CHRONIC PAIN
CPM for knee or shoulder joints: Advantage only in two therapeutic indications:
Patients who have had knee or
shoulder surgery or who require conservative treatment can benefit from
training with motor-driven continuous passive motion (CPM) devices. However,
this only applies to two therapeutic indications, and in each case only to one
treatment outcome. Patients with stiff shoulder have less pain with CPM
treatment than with physiotherapy alone. The range of motion after total knee
replacement is improved if CPM is used in addition to physiotherapy. This is
the result of the final report published by the Institute for Quality and
Efficiency in Health Care (IQWiG).
Most common shoulder operation is no more beneficial than placebo surgery: The Finnish Shoulder
Impingement Arthroscopy Controlled Trial (FIMPACT) compared surgical treatment
of shoulder impingement syndrome to placebo surgery. Two years after the
procedure the study participants, both those in the group who underwent surgery
and the ones in the placebo group, had equally little shoulder pain and were
equally satisfied with the overall situation of their shoulder. "These
results show that this type of surgery is not an effective form of treatment
for this most common shoulder complaint. BMJ
Child Abuse Linked to Fibromyalgia: A new
study has shown that women Veterans being treated for fibromyalgia exhibit high
rates of childhood abuse. Journal of General Internal Medicine
Acupuncture May Cut
Arthralgia From Aromatase Inhibitors: Acupuncture may cut joint pain among postmenopausal women
with early-stage breast cancer and aromatase inhibitor-related pain, according
to a study published in the July 10 issue of the Journal of the American
Medical Association.
COMPLEMENTARY & ALTERNATIVE MEDICINE
HerbList App Launched to Provide Information on Herbal Products: The National Institutes of Health's National Center for
Complementary and Integrative Health (NCCIH) has announced the launch of an app
for easy access to research-based information on the safety and effectiveness
of herbal products. HerbList allows users to access information about the
science of more than 50 popular herbs and herbal supplements, including kava,
acai, ginkgo, turmeric, and others marketed for health purposes. Information on
potential safety problems, side effects, and herbal-drug interactions can be also
be accessed via additional links for more information. Favorite herbs can be
marked for quick recall and offline accessibility.
FDA ACTION
•
Approved TPOXX (tecovirimat), the first drug with an indication for treatment
of smallpox.
•
Requires strengthening the current warnings in the prescribing information that
fluoroquinolone antibiotics may cause significant decreases in blood sugar and
certain mental health side effects.
• Approved first targeted treatment, Tibsovo tablets, for
relapsed or refractory acute myeloid leukemia (AML) with IDH1 mutation in adult
patients.
• Approved the Magrace and Sentimag Magnetic
Localization System for guiding sentinel lymph node biopsies in certain
patients with breast cancer.
• Warns
of the Dangers of 'Vaginal Rejuvenation'
•
Approved segesterone acetate and ethinyl estradios, a new vaginal ring for 1
year of birth control
•
Approved the first identical alternative to the EpiPen
• Permits
Marketing of Brain stimulation device-transcranial magnetic stimulation- to
treat obsessive compulsive disorder
PREVENTION
Older adults who get physical can lower their heart disease risk Adults in their early 60s, who
spend less time sitting and more time engaged in physical activity have
healthier levels of heart and vessel disease indicators. The results from
increased physical activity were found to be particularly good among women. JAHA
Cardiac Profiles Up With Exercise, Less Sitting in Early Old Age: For adults aged 60 to 64 years, greater light physical
activity (PA) and moderate-to-vigorous intensity PA and less sedentary time are
associated with more favorable cardiovascular profiles, according to a study
published online Aug. 8 in the Journal of the American Heart Association.
Exercise Cuts Risk of Chronic Disease in Older Adults: People
who engaged in the highest levels of total physical activity were twice as
lively to avoid stroke, heart disease, angina, cancer and diabetes, and be in
optimal physical and mental shape 10 years later, experts found. Scientific
Reports
Perspectives on USPSTF A-Fib Screening Recommendation:
The U.S. Preventive Service Task Force published a final recommendation on Aug.
