Author: bCchec01a

Adult HPV Vaccine Age, Guidelines

“The HPV vaccine is having a significant effect of decreasing cervical cancer.  More recently HPV is associated with oral cancer and anal cancer.

HPV goes through latex And many of  other sexually transmitted diseases do not.  Many adults don’t know that the “safe sex” procedures they use may not work with HPV.

This recent review of this CDC information says that the vaccine has a low side effect rate in adults.  The CDC data is established up to age 26.  The CDC cannot recommend the vaccines for older adults.  Adults older than 26 years who are sexually active should examine this data and balance that with their HPV risks.

 Gardasil 9 has the broadest range of efficacy.  The Prevents infection by 9 different types of HPV virus.  These 9 types account for 90% of cervical cancers.”                                                                  Bill Chesnut M.D.

Return to New Health News, http://billchesnutmd.com/new-health-news/

  • ·         Why Adults Should Get the HPV Vaccine
  • ·         When Should Adults Get the HPV Vaccine?
  • ·         Are There Any Adults Who Should Not Receive the HPV Vaccine?
  • ·         What Are the HPV Vaccine Ingredients?
  • ·         What Are the Risks and Side Effects of the HPV Vaccine?
    Human papillomavirus (HPV) is the virus that causes cervical cancer in women and genital warts in men and women. The HPV vaccine effectively prevents infection with the HPV types responsible for most cervical cancers and can also prevent genital warts. HPV vaccination is most effective during childhood or adolescence, but adults can also benefit from the HPV vaccine.

Why Adults Should Get the HPV Vaccine

HPV infection is extremely common; most sexually active people will be infected with HPV at some point in life. HPV infection usually causes no symptoms, but can cause genital warts and anal cancer in both women and men. HPV can also cause throat cancer.

In women, HPV infection can cause cells in the cervix to grow abnormally. In a small fraction of women, these HPV-induced changes will develop into cervical cancer. About 12,000 women are diagnosed with cervical cancer each year and about 4,000 women die from the condition.

The HPV vaccine prevents infection by the HPV types responsible for most cervical cancers. There are three available forms of the HPV vaccine:

Cervarix: Prevents infection by HPV-16 and HPV-18. These two HPV types cause 70% of all cervical cancers. It is used for the prevention of cervical cancer and precancers.
Gardasil: Prevents infection by HPV-16, HPV-18, and also HPV-6 and HPV-11, the two HPV types that cause 90% of genital warts. It is used to prevent cancers and precancers of the cervix, vulva, vagina, anus, penis, and throat.
Gardasil 9: Prevents infection by the same HPV types as Gardasil, plus HPV-31, HPV-33, HPV-45, HPV-52, and HPV-58. Collectively, these types are implicated in 90% of cervical cancers.
All HPV vaccines are extremely effective at preventing infection by the HPV types they cover. Getting the HPV vaccine reduces a woman’s risk of cervical cancer and precancerous growths substantially. Men cannot develop cervical cancer, but the HPV vaccine may prevent genital warts, anal cancer, and the spread of HPV to sexual partners. Gardasiland, Gardasil 9 are approved for males ages 9 through 26.

The HPV vaccine does not treat or cure an HPV infection in women or men who are already infected by one of these HPV types.

When Should Adults Get the HPV Vaccine?

The CDC recommends that all women ages 26 years and younger receive three doses of the HPV vaccine. The CDC recommends that all men ages 21 years and younger receive three doses of the HPV vaccine. It is an option for all men, but is recommended for men who have sex with men or who have a compromised immune system (including HIV) who are ages 26 and younger.

CDC guidelines recommend the three doses of the HPV vaccine should be given as follows:

First dose: ideally at ages 11 or 12
Second dose: one to two months after the first dose
Third dose: six months after the first dose
Some adults may have received doses of the HPV vaccine in childhood or adolescence. All three doses should be given to get the most protection from HPV infection. Re-vaccination in adulthood is recommended if the vaccination schedule was not completed.

Are There Any Adults Who Should Not Receive the HPV Vaccine?

Certain people should not get the HPV vaccine or should wait before getting it:

Anyone who has had a life-threatening allergic reaction to a previous dose of the HPV vaccine
Anyone who has had a previous life-threatening allergic reaction to an ingredient in the HPV vaccine
Pregnant women
Anyone with a moderate or severe illness; people who feel mildly ill may still receive the HPV vaccine.
The HPV vaccine is not known to be harmful to pregnant women or their babies. However, until more information is known, pregnant women are advised not to receive the HPV vaccine. Women who are breastfeeding can safely receive the HPV vaccine.

The HPV vaccine’s safety and effectiveness have not yet been studied in adults older than age 26. Until that information is available, the HPV vaccine is not recommended for adults older than age 26.

What Are the HPV Vaccine Ingredients?

The HPV vaccine contains no viruses and is not made from human papillomavirus. The active ingredients in the HPV vaccine are proteins that are similar to those found in the human papillomavirus. Genetically modified bacteria produce the proteins, which are then purified and mixed into a sterile, water-based solution.

What Are the Risks and Side Effects of the HPV Vaccine?

In clinical trials and in real-world use, the HPV vaccine appears to be very safe. More than 40 million doses of the vaccine — mostly Gardasil, which was approved in 2006 — have been given in the U.S. Cervarix was approved in 2009 and Gardasil 9 was approved in 2014.

From 2006 to 2014, there were about 25,000 reports to the government of HPV vaccine side effects. Over 90% of these were classified as nonserious. The most common side effects of the HPV vaccine are minor:

About one in 10 people will have a mild fever after the injection.
About one person in 30 will get itching at the injection site.
About one in 60 people will experience a moderate fever.
These symptoms go away quickly without treatment. Other mild-to-moderate side effects resulting from the HPV vaccine include:

Nausea
Fainting
Headache
Arm pain

Severe side effects, or adverse events, are uncommonly reported and have included:

Blood clots
Seizures
Guillain-Barre syndrome
Chronic inflammatory demyelinating polyneuropathy
Systemic exertion intolerance disease (formerly called chronic fatigue syndrome)
Death
Government, academic, and other public health investigators could not identify the HPV vaccine as the cause of any severe adverse event. There were 117 deaths as of September 2015, none of which could be directly tied to the HPV vaccine. The conclusion of public health investigators was that the HPV vaccine was unlikely to be the cause of these events. Such events occur at a certain rate in any group of tens of millions of people. The vaccination before each adverse event seemed to be a simple coincidence.

 

PPIs prematurely age cells that line the inside of blood vessels.

“The side effects of long term Omeprazole, Nexium and its related drugs, called PPIs, is alarming. On May 10 a report described PPI drugs being associated with central nervous system dysfunction. Avoid PPI drugs and use Zantac and its class of medications.” Bill Chesnut, MD

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

PPIs prematurely age cells that line the inside of blood vessels, study suggests.  AMA Wire  __May 11, 2016.

The Houston Chronicle (5/10, Hawryluk) reports that research suggests “proton pump inhibitors prematurely age the cells that line the inside of blood vessels, making them less resistant to blockages that can cause heart attacks and strokes.” The findings were published in Circulation Research.

HealthDay (5/10, Thompson) reports that the findings, from “lab tests,” may “explain why other studies have shown increased risk of heart disease in people who use” PPIs, “said study senior author Dr. John Cooke.”

