CHRONIC PAIN
Simple, cost effective treatment following failed back surgery shows promise: Failed
back surgery (continued low back and leg pain after surgery) is relatively
common. With each reoperation, success, as defined by pain reduction, becomes
less likely and most patients do not improve. However, preliminary studies
using a simple procedure to remove scar tissue or adhesions suggests a new
treatment could help those with post-surgical, chronic low back pain. Pain
Medicine
Can chiropractic care disrupt vision? In rare occurrences, forceful manipulation of neck is
linked to damaging side effect. For
those in the habit of getting their neck adjusted by a chiropractor, there's an
interesting case to know about: High velocity neck manipulation has been shown
to create stress on the eye and lead to spotty vision. American Journal of
Ophthalmology Case Reports
Sex differences in brain activity alter pain therapies: A female brain's resident immune cells
are more active in regions involved in pain processing relative to males,
according to a recent study. The study, published in the Journal of
Neuroscience, found that when microglia, the brain's resident immune cells,
were blocked, female response to opioid pain medication improved and matched
the levels of pain relief normally seen in males. Women suffer from a higher
incidence of chronic and inflammatory pain conditions such as fibromyalgia and
osteoarthritis. While morphine continues to be one of the primary drugs used
for the treatment of severe or chronic pain, it is often less effective in
females.
New hope for people with fibromyalgia: A novel psychological therapy that encourages addressing
emotional experiences related to trauma, conflict and relationship problems has
been found helpful for people with the chronic pain condition fibromyalgia. Pain
Migraine can be treated without medicine, pilot study finds: Some migraine patients can cut
down on medication or stop using it completely by using a newly developed
inhaler which changes the composition of the air we breathe, according to
results of a recent pilot study. By
slightly changing the body's own molecules using a small inhaler, certain
migraine patients can either cut down on medication or do without it
completely. Cephalalgia
Payer Policies May Discourage Non-Pharma Tx for Low Back Pain: Physical therapy, psychological counseling, other
alternatives not consistently covered. There is a need for public and private
insurers to broaden their coverage policies for non-drug pain treatments for
low back pain, according to a study published online Oct. 5 in JAMA Network
Open.
Inflammatory Back Pain Resolves in Many Patients:
Inflammatory back pain (IBP) often resolves, while in 30 percent of patients it
progresses to spondyloarthritis (SpA) within 10 years, according to a study
published in a recent issue of Arthritis & Rheumatology.
COMPLEMENTARY & ALTERNATIVE MEDICINE
Alternative Medicines May Aid
in the Treatment of Psoriasis: Some complementary and alternative medicines (CAMs) may be
helpful in the treatment of psoriasis, according to a review published online
Sept. 5 in JAMA Dermatology. Compared with placebo, topical indigo
naturalis showed significant improvements in psoriasis. Curcumin showed
statistically and clinically significant improvements in psoriasis plaques.
Twenty studies evaluated fish oil treatment, with most RCTs showing no
significant improvement in psoriasis; however, most uncontrolled studies showed
benefit with daily use. There was modest efficacy associated with meditation
and guided imagery therapies. Acupuncture showed significant improvement in one
meta-analysis of 13 RCTs versus placebo.
Even mild physical activity immediately improves memory function People who include a little
yoga or tai chi in their day may be more likely to remember where they put
their keys. Researchers at the University of California, Irvine and Japan's
University of Tsukuba found that even very light workouts can increase the
connectivity between parts of the brain responsible for memory formation and
storage. Proceedings
of the National Academy of Sciences
Weight Loss Can Be Boosted 5-Fold With Novel Mental Imagery Technique: Overweight people who used a new motivational intervention called
Functional Imagery Training (FIT) lost an average of 5 times more weight than
those using talking therapy alone, according to a study published in the International
Journal of Obesity.
FDA ACTION
• Approves PK Papyrus Covered Coronary
Stent System, a device intended to treat acute coronary artery perforations, or
tears in the blood vessels of the heart.
