Saturday, December 15, 2018

Journal Watch December 2018






CHRONIC PAIN
Extract from sour sopleaves can prevent the symptoms of fibromyalgia: The consumption of extract of Annona muricata L. leaves in pharmaceutical form and in the correct dosage can reduce the chronic pain, anxiety and depression that accompany this disease. Journal of Ethnopharmacology 

Functional Nasal Surgery Can Improve Headache Symptoms: For appropriately selected patients, functional nasal surgery is viable for improving headache symptoms, according to a review published in the December issue of Plastic and Reconstructive Surgery.

Joint Mobilization Plus Exercise Beneficial for Knee: Patellar mobilization therapy (PMT) plus exercise has the potential to reduce pain and improve function and quality of life for patients with knee osteoarthritis, according to a phase 2 study published Nov. 12 in the Annals of Family Medicine.

Refractory Back Pain Responds to CT-Guided Pulsed RF: Computed tomography (CT)-guided pulsed radiofrequency (pRF) is effective for patients with acute or subacute neuroradicular low back pain that is refractory to usual care, according to a study presented at the annual meeting of the Radiological Society of North America.

AI-Based Smartphone App Can Help Cut Cancer Pain Severity: An artificial intelligence (AI)-based smartphone app, called ePal, can reduce the severity of cancer patients' reported pain and hospital admissions, according to a study presented at the annual Palliative and Supportive Care in Oncology Symposium.

Treatments Appear No Better Than Placebo for Tennis Elbow: At best, all treatments provide 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.

Smoking Linked to Cognitive Dysfunction in Fibromyalgia: Smoking tobacco is a risk factor for cognitive dysfunction in patients with fibromyalgia (FM), according to a study presented at the 17th Annual Pain Medicine Meeting, a meeting of the American Society of Regional Anesthesia and Pain Medicine.

Recommendations Developed for Psoriatic Arthritis Treatment: Recommendations have been developed for pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA); the evidence-based guideline was published online Nov. 30 in Arthritis & Rheumatology. 

Early PT Can Reduce Risk, Amount of Long Term Opioid Use: Patients who underwent physical therapy soon after being diagnosed with pain in the shoulder, neck, low back or knee were approximately 7 to 16 percent less likely to use opioids in the subsequent months, according to a new study. Science Daily


COMPLEMENTARY & ALTERNATIVE MEDICINE
Hypnotherapy Beats Education for Relief of IBS Symptoms: For patients with irritable bowel syndrome (IBS), individual and group hypnotherapy are more effective than educational supportive therapy in relieving symptoms, according to a study published online Nov. 22 in The Lancet Gastroenterology & Hepatology. 

Cannabis-based drug in combination with other anti-spasticity: Drugs may help to relieve symptoms of motor neuron disease Oral spray containing two compounds derived from the cannabis plant reduced spasticity compared with placebo in patients already taking anti-spasticity drugs. The Lancet

FDA ACTION
• Updating the US system for approving medical devices.
• Lifted advisory on Romaine Lettuce Check Labels for lettuce that is grown outside of the Central Coast growing regions of northern and central California
• Will take steps to limit or ban access to flavored electronic cigarettes, menthol cigarettes and flavored cigars
• Issued a warning letter to Zhejiang Huahai Pharmaceutical Co. Ltd. (ZHP), in Linhai, Taizhou Zhejiang China, the manufacturer of the active pharmaceutical ingredient (API) found in valsartan that is the subject of an ongoing FDA investigation into probable cancer-causing impurities in certain commonly prescribed heart medicines.
• Cleared an app to help increase retention in outpatient treatment program for individuals with opioid use disorder
• Approved first treatment for Lambert-Eaton myasthenic syndrome
• Approved Xospata (gilteritinib) tablets for the treatment of adult patients who have relapsed or refractory acute myeloid leukemia (AML) with a FLT3 mutation
• Approved Truxima (rituximab-abbs) as the first biosimilar to Rituxan (rituximab) for the treatment of adult patients with CD20-positive, B-cell non-Hodgkin’s lymphoma (NHL) to be used as a single agent or in combination with chemotherapy
• Accelerated approval to Vitrakvi (larotrectinib), a treatment for adult and pediatric patients whose cancers have a specific genetic feature (biomarker).
• Approved Daurismo (glasdegib) tablets to be used in combination with low-dose cytarabine (LDAC), a type of chemotherapy, for the treatment of newly-diagnosed acute myeloid leukemia (AML) in adults who are 75 years of age or older or who have other chronic health conditions or diseases (comorbidities) that may preclude the use of intensive chemotherapy.
• Approved Gamifant (emapalumab-lzsg) for the treatment of pediatric (newborn and above) and adult patients with primary hemophagocytic lymphohistiocytosis (HLH) who have refractory, recurrent or progressive disease or intolerance with conventional HLH therapy.
• Approved Aemcolo (rifamycin), an antibacterial drug indicated for the treatment of adult patients with travelers’ diarrhea caused

