Friday, December 20, 2019

Journal Watch December 2019


PAIN
New Migraine Drug Performs Well in Clinical Trial:A new migraine medication has shown promising results in a successful large-scale clinical trial. The drug, called ubrogepant, performed better than a placebo and has fewer risks than other drugs, researchers are reporting. Within 2 hours of being taken in a clinical trial, researchers say ubrogepant was able to completely stop a severe migraine attack. JAMA 

Cannabis May Help Reduce Migraine Pain — If You Inhale: Researchers say people who inhale cannabis reported significant reduction in pain from migraine attacks and other severe headaches. Experts say the research is preliminary, but they add cannabis can relax the central nervous system and relieve the stress that sometimes causes headaches. Experts add that inhaling cannabis provides relief more quickly than eating cannabis products that need to go through the digestive system. The Journal of Pain

 Migraine headaches? Consider aspirin for treatment and prevention: Evidence from 13 randomized trials of the treatment of migraine in 4,222 patients and tens of thousands of patients in prevention of recurrent attacks supports the use of high dose aspirin from 900 to 1,300 milligrams to treat acute migraine as well as low dose daily aspirin from 81 to 325 milligrams to prevent recurrent attacks. Aspirin is available without a prescription, is inexpensive, and has a relatively favorable side-effect profile compared to alternative more expensive medications. The American Journal of Medicine 


Researchers Explore A Drug-Free Idea To Relieve Chronic Pain: Green Light: The results of this migraine study aren't published yet. But they build on a small but growing body of research suggesting a link between green light and pain. In a study of 25 people exposed to green LED light, on average, people experienced a 60% decrease in the intensity of their migraines and a drop from 20 migraines a month to about six. NPR

A New Technique in Knee Surgery — the ‘Artificial Meniscus’: A new “artificial meniscus” is being hailed as a less painful and less complicated way to perform knee surgery.  The U.S. Food and Drug Administration has granted “breakthrough device” status for the product with clinical trials scheduled to be completed next year and in 2023. Healthline

 

COMPLEMENTARY & ALTERNATIVE MEDICINE
Cannabis found not to be a substitute for opioids: A meta-analysis found cannabis use didn't reduce illicit opioid use during treatment nor did it retain people in treatment. "There is limited evidence that cannabis use may reduce opioid use in pain management, and some high-profile organizations have suggested cannabis is an 'exit drug' for illicit opioid use, but we found no evidence to suggest cannabis helps patients with opioid use disorder stop using opioids." Canadian Medical Association Journal

Daily cannabis use lowers odds of using illicit opioids among people who have chronic pain: For those using illicit opioids to manage their chronic pain, cannabis may be a beneficial -- and a less dangerous -- alternative, according to new research. Researchers from the BCCSU and University of British Columbia (UBC) interviewed more than 1,100 people at highest risk of opioid overdose in Vancouver between 2014 and 2017 who reported substance use and major or chronic pain. They found that daily cannabis use was associated with significantly lower odds of daily illicit opioid use, suggesting people are replacing opioids with cannabis to manage their pain. Plos Medicine 

Purified CBD May Help Treat Drug-Resistant Epilepsy: Among patients with tuberous sclerosis complex (TSC), the reduction in the frequency of TSC-associated seizures was greater in those receiving a purified version of cannabidiol (CBD) than in those receiving placebo, according to a study presented at the annual meeting of the American Epilepsy Society

NIH study reports more than half of US office-based physicians recommend CHA: A new study has shown that more than half (53.1%) of office-based physicians in the U.S., across specialty areas, recommended at least one complementary health approach (CHA) to their patients during the previous 12 months, with female physicians (63.2%) more likely to recommend a CHA than male physicians (49.3%). Overall, massage therapy was the most commonly recommended CHA, followed by chiropractic/osteopathic manipulation, herbs/nonvitamin supplements, yoga, and acupuncture. JACM

