01/25/18

Thursday, January 25, 2018

More birth defects in U.S. areas where Zika spread

A new government report finds a spike in potential Zika-linked birth defects in the last half of 2016 compared with births in the first half of that year

From: http://www.cbsnews.com/news/more-birth-defects-in-u-s-areas-with-local-zika-spread/

Zika Tied to Rise in U.S. Birth Defects: CDC

For the study, researchers analyzed data from 15 states and territories in 2016, and found that about three of every 1,000 newborns had a birth defect possibly caused by Zika infection in the mother during pregnancy.

From: https://www.webmd.com/a-to-z-guides/news/20180125/zika-tied-to-rise-in-us-birth-defects-cdc?src=RSS_PUBLIC

USDA Secretary Perdue in Pennsylvania

From: USDA https://www.youtube.com/watch?v=Pg_uAMUEroE

Take Care of Fido: Dog Flu On The Rise

Canine flu has not been reported in many states yet, although hot spots include northern Kentucky, southern Ohio, and central California. One case has been reported in Michigan.

From: https://pets.webmd.com/news/20180125/take-care-of-fido-dog-flu-on-the-rise?src=RSS_PUBLIC

Patients seeking "death with dignity" face drug price-gouging

Since the "right-to-die" law was implemented a year ago, doctors have written hundreds of lethal prescriptions, but they say many patients can't afford the medicine

From: http://www.cbsnews.com/news/patients-seeking-death-with-dignity-face-drug-price-gouging/

New Treatments Tackling Tough Lung Cancer

Lung cancer kills about 1.6 million people worldwide each year. The type known as non-small cell lung cancer accounts for about 85 percent of lung cancer cases.

From: https://www.webmd.com/lung-cancer/news/20180125/new-treatments-tackling-tough-lung-cancer?src=RSS_PUBLIC

Smoke 1 Cigarette a Day? It Can Still Kill You

British researchers say lighting up just once a day was linked to a much higher risk of heart disease and stroke than might be expected.

From: https://www.webmd.com/smoking-cessation/news/20180125/smoke-1-cigarette-a-day-it-can-still-kill-you?src=RSS_PUBLIC

Association's endorsement program changes name to ADA Member Advantage

ADA Business Resources, the Association's managed endorsement program, is now called ADA Member Advantage.

From: https://www.ada.org/en/publications/ada-news/2018-archive/january/associations-endorsement-program-changes-name-to-ada-member-advantage

Many Stroke Survivors Don't Improve Health Habits

Fewer than 1 in 100 stroke survivors met all seven heart-health goals identified by the American Heart Association. And just 1 in 5 met four of those goals.

From: https://www.webmd.com/stroke/news/20180124/many-stroke-survivors-dont-improve-health-habits?src=RSS_PUBLIC

Mayo Clinic Minute: How to know when to seek medical treatment for influenza

From: Mayo Clinic https://www.youtube.com/watch?v=9phPeNqdkmg

Another Alzheimer's Drug Fails; Scientists Stymied

In recent weeks, a pair of high-profile disappointments have been reported, including one just announced on a trial of the Eli Lily drug solanezumab.

From: https://www.webmd.com/alzheimers/news/20180125/another-alzheimers-drug-fails-scientists-stymied?src=RSS_PUBLIC

Clot-Removal Device Could Boost Stroke Outcomes

In the emergency procedure, called thrombectomy, doctors snake a catheter device through blood vessels to grab and remove the blockage.

From: https://www.webmd.com/stroke/news/20180125/clot-removal-device-could-boost-stroke-outcomes?src=RSS_PUBLIC

One cigarette a day can kill you, study finds

New research warns lighting up just once a day is linked to a much higher risk of heart disease and stroke than might be expected

From: http://www.cbsnews.com/news/even-one-cigarette-a-day-can-still-kill-you-study/

NYU gets NIH grant to study oral cancer pain

New York University researchers will use a $3.7 million, five-year grant to study proteases and neuronal signaling responsible for oral cancer pain, the university said in a Jan. 23 news release.