________________________________________________________________

CIRCULATION RESEARCH_American Heart Association.

Proton Pump Inhibitors Accelerate Endothelial Senescence

Abstract
Rationale: Proton pump inhibitors (PPIs) are popular drugs for gastroesophageal reflux, now available for long-term use without medical supervision. Recent reports suggest that PPI use is associated with cardiovascular, renal and neurological morbidity.

Objective: To study the long-term effect of PPIs on endothelial dysfunction and senescence and investigate the mechanism involved in PPI induced vascular dysfunction.

Methods and Results: Chronic exposure to PPIs impaired endothelial function and accelerated human endothelial senescence by reducing telomere length.

Conclusions: Our data may provide a unifying mechanism for the association of PPI use with increased risk of cardiovascular, renal and neurological morbidity and mortality.

 

Silent heart attacks make up 45% of all heart attacks.

“The Wake Forest School of Medicine studied > 9,000 people. The paper is Race and Sex Differences in the Incidence and Prognostic Significance of Silent Myocardial Infarction in the Atherosclerosis Risk in Communities (ARIC) Study. The important finding is not about sex and race differences but that 45% of heart attacks (myocardial infarction) are not clinically documented meaning not causing enough symptoms to cause medical attention. The silent myocardial infarction (SMI) incidence was surprising. The SMI was detected by EKG changes in people who had no symptoms of ever having a heart attack. The study was over eight years. The combined total of heart attacks was 7.4% of the studied group. A heart healthy life style is even more important with this information.” Bill Chesnut, MD
(Return to New Health News, http://billchesnutmd.com/new-health-news/)
Silent heart attacks make up 45% of all heart attacks, study suggests

TIME (5/16, Alter) reports that research suggests “silent heart attacks, which have no symptoms but still involve a loss of blood flow to the heart, make up 45% of all heart attacks and triple the chances of dying from heart disease.” The findings were published in Circulation.

NBC News (5/16, Fox, Powers) reports on its website that investigators “looked at the medical records of 9,500 middle-aged men and women taking part in a heart disease risk study.” The researchers found that “nine years into the study, 317 of the volunteers had ‘silent’ heart attacks and 386 had heart attacks that were noticed right away.”

On its website, CBS News (5/16, Marcus) reports that the researchers also found that “found that silent heart attacks were more common in men – but more likely to cause death in women.”

CNN (5/16, Kounang) reports that the study indicated “having a silent heart attack increased the chances of dying from heart disease threefold and increased chances of dying from any cause by 34%.”

 

The serious side effects associated with fluoroquinolone antibacterial drugs.

 “The FDA issues advisory regarding treatment with fluoroquinolone antibacterial drugs. The tendon side effects include tendon ruptures. I was not aware of the central nervous system side effects. I posted a list of the brand names below for your information. The best known antibiotic in this class is Cipro.” Bill Chesnut, MD

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

The U.S. Food and Drug Administration (FDA) is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with sinusitis, bronchitis, and uncomplicated urinary tract infections who have other treatment options. An agency safety review has shown that, when used systematically, fluoroquinolones are associated with disabling and potentially permanent serious side effects that can occur together. Side effects can involve the tendons, muscles, joints, nerves, and central nervous system. As a result, FDA is requiring the drug labels and medication guides for all fluoroquinolone antibacterial drugs to be updated to reflect this new safety information. The agency states that healthcare professionals should stop systemic fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course.

First-generation[edit]

Second-generation[edit]

The second-generation class is sometimes subdivided into “Class 1” and “Class 2”.[78]

Third-generation[edit]

Unlike the first- and second-generations, the third-generation is active against streptococci.[78]

Fourth-generation[edit]

Fourth-generation fluoroquinolones act at DNA gyrase and topoisomerase IV.[82] This dual action slows development of resistance.

In development[edit]

 

 

Take care of your teeth to reduce your risk of stroke.

“Here is another reason to put in the effort for the best gum health possible. Orthopedic surgeons tell patients that dental infections are a leading cause of infections in the blood stream getting into a total joint implant causing it to fail. Here is a report about an increased risk of stroke.

I love the Panasonic water irrigator. http://www.amazon.com/Panasonic-Dental-Flosser-Pressure-Settings/dp/B0027LSEPS/ref=sr_1_1_a_it/189-9774289-5118830?ie=UTF8&qid=1461892248&sr=8-1&keywords=panasonic+water+irrigator . It cleans my teeth and gums  better than a water pik, the more common irrigator.

Try this trick to motivate yourself. I timed how long it took me to use the irrigator thoroughly inside and outside of the teeth. It takes 2.5 minutes, 150 seconds. I always find the 150 seconds to keep my teeth healthy. “ Bill Chesnut, MD

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

 

March 22, 2016 Cleveland Clinic Wellness Newsletter
Take care of your pearly whites! It may reduce your risk of stroke.
Raise your hand if you received a reminder card from your dentist and tossed it in the recycling bin. Now use that hand to grab the phone and call for an appointment! New research underscores the links between your oral health and your overall health, and calls attention to the importance of seeing your dental professional every six months. Multiple studies indicate a link between periodontal disease and heart disease — and, on the “good news” front, treating periodontal disease has been shown to lower your risk of heart attack. Now a new study sheds light on how the presence of Streptococcus mutans, a cavity-causing bacteria, may increase your risk of hemorrhagic stroke. Professional cleanings can reduce not only bacteria but also harmful inflammation, which may also contribute to heart disease. Brush and floss daily, and see your dental pro twice a year for cleaning and evaluation. If you find yourself slacking, remind yourself that, when it comes your health, everything is connected, so that good health anywhere in the body improves the likelihood of good health everywhere.

 

Surgical options correct the cause of reflux

“The treatment options for sufferers of GERD are increasing. The surgery to correct refractory cases is becoming less major with a faster recovery. Also the incidences of side effects of the Proton Pump Inhibitor medications is increasing, now including central nervous system problems. I included this here because the improvements in treatments is not widely known.” Bill Chesnut, MD

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

Surgical options correct the cause of reflux

The surgical options attack the actual cause of the problem – the dysfunction of the lower esophageal sphincter (LES). Each attempts to correct the problem rather than covering it up with PPIs. I will summarize every available alternative and encourage further investigation of each.

Nissen fundoplication

Considered the “gold standard” of surgical antireflux therapy is the laparoscopic Nissen Fundoplication. This procedure restores the function of the LES by wrapping a portion of the upper stomach loosely around the lower esophagus. It is performed under general anesthesia using minimally invasive techniques. Five 1/2-1 inch incisions are required and it necessitates a one-day hospital stay.  A “soft food” diet is typically suggested initially with gradual resumption to a normal diet taking 6-12 weeks. Although this is not a difficult procedure, it has its nuances and must be performed by a surgeon experienced in this procedure for optimal results. This operation stops the reflux in approximately 80-85% of patients, returning the pH test to normal.

This procedure eliminates the need for PPIs in most patients with the most well performed studies showing approximately 90% of surgical patients do not require those medications.  Approximately the same number indicate that they are satisfied with the procedure in the 5-10 year time frame.

Even though the satisfaction rate is great, there are side effects with this procedure including swallowing difficulty (2-5% of patients), bloating and diarrhea to various degrees (10-20% of patients), and the inability to belch and vomit (30% of patients). These side effects seem to vary with the experience of the surgeon. In good hands, this is a proven, effective alternative to PPI therapy. Susan should also understand that a Nissen procedure can repair even the largest of hiatal hernias.

