CHRONIC PAIN
New Guidelines Issued for Patellofemoral Pain Management: The National Athletic Trainers'
Association has issued recommendations for identifying and managing patients
with patellofemoral pain (PFP); these recommendations form the basis of a
position statement published in the September issue of the Journal of Athletic
Training.
Back pain shows significant association with mortality among older women: Researchers found
that frequent, persistent back pain is associated with earlier death in a study
of more than 8,000 older women who were followed for an average of 14 years.
Journal of General Internal Medicine
Pain can be a self-fulfilling prophecy: A new brain imaging study of 34 people found that
when people expect to feel intense pain, they do, even if they aren't subjected
to painful stimuli. Surprisingly, these false expectations can persist even
when reality demonstrates otherwise, the study found. Nature Human Behaviour, 2018; 2
only small pain relief for tennis elbow, according
to a review published online Oct. 31 in the American Journal of Sports Medicine.
Only local corticosteroid injection improved pain at short-term follow-up;
however, it was associated with pain worse than placebo at long-term follow-up.
Laser therapy and local botulinum toxin injection improved pain at midterm
follow-up. Extracorporeal shock wave therapy provided pain relief at long-term
follow-up. Only laser therapy showed better outcomes for grip strength compared
with placebo. All treatments increased adverse events compared with placebo.
After receiving placebo, most patients experienced pain resolution within four
weeks of follow-up.
COMPLEMENTARY & ALTERNATIVE MEDICINE
Quitting Cannabis Tied to Improved Memory: Abstaining from cannabis is associated with
improvements in memory and verbal learning in adolescents and young adults,
according to a study published online Oct. 30 in the Journal of Clinical
Psychiatry.
New insights into the neural risks and benefits of marijuana use: Compounds in cannabis can
impair or improve memory depending on age, disease: Research underscores both
the dangers and the therapeutic promise of marijuana, revealing different
effects across the lifespan. Marijuana exposure in the womb or during
adolescence may disrupt learning and memory, damage communication between brain
regions, and disturb levels of key neurotransmitters and metabolites in the
brain. In Alzheimer's disease, however, compounds found in marijuana, such as
the psychoactive compound delta-9-tetrahydrocannabinol (THC), may improve
memory and mitigate some of the disease's symptoms. Society for Neuroscience
Home-based biofeedback therapy is effective option for tough-to-treat constipation: Biofeedback
therapy used at home is about 70 percent effective at helping patients learn
how to coordinate and relax bowel muscles and relieve one of the most
difficult-to-treat types of constipation, investigators report. Lancet Gastroenterology &
Hepatology
Singing may reduce stress, improve motor function for people with Parkinson's disease: Singing
may provide benefits beyond improving respiratory and swallow control in people
with Parkinson's disease, according to new data. The results from the pilot
study revealed improvements in mood and motor symptoms, as well as reduced physiological
indicators of stress as well as reduced physiological indicators of stress.
Society for Neuroscience 2018 conference.
Blue light can reduce blood pressure, study suggests: Exposure to blue light decreases blood
pressure, reducing the risk of developing cardiovascular disease, a new study
suggests. During this study, published in the European Journal of Preventative
Cardiology, participants were exposed to 30 minutes of whole-body blue light at
approximately 450 nanometres, a dose comparable to daily sunlight -- followed
by exposure to a control light on a different day. Visible blue light, as
opposed to ultraviolet (UV) light, is not carcinogenic. To assess the impact,
participants' blood pressure, stiffness of arteries, blood vessel dilation and
blood plasma levels of nitric oxide stores were measured before, during, and up
to two hours after irradiation with both lights. Researchers discovered that exposure
to whole-body blue light significantly reduced the systolic blood pressure of
participants by almost 8 mmHg, compared to the control light which had no
impact. The reduction of blood pressure from blue light is similar to what is
seen in clinical trials with blood pressure lowering drugs.
FDA ACTION
• Approved an
extremely potent new opioid painkiller, Dsuvia
• Approving a ban on
most flavored E cigarettes in retail stores and gas stations
• Approved New
Version of Over the Counter Primatene Mist
• Approved Aemcolo (rifamycin),
an antibacterial drug indicated for the treatment of adult patients with
travelers’ diarrhea caused by noninvasive strains of Escherichia coli
(E. coli), not complicated by fever or blood in the stool.
• Expanded
the approved use of Adcetris (brentuximab vedotin) injection in combination
with chemotherapy for adult patients with certain types of peripheral T-cell
lymphoma (PTCL).
•
Warned patients and doctors, who use at-home or in-the-office medical devices
to monitor levels of the blood thinner, warfarin, that certain test strips used
with the devices may provide inaccurate results and should not be relied upon
to adjust the drug dosage.