From: https://www.ada.org/en/publications/ada-news/2018-archive/january/nyu-gets-nih-grant-to-study-oral-cancer-pain

Flu can spike heart attack risk in elderly, study finds

The disheartening findings come in the midst of a particularly brutal flu season

From: http://www.cbsnews.com/news/flu-tied-to-heart-attack-risk-in-elderly/

Giving free rides, and a fighting chance, to cancer patients

ChemoCars, a service in metro Charlotte, offers free rides to cancer patients so they don't miss treatments

From: http://www.cbsnews.com/news/chemocars-service-gives-free-rides-and-a-fighting-chance-to-cancer-patients/

Acupuncture for headache

It is easy to ridicule a 2000-year-old treatment that can seem closer to magic than to science. Indeed, from the 1970s to around 2005, the skeptic’s point of view was understandable, because the scientific evidence to show that acupuncture worked, and why, was weak, and clinical trials were small and of poor quality.

But things have changed since then. A lot.

Thanks to the development of valid placebo controls (for example, a retractable “sham” device that looks like an acupuncture needle but does not penetrate the skin), and the publication of several large and well-designed clinical trials in the last decade, we have the start of a solid foundation for truly understanding the effectiveness of acupuncture.

How do we know if acupuncture really works for pain?

Individual large-scale clinical studies have consistently demonstrated that acupuncture provided better pain relief compared with usual care. However, most studies also showed little difference between real and sham (fake) acupuncture. In order to address this concern, a 2012 meta-analysis combined data from roughly 18,000 individual patients in 23 high-quality randomized controlled trials of acupuncture for common pain conditions. This analysis conclusively demonstrated that acupuncture is superior to sham for low back pain, headache, and osteoarthritis, and improvements seen were similar to that of other widely used non-opiate pain relievers.

And the safety profile of acupuncture is excellent, with very few adverse events when performed by a trained practitioner. Meanwhile, basic science studies of acupuncture involving animals and humans have shown other potential benefits, from lowering blood pressure to long-lasting improvements in brain function. More broadly, acupuncture research has resulted in a number of insights and advances in biomedicine, with applications beyond the field of acupuncture itself.

Is acupuncture really that good?

We understand why there may be continued skepticism about acupuncture. There has been ambiguity in the language acupuncture researchers employ to describe acupuncture treatments, and confusion surrounding the ancient concept of acupuncture points and meridians, which is central to the practice of acupuncture. Indeed, the question of whether acupuncture points actually “exist” has been largely avoided by the acupuncture research community, even though acupuncture point terminology continues to be used in research studies. So, it is fair to say that acupuncture researchers have contributed to doubts about acupuncture, and a concerted effort is needed to resolve this issue. Nevertheless, the practice of acupuncture has emerged as an important nondrug option that can help chronic pain patients avoid the use of potentially harmful medications, especially opiates with their serious risk of substance use disorder.

Finding a balanced view

A post on acupuncture last year dismissed acupuncture as a costly, ineffective, and dangerous treatment for headache. This prompted us to point out the need for a measured and balanced view of the existing evidence, particularly in comparison to other treatments. Although the responses that followed the article overwhelmingly supported acupuncture, it nevertheless remains a concern that this practice attracts this kind of attack. Acupuncture practitioners and researchers must take responsibility for addressing deficiencies in acupuncture’s knowledge base and clarifying its terminology.

That said, we need to recognize that acupuncture can be part of the solution to the immense problem of chronic pain and opiate addiction that is gripping our society. That this solution comes from an ancient practice with a theoretical foundation incompletely understood by modern science should make it even more interesting and worthy of our attention. Clinicians owe it to their patients to learn about alternative, nondrug treatments and to answer patients’ questions and concerns knowledgeably and respectfully.

Sources

Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet, July 2005.

Acupuncture in Patients With Chronic Low Back Pain: A Randomized Controlled Trial. JAMA Internal Medicine, February 2006.

Acupuncture in patients with tension-type headache: randomised controlled trial. BMJ, August 2005.

Acupuncture for Patients With Migraine: A Randomized Controlled Trial. JAMA, May 2005.

Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. JAMA Internal Medicine, October 2012.

Survey of Adverse Events Following Acupuncture (SAFA): a prospective study of 32,000 consultations. Acupuncture in Medicine, December 2001.

Safety of Acupuncture: Results of a Prospective Observational Study with 229,230 Patients and Introduction of a Medical Information and Consent Form. Complementary Medicine Research, April 2009.

The safety of acupuncture during pregnancy: a systematic review. Acupuncture in Medicine, June 2014.

Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee. PLOS One, March 2017.

Paradoxes in Acupuncture Research: Strategies for Moving Forward. Evidence-Based Complementary and Alternative Medcine, 2011.

