Journal Watch September 2019

PAIN

Virtual Reality for Management for Pain: VR significantly reduces pain versus an active control condition in hospitalized patients. VR is most effective for severe pain. Future trials should evaluate standardized order sets that interpose VR as an early non-drug option for analgesia. PLOS One

Lower back pain? Self-administered acupressure could help: A recent study found that people with chronic lower back pain who performed self-administered acupressure experienced improvement in pain and fatigue symptoms. "Acupressure is similar to acupuncture, but instead of needles, pressure is applied with a finger, thumb or device to specific points on the body." Pain Medicine

Use of PainReliever Tramadol May Up Risk for Hypoglycemia: Use of the widely prescribed opioid tramadol is associated with a greater risk for developing hypoglycemia compared with almost every other opioid, according to a study published online Aug. 28 in Scientific Reports.

 

Losing 20 lb Improves Knee Replacement Outcomes: Losing at least 20 lb before total knee arthroplasty is associated with better outcomes among morbidly obese patients, according to a study published online Aug. 21 in The Journal of Bone & Joint Surgery.

 

Risk Factors ID'd for Worse Quality of Life From Knee Osteoarthritis: It may be possible to identify persons at risk for suffering a worsening in health-related quality of life (HRQoL) due to knee osteoarthritis (OA), according to a study published online July 19 in PLOS ONE. Female gender, overweight, smoking, knee pain, lower income tied to rapidly worsening quality of life.

Facial Involvement in Primary Headaches Occurs Infrequently: Facial involvement in primary headaches occurs infrequently, according to a study published online Aug. 21 in Neurology. Facial pain reported as independent or additional symptom in 291 patients of 2,912 patient data sets.

Ultrasonography Helps Differentiate Arthritis Types: Ultrasound is effective for differentiating between the major types of arthritis when combined with a physical exam and patient history, according to a review recently published in The Open Medical Imaging Journal.

 

COMPLEMENTARY & ALTERNATIVE MEDICINE

Benefits of cognitive behavioural therapy for IBS continue 2 years after treatment: Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder affecting 10 - 20 per cent of people. Previous research (the ACTIB trial) showed that that Cognitive Behavioural Therapy (CBT) tailored specifically for IBS and delivered over the telephone or through an interactive website is more effective in relieving the symptoms of IBS than current standard care one year after treatment. This 24 month follow up research published in Lancet Gastroenterology and Hepatology has shown that benefits continue two years after treatment despite patients having no further therapy after the initial CBT course.

Study shows BioCell collagen can visibly reduce common signs of skin aging within 12 weeks: In one of the most substantial studies of a skin health supplement, BioCell Collagen®, was found to visibly reduce common signs of skin aging, including lines and wrinkles, within 12 weeks of daily use. The findings reported in this randomized, double-blind, placebo-controlled clinical trial included a measurable improvement in signs of aging in women, represented by increased skin elasticity, reduction of crow's feet, and improvement in depth and number of fine lines and wrinkles. The full findings of the peer-reviewed study are presented in June 2019 during the annual meeting of the American Society for Nutrition. No adverse reactions were reported during the study. Participants surveyed at the sixand twelve-week marks reported a positive perception of the supplement effectiveness. published in the September/October issue of Alternative Therapies in Health and Medicine and posted on PubMed.

Women Who Smoke Marijuana May Have Less Success with Fertility Treatment: Among women undergoing fertility treatment, those who reported smoking marijuana at the time were more than twice as likely to lose a pregnancy than those who never smoked or did not currently smoke. Aug. 14 Human Reproduction

Review: Biofeedback could help treat a number of conditions: A literature review by Veterans Affairs researchers highlights the usefulness of biofeedback for headache and incontinence treatment, and stroke recovery. There was less evidence for its role in other conditions.

