder pain than the sham surgery. The Lancet

• Hip steroid injections associated with risky bone changes: Osteoarthritis patients who received a steroid injection in the hip had a significantly greater incidence of bone death and collapse compared with control groups, according to new research. Radiological Society of North America

• Noninvasive, nonpharmacological Treatmentof Chronic Pain: A Systematic Review: A number of nonpharmacological interventions can provide beneficial effects on function and/or pain that are durable 1 month to 1 year after the completion of therapy. Exercise, multidisciplinary rehabilitation, acupuncture, and mind-body and mindfulness practices may slightly to moderately improve function and pain across multiple chronic pain conditions. Our findings provide some support for clinical strategies that focus on use of nonpharmacological therapies as preferred interventions for chronic pain. Additional comparative research on sustainability of effects beyond the immediate post-treatment period is needed, particularly for conditions other than low back pain. Agency for Healthcare Research and Quality

COMPLEMENTARY & ALTERNATIVE MEDICINE

• Acupuncture May Ease Pain Tied to Breast Cancer Care: Some common breast cancer medications can trigger joint pain, but new research suggests acupuncture may ease that side effect. San Antonio Breast Cancer Symposium

• Does Alternative Treatment for Cancer Increase Risk of Death?: The survival rates of the 281 selected patients who chose the alternative medicine route were compared with 560 conventional treatment patients, matched for demographic and clinical factors. After statistic analyses were completed, the results showed that, overall, patients who pursued alternative treatment for cancer had markedly worse five-year survival rates than those who underwent conventional therapy. Even after controlling for clinical and demographic factors, choosing alternative medicine over traditional treatment was an independent predictor of an increased risk of death. NCI: Journal of the National Cancer Institute

FDA ACTION

• Approved Juluca, the first complete treatment regimen containing only two drugs to treat certain adults with human immunodeficiency virus type 1 (HIV-1)

• Approved Ozempic for Type 2 Diabetes

• Approved insulin lispro injection (Admelog), a short-acting insulin indicated to improve glycaemic control

• Approved “biosimilar’ Ogivri for breast, stomach cancers

• Approved once monthly injection buprenorphine to treat opiod use disorder

• Approved first use of mepolizumab (Nucala) to treat adult patients with eosinophilic granulomatosis with polyangiitis (EGPA)

PREVENTION

• Dog Owners Have Lower Risk of Cardiovascular Disease: Dogs shower their owners with affection and demand walks on a regular basis. And according to medical researchers, a corresponding link between dog ownership and heart health — previously called "probable" by experts — is supported by Swedish data. An examination of Sweden's national records — spanning more than 3.4 million people and 12 years — found that registered dog owners had a lower rate of cardiovascular disease and a lower risk of death. Nature’s Scientific Reports

'Brain Training' Program Helps Prevent Dementia In what is being billed as a first, researchers report that healthy seniors who tried a new brain-training program were less likely to develop dementia down the road. In essence, the program, called BrainHQ, tries to speed thinking by giving seniors the task of distinguishing between a series of ever-changing objects on a computer screen -- both in the center and periphery of their vision. Over time, the objects appear more quickly, and look more similar to one another. This makes the task increasingly difficult, with the aim being to boost the individual's ability to rapidly and accurately identify the objects at hand. Over a 10-year period, the speed-of-thought-processing program lowered dementia risk by nearly 30 percent, the study team said, when compared with seniors who didn't have such training. Alzheimer's & Dementia: Translational Research & Clinical Interventions

• Any physical activity in elderly better than none at all for reducing cardiovascular risk: Any physical activity in the elderly is better than none at all for reducing cardiovascular risk, according to an 18-year study in more than 24,000 adults published today in the European Journal of Preventive Cardiology.

• Some video games are good for older adults' brains: Playing 3D-platform video games on a regular basis may improve cognitive functions in seniors and increase grey matter in a brain structure called the hippocampus, a new study suggests. If you're between 55 and 75 years old, you may want to try playing 3D platform games like Super Mario 64 to stave off mild cognitive impairment and perhaps even prevent Alzheimer's disease. Plos One

• Vigorous Exercise May Help Slow Parkinson’s Disease: People with early stage Parkinson's may be able to delay a worsening of the disease through a regimen of intense exercise, new research found. "If you have Parkinson's disease and you want to delay the progression of your symptoms, you should exercise three times a week with your heart rate between 80 to 85 percent maximum. JAMA Neurology 

NUTRITION/SUPPLEMENTS/VITAMINS

• Low-salt, heart-healthy dash diet as effective as drugs for some adults with high blood pressure: A study of more than 400 adults with prehypertension, or stage 1 high blood pressure, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowers systolic blood pressure -- the top number in a blood pressure test -- especially in people with higher baseline systolic readings. Journal of the American College of Cardiology

