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Opioids Won’t Help Arthritis Patients Long-Term: Study

SATURDAY, Nov. 9, 2019 — Opioid painkillers may temporarily ease the discomfort of arthritis, but they have no clear lasting benefit, a research review finds.

In an analysis of 23 clinical trials, researchers found that, on average, opioid medications were somewhat effective at easing pain in patients with osteoarthritis. That’s the common form of arthritis in which cartilage cushioning the joints gradually wears down, leading to swelling, stiffness and pain.

But the trials found no evidence that opioids improved patients’ quality of life or helped with their depression. And any benefits for pain seemed to wane with time.

“We found that the magnitude of these effects is small and continues to decrease over time,” said lead researcher Dr. Raveendhara Bannuru. He is director of the Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center, in Boston.

Treatment guidelines for chronic pain, other than cancer-related pain, already say opioids should be a last resort.

With osteoarthritis, Bannuru said, the drugs are only recommended if a patient has not gotten relief from other medical therapies, and if surgery — like knee or hip replacement — is not an option.

Instead, patients should try to exercise regularly and maintain a healthy lifestyle. As for medications, Bannuru said, topical versions of nonsteroidal anti-inflammatory drugs (NSAIDs) — like ibuprofen and naproxen — are a “first choice.”

These creams or ointments help people avoid the side effects that can come with prolonged used of oral NSAIDs (such as Motrin, Advil, Aleve), Bannuru noted. Injections of hyaluronic acid, a substance in joint fluids, are another option, he said.

In addition, aerobic activity, like walking, and exercises that strengthen the muscles around the arthritic joint can be helpful, according to Dr. Steven Eyanson, a rheumatologist who was not involved in the study.

And if a patient is overweight, shedding some pounds can help ease pain and improve joint function, said Eyanson, a retired adjunct assistant professor at the University of Iowa in Iowa City.

“In the case of osteoarthritis, the benefits of therapy by opioid pain relief are very limited,” Eyanson said.

Bannuru was scheduled to present the findings Saturday at the American College of Rheumatology’s annual meeting, in Atlanta. Research presented meetings is generally considered preliminary until it is published in a peer-reviewed journal.

For the study, the researchers pooled the results of 23 previously published clinical trials that involved more than 11,400 osteoarthritis patients.

Overall, the investigators found, opioid treatment had a modest effect on people’s pain over two to 12 weeks. At higher doses, the drugs were actually less effective, and carried a higher risk of side effects, such as nausea, constipation and diarrhea.

“In light of dependency concerns and the discomfort that many patients feel while taking the drugs, it would appear that there is no optimal therapeutic window for the use of oral opioids in osteoarthritis,” Bannuru said.

The results come during a national crisis of opioid addiction that, according to government figures, is killing 130 Americans each day.

After years of skyrocketing, prescriptions for opioids — like OxyContin, Vicodin and Percocet — have been declining since 2012, according to the U.S. Centers for Disease Control and Prevention. In recent years, illegal opioids — like heroin and illicitly manufactured fentanyl — have become the biggest concern.

Still, prescription opioids were involved in 36% of opioid overdose deaths in 2017, the CDC says.

“We hope the results of our study will empower osteoarthritis patients to have informed discussions with their health care providers about the safest and most effective treatment options for their pain,” Bannuru said.

Eyanson said that, to him, “the take-home messages are that opioids have limited benefit in osteoarthritis pain control, and have significant potential for risk.”

Most osteoarthritis patients will benefit from a “more holistic approach” — including medication and non-drug therapies, and in some cases, surgery, he added.

More information

The Arthritis Foundation has more on treating osteoarthritis.

© 2019 HealthDay. All rights reserved.

Posted: November 2019

Drugs.com – Daily MedNews

Exercise Can Help Prevent Depression

By Robert Preidt
HealthDay Reporter

WEDNESDAY, Nov. 6, 2019 (HealthDay News) — Getting more exercise could help ward off depression, even if you have a genetic risk for it, new research shows.

For the study, researchers analyzed data from nearly 8,000 people and found that those with a genetic predisposition were more likely to be diagnosed with depression over the next two years.

But that was less likely for people who were more active at the study’s start, even if they had an inherited risk. Higher levels of physical activity helped protect even those with the highest genetic risk for depression, the investigators found.

Both high-intensity exercise (such as aerobics, dance and exercise machines) and lower-intensity activities (such as yoga and stretching) were associated with a reduced risk of depression, the findings showed.

Adding four hours of exercise a week could lower the risk of a new episode of depression by 17%, according to the study published Nov. 5 in the journal Depression and Anxiety.

“Our findings strongly suggest that, when it comes to depression, genes are not destiny and that being physically active has the potential to neutralize the added risk of future episodes in individuals who are genetically vulnerable,” said lead author Karmel Choi. She is a clinical fellow in psychiatry at Massachusetts General Hospital and Harvard T.H. Chan School of Public Health in Boston.

“On average, about 35 additional minutes of physical activity each day may help people to reduce their risk and protect against future depression episodes,” Choi said in a hospital news release.

Depression is the leading cause of disability worldwide.

“The magnitude of depression around the world underscores the need for effective strategies that can impact as many people as possible,” Choi said.

Mental health and primary care providers can use the findings to advise patients that “here is something meaningful they can do to lower their risk even if they have a family history of depression,” she suggested.

WebMD News from HealthDay

Sources

SOURCE: Massachusetts General Hospital, news release, Nov. 5, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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Daily Low-Dose Aspirin May Help Some People

By Dennis Thompson
HealthDay Reporter

MONDAY, Sept. 16, 2019 (HealthDay News) — Debate over the benefits and drawbacks of daily low-dose aspirin has flared in recent years, with guidelines now generally urging against the regimen to prevent a first heart attack or stroke in healthy people.

