[Press release] Discussing alternative medicine choices for better health outcomes
English: A graph of age-adjusted percent of adults who have used complementary and alternative medicine in 2002 in the United States according to the National Center for Complementary and Alternative Medicine. (Photo credit: Wikipedia)
From the 3 October 2014 press release at EurkAlert
Discussing alternative medicine choices for better health outcomes
In the field of medicine there has often been a divide between those who focus on modern medicine and those who prefer alternative practices. But pediatrician Sunita Vohra is a firm believer there should be room for both.
A new study from Vohra, a professor in the Faculty of Medicine & Dentistry’s Department of Pediatrics at the University of Alberta, and a pediatric physician for Clinical Pharmacology with Alberta Health Services, is giving insight into the use of alternative medicines by pediatric cardiac patients and how effective they are seen to be. “We wanted to know if the use of alternative therapies helped or not, and we wanted to know if it hurt them or not,” she says.
The study, published in the journal CMAJ Open, examined the use of alternative therapies such as multivitamins, minerals, chiropractic care and Aboriginal healing in 176 patients at the Stollery Children’s Hospital in Edmonton, Alberta, and the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa, Ontario.
It found 64 per cent of patients at the Stollery Children’s Hospital reported using complementary and alternative medicine products and practices, compared with just 36 per cent at CHEO. Of those patients, Vohra says most had no regrets about their choices.
English: Classification of complementary and alternative therapies Italiano: Classificazione di terapie complementari e alternative (Photo credit: Wikipedia)
“The vast majority felt that they had been helped by the complementary therapy that they took and it was extremely unusual for them to report that they felt an adverse event had occurred because of it.”
The study also found one third of patients and their families did not discuss the use of alternative medicines with their physicians. Vohra believes it shows that patients may be reluctant to discuss their choices if they’re not sure how it will be received by health care providers.
That decision could have important health consequences, says Vohra, who also serves as director of the Complementary and Alternative Research and Education (CARE) program at the University of Alberta, and that patients’ discussing alternative therapies with health professionals is vital in order for them to make informed choices.
“There may be some therapies that help children feel better, but there may be others that, unbeknownst to the family, cause interaction between a specific natural health product and a prescription medicine. In that setting, instead of helping the child get better, harm may actually be happening.”
Vohra stresses the need for open communication and says children’s hospitals in Canada need to do a better job of providing information to patients looking at other avenues to health.
“That communication is essential because the health-care providers and the parents—together we are a team. And everyone’s hope is for that child’s better health.”
Other highlights from the study:
- Multi-vitamins were the most common complementary and alternative medicine products with 71 percent of patients using them, followed by vitamin C (22 per cent), calcium (13 per cent) and cold remedies (11.8 per cent)
- The most common practices include massage (37.5 per cent), faith healing (25 per cent), chiropractic (20 per cent), aromatherapy (15 per cent) and Aboriginal healing (7.5 per cent)
- Almost half (44 per cent) of patients used complementary and alternative medicine products along with conventional treatments. The study’s research was supported by funding from the Sick Kids Foundation and Alberta Innovates Health Solutions.
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Robotic surgery: More complications, higher expense for some conditions
From the 8 October press release at EurkAlert
For benign ovarian surgery, conventional laparoscopy causes fewer complications, is less expensive, than robot-assisted surgery
NEW YORK, NY (October 8, 2014)—For benign gynecologic conditions, robot-assisted surgery involves more complications during surgery and may be significantly more expensive than conventional laparoscopic surgery, according to a study by researchers at Columbia University Medical Center (CUMC). The results were published online today in Obstetrics & Gynecology.
Robot-assisted surgery was first widely used for radical prostatectomy. For procedures such as prostatectomy, where there were previously no minimally invasive options, robot-assisted laparoscopy often offered a dramatic improvement. But in the two gynecologic surgeries looked at in this study—oophorectomy (removal of one or both ovaries) and cystectomy (removal of an ovarian cyst) —surgeons already had laparoscopic options. The rate of robot-assisted surgery increased from 3.5 percent in 2009 to 15.0 percent in 2012 for oophorectomy and from 2.4 percent in 2009 to 12.9 percent in 2012 for cystectomy.
