Older patients increasingly use mobility devices

By jeremyc | May 21, 2015

Older patients are more commonly using canes, wheelchairs and other mobility devices than before, according to a new study.

The researchers surveyed older adults, and they found that a quarter of them used mobility devices, which is a higher percentage than indicated by past studies. The study was led by Nancy Gell, PhD, of the University of Vermont in Burlington, who said, “Staying active is a key component to staying healthy and maintaining mobility and function. It’s important for people to use the device that best matches their needs in order to stay as mobile as possible, but safely.”

A total of 7,609 adults on Medicare were surveyed for this study. They were asked about whether they used mobility devices, and whether they had had a fall recently. Among the respondents, 24 percent used a mobility devices and 9 percent used multiple devices in the previous month.

The researchers noted that using a mobility device did not result in a higher rate of fall, but adults using canes may limit their mobility because of a fear of falling. Also, the use of mobility devices had increased by almost 50 percent since 2004.

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Peripheral artery disease may cause leg pain, but hip exercise can ease the problem

By jeremyc | May 19, 2015

Peripheral artery disease (PAD) is a common circulatory condition in which the arteries of the limbs narrow, which can cause leg pain. However, exercise to strengthen hip muscles can bring relief to this problem.

According to a new study, strengthening and building up hip flexor muscles through exercise can lower leg pain associated with PAD. The study was led by Takaaki Kakihana, a physical therapist and doctoral candidate at Tohoku Graduate School of Medicine in Sendai, Japan.

Kakihana said, “PAD patients should ask for an expert, such as a physical therapist, to evaluate their gait and the strength of their hip flexors and other muscles. Based on the evaluation, a combination of muscle training and walking exercise may increase how far they can walk and reduce their calf pain during walking.”

For this study, the researchers looked at 16 PAD patients and seven healthy control subjects. The average age of patients was 71 years. They had moderate aches and blocked leg arteries in both legs or one leg when walking. They also walked abnormally; moving more slowly even when they tried moving faster. They also took smaller steps.

The PAD patients were also found to have different leg muscle movements; they did not use hip flexor muscles as much as healthy people. Kakihana said, “Usually older people have relatively weaker ankle flexors and use their hip flexors more during the push-off phase of walking. People with PAD use their ankle flexors more to compensate for hip muscle weakness.”

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New combination may be ideal for hepatitis C treatment

By jeremyc | May 17, 2015

A new combination of three drugs - beclabuvir, asunaprevir and daclatasvir - may be effective in treatment hepatitis C patients without or with liver cirrhosis.

Two studies have found that this trio of medications was successful in treatment the viral infection. One of these studies was led by Andrew J. Muir, MD, of Duke University Medical Center in Durham, North Carolina, who said, “Chronic hepatitis C virus (HCV) infection remains a substantial cause of chronic liver disease, affecting approximately 130 to 150 million individuals worldwide.”

The second study was led by Fred Poordad, MD, of the University of Texas Health Science Center in San Antonio, Texas, and involved 312 patients who did not receive treatment before, and 103 patients who did receive prior treatment.

The patients were prescribed the trio two times a day. After a two-week treatment period, 91.3 percent of the patients showed sustained virologic response, indicating that their hepatitis C blood count was either very low or undetectable. This was noted in 92 percent of the patients who never received treatment and in 89.3 percent of those who received past treatment.

The second study by Muir saw 202 patients with cirrhosis. Among them, 112 did not receive treatment before and 90 had a record of treatment. Among the non-treated patients, 93 percent showed sustained virologic response. This was 87 percent for the patients who had a record of treatment.

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Obese patients may have greater bleeding risk with warfarin

By jeremyc | May 15, 2015

New research suggests that obese patients may have a greater risk of bleeding when they take warfarin, a commonly prescribed blood thinner.

Patients are often prescribed warfarin after a heart attack or developing a blood clot. The study was led by Adedotun Ogunsua, an internal medicine resident at University of Massachusetts Medical School in Worcester, who said, “We realized that patients who required longer periods [of treatment] and higher doses of warfarin tend to be more obese compared to their non obese counterparts.”

He added, “… This should place them at increased risk of bleeding. We noted there was little in the literature regarding this.”

