Journal Watch May 2020

It’s time to get back to normal and focus on chronic conditions and not just Covid-19.  A lot of the medical literature is focused on the pandemic, but there is also important news pertaining to other conditions.

PAIN

People with Rheumatoid Arthritis Have Higher Risk for Heart Disease: A new study published in the journal RMD Open concluded that the presence of rheumatoid arthritis (RA) may be associated with an increased risk of major adverse cardiovascular events, also known as MACE.

Smartphone Use Linked to Increased Meds Required for Headache: Use of smartphones seems to be associated with increased requirements for acute medication for headache and less relief with acute medication, according to a study published online March 4 in Neurology Clinical Practice.

Vitamin D Tied to Back Problems in Postmenopausal Women: Vitamin D deficiency is associated with lumbar disc degeneration (LDD) and low back pain (LBP) in postmenopausal women, according to a study published online Feb. 10 in Menopause.

 

Keeping lower back pain at bay: Better exercises: Scientists have devised a spinal stabilization exercise program for managing lower back pain for people who perform a sedentary job. After testing the program with 70 volunteers, the researchers have found that the exercises are not only efficient in diminishing the non-specific lower back pain, but their effect lasts 3 times longer than that of a usual muscle strengthening exercise program. Clinical Biomechanics

For better migraine treatment, try adding some downward dogs: Adding yoga to your regularly prescribed migraine treatment may be better than medication alone, according to a new study. The new research suggests yoga may help people with migraines have headaches that happen less often, don't last as long and are less painful. Neurology

Long-Term Physical Activity Not Tied to Knee Arthritis: There is no association between long-term strenuous physical activity participation and incident radiographic knee osteoarthritis (KOA), according to a study published online May 4 in JAMA Network Open. 

Outcomes Better at One Year With Physical Therapy for Knee OA: For patients with osteoarthritis of the knee, those undergoing physical therapy have less pain and functional disability at one year compared with those who receive an intraarticular glucocorticoid injection, according to a study published in the April 9 issue of the New England Journal of Medicine. 

Many Legal Marijuana Products Too Strong for Treating Pain: Legally dispensed marijuana products have stronger concentrations of tetrahydrocannabinol (THC) and cannabidiol (CBD) than needed for chronic pain relief, according to a study published online March 26 in PLOS ONE.

Prophylactic Manual Acupuncture Reduces Migraine Days: For patients with episodic migraine without aura, undergoing 20 sessions of manual acupuncture is superior to sham acupuncture and usual care for prophylactic treatment, according to a study published online March 25 in The BMJ.

COMPLEMENTARY & ALTERNATIVE MEDICINE

Online mindfulness-based cognitive therapy to improve lingering depression: Researchers have found that online mindfulness-based cognitive therapy (MBCT) can improve lingering depressive symptoms. JAMA Psychiatry

NCCIH Clinical Digest: Yoga for Health:The National Center for Complementary and Integrative Health has issued a new clinical digest Yoga for Health. Many people practice yoga for health-related reasons, such as for well-being and fitness, to help control stress, or to help manage or prevent a health problem. Results of studies on the effects of yoga on health have found that yoga may be more beneficial for some health conditions than for others. This issue of the digest summarizes the current research on yoga for several health conditions and in different populations. 

Yoga May Help Ease Depressive Symptoms: Yoga is associated with a reduction in depressive symptoms among adults with a diagnosed mental health disorder, according to a review published online May 18 in the British Journal of Sports Medicine.

Coronavirus and Alternative Treatments:There is no scientific evidence that any of these alternative remedies can prevent or cure the illness caused by this virus. In fact, some of them may not be safe to consume. NCCIH

Cannabis Smoking May Increase Risk for Fungal Infection: The likelihood of having a fungal infection was increased in association with cannabis use in 2016, according to a study published online May 13 in Emerging Infectious Diseases, a publication of the U.S. Centers for Disease Control and Prevention. 

Mindfulness training shows promise for people with MS: New research suggests mindfulness training may help multiple sclerosis patients in two very different ways: regulating negative emotions and improving processing speed. Rehabilitation Psychology, and secondary analysis in Neuropsychology.