But some people with good heart health still might benefit from taking daily low-dose aspirin, a new study from New Zealand argues.

About 2.5% of women and 12% of men would likely benefit from daily aspirin during a five-year period, based on an analysis of more than 245,000 heart-healthy New Zealand residents.

“In our study, we were able to predict for each individual, by taking into account their personal characteristics, their propensity to benefit from or be harmed by aspirin,” said lead researcher Vanessa Selak, an epidemiologist with the University of Auckland in New Zealand.

“Using this personalized approach enabled us to identify specific individuals who were likely to benefit from aspirin after weighing up aspirin’s effects on both cardiovascular events and serious bleeding,” Selak continued.

That would seem to contradict new guidelines issued earlier this year by the American Heart Association (AHA) and the American College of Cardiology (ACC).

The two groups concluded that for older adults with healthy hearts, the risk of bleeding that comes with aspirin therapy outweighs any heart benefit.

“We used to say aspirin generally yes, occasionally no. Now we say aspirin generally no, occasionally yes,” said Dr. Amit Khera, who served on the ACC/AHA committee that wrote the guidelines.

However, Khera feels this new study actually supports the new guidelines.

“This modeling exercise confirmed it’s a very small group of the population that potentially could be eligible for aspirin,” said Khera, a professor of cardiology with UT Southwestern Medical Center in Dallas.

These guidelines are not for people who’ve had an emergency regarding their heart health. Those people do derive overall benefit from aspirin, he said.

“If you’ve had a heart attack or stroke, continue to take your aspirin,” Khera said.

But clinical trial data that emerged in 2018 showed that daily aspirin taken by people in good heart health only reduces their risk of heart attack and stroke by 11%, but increases their risk of dangerous bleeding by 43%, he added.

Continued

“I want to be clear that I’m not talking about nosebleeds,” Khera said. “I’m talking about needing a transfusion, being hospitalized, bleeding in the brain. Big stuff.”

To take a closer look at the potential benefits of aspirin, Selak and her colleagues studied hundreds of thousands of New Zealanders without heart disease who had their heart health risk calculated between 2012 and 2016.

The net effect of aspirin was calculated for each person by subtracting the number of heart emergencies the person was likely to have over five years from the number of major bleeds aspirin could cause.

After personalizing the risk-versus-benefit calculation, the researchers found that a select group of people would have a net benefit from aspirin if one heart health emergency that led to hospitalization or death was considered equal to one major bleed that led to hospitalization or death.

The percentages increased to 21% of women and 41% of men if a heart health emergency was considered equal to two major bleeds, the findings showed.

“This research suggests that decisions regarding the use of aspirin among people who have not already had a cardiovascular event should be made after undertaking a personalized prediction of cardiovascular benefits and bleeding harms from aspirin,” Selak said.

That’s already standard procedure under the U.S. guidelines, Khera said.

“No one is saying aspirin doesn’t help. It just doesn’t help as much as we used to think, and you have to appreciate the bleeding penalty,” Khera said. “Some people are more concerned about heart attack risk and are willing to pay the bleeding penalty, especially if they’ve never had any bleeding problems. It’s still OK for them to consider it.”

Both Selak and Khera recommended that people talk with their doctor about the risks and benefits before starting to take daily aspirin. Calculators are available that help physicians weigh your risk of heart attack and stroke against the risk of bleeding.

“In many ways, people think of aspirin as this benign thing because it’s been around for centuries. Anybody can get it over the counter,” Khera said. “But if you’re going to take it every day for the next couple of decades, there are definite penalties to it.”

The new study was published online Sept. 17 in the Annals of Internal Medicine.

WebMD News from HealthDay

Sources

SOURCES: Vanessa Selak, Ph.D., epidemiologist, University of Auckland, New Zealand; Amit Khera, M.D., professor, cardiology, UT Southwestern Medical Center, Dallas; Sept. 17, 2019,Annals of Internal Medicine, online

Copyright © 2013-2018 HealthDay. All rights reserved.

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How to Help Your Heart Weather Extreme Heat

SUNDAY, Aug. 11, 2019 — As extreme heat events become more common, you need to know how to protect your heart.

Hot temperatures and high humidity can lead to dehydration, which causes the heart to work harder and puts it at risk, according to the American Heart Association (AHA). Staying hydrated makes it easier for the heart to pump blood to your muscles.

“If you’re a heart patient, older than 50 or overweight, you might need to take special precautions in the heat,” said AHA President Dr. Robert Harrington.

“Certain heart medications like angiotensin receptor blockers [ARBs], angiotensin-converting enzyme [ACE] inhibitors, beta blockers, calcium channel blockers and diuretics, which deplete the body of sodium, can exaggerate the body’s response to heat and cause you to feel ill in extreme heat,” said Harrington, a cardiologist who heads the Department of Medicine at Stanford University in California.

If you have heat-related concerns about these medications, discuss them with your doctor. Never stop taking medications on your own.

Infants and the elderly are also at increased risk of heat-related problems, but everyone needs to take precautions in extreme heat.

“It is easy to get dehydrated as you may not be aware that you’re thirsty,” Harrington said in an AHA news release. “If you’re going to be outside, it’s important to drink water even if you don’t think you need it. Drink water before, during and after going outside in hot weather.”

Here are some other important hot weather precautions.

  • Avoid the outdoors between noon and 3 p.m., when the sun is usually at its strongest. When outside, wear lightweight, light-colored clothing made of breathable fabrics such as cotton, or a newer fabric that repels sweat. Wear a hat and sunglasses. Apply a water-resistant sunscreen with at least SPF 15 every two hours.
  • To stay hydrated, drink a few cups of water before, during and after exercise. Avoid caffeine and alcohol. Take regular breaks. Stop for a few minutes in shade or a cool place, hydrate and start again.

