Saturday, August 17, 2019

Journal Watch August 2019


PAIN
Online Symptom Self-Management + Telehealth Aids Pain, Mood: Online symptom self-management plus clinician telecare can be effective for individuals with pain, depression, and anxiety, according to a study recently published in the Journal of General Internal Medicine.

Filgotinib Bests Placebo in Tx of Refractory Rheumatoid Arthritis: Among patients with moderately to severely active rheumatoid arthritis (RA) resistant to previous therapy with biologic agents, a significantly higher clinical response rate was seen at 12 weeks for those receiving filgotinib versus placebo, according to a study published in the July 23/30 issue of the Journal of the American Medical Association.

Sleep Disorders Up Health Care Visits, Costs for Low Back Pain: The presence of a sleep disorder diagnosis has a significant effect on low back pain (LBP)-related health care visits and costs, independent of pain intensity and disability, according to a study published online July 5 in Spine.

Adults who mix cannabis with opioids for pain report higher anxiety, depression: Adults who take prescription opioids for severe pain are more likely to have increased anxiety, depression and substance abuse issues if they also use marijuana. Journal of Addiction Medicine

Conservative treatment with a sling can replace surgery for shoulder fractures: There is nothing to be gained by operating on a patient with a so-called displaced fracture of the shoulder. Three weeks with the arm in a sling so that the shoulder is kept inactive yields the same results. PLOS Medicine

1-2 caffeinated drinks not linked with higher risk of migraines; 3+ may triggerthem: In a study published in the American Journal of Medicine researchers found that, among patients who experience episodic migraine, one to two servings of caffeinated beverages were not associated with headaches on that day, but three or more servings of caffeinated beverages may be associated with higher odds of migraine headache occurrence on that day or the following day.

Evidence Supports Meds Used for Pain Relief in Pediatric Migraine: Evidence-based therapies are available for the acute symptomatic treatment of migraine in children and adolescents, but evidence is lacking for the impact of many treatments for migraine prevention, according to two updated guidelines published online Aug. 14 in Neurology.

NSAIDs Contribute to Increased CVD Risk in Osteoarthritis: Osteoarthritis (OA) is an independent risk factor for increased cardiovascular disease (CVD), and nonsteroidal anti-inflammatory drugs (NSAIDs) contribute substantially to this risk, according to a study published online Aug. 6 in Arthritis & Rheumatology.

COMPLEMENTARY & ALTERNATIVE MEDICINE
Saw Palmetto: Although several small studies have suggested modest benefit of saw palmetto for treating symptoms of Benign Prostatic Hyperplasia (BPH), a large study evaluating high doses of saw palmetto and a Cochrane review found that saw palmetto was not more effective than placebo for treatment of urinary symptoms related to BPH. A single randomized controlled trial showed combination therapy of saw palmetto plus lycopene, selenium, and tamsulosin was more effective than single therapies alone.
NCCIH Clinical Digest

Adults with mild cognitive impairment can learn and benefit from mindfulness meditation: A pilot study shows promising evidence that adults with MCI can learn to practice mindfulness meditation, and by doing so may boost their cognitive reserve. Journal of Alzheimer's Disease

Pediatric Cannabis Exposure Up after Medical Legalization: Following medical marijuana legalization (MML) in Massachusetts in 2012, there was an increase in pediatric cannabis exposure calls of 140% according to a study published online Aug. 16 in JAMA Network Open.

A Fatty Meal Might Affect How You Absorb CBD: A new study suggests that fatty foods might boost the body's absorption of cannabidiol (CBD). There were no differences in mental functioning when the patients took CBD after eating or fasting, according to the study in the August issue of the journal Epilepsia.

