Many doctors over-prescribing instead of using drug-free conservative approaches

With almost half of all Americans using a prescription in the past month according to the Centers for Disease Control and Prevention, experts are worried about the rampant practice of over-prescribing.

And other statistics related to the issue are of grave concern:

• The majority of patients under age 65 years receive at least one prescription drug annually.
• Four million prescriptions for long-acting painkillers are written every year; painkillers are the most commonly prescribed drugs in America.
• In 2007 there were 11,500 deaths related to painkillers; experts say the drugs do not always deliver substantial pain relief, and carry a high risk of addiction, side effects, and death.

Gordon D. Schiff, M.D., from Harvard Medical School, Boston, with colleagues in the medical and pharmacy divisions of the University of Illinois at Chicago, outlines a series of steps in their published report that appeared Archives of Internal Medicine,one of the JAMA/Archives journals, that can be taken to rein in prescription writing. “Although others have used labels such as healthy skepticism, more judicious, rational, careful, or cautious prescribing,” they write, “we believe that the term conservative prescribing conveys an approach that goes beyond the oft-repeated physician’s mantra, ‘first, do no harm.’”

Continue reading »

Consuming olive oil may prevent strokes

If you, or someone you know, is 65 or older, researchers are now suggesting the inclusion of more olive oil in your diet to help prevent stroke.

In a study by the University of Bordeaux of 7,625 people aged 65 and older, those who regularly used olive for cooking and as a dressing had a 41 percent lower risk of stroke compared with those who never consumed olive oil.

“Our research suggests that a new set of dietary recommendations should be issued to prevent stroke in people 65 and older,” said study author Cécilia Samieri, PhD, with the University of Bordeaux and the National Institute of Health and Medical Research (INSERM) in Bordeaux, France. “Stroke is so common in older people and olive oil would be an inexpensive and easy way to help prevent it.”

Olive oil is associated with other proven health benefits as well, such as protective effects against diabetes, high blood pressure, high cholesterol, and diabetes.

Hypnosis helps the healing process after surgery

In Belgium, anesthesiologists who used a combination of hypnosis and local anesthesia, vs. only general anesthesia, found that patients’ opioid drug use was greatly diminished, as well as time spent in the recovery room and the length of their hospital stay.

The hypnosis was performed on breast cancer and thyroid patients. ”In all of these procedures local anaesthesia is feasible but not, on its own, sufficient to ensure patient comfort,” says Professor Roelants from the Department of Anaesthesiology at the Cliniques Universitaires St. Luc, UCL, Brussels, Belgium.

“In addition to reducing drug use and hospital stay time, being able to avoid general anaesthesia in breast cancer surgery is important because we know that local anaesthesia can block the body’s stress response to surgery and could therefore reduce the possible spread of metastases,” said Professor Roelants.

The anesthesiologists use eye fixation, progressive muscle relaxation, or the retrieval of a pleasant memory to focus a patient’s attention on one particular point, enabling a modified state of consciousness, with a different perception of the world.

“There is still a lot of debate around the exact mechanism that allows hypnosis to reduce pain perception,” said Professor Roelants,” but what it absolutely clear is that it does so. The result is that one third of thyroidectomies and a quarter of all breast cancer surgery carried out at the UCL hospital are performed under local anaesthetic with the patient under hypnosis.”

The anesthesiologists have confirmed that, regardless of sex or age, and if the patient is motivated, ready to co-operate, and trusts the doctors, hypnosis will work. It can also be applied to surgical patients who undergo carotid artery surgery, inguinal hernia, knee arthroscopy, gynaecological surgery, ophthalmology, ear nose and throat, plastic surgery and egg retrieval for fertility treatment.

The research findings were presented June 12, 2011 at the European Anaesthesiology Congress in Amsterdam.

Canned foods have been found to have high levels of BPA

The U.S. FDA recently found 71 out of 78 canned foods tested were contaminated with bisphenol A, commonly known as BPA. One can of green beans contained as much as 730 parts per billion of the synthetic hormone, which is usually found as a component in epoxy can linings. That level of concentration has been associated in laboratory studies with permanent toxicity. In the FDA testing, green beans, peas, chili and refried beans were the food products that contained the highest contamination levels.