PREVENTION
Inflammatory bowel disease linked to prostate cancer: Men with inflamed guts are four to five times at risk for prostate cancer European Urology

Is being a night owl bad for your health? Night owls may have a higher risk of suffering from heart disease and type 2 diabetes than early risers. Advances in Nutrition

Patient Education Can Improve Chronic Disease Management: An educational intervention can improve patients' ability to self-manage their chronic diseases, according to a study published in the November issue of the Journal of the American Osteopathic Association. 

Less Than One Hour of Resistance Training Weekly Tied to Lower CVD Risk: Less than an hour a week of resistance exercise (RE) is associated with decreased risks for cardiovascular disease (CVD)-related events and all-cause mortality, independent of aerobic exercise. Medicine & Science in Sports & Exercise. Weekly RE frequencies of one, two, and three times or a total of one to 59 minutes was associated with approximately a 40 to 70 percent decreased risk for total CVD events, independent of aerobic exercise, compared with no RE. For weekly RE of more than four times or ≥60 minutes, there was no further significant risk reduction.

Limiting Social Media May Improve Psychological Well-Being: Limiting social media use to 30 minutes per day may lead to significant improvement in well-being, according to a study published in the December issue of the Journal of Social and Clinical Psychology. 

Flu Vaccine Linked to Reduced Risk for Death in Heart Failure: After extensive adjustment for confounders, influenza vaccination is associated with a reduced risk for all-cause and cardiovascular death among patients with heart failure, according to a study published online Dec. 10 in Circulation. Compared with intermittent vaccination, annual vaccinations, vaccination early in the year (September to October), and a greater number of vaccinations were correlated with larger reductions in the risk for death.

Sleep Length, Quality Linked to Risk for Falls, Fractures: Women with less than five, more than 10 hours of sleep, poor sleep quality at increased risk for falls. Journal of Bone and Mineral Research 

AHA Guidelines Stress Healthy Lifestyle for Lowering Cholesterol: A healthy lifestyle for lowering cholesterol should be emphasized for reducing cardiovascular risk across the life course, according to a guideline published online Nov. 14 in Circulation to coincide with the annual meeting of the American Heart Association, held from Nov. 10 to 12 in Chicago.

Performance on exercise test predicts risk of death from cardiovascular disease and cancer:Performance on an exercise test predicts the risk of death from cardiovascular disease, cancer, and other causes, a new study finds. Good performance on the test equates to climbing three floors of stairs very fast, or four floors fast, without stopping. The findings underline the importance of fitness for longevity. EuroEcho-Imaging 2018

Study takes stand on true health benefits of getting up out of your chair: The study, published in the journal Medicine & Science in Sports & Exercise, reveals that the 'benefits' of standing over sitting equate to little more than 9 calories an hour -- the equivalent of just one stalk of celery. In fact, purely for weight gain perspective, it would take individuals who opted to stand nearly the entire day to burn just one cup of coffee. 