The CUMC researchers analyzed data on conventional laparoscopic and robot-assisted procedures performed on 87,514 women for benign gynecologic conditions between 2009 and 2012. The procedures took place at 502 U.S. hospitals.
The study showed a small but statistically significant overall increase in intraoperative (during surgery) complications, mainly ureteral and bladder injuries, with the robot-assisted procedures—3.4 percent for robot-assisted oophorectomy vs. 2.1 percent for conventional laparoscopic oophorectomy; 2.0 percent for a robot-assisted cystectomy vs. 0.9 percent for a conventional laparoscopic cystectomy. It is possible that the rate of complications will decline as surgeons become more experienced in robotic technology.
“The findings raise questions about the potential utility of robotic-assisted surgery for ovarian cancer and suggest that further studies are needed prior to considering these procedures as a standard of care,” said co-author Jason Wright, MD, Sol Goldman Associate Professor of Gynecologic Oncology and chief, Division of Gynecologic Oncology, Columbia University College of Physicians and Surgeons.
The researchers also found robot-assisted procedures to be more expensive. The median total cost for robot-assisted oophorectomy was $7,426, while for conventional laparoscopic oophorectomy it was $4,922. The median total cost for robot-assisted cystectomy was $7,444; for conventional laparoscopic cystectomy it was $4,133.
“With the rapid rise in the cost of cancer care, we need to make sure that public policies encourage comparative studies prior to widespread dissemination of new technologies,” said another co-author, Dawn L. Hershman, MD, MS, associate professor of medicine at the College of Physicians and Surgeons, associate professor of epidemiology at Columbia’s Mailman School of Public Health, and leader of the Breast Cancer Program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia.
###The paper is titled, “Comparative Effectiveness of Robotic-Assisted Compared to Laparoscopic Adnexal Surgery for Benign Gynecologic Disease.” The other authors are: Alessandra Kostolias, MD (CUMC), Cande V. Ananth, PhD, MPH (CUMC), William M. Burke, MD (CUMC), Ana I. Tergas, MD (CUMC), Eri Prendergast, MS (CUMC), Scott D. Ramsey, MD, PhD (Fred Hutchinson Cancer Research Center), and Alfred I. Neugut, MD, PhD (CUMC).
Dr. Wright (R01CA169121-01A1) and Dr. Hershman (R01 CA166084) are recipients of grants and Dr. Tergas is the recipient of a fellowship (R25 CA094061-11) from the National Cancer Institute.
The authors declare no financial or other conflicts of interest.
Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cumc.columbia.edu or columbiadoctors.org.
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[Report]What has research over the past two decades revealed about the adverse health effects of recreational cannabis use?
Cannabis sativa (Photo credit: Wikipedia)
From the 2014 article in the journal Addiction
Research in the past 20 years has shown that driving while cannabis-impaired approximately doubles car crash risk and that around one in 10 regular cannabis users develop dependence. Regular cannabis use in adolescence approximately doubles the risks of early school-leaving and of cognitive impairment and psychoses in adulthood. Regular cannabis use in adolescence is also associated strongly with the use of other illicit drugs. These associations persist after controlling for plausible confounding variables in longitudinal studies. This suggests that cannabis use is a contributory cause of these outcomes but some researchers still argue that these relationships are explained by shared causes or risk factors. Cannabis smoking probably increases cardiovascular disease risk in middle-aged adults but its effects on respiratory function and respiratory cancer remain unclear, because most cannabis smokers have smoked or still smoke tobacco.
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[Repost] The Commission for Environmental Cooperation releases its first-ever, multi-year examination of reported industrial pollution in North America
http://www.cec.org/Page.asp?PageID=122&ContentID=25816&SiteLanguageId=1
From the press release
The latest edition of the Taking Stock report details pollutant releases and transfers across the region from 2005 through 2010, with an in-depth review of releases from the pulp and paper industry.
