Saturday, October 19, 2019

Journal Watch October 2019


PAIN
The effectiveness of electrical stimulation in producing spinal fusion: Researchers from The Johns Hopkins University School of Medicine performed a systematic review and meta-analysis of published data on the effect of electrical stimulation therapies on spinal fusion. They found significant improvement overall in the rates of bone fusion following a course of electrical stimulation in both preclinical (animal) and clinical (human) studies. Journal of Neurosurgery

Experimental Growth Factor May Aid Knee Osteoarthritis: An experimental growth factor therapy, sprifermin, may prevent a worsening of osteoarthritis by increasing the thickness of cartilage in the knee, according to a study published in the Oct. 8 issue of the Journal of the American Medical Association.

Caution Urged When Taking Patients Off Opioid Painkillers: Doctors should be more cautious when taking chronic pain patients off opioid painkillers, according to a new U.S. Department of Health and Human Services guidance released.

 

Steroid Injections in the Knee and Hip Can Cause More Damage Than Previously Realized: A new study finds that corticosteroid shots may accelerate arthritis in knee and hip joints, even as it removes pain. Radiology 

Osteoarthritis can increase your risk for social isolation: When older adults become lonely -- a condition health professionals call "social isolation" -- their health and well-being can suffer. In fact, there may be a link between being socially isolated and osteoarthritis (arthritis) which causes joint pain and can limit your ability to get around. Journal of the American Geriatrics

Physical Therapy, Lifestyle Advice Underused in Knee OA: For patients with knee osteoarthritis (KOA), physical therapy (PT) and lifestyle counseling seem to be underutilized, while medication use has increased, according to a study published online Oct. 8 in Arthritis Care & Research.

 

COMPLEMENTARY & ALTERNATIVE MEDICINE
Massage and Music Therapy May Be Better Than Pills for Certain Dementia Symptoms: Massage, music therapy, and other non-drug interventions are effective at treating dementia symptoms such as aggression and agitation suggests a new studyTrusted Source published  in the Annals of Internal Medicine.

Chairy oga more effective than music therapy in older adults with advanced dementia: Researchers assessed the ability of older adults with advanced dementia to participate in non-pharmacological interventions and compared chair yoga with chair-based exercise and music therapy. Results showed that participants with moderate-to-severe dementia could safely adhere to non-pharmacological interventions; more than 97 percent fully engaged in each session. The chair yoga group reported a higher quality of life score, including physical condition, mood, functional abilities, interpersonal relationships, and ability to participate in meaningful activities. American Journal of Alzheimer's Disease & Other Dementias

Cultivating joy through mindfulness: An antidote to opioid misuse, the disease of despair: New research shows that a specific mind-body therapy, Mindfulness-Oriented Recovery Enhancement (MORE), increases the brain's response to natural, healthy rewards while also decreasing the brain's response to opioid-related cues. Science Advances

Mindfulness may reduce opioid cravings, study finds: People suffering from opioid addiction and chronic pain may have fewer cravings and less pain if they use both mindfulness techniques and medication for opioid dependence, according to researchers.
Drug and Alcohol Dependence

FDA ACTION

• Approved Mavyret as 8-Week Treatment for Hep C, Compensated Cirrhosis

• Approved Vaccine for Prevention of Smallpox, Monkeypox

• Approved Reyvow (lasmiditan) tablets for acute treatment of migraine
• Approved Scenesse (afamelanotide), a melanocortin-1 receptor agonist, for adult patients with a history of phototoxic reactions from erythropoietic protoporphyria
• Approved Descovy (emtricitabine 200 mg and tenofovir alafenamide 25 mg) for HIV-1 preexposure prophylaxis (PrEP)
• Approved Rituxan (rituximab) injection to treat granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) in combination with glucocorticoids in children 2 years and older

PREVENTION
Don't make major decisions on an empty stomach, research suggests: The study found that hunger significantly altered people's decision-making, making them impatient and more likely to settle for a small reward that arrives sooner than a larger one promised at a later date. Psychonomic Bulletin & Review

Dog ownership associated with longer life, especially among heart attack and stroke survivors: Dog ownership may be associated with longer life and better cardiovascular outcomes, especially for heart attack and stroke survivors who live alone, according to a new study and a separate meta-analysis published in Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association.