LINX Reflux Management System

Last year, the FDA approved a new procedure called the LINX Reflux Management System. This procedure places a magnetic bracelet around the lower esophagus to “augment” the failed LES. This is a minimally invasive technique and is typically completed in about 30 minutes. A regular diet and full activity is immediately resumed and the reflux is stopped approximately 70% of the time without the typical side effects associated with a Nissen procedure, except that a small number of recipients have difficulty swallowing.

The latest study of 100 patients showed 85% have eliminated PPIs after 3-5 years and 94% would recommend the procedure to a friend. Only 2% had swallowing difficulty, which was corrected with a simple non-surgical dilation (gentle stretching of the esophagus.) This procedure is available at a limited number of select locations in the US.

Incisionless procedures

Two procedures are available that are performed orally and do not require incisions. The TIF procedure, also know as the Esophyx procedure, and the Stretta procedure are both performed through the mouth. Since no incision is required, many individuals find this an attractive feature for both procedures. These two procedures do not have a predictable effect on eliminating reflux and studies have conflicted on the ability of patients to eliminate their PPI use. Many recipients report an improved “quality of life” although there is a concern that the elimination of reflux is not predictable and PPIs may be required long-term for some. In the only 10-year study on Stretta available, only 23% remained off PPIs at 10 years.  As is the case with Nissen procedures, the skill set of the surgeon is an important factor is successful outcomes.  Also, according to several surgeons, patient selection is an important variable as well.

Weigh your options

As discussed, there are alternatives to long-term PPI use to GERD.  These treatment alternatives are becoming more attractive and receiving more interest today as consumers become more aware of the potential for negative long-term side affects from PPIs. For Susan, the best non-medical procedure seems to be the laparoscopic Nissen fundoplication since she describes a hiatal hernia.  If it is greater than 3 cm in size, Nissen is the only recommended choice. If the hernia is less than 3cm, all of these procedures are options.

 

Low AMH hormone levels predict faster bone loss

“The antimullerian hormone is a simple blood test that measures ovary function. This discovery shows the connection of hormone deprivation at menopause and major bone loss in women. I have posted extensively elsewhere on this site about post-menopausal deprivation being associated with a major bone loss between menopause and age 60. There is increasing evidence for hormone replacement hormone therapy to increase this bone loss.” Bill Chesnut, MD.

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

Low AMH hormone levels predict faster bone loss.    AMA News 5.12.16

Lower levels of a hormone produced by the ovaries is associated with a woman’s risk for bone loss during menopause, according to a recent study. Researchers at the University of California Los Angeles found testing levels of anti-mullerian hormone in women who are pre- or early-menopausal shows their likely rate for bone loss, suggesting early intervention may be possible to slow or prevent the condition. Anti-mullerian hormone is produced by cells in the ovarian follicles and is a marker for ovarian health, which the new study linked to decline in bone density of the spine and femur, researchers said in a press release. Bone strength in older ages and the ability to avoid devastating hip and spine fractures depend equally on peak bone mass achieved in young adulthood and the amount of bone lost during and after the menopause transition, Dr. Arun Karlamangla, a professor at UCLA, said in a press release in April, when the study was presented at the Endocrine Society’s 2016 annual conference. For the study, which was published on the society’s website ahead of the conference, researchers analyzed data for 474 women in the Study of Women’s Health Across The Nation who were between 42 and 52 years old, in pre- or early-perimenopause, had an intact uterus with at least one ovary and were not taking supplemental hormones. The researchers found that each fourfold decrease in anti-mullerian hormone was linked to a 0.15 percent faster decline in bone density of the spine and a 0.13 percent per year faster decline in density of the top of the femur, the femoral neck. The same decrease in the hormone was also linked to an 18 percent increase in odds of faster-than-average decline in bone density of the spine and 17 percent increase in odds for decline of the femoral neck. The researchers suggest early intervention — with treatments including increasing exercise or calcium and vitamin D intake — could help stave off bone loss for women at higher risk during menopause. This study’s findings open up the possibility of identifying the women who are going to lose the most bone mass during the transition and targeting them before they have lost a substantial amount of bone mass, Karlamangla said. .

Traumatic Brain Injury associated with sleep problems long after the injury

“I included this article as an example of the public media journalists having no common sense and discretion when there is a minor first study suggesting something. The media prints it as fact though they say “suggestion.” Above are comments from Newsweek, L.A. Times, CBS and NPR.
Below is the abstract of the research. These headlines and their implications are a farce. Only 31 participants had a detailed sleep assessment. That has no statistical significance. My opinion is these minor works publish before anything is proven hoping to get enough financial support to do a real work of medical research.

Beware of public media headlines about medicine. They know better than make such a strong assertion. My opinion is not based on research; I am open to other interpretations” Bill Chesnut, MD.

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

Traumatic Brain Injury associated with sleep problems long after the injury
Newsweek (4/27, Firger) reports that research suggests individuals “who suffer” a traumatic brain injury (TBI) “may experience sleep problems a year and a half after the injury.” The study, published in Neurology, also found that “these patients often aren’t aware that it’s a problem.”

The Los Angeles Times (4/27, Healy) reports that “on average, 1½ years after their brain injury, subjects slept 8.1 hours per night vs. 7.1 hours for healthy controls.” The study indicated that “even with that extra hour, they were more tired during their wakeful hours, as measured by how quickly they fell asleep.”

On its website, CBS News (4/27, Welch) reports, however, that participants with TBI “didn’t report feeling any sleepier than those without head injuries when asked how tired they were during the day.”

According to the NPR (4/27, Hamilton) “Shots” blog, these findings “suggest there could be a quiet epidemic of sleep disorders among people with” TBIs.

Sleep–wake disorders persist 18 months after traumatic brain injury but remain underrecognized              Neurology 10.1212

Objective: This study is a prospective, controlled clinical and electrophysiologic trial examining the chronic course of posttraumatic sleep–wake disturbances (SWD).

Methods: We screened 140 patients with acute, first-ever traumatic brain injury of any severity and included 60 patients for prospective follow-up examinations. Patients with prior brain trauma, other neurologic or systemic disease, drug abuse, or psychiatric comorbidities were excluded. Eighteen months after trauma, we performed detailed sleep assessment in 31 participants. As a control group, we enrolled healthy individuals without prior brain trauma matched for age, sex, and sleep satiation.

Results: In the chronic state after traumatic brain injury, sleep need per 24 hours was persistently increased in trauma patients (8.1 ± 0.5 hours) as compared to healthy controls (7.1 ± 0.7 hours). The prevalence of chronic objective excessive daytime sleepiness was 67% in patients with brain trauma compared to 19% in controls. Patients significantly underestimated excessive daytime sleepiness and sleep need, emphasizing the unreliability of self-assessments on SWD in trauma patients.

Conclusions: This study provides prospective, controlled, and objective evidence for chronic persistence of posttraumatic SWD, which remain underestimated by patients. These results have clinical and medicolegal implications given that SWD can exacerbate other outcomes of traumatic brain injury, impair quality of life, and are associated with public safety hazards.