Montreal, 1 October 2014—The Commission for Environmental Cooperation (CEC) has released a comprehensive report on the changing face of industrial pollution in North America, covering the years 2005 through 2010. This is the first time an edition of the CEC’s Taking Stock series, which gathers data from pollutant release and transfer registers (PRTRs) in Canada, Mexico and the United States, has analyzed North American pollutant information over an extended timeframe.
This volume of Taking Stock documents pollutant releases and transfers reported over the six-year period by approximately 35,000 industrial facilities across the region. Key findings include:
- Total reported amounts of pollutants increased by 14 percent (from over 4.83 billion kilograms in 2005 to more than 5.53 billion kilograms in 2010), driven by releases to land (108-percent increase) and off-site disposal (42-percent increase). These increases reflect the introduction of Canada’s more comprehensive reporting requirements on tailings and waste rock, as well as on total reduced sulfur (TRS), resulting in more complete reporting by the metal ore mining and oil and gas extraction sectors in Canada.
- Most other types of releases and transfers declined over this period—including releases to air from electric utilities, mainly in the United States, which declined by 36 percent. Changes in regulations for fossil fuel–based power plants, along with facility closures, were the drivers of these decreases.
- There was also a 38-percent decrease in releases to air of substances in four categories that have significant potential to cause harm to human health or the environment: known or suspected carcinogens, developmental or reproductive toxicants, persistent, bioaccumulative and toxic (PBT) substances, and metals.
By providing details at the country level, Taking Stock also highlights the gaps in the picture of North American industrial pollution that are created by differences in national PRTR reporting requirements and practices. For example:
- Of the more than 500 pollutants reported across the region every year, only 60 are common to all three PRTRs.
- Oil and gas extraction, a key sector tracked in Canada and that ranks among the top sectors for reported releases and transfers each year, is not subject to reporting in the United States. Mexican data show a low level of reporting by oil and gas extraction facilities.
- Compared to the United States and Canada, Mexican data show wider fluctuations in reporting between 2005 and 2010, reflecting the fact that Mexico’s PRTR is relatively new.
“As a result of ongoing collaboration among the three countries’ PRTR programs and the CEC, we are now able to track industrial pollutant releases and transfers across North America and over time to identify tendencies, as well as important gaps, in reporting. By establishing linkages between PRTR data and facilities’ environmental sustainability efforts, Taking Stock supports the needs of the private sector, governments, citizens, and communities concerned with and affected by North American industrial pollution,” said Irasema Coronado, CEC Executive Director.
Decreases in pollutant releases from pulp and paper mills—a look at the driving factors
This year’s report also takes advantage of six years of North American PRTR data to examine releases reported by pulp and paper mills—which have consistently ranked among the top sectors for releases to air and water in North America. The data show that between 2005 and 2010, the sector’s releases to air decreased by 19 percent and releases to water by 6 percent. Taking Stock identifies the drivers of these decreases, through data analyses, a survey of mills, and information from industry representatives. Among the findings:
- A key driver of the decreases seen over this period has been the shutdown of several facilities in Canada and the United States (the two countries with the most reporting from this sector).
- Emissions typically associated with pulp and paper mills include volatile organic compounds (VOCs), methanol, hydrogen sulfide, phosphorous, and formaldehyde, among others. However, some of these pollutants are not subject to reporting in one or more of the three countries (e.g., methanol in Mexico), creating challenges when analyzing the pollution profiles of pulp and paper mills.
- While factors such as new emissions regulations have played a role in the decline in releases over this period, the report also shows that facilities’ own environmental engagement, as well as customer demand for environmentally-friendly products, have had impacts—with mills adopting environmental management decisions that include pollution prevention and mitigation practices.
Explore North American PRTR data online
The data presented in the Taking Stock report can be searched using the CEC’s Taking Stock Onlinetool, which is updated annually with data from North America’s three PRTRs. It allows users to:
- explore information on industrial pollutant releases and transfers;
- generate reports in a variety of formats, including pie charts and spreadsheets;
- create maps and view them using Google Earth; and
- analyze PRTR data with respect to other information, such as locations of watersheds, rivers, lakes, and population centers, using geospatial data from the North American Environmental Atlas.