The Long-term Effect of Acupuncture for Migraine Prophylaxis: A Randomized Clinical Trial. JAMA Internal Medicine, April 2017.

The post Acupuncture for headache appeared first on Harvard Health Blog.

From: Helene Langevin, MD https://www.health.harvard.edu/blog/acupuncture-for-headache-2018012513146

"Completely unreal": Family shocked after healthy 12-year-old dies of flu

Dylan stayed home from school on Tuesday and when his father returned home later that day, Dylan was dead

From: http://www.cbsnews.com/news/healthy-12-year-old-boy-dylan-winnick-dies-influenza/

North Carolina man gives cancer patients a much-needed lift

Our continuing series, A More Perfect Union, aims to show that what unites us as Americans is far greater than what divides us. In this installment, we share the story of a man inspired by his own mother's health struggle. Zach Bolster is giving cancer patients a better shot at fighting the disease simply by giving them a ride. Mark Strassmann reports.

From: http://www.cbsnews.com/video/north-carolina-man-gives-cancer-patients-a-much-needed-lift/

Parents in disbelief over 12-year-old's flu death

Dylan Winnick, 12, is among the latest victims of the widespread flu epidemic. The flu has killed more than 30 children nationwide since October. Dr. Tara Narula reports.

From: http://www.cbsnews.com/video/parents-in-disbelief-over-12-year-olds-flu-death/

Lawmaker pushes to shift opioid fight from border wall to mailbox

For nearly a year, Sen. Rob Portman and a team of investigators have tracked the deadly, door-to-door delivery of fentanyl

From: http://www.cbsnews.com/news/opioid-epidemic-international-mail-china-screening-challenges-rob-portman/

Preparing for College Survey Methodology

A description of the survey methodology for the WebMD/Medscape survey "Preparing for College: The Mental Health Gap."

From: https://www.webmd.com/special-reports/prep-teens-college/20180125/teen-parents-survey-methodology?src=RSS_PUBLIC

Practitioner/general dentist sought for recognition committee

The Council on Dental Education and Licensure is seeking nominations to fill the vacancy of the practitioner/general dentist position on its Committee on Recognition of Dental Specialties and Interest Areas in General Dentistry.

From: By Kimber Solana
https://www.ada.org/en/publications/ada-news/2018-archive/january/practitioner-general-dentist-sought-for-recognition-committee

Researchers clone 2 healthy monkeys -- are humans next?

Female baby monkeys, about 7 and 8 weeks old, are named Zhong Zhong and Hua Hua

From: http://www.cbsnews.com/news/researchers-use-cloning-method-to-create-two-healthy-monkeys/

Woman shot in head in Vegas massacre makes miraculous recovery

Jovanna Calzadillas will leave Barrow Neurological Institute Thursday and go home with her husband and two children

From: http://www.cbsnews.com/news/miraculous-woman-shot-in-head-in-las-vegas-massacre-to-leave-hospital/

More Bad Flu News: It's Tied to Heart Attack Risk

Among 332 heart attack patients, the complication was six times more likely to strike following a bout of the flu, researchers reported.

From: https://www.webmd.com/cold-and-flu/news/20180124/more-bad-flu-news-its-tied-to-heart-attack-risk?src=RSS_PUBLIC

Are Stroke Patients Skipping Rehab?

For the study, researchers contacted 369 North Carolina stroke patients who were referred to rehabilitation either when they left the hospital or at a follow-up visit within 14 days.

From: https://www.webmd.com/stroke/news/20180124/are-stroke-patients-skipping-rehab?src=RSS_PUBLIC

Study finds troubling trend among moms-to-be

A rare type of stroke is on the rise among pregnant women in the United States, new research finds

From: http://www.cbsnews.com/news/study-finds-troubling-stroke-trend-among-pregnant-women-in-u-s/

Doctors try to save girl's vision with new cancer treatment

The 3-year-old has a tumor in her eye that would normally cost her vision, but doctors are trying a new technique hoping to save her sight

From: http://www.cbsnews.com/news/doctors-try-to-save-girls-vision-with-new-cancer-treatment/

Progress on 'Universal' Flu Vaccine

Trials in mice found that the new shot triggered lasting immunity against influenza A virus strains, which are responsible for up to 90 percent of cases this year.

