Journal Watch January 2016

CHRONIC PAIN

• Exercise to Boost Spine Muscles Can Ease Back Pain: A meta analysis of 29 clinical trials found that motor control exercise showed greater improvement, with less pain and disability, than those who did nothing. When comparing motor control exercise and other types of exercise after three to 12 months, similar improvements in the motor control group were seen. Cochrane Library 

• Exercise Eases Low Back Pain: A review of 23 studies, including 31,000 people found that exercise, alone or with education, can prevent back pain. Exercise and education reduced the risk of a low back pain episode by 45 percent, and exercise alone reduced the risk of a low back pain episode by 35 percent and the risk of time off work due to back pain by 78 percent. They found no evidence that education alone, back belts or shoe inserts lowered the risk of back pain. JAMA Internal Medicine 

• Ending Chronic Pain with New Drug Therapy: A brain region controlling whether we feel happy or sad, as well as addiction, is remodeled by chronic pain, reports a new study. And in a significant breakthrough, scientists have developed a new treatment that restores this region and dramatically lessens pain symptoms in an animal model. The new treatment combines two FDA-approved drugs: a Parkinson's drug, L-dopa, and a non-steroidal anti-inflammatory drug. These drugs target affected brain circuits and completely eliminate chronic pain behavior. The key is administering the drugs together and shortly after an injury. Nature Neuroscience 

COMPLEMENTARY & ALTERNATIVE MEDICINE

• Transcendental Meditation May Help Relieve PTSD: Transcendental meditation may help ease post-traumatic stress disorder (PTSD) symptoms in some soldiers and seems to reduce their need for medication, a new study finds. Military Medicine 

• Certain Yoga Positions May Impact Eye Pressure in Glaucoma Patients: Glaucoma patients may experience increased eye pressure as the result of performing several different head-down positions (e.g. downward facing dog, standing forward bend, plow and legs up the wall) while practicing yoga, according to a new study. PLOS ONE 

• Music Therapy Increases Effectiveness of Pulmonary Rehabilitation: Patients with Chronic Obstructive Pulmonary Disease (COPD) and other chronic respiratory disorders who received music therapy in conjunction with standard rehabilitation saw an improvement in symptoms, psychological well-being and quality of life compared to patients receiving rehabilitation alone, according to a new study. Respiratory Medicine 

FDA ACTION

• Approved Lesinurad to treat hyperuricemia associated with gout

• Orphan drug approval of Uptravi to treat pulmonary arterial hypertension

• Approved Fenix Fecal Continence Restoration System for patients who are not candidates for, or have previously failed, medical or other surgical options.

• Approved the Integra Omnigrat Dermal Rgeneration Matrix to treat diabetic foot ulcers.

PREVENTION

• Not too Late for Flu Shot: Flu activity usually peaks in January or February, and flu can strike as late as May, according to the U.S. Food and Drug Administration. As long as the virus is circulating, it's not too late to receive a flu shot and protect yourself and others against this seasonal misery.

• Exercise May Lower Heart Disease Risk in Depressed People: Depressed people who weren't physically active had stiffer and more inflamed aortas -- the large artery carrying blood from the heart -- two signs of heart disease. But, in depressed people who exercised, aortic stiffening and inflammation were less common. Journal of the American College of Cardiology 

• Bonding With Others May Be Crucial for Long Term Health: Social ties are as important to your long-term health as exercise and healthy eating, a new study suggests. Investigators analyzed data from four surveys of Americans who ranged from adolescents to seniors. Proceedings of the National Academy of Sciences 

NUTRITION/SUPPLEMENTS/VITAMINS

• Could High Dose Vitamin D Help Fight MS: High-dose vitamin D appears safe for people with multiple sclerosis, and it may help quiet the immune system hyperactivity that marks the disease, a small clinical trial finds. The current study shows only that high doses -- 10,400 IU a day -- reduce the proportion of certain immune-system cells that have been implicated in the MS disease process. Neurology 

• Eating More Dark Chocolate Might Help You Avoid Pancreatic Cancer: Indiana University researchers found that increasing magnesium intake by 100 milligrams a day decreased the risk of pancreatic cancer by 24 percent. Science Daily 