 FDA ACTION

• Approved Turalio (pexidartinib) capsules to treat adults with symptomatic tenosynovial giant cell tumor (TGCT)
• Streamlined four tests for marketing with new indications to diagnose Lyme disease using a modified approach with only enzyme immunoassay (EIA) technology-based tests
• Approved the first noninjection glucagon therapy for emergency treatment of severe hypoglycemia
• Approved for the first generic versions of Lyrica (pregabalin) to manage neuropathic pain from diabetic peripheral neuropathy or spinal cord injury, postherpetic neuralgia, and fibromyalgia
• Sent a warning letter has been issued to Massachusetts-based Curaleaf Inc. for illegally selling unapproved cannabidiol (CBD) products online with unproven claims that the products treat cancer, Alzheimer disease, opioid withdrawal, pain, and other health problems
• Approved Pretomanid for drug resistant TB
• Warned about Miracle Mineral Solution, which is sold online as a medical treatment, and can cause serious and potentially life-threatening health problems and should not be bought or used by consumers.
• Approved transcatheter Heart valves for use in low risk patients
• Approved tether device to correct idiopathic scoliosis as an alternative to fusion surgery when patient does not respond to bracing
• Proposes graphic warning labels on cigarettes
• Recalled RELPAX® (eletriptan hydrobromide) 40 mg tablets, lots AR5407 and CD4565, because continued use -treats acute migraines in adults- could lead to serious, life-threatening infections

 PREVENTION
Flu vaccine reduces risk of early death for elderly intensive care patients: An influenza vaccine does not just work when it comes to influenza. A new study shows that elderly people who have been admitted to an intensive care units have less risk of dying and of suffering a blood clot or bleeding in the brain if they have been vaccinated. And this is despite the fact that they are typically older, have more chronic diseases and take more medicine then those who have not been vaccinated. Intensive Care Medicine

 

Socially active 60-year-olds face lower dementia risk: Being more socially active in your 50s and 60s predicts a lower risk of developing dementia later on, finds a new UCL-led study. PLOS Medicine

7 'simple' steps for heart health may also stave off dementia: New research suggests that "Life's Simple 7" steps for maintaining heart health may also be a useful tool for predicting dementia risk and preventing the neurological condition. Life Simple 7 are manage blood pressure and cholesterol, lower blood sugar, stay physically active, follow a healthful diet, lose weight and don’t smoke. The BMJ

'Tickle' therapy could help slow aging, research suggests: 'Tickling' the ear with a small electrical current appears to rebalance the autonomic nervous system for over-55s, potentially slowing down one of the effects of ageing, according to new research. Scientists found that a short daily therapy delivered for two weeks led to both physiological and wellbeing improvements, including a better quality of life, mood and sleep. The therapy, called transcutaneous vagus nerve stimulation, delivers a small, painless electrical current to the ear, which sends signals to the body's nervous system through the vagus nerve. This could help protect people from chronic diseases which we become more prone to as we get older, such as high blood pressure, heart disease and atrial fibrillation. The researchers, who published their findings today in the journal Aging, suggest that the 'tickle' therapy has the potential to help people age more healthily, by recalibrating the body's internal control system.

Poor fit between job demands, reasoning abilities associated with health conditions: Older workers whose reasoning abilities no longer allow them to meet the demands of their jobs may be more likely to develop chronic health conditions and retire early, which may not be ideal for the employee or employer, according to research published by the American Psychological Association.

Study reveals 6 top exercises for offsetting 'obesity genes': New research examines the effect of 18 different kinds of exercise on people with a high genetic risk of developing obesity. The findings identify six exercises that can offset the genetic effects on five measures of obesity. While jogging ranked the best, mountain climbing, walking, exercise walking, dancing and a longer practice of yoga also reduced the genetic effects on obesity.

ACIP Recommends Catch-Up HPV Vaccines Through Age 26: Catch-up human papillomavirus (HPV) vaccinations are recommended for all persons through age 26 years and should be considered for some persons aged 27 to 45 years, according to research published in the Aug. 16 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Vaccination Does Not Up Risk for Developing Multiple Sclerosis: Evidence shows that vaccination is not associated with an increased risk for being diagnosed with multiple sclerosis (MS) within the next five years, according to a study published online July 30 in Neurology. Odds of MS were lower in participants with vaccination, especially for influenza and tick-borne illness.