 

Number of Medical Complaints Before Concussion May Help Predict Recovery Time

 

“Good information for you to have when dealing with someone who hit their head and has lots of varied complaints afterwards. Being sensitive to the sensations of your body is unhealthy and associated with my conditions. Recent research using electric shocks to produce pain show changes in nerve behavior. Other evidence implication hyper-somatization with fibromyalgia.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Number of Medical Complaints Before Concussion May Help Predict Recovery Time

Released: 20-Apr-2016 7:05 PM EDT
Source Newsroom: American Academy of Neurology (AAN)

Newswise — MINNEAPOLIS – Athletes who have medical complaints, like aches and pains, that have no known physical cause may take longer to recover after a concussion, according to a study published in the April 20, 2016, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Called psychosomatic symptoms, such complaints are often described as psychological distress expressed as physical illness.

“The goal of this study was to determine how physical complaints before and after concussion play a role in recovery,” said study author Lindsay D. Nelson, PhD, assistant professor of Neurosurgery and Neurology at the Medical College of Wisconsin in Milwaukee. “We found the greatest predictor of recovery after a concussion was the severity of early post-concussion symptoms. But somatic complaints before injury also play an important role, either by possibly enhancing how a person experiences the injury or affecting their reporting of post-concussive symptoms.”

For the study, 2,055 high school and college athletes were evaluated before the start of the season for balance, thinking and memory skills and psychological problems such as depression, anxiety and psychosomatic problems such as feeling faint or dizzy, nausea or upset stomach or pains in chest or heart. For the psychosomatic problems, the athletes rated how often they had been bothered by these symptoms during the last week. About 50 percent of the participants had at least one of 6 symptoms, and the other 50 percent had no symptoms.

During the season, 127 athletes suffered a concussion. Those athletes were then reassessed within the first 24 hours of injury and then again at 8, 15 and 45 days after the injury.

Of the concussed athletes, 61 percent played football, 24 percent played soccer, 6 percent played lacrosse, 3 percent were wrestlers, 3 percent played hockey, 2 percent played rugby and 1 percent played field hockey. Of the group, 80 percent was male.

On average, concussion symptoms lasted five days, with 64 percent of concussed athletes saying their symptoms were gone after one week and the vast majority, 95 percent, saying they no longer had symptoms after one month.

After concussion, those athletes who had reported pre-injury psychosomatic symptoms had longer recovery times, recovering at a slower rate than those who had no psychosomatic symptoms. For people with symptoms, about 80 percent had recovered within about 20 days of the concussion. For those with no symptoms, about 80 percent had recovered within about 10 days.

Those who had more severe physical symptoms after their concussions, like headache and balance issues, recovered at a slower rate than those with less severe symptoms.

“That these athletes were relatively healthy physically and psychologically highlights the relevance of psychosomatic symptoms and the role they play in recovery even in healthy people,” said Nelson. “Our hope is our study will lead to further research, because identifying those at risk for prolonged recovery is critical to developing early interventions that improve outcomes for people who suffer concussions.”

The study was funded by the U.S. Army Medical Research and Materiel Command, the Clinical and Translational Science Institute, and the National Institutes of Health National Center for Advancing Translational Sciences.

Learn more about concussion at www.aan.com/concussion, where you can access the AAN’s Sports Concussion Guideline, QuickCheck app, and other resources.
The American Academy of Neurology, an association of 30,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

Psychother Psychosom Med Psychol. 2011 Feb;61(2):82-6. doi: 10.1055/s-0030-1270518. Epub 2011 Feb 18.

[Article in German]

Franke GH1, Ankerhold A, Haase M, Jäger S, Tögel C, Ulrich C, Frommer J.

Abstract

The BSI-18, an abridged version of the Brief Symptom Inventory of Derogatis, contains the 3 six items scales Somatization, Depression, Anxiety, and the Global Score (GSI). In a sample of N=638 psychotherapeutic patients, reliability and validity were proven. Reliability of the 3 scales was good: Somatization α=0.79, Depression α=0.84, Anxiety α=0.84, and GSI α=0.91. The postulated three-factor structure was proven sufficiently using confirmatory and explorative factor analyses. The questionnaire separated different patients groups. Judgments of the therapists corresponded well with the self-rating behavior of the patients. In conclusion, the psychometric evaluation of the BSI-18 resulted in persuasive evidence for its reliability and validity. The loss of information, as a result of item reduction, is acceptable analyzing large samples; in cases of individual analyses, the SCL-90-R is advised.

 

Exercise linked to reduced risk of several cancers

“I love any article that says I can do something to decrease the risk of cancer. The researchers pooled data from 12 prospective US and European cohorts (baseline 1987-2004). They used self-reported exercise level in Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults.” Bill Chesnut, MD

(Return to New Health News, http://billchesnutmd.com/new-health-news/)
Exercise linked to reduced risk of several cancers

ABC World News Tonight (5/16, story 11, 0:25, Muir) reported, “The National Cancer Institute confirms that moderate exercise, all the way up to intense exercise, lowers the risk of” cancer “in many forms.”

The Los Angeles Times (5/16, Healy) reports that the research, published in JAMA Internal Medicine, suggests “exercise is a powerful cancer-preventive.” Investigators found that “physical activity worked to drive down rates of a broad array of cancers even among smokers, former smokers, and the overweight and obese.”

US News & World Report (5/16, Esposito) reports that investigators “analyzed data from participants in 12 US and European study groups who self-reported their physical activity between 1987 and 2004.” The researchers “looked at the incidence of 26 kinds of cancer occurring in the study follow-up period, which lasted 11 years on average.” The data indicated that “overall, a higher level of activity was tied to a 7 percent lower risk of developing any type of cancer.”

TIME (5/16, Park) reports that “the reduced risk was especially striking for 13 types of cancers.” Individuals “who were more active had on average a 20% lower risk of cancers of the esophagus, lung, kidney, stomach, endometrium and others compared with people who were less active.” Meanwhile, “the reduction was slightly lower for colon, bladder, and breast cancers.”

AMA News 5.17.16

Acupuncture may help with chronic pain and high blood pressure.

“Acupuncture in my practice experience continues to improve with some results that are astonishing. I have patients who find acupuncture relieves their sinus obstructions during their allergy seasons when nothing else works.” Bill Chesnut, MD

 

May 9, 2016 Cleveland Clinic Wellness Newsletter
Get stuck, in a good way! Acupuncture may help with chronic pain and high blood pressure.
Sometimes needles are used to deliver treatment, and other times they are the treatment. Acupuncture, the use of very thin needles to stimulate points on the body, has been practiced for more than 3,500 years as part of Chinese medicine. “It draws on the belief that energy, or qi (pronounced “chee”), circulates throughout our body, from the tops of our heads to the soles of our feet,” notes Cleveland Clinic Medical Director Daniel Neides, M.D. In an exciting new study, nine weekly acupuncture sessions were shown to ease symptoms and improve quality of life in people with fibromyalgia, a hard-to-treat condition characterized by chronic pain. The best part: the positive effects persisted a year later! The study was unusual in that subjects received individualized acupuncture treatments (the way it’s often practiced in the real world) rather than a uniform, one-size-fits-all treatment. Acupuncture has been shown to help a number of chronic pain conditions, from headaches to back pain to arthritis, and a preliminary study suggests it may be helpful for mild to moderate high blood pressure, perhaps in part by lowering levels of norepinephrine, a stress hormone. If you’re dealing with these or other chronic conditions, ask your physician about trying acupuncture as a complementary treatment. As research continues, the day may come when you hear, “Take two needles and call me in the morning!”

