CHRONIC PAIN
Noninvasive Brain Stimulation May Help Prevent Migraines:
Single-pulse transcranial magnetic stimulation device is safe and easy to use.
The efficacy and tolerability of single pulse transcranial magnetic stimulation
(sTMS) for the preventive treatment of migraine among 263 individuals with
migraine (December 2014 to March 2016) was studied. Participants completed a
one-month baseline headache diary followed by three months of treatment,
including preventive (four pulses twice daily) and acute (three pulses repeated
up to three times for each attack) treatment. The researchers observed a mean
reduction of 2.75 headache days from baseline versus the performance goal (0.63
fewer headache days; P < 0.0001). Similarly, the 50 percent responder rate
of 46 percent also significantly exceeded (P < 0.0001) the performance goal
(20 percent). Compared to the performance goal, there were also significant
reductions in acute medication use (P < 0.0001) and total headache days of
any intensity (P < 0.0001). There were no serious adverse events reported,
but there were reports of lightheartedness (3.7 percent), tingling (3.2
percent), and tinnitus (3.2 percent). Cephalalgia.
Erenumbab Shows Promise for Hard to Treat Migraine: For patients with
episodic migraine who have failed prior preventive migraine treatments (PMTs),
erenumab is associated with an increase in the proportion of patients achieving
a ≥50 percent reduction in mean monthly migraine days (MMDs), according to a
study presented at the annual meeting of the American Academy of Neurology
Study finds 31% Don’t use Opioids After Surgery: Almost 63 percent
of patients did not use opioids after having an elective procedure, according
to a study presented at the annual meeting of the American Surgical Association
Opiate Use Linked to Early Mortality in IBD
Patients: Heavy use in
Crohn's, heavy or moderate use in ulcerative colitis tied to increased risk of
death. Clinical Gastroenterology and Hepatology
Ibuprofen, acetaminophen more effective thanopioids in treating dental pain: Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs)
alone or in combination with acetaminophen are better at easing dental pain
than opioids, according to new research that included 460 published studies. JOADA
COMPLEMENTARY & ALTERNATIVE MEDICINE
Medical marijuana gets wary welcome from older adults, poll shows: Few
older adults use medical marijuana, a new national poll finds, but the majority
support its use if a doctor recommends it, and might talk to their own doctor
about it if they developed a serious health condition. And two-thirds say the
government should do more to study the drug's health effects. Science Daily
Position statement: Avoid using medical marijuana to treat sleep apnea:
Medical cannabis and synthetic marijuana extracts should not be used for the
treatment of obstructive sleep apnea, according to a position statement from
the American Academy of Sleep Medicine.
School-based yoga can help children better
manage stress and anxiety: Participating in yoga and mindfulness activities at school helps third-graders
exhibiting anxiety improve their well-being and emotional health, according to
a new study. Psychology Research and Behavior Management
Practicing Tai Chi helps improve respiratory function in patients with COPD: Currently, pulmonary rehabilitation (PR) is used where available to
improve exercise capacity and quality of life, but the treatment requires
access to trained staff and specialized facilities. A new study looked at Tai
Chi as a lower cost, more easily accessed treatment option. Investigators found
that this slow, methodical form of exercise is equivalent to PR for improving
respiratory function in patients with COPD. Chest
Mind and Body Approaches for Substance Use Disorders from the National Center for Complementary and Integrative Health: Mindfulness-based approaches have
shown some success when applied to the treatment of substance abuse and
addiction. To date, there is not enough consistent data to support the use of
acupuncture for substance use outcomes; however, there are some findings that
suggest acupuncture may have positive effects as an adjunctive therapy for
withdrawal/craving and anxiety symptoms. Only a few high-quality studies on
acupuncture for smoking cessation have been conducted, so firm conclusions
about its effectiveness cannot be drawn.
Small link for cannabis use, reduced cognitive functioning: For
adolescents and young adults, frequent or heavy cannabis use has a small
association with reduced cognitive functioning, according to research published
online April 18 in JAMA Psychiatry.
FDA ACTION
• Approves the
first medical device to use artificial intelligence to detect greater than a
mild level of diabetic retinopathy in adults who have diabetes.