More information

The U.S. Centers for Disease Control and Prevention outlines how to prevent heat-related illness.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

Drugs.com – Daily MedNews

Veterans of Toxic Air Fight Vow to Help Others

This story is jointly reported by Brenda Goodman of WebMD and Andy Miller of Georgia Health News.

July 25, 2019 — Twilight was falling, but the heat would not let up.

Cars packed the tiny parking lot for the historic red brick building that sits on a corner of North Church Lane, between Smyrna and Atlanta, their tires crunching through white gravel. When space ran out, they spilled down side streets.

People approached solemnly.

“Where do you live?” they asked each other. Then, after a nod of recognition, “I’m sorry.”

They came from the stately mansions that overlook the Chattahoochee River. They came from brand-new, freshly painted townhomes. They came from apartment communities and single-family homes. Some had just moved here. Some had lived here for years. Some were trying to sell their homes and leave. They all live near a plant called Sterigenics, which sterilizes medical equipment.

Now they were stuck with the same problem: dirty air.

Everyone was struggling to absorb news that broke last week that state and federal environmental regulators had flagged certain neighborhoods in the area as having higher cancer risks because of a toxic gas called ethylene oxide.

In the Smyrna area, which straddles Cobb and Fulton counties, the ethylene oxide comes from Sterigenics, which uses the gas to sterilize medical products and supplies, drugs, and spices. In Covington, which sits east of Atlanta, the ethylene oxide comes from a plant called BD, formerly Bard.

For decades, the small building where they gathered was a church, its walls ringing with the exhortations of primitive Baptist preachers. But the church was sold in the 1980s to the Atlanta Freethought Society, which encourages its members to “dare to think for yourself.”

On Wednesday, the society waived the $ 75 rental fee so the community could gather to hear a very different kind of evangelist: Margie Donnell, a petite blond real estate attorney and mom from suburban Chicago, who, with her neighbors, has been fighting a Sterigenics plant where she lives.

Donnell’s friend and fellow activist, Neringa Zymancius, flew in from Illinois to join her in speaking to the Georgia group, which had lately inundated their Stop Sterigenics Facebook page with questions.

Tony Adams, a Smyrna-area resident for 12 years and a massage therapist who has taken on the daunting task of trying to turn the worries and anger of his neighbors in recent days into community action, joined Donnell and Zymancius at the podium.

People squeezed into every available seat. When space in the pews and chairs ran out, they stood against the walls and sat in the aisles.

For more than 2 hours, they leaned forward as they sat in heat that approached 90 degrees, red-faced and rapt. Some took notes in the margins of news stories they’d printed from their computers.

Before they started, the Illinois visitors stood with the crowd behind them and sent live video to the Stop Sterigenics Facebook page.

“Thanks for being here tonight,” Adams said. “I wish we didn’t have to be here.”

Bracing his arms on both sides of the podium, he explained that he grew up in the small town of Fort Valley, GA, that had been polluted by the Woolfolk Chemical Works. The plant was right next to his parents’ shop.

“You could smell the chemicals every day,” he said.

When he was 16, he said, “I watched my mom suffer and die from cancer at 52.” He said he’d also lost numerous high school friends to cancer before they were 30 to 40 years old. “The cancer rates in my hometown were off the charts,” he said. “It took 15 years for the EPA to shut that chemical facility down and declare it a Superfund site.”
“I swore as a 16-year-old,” he said, emotion choking his voice. “If I ever felt that I was being put in that situation again, I was not going to sit around a wait for somebody to do something.”

“I’m sorry if some of you are upset with me because of our property values,” he said. “This is bigger than North Church Lane.”

Veterans of the Fight

Donnell stepped up to the podium in a Stop Sterigenics T-shirt and white pants.

“First let me say that Neringa and I will stay here as late as you all need us to. Until the very last person has their question answered, we will not leave,” she said.

Donnell explained that although she works as an attorney, she wasn’t here in that capacity.

“I’m a volunteer community member, part of this grassroots organization,” she said. She said she happened to be in Atlanta to visit her company’s corporate headquarters when the news of the Smyrna and Covington pollution broke.

“We all have other jobs,” she said.

Her message was blunt:  Be loud. Be persistent. Get the air tested. Without air testing, she explained, you don’t really know what’s going on. She was girding them for battle.

“I remember the first meeting, the first town hall we had. I was sitting down just like you,” said Zymancius, whose red curls bobbed on top of her head while she spoke.

“I’m a mom. I live in Darien. I bought my first house. I did my research. I wanted the nicest neighborhood. In Darien, literally, the motto is ‘A nice place to live.’ ” She said.

“I looked at the water. I looked at everything. I never look at the air, because who would sit here in America right now to think that we are being poisoned and the government is allowing this to happen?”

“Nobody here,” she said. “Nobody in Willowbrook. Nobody in Chicago, nobody in Allentown, Pennsylvania. Nobody in New Orleans. Nobody in Michigan. These are all towns that are going through the same thing. We were all surprised just as you all are sitting here right now. My bubble was burst that day.”

According to reporting from the Chicago Tribune, half a million people live in census tracts the EPA has identified as having higher than acceptable risks for cancer caused by ethylene oxide.

Now, Zymancius  regularly texts with Erin Brockovich, the environmental activist famously portrayed on screen by Julia Roberts, who sent a message of support to the meeting.

“I’m with them and here for full support,” read the text. People stepped up to take photos of it.

Many people had already called or emailed the EPA and Georgia’s Environmental Protection Division. Some had spoken to doctors at the CDC.

Most had already gotten the same kinds of canned answers: We’re looking into it.