•
Permitted marketing, with special controls, of the 23andMe Personal Genome
Service Pharmacogenetic Reports test as a direct-to-consumer test for providing
information about genetic variants that may be associated with a patient’s
ability to metabolize some medications to help inform discussions with a health
care provider. The FDA is authorizing the test to detect 33 variants for
multiple genes.
•
Permitted marketing of the PicoAMH Elisa diagnostic test as an aid in the
determination of a patient’s menopausal status
•
Approved Xofluza (baloxavir marboxil) for the treatment of acute uncomplicated
influenza (flu) in patients 12 years of age and older who have been symptomatic
for no more than 48 hours.
PREVENTION
Age to Stop Cervical Cancer Screening Depends on Test Used: Continuing regular cytology
screening up to age 75 years or performing an exit human papillomavirus (HPV)
test to confirm the absence of oncogenic HPV strains past the age of 55 years
offers preventive benefit for older women with a cervix, according to a study
published online Nov. 1 in The Lancet Oncology.
Association of
Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing
Exercise Treadmill Testing: Cleveland Clinic researchers have found that
better cardiorespiratory fitness leads to longer life, with no limit to the
benefit of aerobic fitness. Researchers retrospectively studied 122,007
patients who underwent exercise treadmill testing at Cleveland Clinic between
Jan. 1, 1991, and Dec. 31, 2014, to measure all-cause mortality relating to the
benefits of exercise and fitness. The study found that increased
cardiorespiratory fitness was directly associated with reduced long-term
mortality, with no limit on the positive effects of aerobic fitness. Extreme
aerobic fitness was associated with the greatest benefit, particularly in older
patients (70 and older) and in those with hypertension. The risk associated
with poor cardiorespiratory fitness was comparable to or even exceeded that of
traditional clinical risk factors, such as cardiovascular disease, diabetes and
smoking. The study's findings emphasize the long-term benefits of exercise and
fitness, even to extreme levels, regardless of age or coexistent cardiovascular
disease. JAMA Netw Open. 2018;1(6):e183605.
doi:10.1001/jamanetworkopen.2018.3605
Physical Activity Guidelines for Americans Updated: Key guidelines for recommended physical
activity in Americans have been updated, according to a special report
published online Nov. 12 in the Journal of the American Medical Association To
enhance growth and development, preschool-aged children should be physically
active throughout the day. At least 60 minutes or more of moderate-to-vigorous
physical activity daily is recommended for children and adolescents aged 6 to
17 years. Adults should do at least 150 to 300 minutes a week of
moderate-intensity or 75 to 150 minutes of vigorous-intensity aerobic physical
activity, or an equivalent combination, as well as muscle-strengthening activities
on two or more days per week. Multicomponent physical activity that includes
balance training and aerobic and muscle-strengthening activities is recommended
for older adults. Nearly everyone will benefit from moving more and sitting
less.
Urinary Incontinence Common in Women over 50: Nearly
half of women older than 50 years report having urinary incontinence, according
to the results of the National Poll on Healthy Aging, published on Nov. 1.
USPSTF Recommends Screening Adults for Unhealthy Alcohol Use: The U.S. Preventive Services
Task Force (USPSTF) recommends that primary care clinicians screen all adults,
including pregnant women, for unhealthy alcohol use and provide brief
behavioral counseling to reduce unhealthy alcohol use. These findings form the
basis of a final recommendation statement published in the Nov. 13 issue of the
Journal of the American Medical Association.
Aggressive Control of BP, Lipids in Type 2 Diabetes May Up Kidney Risk: Intensive blood pressure
(BP) control and fenofibrate use in patients with type 2 diabetes who are at
high risk for cardiovascular disease may increase the risk for adverse kidney
events, according to a study published in the Clinical Journal of the American
Society of Nephrology
Hands-only CPR training kiosks can increase by stander intervention, improve survival: Prompt action
from a bystander can impact the likelihood a person survives cardiac arrest
that occurs outside of a hospital. One common and proven intervention that
anyone can learn is Hands-Only Cardiopulmonary Resuscitation (CPR). Hands-Only
CPR training kiosks are becoming more widespread and are an effective training
tool, a new Annals of Emergency Medicine analysis finds.