For the study, the researchers looked at 833 people who were on blood thinning therapy. During the year-long study period, 71 of them reported abnormal bleeding. Moreover, obese patients were two times more likely to experience an episode of major bleeding, such as a stomach or brain blood vessel breaking and bleeding.

Ogunsua said, “here are a number of factors responsible for higher bleeds in this population including the possibility that very heavy people may have genetic factors that make them more likely to bleed.”

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Measles vaccine may indirectly prevent other diseases

By jeremyc | May 13, 2015

Measles is known to weaken the immune systems for years on end, meaning that vaccines may indirectly prevent people from catching other infectious diseases, giving public health a major boost.

A new study has found that the immune system-weakening effects of measles may even last longer than previously thought. The disease is already known to temporary suppress the immune system of children.

The lead author of the study was Michael J. Mina, a postdoctoral researcher at Princeton University, who said, “Our findings suggest that measles vaccines have benefits that extend beyond just protecting against measles itself. It is one of the most cost-effective interventions for global health.”

Bradley R. Berg, division director of pediatrics at Baylor Scott and White in Austin and Round Rock, said, “This study shows that children who contract measles also lose their immunity to other diseases which lasts up to 3-5 years. This means that they are 30-50% more likely to die from another childhood illness.”

The measles virus attacks T-lymphocytes in the body of the patient, which are known to build immune memory to the infection. After a measles infection, T-lymphocytes temporarily only work against the measles virus, thereby suppressing the immune system and making patients more vulnerable to infections.

For this study, the researchers looked at deaths among one to nine-year old children in the UK and one- to 14-year-old children in the US. On comparison of measles incidence, they found a significant link between the disease and death from other conditions.

The researchers also found that the immune system remains suppressed for up to three years, rather than the three months generally thought by scientists.

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PTSD may be linked with premature aging

By jeremyc | May 9, 2015

According to a new study, post-traumatic stress disorder (PTSD) may be linked to greater risk of premature aging and medical conditions linked with old age.

As such, PTSD treatments may need to also include anti-inflammatory drugs or other anti-aging therapies, and not just mental health therapy according to the study’s authors.

The study was led by Dilip V. Jeste, MD, of the University of California, San Diego School of Medicine, who said, “This is the first study of its type to link PTSD, a psychological disorder with no established genetic basis, which is caused by external, traumatic stress, with long-term, systemic effects on a basic biological process such as aging.”

The researchers looked into 64 studies on aging and PTSD, conducted in January 2000-November 2014. They looked for chronic conditions associated with old age or premature aging, and biological aging signs.

Most studies had suggested PTSD patients have a greater risk of type 2 diabetes, dementia, gastrointestinal ulcers, heart disease and other such conditions linked to aging. Also, the biological indicators used to measure signs of aging showed signs of premature aging.

Seven out of ten studies also found possible links between early death and PTSD; patients had a 29 percent higher risk than those without the condition.

Jeste and team wrote, “Post-traumatic stress disorder has major public health significance. Evidence that PTSD may be associated with [early aging] would have major implications for quality of life and healthcare policy.” They added, “Our findings warrant a deeper look at this phenomenon and a more integrated medical-psychiatric approach to their care.”

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Type 2 diabetes risk decreases with unsweetened beverages

By jeremyc | May 7, 2015

According to a new study, the risk of type 2 diabetes may decrease if patients switch from sweetened to unsweetened beverages like tea or coffee.

The study was led by Laura O’Connor, PhD, of the University of Cambridge School of Clinical Medicine in the UK. The researchers wrote, “Our findings suggest that reducing consumption of sweet beverages, in particular soft drinks and sweetened-milk beverages, and promoting drinking water and unsweetened tea or coffee as alternatives may help curb the escalating diabetes epidemic.”

The study looked at different sugar-sweetened beverage types like sweetened milk beverages, sweetened coffee or tea, soft drinks and artificially sweetened juice or drinks.

For this study, the researchers analyzed 25,639 UK adults from the European Prospective Investigation into Cancer and Nutrition-Norfolk study. The patients were 40-79 years old and did not have diabetes at the start of the study.

Through a four-year period, the patients kept seven-day diet diaries. The researchers followed up on the patients for an average of 10.8 years and recorded 847 cases of type 2 diabetes.