In a statement, Georgia’s Environment Protection Division said it expected the EPA to impose new rules on sterilizing plants this summer.  Until that happens, though, the state says it will “continue to work with both facilities on voluntary measures to further reduce ethylene oxide”

Faye Sullivan, 76, says she has lived in the area for 50 years. She moved in the same year as the moon landing. She came to the meeting because news about the chemical had suddenly recast family tragedies in a different light: Her husband died of cancer; her son had died of a brain tumor; and her daughter was just 43 when she got breast cancer. Now she was wondering if ethylene oxide was responsible.

So far, the state’s modeling results based on self-reported emissions from the companies show the cancer risks in Georgia appear to be lower than those predicted at first by the EPA. Still, the state’s models show that both companies are exceeding the state’s annual acceptable area concentration (AAC) for ethylene oxide, the level where health risks begin to rise.

In Covington, ethylene oxide concentrations around the BD plant are 17 to 97 times higher than the state’s AAC. In the Smyrna area, they are 27 to 61 times higher in neighborhoods around the Sterigenics plant.

According to the EPA, ethylene oxide causes cancer. It is most closely linked to breast and blood cancers such as leukemia and lymphoma. Long-term exposure is also tied to other brain and nervous system effects like headaches, memory loss, and numbness.

After the last stragglers had finally filed out, Donnell and Zymancius led a small group over to the Sterigenics plant, which was minutes away.

Company Responses

In a statement sent to WebMD and Georgia Health News, Sterigenics said, “The Sterigenics Smyrna facility already meets and outperforms all current permit and regulatory requirements today. We plan to implement additional emissions controls that would further capture and control emissions from this facility.” The company also said the Smyrna facility has been in operation since the 1970s.

BD, the sterilizing plant in Covington, said their pollution control equipment destroys more than 99% most of the ethylene oxide they use before it reaches the air. They say the gas they release has always been within legal limits.

In DuPage County, IL, yesterday, where Sterigenics is trying to reopen its plant, which has been sealed since February, a judge put off the reopening of the plant for another month to consider arguments in the case from surrounding communities.

As they stood in the street, in the dark, bathed in the glow of street lamps, the Illinois activists  posted another live video to social media.

“It is absolutely appalling that Sterigenics is here doing the exact same thing as they did in Willowbrook,” said Zymancius, staring into her phone.

“We want Sterigenics to know that we’re here now, and we’re not going away,” said Donnell.

Sources

Margie Donnell, mom, attorney, co-founder, Stop Sterigenics, Willowbrook, IL.

Neringa Zymancius, member, Stop Sterigenics, Darien, IL.

Tony Adams, area resident, Smyrna, GA.

Faye Sullivan, area resident, Smyrna, GA.

Sterigenics, written statement.

BD, written statement.

Georgia Open Records Request, Georgia Environmental Protection Division, Atlanta.

© 2019 WebMD, LLC. All rights reserved.

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ADHD Meds Help Keep Kids Out of Trouble

TUESDAY, July 23, 2019 — Some parents may be reluctant to give their kids powerful stimulants to treat the symptoms of attention-deficit/hyperactivity disorder (ADHD), but a new review shows the medications bring significant benefits.

In addition to helping kids calm down and concentrate in school, the review also found that the drugs help children avoid a lot of long-term negative consequences associated with ADHD, including depression, substance abuse and even driving problems.

“Treating ADHD can help children avert some of the serious complications associated with ADHD,” said study author Dr. Joseph Biederman. He’s chief of clinical and research programs in pediatric psychopharmacology and adult ADHD at Massachusetts General Hospital, in Boston.

Specifically, the study suggested that early use of ADHD stimulant medications was linked to a lower risk of:

  • Major depression
  • Anxiety
  • Oppositional defiant disorder
  • Conduct disorder
  • Bipolar disorder
  • Smoking
  • Substance abuse
  • Driving problems, such as car accidents
  • Poor performance in school

Although the current study can’t prove a definitive cause-and-effect relationship, Dr. Alan Geller, a psychiatrist from Gracie Square Hospital in New York City who treats children and adolescents, said it makes sense that treating ADHD symptoms can help prevent other problems.

“A hyperactive child who interrupts and disrupts class is annoying. They end up getting marginalized, which can lead to substance abuse or conduct disorders, or depression and anxiety if they’re constantly frustrated,” he explained.

Geller said adults with ADHD can have trouble at work and have difficulty in their personal lives.

“It can start around 7 or 8, when they’re not able to navigate life the way other kids do. They end up feeling alone and like no can help. It’s a major problem without treatment,” he said.

But, Geller said, this research shows that if you treat a child with medications that help them control their ADHD symptoms, there’s less risk of marginalization or of seeking stimulation in things like cigarettes or driving recklessly.

Geller said the findings point to the benefits of ADHD medications outweighing their risks. Adverse effects from these drugs include a slight height suppression, appetite suppression and a potential risk of addiction.

The review included three studies. Two were long-term prospective studies of children with and without ADHD. Some of the children diagnosed with ADHD were treated with stimulant medications and some were not.

The average age of the youngsters in the study was 11 when the study began. They were 20 at the follow-up.

The third study looked at young adults (18 to 26) with ADHD. Researchers checked the volunteers’ performance on a driving simulator before they started taking stimulant medication and then again six weeks after they had started treatment.

The researchers calculated the number of people who needed to be treated with medication for a benefit to be seen. They found:

  • Three people needed to be treated with ADHD medication to prevent one child from repeating a grade or developing anxiety, conduct disorder or oppositional defiant disorder.
  • Four people needed treatment to prevent one person from having major depression or an accident during the driving simulation.
  • Five people needed treatment to prevent bipolar disorder.
  • Six people had to be treated to prevent one person from smoking cigarettes, and 10 people needed treatment for one person to avoid a substance use disorder.