• Americans Still Consume Too Much Salt: More than 90 percent of children and 89 percent of adults consume more sodium than is recommended in the new 2015-2020 Dietary Guidelines for Americans, according to the U.S. Centers for Disease Control and Prevention. The new guidelines advise no more than 2,300 milligrams (mg) of salt a day -- about a teaspoon -- for most adults. Most of it comes from processed or restaurant food.  MMWR 

• New US Dietary Guidelines: Americans need to cut back on added sugars, saturated fats and salt if they want to eat a diet that can improve their health, according to the federal government's latest version of its Dietary Guidelines. Overall, the guidelines emphasize the adoption of a healthy eating pattern that fits into a person's lifestyle, rather than recommending specific amounts of different foods, such as vegetables or meats. "Americans can meet these recommendations by following simple advice: eat more unprocessed foods -- especially fruits, vegetables and whole grains -- and when removing unwanted sugar and fat from your diet, replace those foods with plant-based foods, including whole grains, fruits and vegetables. " 

• DASH Diet Best Overall Eating Plan: For the sixth year in a row, a panel of health experts has named the heart-healthy DASH diet the best overall eating plan, according to U.S. News & World Report's 2016 Best Diets ranking. The DASH (Dietary Approaches to Stop Hypertension) diet was designed to lower blood pressure and cholesterol levels by limiting fats, red meat and sugar in favor of healthy grains, poultry, low-fat dairy and nuts. 

• Sugary Drinks Tied to Increase in Deep Belly Fat: People who drink sugary beverages every day tend to accumulate more deep belly fat over time, new research suggests. The study, of over 1,000 adults, found that those who downed at least one sugar-sweetened drink a day had a bigger increase in deep abdominal fat over the next six years. Circulation 

• Green, Leafy Vegetables Each Day May Help Prevent Glaucoma: Eating green leafy vegetables daily may decrease the risk of glaucoma -- a serious eye disease -- by 20 percent or more over many years, a new study suggests. JAMA Ophthalmology 

• Flavonoid-Rich Diet Tied to Lower Erectile Dysfunction Risk: A study involving 25,096 middle-aged and older men who have filled out regular health surveys since 1986 found that higher total fruit intake was associated with a 14 percent reduction in the risk of erectile dysfunction. Further, combining flavonoid-rich foods with exercise reduced the risk of erectile dysfunction by 21 percent. The benefits of flavonoids were found to be greatest in men younger than 70. American Journal of Clinical Nutrition 

• Diet and Exercise Benefit People with Heart Failure: Lifestyle changes that include a healthy diet and regular exercise appear to improve heart function and exercise capacity in people with heart failure with preserved ejection fraction (HFPEF). JAMA 

• Lower Vitamin D Doses May Be More Effective in Preventing Falls than High Doses in Elderly: Higher doses of vitamin D don't improve mobility for the elderly, and may actually raise the risk for falls among certain seniors. Individuals who took the lowest dose of vitamin D, at 800 IU daily, had less falls than those taking higher doses.. JAMA Internal Medicine 

• Male Sexual Enhancement Supplements Often Ineffective, Possibly Harmful: There's no proof that over-the-counter sexual enhancement supplements for men work, and some are potentially dangerous, a new study reports. Some of the supposedly "natural" products have traces of phosphodiesterase-5-inhibitors (PDE5Is), the medication found in prescription drugs -- such as Viagra -- used to treat impotence. One study found that 81 percent of tested samples of over-the-counter male sexual enhancement products bought in the United States and Asia contained PDE5Is. Journal of Sexual Medicine 

TREATMENT

• Researchers Retract Study that Claimed Nitroglycerin Might Boost Bone Density: Some authors of a published study that claimed the heart medicine nitroglycerin might boost bone density in older women have asked that the study be retracted, saying the lead researcher falsified data in the report. The research was first published in February 2011 in the Journal of the American Medical Association. The request for a retraction appeared online Dec. 28 on the journal's website. The investigation found that Dr. Sophie Jamal, formerly a researcher with Women's College Hospital in Toronto, fabricated the data for the study. Medline Plus 