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Partners in Information Access for the Public Health Workforce – Great site to learn and keep updated about issues afffecting all
Keeps you informed about news in public health, upcoming meetings, and new public health online resources
Partners in Information Access for the Public Health Workforce is a collaboration of U.S. government agencies, public health organizations and health sciences libraries. This comprehensive collection of online public health resources includes the following topic pages. Each has links to news items; links to relevant agencies, associations, and subtopics; literature and reports; data tools and statistics; grants and funding; education and training; conferences and meetings; jobs and careers; and more
Main Topic pages include material on
- Health Promotion and Health Education -news and resources
- Health Data Tools and Statistics- links to international, national, state, county and local data resources
- Grants and Funding
- Education and Training -many free and online
- Conferences and Meetings
- Finding People – directories of people and organizations in public health.
- Discussion and E-mail Lists
- Jobs and Careers
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Caution: Some Over-the-Counter Medicines May Affect Your Driving
http://www.fda.gov/forconsumers/consumerupdates/ucm417426.htm
From the FDA Web site
Anyone who operates a vehicle of any type—car, bus, train, plane, or boat—needs to know there are over-the-counter medicines that can make you drowsy and can affect your ability to drive and operate machinery safely.
Over-the-counter medicines are also known as OTC or nonprescription medicines. All these terms mean the same thing: medicines that you can buy without a prescription from a healthcare professional. Each OTC medicine has a Drug Facts label to guide you in your choices and to help keep you safe. OTC medicines are serious medicines and their risks can increase if you don’t choose them carefully and use them exactly as directed on the label.
According to Ali Mohamadi, M.D., a medical officer at FDA, “You can feel the effects some OTC medicines can have on your driving for a short time after you take them, or their effects can last for several hours. In some cases, a medicine can cause significant ‘hangover-like’ effects and affect your driving even the next day.” If you have not had enough sleep, taking medicine with a side effect that causes drowsiness can add to the sleepiness and fatigue you may already feel. Being drowsy behind the wheel is dangerous; it can impair your driving skills.
Choosing and Using Safely
You should read all the sections of the Drug Facts label before you use an OTC medicine. But, when you know you have to drive, it’s particularly important to take these simple steps:
First, read the “active ingredients” section and compare it to all the other medicines you are using. Make sure you are not taking more than one medicine with the same active ingredient. Then make sure the “purpose” and “uses” sections of the label match or fit the condition you are trying to treat.
Next, carefully read the entire “Warnings” section. Check whether the medicine should not be used with any condition you have, or whether you should ask a health care professional whether you can use it. See if there’s a warning that says when you shouldn’t use the medicine at all, or when you should stop using it.
The “When using this product” section will tell you how the medicine might make you feel, and will include warnings about drowsiness or impaired driving.
Look for such statements as “you may get drowsy,” “marked drowsiness will occur,” “Be careful when driving a motor vehicle or operating machinery” or “Do not drive a motor vehicle or operate machinery when using this product.”
Other information you might see in the label is how the medicine reacts when taken with other products like alcohol, sedatives or tranquilizers, and other effects the OTC medicine could have on you. When you see any of these statements and you’re going to drive or operate machinery, you may want to consider choosing another medicine for your problem this time. Look for an OTC medicine that treats your condition or problem but has an active ingredient or combination of active ingredients that don’t cause drowsiness or affect your ability to drive or operate machinery.
Talk to your healthcare professional if you need help finding another medicine to treat your condition or problem. Then, check the section on “directions” and follow them carefully.
Here are some of the most common OTC medicines that can cause drowsiness or impaired driving:
- Antihistamines: These are medicines that are used to treat things like runny nose, sneezing, itching of the nose or throat, and itchy or watery eyes. Some antihistamines are marketed to relieve cough due to the common cold. Some are marketed to relieve occasional sleeplessness. Antihistamines also can be added to other active ingredients that relieve cough, reduce nasal congestion, or reduce pain and fever. Some antihistamines, such as diphenhydramine, the active ingredient in Benadryl, can make you feel drowsy, unfocused and slow to react.