• Maintaining sufficient vitamin D levels may help to prevent rheumatoid arthritis: Maintaining sufficient vitamin D levels may help to prevent the onset of inflammatory diseases like rheumatoid arthritis, research has discovered. Journal of Autoimmunity

• Can diet help reduce disability, symptoms of MS?: For people with multiple sclerosis (MS), eating a healthy diet of fruits, vegetables and whole grains may be linked to having less disability and fewer symptoms than people whose diet is less healthy, according to a study. Neurology 

• Drinking tea protects vision?: The study of U.S. adults found that people who drank hot tea on a daily basis were 74 percent less likely to have glaucoma, compared to those who were not tea fans. Experts were quick to stress that it may not be tea, itself, that wards off the eye disease. There could be something else about tea lovers that lowers their risk. British Journal of Opthamology

TREATMENT

• Hormone therapy in the menopause transition does not increase risk of stroke: Postmenopausal hormone therapy is not associated with increased risk of stroke, provided that it is started early, according to a new report. PLOS Medicine

• Four simple tests could help GPs spot pneumonia and reduce unnecessary antibiotics: Testing for fever, high pulse rate, crackly breath sounds, and low oxygen levels could be key to helping GPs distinguish pneumonia from less serious infections, according to a large study. European Respiratory Journal

• Clot-busting drugs not recommended for most patients with blood clots: Large clinical trial concludes such treatment does not prevent long-term complications About half of people with blood clots in the deep veins of their legs develop a complication that involves chronic limb pain and swelling, making it difficult to walk and perform daily activities. A large-scale clinical trial has shown that a risky, costly procedure to remove such clot fails to reduce the likelihood that patients will develop the debilitating complication. NEJM

• Bleach Baths for Eczema Not Needed: Bathing in water is just as effective for the treatment of eczema as bathing in a bleach solution, a new review of previous research indicates. Annals of Allergy, Asthma and Immunology

• Birth Control Pill Tied to Slight Rise in Cancer Risk: Newer versions of the birth control pill carry a similar increased risk of breast cancer as earlier ones that were abandoned in the 1990s, a new study reveals.Women taking modern formulations of the pill have a 20 percent increased risk of breast cancer compared with those who've never been on hormonal contraception, the study of almost 2 million Danish women found. NEJM

• Self-Taught Breathing Retraining Improves Quality of Life for Patients With Asthma: Self-taught breathing retraining improves quality of life just as much as training by a physiotherapist, according to a randomised controlled trial published in The Lancet Respiratory Medicine.

• No Association Between Statin Use and Reduced Risk of Breast Cancer Recurrence: While other studies have reported that statins may be associated with decreased odds of breast cancer recurrence, a multivariable analyses presented hat the 2017 Annual San Antonio Breast Cancer Symposium (SABCS) do not support those results. “While OR estimates were not statistically significant, the associations between statin use and breast cancer recurrence were in the direction of increased risk of recurrence.”

• Postmenopausal Women Should Still Steer Clear of HRT: Task Force: et again, the nation's leading authority on preventive medicine says postmenopausal women should avoid hormone replacement therapy (HRT). The U.S. Preventive Services Task Force is standing by its original recommendation that women who have already gone through menopause should avoid using female hormones to guard against osteoporosis or diabetes. JAMA 

• Hyperbaric oxygen therapy may alleviate symptoms of Alzheimer's Disease: A new study reveals that hyperbaric oxygen treatments may alleviate symptoms experienced by patients with Alzheimer's disease. Neurobiology of Aging

CAREGIVING

• Are Women with Parkinson’s Disease at a Disadvantage: Women with Parkinson's disease appear to face a disadvantage: They're much less likely than men to have caregivers, a new study finds. That's probably because women often outlive their most likely potential caregiver. "Care provided by family and friends to people with Parkinson's disease is an important source of support, and our findings show that women living with Parkinson's are less likely to receive this support than men," Neurology

OTHER

• Cancer Survivors Can Develop PTSD:  A study of 469 adults with different types of cancer found that nearly 22 percent had symptoms of PTSD six months after their cancer diagnosis. And about 6 percent still had the condition four years after diagnosis. Cancer

• Checking Prices for Medical Procedures Online? Good Luck: A new study has found that people searching online to figure out how much they'll pay for a medical procedure will come away disappointed most of the time. "Fewer than 1 in 5 websites actually yielded a local price estimate that was relevant to the health care procedure in question." JAMA Internal Medicine

• Man Flu: Doctors and women alike have long noticed that men tend to bemoan those symptoms more than women. The phenomenon even has a name: the "man flu." So, are men just whiny wimps? No, a new analysis out of Canada suggests, because respiratory illnesses may indeed hit men harder than women. BMJ