• Authorizes new use of test, first to identify the
emerging pathogen Candida auris
• Approves first therapy for rare inherited form of rickets,
x-linked hypophosphatemia
• Takes steps
to protect consumers against dietary supplements containing dangerously high
levels of extremely concentrated or pure caffeine
• Clears first
contact lens with light adaptive technology
• Restricts
sale and distribution of Essure
• Expands
approval of Bilincyto for treatment of a type of leukemia in patients who have
a certain risk factor for relapse
• Authorizes first
fully interoperable continuous glucose monitoring system
• Expands
approval of Adcetris for first line treatment of Stage III or IV classical
Hodgkin lymphoma in combination with chemotherapy
PREVENTION
Music intensifies effects of
anti-hypertensive medication:
Research shows anti-hypertensive drugs improve heart rate more in patients who
listen to music after taking medication. Among musical genres, classical music
is the one with greatest efficiency at reducing arterial pressure; authors of
the study speculate whether music acts on the patients' parasympathetic system,
increasing their capability of absorbing medication. Scientific Reports
Lingering negative responses to stress linked with health a decade later:
People whose negative emotional responses to stress carry over to the following
day are more likely to report health problems and physical limitations later in
life compared with peers who are able to 'let it go.' Psychological Science
Number of Cigarettes Smoked Daily Tied to Stroke Risk: Among men
younger than 50, more cigarettes smoked linked to increased risk of ischemic
stroke. Stroke
Exercise Prevents Falls in Elderly: The U.S. Preventive Services Task Force
(USPSTF) concludes that exercise interventions may be beneficial for preventing
falls in older adults; however, the evidence is insufficient to weigh the
benefits and harms of vitamin D, calcium, and combined supplementation. These
findings form the basis of two recommendation statements published April 17 in
the Journal of the American Medical Association.
Exercise Best Defense for those at Genetic Risk for CVD: Fitness and physical
activity are tied to lower risk of incident cardiovascular disease in the
general population and among individuals with elevated genetic risk for
cardiovascular diseases, according to a study published online April 9 in
Circulation.
TBI Associated with Increased Risk of
Subsequent Dementia:
Traumatic brain injury (TBI) is associated with increased risk of dementia,
according to a study published online April 10 in The Lancet Psychiatry.
NUTRITION/SUPPLEMENTS/VITAMINS
Dietary supplement shows promise for
reversing cardiovascular aging:A novel nutraceutical called nicotinomide riboside (NR_ has been found to
kick-start the same biological pathways as calorie restriction does, and boost
arterial health in people with mild hypertension. Supplementation
also tends to improve blood pressure and arterial health, particularly in those
with mild hypertension, the study found. The researchers found that 1,000 mg
daily of NR boosted levels of another compound called nicotinamide adenine
dinucleotide (NAD+) by 60 percent. NAD+ is required for activation of enzymes
called sirtuins, which are largely credited with the beneficial effects of
calorie restriction. It's involved in a host of metabolic actions throughout
the body, but it tends to decline with age.Nature Communications
n-3 Fatty Acids Don't Seem to Be of Any Benefit in Dry Eye Disease:
Supplementation with n-3 fatty acids is not associated with significant benefit
in dry eye disease, according to a study published online April 13 in the New
England Journal of Medicine
Consuming more than five drinks a week could shorten your life: Even
moderate alcohol drinking linked to heart and circulatory diseases, study finds.
drinking
more alcohol is associated with a higher risk of stroke, fatal aneurysm, heart
failure and death. The study compared the health and drinking habits of over
600,000 people in 19 countries worldwide and controlled for age, smoking,
history of diabetes, level of education and occupation. Findings challenge the
widely held belief that moderate drinking is beneficial to cardiovascular
health, and support the UK's recently lowered guidelines. The Lancet
Links between eating red meat and distal colon cancer in women: A new
study suggests that a diet free from red meat significantly reduces the risk of
a type of colon cancer in women living in the United Kingdom. When comparing
the effects of certain diets to cancer development in specific subsites of the
colon, scientists found that those regularly eating red meat compared to a red
meat-free diet had higher rates of distal colon cancer -- cancer found on the
descending section of the colon, where feces is stored. International Journal of Cancer
People with Type 2 diabetes who eat breakfast later, more likely to have a higher BMI: Being an "evening person" is linked to higher body mass
indices among people with Type 2 diabetes, and having breakfast later in the
day seems to be what drives this association, according to a new article. Science
Daily
High omega-6 levels can protect against premature death: Could
omega-6 fatty acids protect you against premature death? The answer is yes,
according to a new study. While protecting against death, omega-6 fatty acids
also keep cardiovascular diseases at bay. “Linoleic acid is the most common
polyunsaturated omega-6 fatty acid. We discovered that the higher the blood
linoleic acid level, the smaller the risk of premature death,” says one of the
researchers. The American Journal of Clinical Nutrition
Raw fruit and vegetables provide better mental health outcomes: Researchers
have discovered raw fruit and vegetables may be better for your mental health
than cooked, canned and processed fruit and vegetables. Frontiers in Psychology
Nut Consumption Associated with Reduced Risk
of A-Fib: Nut consumption
is associated with reduced risk of atrial fibrillation, according to a study
published online April 16 in Heart.
