Saturday, July 20, 2019

Journal Watch July 2019




PAIN

Cancer Survivors Have High Prevalence of Chronic Pain: The prevalence of chronic pain and HIPC were higher for survivors with less than a high school education, low household income, public insurance, or no paid employment. The adjusted prevalence of chronic pain was highest among survivors of cancer of the bone, kidney, throat-pharynx, and uterus. JAMA Oncology


Tanezumab Improves Scores for Pain, Function in Osteoarthritis: For patients with osteoarthritis (OA) of the knee or hip, tanezumab is associated with significant improvements in pain and physical function versus placebo, according to a study published in the July 2 issue of the Journal of the American Medical Association.


Rimegepant Shows Promise for Relief From Migraine Attacks: Compared with placebo, rimegepant, an orally administered, small-molecule, calcitonin gene-related peptide (CGRP) receptor antagonist, can increase the percentage of patients free of pain and free from their most bothersome symptom during a migraine attack, according to a study published in the July 11 issue of the New England Journal of Medicine.

Galcanezumab Can Cut Frequency of Cluster Headache Attacks: Galcanezumab can reduce the frequency of episodic cluster headache attacks, according to a study published in the July 11 issue of the New England Journal of Medicine.

COMPLEMENTARY & ALTERNATIVE MEDICINE
Hepatitis C and Dietary Supplements: A new report from the National Center for Complementary and Integrative Health  has found that no dietary supplement has been shown to be effective Hep C or its complications. Research on other dietary supplements for hepatitis C, such as zinc, licorice root (or its extract glycyrrhizin), SAMe, and lactoferrin, is in its early stages, and no firm conclusions can be reached about the potential effectiveness of these supplements. Colloidal silver is sometimes promoted for treating hepatitis C, but is not safe. Colloidal silver can cause irreversible side effects, including a permanent bluish discoloration of the skin.

Safety concerns: Herbal supplement used to treat addiction and pain: The herb kratom is increasingly being used to manage pain and treat opioid addiction, but it's not safe to use as an herbal supplement, according to new research led by faculty at Binghamton University, State University of New York. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy

Music Relieves Pre op Anxiety Before Peripheral Nerve Block: Patients undergoing preoperative peripheral nerve block placement have a similar change in anxiolytic scores when they receive music medicine versus midazolam, according to a study published online July 18 in Regional Anesthesia & Pain Medicine.

FDA ACTION
• Approved Recarbrio (imipenem, cilastatin and relebactam), an antibacterial drug product to treat adults with complicated urinary tract infections (cUTI) and complicated intra-abdominal infections (cIAI)
• Granted accelerated approval to Xpovio (selinexor) tablets in combination with the corticosteroid dexamethasone for the treatment of adult patients with relapsed refractory multiple myeloma (RRMM) who have received at least four prior therapies and whose disease is resistant to several other forms of treatment, including at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti-CD38 monoclonal antibody.
• Issued warning letters to three repackers of active pharmaceutical ingredients (API), B&B Pharmaceuticals, Inc., Asclemed USA, Inc., doing business as Enovachem and Spectrum Laboratory Products, Inc., for significant violations of current good manufacturing practice (CGMP) requirements.
• Warned patients and health care providers that certain Medtronic MiniMed insulin pumps are being recalled due to potential cybersecurity risks and recommends that patients using these models switch their insulin pump to models that are better equipped to protect against these potential risks.
• Approved Soliris (eculizumab) injection for intravenous use for the treatment of neuromyelitis optica spectrum disorder (NMOSD) in adult patients who are anti-aquaporin-4 (AQP4) antibody positive.
• Approved Dupixent (dupilumab) to treat adults with nasal polyps (growths on the inner lining of the sinuses) accompanied by chronic rhinosinusitis (prolonged inflammation of the sinuses and nasal cavity). This is the first treatment approved for inadequately controlled chronic rhinosinusis with nasal polyps.

Issued warnings to companies selling illegal, unapproved kratom drug products marketed for opioid cessation, pain treatment and other medical uses

Approved Vyleesi (bremelanotide) to treat acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women.
• Expanded the indication for Symdeko (a combination of tezacaftor/ivacaftor) tablets for treatment of pediatric patients ages 6 years and older with cystic fibrosis who have certain genetic mutations.

PREVENTION

Long work hours associated with increased risk of stroke: People who worked long hours had a higher risk of stroke, especially if they worked those hours for 10 years or more. Stroke


Morning Preference Has Protective Effect on Breast Cancer Risk: Morning preference seems to have a protective effect on breast cancer risk, according to a study published online June 26 in The BMJ.