Temps up blood pressures down in hot yoga study: Adults taking hot yoga had lower blood pressure measurements after three months of classes, in a small study examining hot yoga's impact on blood pressure. Hot yoga is typically a vigorous workout practiced under hot and humid conditions. Study researchers say this is one of the first studies of hot yoga's benefits in lowering blood pressure and more research is needed to determine if the practice has true blood pressure lowering power. American Heart Association's Hypertension 2019 Scientific Sessions

FDA ACTION

• Alerted that some ranitidine medicines, including some products commonly known as the brand-name drug Zantac, contain a nitrosamine impurity called N-nitrosodimethylamine (NDMA) at low levels. NDMA is classified as a probable human carcinogen (a substance that could cause cancer) based on results from laboratory tests. NDMA is a known environmental contaminant and found in water and foods, including meats, dairy products, and vegetables.

• Issued a warning letter to JUUL Labs Inc. for marketing unauthorized modified risk tobacco products by engaging in labeling, advertising, and/or other activities directed to consumers, including a presentation given to youth at a school.

• Approves first treatment for patients with rare type of lung disease-Ofev capsules for adults with interstitial lung disease associated with systemic sclerosis or scleroderma

• Approves new add on drug-Nourianz-to treat patients with Parkinson’s Disease experiencing “off” episodes

• Approved Xenleta to treat adults with community-acquired bacterial pneumonia.

PREVENTION

Do Not Use Electronic Cigarettes: Americans should not use electronic cigarettes while health officials investigate cases of severe lung illness that may be linked to the devices, according to a statement issued by Patrice A. Harris, M.D., president of the American Medical Association.

Dog ownership associated with better cardiovascular health: Owning a pet may help maintain a healthy heart, especially if that pet is a dog, according to the first analysis of data from the Kardiozive Brno 2030 study. The study demonstrates an association between dog ownership and heart health, which is in line with the American Heart Association's scientific statement on the benefits of owning a dog in terms of physical activity, engagement and reduction of cardiovascular disease risk.

E-cigs can trigger same lung changes seen in smokers, emphysema: Scientists found that the lungs of vapers -- like the lungs of smokers -- have elevated levels of protease enzymes, a condition known to cause emphysema in smokers. The researchers also found that the nicotine in vaping liquids is responsible for the increase in protease enzymes. Journal of Respiratory and Critical Care Medicine

Sleeping too much -- or too little -- boosts heart attack risk: Even if you are a non-smoker who exercises and has no genetic predisposition to cardiovascular disease, skimping on sleep - or getting too much of it - can boost your risk of heart attack, according to a new University of Colorado Boulder study of nearly a half-million people. The research, published Sept. 2 in the Journal of the American College of Cardiology, also found that for those at high genetic risk for heart attack, sleeping between 6 and 9 hours nightly can offset that risk.

It takes a community to lower cardiovascular risk: Concerted effort by friends, family and non-physician health workers can make a dramatic difference in reducing the risk factors for heart problems in patients with hypertension, an international study by Hamilton researchers has found. The Lancet

Cardiovascular disease patients benefit more from exercise than healthy people: A study of nearly half a million people has found for the first time that those with heart or blood vessel problems benefit more from having a physically active lifestyle than do healthy people without cardiovascular disease (CVD). European Heart Journal

Aspirin should not be recommended for healthy people over 70: Low-dose aspirin does not prolong disability-free survival of healthy people over 70, even in those at the highest risk of cardiovascular disease. The late breaking results of the ASPREE trial are presented today at ESC Congress 2019 together with the World Congress of Cardiology.(1)

Pollution and noise reduction advised in ESC guidelines on chronic coronary syndromes: "Air pollution and environmental noise increase the risk of heart attack and stroke, so policies and regulations are needed to minimise both. Patients with chronic coronary syndromes should avoid areas with heavy traffic congestion and may consider wearing a respirator face mask. Air purifiers with high efficiency particulate air filters can be used to reduce indoor pollution." European Heart Journal

Poor oral health linked to cognitive decline, perceived stress: Oral health is an essential part of psychological well-being and overall health in older adults. Poor oral health is associated with decreased quality of life, depression, hypertension, and cognitive decline. Two Rutgers studies published in the Journal of the American Geriatrics Society, explored the relationship between poor oral health and cognitive decline and the effects of perceived stress and social support on dry mouth among older Chinese Americans.