Eating Pecans May Cut Risk of Cardiovascular
Disease, Diabetes: Benefits seen
in markers of cardiometabolic disease, including insulin sensitivity Nutrients
Coffee Consumption Cuts Coronary Artery Calcification: Odds of coronary calcification significantly
lower for never smokers drinking more than 3 cups/day. Journal of the American
Heart Association
Antiepileptic Drugs Increase Risk ofAlzheimer’s Disease, Dementia:
The use of antiepileptic drugs is associated with an increased risk of
Alzheimer’s disease and dementia, according to a study published in the Journal
of the American Geriatrics Society. Continuous use of
antiepileptic drugs for a period exceeding 1 year was associated with a 15%
increased risk of Alzheimer’s disease and with a 30% increased risk of
dementia.
Blue-Light Therapy May Reduce Anxiety, Sleep Difficulties After Mild Traumatic Brain Injury: Morning use of blue-light therapy may
increase cortical volume and help reduce trait anxiety and sleep difficulties
in people with mild traumatic brain injury, according to preliminary findings
of a prospective study presented at the 38th Annual Meeting of the Anxiety and
Depression Association of America (ADAA).
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Pembrolizumab
is associated with significantly longer recurrence-free survival than placebo
as adjuvant therapy for high-risk stage III melanoma, according to a study
published online April 15 in the New England Journal of Medicine.
Fecal microbiota transplantation produces sustained improvements in cognitive and clinical outcomes: A single treatment using an
optimized, targeted form of fecal microbiota transplantation (FMT) produces
sustained clinical and cognitive improvements, according to the results of a
long-term follow-up of patients with liver cirrhosis and hepatic
encephalopathy (HE) who had participated in a short-term study. The original,
randomized, open label study, which enrolled 20 outpatient men with cirrhosis
and recurrent HE receiving standard-of-care (SOC) treatment, had previously
reported that a single FMT enema after antibiotic pretreatment improved
cognitive function at Day 20 and reduced HE episodes and hospitalizations
over the following 5 months compared with SOC.1 The long-term outcomes of
this study, which were presented today at The International Liver Congress™
2018 in Paris, France, demonstrated sustained and statistically significant
reductions in the number of HE episodes and hospitalizations as well as
improvements in cognitive function over 1 year in the men who received FMT
compared with the control group.
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Neuromodulation Therapy Gives Relief FromHand Tremor:
Non-invasive neuromodulation therapy using a custom stimulation pattern
provides symptomatic relief from hand tremor in essential tremor, according to
a study presented at the annual meeting of the American Academy of Neurology
Triple Therapy Tied to Reduced Rate of COPD Exacerbations: Benefits seen
for triple therapy with fluticasone furoate, umeclidinium, and vilanterol. NEJM
Calcium Channel Blockers May up Cancer Risk in Women: Use of
short-acting calcium channel blockers (CCBs) is associated with increased risk
of pancreatic cancer in postmenopausal women, according to a study presented at
the annual meeting of the American Association for Cancer Research.
OTHER
Physicians devise emergency and trauma care referral map for US: In
response to repeated calls for an integrated emergency care system in the US,
physicians rose to the challenge and divided the nation into hundreds of
referral regions that describe how patients access advanced care, in a way that
respects geopolitical borders. Annals of Emergency Medicine
Three-Quarters of COPD Cases Are Linked to Childhood Risk Factors That Are Exacerbated in Adulthood: Three-quarters of chronic obstructive
pulmonary disease (COPD) cases have their origins in poor lung function
pathways beginning in childhood. These pathways are associated with exposures
in childhood, and amplified by factors in adulthood, according to a study
published in The Lancet Respiratory Medicine. While smoking
remains the biggest risk factor for COPD, the study demonstrates that childhood
illnesses (such as asthma, bronchitis, pneumonia, allergic rhinitis, eczema)
and exposures to parental smoking are also linked to the disease. A second
study in the journal also suggests that there could be a window of opportunity
during childhood to reduce the risk of poor lung function in later life. Both
studies identified pathways of how lung function changes over life, which are
associated with different risk factors and disease risk in later life. The
authors said that these insights are important for lung disease prediction,
prevention, and treatment.
Most
Doctors' Offices Don't Offer Flexibility for Uninsured:Most uninsured patients can make primary care appointment but only if can pay
full cash amount. Health Affairs
Age affects how we predict and respond to stress at home: A recent study finds that older adults
are better than younger adults at anticipating stressful events at home -- but
older adults are not as good at using those predictions to reduce the adverse
impacts of the stress. The Journals of Gerontology
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