FDA ACTION

• Approved three drugs for nonprescription over-the-counter use: Voltaren Arthritis Pain (diclofenac sodium topical gel, 1 percent), Pataday Twice Daily Relief (olopatadine HCl ophthalmic solution/drops, 0.1 percent), and Pataday Once Daily Relief (olopatadine HCl ophthalmic solution/drops, 0.2 percent)

• Approved Nexletol as an alternative for people who cannot tolerate, or fully respond to statins for cholesterol lowering

• issued Boxed warning for allergy drug Singulair due to serious side effects including suicidal thoughts.

• Approved Isturisa oral tables for adults with Cushing disease.

• Spproved generic versions of two drugs: one for ProAir HFA (albuterol sulfate) Inhalation Aerosol to treat or prevent bronchospasm and one for Daraprim (pyrimethamine) tablets for treatment of toxoplasmosis when used with a sulfonamide.

• Approved Retevmo for Certain Lung, Thyroid Cancers

• Approved First Antigen Test to Quickly Spot COVID-19

• Approved first at home saliva test for Covid-19

• Approved Tabrecta for Metastatic NSCLC with specific mutations

• ø˚s Farxiga for heart failure with reduced Ejection Fraction

• Approved Qinlock as Fourth Line Treatment for advanced gastrointestinal stromal tumors (GIST)

   PREVENTION: Exercise

Anxiety, Depression Can Be Eased with 150 Minutes of Exercise a Week: Researchers say exercising for 150 minutes a week can help ease mental health disorders such as anxiety and depression. Those who exercise outdoors get more benefits than people who exercise indoors. There are mental health benefits to both team sports as well as individual activities. Researchers cautioned that more isn’t necessarily better, so a moderate amount of exercise is best for most people. Human Movement

 

Here’s Why HIIT Workouts May Be Best for Your Body — and Brain: Research finds that workout routines with bursts of intensity followed by short periods of rest have a positive effect on the brain’s neuroplasticity. Neuroplasticity refers to the brain’s ability to adapt to change by altering its functional and structural properties.  Researchers say longer bouts of high intensity exercise may increase levels of cortisol in the body enough to interfere with some of the positive benefits from the exercise. Journal of Science & Medicine in Sport

 

Getting In Your Daily Steps Can Reduce Your Risk of Diabetes and High Blood Pressure: The researchers state that middle-aged study participants who walked the most steps per day over an average of 9 years had a 43 percent lower risk of diabetes and a 31 percent lower risk of high blood pressure. Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions 2020

Older Adults Can Reduce Brain Shrinkage by Gardening, Dancing, Walking:  Researchers say moderate exercise such as gardening, swimming and even dancing can help slow down brain shrinkage. In their study, the researchers said people who did a moderate or high level of exercise per week had brains that had the equivalent of 4 fewer years of brain aging. American Academy of Neurology’s annual meeting

PREVENTION: Diet/Nutrition

Don’t Let a Fear of Pesticides Stop You from Eating Fruits and Veggies: According to the small survey of registered dietitians (RDs) from the Alliance for Food and Farming (AFF), 94 percent of dietitians think fear-based messaging around pesticides on produce leads to excessive concern about whether conventionally grown fruits and vegetables are safe to eat. “Potential residues on either conventional or organic produce are in [tiny] amounts that are not linked to any adverse health effects. The U.S. Department of Agriculture Agricultural Marketing Service has issued reports confirming that overall pesticide chemical residues found on foods are at levels below the tolerances established by the U.S. Environmental Protection Agency and do not pose a safety concern.”

 Want to Lose Weight? Researchers Say a Registered Dietitian May Be Your Best Bet:  Researchers say people who used a dietitian lost an average of 2.6 pounds while those who didn’t use a dietitian gained 0.5 pounds. Experts say dietitians can help guide people through lifestyle changes as well as personalize a diet plan. They add that a dietitian may not work for everyone, so people should stick to whatever system is best for them. Family Practice

More Good News About Mediterranean, Plant-Based Diets and Your Gut Health: Researchers say a plant-based diet such as the Mediterranean diet can improve the gut microbiome in a number of ways. One study  concluded these diets can increase the type of gut bacteria associated with healthy aging in older adults. Another study concluded plant-based diets can reduce the kind of gut bacteria associated with heart disease. Experts say plant-based diets can also reduce inflammation in the body and improve a person’s overall health.