Physical activity in the evening does not cause sleep problems: Contrary to popular belief, there is no reason to avoid exercising in the evening, an analysis of the scientific literature has revealed. Sports Medicine 


NUTRITION/SUPPLEMENTS/VITAMINS
Low-Carbohydrate Diets Linked to Increase in Calories Burned: Low dietary carbohydrate intake is associated with increased energy expenditure during weight-loss maintenance. The BMJ 

New evidence that females might benefit most from a low-salt diet: A low-salt diet may be more beneficial in lowering blood pressure in females than males, report scientists who found that while actual salt retention isn't higher in females, there is still an effect that drives pressure up.  Hypertension 

New review of scientific studies confirms food cravings can be reduced: Food craving, the intense desire to eat certain foods, can sabotage efforts to maintain healthy eating habits and body weight, no matter the time of year. However, an examination of 28 current peer-reviewed scientific studies largely substantiates findings that changes in diet, prescription medications, physical activity and bariatric surgery reduce craving. Current Opinion in Endocrinology & Diabetes and Obesity 

Weight cycling is associated with a higher risk of death: Weight cycling, or the constant losing and gaining of weight (usually from diet), leads to adverse health outcomes. By some estimates, 80 percent of people who lose weight will gradually regain it to end up at the same weight or even heavier than they were before they went on a diet. The Endocrine Society's Scientific Statement on the causes of obesity found this was because once an individual loses weight, the body typically reduces the amount of energy expended at rest, during exercise and daily activities while increasing hunger. This combination of lower energy expenditure and hunger creates a "perfect metabolic storm" of conditions for weight gain. Journal of Clinical Endocrinology & Metabolism. 

Intermittent fasting: No advantage over conventional weight loss diets: Intermittent fasting helps lose weight and promotes health. However, it is not superior to conventional calorie restriction diets, scientists have found out in the largest investigation on intermittent fasting to date. The scientists conclude that there are many paths leading to a healthier weight. Everybody must find a diet plan that fits them best and then just do it!  The American Journal of Clinical Nutrition


TREATMENT
Blood pressure: Early treatment advised by US guidelines has no survival benefits: When is high blood pressure dangerous? Medical associations offer widely differing answers. In the USA, for example, patients are seen as hypertensive much sooner than in Germany. A team has concluded that treating patients sooner does not reduce the risk of deadly heart disease. It could even negatively affect their mental health.  European Heart Journal 

Low Risk of Side Effects for Statins: Statins are associated with a low risk for side effects, according to a scientific statement from the American Heart Association (AHA). he risks for statin-induced serious muscle injury and serious hepatotoxicity are <0 .1="" 0.001="" 0.2="" a="" about="" and="" between="" cancer="" cataracts="" causal="" cognitive="" convincing="" diabetes="" diagnosed="" dysfunction="" erectile="" evidence="" for="" is="" mellitus="" nbsp="" neuropathy="" newly="" no="" of="" or="" p="" per="" percent="" peripheral="" relationship="" respectively="" risk="" seen="" statin-induced="" statins="" tendonitis.="" the="" treatment.="" was="" year="">

Among older women, the naturally occurring hormone DHEA may preserve bone and muscle mass when compared with placebo, study suggests. Clinical Endocrinology

OTHER
Fear Impacts Quality of Life for Young Adults With Type 1 Diabetes: Fear of complications and frustration at the amount of time required to manage type 1 diabetes impact the quality of life of young adults with the disease, according to a study published in the December issue of The Diabetes Educator.

Some E-Cigarette Liquids Contain Erectile Dysfunction Meds: Consumers should not use two electronic cigarette liquids that contain erectile dysfunction drugs because they may pose health risks, according to the U.S. Food and Drug Administration. Lab tests revealed both sildenafil and tadalafil in E-Cialis HelloCig E-Liquid and sildenafil in E-Rimonabant HelloCig E-Liquid. The e-liquids are made by HelloCig Electronic Technology Co. Ltd., based in Shanghai. 

Recalled KotexTampons Can Unravel Inside Body: Certain Kotex tampons are being recalled by Kimberly-Clark because they can unravel and leave pieces inside women's bodies. There have been "a small number of reports of infections, vaginal irritation, localized vaginal injury, and other symptoms" among users of U by Kotex Sleek Tampons, Regular Absorbency, according to the company, CBS News reported.

Online Tool Helps Patients with Advance Care Planning: The patient-facing PREPARE advance care planning program plus an easy-to-read advance directive significantly increases documentation of advance care planning and patient-reported engagement, according to a study published online Oct. 29 in JAMA Internal Medicine.