•
Approves Moxetumomab Pasudotox-tdfk for hairy cell leukemia
• Approves
new dosage strength of buprenorphine and naloxone sublingual film as
maintenance treatment for opioid dependence
• Approved
Libtayo injection for intravenous use for the treatment of metastatic cutaneous
squamous cell carcinoma or locally advanced CSCC who are not candidates for
curative surgery or radiation
• Permitted
marketing of ClonoSEQ assay, a next generation sequencing (NGS)-based test for
minimal residual disease (MRD) in patients with acute lymphoblastic leukemia
(ALL) or multiple myeloma.
• Approved Arikayce (amikacin liposome inhalation
suspension), for the treatment of lung disease caused by a group of bacteria,
Mycobacterium avium complex (MAC) in a limited population of patients with the
disease who do not respond to conventional treatment (refractory disease).
• Approved Gardasil
9 human papillomavirus (HPV) vaccine being expanded to include people ages 27
through 45
• Approved
marketing of Bose Hearing Aid, a user-fitted device for people 18 and older
with mild-to-moderate hearing loss
PREVENTION
Effect of Aspirin on Disability Free Survival: Aspirin use in healthy elderly persons did not prolong
disability-free survival over a period of 5 years but led to a higher rate of
major hemorrhage than placebo. NEJM
Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly: The
use of low-dose aspirin as a primary prevention strategy in older adults
resulted in a significantly higher risk of major hemorrhage and did not result
in a significantly lower risk of cardiovascular disease than placebo. NEJM
Effect of Aspirin on All-Cause Mortality in the Healthy Elderly: Higher all-cause mortality was
observed among apparently healthy older adults who received daily aspirin than
among those who received placebo and was attributed primarily to cancer-related
death. In the context of previous studies, this result was unexpected and
should be interpreted with caution. NEJM
Low-Dose Aspirin May Reduce Ovarian Cancer Risk:
Low-dose aspirin use is associated with a reduced risk for ovarian cancer,
according to a study published online Oct. 4 in JAMA Oncology.
Long-Term Aspirin Use Linked to Reduction in Liver Cancer Risk: Regular long-term aspirin use is associated with a
dose-dependent reduction in the risk for hepatocellular carcinoma (HCC),
according to a study published online Oct. 4 in JAMA Oncology.
Cooking with wood or coal is linked to increased risk of respiratory illness and death: Burning
wood or coal to cook food is associated with increased risk of hospitalization
or dying from respiratory diseases. American Thoracic Society
Web-Based Lifestyle Program
Works for Liver Disease Patients: Web-based programs may be effective in helping patients
make lifestyle changes to control non-alcoholic fatty liver disease (NAFLD),
according to a study published in the November issue of the Journal of
Hepatology.
Weight Loss May Cut Breast CA Risk in Postmenopausal Women: Postmenopausal women with weight loss have a reduced risk
for breast cancer, according to a study published online Oct. 8 in Cancer.
Sexual
Harassment, Assault Tied to Women's Health Issues: Sexual harassment and sexual
assault among midlife women are associated with poorer physical and mental
health, according to a study published online Oct. 3 in JAMA Internal
Medicine.
NUTRITION/SUPPLEMENTS/VITAMINS
High-Dose Vitamin DSupplementation May Have Beneficial Effect on Bone Microarchitecture in Seniors: Long-term,
high-dose vitamin-D supplementation of 2,000 IU daily may have a slight
beneficial effect on bone microarchitecture in seniors, according to results of
a double-blind study presented at the 2018 Annual Meeting of the American
Society for Bone and Mineral Research (ASBMR).
Cases Show Periodic Fasting
May Cut Medication Use in T2DM: Medically supervised, therapeutic fasting regimens can help
reverse type 2 diabetes (T2D) and minimize the need for pharmacological
interventions, according to a case series published online Oct. 9 in BMJ
Case Reports.
Active Pharmaceuticals ID'd
in >700 Dietary Supplements: Dietary supplements often include active pharmaceuticals,
even after warnings from the U.S. Food and Drug Administration, according to a
study published online Oct. 12 in JAMA Network Open. The researchers
found 776 FDA-identified adulterated dietary supplements, with 146 companies
implicated. Most of the products were marketed for sexual enhancement, weight
loss, or muscle building.