- Antidiarrheals: Some antidiarrheals, medicines that treat or control symptoms of diarrhea, can cause drowsiness and affect your driving. One of these is loperamide, the active ingredient in Imodium.
- Anti-emetics: Anti-emetics, medicines that treat nausea, vomiting and dizziness associated with motion sickness, can cause drowsiness and impair driving as well.
“If you don’t read all your medicine labels and choose and use them carefully,” says Dr. Mohamadi, “you can risk your safety. If your driving is impaired, you could risk your safety, and the safety of your passengers and others.”
Please visit, Over-the-Counter Medicines and Driving, for the audio and slide presentation for more about driving and OTC medicines and with practice looking at Drug Facts labels.
This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.
For More Information
- Driving When Using Medicine – Links to Additional Resources
- FDA Basics Webinar June 30, 2014: Over-The-Counter Medicines and Driving
- Driving When You Are Taking Medications
- Over-the-Counter Drug Facts Label – Video
- Medicines in My Home
- National Transportation Safety Board
- National Highway Traffic Safety Administration
Related Consumer Updates
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[Repost] BreastCancerAction says Stop the Distraction; rethinking awareness
Breast CancerAction says Stop the Distraction; rethinking awareness.
From the 3 October 2014 post at HealthNewsReview
As the Green Bay Packers were walloping the Minnesota Vikings on Thursday Night Football last night, the NFL’s “A Crucial Catch Day” campaign for breast cancer – which “is focused on the importance of annual screenings, especially for women who are 40 and older” – was on display at the stadium. Banners similar to this one appeared in the stadium. Some players wore pink gloves or other pink paraphernalia. It was the first game of October, the first of many more pink pigskin promotions to come throughout this month.
But the Breast Cancer Action group, well known for its “Think Before You Pink” campaign, calls the NFL campaign “a distraction.” The group names the NFL as part of “a six-point take-down of pink ribbon cause marketing and the broader culture of “pink” which expands BCAction’s long-standing commitment to addressing exploitation, corporate profiteering and hypocrisy in breast cancer fundraising. The six points, according to Breast Cancer Action, are:
…..
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[Repost] The Healthy Woman: A Complete Guide for all Ages
The Healthy Woman: A Complete Guide for all Ages | Publications.USA.gov.
Can be downloaded for free!
A comprehensive reference with helpful charts and personal stories. The guide covers major diseases, aging mental health, reproductive health, nutrition and alternative medicine. It also provices advice on common screening tests and immunizations you may need. (Previous item number: 107W)
Source: U.S. Department of Health and Human Services
Released: 2008
Pages: 500
[Repost] Yay for BMJ journal news release for caveats about observational study!
An example of a heart attack, which can occur after the use of a performance-enhancing drug. (Photo credit: Wikipedia)
Yay for BMJ journal news release for caveats about observational study!.
From the 19 August 2014 post at HealthNewsReview
Posted by Gary Schwitzer in Journal practices, Limits of observational studies, News releases
I’ve criticized them many times, so now it’s time to salute them.
And let’s hope the news release writers for BMJ journals continue this practice.
This week, in a news release about a paper in one of the journals published by the BMJ, the Journal of Epidemiology & Community Health, was this caveat:
“This is an observational study so no definitive conclusions can be drawn about cause and effect, and the researchers admit that some potentially important risk factors, such as family history of heart disease/stroke and genetic influences were not known.”
Such a statement of limitations has been missing many times in past news releases from/about BMJ journals.
I can’t see everything, so I may have missed other good examples in the past.
Here is the full text of the news release in question:
Good neighbours and friendly local community may curb heart attack risk
Might extend social support network which is also linked to lower cardiovascular disease risk, say researchers
[Perceived neighbourhood social cohesion and myocardial infarction Online First doi 10.1136/jech-2014-204009]
Having good neighbours and feeling connected to others in the local community may help to curb an individual’s heart attack risk, concludes research published online in the Journal of Epidemiology & Community Health.