Name-Brand Medications Driving Spike in U.S. Drug Spending: "Total prescription drug spending increased 10 percent annually since 2010," and 82 percent of prescriptions were for cheaper, generic drugs, according to the Blue Cross Blue Shield study, NBC News reported. But the study also showed that expensive "branded prescription drugs accounted for only 17 percent of total prescriptions filled, but 79 percent of total prescription drug spending [$79.5 billion]." The biggest costs were from three rheumatoid arthritis drugs -- Humira, Remicade, and Enbrel -- a quick-acting insulin called Novolog, and Neulasta, an immune system-strengthening treatment for cancer patients, NBC News reported.



Wednesday, December 12, 2018

Take a Break: Scandinavian Christmas-St. Lucia’s Day



December 13 is St. Lucia’s day. This feast honors the saint, who, according to legend brought food and aid to Christians hiding in the catacombs using a candle lit wreath to light her way thereby leaving her hands free to carry as much food as possible. 

A celebration dating back to the middle ages, it’s a time to bring light at the darkest part of the winter. Watch the video below to learn more about this tradition. 



If you would like to try one of the recipes for the special buns served, try King Arthur’s recipe.

May this day bring joy and light as we await the coming winter solstice and Yule!

Not interested in today’s activities, try the Take a Break Pinterest Board.


Saturday, December 8, 2018

Being Seriously Ill Can Bankrupt You




In the last month I’ve been working with a family that has been brought to their knees by medical bills. One would think that a combination of Medicare and supplemental insurance would take care of most needs, but it’s become crystal clear that even those who have put aside what they believe is plenty of money for retirement can quickly find themselves in a dire straights.

And it’s not just those who are retired. Anyone with a serious condition can find themselves in financial trouble in no time due to lost wages, high out of pocket costs for both health insurance as well as for services not covered by the insurance they may be paying top dollar for.

The number of people and agencies I’ve interacted with lately, where they just don’t understand, is astonishing to me. It’s quite simple unless you qualify for a combination of Medicare and Medicaid, medicine, eye care, dental, medical supplies, personal care etc., can deplete savings and then some. Of course if you qualify for Medicaid you most likely have other sets of issues from housing to mobility.

It’s time we start having frank discussions at all levels about the real costs of being seriously and/or chronically ill and why just looking at income is inadequate to evaluate need.

Instead of my trying to map this out, I’m encouraging people to watch. Being Seriously Ill in the U.S.: Financial and Healthcare Impacts, from the Forum at the Harvard T.H. Chan School of Public Health that took place in November.

Let’s start the solution conversation.

Wednesday, December 5, 2018

Take a Break: Scandinavian Christmas-Woven hearts




The classic red and white woven heart baskets are very popular throughout Norway, Sweden and Denmark. The origins of the heart is unknown but by 1860, the famous Danish writer, Hans Christian Anderson, was making them.

The easiest thing to do is download a template 

You can make your own patterns, as the basic template is a square with an arch on one side.  Use any type of material-paper, construction paper, card stock, Duct tape, felt etc. However, for starting out, use copy paper since it’s light and easier to weave. The more complex the pattern you wish to weave, the lighter your paper should be. If you wish to do more complex designs, you can forgo the basket feature and do single sheets of paper. Keep in mind the smaller the hearts and the more intricate patterns, the harder it will be to weave.

For different patterns, check out the video below. 
 


Not interested in today’s activities, try the Take a Break Pinterest Board.

Saturday, December 1, 2018

Life with Chronic Conditions: A Very Helpful Comment



 This past week has been exceedingly challenging for a number of reasons, so when a friend asked if I were able to do one more thing, I came close to loosing it. My friend replied with the following comment, “Remember this is an elective activity. Feel free to say, "Help, I've lost my mind and my body no longer follows my orders.  Could YOU take care of it, Dave?"  I can and will.”  

It’s one of the most reassuring things I’ve heard in a long time.  Not only did it help me calm down and reassure me, I actually was able to complete one more task.

So, the next time you encounter someone who is “over the top,” consider some variation of Dave’s comments. It really helps.

Wednesday, November 28, 2018

Take a Break: Scandinavian Christmas-Tomtem Garland

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With Christmas approximately four weeks away, “take a breaks” will focus on Scandinavian holidays. This week is all about creating a Tomtem garland.