Regular exercise is good for your heart, no matter how old you are! Regular exercise is highly beneficial for all patients with cardiovascular disease regardless of age, report investigators in the Canadian Journal of Cardiology. Their results showed that the patients who benefited most from cardiac rehabilitation were those who started out with the greatest physical impairment.

Increase health benefits of exercise by working out before breakfast: According to a new study, published in the Journal of Clinical Endocrinology and Metabolism, health scientists Birmingham found that by changing the timing of when you eat and exercise, people can better control their blood sugar levels. The six-week study, which involved thirty men classified as obese or overweight and compared results from two intervention groups (who ate breakfast before / after exercise) and a control group (who made no lifestyle changes), found that people who performed exercise before breakfast burned double the amount of fat than the group who exercised after breakfast.

Cancer patients who exercise have less heart damage from chemotherapy: Patients with cancer should receive a tailored exercise prescription to protect their heart, reports a paper published today in the European Journal of Preventive Cardiology

Violence linked to social isolation, hypervigilance and chronic health problems: Exposure to violence can negatively impact a person's physical and psychosocial health, according to two new studies. The studies were based on in-person surveys of more than 500 adults living in Chicago neighborhoods with high rates of violent crime, and in predominantly racial and ethnic minority groups. Health Affairs

CTE risk, severity increases with years playing American football: The risk and severity of developing chronic traumatic encephalopathy (CTE) increases with the number of years playing American football according to a new study that appears online in Annals of Neurology. These findings reaffirm the relationship between playing tackle football and CTE, and for the first time quantify the strength of that relationship. In a sample of 266 deceased former amateur and professional football players, the study found that the risk of developing CTE increased by 30 percent per year played, meaning that for each 2.6 additional years of football played, the odds of developing CTE doubled. Among those with CTE, for each additional 5.3 years played, the odds of developing severe CTE doubled.

Cleaning with Bleach Can Release Harmful Airborne Particles: When bleach fumes mix with a citrus compound found in many household cleaners, they can form ultrafine particles like those found in smog. This compound is called limonene and is usually relatively mild but in large amounts can irritate the eyes, throat, lungs and skin.  Some green products may be safer than traditional bleach, but some experts say using vinegar and baking soda can also be non-toxic way to clean your home.

 

Ex-smokers,light smokers not exempt from lung damage: A new study shows that smoking even a few cigarettes a day is harmful to lungs and that former smokers continue to lose lung function at a faster rate than never-smokers for decades after quitting. People who smoke fewer than five cigarettes a day cause long-term damage to their lungs, according to a new study. The Lancet Respiratory Medicine

Flight Attendants Avoid Drinking Tap Water on Planes. You Should Too: Recent testing found the tap water on airplanes isn’t very sanitary and the quality varies greatly between different airlines. Researchers advise airline passengers to never drink water aboard an airplane unless it’s sealed in a bottle. That includes coffee or tea. They also advise passengers to avoid washing your hands in the bathrooms. Use hand sanitizer instead. Airline Water Study 2019,

What Is IQOS, and How Is It Different from Vaping or Smoking? Smoking giants Philip Morris and Altria have launched IQOS, a “HeatStick” that heats up rather than burns tobacco, for sale in the United States. IQOS looks like other e-cigarettes.  It is being pitched as a safer product than vaping. At this juncture it’s soon to know if it’s a safer choice and what the long term effects might be. As with any tobacco product, there are health risks. Healthline

NUTRITION/SUPPLEMENTS
Panel Votes Yes to Current Level of Red, Processed Meat Intake: An international panel suggests that adults continue their current levels of consumption of red or processed meat based on evidence from five systematic reviews published online Oct. 1 in the Annals of Internal Medicine Since the study was released, a number of members of the scientific community have come out against the study, which is in opposition to the current belief. Equally concerning is a new report that found ties between the lead author and the food industry, which he failed to disclose. The study was funded by International Life Sciences Institute (ILSI), an industry trade group heavily funded by big business.