 

Administration working to reshape healthcare with 34 new regulations before next January

“This type of change in American healthcare delivery allows unintended consequences. I find it interesting to look up the professional biography of the physicians involved in making these changes. My experience is the vast majority of these doctors do not have qualifying experience delivering care to understand the complexity of this issue. Put me to the test and look up the practice experience of the top expert in this matter, Dr. Patrick Conway, chief medical officer at the Centers for Medicare and Medicaid Services, who oversees CMMI.” Bill Chesnut, MD

(Return to New Health News, http://billchesnutmd.com/new-health-news/)

Obama Administration working to reshape healthcare before next January.                                                       AMA News May 10, 2016.

STAT (5/10, Scott) reports that as January 20, 2017 approaches, “the Obama administration is racing to burnish its health care legacy, introducing major new initiatives that will take full effect just weeks before the president leaves office.” The article says the number of uninsured has dropped significantly because of the Affordable Care Act, yet, Administration officials are moving “to use other parts of the law to reshape how health care itself is delivered across the United States.” According to the Administration, “34 initiatives have been announced or are currently being tested at” the Center for Medicare and Medicaid Innovation.
WASHINGTON — As the clock ticks toward Jan. 20, 2017, the Obama administration is racing to burnish its health care legacy, introducing major new initiatives that will take full effect just weeks before the president leaves office.

The ranks of the uninsured have dropped dramatically since the passage of the Affordable Care Act six years ago. But administration officials are now hustling to use other parts of the law to reshape how health care itself is delivered across the United States.

They’re trying to tackle the biggest health care issue of the day — drug prices— and setting ambitious goals for revamping how primary care is provided. They have also undertaken significant new efforts when it comes to paying for surgeries and preventing disease.

What will happen over the next eight months is as much as these projects can be accelerated, they will be,” said Kathleen Sebelius, the former US Health and Human Services secretary. “The time clock is very much in everybody’s mind.”

Every administration tries to get as much done as it can before time runs out, but this White House has a tool that none of its predecessors did: an agency created by the Affordable Care Act and given $10 billion over 10 years to test new models for paying for and delivering health care.

The administration seems intent on stretching the authority given to this new agency, called the Center for Medicare and Medicaid Innovation, as far as it can in its final days. The agency, for instance, recently proposed a new plan for overhauling Medicare Part B drug payments — and it’s mandatory for many providers.

“They are definitely taking a broad interpretation of the authority and using it as a vehicle,” said Caroline Pearson, senior vice president at Avalere Health, an independent consulting firm. “They’re trying to push through as much regulatory reform as they can.”

The administration said that 34 initiatives have been announced or are currently being tested at CMMI.

Broadly speaking, the agency has stuck to widely supported ideas for improving health care. That means paying doctors as a group to treat a patient instead of for each individual service, which should foster cooperation. And it means encouraging preventive care to forestall more costly problems down the road.

“We believe delivery system reform, and the work of the innovation center, is truly bipartisan,” said Dr. Patrick Conway, chief medical officer at the Centers for Medicare and Medicaid Services, who oversees CMMI. “We think it will continue beyond this administration.”

But some of its work is highly controversial — and will still be in its infancy when the next administration takes over, putting it at risk of being undone.

The second part of the Medicare drug overhaul, which aims to encourage doctors to prescribe less expensive drugs without sacrificing the quality of care, is currently expected to take effect after Jan. 1, 2017.

The pharmaceutical industry is lobbying hard against it, and some physician and patient groups have also said they are deeply concerned. Republicans in Congress have already urged the White House to withdraw the proposal altogether. The opponents describe the plan as an overreach of what CMMI was intended to do and warn it could compromise the care that cancer patients receive.

“The part that maybe was unforeseen was the size of the demo, the fact that it was mandatory, the length of time that it was in existence, and the lack of detail about pretty significant changes” to drug payments from the insurance program, Lori Reilly, executive vice president of policy and research at PhRMA, told reporters at a recent briefing.

There is some disagreement about what would need to be done to undo what the Obama White House is trying to accomplish — Could a President Trump just sign a piece of paper? Or would he need to go through the regulatory process? What about any contracts that have been signed? — but everybody acknowledges that a GOP president and a Republican Congress could find a way to stop the plans that this administration has put into motion.

“If the Republicans win and get their acts together, I think Phase 2 never gets implemented,” Pearson said. “It probably doesn’t go anywhere.”

 

Blood test helps measure women’s ovarian reserve

“News I did not know. Using AMH blood levels to monitor ovary productivity makes sense considering the risk/benefit ratio. For career minded or later married couples having this information will be helpful. Here is more information from a non-profit website. https://labtestsonline.org/understanding/analytes/anti-mullerian-hormone/tab/test/ “ Bill Chesnut, MD.

To go back to New Health News: http://billchesnutmd.com/new-health-news

Blood test helps measure women’s ovarian reserve _AMA Wire newsletter March 31, 2016.

NBC Nightly News (3/30, story 10, 2:00, Holt) reported, “It’s a question that can keep many women up at night, whether there’s still enough time to have a baby, but now more women are using an easy test that can take all the guesswork out of how much time is left on their biological clocks.” NBC News correspondent Janet Shamlian explained that “a simple blood test” with the nickname of “the baby deadline test is like a checkup for the ovaries.” The test “used to be for women already struggling to get pregnant,” but is “now being used to predict infertility problems.”

The NBC News (3/31, Dunn, Deo) website reports that the official name of the test is “the Anti-Müllerian hormone (AMH) test.” Some physicians “are now offering it as an option to healthy women to assess what they call their ovarian reserve.” The test, which “usually costs less than $100,” is a measure of AMH “circulating in a woman’s bloodstream” and “predicts the amount of possible eggs a woman has.”

 

Hormone replacement therapy, HRT, in early menopause may slow progression of cardiovascular disease.

“Hormone Replacement therapy in early menopause is important to decrease the bone loss following menopause. I have posted several articles on this website related to osteoporosis. Post-menopausal women not taking hormone replacement lose 60% of their total bone mass between menopause and 60 years of age.

Now another benefit is reported. The study below shows slowing of atherosclerosis by taking hormone replacement.

It is important to know what replacement is most safe. Also know the safety advantages of vaginal or topical HRT versus oral hormone placement. The metabolism is different when taking a medical orally than transcutaneous. Vaginal HRT with estriol elevates estriol a little and transiently if it elevates blood levels at all.

Testosterone is another hormone loss in menopause. Its involvement in bone loss and atherosclerosis has not been as extensively tested. The research available that I found does not report a significant risk of  testosterone replacement to keep the normal pre-menopausal blood level.

This finding is so important in my view that I posted the abstract of the original article just below the announcement in the popular press.

If you know women in the age group to be peri-menopausal please tell them the news.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Starting HRT in early menopause may slow progression of cardiovascular disease, study indicates

The Wall Street Journal (3/30, Beck, Subscription Publication) reports the findings of a 643-patient study published in the New England Journal of Medicine study add to the evidence that beginning hormone replacement therapy (HRT) in early menopause may be protective against cardiovascular disease.