Pilot study suggests pedal desks could address health risks of sedentary workplace: A recent
pilot study by kinesiologists found that pedaling while conducting work tasks
improved insulin responses to a test meal. Investigators found that insulin
levels following the meal were lower when sedentary workers used a pedal desk
compared to a standard desk. In addition, work skills were not decreased in the
pedaling condition. Medicine & Science in Sports & Exercise
Weight lifting is good for your heart and it doesn't take much: Lifting weights for less than
an hour a week may reduce your risk for a heart attack or stroke by 40 to 70
percent, according to a new study. Spending more than an hour in the weight
room did not yield any additional benefit, the researchers found. The results
show benefits of strength training are independent of running, walking or other
aerobic activity. Medicine &
Science in Sports & Exercise, 2018;
Different types of physical activity offer varying protection against heart disease: While it
is well known that physical activity is important for heart health, neither
research nor recommendations consistently differentiate between the benefits of
different types of physical activity. New research found that while all
physical activity is beneficial, static activities -- such as strength
training-- were more strongly associated with reducing heart disease risks than
dynamic activities like walking and cycling. ACC Latin American Conference
Phone app effectively identifies potentially fatal heart attacks with near accuracy of medical ECG:
Can your smart phone determine if you're having the most serious -- and deadly
-- form of heart attack? A new research study says it can -- and may be a
valuable tool to save lives. Science Daily
Social isolation linked to higher risk of death: A
large American Cancer Society study links social isolation with a higher risk
of death from all causes combined and heart disease for all races studied, and
with increased cancer mortality in white men and women. The study, appearing in
the American Journal of Epidemiology, says addressing social isolation
holds promise if studies show interventions are effective, as they could be
relatively simple and could influence other risk factors, as social isolation
is also associated with hypertension, inflammation, physical inactivity,
smoking, and other health risks.
Untreated Hearing Loss ups Costs & Conditions: Older
adults with untreated hearing loss have increased total health care costs and
an increased risk for medical comorbidities, according to two studies published
online Nov. 8 in JAMA Otolaryngology-Head & Neck Surgery.
Grief linked to sleep disturbances that can be bad for the heart: People who have recently lost a
spouse are more likely to have sleep disturbances that exacerbate levels of
inflammation in the body, according to new research. These elevated levels of
inflammation may increase risk for cardiovascular illness and death. Psychosomatic Medicine
NUTRITION/SUPPLEMENTS/VITAMINS
Most Supplements Contain Prohibited Stimulants: Many
supplements contain one or more stimulants that have been the subject of U.S. Food
and Drug Administration-issued public notices, according to a research letter
published online Oct. 22 in JAMA Internal Medicine.
Plant Based Diets Beneficial for Adults with Type 2 Diabetes: For adults with type 2 diabetes, plant-based diets can
improve psychological health, quality of life, hemoglobin A1c levels, and
weight, according to a review published online Oct. 30 in BMJ Open Diabetes
Research & Care.
Limited Benefit forn-3 Fatty Acids in CVD, Cancer Prevention: Omega-3 fatty acids and vitamin
D do not significantly reduce major cardiovascular events or cancer incidence,
according to two studies published online Nov. 10 in the New England Journal of
Medicine.
Trial finds diet rich in fish helps fight asthma: The international study found children with
asthma who followed a healthy Mediterranean diet enriched with fatty fish had
improved lung function after six months. Journal of Human Nutrition and
Dietetics.
Resistant bacteria:
Can raw vegetables and salad pose a health risk?: Salad is popular with
people who want to maintain a balanced and healthy diet. Salad varieties are
often offered for sale ready-cut and film-packaged. It is known that these
types of fresh produce may be contaminated with bacteria that are relevant from
the point of view of hygiene. Researchers have now shown that these bacteria
may also harbor bacteria that are resistant to antibiotics. Consumers should
always wash raw vegetables, leaf salad and fresh herbs thoroughly with drinking
water before eating them in order to minimise the risk of ingestion of
pathogens or antimicrobial-resistant bacteria. Pregnant women and people with
compromised immune systems as a result of advanced age, pre-existing conditions
or medication intake should additionally refrain from eating pre-cut and
packaged salads as a precaution against foodborne infections and should instead
prepare salads themselves using fresh and thoroughly washed ingredients shortly
before consumption. Federal Institute for Risk Assessment
Nuts for nuts? Daily serving may help control weight and benefit health: Eating Brazil nuts and
other varieties of nuts daily may prevent weight gain and provide other
cardiovascular benefits, according to two separate preliminary studies.