'Safety signals' may help slow down anxiety: For as many as one in three people, life events or situations that pose no real danger can spark a disabling fear, a hallmark of anxiety and stress-related disorders. Researchers at Yale University and Weill Cornell Medicine report on a novel way that could help combat such anxiety. In humans and in mice, a 'safety signal' -- a symbol or a sound that is never associated with adverse events -- can relieve anxiety through an entirely different brain network than that activated by existing behavioral therapy. "A safety signal could be a musical piece, a person, or even an item like a stuffed animal that represents the absence of threat." Proceedings of the National Academy of Sciences

Mindfulness Program May Help Lower Blood Pressure: Participants in a mindfulness program have significant improvements in self-regulation skills and reductions in blood pressure, according to a small study published online Nov. 27 in PLOS ONE.

 

FDA ACTION
• Approved cefiderocol (Fetroja) treat certain UTIs only to be used as a last resort when other antibiotics have failed.

Approved Adakveo for Sickle Cell Disease Complication

• Approved Oxbryta for Treatment of Sickle Cell Disease

• Approved Brukinsa for Relapsed, Refractory Mantle Cell Lymphoma

• Approved First Contact Lens That Slows Myopia Progression in children ages 8 to 12 years

• Approved First System to Insert Ear Tubes Under Local Anesthesia

• Approved Oxbryta for Treatment of Sickle Cell Disease

• Approved XCOPRI for Treatment of Partial-Onset Seizures

• Approved Givlaari for Acute Hepatic Porphyria

 • Approved Calquence to Treat CLL, SLL

• Issued Warning that products that contain cannabidiol may not be as safe as people think and have sent warning letters to 15 companies that sell products with cannabidiol. Officials say most of these products haven’t been tested by the FDA and may have serious side effects.
• Approved first generics of Fingolimod for MS
• Authorized the sale of two new reduced nicotine cigarettes.
• Approved Vascepa, a drug derived from fish oil as an adjuvant therapy for people at risk of experiencing cardiovascular events.
• Approved marketing of an interoperable automated glycemic controller device, the Tandem Diabetes Care Control-IQ Technology

• Approved Padcev for Treatment of Advanced Urothelial Cancer

• Unveiled plans to allow prescription drug imports from Canada and other foreign nations.

PREVENTION: Exercise
Vigorous Exercise Can Greatly Reduce Your Risk of Cancer, Heart Disease: Women with a greater exercise capacity on a heart stress test had a lower risk of dying from heart disease and other conditions. The study found poor exercisers were twice as likely to die from cancer and more than four times as likely to die from other causes, compared to women on a higher fitness level. EuroEcho 2019,

Aerobic Exercise May Slow Cognitive Decline in Older Adults: Among older adults who have cardiovascular disease (CVD) risk factors and cognitive impairments with no dementia (CIND), cognitive function was better at one-year follow-up in participants compared with controls after a six-month exercise intervention, with or without the Dietary Approaches to Stop Hypertension (DASH) diet, according to a study published online Nov. 22 in the Journal of the American Geriatrics Society.

People with Rheumatoid Arthritis Can Slow Cognitive Decline by Exercising: A new study concludes that exercise can lower the risk of cognitive decline for people with rheumatoid arthritis. Past studies have reported that rheumatoid arthritis can increase difficulties with cognition such as brain fog. The latest findings were from a 10-year study of 1,219 people. ACR  

Physical activity may protect against prostate cancer: Individuals with a genetic variation that increased their likelihood of being physically active had a 51% lower risk of prostate cancer than people who did not have this genetic variation. "Physical activity," in this case, refers to all forms of activity, not just exercise. the study authors conclude that interventions encouraging males to ramp up their levels of physical activity may have a protective effect against this widespread form of cancer.  International Journal of Epidemiology

Reducing the side-effects of prostate hormone therapy with exercise: A prescription of short-term exercise for patients with advanced prostate cancer could help to reduce the side-effects of hormone therapy, according to new research. The trial aimed to reduce the adverse side-effects of hormone therapy such as weight gain and an increased risk of heart problems. The results show that a three month programme of aerobic and resistance training intervention prevented adverse changes in cardiopulmonary fitness and fatigue. British Journal of Urology International 

Moderate Physical Activity Tied to Lower Fasting GLP-1 in Men: For overweight men, physical activity (PA) even at moderate intensity is associated with lower fasting and greater glucose-stimulated glucagon-like peptide-1 (GLP-1) responses, according to a study published online Dec. 1 in Endocrine Connections.