The NPR (3/30, Bichell) “Shots” blog reports that in the study, investigators “directly tested the effect of starting hormone therapy within the first six years after menopause, versus the effect of starting 10 years or more after menopause.” After five years, researchers found that “women who started hormones within six years of menopause had artery walls that thickened a little more slowly than the women on the placebo, whereas the extra estrogen did not seem to slow thickening in the group that started the hormone therapy later.”

 

ORIGINAL ARTICLE

Vascular Effects of Early versus Late Postmenopausal Treatment with Estradiol

Howard N. Hodis, M.D., Wendy J. Mack, Ph.D., Victor W. Henderson, M.D., Donna Shoupe, M.D., Matthew J. Budoff, M.D., Juliana Hwang-Levine, Pharm.D., Yanjie Li, M.D., Mei Feng, M.D., Laurie Dustin, M.S., Naoko Kono, M.P.H., Frank Z. Stanczyk, Ph.D., Robert H. Selzer, M.S., and Stanley P. Azen, Ph.D., for the ELITE Research Group*

N Engl J Med 2016; 374:1221-1231March 31, 2016DOI: 10.1056/NEJMoa1505241

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BACKGROUND

Data suggest that estrogen-containing hormone therapy is associated with beneficial effects with regard to cardiovascular disease when the therapy is initiated temporally close to menopause but not when it is initiated later. However, the hypothesis that the cardiovascular effects of postmenopausal hormone therapy vary with the timing of therapy initiation (the hormone-timing hypothesis) has not been tested.

METHODS

A total of 643 healthy postmenopausal women were stratified according to time since menopause (<6 years [early postmenopause] or ≥10 years [late postmenopause]) and were randomly assigned to receive either oral 17β-estradiol (1 mg per day, plus progesterone [45 mg] vaginal gel administered sequentially [i.e., once daily for 10 days of each 30-day cycle] for women with a uterus) or placebo (plus sequential placebo vaginal gel for women with a uterus). The primary outcome was the rate of change in carotid-artery intima–media thickness (CIMT), which was measured every 6 months. Secondary outcomes included an assessment of coronary atherosclerosis by cardiac computed tomography (CT), which was performed when participants completed the randomly assigned regimen.

RESULTS

After a median of 5 years, the effect of estradiol, with or without progesterone, on CIMT progression differed between the early and late postmenopause strata (P=0.007 for the interaction). Among women who were less than 6 years past menopause at the time of randomization, the mean CIMT increased by 0.0078 mm per year in the placebo group versus 0.0044 mm per year in the estradiol group (P=0.008). Among women who were 10 or more years past menopause at the time of randomization, the rates of CIMT progression in the placebo and estradiol groups were similar (0.0088 and 0.0100 mm per year, respectively; P=0.29). CT measures of coronary-artery calcium, total stenosis, and plaque did not differ significantly between the placebo group and the estradiol group in either postmenopause stratum.

CONCLUSIONS

Oral estradiol therapy was associated with less progression of subclinical atherosclerosis (measured as CIMT) than was placebo when therapy was initiated within 6 years after menopause but not when it was initiated 10 or more years after menopause. Estradiol had no significant effect on cardiac CT measures of atherosclerosis in either postmenopause stratum. (Funded by the National Institute on Aging, National Institutes of Health; ELITE ClinicalTrials.gov number, NCT00114517.)

 

 

Specific genes associated with marijuana addiction

“A genetic factor in cannabis dependence severity is important for the public to know. Look into the paragraph of Design, Setting, and Participants to appreciate the quality of this research. A 90% association of this genetic factor with another psychiatric condition or addiction is stunning.

The first paragraph is an announcement in the popular media. I looked up the original article and publish that article’s abstract below the horizontal line.”  Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Researchers identify specific genes associated with marijuana addiction

TIME (3/30, Szalavitz) reports that “specific genes associated with marijuana addiction have been identified – and some of them are also linked to increased risk for depression and schizophrenia.” Researchers arrived at this conclusion after studying “the genes of nearly 15,000 people from three different groups.” The study’s findings may “help explain why 90% of people with marijuana addictions also suffer from another psychiatric condition or addiction.” The study was published online in JAMA Psychiatry.

 

Below is the abstract of that original research publication March 30, 2016.

Online First >

Original Investigation | March 30, 2016

Genome-wide Association Study of Cannabis Dependence Severity, Novel Risk Variants, and Shared Genetic Risks ONLINE FIRST

Richard Sherva, PhD1; Qian Wang, MS2; Henry Kranzler, MD3,4; Hongyu Zhao, PhD2,5,6,7; Ryan Koesterer, MS1; Aryeh Herman, PsyD8; Lindsay A. Farrer, PhD1,9,10,11,12; Joel Gelernter, MD7,8,13,14

JAMA Psychiatry. Published online March 30, 2016. doi:10.1001/jamapsychiatry.2016.0036

ABSTRACT

ABSTRACT | INTRODUCTION | METHODS | RESULTS | DISCUSSION | CONCLUSIONS |ARTICLE INFORMATION | REFERENCES

Importance  Cannabis dependence (CAD) is a serious problem worldwide and is of growing importance in the United States because cannabis is increasingly available legally. Although genetic factors contribute substantially to CAD risk, at present no well-established specific genetic risk factors for CAD have been elucidated.

Objective  To report findings for DSM-IV CAD criteria from association analyses performed in large cohorts of African American and European American participants from 3 studies of substance use disorder genetics.

Design, Setting, and Participants  This genome-wide association study for DSM-IV CAD criterion count was performed in 3 independent substance dependence cohorts (the Yale-Penn Study, Study of Addiction: Genetics and Environment [SAGE], and International Consortium on the Genetics of Heroin Dependence [ICGHD]). A referral sample and volunteers recruited in the community and from substance abuse treatment centers included 6000 African American and 8754 European American participants, including some from small families. Participants from the Yale-Penn Study were recruited from 2000 to 2013. Data were collected for the SAGE trial from 1990 to 2007 and for the ICGHD from 2004 to 2009. Data were analyzed from January 2, 2013, to November 9, 2015.

Main Outcomes and Measures  Criterion count for DSM-IV CAD.

Results  Among the 14 754 participants, 7879 were male, 6875 were female, and the mean (SD) age was 39.2 (10.2) years. Three independent regions with genome-wide significant single-nucleotide polymorphism associations were identified, considering the largest possible sample. These included rs143244591 (β = 0.54,P = 4.32 × 10−10 for the meta-analysis) in novel antisense transcript RP11-206M11.7;rs146091982 (β = 0.54,P = 1.33 × 10−9 for the meta-analysis) in the solute carrier family 35 member G1 gene (SLC35G1); andrs77378271 (β = 0.29, P = 2.13 × 10−8 for the meta-analysis) in the CUB and Sushi multiple domains 1 gene (CSMD1). Also noted was evidence of genome-level pleiotropy between CAD and major depressive disorder and for an association with single-nucleotide polymorphisms in genes associated with schizophrenia risk. Several of the genes identified have functions related to neuronal calcium homeostasis or central nervous system development.

Conclusions and Relevance  These results are the first, to our knowledge, to identify specific CAD risk alleles and potential genetic factors contributing to the comorbidity of CAD with major depression and schizophrenia.