• Psych Therapies May Have Long Term Benefits for Irritable Bowel Patients: A meta analysis of 41 clinical trials have found that psychological therapies, such as relaxation and hypnosis, have short term and long term benefit for IBS patients. The analysis found several different psychological therapies -- including relaxation, hypnosis and cognitive behavioral therapy -- equally beneficial in helping people change the way they think. Regardless of the length of treatment, the researchers found the effects may last at least six to 12 months after treatment ends. Clinical Gastroenterology and Hepatology 

• Statins May Reduce Heart Risks Linked to Sleep Apnea: A new discovery about the way sleep apnea may raise the risk of heart disease also suggests that taking cholesterol-lowering statin drugs might reduce that risk, according to a new study. Science Translational Medicine 

• Dementia Drug May Lower Risk of Parkinson’s Related Falls: A widely used dementia drug rivastigmine (Exelon) shows potential in reducing the risk of falls among Parkinson's patients, according to a double blind study. The Lancet Neurology 

• Frozen as Good as Fresh for Fecal Transplants: A new clinical trial has shown that frozen stool samples work just as well as freshly donated samples when treating a tough C. difficile infection through a procedure called fecal transplantation. JAMA 

• Heartburn Meds Linked to Chronic Kidney Disease: Heartburn medication- proton pump inhibitors- (Prilosec, Nexium and Prevacid) may be linked to long-term kidney damage, a new study suggests. People who use proton pump inhibitors (PPIs) have a 20 percent to 50 percent higher risk of chronic kidney disease compared with nonusers.  JAMA Internal Medicine 

OTHER

• Save Money On Meds: Consumer Reports provides six tips for finding the best prescription drug prices including: skip chain drugstores (Costco offered the lowest price); support independents; don’t always use your health insurance; always ask if this is your lowest price; seek a 90 day prescription; look online. 

• Asthma May Be Linked to Shingles: Chances of getting painful skin condition 70 percent higher among people with respiratory condition, study finds. The finding builds on previous research that suggested a link between childhood asthma and shingles risk. Journal of Allergy and Clinical Immunology 

• Cancer Deaths Down 23% Since 1991: "Cancer death rates are continuing to decline by about 1.5 percent per year," since peaking in 1991. CA: A Cancer Journal for Clinicians 

• Doctor Patient Emails Can Help the chronically Ill: For people with chronic conditions, the ability to communicate with their doctor via email may improve their health, new research suggests. Online communications reduced need for phone calls and office visits for many. American Journal of Managed Care.

Take a Break: Replacing Holiday Lights with Something New to Enjoy

I don’t know if it’s because I live in Vermont, but holiday decorations are a bit of a permanent feature, particularly outside. At a recent party, people were discussing how long they leave their trees up. Valentine’s Day was the take down date for more than one person. While the cold weather lends itself to keeping things up longer outside, there is something about a tree with twinkling lights that seems so comforting on a cold winter’s night.

This year, I’m creating a paper village for our mantelpiece that will be lit with a strand of lights from our Christmas tree. While a number of the houses are white, there are some red ones with heart windows to celebrate Valentine’s Day. With each passing month, the colored houses will be swapped out for ones that reflect the time of year-pastels for spring, a few “fairy houses” for mid summer night’s eve, red, white, and blue features for the patriotic holidays and lots of scary ones in the fall. If that’s an idea that sounds like fun, start with Make Tiny Paper Houses. 

Other ways to incorporate lights for year round enjoyment

• Depending on space, create a new light feature by winding string lights around twigs or branches stuck in a vase or large pot-all depending on size of “branches.” Paint the branches white for an even bigger effect. Hang “seasonal” ornaments, such as hearts for Valentine’s day, small masks for Mardi Gras, Easter Eggs, stars (red, white and blue)

• Light “Garlands” are suitable all year round. Some ways to use them: 

-       * Hang lights and use clips to attach photographs, art work

-      *  Punch holes in doilies and push the light through

-       * Tie squares of tulle fabric between lights. Can purchase tulle in many different colors so an easy switch out throughout the year.

-       * Mix with rope for a nautical themed room

-       * Use colorful cupcake papers and make lots of flowers with the light being the center of the flower.  Painting egg cartons can also create lovely flowers. 