PREVENTION: Diet/Nutrition
Plant-based diet may prevent cognitive decline: New research finds that following a diet rich in plant-based foods and low in animal products during midlife is associated with a significantly lower risk of cognitive impairment later in life. American Journal of Clinical Nutrition Trusted Source.

High-protein diets may harm your kidneys: " The promise of saving calories and losing weight is why a high-protein diet is very often recommended to people who suffer from diabetes or who are obese. But the crux of the matter is that these groups of people are especially vulnerable to the kidney-harming effects of a high protein intake. Nephrology Dialysis Transplantation

 

Healthful diet tied to lower risk of hearing loss: Investigators have found that eating a healthy diet may reduce the risk of acquired hearing loss. Using longitudinal data collected in the Nurses' Health Study II Conservation of Hearing Study (CHEARS), researchers examined three-year changes in hearing sensitivities and found that women whose eating patterns more closely adhered to commonly recommended healthful dietary patterns, such as the Dietary Approaches to Stop Hypertension (DASH) diet, the Alternate Mediterranean (AMED) diet, and the Alternate Healthy Index-2010 (AHEI-2010), had substantially lower risk of decline in hearing sensitivity. American Journal of Epidemiology

Study finds no link between statin use and memory harm in older adults: There is no link between statin use and memory impairment, researchers have concluded, after evaluating effects of the cholesterol-lowering drugs over 6 years in more than 1,000 older people in Australia. Journal of the American College of Cardiology

Peas and beans: Can they improve heart health? A recent review and meta-analysis focus on the role of legumes in heart health. Taking data from multiple studies and earlier analyses, the authors conclude that legumes might benefit heart health but that the evidence is not overwhelming. Advances In Nutrition

Another Benefit from Coffee: It Can Reduce Risk of Metabolic Syndrome: Coffee consumption at a level of one to four cups per day is associated with a reduced risk of metabolic syndrome (MetS) in observational studies. Experts say that losing weight, not smoking, and getting sufficient exercise are still the most effective ways to prevent or reverse this condition. 13th European Nutrition Conference

New diet that matches biological clock may be better for diabetes: A new study confirming that the three meals a day approach could be more helpful for those with type 2 diabetes. "[O]ur research proposes shifting the starch-rich calories to the early hours of the day. This produces a glucose balance and improved glycemic control among [people with type 2 diabetes]," the specialist explains. Diabetes Care

Eat For 10 Hours. Fast For 14. This Daily Habit Prompts Weight Loss: Researchers tracked a group of overweight participants who followed this approach for about three months. "Typically, people would go for an 8 a.m. to 6 p.m. eating window. During the fasting period, participants were encouraged to stay hydrated with water. Each day, they logged the timing of their meals and their sleep in an app. "We saw a 3% reduction in their weight and a 4% reduction in abdominal visceral fat." "We didn't ask them to change what they eat." In addition to the weight loss, "we saw that cholesterol levels improved and blood pressure [levels] also improved." The study was small, just 19 people. All the participants were overweight and had a cluster of risk factors (elevated blood sugar, elevated cholesterol levels and high blood pressure) that put them at higher risk for Type 2 diabetes and heart disease. Cell Metabolism

Even light alcohol consumption linked to higher cancer risk in Japan: In a study conducted in Japan, even light to moderate alcohol consumption was associated with elevated cancer risks. The overall cancer risk appeared to be the lowest at zero alcohol consumption. Cancer

Hydration may affect cognitive function in some older adults: Among women, lower hydration levels were associated with lower scores on a task designed to measure motor speed, sustained attention, and working memory. They did not find the same result for men. European Journal of Nutrition

Could hot chili peppers reduce mortality risk? According to a recent study, people who regularly consume chili peppers have a reduced mortality risk compared with those who never eat chilis. Journal of the American College of Cardiology.