HPV Vaccination Program Has Considerable Impact: After five to eight years of vaccination, prevalence of HPV 16 and 18 decreased and anogenital wart diagnoses was down in girls, women, boys, men. The Lancet


Three Interventions Could Cut Cardiovascular Deaths: Lowering blood pressure, cutting sodium intake, and eliminating intake of trans fat could cut the incidence of premature death from cardiovascular disease by 94 million people worldwide during the next 25 years, according to a study published online June 10 in Circulation.


Timing of Exercise May be Key to Successful Weight Loss: In a study of 375 adults who have successfully maintained weight loss and who engage in moderate-to-vigorous intensity physical activity, most reported consistency in the time of day that they exercised, with early morning being the most common time. Being consistent in the timing of physical activity was associated with higher physical activity levels, regardless of whether people exercised consistently during the morning, afternoon, or evening. Obesity

Smokers three times likely to die from heart disease: The study, the most in-depth in the world, shows for the first time how smoking harms all of the cardiovascular system - the heart and major blood vessels. BMC Medicine


Extremely Low LDL Cholesterol May Up Stroke Risk: Cholesterol levels that are too low may increase the risk for hemorrhagic stroke, according to a study published online July 2 in Neurology.

Healthy lifestyle may offset genetic risk of dementia: The study was led by the University of Exeter -- simultaneously published today in JAMA and presented at the Alzheimer's Association International Conference 2019 in Los Angeles. The research found that the risk of dementia was 32 per cent lower in people with a high genetic risk if they had followed a healthy lifestyle, compared to those who had an unhealthy lifestyle. Participants with high genetic risk and an unfavourable lifestyle were almost three times more likely to develop dementia compared to those with a low genetic risk and favourable lifestyle. 

Mentally Stimulating Activities Lower Risk for Cognitive Decline: Among community-dwelling older persons, engaging in a higher number of mentally stimulating activities(reading books, using computers, social or craft activities, playing games) particularly in late life, is associated with a lower risk for developing mild cognitive impairment (MCI), according to a study published online July 10 in Neurology.

Take a bath 90 minutes before bedtime to get better sleep: A stematic review protocols -- a method used to search for and analyze relevant data -- allowed researchers to analyze thousands of studies linking water-based passive body heating, or bathing and showering with warm/hot water, with improved sleep quality. Researchers in the Cockrell School of Engineering found that bathing 1-2 hours before bedtime in water of about 104-109 degrees Fahrenheit can significantly improve your sleep. Sleep Medicine Review 

Excess Risk for Diabetes-Linked Heart Failure Greater in Women: The excess risk for heart failure associated with diabetes is significantly greater in women than men, according to a meta-analysis published online July 18 in Diabetologia.


NUTRITION/SUPPLEMENTS

Diet quality may affect risk of frailty in older adults: Poorer overall diet quality was linked with an increased risk of becoming frail in a study of U.S. community-dwelling older adults, published in the Journal of the American Geriatric Society. The quality of the overall diet appeared to be more important than protein intake for a lower risk of frailty.


Vast majority of dietary supplements don't improve heart health or put off death,study finds:In a massive new analysis of findings from 277 clinical trials using 24 different interventions, researchers say they have found that almost all vitamin, mineral and other nutrient supplements or diets cannot be linked to longer life or protection from heart disease. Although they found that most of the supplements or diets were not associated with any harm, the analysis showed possible health benefits only from a low-salt diet, omega-3 fatty acid supplements and possibly folic acid supplements for some people. Researchers also found that supplements combining calcium and vitamin D may in fact be linked to a slightly increased stroke risk. Annals of Internal Medicine.



Possible link between sugary drinks and cancer: A study published by The BMJ  reports a possible association between higher consumption of sugary drinks and and an increased risk of cancer. While cautious interpretation is needed, the findings add to a growing body of evidence indicating that limiting sugary drink consumption, together with taxation and marketing restrictions, might contribute to a reduction in cancer cases.

Are testosterone-boosting supplements effective? Not likely: Men who want to improve their libido or build body mass may want to think twice before using testosterone-boosting supplements -- also known as "T boosters" -- as research shows these alternatives to traditional testosterone replacement therapy may not have ingredients to support their claims. The World Journal of Men's Health

Frequent Fried Food Intake Increases Risk for Coronary Artery Disease

The frequency of fried food consumption shows a positive linear relationship with the risk for coronary artery disease (CAD), according to a study recently published in Clinical Nutrition.

