Journal Watch February 2018

CHRONIC PAIN

Medical cannabis significantly safer for elderly with chronic pain than Opioids: A new study found cannabis therapy is safe and efficacious for elderly patients who are seeking to address cancer symptoms, Parkinson's disease, post-traumatic stress disorder, ulcerative colitis, Crohn's disease, multiple sclerosis, and other medical issues. After six months, more than 18 percent of patients surveyed had stopped using opioid analgesics or had reduced their dosage. The European Journal of Internal Medicine 

Pilot study in Kenya shows link between chronic pain and glutamate consumption: Preliminary research from a small pilot study carried out in Meru, in eastern Kenya, shows a link between chronic pain and consumption of glutamate, a common flavor enhancer found in Western and non-Western diets worldwide. Results demonstrated that when study participants cut monosodium glutamate from their diets, their symptoms improved. Nutrition 

Limited Evidence for Effect of Cranial Electrical Stimulation: Evidence for the effectiveness of cranial electrical stimulation (CES) is sparse, according to a review published online Feb. 13 in the Annals of Internal Medicine. Researchers reviewed evidence relating to the benefits and harms of CES for adults with chronic painful conditions, depression, anxiety, and insomnia. "Evidence is insufficient that CES has clinically important effects on fibromyalgia, headache, neuromusculoskeletal pain, degenerative joint pain, depression, or insomnia; low-strength evidence suggests modest benefit in patients with anxiety and depression," the authors write.

COMPLEMENTARY & ALTERNATIVE MEDICINE

Stress-Reducing Techniques Can Reduce Seizure Frequency in Patients With Refractory Epilepsy: Learning techniques to help manage stress may help people with epilepsy reduce how often they have seizures, according to a study published in Neurology. 

Therapeutic Horseback Riding Can Help alleviate PTSD: For military veterans, therapeutic horseback riding (THR) may be a clinically effective intervention for relieving symptoms of post-traumatic stress disorder (PTSD), according to a study published online Jan. 19 in Military Medical Research.

FDA ACTION

• Approved the first blood test to evaluate mild traumatic brain injury (mTBI) in adults

• Approved apalutamide (Erleada) for the treatment of patients with non-metastatic, castration-resistant prostate cancer.

• Expands approval of Imfinzi to reduce the risk of non small cell lung cancer progressing

• Expands treatment window for use of clot retrieval devices in certain stroke patients

• Approved marketing of clinical decision support software for altering providers of a potential stroke in patients

PREVENTION

Poor fitness linked to weaker brain fiber, higher dementia riskScientists have more evidence that exercise improves brain health and could be a lifesaving ingredient that prevents Alzheimer's disease. A new study from UT Southwestern's O'Donnell Brain Institute suggests that the lower the fitness level, the faster the deterioration of vital nerve fibers in the brain. This deterioration results in cognitive decline, including memory issues characteristic of dementia patients. "This research supports the hypothesis that improving people's fitness may improve their brain health and slow down the aging process," Journal of Alzheimer's Disease

Climb stairs to lower blood pressure and strengthen leg muscles: A new study demonstrates that stair climbing not only lowers blood pressure but also builds leg strength, especially in postmenopausal women with estrogen deficiencies who are more susceptible to vascular and muscle problems. The study involved Korean postmenopausal women who trained four days a week, climbing 192 steps two to five times a day. North American Menopause Society 

Running helps brain stave off effects of chronic stress: The study finds that running mitigates the negative impacts chronic stress has on the hippocampus, the part of the brain responsible for learning and memory. Neurobiology of Learning and Memory

Can ultraviolet light fight the spread of influenza? Overhead far-UVC light, a type of ultraviolet light that is harmless to humans, effectively killed airborne flu virus, researchers have found. The lighting may offer a new weapon against the spread of flu virus in public spaces. Scientific Reports 

Rotating Night Shift Increases Odds of Type 2 Diabetes: Rotating shift work, which includes night shifts is associated with increased odds of type 2 diabetes, according to a study published online Feb. 12 in Diabetes Care.

  

NUTRITION/SUPPLEMENTS/VITAMINS

Drinking hot tea associated with a 5-fold increased risk for esophageal cancer for some: Consuming hot tea at high temperatures is associated with an increased risk for esophageal cancer in those who also drink alcohol and smoke cigarettes, a new study finds. American College of Physicians

Eating Slower Tied to Lower Obesity Risk inType 2 Diabetes: Slower eating also found to be associated with reduced BMI, waist circumference. Eating speed can affect changes in obesity, body mass index (BMI), and waist circumference in patients with type 2 diabetes, according to a study published online Feb. 12 in BMJ Open.

 Vitamin D3 could help heal or prevent cardiovascular damage: A new study conducted suggests that a little more sunlight might help restore damage to your cardiovascular system. The study shows that Vitamin D3 -- which is made by the body naturally when skin is exposed to the sun -- can significantly restore the damage to the cardiovascular system caused by several diseases, including hypertension, diabetes and atherosclerosis. Vitamin D3 supplements are also available over-the-counter.