Processed meat and cancer link depends on nitrite content: In 2015, the World Health Organization (WHO) classified processed meats as Group 1 carcinogens, citing sufficient evidence that they cause cancer in humans. Now, a new review challenges this blanket classification, having found that the strength of the evidence varies according to whether the meat contains nitrites. However, not all processed meats contain nitrites. British and Irish sausages, for instance, are free of nitrites, whereas frankfurters, chorizo, and pepperoni from the United States and continental Europe are not. Medical News Today

Cardiovascular disease: Dietary cholesterol may not raise risk: According to the American Heart Association (AHA), consumers should continue to stick to heart-healthy diets for optimum cardiovascular health. However, there is no numerical recommendation of cholesterol intake from food, as the AHA finds no link between dietary cholesterol and cardiovascular risk. Circulation.

Ultra-processed foods may raise the risk of type 2 diabetes: Sugary drinks, packaged snacks, and ready-made meals all count as ultra-processed foods — that is, foods that contain a higher number of additives and last longer because of the added preservatives. New research suggests that these foods also raise the risk of type 2 diabetes. J AMA Internal Medicine.

 

PREVENTION: Supplements
Study Finds Omega-3s May Help Your Heart, Doesn’t Increase Prostate Cancer Risk: New research shows that omega-3s may continue to protect against heart disease-related death without the risk of prostate cancer. Omega-3 fatty acids are found in foods such as fish and flaxseeds and in dietary supplements such as fish oil. The study confirmed that omega-3s may be a contributing factor in lowering certain heart disease risks. American Heart Association Scientific Sessions

Should You Be Taking Prescription-Strength Fish Oil? An FDA advisory panel has recommended that more people be eligible for prescription-strength fish oil. The prescription medicine has been shown to reduce triglyceride levels and heart attack risk. There can be side effects, including irregular heartbeat and excessive bleeding.

Many Nutritional Supplements Claim to Improve Heart Health. Only 3 Do

When it comes to your heart health, however, a report published in the Methodist DeBakey Cardiovascular Journal claims these three nutritional supplements are the ones most likely to help: Omega 3 Fatty acids; Co Q 10 and Red Rice Yeast.

Vitamin D Supplementation Alone May Not Reduce Fracture Risk: However, meta-analysis shows significant reduction in any, hip fracture with vitamin D plus calcium. JAMA Network Open.

PREVENTION: Other
Shingles Vaccine Is So Effective, There’s Now a Shortage: There is a shortage of the shingles vaccine Shingrix due to consumer demand because of its effectiveness. The vaccine is for people over the age of 50, especially those individuals who had chickenpox as children.

Brush your teeth to protect the heart: Brushing teeth frequently is linked with lower risks of atrial fibrillation and heart failure, according to a study published in the European Journal of Preventive Cardiology. Tooth brushing three or more times a day was associated with a 10% lower risk of atrial fibrillation and a 12% lower risk of heart failure during 10.5-year follow up.

Cellphone-Related Injuries to Head, Neck on the Rise: The number of head and neck injuries related to cellphone use that require emergency department attention has increased during a 20-year period, according to a study published online JAMA Otolaryngology-Head & Neck Surgery. Many of these injuries, particularly in younger patients, result from distraction while using cellphone.

Reductions in Air Pollution Yield Substantial Health Gains: Reductions in air pollution yield prompt and substantial health benefits, according to research published in the December issue of the Annals of the American Thoracic Society. The researchers note that reducing air pollution can result in prompt and substantial health gains. An Irish indoor smoking ban had an impact starting from week 1, with reductions in all-cause mortality, ischemic heart disease, stroke, and chronic obstructive pulmonary disease; at one month, workers experienced decreased wheeze, dyspnea, cough, phlegm, irritated eyes, painful throat, nasal itch, runny nose, and sneeze. Within weeks of a steel mill closure, respiratory symptoms, school absenteeism, daily mortality, and premature births decreased. Asthmatic symptoms improved four weeks after home heater change. Use of clean cook stoves during pregnancy resulted in higher birth weights, older gestational age at delivery, and less perinatal mortality. A reduction in Swiss air pollution resulted in a decrease in respiratory deaths and cardiac deaths at six years. U.S pollution tracking resulted in a life expectancy increase at seven years for each 10 µg/m² reduction of fine particulate matter.