-       * Use the lights to spell out a word or phrase.

• Use a blank canvas or even a picture and punch holes so that the light will shine through.

• String lights on large plants and/or hanging baskets.

• Make a bed canopy with lights

Not interested in today’s activity? Check out the Take a Break Pinterest for lots of Take a Break ideas. 

Is it Gossip or Caring When You Relate Someone’s Health Status?

Whether we like it or not, HIPAA (Health Information Privacy Act) no longer extends to just medical professionals but has invaded every aspect of life including our relationships with one another. For generations, when someone was ill, injured, or in trouble, people would pass this information on at church, Grange, Sunday supper, a quick phone call or another community gathering spot and respond accordingly. Today, discussing someone’s health is pretty much akin to gossip in our uber confidential society.

I was recently reminded of this because of an individual’s behavior that’s putting others at risk. “We’ve done the best we can and have let people know of the situation,” one person noted. However, that isn’t true.  Those who know are very concerned, but for the most part the community is unaware because there is an unwritten rule that health related information not be shared.

So what’s the difference between giving information because you care and gossiping? Should you do it?

Lets be clear, every one gossips. We talk among friends, colleagues, neighbors and family. It can be meaningless, but it’s also a way people bond and most importantly, it’s how we come to understand societal norms and acceptable behaviors. So in essence, there is value in this practice.

What’s not okay is passing along information that you don’t know to be true, and/or which can be very damaging. It is also harmful when you vicariously describe someone’s pain and suffering or gloat over their difficulties. Getting pleasure out of someone’s misfortune isn’t okay and it generally doesn’t bode well in the long run for those who like to “gossip” in this manner.

The arrival of HIPAA brought about a societal shift where it’s no longer okay to talk about health status, including your own to some extent. In fact, people have been sued and lost jobs because of it.

One of the worse examples I recall was when a teacher was dying and the school adopted a “confidentiality” gag order, with students being kept in the dark. Without belaboring it, things did not go well for the students and some of the faculty when the teacher died.

My concern with this approach is that we are fostering secrecy to a level whereby those most in need of support and help aren’t getting it. Further, by needing to keep things “secret” more power is given to disease then it deserves. When this happens, instead of fostering support, caring and compassion, we encourage fear, shame, and guilt. 

Bottom line-unless you are acting in a professional manner under HIPAA, you aren’t governed by it. That said, use discretion and tact about what and to whom you share information.

Related Posts

 How to Respond When Someone is Ill or Injured 

Organizing Community to Aid Those affected by aging, illness and/or injury 

Relaying Information 

Confidentiality, HIPAA and Getting What You Want 

I’m really sick, but don’t tell anyone 

How to Help Those Who Are Injured, Ill, Grieving or in Need of Comfort 

Take a Break: One a Day Projects in January

Some times it feels like a “jumpstart” is needed when January rolls around. In Vermont, temps are in the minus readings and hibernation can lead to “cabin fever,” which is less than desirable. Last year’s Fun a Day project was a good boost to get the New Year off, so this year it’s One a Day projects.

My theme is making something every day with recycled aluminum cans (beer and soda cans). Since the Christmas tree is still up, reflectors for the lights on the tree have become an obsession. Some I like, some not so much, but I’m finding that my first thoughts of the morning are about a new approach to creating the reflectors, which is an improvement over worrying about something I have no control over any way.

While many communities have One a Day or Fun A Day shows, you can easily share your projects on social media to help inspire yourself and others. Also, don’t feel you need to limit them to something artistic. There are just two simple rules

• It’s enjoyable (fun)

• It’s something you want to do or try.

Consider the following One a Day projects

• Draw, sketch, color, paint

• Cut, saw, piece, sew

• Glue, tear, construct

• Write (short story, chapter, poem, essay)

• Photograph

• Organize: Could be a room where you do something every day so that by Feb. 1 it’s a new and inspiring place to be. Have a collection of stuff? Spend time each day organizing them into a unique display

• Read

• Meditate

• Hike, bike, swim, walk

• Yoga, Qigong, Tai chi

Need more ideas? Check out the Take a Break Pinterest for lots of Take a Break ideas.