7 citing insufficient evidence to assess the benefits and harms of screening
for atrial fibrillation (AF) with electrocardiography (ECG) in asymptomatic,
older adults. A series of editorials published in the JAMA network
journals offer additional perspectives, with recognition of the need to develop
a national screening strategy.
Some Bacteria Now More
Tolerant of Alcohol-Based Sanitizers: Some types of bacteria are developing tolerance of
alcohol-based hand sanitizers used in hospitals, according to a study published
in the Aug. 1 issue of Science Translational Medicine. The introduction
of these sanitizers into hospitals led to reductions in staph infections in
patients and certain kinds of drug-resistant bacteria, but there was a rise in
enterococcal infections, NPR reported. Worldwide, enterococci account
for 10 percent of bacterial infections acquired in the hospital. In North
America and Europe, they are a leading cause of sepsis.
Greater Weight Loss Benefits Metabolic Health People who lose more than a fifth of their body
weight more than double their likelihood of good metabolic health, compared
with those who only lose a relatively small amount, according to a study
published in Mayo Clinic Proceedings.
NUTRITION/SUPPLEMENTS/VITAMINS
Study finds average salt consumption safe for heart health: New research shows that for the vast
majority of individuals, sodium consumption does not increase health risks
except for those who eat more than five grams a day, the equivalent of 2.5
teaspoons of salt. Fewer than five per cent of individuals in developed
countries exceed that level. The large, international study also shows that
even for those individuals there is good news. Any health risk of sodium intake
is virtually eliminated if people improve their diet quality by adding fruits,
vegetables, dairy foods, potatoes, and other potassium rich foods. The Lancet
A Diverse Diet May Not Be the Healthiest One: Encouraging
people to eat a wide variety of foods to ensure they meet all their dietary
needs may backfire, according to a new scientific statement from the American
Heart Association that provides an overview of recent scientific studies. There
is some evidence that a wider variety of food options in a meal may delay
people's feeling of satiation (fullness), increasing the amount of food they
eat. Limited evidence suggests that greater dietary diversity is associated
with eating more calories, poor eating patterns and weight gain in adults.
Instead of telling people to eat a variety of foods, the statement authors
conclude that dietary recommendations should emphasize adequate consumption of
plant foods, such as fruit, vegetables, beans and whole grains, low-fat dairy
products, non-tropical vegetable oils, nuts, poultry and fish, and limit
consumption of red meat, sweets and sugary drinks. Circulation
Review Addresses Nutritional Hype for Popular Foods:
While many dietary patterns, foods, and nutrients receive substantial media
attention and are hyped as having cardiovascular benefits, some have evidence
for these benefits and others do not, according to a review published in the
July 31 issue of the Journal of the American College of Cardiology. The
researchers found evidence of harm and recommend limiting or avoiding added
sugars and energy drinks. They found a lack of evidence of harm or benefit for
dairy products and fermented food and seaweed. They found evidence of benefit
for legumes, moderate habitual coffee consumption, tea, mushrooms, alcohol in
recommended amounts, plant or marine omega-3 fatty acids, and vitamin B12
supplements for those who are deficient.
Nut Intake Reduces HbA1c
Among Adults With T2DM:Nut intake reduces hemoglobin A1c (HbA1c) among individuals with type 2
diabetes, according to a study published in the August issue of Diabetologia.
"Nut intake as a replacement for carbohydrate consumption improves
glycemic control and lipid risk factors in individuals with type 2 diabetes.”
Moderate carbohydrate intake may be best for health, study suggests: The observational study of more than 15,400 people from the
Atherosclerosis Risk in Communities Study (ARIC) in the USA found that diets
both low (< 40% energy) and high (>70% energy) in carbohydrates were
linked with an increase in mortality, while moderate consumers of carbohydrates
(50-55% of energy) had the lowest risk of mortality. The Lancet
TREATMENT
Cognitive and Motor Training Combined May Slow or Reverse the Progress of Dementia: Research published in Dementia
and Geriatric Disorders found that just 30 minutes of visually-guided
movements per week can slow and even reverse the progress of dementia. Those in
the early stages of dementia who were exposed to 30 minutes a week to a game
which used rules to make visually-guided movements, were able to slow down the
progress of dementia and for some, even reverse their cognitive function to
healthy status. “These results suggest that even in the earliest stages of
neurodegeneration, the aging brain has enough neuroplasticity left that if you
can train it on this kind of thinking and moving task, it will improve their
cognitive skills.”