Aspirin's health benefits under scrutiny: Taking a baby aspirin every day to prevent a heart attack or stroke should no longer be recommended to patients who haven't already experienced one of these events, new research suggests. Family Practice

 

Permanent hair dye and straighteners may increase breast cancer risk: Scientists found that women who use permanent hair dye and chemical hair straighteners have a higher risk of developing breast cancer than women who don't use these products. The study suggests that breast cancer risk increased with more frequent use of these chemical hair products. International Journal of Cancer

First Long-Term Study of E-Cigs Finds Link to COPD Risk: People who use e-cigarettes have an increased risk for developing asthma, bronchitis, emphysema, or chronic obstructive pulmonary disease (COPD), a long-term study shows. For e-cigarette users, the odds of developing lung disease increased by about a third, even after controlling for their tobacco use and their clinical and demographic information. People who vaped had a lower risk than cigarette smokers. But for people who both smoked combustible tobacco and vaped — dual users — the risk for developing respiratory disease was even higher. American Journal of Preventive Medicine

Advil, Aleve May Help Women with a Higher Risk of Breast Cancer: Women with an elevated risk of breast cancer can lower their chances of getting the disease by as much as 40 percent by taking ibuprofen or naproxen. San Antonio Breast Cancer Symposium in Texas. 

Low-Dose Aspirin May Cut Dementia Risk in Women With Diabetes: Long-term use of low-dose aspirin may reduce the risk for dementia in women with type 2 diabetes, according to a study published online Dec. 4 in Diabetes Care.

T2DM Risk Cut With Weight Loss Even in Non overweight People: Losing weight is consistently associated with reduced type 2 diabetes risk across body mass index (BMI), family history, and genetic risk categories, according to a study published online Dec. 10 in PLOS Medicine

Sustained Weight Loss at 50+ May Lower Risk for Breast Cancer: For women aged ≥50 years, sustained weight loss is associated with a reduced breast cancer risk, according to a study published online Dec. 17 in the Journal of the National Cancer Institute.

 

Menopause Linked to Increase in Sleep-Onset Insomnia: Postmenopausal women more often have sleep-onset insomnia disorder and are more likely to screen positive for obstructive sleep apnea, according to a study published online Dec. 13 in Menopause.

 

Domestic Abuse Increases Risk for Fibromyalgia, Chronic Fatigue: There is an association between a history of intimate partner violence (IPV) and the development of functional syndromes, including fibromyalgia and chronic fatigue syndrome (CFS), in women, according to a study published online Dec. 6 in the Journal of Interpersonal Violence.

 

TREATMENT
9 in 10 people who think they are allergic to penicillin may not be: While 10% of people in the United States report being allergic to penicillin, 9 in 10 are not. However, this can be difficult to scratch from medical records. ACAII Meeting

 

Experimental cholesterol-lowering drug effective at lowering bad cholesterol, study shows: Twice-yearly injections of an experimental cholesterol-lowering drug, inclisiran, were effective at reducing low-density lipoprotein (LDL) cholesterol, often called bad cholesterol, in patients already taking the maximum dose of statin drugs. American Heart Association's Scientific Sessions 2019. 