From: https://www.webmd.com/cold-and-flu/news/20180124/progress-on-universal-flu-vaccine?src=RSS_PUBLIC

Troubling Stroke Trend Among U.S. Moms-to-Be

This type of stroke is called spontaneous subarachnoid hemorrhage. It's potentially life-threatening and occurs when blood vessels on the surface of the brain rupture.

From: https://www.webmd.com/stroke/news/20180124/troubling-stroke-trend-among-us-moms-to-be?src=RSS_PUBLIC

Monkeys Cloned From 'Dolly' the Sheep Process

But both the scientists and other experts say it's highly unlikely this advance will result in human clones in the foreseeable future.

From: https://www.webmd.com/a-to-z-guides/news/20180124/monkeys-cloned-from-dolly-the-sheep-process?src=RSS_PUBLIC

Philadelphia backs safe injection sites to curb opioid overdoses

Philadelphia has the highest opioid death rate of any large U.S. city: More than 1,200 people fatally overdosed in Philadelphia in 2017

From: http://www.cbsnews.com/news/safe-injection-sites-philadelphia-elected-officials-back-curb-overdose-deaths/

Why mixing herbal supplements and Rx drugs could be risky

More than half of Americans say they take dietary and herbal supplements

From: http://www.cbsnews.com/news/herbal-supplements-prescription-drugs-mixing-risk/

Watch: Doctor Flips Pregnant Mom’s Baby Bump

When you’re a mom-to-be, you’re almost guaranteed to feel your growing baby kick or move around some. Then there’s Vanessa Fisher. She felt her unborn son do a complete 180 with a big assist from her doctor.

From: https://www.webmd.com/parenting/baby/features/pregnancy-breech-baby-turn?src=RSS_PUBLIC

Involuntary treatment for substance use disorder: A misguided response to the opioid crisis

Recently, Massachusetts Governor Charlie Baker introduced “An Act Relative to Combatting Addiction, Accessing Treatment, Reducing Prescriptions, and Enhancing Prevention” (CARE Act) as part of a larger legislative package to tackle the state’s opioid crisis. The proposal would expand on the state’s existing involuntary commitment law, building on an already deeply-troubled system. Baker’s proposal is part of a misguided national trend to use involuntary commitment or other coercive treatment mechanisms to address the country’s opioid crisis.

The CARE Act and involuntary hold

Right now, Section 35 of Massachusetts General Law chapter 123 authorizes the state to involuntarily commit someone with an alcohol or substance use disorder for up to 90 days. The legal standards and procedures for commitment are broad; a police officer, physician, or family member of an individual whose substance use presents the “likelihood of serious harm” can petition the court.

Upon reviewing a petition, the court can issue a warrant for the arrest of the person with substance use disorder. The individual — who is not charged with a crime — is held pending an examination by a court-appointed clinician. The statute mandates that the determination proceed at a rapid pace, making it difficult to mount a meaningful defense.

The CARE Act proposes to further accelerate this process. The proposal would allow clinical professionals — including physicians, psychiatric nurses, psychologists, and social workers (or police officers when clinicians are not available) — to transport a person to a substance use treatment facility when the patient presents a likelihood of serious harm due to addiction and the patient will not agree to “voluntary treatment.” Upon determination by a physician that the failure to treat the person would create “a likelihood of serious harm,” the treatment facility has 72 hours to get the person to agree to voluntary treatment. If the person refuses, but the facility superintendent determines that discontinuing treatment would again cause “a likelihood of serious harm,” the facility must petition the court for involuntary treatment under the process outlined in Section 35.

The expanded use of these laws

Laws that allow the state to commit people for substance use disorder are not new. The number of states with such laws went from 18 in 1991 to 38 jurisdictions, and counting. Existing laws vary significantly in the specific criteria for commitment, length, and type of treatment, if any is provided. The use of this mechanism has rapidly expanded as the opioid crisis has worsened; Massachusetts, with a population of under 7 million, committed a shockingly high number — more than 6,500 individuals — in 2016. Ironically, this expansion has occurred in conjunction with calls to move away from a criminal justice and toward a public health approach to the crisis, including a more concerted emphasis on treatment for people with addiction. But this well-intentioned shift carries little meaning when coercion and institutionalization are involved. In fact, 70% of the beds for men in Massachusetts are at a prison facility, where patients wear prison uniforms and answer to correctional officers. In recent months, these facilities have been rocked by a series of high-profile scandals, including escapes, suicides, and alleged sexual assault.