Tomte are Swedish gnome like creatures who are responsible for the protection and welfare of the home and farm. Often described as an older, little man about the size of a young child, he wears old often ragged clothes, usually gray or navy, and sports a bright red cap on his head. Residing in the pantry or barn, he watches over the household and farm and is responsible for the care of the farm animals, especially the horses. The tomte has an enormous capacity for work but will not tolerate anyone’s interference. It is believed that a clean and orderly home or farm is an indication that this domestic sprite resides there.

The Norwegians have a similar character named nisse.

Tomtar and nisser require very little of the humans they work for. They demand only the respect and trust of the farmer and a bowl of julegrøt (Christmas porridge) with butter on Christmas Eve. These spirits will not remain in a home where respect is lacking and thus the farm will not thrive and the farmer will be reduced to poverty.

The present day version of the julenisse is very different form the legends of the domestic tomte or nisse. The julenisse is portrayed as an older, good natured, adult-sized man (not surprisingly the size of an uncle or father) with a long white beard and a red hat and suit. He carries a sack of toys on his back, visits children in their homes on Christmas Eve and always asks, “Are there any good children here?” (“Er det noen snille barn her?”) Many Scandinavian children also believe he lives at the North Pole where he has a workshop.

Learn more about the Legend of the Nisse and Tomte.

Make a Tomtem Garland out of red and white triangles and a circle for the face. Click here for directions. This is a good project to do with kids.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Saturday, November 24, 2018

Life with Chronic Conditions: Having faith in humanity



 It is not uncommon for those affected by long illnesses to question both their faith in humanity as well as the purpose of life. Below are three famous people’s responses to these questions E.B. White, writer of "Charlotte's Web"; Albert Einstein (scientist); and the Fourteenth Dalai Lama:

E.B. White
March 30, 1973

"Dear Mr. Nadeau:
As long as there is one upright man, as long as there is one compassionate woman, the contagion may spread and the scene is not desolate. Hope is the thing that is left to us, in a bad time. I shall get up Sunday morning and wind the clock, as a contribution to order and steadfastness.

Sailors have an expression about the weather: they say, the weather is a great bluffer. I guess the same is true of our human society - things can look dark, then a break shows in the clouds, and all is changed, sometimes rather suddenly. It is quite obvious that the human race has made a queer mess of life on this planet. But as a people we probably harbor seeds of goodness that have lain for a long time waiting to sprout when the conditions are right. Man’s curiosity, his relentlessness, his inventiveness, and his ingenuity have led him into deep trouble. We can only hope that these same traits will enable him to claw his way out.

Hang on to your hat. Hang on to your hope. And wind the clock, for tomorrow is another day.
Sincerely,
E. B. White"

Albert Einstein
A woman wrote to Einstein saying, We were having one war after another — first we had the First World War, then we had the Second World War and I just couldn’t see any point to the whole thing. So I wrote him a letter and I said, “What’s the point of living with what we’re going through here — having one war after another?”

April 28, 1951
Dear Miss Block:

The question “why” in the human sphere is easy to answer: to create satisfaction for ourselves and for other people. In the extra-human sphere the question has no meaning. Also the belief in God is no way out for in this case you may ask “Why God.”

Sincerely yours,
Albert Einstein

The Dalai Lama
ONE GREAT QUESTION underlies our experience, whether we think about it consciously or not: What is the purpose of life?  I have considered this question and would like to share my thoughts in the hope that they may be of direct, practical benefit to those who read them.

 I believe that the purpose of life is to be happy.  From the moment of birth, every human being wants happiness and does not want suffering.  Neither social conditioning nor education nor ideology affect this.  From the very core of our being, we simply desire contentment.  I don't know whether the universe, with its countless galaxies, stars and planets, has a deeper meaning or not, but at the very least, it is clear that we humans who live on this earth face the task of making a happy life for ourselves.  Therefore, it is important to discover what will bring about the greatest degree of happiness.

From my own limited experience I have found that the greatest degree of inner tranquility comes from the development of love and compassion.

Read the entire letter online at Compassion and the Individual by the Fourteenth Dalai Lama