The researchers are planning future research to see if treating ADHD with medications can help lessen the risk of post-traumatic stress disorder, traumatic brain injuries and suicide. They also plan to study if ADHD treatment is linked to work success, Biederman said.

The review was published July 23 in the Journal of Adolescent Health.

Funding for the studies in the review came from several places, including the U.S. National Institutes of Health, and for one study, pharmaceutical manufacturer Shire. Shire is now part of Takeda, and manufactures ADHD stimulant medications such as Adderall XR, Mydayis and Vyvanse. Research funders had no role in the design, implementation or reporting of the review, the study authors said.

More information

Read about available treatments for ADHD from the American Academy of Pediatrics.

© 2019 HealthDay. All rights reserved.

Posted: July 2019

Drugs.com – Daily MedNews

How Pushups Can Help Men’s Hearts

man doing push ups

In a 10-year study published in February, researchers reported that men who can do 40 pushups have a whopping 96% lower risk of heart disease than guys who can’t muster 10. The average man in the study: Nearly 40 years old and overweight, but not obese. All 1,562 men were physically active firefighters rather than office workers. The study’s results strengthen the case that muscle-building promotes heart health.

“Resistance training is super important,” says Kaiser Permanente sports medicine specialist Robert E. Sallis, MD, who was not involved in the study. “It seems to have the same benefits as cardiovascular exercise.”

Can’t do 40 pushups? Don’t sweat it. In the study, even men who could do only 11 pushups dropped their risk of heart disease by 64%. The biggest difference, says Sallis, lies between those who do no exercise and those who at least do some: “Even if you can only do a little exercise, you get tremendous benefits.”

The study focused on pushups, but don’t limit yourself to that one exercise. Your workout should include a variety of movements that work as many muscles as you can. Sallis recommends weightlifting, situps, pullups, and interval training. “Your goal shouldn’t be simply to do more pushups in order to live longer,” he says. “It’s about your overall fitness.”

Sallis says that men often become discouraged when their exercise routine does not lead to weight loss: “They think their program’s not working, but that’s wrong.” He says that fitness — or your capacity for exercise — is a much better indicator of your health than weight, at least up to a point.

“All of the data tells us that if you can be active and do those pushups or other exercises, the weight doesn’t matter unless you’re morbidly obese,” says Sallis.

New to exercise? Start slow and ramp up. Sallis recommends daily brisk walks at first, building up to 150 minutes per week, or 30 minutes a day.

“Try 10 minutes a day at first,” he says. “If that’s all you can do, I’ll take it. Even low doses of exercise provide benefits.”

And if you don’t like pushups? That’s OK. Do something else. “I don’t necessarily want people to do more pushups,” says Sallis. “I want them to be more fit. Do whatever you want to do — you’ve got a large menu.”

Continued

Questions for Your Doctor

Should I avoid some types of exercise?

Some conditions will make certain exercises a bad choice. For example, shoulder arthritis may make pushups impossible. Try other bodyweight exercises.

Do I need to be evaluated before I exercise?

Most people don’t need a doctor’s permission to start moderate exercise, like a walking program, but if you have heart disease, diabetes, or other chronic health problems, check in with your doctor.

What health red flags should I watch for?

See your doctor if you feel any chest pains while working out or if you have excessive shortness of breath. Knee pain also should not be ignored.

Do my medications mix well with exercise?

Some blood pressure medications affect your heart rate, cause shortness of breath and dizziness, and make you more likely to get dehydrated. Review your prescription drugs with your doctor when starting to exercise.

Find more articles, browse back issues, and read the current issue of WebMD Magazine.

Sources

SOURCES:

Robert E. Sallis, MD, Kaiser Permanente sports medicine specialist.

American Council on Exercise: “Common Medications and Their Effects on Exercise Response.”

Mayo Clinic: “Exercise: When to check with your doctor first.”

JAMA Network Open: “Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men.”

© 2019 WebMD, LLC. All rights reserved.

‘); } else { // If we match both our test Topic Ids and Buisness Ref we want to place the ad in the middle of page 1 if($ .inArray(window.s_topic, moveAdTopicIds) > -1 && $ .inArray(window.s_business_reference, moveAdBuisRef) > -1){ // The logic below reads count all nodes in page 1. Exclude the footer,ol,ul and table elements. Use the varible // moveAdAfter to know which node to place the Ad container after. window.placeAd = function(pn) { var nodeTags = [‘p’, ‘h3′,’aside’, ‘ul’], nodes, target; nodes = $ (‘.article-page:nth-child(‘ + pn + ‘)’).find(nodeTags.join()).not(‘p:empty’).not(‘footer *’).not(‘ol *, ul *, table *’); //target = nodes.eq(Math.floor(nodes.length / 2)); target = nodes.eq(moveAdAfter); $ (”).insertAfter(target); } // Currently passing in 1 to move the Ad in to page 1 window.placeAd(1); } else { // This is the default location on the bottom of page 1 $ (‘.article-page:nth-child(1)’).append(”); } } })(); $ (function(){ // Create a new conatiner where we will make our lazy load Ad call if the reach the footer section of the article $ (‘.main-container-3’).prepend(”); });

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AHA News: Genetics May Help Predict the Right Blood Pressure Drug for You

TUESDAY, June 25, 2019 (American Heart Association News) — Medication can play a huge role in reducing high blood pressure, a leading cause of stroke, heart attack and other serious health problems. Yet given the wide selection of drugs for doctors to choose from, figuring out which drug works best for someone is difficult.

But researchers may have found a better way to predict the effectiveness and side effects of blood pressure drugs, and it doesn’t involve taking a single pill. Instead, it relies on genetics.