Large, long-term study suggests link between eating mushrooms and a lower risk of prostate cancer: Results from the first long-term cohort study of more than 36,000 Japanese men over decades suggest an association between eating mushrooms and a lower risk of prostate cancer. International Journal of Cancer

Science Finds Simple Way to Lower Diabetes, High Blood Pressure Risk: New research finds a diet high in fiber, like shredded wheat, can help combat effects of type 2 diabetes and hypertension. Those on a high-fiber diet had lower cholesterol, lower blood pressure, and lower blood sugar.  Only 25 percent of adults get the recommended amount of fiber daily. American College of Cardiology Conference

In major meta-analysis of clinical trials, omega-3 fish oil supplements linked with lower cardiovascular disease risk People who increase their consumption of sugary beverages-whether they contain added or naturally occurring sugar-may face moderately higher risk of type 2 diabetes. The study also found that drinking more artificially sweetened beverages (ASBs) in place of sugary beverages did not appear to lessen diabetes risk. However, diabetes risk decreased when one daily serving of any type of sugary beverage was replaced with water, coffee, or tea. Diabetes Care.

Vitamin D and fish oil show promise in prevention of cancer death and heart attacks: The VITamin D and OmegA-3 Trial (VITAL) is the largest and most recent to test whether vitamin D or fish oil can effectively prevent cancer or cardiovascular disease. Results to date have been mixed but show promise for some outcomes, now confirmed by updated pooled (meta) analyses.T he North American Menopause Society (NAMS) Annual Meeting in Chicago

Alcohol consumption may increase dementia risk for people with mild cognitive impairment: Adults age 72 and older with mild cognitive impairment (MCI) who drank more than 14 alcoholic drinks a week were 72% more likely to progress to dementia over an eight-year period than those who drank less than one drink a week. For participants without MCI, alcohol consumption was not associated with higher dementia risk.

Replacing less healthy foods with nuts could help lower risk of long-term weight gain: People who ate a daily half-serving of nuts (about a handful) instead of the same amount of refined grains, red meat, or dessert gained less weight over a 24-year study period than those who ate nuts less frequently. Diabetes

Vitamins B-6 and B-12 linked with increased risk of hip fracture: A study of postmenopausal women in the Nurses’ Health Study found that a combined high intake of vitamins B6 and B12 was associated with an increased risk of hip fracture. The intakes were far higher than the recommended dietary allowances. These findings add to previous studies suggesting that vitamin supplements should be used cautiously because adverse effects can occur. JAMA Open Network

 

Frequent drinking is greater risk factor for heart rhythm disorder than binge drinking: Drinking small amounts of alcohol frequently is linked with a higher likelihood of atrial fibrillation than binge drinking, according to new research. EP Europace

Drinking more sugary beverages of any type may increase type 2 diabetes risk: People who increase their consumption of sugary beverages -- whether they contain added or naturally occurring sugar -- may face moderately higher risk of type 2 diabetes. Diabetes Care

Vitamin C therapy linked to better survival rates after sepsis: New research suggests that patients with sepsis and septic lung injury could have a better chance of survival and recover more quickly when treated with vitamin C infusions. On average, the vitamin C group spent three fewer days in the ICU at day 28 and a week less in the hospital overall by day 60 than the placebo group. JAMA

 

To fight effects of sleep deprivation, reach for healthy snacks: In a study of 245 Stanford physicians, researchers found that a better diet is associated with reduced side effects of sleep deprivation. Stanford Medicine

TREATMENT
Commonly used drug for Alzheimer's disease doubles risk of hospitalization: A drug commonly used to manage symptoms of Alzheimer disease and other dementias -- donepezil -- is associated with a two-fold higher risk of hospital admission for rhabdomyolysis, a painful condition of muscle breakdown, compared with several other cholinesterase inhibitors, found a study in CMAJ (Canadian Medical Association Journal).

 

Rivaroxaban Cuts Recurrent Blood Clots in Obese Patients: Real-world evidence shows that rivaroxaban reduces the risk for recurrent venous thromboembolism (VTE) in morbidly obese patients, with similar safety and efficacy as warfarin, according to a study published in the October issue of Thrombosis Research.

Nivolumab Therapy Prolongs Survival in Advanced Melanoma: More patients with advanced melanoma receiving nivolumab plus ipilimumab or nivolumab alone have sustained long-term survival at five years compared with those receiving ipilimumab alone, according to a study published online Sept. 28 in the New England Journal of Medicine.