On analysis, they found that a 5 percent higher intake of sweetened beverages was linked to an 18 percent higher risk of diabetes. Also, replacing a single serving of sweetened milk or soft drinks for unsweetened drinks could reduce diabetes risk by 14-25 percent.

Among regular consumers of sweetened beverages, 15 percent of the diabetes cases could have been prevented by reducing their drinks to less than 2 percent of their energy intake, according to the researchers.

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FDA approves new adult asthma medication

By jeremyc | May 5, 2015

The US Food and Drug Administration (FDA) has approved a new drug form the treatment of asthma in adults: Breo Ellipta from GlaxoSmithKline (GSK) and Theravance.

Breo Ellipta is the brand name for fluticasone furoate, an inhaled corticosteroid recommended to be used once a day. It is only approved for adults.

Darrell Baker, head of the GSK Global Respiratory Franchise, said, “Breo Ellipta is our second asthma treatment to be approved in the US in the past year, and now provides physicians with a range of treatment options delivered via the Ellipta inhaler to meet the needs of appropriate adult patients with differing asthma severities.”

Asthma is a chronic respiratory disease in which there is inflammation in the airways that causes them to swell and narrow and produce excessive mucus. The symptoms of this condition include shortness of breath, wheezing and coughing.

Breo Ellipta was approved by the FDA after the drug was tested in over 12,000 patients in 23 trials. The drug was found to be effective and safe in these trials. However, GSK noted that there are some possible side effects, such as irregular heartbeat, raised blood pressure and increased pulse. It also said that the medicine must not be used to treat acute bronchospasms or asthma attacks.

Topics: Asthma | No Comments »

Reduction in drunk driving increases US economy

By jeremyc | May 3, 2015

A recent study has found that a dramatic decrease in impaired driving car accidents since the middle of the 1980s may have boosted the US economy by $20 billion in 2010 and also increased national employment and income levels.

The study was done by Eduard Zaloshnja, PhD, of the Pacific Institute for Research and Evaluation in Silver Spring, MD, and colleagues. He said, “Preventing traffic crashes reduces crash costs paid by employers and employees. The related savings filter through the economy, impacting its performance.”

The researchers used data from the National Highway Traffic Safety Administration and calculated the economic losses and gains caused by a 50 percent reduction in drunk driving accidences since 1984-1986. They looked at costs such as emergency response, property damage, productivity and medical costs.

They said, “A range of effective interventions have halved the impaired driving toll in the USA over the past 30 years. The cost-effectiveness of those efforts is well-documented. Laws and their enforcement have played a critical role in reducing the toll.”

The authors said that the drop in drunk driving accidences appears to have raised the economic output by $20 billion and created over 200,000 jobs in 2010. In the same year, the US economy had grown by $6.5 billion.

Also, a reduction in accident frequency may have boosted the country’s GDP, which grew by $10 billion. The gains included profits, tax revenues and wages.

According to the study, just over 10 percent of car accidents in the US in 2010 had alcohol involved. Drunk driving accidents caused $49 billion in that year, excluding the impact on quality of life and household work.

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Some anticoagulants may raise bleeding risk

By jeremyc | May 1, 2015

A new study comparing three anticoagulants has found that some of these blood thinners may raise the risk of bleeding. The medicines compared in this study were warfarin, rivaroxaban and dabigatran. Warfarin was found to have the lowest risk of bleeding, while dabigatran had the highest risk.

The team was led by Hsien-Yen Chang, an assistant scientist at the Johns Hopkins Bloomberg School of Public Health. They said, “Evidence from observational studies such as ours should prove useful to clinicians in selecting the appropriate anticoagulant for patients after incorporating other information about the safety, efficacy, and effectiveness of these agents, as well as their cost and patients’ preferences regarding anticoagulant therapy.”

Anticoagulants are generally prescribed for patients with atrial fibrillation or stroke, who have a higher risk of having blood clots than healthier individuals.

For this study, the researchers looked into data on over 46,000 patients in the US with commercial insurance. In case of all three medications, the overall risk of gastrointestinal bleeding was mostly the same. Although dabigatran had the greater risk of bleeding and warfarin had the lowest risk, the researchers did not find statistically significant differences.

However, they did find that the risks were higher for patients who were older. Despite the small risk differences, they were unable to rule out the higher risk of bleeding completely for both the new blood thinners as compared to warfarin.

Topics: Warfarin | No Comments »

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