Current evidence suggests that the characteristics of an area in which a person lives can negatively affect their cardiovascular health. This includes, for example, the density of fast food outlets; levels of violence, noise, and pollution; drug use; and building disrepair.
But few studies have looked at the potential health enhancing effects of positive local neighbourhood characteristics, such as perceived neighbourhood social cohesion, say the authors.
They therefore tracked the cardiovascular health of over 5000 US adults with no known heart problems over a period of four years, starting in 2006. Their average age was 70, and almost two thirds were women and married (62%).
All the study participants were taking part in the Health and Retirement Study, a nationally representative study of American adults over the age of 50, who are surveyed every two years.
In 2006 participants were asked to score on a validated seven point scale how much they felt part of their local neighbourhood; if they felt they had neighbours who would help them if they got into difficulty; whether they trusted most people in the area; and felt they were friendly.
Potentially influential factors, such as age, race, gender, income, marital status, educational attainment, outlook and attitude, social integration, mental health, lifestyle, weight, and underlying health issues, such as diabetes and high blood pressure, were all taken into account.
During the four year monitoring period, 148 of the 5276 participants (66 women and 82 men) had a heart attack.
Analysis of the data showed that each standard deviation increase in perceived neighbourhood social cohesion was associated with a 22% reduced risk of a heart attack. Put another way, on the seven-point scale, each unit increase in neighbourhood social cohesion was associated with a 17% reduced risk of heart attack.*
This association held true even after adjusting for relevant sociodemographic, behavioural, biological, and psychosocial factors, as well as individual-level social support.
The researchers say their findings echo those of other studies which have found a link between well integrated local neighbourhoods and lower stroke and heart disease risk.
This is an observational study so no definitive conclusions can be drawn about cause and effect, and the researchers admit that some potentially important risk factors, such as family history of heart disease/stroke and genetic influences were not known. But a strong social support network of friends and family has been linked to better health, so friendly neighbourhoods might be an extension of that, they say.
“Perceived neighbourhood social cohesion could be a type of social support that is available in the neighbourhood social environment outside the realm of family and friends,” they write.
And tight-knit local communities may help to reinforce and ‘incentivise’ certain types of cohesive behaviours and so exclude antisocial behaviours, they suggest.
——————–
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About
This blog presents a sampling of health and medical news and resources for all. Selected articles and resources will hopefully be of general interest but will also encourage further reading through posted references and other links. Currently I am focusing on public health, basic and applied research and very broadly on disease and healthy lifestyle topics.
Several times a month I will post items on international and global health issues. My Peace Corps Liberia experience (1980-81) has formed me as a global citizen in many ways and has challenged me to think of health and other topics in a more holistic manner.
Do you have an informational question in the health/medical area?
Email me at jmflahiff@yahoo.com
I will reply within 48 hours.
This blog is a companion site to my Health and Medical News and Resources Web site with…
- Great places to start (locating health information)
- Links to help from others (as health care providers and support groups)
- Interactive tools (as health calculators and apps)
- Select related news sites and blogs
My professional work experience and education includes over 15 years experience as a medical librarian and a Master’s in Library Science. In my most recent position I enjoyed contributing to our library’s blog, performing in depth literature searches, and collaborating with faculty, staff, students, and the general public.
While I will never be be able to keep up with the universe of current health/medical news, I subscribe to the following to glean entries for this blog.
- Science Daily – Your source for the latest research news
- MedlinePlus email updates from the US National Institutes of Health
- Partners in Information Access for the Public Health Workforce – a collaboration of U.S. government agencies, public health organizations and health sciences libraries
- US Agency for Healthcare Research and Quality (AHRQ) news now with updates on the agency’s efforts to “improve the quality, safety, efficiency, and effectiveness of health care for all Americans”
- Research Buzz, “news about search engines, digital archives, online museums, databases, and other Internet information collections since 1998”
- Scout Report, a “weekly publication offering a selection of new and newly discovered Internet resources of interest to researchers and educators”
- KevinMD.com -“Social Media’s leading physician voice”
- EurekAlert-Medicine and Health
Health and Medical News and Resources 