Journal Watch July 2018

CHRONIC PAIN

Anticonvulsant drugs ineffective for low back pain and can cause harm, despite increased prescribing: Anticonvulsant drugs are increasingly being used to treat low back pain, but a new study finds they are ineffective and can have adverse effects. CMAJ 

What a pain: The iPad neck plagues women more: Posture -- not screen time -- is biggest factor behind neck and shoulder pain a new study finds. The condition is more prevalent among young adults than older adults. Women were 2.059 times more likely to experience musculoskeletal symptoms during iPad use than men. Those with a history of neck and shoulder pain reported experiencing more neck and shoulder symptoms during tablet computer use. Journal of Physical Therapy Science

New Rules May Constrain Docs' Ability to Treat Chronic Pain: New laws and regulations designed to limit the use of prescription narcotics may further constrain doctors' ability to treat patients, according to an article published online May 30 in Medical Economics.

New Recommendations Guide Arthritis Pain Management:The European League Against Rheumatism has released recommendations -- published in the June issue of the Annals of the Rheumatic Diseases -- for health professionals to use in approaching pain management in inflammatory arthritis (IA) and osteoarthritis (OA). The task force emphasized the importance for the health professional of adopting a patient-centered framework within a biopsychosocial perspective, having sufficient knowledge of IA and OA pathogenesis, and being able to differentiate localized and generalized pain. Pain treatment usually includes education, which can be complemented with physical activity and exercise; orthotics; psychological and social interventions; sleep hygiene education; weight management; pharmacological and joint-specific treatment options; or interdisciplinary pain management. Pain was consistently positively affected by physical activity and exercise interventions as well as psychological interventions.

COMPLEMENTARY & ALTERNATIVE MEDICINE

Smoking Marijuana May Be Tied to Cough, Sputum Production: Smoking marijuana seems to be associated with increased risk of cough, sputum production, and wheezing, according to a review published online July 3 in the Annals of Internal Medicine. Insufficient evidence for link between marijuana and pulmonary function, obstructive lung disease.

FDA ACTION

• Approves first CGM system with a fully implantable glucose sensor and compatible mobile app for adults with diabetes

• Approved cannabidiol oral solution to treat rare, severe forms of epilepsy

• Approved first catheter-based systems used to create vascular access for hemodialysis patients

• Approved a new device, the Zephyr Endobronchial Valve (Zephyr Valve), intended to treat breathing difficulty associated with severe emphysema.

• Strengthened current warnings in the prescribing information about fluoroquinolone antibiotics causing significant decreases in blood glucose as well as mental health side effects

PREVENTION

In Women, Even Mild Sleep Problems May Increase Blood Pressure: t is well known that chronic sleep deprivation can affect cardiovascular health. However, according to a study published in the Journal of the American Heart Association showed that even mild sleep problems can increase blood pressure in women. Nearly one-third of adults don’t get enough sleep. For women, the problem may be even bigger. Studies suggest that women are at greater risk for sleep problems, with some researchers reporting that chronic insomnia may be twice as common in women as in men.

Weight Loss Reverses Atrial Fibrillation in Patients With Obesity: Patients with obesity who are suffering from atrial fibrillation (AF) can reduce or reverse the effects of the condition by losing weight, according to a study published in Europace. The researchers found that a 10% loss in weight, along with management of associated risk factors, can reverse the progression of the disease. 

Clocking up 45+ working hours/week linked to heightened risk of diabetes in women Sticking to a working week of 30-40 hours may help to curb this risk, suggest researchers. BMJ Diabetes Research & Care

Headers may cause balance issues: Soccer players who head the ball may be more likely to experience short-term balance problems, suggesting that repetitive head impacts could have the potential to cause subtle neurological deficits not previously known, according to a preliminary study. American Academy of Neurology's Sports Concussion Conference

Obesity Affects Prostate Cancer Test Results: The results of the most widely used test for prostate cancer may be affected by obesity, according to a study published in Endocrine-Related Cancer. 

Obesity and Overweight Linked to Long-Term Health Problems After Traumatic Brain Injury:Especially at longer follow-up times, overweight and obesity are associated with chronic disease risks for survivors of moderate to severe traumatic brain injury (TBI), reports a study in the July/August issue of the Journal of Head Trauma Rehabilitation.

Blacks Have Elevated HTN Risk Through Age 55 Years: Blacks have considerably increased risk for hypertension than whites through age 55 years, regardless of blood pressure levels through young adulthood, according to a study published online July 11 in the Journal of the American Heart Association.

Asthma, Uncontrolled Asthma Associated With Risk of A-Fib: There is a correlation for asthma and lack of asthma control with the risk of atrial fibrillation (AF), according to a study published online July 11 in JAMA Cardiology.