Concussions linked to erectile dysfunction in NFL players: Head trauma suffered by former NFL players was linked to erectile dysfunction, according to a new study published in JAMA Neurology.

 

Occasional Napping Linked to Lower Risk for Cardiovascular Events: Napping once or twice per week is associated with a lower risk for incident cardiovascular disease (CVD) events, according to a study published online Sept. 9 in Heart.

Women With Heart Attack Do Present With Typical Symptoms: Typical symptoms of myocardial infarction are more common and have greater predictive value in women than in men, according to a study published in the Sept. 3 issue of the Journal of the American Heart Association.

Intrauterine Device Use May Reduce Incidence of Ovarian Cancer: Intrauterine device (IUD) use among reproductive women is associated with a decreased incidence of ovarian cancer, according to a review published online Sept. 10 in Obstetrics & Gynecology. 

Mammos May Not Benefit Elderly Women With Chronic Illness: For older women, the cumulative incidence of death from other causes is many times higher than breast cancer incidence and death, according to a study published online Sept. 6 in the Journal of the National Cancer Institute.

NUTRITION/SUPPLEMENTS

Prescription omega-3 fatty acid medications effectively lower high triglycerides: Four grams per day of prescription omega-3 fatty acid medication effectively lower high triglyceride levels, but identification of secondary causes of high triglycerides, such as hypothyroidism and poorly managed type 2 diabetes as well as lifestyle changes should be addressed before prescribing drugs. American Heart Association

Peanuts may help protect against age-related cognitive decline: “People who eat peanuts regularly have a lower risk of heart disease; and there is growing evidence that the risk of developing Alzheimer’s disease is associated with risk of cardiovascular disease,” Sacks told the Times Free Press in an August 20, 2019 article. “We surmise that peanuts could be an important component of a diet that prevents cognitive decline with aging. That is one reason why we included peanuts in the MIND study.”

Are fake meat products better for human and planetary health?: Recently, plant-based products such as hamburger patties that mimic the taste and texture of meat have gained popularity as an alternative. In a JAMA Viewpoint published August 26, 2019, Harvard T.H. Chan School of Public Health’s Frank Hu, chair of the Department of Nutrition, and co-authors including Gina McCarthy, director of C-CHANGE, looked at whether plant-based meat alternatives can be part of a healthy and sustainable diet. They conclude that the answer remains far from clear given the lack of rigorously designed, independently funded studies. Among the health-related concerns they raise are the high sodium and caloric content in several popular imitation burger patties, and that these products are highly processed, which can lead to loss of nutrients.

Few people with peanut allergy tolerate peanut after stopping oral immunotherapy: Studies have shown that peanut oral immunotherapy (OIT) -- ingesting small, controlled amounts of peanut protein -- can desensitize adults and children and prevent allergic reactions, but the optimal duration and dose is unknown. In a study that followed participants after successful OIT, discontinuing OIT or continuing OIT at a reduced dose led to a decline in its protective effects. The study also found that blood tests administered before OIT could predict the success of therapy. The Lancet

Drinking tea improves brain health, study suggests: A recent study led by researchers from the National University of Singapore (NUS) revealed that regular tea drinkers have better organised brain regions -- and this is associated with healthy cognitive function -- compared to non-tea drinkers. The research team made this discovery after examining neuroimaging data of 36 older adults. Aging

 