TREATMENT

Study challenges 'no pain no gain' requirement for patients with clogged leg arteries: Patients with peripheral arterial disease should be given the option of pain-free exercise, according to a study published today in the European Journal of Preventive Cardiology. This study compiled the best evidence and compared completion and adherence rates between traditional versus alternative exercise programmes of at least four weeks duration. Traditional programmes consisted of walking until moderate to severe pain was induced, resting until the pain subsided, then repeating the process. Alternative exercises included walking without pain, arm ergometer (an exercise bike for the arms), resistance training, circuit training, lower limb aerobic exercise, and walking with poles. "Many patients with PAD exercise very little or not at all. It has been suggested that the pain component of conventional exercise programmes is a deterrent. More recent studies have shown that pain-free forms of exercise are equally effective, but patients are not always given the option."


Outcomes Improved After ACL Repair With Three Tendon Graft Types

Patients who received patellar tendon, hamstring tendon, or "double-bundle" hamstring tendon grafts for anterior cruciate ligament (ACL) repair had no significant difference in quality of life at five years postsurgery, according to a study published in the June 5 issue of The Journal of Bone & Joint Surgery.

Testosterone replacement therapy (TRT) can increase men's risk of stroke and heart attack: Aging men with low testosterone levels who take testosterone replacement therapy (TRT) are at a slightly greater risk of experiencing an ischemic stroke, transient ischemic attack (TIA), or myocardial infarction, especially during the first two years of use, reports a new study. The findings confirm concerns voiced by many health agencies about the potential risks associated with the treatment. American Journal of Medicine

 

Link found between gut bacteria, successful joint replacement: Having healthy gut flora -- the trillions of bacteria housed in our intestines -- could lower the risk of infection following knee and hip replacement surgeries, while an unhealthy intestinal flora may increase the risk of infection. Clinical Orthopaedics and Related Research

CAREGIVING
At-home support helps stroke patients adjust after hospital stay: Michigan State University researchers have found that many stroke patients feel unprepared when discharged from the hospital. Their caregivers feel the same.  But when a home-based support network using social work case managers and online resources is put into place, quality of life and confidence in managing one's health improve, according to a new study published in the American Heart Association's journal Circulation: Cardiovascular Quality and Outcomes.


OTHER

Nursing home care cost significantly out paces general inflation and medical care prices: One of the largest studies on out-of-pocket costs for nursing home care finds prices are high and rising faster than other medical care and consumer prices, reports a team of health policy researchers. Medical Care Research and Review


Electronic Health Record medication lists lack accuracy, may threaten patient safety:When it comes to keeping track of prescribed medications between clinic visits, many patients rely on printed medication lists automatically generated from electronic health records (EHRs). An examination of the EHRs of a cohort of ophthalmology patients revealed that one-third had at least one discrepancy between the medications discussed in the clinician's notes and those on the medication list. JAMA Ophthalmology


One in 10 people have 'near-death' experiences, according to new study: Near-death experiences where people report a range of spiritual and physical symptoms, including out-of-body sensations and seeing or hearing hallucinations, affect 10% of people, according to a new study analysing participants from 35 countries. Experiences most frequently reported by participants in their study included: abnormal time perception (87 per cent), exceptional speed of thought (65 per cent), exceptionally vivid senses (63 per cent) and feeling separated from, or out of their body (53 per cent). The study group who reported NDEs variously described feeling at total peace, having their 'soul sucked out', hearing angels singing, being aware they were outside their body, seeing their life flashing before them, and being in a dark tunnel before reaching a bright light. European Academy of Neurology Congress

 

Older adults: Daunted by a new task? Learn 3 instead: Learning several new things at once increases cognitive abilities in older adults, according to new research. After just 1.5 months learning multiple tasks in a new study, participants increased their cognitive abilities to levels similar to those of middle-aged adults, 30 years younger. Control group members, who did not take classes, showed no change in their performance. One important way of staving off cognitive decline is learning new skills as a child would. That is, be a sponge: seek new skills to learn; maintain motivation as fuel; rely on encouraging mentors to guide you; thrive in an environment where the bar is set high. The Journals of Gerontology

Do You Need That Surgery? How To Decide, And How To Pick A Surgeon If You Do: So your doctor has told you some of the scariest words you can possibly hear: You need surgery. What do you do next? Advise from a primary care doctor that he gives his patients. NPR

The unpopular truth about biases toward people with disabilities: Needing to ride in a wheelchair can put the brakes on myriad opportunities -- some less obvious than one might think. New research from Michigan State University sheds light on the bias people have toward people with disabilities, known as "ableism," and how it shifts over time. Contrary to popular belief, the findings suggest that biases toward people with disabilities increase with age and over time, but that people are less likely to show how they really feel publicly. Journal of Social Issues

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