In a new study published Tuesday in the American Heart Association journal Circulation, researchers tapped into a large genetic database in the United Kingdom to look for specific genes that contain the instructions for making proteins targeted by three commonly used blood pressure medicines – ACE inhibitors, beta-blockers and calcium channel blockers.

They then used people’s genes to evaluate what a drug would do – both benefits and harms.

Researchers were able to match certain variations in genes with the drug class’s effect on lowering heart disease and stroke risk. But they found a possible complication from one particular category of blood pressure drugs examined in the study.

The genetic variants targeted by calcium channel blockers had a “previously unreported possible side effect.” Specifically, they were linked to an increase risk of developing diverticulosis, a condition where small pouches develop along the walls of the large intestine. When the pouches get infected or tear, these complications can lead to hospitalization.

“As far as we know, this effect isn’t related to blood pressure at all, and this is very much a novel insight generated by the study,” said the study’s lead author, Dr. Dipender Gill, a clinical research fellow at Imperial College London.

Neither ACE inhibitors nor beta-blockers showed previously unknown side effects.

Researchers corroborated the association between calcium channel blockers and diverticulosis by tapping into another genetic database, this one of DNA samples available through the biobank operated by Vanderbilt University in Tennessee.

An estimated 874 million adults worldwide have high blood pressure, often called “the silent killer” because it rarely shows obvious symptoms while it wreaks havoc on the body. Also called hypertension, high blood pressure is usually treated through lifestyle modifications – specifically changes in diet and physical activity levels – and the use of one or more medications.

But most high blood pressure drugs are tested in older or high-risk populations for a relatively short period of time, and the trials rarely capture side effects beyond the more obvious ones.

“The real strength of the study is that it was able to assess for unexpected effects of medications on human health in an unbiased way,” said Dr. Kiran Musunuru, an associate professor of cardiovascular medicine and genetics at the University of Pennsylvania, who was not involved in the research.

“There’s no obvious connection that would have led the medical community to suspect a link between calcium channel blockers and diverticulosis, but it appears there might be one after all,” he said. “The idea of using genetic variants that mimic the effects of medications to get a better sense of whether the drugs will be effective and safe, before the medications are used in people, will be an important element of drug development going forward.”

But Musunuru warned the connection between calcium channel blockers and diverticulosis is still preliminary and isn’t enough for medical providers and their patients to stop using calcium channel blockers for that reason alone.

Gill agreed.

“These medications are very useful. The doctor’s prescribing them for an important reason. What we’ve highlighted is information that should inform further study and investigation,” he said.

Gill said although the study offers “novel insight” into possible side effects of calcium channel blockers, the bigger implication is for future research.

“In the current era, the vastness of genetic data makes it possible to do very advanced and sophisticated analyses very rapidly,” he said.

Ioanna Tzoulaki, the study’s senior author and an epidemiologist at Imperial College London, added, “This approach is evolving as a powerful cost- and time-efficient tool to help prioritize or design those trials that are more likely to be successful.”

© 2019 HealthDay. All rights reserved.

Posted: June 2019

Drugs.com – Daily MedNews

FDA Approves Second Drug, Vyleesi, to Help Women With Low Libido

FRIDAY, June 21, 2019 — The U.S. Food and Drug Administration on Friday gave its approval to Vyleesi, the second medication so far approved to help women with low sexual desire.

In a news release, the FDA said that Vyleesi (bremelanotide) is a drug that would be administered by injection prior to having sex.

It’s been specifically approved for premenopausal women with a condition known as acquired, generalized hypoactive sexual desire disorder (HSDD).

“There are women who, for no known reason, have reduced sexual desire that causes marked distress, and who can benefit from safe and effective pharmacologic treatment,” said Dr. Hylton Joffe, who directs the FDA’s Center for Drug Evaluation and Research’s Division of Bone, Reproductive and Urologic Products.

“Today’s approval provides women with another treatment option for this condition,” Hylton said in the news release.

According to the agency, HSDD is not caused by any medical or psychiatric condition, relationship issues or drug side effects.

Instead, women with HSDD have “previously experienced no problems with sexual desire,” the FDA said. “Generalized HSDD refers to HSDD that occurs regardless of the type of sexual activity, situation or partner.”

The exact way in which Vyleesi helps stimulate sexual desire remains unclear, but it works on melanocortin receptors on cells, the FDA said.

The drug is injected under the skin of the abdomen or thigh at least 45 minutes prior to a sexual encounter, although the best timeframe for dosing could vary from user to user.

Side effects can occur, the FDA added, and include nausea and vomiting, flushing, injection site reactions and headache. Nausea was especially common, affecting 40% of users in the clinical study that led to approval.

That study involved 1,247 premenopausal women with HSDD who received Vyleesi or a placebo in one of two 24-week trials.

“In these trials, about 25% of patients treated with Vyleesi had an increase of 1.2 or more in their sexual desire score (scored on a range of 1.2 to 6.0, with higher scores indicating greater sexual desire) compared to about 17% of those who took placebo,” the FDA noted.

Still, the overall benefit was not large. “There was no difference between treatment groups in the change from the start of the study to end of the study in the number of satisfying sexual events. Vyleesi does not enhance sexual performance,” the FDA said.

And there was one other caveat: Vyleesi can hike blood pressure, so people with heart disease or high blood pressure should not take it, the FDA said.

Vyleesi should also not be taken by anyone who is also taking the drug naltrexone, used to combat opioid dependency, because Vyleesi reduces naltrexone’s effectiveness.

Vyleesi is not the first drug approved to enhance flagging libido in women. In 2015 the FDA approved Addyi (flibanserin) for the purpose, but the drug did not become widely used because it cannot be taken with alcohol and only certain certified health care providers are allowed to prescribe it.