Consuming Caffeine From Coffee Reduces Incident Rosacea: Caffeine intake from coffee is inversely associated with
the risk for incident rosacea, according to a study published online Oct. 17 in
JAMA Dermatology. There was no correlation between increased caffeine
intake from foods other than coffee and decreased risk for rosacea.
Daily Drinking Associated With Increased Mortality Risk: Daily drinking, even at low levels, may be detrimental to
one's health, according to a study published online Oct. 3 in Alcoholism:
Clinical & Experimental Research. Minimum risk of low-level drinking
frequency for all-cause mortality found to be about three times weekly.
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Modest Alcohol Consumption May Reduce Mortality in Nonalcoholic fatty liver disease: For patients with
nonalcoholic fatty liver disease (NAFLD), modest alcohol consumption is
associated with a reduction in all-cause mortality, while drinking 1.5 or
more drinks per day may increase mortality, according to a study recently
published in Hepatology.
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Increasing Water Intake Can Cut Cystitis Recurrence: For women at high risk for cystitis recurrence
who drink low volumes of fluid daily, increasing water intake prevents
recurrence, according to a study published online Oct. 1 in JAMA Internal
Medicine.
TREATMENT
Inhaled Steroids May Increase Risk of Non tuberculous Mycobacteria Lung Infections: Patients
using inhaled steroids to control asthma and other breathing problems may be at
greater risk for developing nontuberculous mycobacteria (NTM) lung infections,
according to new research published online in the Annals of the American
Thoracic Society. Although they cannot be spread from person to person, NTM
are difficult to treat and can cause serious illness, and even death.
Patients Report Myriad Side Effects With Use of Oral Corticosteroids for Severe Asthma: In
response to an online survey, 1,210 people with severe asthma who had used oral
corticosteroids reported quality of life (QoL) issues that are often overlooked
by conventional assessment tools, according to findings presented here at the
2018 International Congress of the European Respiratory Society (ERS). Side
effects mentioned included weight gain, anxiety, and heightened emotional
moods.
Severe Asthma Exacerbations Controlled with Dupilumab in Patients With Comorbid ChronicRhinosinusitis and/or Nasal Polyposis: Dupilumab
consistently reduced the rate of severe
exacerbations in moderate to severe
asthma and showed comparative efficacy in patients with and without comorbid
chronic rhinosinusitis or nasal polyposis (CRS/NP), according to a post hoc
analysis of the phase 3 Liberty Asthma QUEST trial presented here at the 2018
International Congress of the European Respiratory Society (ERS).
Eradicating Helicobacter pylori Infections May Be a Key Treatment for Parkinson’s Disease: A study published in the Journal of Parkinson’s Disease suggests that Helicobacter pylori may play a role in Parkinson’s disease (PD) as well. A literature review to explore the association between H pylori and PD.uncovered 4 key findings: People with PD were 1.5 to 3 times more likely to be infected with H pylori than people without PD. Patients with PD and H pylori displayed worse motor functions than patients with PD who did not have H pylori. Eradication of H pylori improved motor function in patients with PD compared with patients whose infection was not eradicated.Eradication of H pylori improved levodopa absorption in patients compared with those whose infection was not eradicated.
Baloxavir Marboxil Appears Safe and Effective for Treatment of Acute Influenza: Baloxavir
marboxil (BXM), an oral selective cap-dependent endonuclease inhibitor, is safe
and effective for treating acute influenza in otherwise healthy patients,
according to a study presented here at ID Week 2018, the 56th Annual Meeting of
the Infectious Diseases Society of America (IDSA).
Oral Vaccination for Influenza Is Protective: An oral vaccine to a prevalent influenza strain is
protective and induces a mucosal immune response at least as good as a
commercial injectable quadrivalent influenza vaccine, according to a study
presented here at ID Week 2018, the 56th Annual Meeting of the Infectious
Diseases Society of America (IDSA).
Triple Combo Regimens May Address Cause of Cystic Fibrosis: Triple therapy with VX-659 or VX-445 combined with
tezacaftor-ivacaftor shows promise for the treatment of adult patients with
cystic fibrosis who have mutations in the cystic fibrosis transmembrane
conductance regulator (CFTR), according to two studies published online Oct. 18
in the New England Journal of Medicine. The studies were published to
coincide with presentation at the annual North American Cystic Fibrosis
Conference, held from Oct. 18 to 20 in Denver.