Recent Stressful Life Events Linked to Later Verbal Memory Decline: Middle-aged women, but not men, with a greater number of recent stressful life events have memory decline later in life, according to a study published in the July issue of the International Journal of Geriatric Psychiatry.

Severe Lung Injury After Vaping Reported: Four cases of severe lung injury possibly linked with vaping in Minnesota are similar to dozens of cases in Wisconsin and Illinois. The patients had symptoms such as shortness of breath, fever, cough, vomiting, diarrhea, headache, dizziness and chest pain, and some were hospitalized for "multiple weeks, with some patients being admitted to the intensive care unit," according to a Minnesota Department of Health statement, CNN reported.

 

NUTRITION/SUPPLEMENTS
Vitamin D supplementation may slow diabetes progression: Vitamin D supplementation may slow the progression of type 2 diabetes in newly diagnosed patients and those with prediabetes, according to a study published in the European Journal of Endocrinology. The study findings suggest that high-dose supplementation of vitamin D can improve glucose metabolism to help prevent the development and progression of diabetes.

 

Dangerous Sesame Allergy Affects Many Americans: More than 1.5 million children and adults in the United States have sesame allergy -- more than previously believed, a new study finds. And even though sesame allergy can cause severe reactions, sesame is often not declared on food product labels, the Northwestern University researchers said.

 

Plant-Based Diets May Lower CV Disease, Deaths in Middle-Aged: Diets higher in plant-based foods and lower in animal-based foods are associated with lower risks for developing or dying from cardiovascular disease among middle-aged adults, according to a study published online Aug. 7 in the Journal of the American Heart Association.

Reduced carbohydrate intake improves type 2 diabetics' ability to regulate blood sugar: Patients with type 2 diabetes improve their ability to regulate blood sugar levels if they eat food with a reduced carbohydrate content and an increased share of protein and fat. This is shown by a recent study conducted at Bispebjerg Hospital in collaboration with, among other partners, Aarhus University and the Department of Nutrition, Exercise and Sports at the University of Copenhagen. The findings are contrary to the conventional dietary recommendations for type 2 diabetics. "The study shows that by reducing the share of carbohydrates in the diet and increasing the share of protein and fat, you can both treat high blood sugar and reduce liver fat content. Further intensive research is needed in order to optimise our dietary recommendations for patients with type 2 diabetes," says Thure Krarup, stressing that the findings should be confirmed in large-scale, long-term controlled trials.

Mankai duckweed plant found to offer health benefits: In this new study, the researchers compared Mankai shake consumption to a yogurt shake equivalent in carbohydrates, protein, lipids, and calories. Following two weeks of monitoring with glucose sensors, participants who drank the duckweed shake showed a much better response in a variety of measurements including lower glucose peak levels; morning fasting glucose levels; later peak time; and faster glucose evacuation. The participants also felt more full. Diabetes Care

Replacing Beef with Chicken couldreduce breast cancer risk: Researchers, using data from more than 40,000 women, conclude that eating red meat is associated with an increased risk of breast cancer, but consuming poultry appears to link to a lower risk. women who ate the most red meat had a 23% higher risk of developing breast cancer than those who ate the least red meat.


Robotic neck brace dramatically improves functions of ALS patients: A novel neck brace, which supports the neck during its natural motion, was designed by Columbia engineers. This is the first device shown to dramatically assist patients suffering from Amyotrophic Lateral Sclerosis (ALS) in holding their heads and actively supporting them during range of motion. This advance would result in improved quality of life for patients, not only in improving eye contact during conversation, but also in facilitating the use of eyes as a joystick to control movements on a computer, much as scientist Stephen Hawkins famously did. 

Osteoporosis drugs linked to reduced risk of premature death: Two studies led by the Garvan Institute of Medical Research have revealed that nitrogen-bisphosphonates, drugs commonly prescribed for osteoporosis, reduced the risk of premature mortality by 34% in a cohort of over 6,000 individuals. This reduction in early mortality risk was significantly associated with a reduction in bone loss compared with no treatment.