According to CNN, Vyleesi’s maker, AMAG Pharmaceuticals, said the new drug will not be available until September, and pricing and reimbursement have yet to be determined.

One expert in female sexual health said it remains to be seen how widely Vyleesi will be used.

“Female sexual dysfunction is more complicated in some ways than male sexual dysfunction, so it’s more difficult to treat,” Dr. Nicole Cirino, co-director of the Menopause and Sexual Therapy Clinic at Oregon Health and Science University’s Center for Women’s Health, told CNN. She had no role in Vyleesi’s development.

Cirini suspects Vyleesi probably will not be the first option women with HSDD turn to, but it might prove a useful adjunct to standard psychotherapy and Addyi.

Vyleesi, like Addyi, probably won’t be overprescribed, Cirino added. When Addyi was introduced, there were concerns “that doctors would just be prescribing this medication to anybody that came in saying that they were having an issue with their libido,” she said. “And I think we have to give physicians more credit than that. In fact, that didn’t happen at all.”

Still, Vyleesi could help some women, Cirino said.

“There’s so many chemical factors that influence our libido,” she told CNN. “So you can’t discount using a chemical treatment as part of the broad approach to low libido.”

More information

There’s more on HSDD at the American Sexual Health Association.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

Drugs.com – Daily MedNews

FDA Approves Second Drug to Help Women With Low Libido

FRIDAY, June 21, 2019 — The U.S. Food and Drug Administration on Friday gave its approval to Vyleesi, the second medication so far approved to help women with low sexual desire.

In a news release, the FDA said that Vyleesi (bremelanotide) is a drug that would be administered by injection prior to having sex.

It’s been specifically approved for premenopausal women with a condition known as acquired, generalized hypoactive sexual desire disorder (HSDD).

“There are women who, for no known reason, have reduced sexual desire that causes marked distress, and who can benefit from safe and effective pharmacologic treatment,” said Dr. Hylton Joffe, who directs the FDA’s Center for Drug Evaluation and Research’s Division of Bone, Reproductive and Urologic Products.

“Today’s approval provides women with another treatment option for this condition,” Hylton said in the news release.

According to the agency, HSDD is not caused by any medical or psychiatric condition, relationship issues or drug side effects.

Instead, women with HSDD have “previously experienced no problems with sexual desire,” the FDA said. “Generalized HSDD refers to HSDD that occurs regardless of the type of sexual activity, situation or partner.”

The exact way in which Vyleesi helps stimulate sexual desire remains unclear, but it works on melanocortin receptors on cells, the FDA said.

The drug is injected under the skin of the abdomen or thigh at least 45 minutes prior to a sexual encounter, although the best timeframe for dosing could vary from user to user.

Side effects can occur, the FDA added, and include nausea and vomiting, flushing, injection site reactions and headache. Nausea was especially common, affecting 40% of users in the clinical study that led to approval.

That study involved 1,247 premenopausal women with HSDD who received Vyleesi or a placebo in one of two 24-week trials.

“In these trials, about 25% of patients treated with Vyleesi had an increase of 1.2 or more in their sexual desire score (scored on a range of 1.2 to 6.0, with higher scores indicating greater sexual desire) compared to about 17% of those who took placebo,” the FDA noted.

Still, the overall benefit was not large. “There was no difference between treatment groups in the change from the start of the study to end of the study in the number of satisfying sexual events. Vyleesi does not enhance sexual performance,” the FDA said.

And there was one other caveat: Vyleesi can hike blood pressure, so people with heart disease or high blood pressure should not take it, the FDA said.

Vyleesi should also not be taken by anyone who is also taking the drug naltrexone, used to combat opioid dependency, because Vyleesi reduces naltrexone’s effectiveness.

Vyleesi is not the first drug approved to enhance flagging libido in women. In 2015 the FDA approved Addyi (flibanserin) for the purpose, but the drug did not become widely used because it cannot be taken with alcohol and only certain certified health care providers are allowed to prescribe it.

According to CNN, Vyleesi’s maker, AMAG Pharmaceuticals, said the new drug will not be available until September, and pricing and reimbursement have yet to be determined.

One expert in female sexual health said it remains to be seen how widely Vyleesi will be used.

“Female sexual dysfunction is more complicated in some ways than male sexual dysfunction, so it’s more difficult to treat,” Dr. Nicole Cirino, co-director of the Menopause and Sexual Therapy Clinic at Oregon Health and Science University’s Center for Women’s Health, told CNN. She had no role in Vyleesi’s development.

Cirini suspects Vyleesi probably will not be the first option women with HSDD turn to, but it might prove a useful adjunct to standard psychotherapy and Addyi.

Vyleesi, like Addyi, probably won’t be overprescribed, Cirino added. When Addyi was introduced, there were concerns “that doctors would just be prescribing this medication to anybody that came in saying that they were having an issue with their libido,” she said. “And I think we have to give physicians more credit than that. In fact, that didn’t happen at all.”

Still, Vyleesi could help some women, Cirino said.

“There’s so many chemical factors that influence our libido,” she told CNN. “So you can’t discount using a chemical treatment as part of the broad approach to low libido.”

More information

There’s more on HSDD at the American Sexual Health Association.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

Drugs.com – Daily MedNews

A Simple Way to Help Prevent Child Obesity

FRIDAY, June 14, 2019 — Kids who don’t drink water take in nearly 100 more calories from sugary drinks every day than those who do, according to a recent Penn State study.

About one-fifth of children fall into the no-water group.

But a multi-year experiment in the New York City public schools involving more than 1 million students found that installing water dispensers in school can change that. Having dispensers increases the amount of water the kids drink, decreases purchases of sugary chocolate milk and the number of sodas and juices brought to school, and helps prevent excess weight in both boys and girls.