Limited Evidence for OTC
Preps to Treat Nasal Symptoms of Colds: Limited evidence is available for over-the-counter (OTC)
treatments for nasal symptoms of the common cold, according to a report
published online Oct. 10 in The BMJ. For adults, low-quality evidence
suggests that decongestants may have a small effect on nasal symptoms; however,
harms include increased risk for insomnia, drowsiness, headache, or
gastrointestinal upset, and long-term use can lead to chronic nasal congestion.
No evidence of nasal symptom relief was seen for other commonly used OTC
treatments. Evidence for common cold treatments is more limited in children,
with trials lacking for children younger than 12. Low-quality evidence suggests
that saline irrigations or drops may be effective and safe in young children.
Evidence for decongestants is limited, and their safety is unclear, especially
in young children. Serious harms have been linked to decongestant use in very
young children. Adequate evidence is not available to support other commonly
used OTC and home treatments.
Hormone Therapy Not Beneficial in Subclinical Hypothyroidism: No benefit regarding quality of life or thyroid-related
symptoms found for thyroid hormone therapy. Thyroid hormone therapy is not
associated with improvements in general quality of life or thyroid-related
symptoms in non-pregnant adults with subclinical hypothyroidism, according to a
review published in the Oct. 2 issue of the Journal of the American Medical
Association.
Zoledronate Lowers Fracture Risk in Women With Osteopenia: The risk for fragility fractures is significantly lower in
women with osteopenia who receive zoledronate than in those who receive
placebo, according to a study published online Oct. 1 in the New England
Journal of Medicine.
ADA, EASD Issue New Recommendations for T2DM: Recommendations
for the management of type 2 diabetes have been updated, according to a
consensus report by the American Diabetes Association (ADA) and the European
Association for the Study of Diabetes (EASD) published online Oct. 5 in Diabetes
Care.
Digital Cognitive Therapy Eases Daytime Effects of Insomnia: Digital cognitive behavioral therapy (dCBT) is effective in
improving functional health, psychological well-being, and sleep-related
quality of life in people reporting insomnia, according to a study published online
Sept. 25 in JAMA Psychiatry.
Albiglutide Beats Placebo for Cardiovascular Events in T2DM: For patients with type 2 diabetes
and existing cardiovascular disease, albiglutide results in fewer
cardiovascular events, according to a study published online Oct. 2 in The
Lancet. In 2017, GlaxoSmithKline withdrew the glucagon-like peptide 1
(GLP-1) receptor agonist albiglutide for commercial reasons.
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Gastric Banding, Metformin Similar for Improving Glycemia: In adults with moderate obesity and either impaired
glucose tolerance (IGT) or recently diagnosed mild type 2 diabetes (T2D),
gastric banding and metformin are similarly effective for slowing disease
progression over a two-year period, according to a study published online
Oct. 3 in Diabetes Care.
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OTHER
Sharp Drop in U.S. Life
Expectancy Rankings by 2040: U.S. expected to fall from 43rd in 2016 to 64th by 2040,
with an average life expectancy of 79.8. Drug-related deaths and obesity are
believed to be major factors in the decline, CNN reported. There were
63,600 accidental drug overdose deaths in 2016, and nearly 40 percent of adults
and 18.5 percent of children are obese.
Violent Video Games Tied to Physical Aggression: A meta analysis, including multiple
ages, nationalities and ethnicities found that playing violent video games is
associated with subsequent increases in physical aggression. Proceedings of
the National Academy of Sciences.
Aetna-CVS Merger Approved: Under the approval, Aetna
must sell off its private Medicare drug plans
Price Hikes Noted in Small Subset of Generic Drugs: A small but growing subset of
generic drugs experienced sudden large price increases from 2007 to 2013,
according to a study published in the October issue of Health Affairs.
Most of these medications were initially low or medium in price and were not
among the most widely used generics. There were modest changes in out-of-pocket
spending for these drugs. The price elevation lasted for two to five years.
Similar trends were seen with data for 2011 to 2015.
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