Skin Cancer Risk Higher in Military Personnel: There is an increased risk for skin cancer among U.S. active duty service members and veterans, according to a review published in the June issue of the Journal of the American Academy of Dermatology. Increased sun exposure, lack of protection may be responsible for increased risk

Marriage May Protect Against Cardiovascular Disease:Marital status may influence cardiovascular disease (CVD) risk and prognosis after CVD, according to a review published online June 19 in Heart.

AMA Urges Caution With Use of Wire-Bristle BBQ Grill Brushes: The American Medical Association (AMA) states that caution should be exercised with use of wire-bristle grill brushes due to the potential health and safety risks associated with bristles that may break off and adhere to the grill or cooked food.

Prolonged Leisure-Time Sitting Tied to Increased Mortality Risk: Prolonged leisure-time sitting is associated with increased risk of mortality, according to a study published online in the American Journal of Epidemiology. The researchers found that prolonged leisure-time sitting (6+ hours versus <3 activity="" adjustment.="" after="" all-cause="" alzheimer="" and="" association="" cancer="" cardiovascular="" chronic="" correlated="" day="" diabetes="" digestive="" disease="" disorders="" due="" hours="" increased="" independent="" kidney="" level.="" liquids="" liver="" moderate-vigorous="" mortality="" multivariable="" musculoskeletal="" nervous="" obstructive="" of="" other="" parkinson="" pneumonitis="" pulmonary="" risk="" s="" solids="" span="" suicide="" the="" to="" was="" with="">

USPSTF Favors Osteoporosis Screening to Prevent Fracture: The U.S. Preventive Services Task Force (USPSTF) recommends screening for osteoporosis to prevent fractures for women aged ≥65 years and for postmenopausal women aged <65 26="" a="" at="" basis="" final="" findings="" form="" i="" in="" increased="" june="" of="" online="" osteoporosis.="" published="" recommendation="" risk="" statement="" the="" these="" years="">Journal of the American Medical Association

.

Sleep Disruption Increases Risk of Atrial Fibrillation: Sleep disruption consistently predicts risk of atrial fibrillation (AF) before and after adjusting for obstructive sleep apnea, according to a study published online June 25 in Heart Rhythm.

Obesity alone does not increase risk of death: Researchers have found that patients who have metabolic healthy obesity, but no other metabolic risk factors, do not have an increased rate of mortality. The results of this study could impact how we think about obesity and health. Clinical Obesity

NUTRITION/SUPPLEMENTS/VITAMINS

Linked between Consumption of fast food and asthma, other allergic diseases: A new review and analysis of published studies reveals a link between fast food consumption and an increased likelihood of having asthma, wheeze, and several other allergic diseases such as pollen fever, eczema, and rhino-conjunctivitis. Respirology

How a Mediterranean diet could reduce bone loss in osteoporosis: Eating a Mediterranean-type diet could reduce bone loss in people with osteoporosis -- according to new research. New findings show that sticking to a diet rich in fruit, vegetables, nuts, unrefined cereals, olive oil, and fish can reduce hip bone loss within just 12 months. The American Journal of Clinical Nutrition

Vitamin D No Defense Against Multiple Sclerosis, Parkinson’s Disease, Alzheimer’s Disease: Research published in Nutritional Neuroscience has shown that vitamin D is unlikely to protect individuals from multiple sclerosis, Parkinson’s disease, Alzheimer’s disease or other brain-related disorders.

Taking Multivitamins/Minerals Doesn't Improve CVD Outcomes: Multivitamin/mineral (MVM) supplementation seems not to be associated with cardiovascular disease (CVD) outcomes, according to a review published online July 10 in Circulation: Cardiovascular Quality and Outcomes.

Evidence Lacking for ABI for PAD Screen in Asymptomatic: The U.S. Preventive Services Task Force (USPSTF) concludes that there is currently insufficient evidence to assess the benefits and harms of screening for peripheral artery disease (PAD) with the ankle branchial index (ABI) in asymptomatic adults. These findings form the basis of a final recommendation statement published in the July 10 issue of the Journal of the American Medical Association.

Coffee Drinking Found to Lower Risk of All-Cause Mortality: Increased coffee intake may be a beneficial addition to a healthy diet, according to a study published online July 2 in JAMA Internal Medicine. The researchers found that coffee drinking was inversely associated with all-cause mortality. indings were similar for instant, ground, and decaffeinated coffee; across common causes of death; and irrespective of genetic caffeine metabolism score.