The “safe” exposure level established by EPA, at 50 micrograms of BPA per kilogram of body weight per day (50 ug/kg/d), is considered up to 25 times higher than harmful levels. Establishing safe public levels continues to be concern, as BPA is known to cause harmful effects, specifically disrupting the body’s hormone system, since it mimics estrogen – even at low doses.

“Federal health agencies warn parents to limit their children’s BPA exposures,” Environmental Working Group’s senior analyst Sonya Lunder, M.P.H., said. “But with the chemical found in canned food, store receipts and even umbilical cord blood, we think that ‘buyer beware’ isn’t good health policy. Systematic protections for children are the only solution.” EWG has forcefully advocated for health protective safety standards to limit BPA exposures for infants and children.

Hundreds of animal and human studies have linked BPA to abnormal reproductive system development, diminished intellectual capacity, behavioral problems, reproductive system cancer, obesity, diabetes, early puberty, resistance to chemotherapy, asthma, cardiovascular system problems and other chronic disorders. Worker studies have shown lower sperm counts and other ailments of the male reproductive system.

Prescription drugs now average 70 side effects

The side effects shown on the list that accompanies prescription drugs now averages 70 reactions per drug, posing an overwhelming problem for physicians as they try to weigh the risks and benefits when prescribing for patients. The more commonly prescribed drugs average around 100 side effects – one drug even listed 525 possible reactions.

A new study of drug labels from the Regenstrief Institute and the Indiana University School of Medicine demonstrates the complexity of drug labels. The lead author, Jon Duke, M.D., Regenstrief Institute investigator and assistant professor of medicine at the IU School of Medicine, said that much of the labeling has less to do with true toxicity than with protecting manufacturers from potential lawsuits.

The greatest number of side effects was found in antidepressants, antiviral medications and newer treatments for restless legs syndrome and Parkinson’s disease. In general, medications typically used by psychiatrists and neurologists had the most complex labels, while drugs used by dermatologists and ophthalmologists had the least.

Yoga improves breast cancer patients’ quality of life

Yogic breathing, postures, meditation and relaxation techniques that are part of a regular yoga practice helps breast cancer patients with improved physical functioning, better general health, and lower cortisol (stress hormone) levels. The women are also better able to find meaning in their cancer experience.

The MD Anderson Cancer Center at the University of Texas provided findings on 163 women with breast cancer as part of a study to assess the benefits of yoga vs. simple stretching exercises. The study is part of an ongoing effort to scientifically validate the age-old belief that mind-body interventions have a beneficial impact on the health of cancer patients. The research was conducted in collaboration with India’s largest yoga research institution, Swami Vivekananda Yoga Anusandhana Samsthana in Bangalore, India.

In the study of 163 breast cancer patients, those who completed radiation treatment and participated in the yoga and stretching groups were the only women to report a reduction in fatigue. They also had the steepest decline in their cortisol levels throughout the day. This is one of the more important findings, since higher stress hormone levels across the day, known as a blunted circadian cortisol rhythm, have been linked to worse outcomes in breast cancer.

According to Lorenzo Cohen, PhD, professor and director of the Integrative Medicine Program at MD Anderson, developing a yoga practice also helps patients after completing cancer treatment. “The transition from active therapy back to everyday life can be very stressful as patients no longer receive the same level of medical care and attention. Teaching patients a mind-body technique like yoga as a coping skill can make the transition less difficult.”

New salt findings contradict long-standing thinking

A report recently published in the prestigious Journal of the American Medical Association created a controversy over its results that indicated a low-salt diet could lead to heart disease.

Belgium researchers followed almost 3,700 people for an eight-year period, ending when the participants were approximately 49 years old, and found that those individuals who consumed the lowest amount – approximately 2,500 mg per day – were no more likely to develop hypertension (high blood pressure) compared with individuals who consumed an average of 6,000 mg per day. There was also a higher rate of death from heart disease (4 percent) associated with the lowest amounts of consumption, whereas the rate was only 1 percent among those who consumed the highest amounts.

A couple of other recent studies also point to similar results: A national nutrition survey published September 2008 in the Journal of General Internal Medicine found that low sodium intake was linked to higher cardiovascular mortality, and a study published in the April 2011 edition of Diabetes Care found that type 1 diabetes patients with the lowest sodium intake were most likely to die during its 10-year duration.