Vitamin D: How much is too much of a good thing?: A three-year study has shown that there is no benefit in taking high doses of vitamin D (4000IU and 10,000 IU). More research is required to determine if high doses may actually compromise bone health. For normal, healthy adults, Health Canada recommends a total daily intake of 600 international units (IU) up to age 70, and 800 IU after age 70. Other sources, like Osteoporosis Canada, suggest adults at risk of osteoporosis, a condition characterized by bone loss, should take 400 -- 2,000 IU of Vitamin D. Those taking high doses were more likely to develop hypercalciuria (elevated levels of calcium in the urine), which is associated with increased risk of kidney stones. JAMA

Study Reveals Mixed Effects on Health for Vegetarian Diet: Vegetarians and fish eaters have a lower risk for ischemic heart disease compared with meat eaters, but vegetarians have a higher risk for stroke, according to a study published online Sept. 4 in The BMJ.

 

Drinking More Coffee Tied to Lower Risk for Gallstone Disease: Individuals with genetic variants linked to increased coffee consumption have reduced risk for gallstones. Journal of Internal Medicine

Drinking Soft Drinks Tied to Higher Risk for Early Death: Greater consumption of soft drinks, both sugar-sweetened and artificially sweetened, is associated with a higher risk for all-cause mortality, according to a European study published online Sept. 3 in JAMA Internal Medicine.

Low-Fat Dietary Pattern Offers Long-Term Health Benefits: A low-fat dietary pattern provides lasting health benefits, according to a study published in the September issue of The Journal of Nutrition. Significant benefits seen in relation to breast cancer, CHD, diabetes, without adverse effects.

TREATMENT

Study shows metabolic surgery associated with lower risk of death and heart complications: A large Cleveland Clinic study shows that weight-loss surgery performed in patients with type 2 diabetes and obesity is associated with a lower risk of death and major adverse cardiovascular events than usual medical care. These patients also lost more weight, had better diabetes control, and used fewer medications for treatment of their diabetes and cardiovascular disease than those undergoing usual medical care. JAMA

 

For patients with diabetes, ticagrelor reduced heart attacks, strokes: Taking ticagrelor in addition to aspirin reduced the risk of a composite of cardiovascular death, heart attack, or stroke. Patients on this dual-antiplatelet therapy also experienced greater risk of major bleeding. In THEMIS-PCI, a study that specifically looked at THEMIS patients with a history of previous percutaneous coronary intervention (PCI) that includes stenting, versus the overall THEMIS population, investigators found even more favorable results for patients taking ticagrelor plus aspirin. Results of THEMIS are published simultaneously in The New England Journal of Medicine and results from THEMIS-PCI are published simultaneously in The Lancet.

Position Statement Clarifies Benefits of Testosterone Therapy for Women: Testosterone can be used for postmenopausal women with hypoactive sexual desire dysfunction (HSDD) but is not recommended for other symptoms or medical conditions, according to a position statement published online Sept. 2 in the Journal of Clinical Endocrinology & Metabolism. 

Type and Timing of Menopausal HRT Affect Risk for Breast Cancer: Use of menopausal hormone therapy (MHT) is associated with an increased incidence of breast cancer, according to a study published online Aug. 29 in The Lancet.

OTHER

Evidence Lacking for Cognitive Screening in Older Adults: The U.S. Preventive Services Task Force (USPSTF) concludes that the evidence is currently inadequate for weighing the benefits and harms of screening for cognitive impairment among older adults. These findings form the basis of a draft recommendation statement published online Sept. 10 by the USPSTF.

Poverty Rate Drops, but Fewer Americans Have Health Insurance: The percentage of Americans living in poverty declined in 2018, but the rate of those without health insurance increased, according to a U.S. Census Bureau report. Meanwhile, about 27.5 million people (8.5 percent of the population) lacked health insurance for all of 2018, up from 7.9 percent in 2017, which was the first increase since the Affordable Care Act took full effect in 2014. 

Adolescent Oral Contraceptive Use Tied to Later Depression Risk: There is a long-term association between adolescent oral contraceptive (OC) use and depression risk in adulthood, according to a study published online Aug. 28 in the Journal of Child Psychology and Psychiatry.