Long-term study data shows DBS is effective treatment for most severe form of depression: A study published online on Friday, October 4, in the American Journal of Psychiatry found that deep brain stimulation (DBS) of an area in the brain called the subcallosal cingulate (SCC) provides a robust antidepressant effect that is sustained over a long period of time in patients with treatment-resistant depression--the most severely depressed patients who have not responded to other treatments.

More evidence linking common bladder medication to a vision-threatening eyecondition:A drug widely prescribed for a bladder condition for decades, now appears to be toxic to the retina, the light sensing tissue at the back of the eye that allows us to see. After an initial report last year that Elmiron (pentosan polysulfate sodium) may be associated with retinal damage, three ophthalmologists conducted a review of patients at Kaiser Permanente in Northern California. They found that about one-quarter of patients with significant exposure to Elmiron showed definite signs of eye damage, and that this medication toxicity could masquerade as other known retinal conditions, such as age-related macular degeneration or pattern dystrophy. Annual Meeting of the American Academy of Ophthalmology.

Surgery May Be Best Option for Some With Refractory Heartburn: In patients who truly have proton pump inhibitor (PPI)-refractory heartburn, including those with reflux hypersensitivity, surgery may be the best treatment option, according to a study published in the Oct. 16 issue of the New England Journal of Medicine.

Dopamine Agonists Tied to Higher Risk for Psychiatric Events: Patients with primary restless leg syndrome who begin dopamine agonist (DA) therapy may be at increased risk for adverse psychiatric events, according to a large study published in the September issue of the Journal of Clinical Sleep Medicine.

 

Some Blood Pressure Medications May Increase a Person’s Risk for Suicide: Certain types of medications used for blood pressure, kidney disease, heart failure, and diabetes could increase suicide risk. People using angiotensin receptor II blockers (ARBs) are 1.5 times more likely to die by suicide than people who take angiotensin converting enzyme inhibitors (ACE inhibitors). The research is preliminary and needs follow-up studies, but they say people with mental health issues should consult with their physicians before taking these types of medications. JAMA Network Open

Estrogen exposure may stave off cognitive decline in women: The conclusion of a study of 2,000 postmenopausal women followed for 12 years found that estrogen exposure is linked with better cognitive healthin older women. Benefits were stronger for the oldest women in the sample who started taking estrogen the earliest. Menopause


Artificial Pancreas Helps T1DM Patients Meet Glycemic Targets: Patients with type 1 diabetes using an artificial pancreas or closed-loop system spend a greater percentage of time in a target glycemic range compared with those using a sensor-augmented insulin pump, according to a study published online Oct. 16 in the New England Journal of Medicine.

OTHER
Sanofi is recalling Zantac: The pharmaceutical company Sanofi announced today that it’s undertaking a voluntary recall of Zantac due to concerns about a potential cancer-causing chemical.  This comes weeks after the popular heartburn drug ranitidine, known by the brand name Zantac, was found to contain a cancer-causing chemical. Last month, multiple drugstores decided to no longer sell the medication.

Johnson & Johnson Recalls Baby Powder Due to Presence of Asbestos: A shipment of baby powder has been recalled by Johnson & Johnson after U.S. authorities found asbestos in it. The recall comes after months of denial from the company about the presence of the cancer-causing substance in its talc-based products, The New York Times reported Friday. But the U.S. Food and Drug Administration found trace levels of chrysotile asbestos in samples from a bottle of baby powder bought from an online retailer, according to Johnson & Johnson. The recalled lot of baby powder is #22318RB and includes 33,000 bottles sold by an unidentified retailer, said company spokesman Ernie Knewitz. He added that this is the first time Johnson & Johnson has pulled its baby powder from the market, The Times reported.

25% of US Health Care Spending is Wasteful: A study published Monday in the medical journal JAMA finds that up to a quarter of all United States health care spending is wasteful. Researchers found that $760 billion to $935 billion health care dollars are wasted every year The study cited multiple reasons for the wasteful spending. The biggest driver was administrative issues related to billing and coding. That represented 28% to 35% of total waste. The second greatest contributor was what authors called "pricing failure.” This was described as waste related to the price of drugs and services "because of the absence of effective transparency and competitive markets." Other factors are over-treatment, unnecessary hospital visits, and lack of preventative care. The U.S. spends more on health care per capita than any other developed nation. JAMA

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