The Centers for Disease Control and Prevention was quick to publicly criticize the Belgium study. “Salt increases blood pressure.  More salt leads to higher blood pressure and higher blood pressure leads to worse cardiovascular health,” said Dr. Briss of the CDC. He also stated the study was too small, the participants too young, and some of the participants were heavy smokers.

U.S. public health officials set the maximum recommended daily consumption at 2,300 mg, while the American Heart Association recommends no more than 1,500 mg per day.

Canadian doctors secretly use placebos, too

In a survey of Canadian physicians and psychiatrists, one in five admitted to administering placebos to their patients. Approximately 35 percent of the survey’s psychiatrists also secretly prescribed “subtherapeutic” doses for their patients. More than 60 percent of the psychiatrists believe that placebos have therapeutic value; only 2 percent felt they have no clinical benefit at all.

“Psychiatrists seem to place more value in the influence placebos wield on the mind and body,” says McGill University Psychiatry Professor and Senior Lady Davis Institute Researcher Amir Raz, who led the survey.

“While most physicians probably appreciate the clinical merits of placebos, limited guidelines and scientific knowledge, as well as ethical considerations, impede open discussion about the best way we may want re-introduce placebos into the medical milieu,” says Raz. He adds, “This survey provides a valuable starting point for further investigations into Canadian physicians’ attitudes towards and use of placebos.”

Medical providers referring patients to mind-body therapies

Approximately one-third of Americans use mind-body therapies, such as yoga, meditation, and tai chi, to complement their healthcare. Now, a recent survey by Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School shows that 1 in 30 Americans are referred to those therapies by their medical provider.

“There’s good evidence to support using mind-body therapies clinically,” said lead author Aditi Nerurkar, MD, Integrative Medicine Fellow, Harvard Medical School and BIDMC. “Still, we didn’t expect to see provider referral rates that were quite so high.”

The study shows that attitudes about healing are changing and that the use of complementary medicine is on the rise. This is especially true for patients who are sicker and are seeking alternatives to their failed traditional treatments.

“What we learned suggests that providers are referring their patients for mind-body therapies as a last resort once conventional therapeutic options have failed. It makes us wonder whether referring patients for these therapies earlier in the treatment process could lead to less use of the health care system, and possibly, better outcomes for these patients,” said Nerurkar.

Green environments are an essential component to overall health

People who routinely spend more time in green environments experience greater overall health, according to University of Illinois environment and behavior researcher Frances “Ming” Kuo, who has studied the effect of green space on humans in a number of settings in order to prove or disprove folklore notions that nature has healing powers. After undergoing rigorous scientific scrutiny, Kuo says the benefits of nature are indisputable.

“In greener settings, we find that people are more generous and more sociable. We find stronger neighborhood social ties and greater sense of community, more mutual trust and willingness to help others.

“In less green environments, we find higher rates of aggression, violence, violent crime, and property crime—even after controlling for income and other differences,” Kuo said. “We also find more evidence of loneliness and more individuals reporting inadequate social support.”

Additional findings by Kuo include:

• Access to nature and green environments yields better cognitive functioning, more self-discipline and impulse control, and greater mental health overall.
• Less access to nature is linked to exacerbated attention deficit/hyperactivity disorder symptoms, higher rates of anxiety disorders, and higher rates of clinical depression.

If that isn’t convincing enough, Kuo says the impacts of parks and green environments on human health extend beyond social and psychological health outcomes to include physical health outcomes.

• Greener environments enhance recovery from surgery, enable and support higher levels of physical activity, improve immune system functioning, help diabetics achieve healthier blood glucose levels, and improve functional health status and independent living skills among older adults.
• By contrast, environments with less green space are associated with greater rates of childhood obesity; higher rates of 15 out of 24 categories of physician-diagnosed diseases, including cardiovascular diseases; and higher rates of mortality in younger and older adults.

Because of this strong correlation between human health and green environments, Kuo encourages city planners to design communities with more public green spaces in mind, not as mere amenities to beautify a neighborhood, but as a vital component that will promote healthier, kinder, smarter, more effective, more resilient people.