 

Heavy marijuana use in late adolescence may put men at higher risk for death

“More long term effects of regular marijuana use continue to arrive. The plant bud is an anxiolytic drug. There are better and safer drugs for anxiety, including a daily workout.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Heavy marijuana use in late adolescence may put men at higher risk for death by age 60, study finds

The CBS News (4/22, Marcus) website reported, “Heavy marijuana use in the late teen years puts men at a higher risk for death by age 60,” the findings of a study published online in the American Journal of Psychiatry suggest.

HealthDay (4/22, Preidt) reported that men “who were heavy marijuana users in their late teens were 40 percent more likely to die by age 60 than those who never used the drug, the investigators found.”

AMA News _ April 25, 2016.

Number of Medical Complaints Before Concussion May Help Predict Recovery Time

 

“Good information for you to have when dealing with someone who hit their head and has lots of varied complaints afterwards. Being sensitive to the sensations of your body is unhealthy and associated with my conditions. Recent research using electric shocks to produce pain show changes in nerve behavior. Other evidence implication hyper-somatization with fibromyalgia.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Number of Medical Complaints Before Concussion May Help Predict Recovery Time       Released: 20-Apr-2016 7:05 PM EDT
American Academy of Neurology (AAN)

 

Number of Medical Complaints Before Concussion May Help Predict Recovery Time               Newswise — MINNEAPOLIS – Athletes who have medical complaints, like aches and pains, that have no known physical cause may take longer to recover after a concussion, according to a study published in the April 20, 2016, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Called psychosomatic symptoms, such complaints are often described as psychological distress expressed as physical illness.

“The goal of this study was to determine how physical complaints before and after concussion play a role in recovery,” said study author Lindsay D. Nelson, PhD, assistant professor of Neurosurgery and Neurology at the Medical College of Wisconsin in Milwaukee. “We found the greatest predictor of recovery after a concussion was the severity of early post-concussion symptoms. But somatic complaints before injury also play an important role, either by possibly enhancing how a person experiences the injury or affecting their reporting of post-concussive symptoms.”

For the study, 2,055 high school and college athletes were evaluated before the start of the season for balance, thinking and memory skills and psychological problems such as depression, anxiety and psychosomatic problems such as feeling faint or dizzy, nausea or upset stomach or pains in chest or heart. For the psychosomatic problems, the athletes rated how often they had been bothered by these symptoms during the last week. About 50 percent of the participants had at least one of 6 symptoms, and the other 50 percent had no symptoms.

During the season, 127 athletes suffered a concussion. Those athletes were then reassessed within the first 24 hours of injury and then again at 8, 15 and 45 days after the injury.

Of the concussed athletes, 61 percent played football, 24 percent played soccer, 6 percent played lacrosse, 3 percent were wrestlers, 3 percent played hockey, 2 percent played rugby and 1 percent played field hockey. Of the group, 80 percent was male.

On average, concussion symptoms lasted five days, with 64 percent of concussed athletes saying their symptoms were gone after one week and the vast majority, 95 percent, saying they no longer had symptoms after one month.

After concussion, those athletes who had reported pre-injury psychosomatic symptoms had longer recovery times, recovering at a slower rate than those who had no psychosomatic symptoms. For people with symptoms, about 80 percent had recovered within about 20 days of the concussion. For those with no symptoms, about 80 percent had recovered within about 10 days.

Those who had more severe physical symptoms after their concussions, like headache and balance issues, recovered at a slower rate than those with less severe symptoms.

“That these athletes were relatively healthy physically and psychologically highlights the relevance of psychosomatic symptoms and the role they play in recovery even in healthy people,” said Nelson. “Our hope is our study will lead to further research, because identifying those at risk for prolonged recovery is critical to developing early interventions that improve outcomes for people who suffer concussions.”

The study was funded by the U.S. Army Medical Research and Materiel Command, the Clinical and Translational Science Institute, and the National Institutes of Health National Center for Advancing Translational Sciences.

Learn more about concussion at www.aan.com/concussion, where you can access the AAN’s Sports Concussion Guideline, QuickCheck app, and other resources.
The American Academy of Neurology, an association of 30,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

 

 

 

Psychother Psychosom Med Psychol. 2011 Feb;61(2):82-6. doi: 10.1055/s-0030-1270518. Epub 2011 Feb 18.

[The usefulness of the Brief Symptom Inventory 18 (BSI-18) in psychotherapeutic patients].

[Article in German]

Franke GH1, Ankerhold A, Haase M, Jäger S, Tögel C, Ulrich C, Frommer J.

Author information

Abstract

The BSI-18, an abridged version of the Brief Symptom Inventory of Derogatis, contains the 3 six items scales Somatization, Depression, Anxiety, and the Global Score (GSI). In a sample of N=638 psychotherapeutic patients, reliability and validity were proven. Reliability of the 3 scales was good: Somatization α=0.79, Depression α=0.84, Anxiety α=0.84, and GSI α=0.91. The postulated three-factor structure was proven sufficiently using confirmatory and explorative factor analyses. The questionnaire separated different patients groups. Judgments of the therapists corresponded well with the self-rating behavior of the patients. In conclusion, the psychometric evaluation of the BSI-18 resulted in persuasive evidence for its reliability and validity. The loss of information, as a result of item reduction, is acceptable analyzing large samples; in cases of individual analyses, the SCL-90-R is advised.

 

People who consume full-fat dairy may weigh less

“This finding supports recent thinking that cultured daily products, cottage cheese, yogurt, etc., are better for health using regular milk, no low or no fat milk. They are a stable in my daily food.” Bill Chesnut, MD.

To go back to New Health News: http://billchesnutmd.com/new-health-news

People who consume full-fat dairy may weigh less, may be less likely to develop diabetes than those who eat low-fat dairy products

The Atlanta Journal-Constitution (4/6, Foreman) reports that “people who consume full-fat dairy weigh less and are less likely to develop diabetes than those who eat low-fat dairy products,” the findings of a 3,333-adult, 15-year study published in the journal Circulation suggest. The study revealed that “people with higher levels of three different byproducts of full-fat dairy had, on average, a 46 percent lower risk of getting diabetes than those with lower levels.”

The CBS News (4/6, Marcus) website points out that another study involving “more than 18,000 middle-age women who were part of the Women’s Health Study – and [of] normal weight, free of cardiovascular disease, cancer, and diabetes at the start of the research – found that those who ate more high-fat dairy had an 8 percent lower chance of going on to become obese over time compared to those who ate less.” No such link was seen “with low-fat dairy product intake,” however.

 

Using earplugs when listening to live music

“Have you noticed the volume of soundtracks in movie theaters? The noise of most projected movies now causes me to wear earplugs throughout. With plugs in, I still hear the audio plainly.  The movie is just as good and more comfortable if I wait for it to be online and listen to it at home. “  Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Study recommends using earplugs when listening to live music _AMA Morning Rounds April 8, 2016.

On its website, CBS News (4/7, Welch) reports a new study (4/8) published Thursday in JAMA Otolaryngology-Head & Neck Surgery recommends wearing earplugs when listening to live music. According to the National Health and Nutrition Examination Survey, the prevalence of hearing loss in US adolescents jumped 31 percent between 1998 and 2006. A major contributor to this trend “is the increase in exposure to recreational noise, including loud music at venues like concerts, music festivals, and night clubs.”