Rivaroxaban Effective for Atrial Fibrillation, VTE in Morbidly Obese: Morbid obesity does not appear to compromise the efficacy or
safety of anticoagulation treatment with the direct oral anticoagulants (DOAC)
rivaroxaban, according to a retrospective analysis of more than 600 obese patients
presented here at the International Society on Thrombosis and Haemostasis
(ISTH) 64th Annual Scientific and Standardization Committee (SSC) Meeting.
Depression, Antidepressants Are Associated With an Increased Risk of VTE: In the first
review of its kind, new research has found that depression and the use of
antidepressants are each associated with an increased risk of venous
thromboembolism (VTE). The study, published in the Annals of Medicine, also
showed that each of the various classes of antidepressant medications are
associated with an increased risk of VTE.
Tamsulosin Does Not Appear to Promote Urinary Stone Passage: Tamsulosin does not significantly increase the urinary
stone passage rate compared with placebo, according to a study published online
June 18 in JAMA Internal Medicine. Findings do not support tamsulosin
treatment for symptomatic urinary stones <9 mm="" span="">
Flu Vaccine Cuts Mortality in
Rheumatoid Arthritis Patients: Patients with rheumatoid arthritis (RA), particularly
elderly patients, who receive the influenza vaccine have significantly lower
morbidity and mortality, according to a study published in the June issue of
the International Journal of Rheumatic Diseases.
Benzodiazepines Associated With Increased Risk of Alzheimer’s Disease: The use of
benzodiazepines and related drugs is associated with a modestly increased risk
of Alzheimer’s disease, according to a study published in Acta Psychiatrica
Scandinavica. The risk increase was similar with both benzodiazepines and
related drugs regardless of their half-life.
Triple Combo Blood Pressure Pill Can Improve BP Control: Treatment with a pill combining low doses of three
antihypertensive drugs results in an increased proportion of patients with
mild-to-moderate hypertension achieving their target blood pressure (BP),
according to a study published in the Aug. 14 issue of the Journal of the
American Medical Association.
CAREGIVING
OTHER
New Tick Species Spreading in the United States:
The first new tick species to appear in the United States in 50 years is
spreading rapidly in the east and has been confirmed in seven states and the
suburbs of New York City. In its home range, the Asian longhorned tick (Haemaphysalis
longicornis) carries a virus that kills 15 percent of its victims, but is
considered a greater threat to livestock than to humans, The New York Times
reported.
More Than 40% of Women With Asthma May Develop COPD More than 4 in 10 women with asthma may
go on to develop chronic obstructive pulmonary disease (COPD), according to a
study published in the Annals of the American Thoracic Society.
In addition to smoking, the
study identified obesity, rural residence, lower education levels, and
unemployment as significant risk factors for ACOS. The researchers speculate
that these factors indicative of low socioeconomic status may result in
suboptimal access to care, undertreatment of asthma, and poor compliance to
medications, all of which lead to more frequent asthma attacks. These attacks,
in turn, may lead to airway remodelling that increases the chances of
developing asthma and COPD overlap syndrome (ACOS).
Patient Portals Don’t Appear to Have Much Traction:
Patient portals have not taken off as expected, according to an article
published in Medical Economics. Portals enable patients to view their
health records and lab results online, share the information with other
providers, and exchange secure messages with their physician's office. But both
anecdotal reports from physicians and some government reports have found that
few patients are actually using them.
Most
Postmenopausal Bleeding Not Associated with Cancer: Most women with
postmenopausal bleeding (PMB) will not be diagnosed with endometrial cancer,
according to a review published online Aug. 6 in JAMA Internal Medicine.
National Guideline Clearinghouse Offline Due to Funding Cuts: The National Guideline
Clearinghouse (NGC) and National Quality Measures Clearinghouse (NQMC) websites
were taken down on July 16 when funding for these federal databases ended,
according to an announcement by the Agency for Healthcare Research and Quality
(AHRQ).