American Heart Association
Should You Eat a Low Gluten Diet?: When
healthy people eat a low-gluten and fiber-rich diet compared with a high-gluten
diet they experience less intestinal discomfort including less bloating which
researchers show are due to changes of the composition and function of gut
bacteria. The new study also shows a modest weight loss following low-gluten
dieting. The researchers attribute the impact of diet on healthy adults more to
change in composition of dietary fibers than gluten itself. Nature
Communications
Drinking coffee may reduce your chances of developing Alzheimer's, Parkinson's: A new study
suggests drinking coffee may protect you against developing both Alzheimer's
and Parkinson's disease. "The
caffeinated and de-caffeinated dark roast both had identical potencies in our
initial experimental tests," says Dr. Mancini. "So we observed early
on that its protective effect could not be due to caffeine." Frontiers in
Neuroscience
TREATMENT
Drug Recall: Certain lots of irbesartan
are being recalled by SciGen because they contain an industrial chemical that
is a suspected carcinogen, CNN reported. The recalled drugs have
"Westminster Pharmaceuticals" and "GSMS Inc." on the label.
Aggressive Control of BP, Lipids in T2DM May Up Kidney Risk: Intensive blood pressure (BP) control and fenofibrate use in
patients with type 2 diabetes who are at high risk for cardiovascular disease
may increase the risk for adverse kidney events, according to a study published
in the Clinical Journal of the American Society of Nephrology to
coincide with its presentation at the American Society of Nephrology's Kidney
Week, held Oct. 23 to 28 in San Diego.
Link Between Statins, Non-CVD Outcomes Lacks Evidence: There
is a lack of convincing evidence for an association between statin use and
non-cardiovascular disease (CVD) outcomes, according to a review published in
the Oct. 16 issue of the Annals of Internal Medicine. The researchers
found no convincing (class I) evidence, two highly suggestive (class II)
associations (decreased cancer mortality in patients with cancer and decreased
exacerbations in patients with chronic obstructive pulmonary disease), 21
suggestive (class III) associations, and 42 weak (class IV) associations for
the observational studies. There was a sufficient amount of evidence with no
hints of bias for one outcome from the RCTs (decreased all-cause mortality in
patients with chronic kidney disease). Observational studies had suggestive
evidence that statins increase the risk for diabetes and myopathy. No
statistically significant effects on myopathy, myalgia, or rhabdomyolysis were
found among the RCTs.
Icosapent Ethyl Cuts CV Risk From Elevated Triglycerides: Icosapent ethyl is associated with a
reduced risk for ischemic events among patients with elevated triglyceride
levels despite taking statins, according to a study published online Nov. 10 in
the New England Journal of Medicine to coincide with the annual meeting of the
American Heart Association.
Aspirin alone a good clot buster after knee surgery: When it comes to preventing blood clots
after a knee replacement, good old aspirin may be just as effective as newer,
more expensive drugs, such as rivaroxaban (Xarelto), according to a orthopedics
study. Science Daily
Hepatitis C treatment can be shortened in 50 percent of patients, study finds: Hepatitis C drugs
cure more than 90 percent of patients, but can cost more than $50,000 per
patient. Findings from a new study could lead to significant cost savings. In
50 percent of patients, the standard 12-week treatment regimen could be
shortened to as little as six weeks without compromising efficacy, the study
found. Science Daily
Diabetic foot ulcers heal quickly with nitric oxide technology: Around the world, 425 million
people live with diabetes and upwards of 15 percent develop foot ulcers, which
increases their risk of death 2.5 times. A new nitric oxide-releasing
technology has the potential to cut down the healing time of diabetic foot
ulcers from 120 days to 21 days. Medical Sciences
Scalpel-free surgery enhances quality of life for Parkinson's patients: A high-tech form of
brain surgery that replaces scalpels with sound waves improved quality of life
for people with Parkinson's disease that has resisted other forms of treatment,
a new study has found. "In
our initial study that looked at the outcomes of focused ultrasound surgery in
Parkinson's disease, we primarily described post-operative improvements in
motor symptoms, specifically tremor," said Scott Sperling, PsyD, a
clinical neuropsychologist at UVA. "In this study, we extended these
initial results and showed that focused ultrasound thalamotomy is not only safe
from a cognitive and mood perspective, but that patients who underwent surgery
realized significant and sustained benefits in terms of functional disability
and overall quality of life." Neurology
OTHER
Psoriasis Linked to Increased Risk for Inflammatory Bowel Disease: Psoriasis appears to be significantly associated with inflammatory
bowel disease (IBD), according to a review published online Oct. 24 in JAMA
Dermatology.
Access to In-Home Support Soon to Be Available for Seniors: In-home services such as help
with household chores and caregiver respite will be available to seniors with
private Medicare Advantage plans in more than 20 states next year. A
health-related reason is needed to qualify, and costs will vary depending on
the plan. With some plans, there will be no added cost. There will be limits on
benefits, the Associated Press reported. The number of states where the new
services are available is expected to grow over time.
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