Milk: Is it as healthful as we think?: Many people include milk in their diet, but few meet the daily recommended quantities. Experts now urge us to rethink these recommendations and explain why milk may not be as healthful as we think. The evidence does not support milk consumption to reduce the risk of hip fractures. On the contrary, countries with high milk and calcium intake also have the highest hip fracture rates. Some studies linked milk consumption to a lower risk of developing colorectal cancer, possibly due to the high levels of calcium found in milk. Other studies, however, pointed to increased rates of breast, prostate, and endometrial cancer. New England Journal of Medicine

New study associates intake of dairy milk with greater risk of breast cancer: Dairy, soy and risk of breast cancer: Those confounded milks, published in the International Journal of Epidemiology, found that even relatively moderate amounts of dairy milk consumption can increase women's risk of breast cancer -- up to 80% depending on the amount consumed. First author of the paper, Gary E. Fraser, MBChB, PhD, said the observational study gives "fairly strong evidence that either dairy milk or some other factor closely related to drinking dairy milk is a cause of breast cancer in women. "Consuming as little as 1/4 to 1/3 cup of dairy milk per day was associated with an increased risk of breast cancer of 30%," Fraser said. "By drinking up to one cup per day, the associated risk went up to 50%, and for those drinking two to three cups per day, the risk increased further to 70% to 80%." No important associations were noted with cheese and yogurt.

How Sugary Drinks Can Affect Cholesterol Levels and Heart Health: New research finds that adults who drink at least one sugary beverage, when compared with those who don’t, have a greater risk for developing dyslipidemia, or higher levels of unhealthy fats (like LDL cholesterol or triglycerides), which can increase the risk of heart disease. Journal of the American Heart Association

Eating Less Red Meat, More Plant Protein and Dairy Can Improve Your Heart Health: Two new studies are promoting the heart health benefits of eating more plant-based protein and dairy products and consuming less red meat. The first study found that people in the United States who got more of their calories from plant-based sources were less likely to die from any cause and also less likely to die specifically of coronary artery disease. A second study presented at the American Heart Association conference came to similar conclusions. Researchers in that study found that men could drastically lower their risk of coronary heart disease by substituting a single serving of red meat or processed meat with foods such as nuts, legumes, whole grains, or dairy.

How Just Half a Tablespoon of Olive Oil a Day Can Improve Heart Health: Their analysis of long-term data, dating back to 1990, shows that eating more than 1/2 tablespoon of olive oil per day lowers one’s risk of cardiovascular disease by 15 percent and the risk of coronary heart disease by 21 percent. Lifestyle and Cardiometabolic Health Scientific Sessions

Is Eating an Egg a Day OK for Heart Health? Latest Research Says It Is:  A new study concludes that eating one egg a day may not significantly increase your cholesterol levels or risk of heart disease. The research is the latest in a long line of studies that present conflicting conclusions on how healthy eggs are in a person’s daily diet. British Medical Journal

 

Combining carbs and sweeteners could affect insulin sensitivity: A new study shows that mixing artificial sweeteners with carbohydrates alters a person’s sensitivity to sweet tastes, which may impact insulin sensitivity. Cell Metabolism,

‘Dry Fasting’ Urges You Not to Drink Water — Why That Might Not Be a Good Idea: A diet fad known as “dry fasting” recommends people get their daily water intake from fruits and vegetables and not from the tap. Supporters say the diet helps with weight loss and strengthens the immune system as well as reduces inflammation. Opponents, however, say the diet can lead to dehydration, low blood pressure, and other serious health issues. Healthline 

Low flavonoid intake associated with Alzheimer’s risk: A new study links a low intake of flavonoid-rich foods — such as berries, apples, and tea — with a higher risk of Alzheimer’s disease and related dementias. American Journal of Clinical Nutrition.