On its website, CNN (4/7, Manella) adds that researchers assigned 25 attendees of an Amsterdam outdoor music festival to wear silicone earplugs and 26 to not wear them. The time-averaged sound pressure level during the festival was 100 decibels. They took a baseline hearing test before the concert and immediately afterwards to determine if there was a loss in hearing. Researchers then found “that the group wearing earplugs had a temporary shift in hearing of 8%, while the group without earplugs had” a temporary shift of 42 percent. They also found that “people who wore earplugs had a lower percentage of tinnitus following sound exposure, 12% compared with 40% in the unprotected group.”

 

Study explores impact of vegetable oil on heart health

“This study is full of surprises. There is much to learn by reviewing the data of previous research published to find new interpretations of the same data. The new interpretations may relate to new science since the original recommendations were made.” Bill Chesnut. MD.

To go back to New Health News: http://billchesnutmd.com/new-health-news

Study explores impact of vegetable oil on heart health _ AMA Morning Rounds April 13, 2016.

TIME (4/12, Park) reports that in a study published in the British Medical Journal, investigators who “re-analyzed data from older unpublished studies” found “that it’s possible that too much vegetable oil could actually increase the risk of heart disease – rather than decrease it.” Researchers “delved into the data from the Minnesota Coronary Experiment, conducted from 1968 to 1973.” The investigators “learned that only part of the trial’s results were published, and other data, suggesting the contrary idea that switching animal fats for vegetable fats didn’t protect the heart, was left out.”

On its website, NBC News (4/12, Fernstrom) reports that the researchers “found no association between lower cholesterol levels and longer life, suggesting that reducing the amount of saturated fat in the diet isn’t enough to reduce risk of death from heart disease.”

CBS News (4/12, Marcus) reports on its website that “curiously, participants who experienced a greater reduction in blood cholesterol actually had a higher risk of death.”

 

Proton Pump Inhibitors (Prilosec, Nexium, et. al.) may be linked to an increased risk of kidney disease

“If you take omeprazole Prilosec or The Purple Pill that is heavily advertised, consider switching to a non-PPI drug. Called H-2-receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac).” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

PPIs may be linked to an increased risk of CKD, study reveals  AMA Morning Rounds, April 15, 2016.

ABC World News Tonight (4/14, story 10, 0:25, Muir) reported that a study has linked “proton pump inhibitors including Nexium [esomeprazole magnesium] and Prilosec [omeprazole] to an increased risk of chronic kidney disease [CKD].”

According to CNN (4/14, Christensen), some “173,321 people who used PPIs and 20,270” who “took a PPI alternative known as histamine H2 receptor blockers” were included in the five-year study.

The CBS News (4/14, Welch) website reports that “over five years of follow-up…15 percent of people using PPIs were diagnosed with chronic kidney disease, versus 11 percent of those on H2-blockers,” which “translated to a 28 percent increased risk of developing kidney disease for PPI users.” While just “a few patients in the study – less than 0.2 percent – developed end-stage kidney failure. The risk was 96 percent higher for those on PPIs.” The study was published online in the Journal of the American Society of Nephrology.

 

Transplants of insulin-producing pancreas cells may help the most seriously ill patients with diabetes

“This research has been maturing as our tools improve. The first published report of the procedure in the Islet Cell Transplant database is 1999 according to the National Library of Medicine. I expect there will be more improvements.” Bill Chesnut, MD.

To go back to New Health News: http://billchesnutmd.com/new-health-news

Transplants of insulin-producing pancreas cells may help the most seriously ill patients with diabetes.  Ama Wire, April 19, 2016.

The AP (4/19, Neergaard) reports that “transplants of insulin-producing pancreas cells” may help “protect the most seriously ill patients” with diabetes “from a life-threatening complication of the disease,” severe hypoglycemia, the findings of a study published online April 18 in Diabetes Care suggest. For the study, “the National Institutes of Health targeted…highest-risk patients, funding a study that gave 48 people at eight medical centers at least one islet cell transplant.” Just one year after transplant, “88 percent were free of severe hypoglycemia events, had their awareness of blood sugar dips restored, and harbored glucose levels in near-normal ranges,” and “two years later, 71 percent of participants still were faring that well,” the study found. The study team now “plans to seek a Food and Drug Administration license for” cell-based diabetes therapy.

 

 

Anticholinergic medications may be linked to increased dementia risk

“Avoiding anticholinergic medications over the counter is a smart choice with this information. The list of common anticholinergic drugs is listed here in Wikipedia. https://en.wikipedia.org/wiki/Anticholinergic . It surprised me.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Anticholinergic medications may be linked to increased dementia risk

ABC World News Tonight (4/18, story 10, 0:20, Muir) reported that “certain medications may increase the risk of dementia,” a new study warns. Medicines, “including tablets for cold and flu, allergies and heartburn,” appear to be linked to “memory problems.”

According to CNN (4/18, Tinker), the study “offers the most definite proof yet of what scientists have known for at least a decade: that anticholinergic” medications are associated with “cognitive impairment and an increased risk of dementia.” Such medicines “are sold over the counter and by prescription as sleep aids and for chronic diseases including hypertension, cardiovascular disease and chronic obstructive pulmonary disease.”

TIME (4/18, Oaklander) points out that researchers “analyzed already existing data from 451 people around ages 70-75 who had normal brains,” then “examined the results of memory tests, MRI brain scans and other neuroimaging data – all while paying particular attention to people who said they took anticholinergic” medications. Seniors “who regularly took at least one anticholinergic drug showed poorer cognition, lower brain volumes and less glucose metabolism in the whole brain and the temporal lobe” than seniors who did not. The study was published online in JAMA Neurology.

 

Anti-smoking medications may not increase risk of mental health disorders

“This finding of no connection between Wellbutrin and its cousin Chantix and new mental health issues makes sense. Wellbutrin has been used a long time with fewer side effects than originally expected. It is available as a generic a lower costs. If you know a smoker, pass the good word along.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Anti-smoking medications may not increase risk of mental health disorders

The AP (4/23, Johnson) reported, “Seven years after US regulators slapped their strictest warning on two popular smoking-cessation medicines citing risks of suicidal behavior, a large international study found no such risk.”

According to HealthDay (4/23, Preidt), a new, FDA-requested, 8,000-participant study published online April 22 in The Lancet suggests anti-smoking medications Chantix (varenicline) and Wellbutrin (bupropion) “don’t appear to raise the risk of serious mental health disorders such as depression, anxiety and suicidal thoughts.” An accompanying editorial observed the study shows “neuropsychiatric adverse events occurring during smoking cessation are independent of the medication used.”

AMA news _4.25.16

 

Taking low-dose aspirin while undergoing cancer treatment may increase survival

“This is a clever research protocol. My hat is off to the originator for considering the bacteria we live with may be related to some of our maladies.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Taking low-dose aspirin while undergoing cancer treatment may increase likelihood of survival, study suggests

Newsweek (4/20, Firger) reports that research suggests “taking low-dose aspirin while undergoing cancer treatment may increase a patient’s chance of survival by as much as 20 percent.” The findings (4/21) were published in PLOS ONE. Researchers looked at data from “five randomized trials and 42 observational studies on patients with breast, prostate and colorectal cancers.” The investigators “found there was a significant reduction in mortality in patients who took daily low-dose aspirin.”

Medical Daily (4/20, Baulkman) reports that aspirin also “helped stop the cancer from spreading.” These “findings echo findings from previous studies.”

 

AMA wire newsletter, April 21, 2016.