But it’s not enough to simply tell kids to give up soda and other sugary drinks and have water instead. It needs to be easier for kids to make this choice. Parents can follow these steps from Children’s Hospital Colorado to encourage kids to choose water.

Make drinking water more fun by adding frozen berries or grapes to a clear reusable water bottle designed for small hands.

Freeze small bottles of water to pack in their afterschool sports bag. The water will thaw during the day, yet still be cold and refreshing when they reach for it.

Let your kids keep the deposit money when you recycle store-bought bottled water containers.

When eating out, choose water as the beverage — you’ll not only save calories, but you’ll also save money.

Finally, set the right example by drinking water yourself.

More information

Access more tips on the Children’s Hospital Colorado website.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

Drugs.com – Daily MedNews

DO CBD Creams Really Help with Pain or is it all hype?

With all of the recent articles emerging about how much CBD can do, you may begin to wonder if things like CBD cream can really provide the benefits that they claim. How exactly does CBD cream help with pain?

Is it possible for it to relieve pain as effectively as it’s said to, or is it mostly hype and placebo effects?

What Exactly Is CBD Anyways?

CBD is short for “cannabidiol,” which is just one type of cannabinoid among the hundreds that have been discovered. They are amazing compounds that hold unique properties, depending on the type of cannabis they’re derived from.

For instance, THC is a type of cannabinoid that produces the psychoactive effects associated with smoking marijuana. CBD has no psychoactive properties while providing great medicinal benefits.

Does CBD Really Have Health Benefits?

There are a lot of sources going crazy about CBD’s uses for your health. It’s been shown to improve conditions from seizures to chronic pain. People are very excited because this provides an alternative to many medications without the harsh side effects that may come along with them.

It’s being regarded as a bit of a panacea, or a cure-all. It certainly seems that way as you scroll through the long list of medicinal benefits! You may raise a skeptical eyebrow to these claims, can one substance really do all of those wonderful things?

We’ve seen it too often before, that the hype of a new super-food or natural remedy dissipates as people realize it’s may not live up to its hype.

Often times treating and curing illness, particularly with natural products, takes cumulative efforts and seldom only requires one product. But is CBD different? It is quite unique, in fact.

There is a special system of cannabinoid receptors within our body, giving CBD it’s almost miraculous ability to regulate the body. A recent study shows that the cannabinoid receptors in the body are directly linked to the central nervous system.

Can CBD Really Help With Pain?

There is also a growing body of research arising around discovering the benefits of CBD. So far there is firm proof that CBD help regulates, including blood pressure, heart rate, and reduce inflammation and pain. And more people are talking about how CBD has helped their particular problem or condition.

It is certainly helping a large number of individuals! But what about CBD creams for pain? Does CBD cream work through the skin effectively?

Apparently, CBD cannot be absorbed into the bloodstream from the skin in the form of creams.In this video Dr. Bond talks about how topical CBD works with the body to reduce pain.

But many people still find it incredibly effective for managing pain. Why is this? The effectiveness of CBD creams is due to their ability to reduce inflammation, thereby reducing nerve sensitivity and soreness in that area.

At Harvard Health Publishing, they talk about how CBD is proven to help managing neuropathic pain. This is the type of pain that is typically ongoing and acute. It can be caused by nerve damage.

This makes it particularly great for arthritis, aching muscles, and other local pain. For whole body pain, taking CBD orally is typically more effective. But CBD creams can drastically help when pain is localized to a single area.

To conclude, CBD is proven to have benefits for reducing inflammation and ongoing pain. CBD creams are best used for localized pain and can be taken on a daily basis. A CBD Cream Study shows that creams are extremely effective in reducing localized pain. There are additional benefits of CBD that help to regulate your body and reduce stress levels, which can even further promote the benefits CBD has to provide for relieving pain levels.

Avatar
Author: Kevin Rachett
Kevin is the founder and chief editor at BestCBDCreamsForPain.com He has been a long time CBD user and a big advocate of CBD for medical uses.

Marijuana & Cannabis News – The 420 Times

Bones Help Black People Keep Facial Aging at Bay

By Steven Reinberg

HealthDay Reporter

TUESDAY, June 11, 2019 (HealthDay News) — Why do so many black adults continue to look youthful as they age?

A new study says it’s in their bones.

Researchers found that the facial bones of black adults retain a higher mineral content than those other races, which makes their faces less likely to reflect their advancing years.

The new study is the first to document how facial bones change as black adults age, and may help guide plastic surgeons’ work.

“It is important for plastic surgeons to understand how the facial aging process differs among racial and ethnic groups to provide the best treatment,” said study author Dr. Boris Paskhover. He is an assistant professor at Rutgers New Jersey Medical School, in Newark.

For the study, his team looked at medical records of 20 black adults from 1973 and 2017. The study patients had at least two face scans taken 10 years apart.

Although all of the faces changed over time, they showed only minor changes, compared to similar studies on the aging white population.

“This finding reflects other studies that show black adults have higher bone mineral density, decreased rates of bone loss and lower rates of osteoporosis as compared to the general population,” Paskhover said in a university news release.

Facial aging results from a combination of changes to the skin, muscle, fat and bones.

As people age, the loss of mineral density causes bone loss. Bone loss can affect the shape of the nose, lower jowl area, cheekbones, and middle and lower areas of the eye sockets, the researchers explained.

“As bones change, they affect the soft tissue around them, resulting in perceived decreases in facial volume,” Paskhover said. “Treatment should consider the underlying bone structure.”

The report was published online recently in JAMA Facial Plastic Surgery.

WebMD News from HealthDay

Sources

SOURCE: Rutgers University, news release, June 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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