Do these laws help or hurt?

Existing data on both the short- and long-term outcomes following involuntary commitment for substance use is “surprisingly limited, outdated, and conflicting.” Recent research suggests that coerced and involuntary treatment is actually less effective in terms of long-term substance use outcomes, and more dangerous in terms of overdose risk. The prospects for positive outcomes from the CARE Act are especially bleak, given the standard of care currently available to Massachusetts residents committed under Section 35. The facilities housing Section 35 patients commonly offer counseling sessions and classes to “learn more about addiction;” shockingly few offer appropriate medication. In fact, the treatment provided is often not rooted in science at all. The state’s own mandated evaluation of overdose data has found that people who were involuntarily committed were more than twice as likely to experience a fatal overdose as those who completed voluntary treatment.

Though further research is needed to confirm these findings, there are several possible reasons for this. One is that recovery is much more likely when it is driven by internal motivation, not by coercion or force (i.e., the person must “want to change”). Second, the state may actually route individuals to less evidence-driven programs on average (e.g., “detox”) than the kind of treatment accessed voluntarily (i.e., outpatient methadone or buprenorphine treatment). Finally, those receiving care in outpatient settings may be more likely to receive services that help address underlying physical or mental health needs, which are often at the root of problematic substance use.

Involuntary commitment for people with substance use disorder deprives them of liberty, fails to offer evidence-based treatment, and may leave patients worse off by making them vulnerable to overdose risk. But for the families or medical providers of individuals with substance use disorder, court-ordered involuntary commitment for their loved ones or patients may seem like an attractive option, or indeed the only viable one, to get them into treatment. Understanding the procedures, ramifications, and consequences of involuntary commitment is vital before initiating a process that deprives a person of liberty just as much as prison would.

What is the alternative?

There is far too little on offer in Massachusetts — or elsewhere — that would trigger the timely assistance and intensive case management necessary to support people in crisis. In the absence of such supports, involuntary commitment promises to help families that are desperate to find treatment for their loved ones. Unfortunately, the promise offered by involuntary treatment is a false one. Instead, we need to develop new approaches to support families and patients in non-coercive, evidence-driven ways.

The post Involuntary treatment for substance use disorder: A misguided response to the opioid crisis appeared first on Harvard Health Blog.

From: Leo Beletsky, JD, MPH https://www.health.harvard.edu/blog/involuntary-treatment-sud-misguided-response-2018012413180

Why herbal supplements taken with prescription drugs may be risky

A new study highlights potentially dangerous interactions between herbal supplements and prescription medications. Researchers looked at dozens of reports of serious drug interactions among patients with disorders like high blood pressure, diabetes, cancer and depression. They found herbal supplements may affect medications' effectiveness or have side-effects. Dr. Tara Narula joins "CBS This Morning" to discuss the risks.

From: http://www.cbsnews.com/video/why-herbal-supplements-taken-with-prescription-drugs-may-be-risky/

Is IQOS, a smoke-free cigarette alternative, safe?

Regulators from the FDA will consider a potentially safer alternative to cigarettes. Philip Morris International, the maker of Marlboro and other top brands, wants the FDA to approve IQOS, a pen-like product that warms tobacco and creates an aerosol that's less toxic than cigarette smoke. Smoking is the leading cause of preventable death in the U.S. Tony Dokoupil reports.

From: http://www.cbsnews.com/video/is-iqos-a-smoke-free-cigarette-alternative-safe/

Questions arise over the risks of smoke-free tobacco device

Philip Morris says the pen-like product creates an aerosol that's less toxic than cigarette smoke and poses less risk of disease

From: http://www.cbsnews.com/news/iqos-philip-morris-cigarette-alternative-smokeless-device-risks/

Oregon approves new taxes to address Medicaid costs

The state approved taxes on hospitals, health insurers and managed care companies in an unusual special election

From: http://www.cbsnews.com/news/oregon-approves-new-taxes-to-address-medicaid-costs/

February JADA examines dental role in facial transplants

Dental professionals can play a critical role in facial transplants, especially in cases that involve the maxilla, mandible and associated teeth, according to research in the February issue of The Journal of the American Dental Association.

From: By Michelle Manchir
https://www.ada.org/en/publications/ada-news/2018-archive/january/february-jada-examines-dental-role-in-facial-transplants