Antibody injection stops peanut allergy for 2 to 6 weeks: One injection of an antibody treatment let people with severe peanut allergies eat a nut's worth of peanut protein two weeks later, a small, Stanford-led pilot study showed. JCI Insight

Major Study on Stents and Heart Disease: Many people with blocked arteries in their heart may benefit as much from drug therapy and lifestyle changes alone as from bypass surgery or stenting procedures, a large study showed. The new study is certain to add fuel to the ongoing debate among cardiologists about the best treatment for people with moderate to severe but stable ischemia. The 7-year new study, which enrolled more than 5,000 people, found that there wasn’t a large benefit for either putting in stents or performing bypass surgery invasive procedures. AHA Meeting

Ultrasound Procedure Reduces Tremors in Parkinson’s Disease, Essential Tremor Disorder: A new ultrasound treatment reduces tremors in people with Parkinson’s disease and essential tremor disorder. The method involves focused beams of sound energy used to heat and destroy a small part of a structure in the brain called the thalamus. There are many advantages to using ultrasound: eliminates surgery and reduces hospital stay. Radiological Society of North America Annual Meeting

Current Statin Use May Lower Risk for Lethal Prostate Cancer: New Ultrasound Treatment for Prostate Cancer Revealed:Researchers have unveiled a new technique using ultrasound to treat prostate cancer. TULSA doesn’t involve surgery and has minimal side effects. The technique is already available for clinical use in Europe and has received initial permission from U.S. regulators to test the device. Radiological Society of North America.

Recalls May Be Prompting People to Stop Taking Their Blood Pressure Medications: Researchers say there’s evidence people have stopped taking their blood pressure medications due to recalls in the past year. Healthline

Anti-hepatitis medicine surprises: New effective treatment of hep C not only combats the virus, but is also effective against complications. Journal of Viral Hepatitis

Cancer drug shows promise in Parkinson's disease safety trial: Nilotinib, a drug that regulators have approved for the treatment of leukemia, has shown promise in a small clinical trial of people with Parkinson's disease. JAMA Neurology

CPAP Mask Helps Patients With Mild Obstructive Sleep Apnea: Among patients with mild obstructive sleep apnea (OSA), quality of life is improved at three months for those receiving continuous positive airway pressure (CPAP) therapy plus standard care compared with standard care alone, according to a study published online Dec. 2 in The Lancet Respiratory Medicine.

 

Bariatric Surgery May Raise Risk for Colon Cancer Years Later: Individuals who undergo bariatric surgery may be at increased risk for developing colon cancer years later, according to a study published online Dec. 4 in the International Journal of Cancer.

 

OTHER
Retail Prescription Drug Prices Fall forFirst Time in 45 Years: Retail prescription drug prices in the United States fell by 1 percent last year, a new government report shows. The report said the overall decrease was due to drops in generic drug prices and slow growth in the cost of brand-name medications, the Associated Press reported.

 

5 Ways to Support a Co-Worker with a Chronic Illness: A new survey from Cancer and Careers found that 88 percent of people have concerns about their ability to support a co-worker with a serious medical condition. The following are ways to support your co-worker: Show empathy; Let them guide you; Respect their privacy; Offer help with work tasks; and Don’t ignore the situation. Cancer and Careers

Being Treated at Home Can Help People Save Money and Heal Faster: A new study found that the home hospital model can potentially improve care while reducing costs. The cost of care was nearly 40 percent lower. Trial participants receiving hospital care in their homes had a 70 percent lower rate of readmission to the hospital. Annals of Internal Medicine

Outcomes Worse for Rural Residents With Chronic Conditions: Rural Medicare beneficiaries with complex chronic conditions have higher preventable hospitalization and mortality rates than their urban peers, which is partially explained by reduced access to specialists, according to a report published in the December issue of Health Affairs, a theme issue on rural health.

 

Flu Season 2019: Cases Top 5 Million, Infections May Increase Over the Holidays: It’s been a wild and unpredictable flu season so far. The flu got an earlier start than usual this year, and a strain that’s particularly harsh among children (influenza B/Victoria viruses) is spreading rapidly across the country. And new research from the University of Arizona suggests that whatever strain you first picked up as a child will determine how well your immune system fights future flu infections — and may explain why different age groups are more affected by certain strains. Now, some health experts predict another wave of the flu is coming just in time for the holidays. Healthline

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