 

Fruit-Veggie-Rich Diet May Soon Lower Markers for Cardiac Injury: For middle-aged adults without preexisting cardiovascular disease, eating a diet rich in fruits and vegetables over eight weeks is associated with lower levels of markers for subclinical cardiac damage and strain, according to a study published online May 19 in the Annals of Internal Medicine.

Higher Intake of Whole-Fat Dairy May Cut Metabolic Syndrome Risk: Higher intake of whole-fat dairy products is associated with a lower prevalence of metabolic syndrome (MetS) as well as hypertension and diabetes, according to a study published online May 18 in BMJ Open Diabetes Research & Care.

 

Drinking sugary drinks daily may be linked to higher risk of CVD in women In a study of female California teachers, drinking one or more sugary beverages daily was associated with nearly a 20% higher risk of having cardiovascular disease when compared to those who rarely or never drank sugary beverages. Daily consumption of fruit drinks with added sugars was associated with a 42% greater likelihood of having cardiovascular disease when compared to those who rarely or never drank sugary beverages. Journal of the American Heart Association

PREVENTION: Supplements

Fish oil supplements offer 'little or no benefit' against cancer: The research relates specifically to supplements, rather than omega-3 derived from eating fish, with experts still suggesting the latter is good for the heart, as well as general health. Omega 3 supplements do not protect against cancer, scientists have said. Researchers performed two systematic reviews using data from more than 100,000 participants to get the clearest possible view of the risks and benefits associated with the food supplement. They found omega 3 supplements may slightly reduce the risk of heart disease while marginally increasing the risk of prostate cancer, with the overall beneficial and harmful effects to be quite small. Irish Times

Antioxidant supplements do not improve male fertility, NIH study suggests: Antioxidant supplements do not improve semen quality among men with infertility, according to a new study. The study also found that antioxidant supplements likely do not improve pregnancy and live birth rates. Fertility and Sterility

Regular Aspirin Use Tied to Lower Risk for Digestive Tract Cancers: Regular aspirin use is associated with a lower risk for colorectal and other digestive tract cancers, according to a review published in the May 1 issue of the Annals of Oncology. 

Good news for menopausal women taking hop supplements: Tests show no drug interactions: Hop-based dietary supplements that many women use to ease the night sweats and hot flashes commonly reported during menopause aren't likely to cause drug interactions, new research shows. Journal of Agricultural and Food Chemistry

PREVENTION: Other

Is Your Partner Optimistic? Why That Impacts Your Health as You Age: Researchers say being in a romantic relationship with an optimist may help you avoid cognitive decline as you age. Optimistic people tend to exhibit healthier behaviors that are linked to good cognitive function. An optimistic partner might set a good example for their spouse to follow. Optimism is a quality that can be learned. Journal of Personality

 

Chemicals Used in Cosmetics May Be Tied to Increased Risk of Autism: Exposure to phthalates was associated with autism traits in boys (but not girls) between ages 3 and 4 years, according to a new study.  However, the risk was diminished in women who took folic acid during their pregnancy. This study is the first to find that folic acid supplements provide a protective effect from phthalates. Environmental Health Perspectives

How Your Lack of Sleep May Be Affecting Your Diet — and Heart Health: A new study has found a link between poor sleep, unhealthy diet, and overeating in women. Unhealthy diet is a risk factor for heart disease. Researchers believe this may explain why poor sleep is linked to increased risk for heart disease. Improved sleep quality may reduce risk.

Eating a heart healthy diet may also lower your risk. Journal of the American Heart Assocation

 

Vaccine Effectiveness 45 Percent for Flu Virus Linked to ARI: The overall vaccine effectiveness (VE) against any influenza virus associated with medically attended acute respiratory illness (ARI) is 45 percent for the current influenza season, according to research published in the Feb. 21 issue of Morbidity and Mortality Weekly Report. https://www.physiciansbriefing.com/infectious-disease-8/flu-news-314/vaccine-effectiveness-45-percent-for-flu-virus-linked-to-ari-755037.html

Activities for brain health: It’s the variety that counts: Individuals who participate in a variety of activities are likely to have better cognitive abilities than those who do not, according to a recent study. Journals of Gerontology: Psychological Sciences and Social Sciences.