Binge Drinking Linked to Increased Systolic BP in Men: For men, binge drinking is associated with increased systolic blood pressure and any drinking is associated with an increased relative risk of hypertension, according to two studies published online June 27 in the Journal of the American Heart Association. 

New research could banish guilty feeling for consuming whole dairy products: Enjoying full-fat milk, yogurt, cheese and butter is unlikely to send people to an early grave, according to new research. The American Journal of Clinical Nutrition

TREATMENT

Tuberculosis Vaccine Improves Blood Sugar in Patients With Type 1 Diabetes: The bacillus Calmette-Guérin vaccine improves haemoglobin A1C (Hb A1C) in patients with longstanding type 1 diabetes, according to a study published in npj Vaccines. “This is clinical validation of the potential to stably lower blood sugars to near normal levels with a safe vaccine, even in patients with longstanding disease.” “In addition to the clinical outcomes, we now have a clear understanding of the mechanisms through which limited bacillus Calmette-Guérin vaccine doses can make permanent, beneficial changes to the immune system and lower blood sugars in type 1 diabetes.”

Human clinical trial reveals verapamil as an effective type 1 diabetes therapy: Researchers have discovered a safe and effective novel therapy to reduce insulin requirements and hypoglycemic episodes in adult subjects with recent onset type 1 diabetes by promoting the patient's own beta cell function and insulin production -- the first such discovery to target diabetes in this manner. Nature Medicine

Apixaban Is Safest Direct Oral Anticoagulant Versus Warfarin: Apixaban seems to be the safest direct oral anticoagulant (DOAC) compared with warfarin, according to a study published July 4 in The BMJ. It reduced risks of major, intracranial, and gastrointestinal bleeding compared with warfarin.

Budesonide With Saline Solution Helpful for Rhinosinusitis: The addition of budesonide to a saline nasal lavage for the treatment of chronic rhinosinusitis provides clinically meaningful benefits, according to a study published online June 7 in JAMA Otolaryngology-Head & Neck Surgery.

Combination of LABA + Inhaled Glucocorticoid Safe in Asthma: Compared to treatment with an inhaled glucocorticoid alone, combination therapy with a long-acting β₂-agonist (LABA) and an inhaled glucocorticoid is not associated with a significantly higher risk of serious asthma-related events, according to a study published online June 27 in the New England Journal of Medicine.

Direct-Acting Antivirals Effective for Hepatitis C in Seniors: For older patients with hepatitis C virus (HCV), direct-acting antiviral (DAA) therapy is effective, according to a study published online May 25 in the Journal of the American Geriatrics Society. Those aged 75 and older are more likely to have clinically significant pretreatment DDIs and experience AEs, including ribavirin-induced anemia, during therapy.

OTHER

11.2% of U.S. Adults Aged ≥45Report Subjective Mental Decline: More than 11 percent of adults aged ≥45 years in the United States report subjective cognitive decline (SCD), according to research published in the July 13 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Honey Smacks Cereal Salmonella Tainted: One hundred people across 33 states have now fallen ill with Salmonella after eating Kellogg's Honey Smacks cereal, according to the U.S. Centers for Disease Control and Prevention. Many of the illnesses linked to the Salmonella Mbandaka strain have been severe -- so far, 30 people have been hospitalized, although no deaths have been reported. The illnesses first surfaced in early March and have continued, with the last illnesses reported on July 2. 

Tick-Caused Meat Allergy on the Rise in the United States: Red meat allergy caused by a bite from the lone star tick appears to be on the rise in the United States, a researcher says. More than 5,000 cases have been reported in the United States, up from 3,500 two years ago, according to Tara Narula, M.D., of the University of North Carolina at Chapel Hill, CBS News reported. The lone star tick is most common in the South, but is also found in much of the eastern United States. The ticks may be spreading to new areas as temperatures rise, research suggests. 

PCPs Often Not Meeting Needs of Seniors With Chronic Conditions: 86 percent of primary care providers (PCP) feel unable to adequately address needs of patients with multiple chronic conditions. Quest Diagnostics

WHO Calls for Renewed Effort to Combat Chronic Disease:The World Health Organization (WHO) Independent High-Level Commission has proposed six recommendations to address the growing epidemic of non-communicable diseases (NCDs), according to a report published online June 1 in The Lancet. The report includes six recommendations: (1) increased political leadership and responsibility from heads of state and governments; (2) prioritization and scaling up of a specific set of priorities within the overall NCD and mental health agenda; (3) identification of synergies within existing chronic care platforms; (4) increased government regulation and collaboration with the private sector and civil society; (5) increased financing of programs addressing NCDs; and (6) improved accountability to ensure commitments made by governments and the private sector are delivered.