Very Low-Calorie Diet Prompts Brief Heart Function Drop: Very low-calorie diets (VLCD) can cause transient deterioration in heart function, according to a study presented at the European Society of Cardiology's joint EuroCMR/SMCR meeting. "The metabolic improvements with a very low-calorie diet, such as a reduction in liver fat and reversal of diabetes, would be expected to improve heart function. Instead, heart function got worse in the first week before starting to improve.” 

Plant Based Milks: The nutritional differences and health benefits among various plant-based alternative milks are discussed in a review published in the January issue of the Journal of Food Science and Technology. Nutritionally, soy milk is the best alternative for replacing cow's milk. Almond milk also has a balanced nutrient profile and was found to have a better flavor than soy milk, but it has a lower nutrient density and total number of calories compared to cow's milk. Those who consume almond milk should take care to get appropriate quantities of various essential nutrients from other dietary sources. Rice milk and coconut milk cannot act as ideal alternatives to cow's milk due to limited nutrient diversity.

Omega 3 Fatty Acids Not Found to Up Risk of Heart Disease: Supplementation with omega-3 fatty acids is not associated with fatal or nonfatal coronary heart disease or major vascular events, according to a review published online Jan. 31 in JAMA Cardiology. This meta-analysis "provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease.”

TREATMENT

Deep Brain Stimulation Shows Promise for Treating Alzheimer’s Disease: Deep brain stimulation (DBS) of frontal lobe networks show promise for treating Alzheimer’s disease. Journal of Alzheimer’s Disease. 

Low-Intensity Electrical Brain Stimulation Improves Memory: Low-intensity electrical stimulation applied to a specific area can improve verbal short-term memory, according to a study published in Brain. “The most exciting finding of this research is that our memory for language information can be improved by directly stimulating this underexplored brain area.”

Medications to Treat Cardiovascular Risk Factors Do Not Impact Erectile Function: A study into the effects of cholesterol-lowering statins and blood-pressure lowering candesartan/HCTZ concludes that these medications do not negatively affect erectile function (ED). .“Previous research suggests that cardiovascular risk factors such as high blood pressure and cholesterol increase the risk of ED, but there has been little research examining whether modifying these risk factors can impact its development.” Canadian Journal of Cardiology 

NICE Recommends Use of Paracetamol to Relievea Sore Throat Rather Than Antibiotics: The National Institute for Health and Care Excellence (NICE) has published guidance recommending that patients with a sore throat, including pharyngitis and tonsillitis, should not be prescribed antibiotics. Instead doctors should help people to manage their symptoms with pain relief, such as paracetamol or ibuprofen. Evidence reviewed by NICE found most people will get better without antibiotics, usually experiencing symptoms for up to a week. 

Opioid cessation may be more successful when depression is treated: Opioid cessation in non-cancer pain may be more successful when depression is treated to remission, a new study shows. Science Daily

Greater Weight Loss With RYGB in Obese With T2DM at Three Years: For obese adults with type 2 diabetes, Roux-en-Y gastric bypass (RYGB) surgery is associated with greater weight loss, lower hemoglobin A1c (HbA1c), and reduced cardiovascular risk compared with intensive medical diabetes and weight management (IMWM), according to a study published online Feb. 6 in Diabetes Care. 

Drug that treats psoriasis also reduces aortic vascular inflammation: An antibody used to treat the skin disease psoriasis is also effective at reducing aortic inflammation, a key marker of future risk of major cardiovascular events. Researchers led a randomized, double-blind, placebo-controlled study and found patients who took the drug ustekinumab had a 19 percent improvement in aortic inflammation, as measured and confirmed by imaging, when compared to the placebo group. American Academy of Dermatology Annual Meeting in San Diego .

Risk Fracture Risk with Long term use of Inhaled Corticosteroids: Long-term, high-dose use of inhaled corticosteroids (ICSs) is associated with a modest increase in the risk of hip and upper extremity fractures in patients with chronic obstructive pulmonary disease (COPD), according to a study published in the February issue of CHEST.

OTHER

TBI Is Associated With Increased Dementia Risk for Decades After Injury:Traumatic brain injury (TBI) increases the risk of a dementia diagnosis for more than 30 years after a trauma, though the risk of dementia decreases over time, according to a study of164,334 individuals with TBI and matched control participants who did not have TBI. PLOS Medicine.

Severe and lingering symptoms occur in some after treatment for Lyme disease: In a study of 61 people treated for the bacteria that causes Lyme disease, researchers conclude that fatigue, pain, insomnia and depression do indeed persist over long periods of time for some people, despite largely normal physical exams and clinical laboratory testing. Frontiers in Medicine 

Multiple chronic diseases leave patients with adversely high costs: Current strategies for treating patients with several chronic diseases are putting an unnecessary financial burden on countries' health systems and individuals, a global study has found. Experts say that the current clinical practice of tackling each disease in isolation may lead to the prescription of unnecessary medicines, resulting in patient expenses that are disproportionate to the number of conditions they have. BMJ Global Health

Hands over knife for pill cutting: Using your hands may be best for splitting an aspirin tablet, according to a study published online Jan. 24 in the Journal of Pharmacy Practice and Research.