Adults don't need tetanus, diphtheria boosters if fully vaccinated as children: Adults do not need tetanus or diphtheria booster shots if they've already completed their childhood vaccination series against these rare, but debilitating diseases. The conclusion aligns with the World Health Organization's recent recommendations to only routinely give adults tetanus and diphtheria vaccines if they didn't receive a full series of shots as children. In the U.S., the CDC's Advisory Committee on Immunization Practices still recommends all adults receive booster shots every 10 years. Clinical Infectious Diseases

Continuing Annual Breast Cancer Screening No Benefit in Over-75s: For women aged 75 years or older, continuing annual breast cancer screening does not result in significant reductions in eight-year breast cancer mortality compared with stopping screening, according to a study published online Feb. 25 in the Annals of Internal Medicine. 

New Recommendation to Start Colorectal Cancer Screenings at Age 45: A new study recommends colorectal cancer screenings start at age 45.Researchers say that’s because of the increasing number of colorectal cancer cases in younger adults. Experts say obesity is a major risk factor for colorectal cancer and the country’s obesity crisis makes earlier screening even more important. New figures released by the American Cancer Society seem to back that up.

High blood pressure linked with lower mortality in older adults: According to a recent investigation, high blood pressure in people aged over 85 may be associated with reduced mortality. The researchers also found that the risk of mortality was even lower for older adults with moderate or severe frailty. Age and Ageing.

Replacing time spent sitting with sleep or light activity may improve your mood New research, published by the American Journal of Preventive Medicine, found that substituting prolonged sedentary time with sleep was associated with lower stress, better mood and lower body mass index (BMI), and substituting light physical activity was associated with improved mood and lower BMI across the next year.

TREATMENT

The Potential Side Effects from Diuretic Drugs Taken for High Blood Pressure: A new study concludes that the diuretic drug chlorthalidone may cause more side effects than hydrochlorothiazide, another commonly prescribed medication for high blood pressure. Researchers say chlorthalidone can produce dangerously low levels of potassium, a nutrient that’s critical to controlling heart and muscle function.

However, experts say the research on diuretics is conflicting, so people shouldn’t switch drugs until more studies are done. JAMA Internal Medicine

Several Drugs Have Similar Efficacy for Plaque Psoriasis: Four drugs have similar Psoriasis Area and Severity Index (PASI) response rates for both short- and long-term treatment of plaque psoriasis, according to a review published online Feb. 5 in JAMA Dermatology. 

Lower dose of newer clot-buster may be appropriate for some stroke patients: New research confirms that the lower 0.25mg/kg dose of the clot-busting agent tenecteplase is appropriate for eligible stroke patients and can reduce the need for mechanical clot removal, according to late breaking science presented today at the American Stroke Association's International Stroke Conference 2020.

 

Gabapentin Seems Efficacious for Alcohol Use Disorder: Gabapentin appears to be efficacious for the treatment of alcohol use disorder (AUD), especially among those with high alcohol withdrawal, according to a study published online March 9 in JAMA Internal Medicine.

 

Osteoporotic Fracture Risk Lower for DOAC Than Warfarin in A-Fib: For patients with atrial fibrillation (AF), the risk for osteoporotic fracture appears to be lower with direct oral anticoagulant (DOAC) use compared with warfarin use, according to a study published online May 19 in the Annals of Internal Medicine.

Sports Concussion Recovery May Be Slower Than Thought: Less than half of patients with sports-related mild traumatic brain injury (SR-mTBI) achieve clinical recovery within two weeks after injury, according to a study published in the March issue of the Clinical Journal of Sport Medicine.

 

CAREGIVING

19.2 Percent of Unpaid Caregivers in Fair, Poor Health: Almost 20 percent of informal caregivers in the United States report being in fair or poor health, with considerable variation between states, according to research published in the Feb. 21 issue of Morbidity and Mortality Weekly Report.

 

OTHER

Taller men might have a lower risk of dementia: A new longitudinal study that analyzed data from hundreds of thousands of men found a link between height and the likelihood of developing dementia. Specifically, men who were taller than average appeared to have a lower risk of dementia than men who were shorter than average.

eLife