Study proves hepatitis C drugs reduce liver-related deaths by nearly half: A new study from the UT Southwestern Simmons Comprehensive Cancer Center demonstrates that antiviral drugs for hepatitis C reduce liver-related deaths by nearly 50% in patients with a history of liver cancer. The finding builds on a December 2018 study by the same researchers who found that antiviral drugs do not increase the risk of liver cancer recurrence, as was previously feared. Gastroenterology

Anti arrhythmic Drugs May Up Fall Injuries in Older A-Fib Patients: Use of antiarrhythmic drugs (AADs) is associated with a higher risk for fall-related injuries and syncope among older patients with atrial fibrillation (AF), according to a study published online July 24 in the Journal of the American Geriatrics Society.

Major Surgery Linked to Lasting Change in Cognitive Trajectory: Major surgery is associated with a small, long-term change in the average cognitive trajectory, according to a study published online Aug. 7 in The BMJ.

Recommendations Developed for Management of Lyme Disease: The Infectious Diseases Society of America, the American Academy of Neurology, and the American College of Rheumatology have released a draft of their joint clinical practice guidelines for the management of Lyme disease. The authors note that for prevention of tick bites and tick-borne infections, wearing protective clothing, checking for ticks, bathing after outdoor activities, drying clothing, and limiting pet exposure are recommended. Repellents to prevent tick bites include permethrin-treated clothing; attached ticks should be removed promptly. Following a tick bite, testing for Borrelia burgdorferi is not recommended in an Ixodes tick, and asymptomatic patients should not be tested for exposure to Borrelia burgdorferi following an Ixodes tick bite. Prophylactic antibiotic treatment should be given to adults and children within 72 hours of removal of an identified high-risk tick. A single dose of oral doxycycline is recommended within 72 hours of tick removal during observation for high-risk Ixodes bites. Erythema migrans skin lesions are the most common clinical manifestation of Lyme disease. Clinical diagnosis is recommended over laboratory testing for patients with lesions compatible with erythema migrans. The public comment period for these draft guidelines has been extended for an additional 30 days, and the deadline for comment is Sept. 9, 2019.

Diabetes over treatment seriously endangers health: People with diabetes, particularly those with type 1 diabetes, may have an increased risk of hypoglycemia (low blood sugar) if they receive too much glucose lowering therapy. New research now warns that many people with diabetes face that risk. Mayo Clinic Proceedings

OTHER
Trouble Driving at Night? Yellow Lenses Won't Help: Night-driving" glasses that promise to dim the glare of headlights may not work as advertised, a new study finds. The glasses, featuring yellow-tinted lenses, have been marketed for years as a way to ward off blinding headlights and make night driving easier. The problem: There's no scientific evidence they work. Now a new study, published online Aug. 1 in JAMA Ophthalmology, offers a buyer-beware message. In driving simulation tests, researchers found that yellow lenses did not improve people's performance over clear lenses -- including when they were faced with oncoming headlights.

Brand-Brand Competition Has Not Cut Prices in Pharma Market: Brand-brand competition in the U.S. pharmaceutical market has not lowered drug list prices, according to a review published online July 30 in PLOS Medicine. 

New Opioid Rx Rules Coming for U.S. Employees' Health Plans: Tighter rules on opioid painkiller prescriptions for U.S. government employees will be implemented in the fall, the Trump Administration says. The new Federal Employee Health Benefits Program rules are meant to prevent over prescribing of the potentially addictive drugs to patients who might require them for only a short period of time, the Associated Press reported. Patients with intractable pain from cancer and other conditions will still be able to get opioid painkillers.AP 

Do electronic devices affect our ability to grasp complex ideas? In today's world, it seems pretty much everyone uses smartphones and tablets on a daily basis. But our brains may not thank us for it, according to new research showing that overuse of electronic devices correlates with a poorer understanding of complex, scientific texts. Scientific Reports

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