Arthritis causes pain and suffering for millions of people around the world, but it’s also the byproduct of an evolutionary mutation that allowed early humans to make the move from Africa to colder climates tens of thousands of years ago.
Researchers at Stanford University have discovered that a genetic variation made humans shorter and more compact as a means of protecting them against frostbite in the colder temperatures of northern climates, Newsweek reports.
In addition, their limbs got shorter, making them less vulnerable to breaking if people should, say, slip on ice. The downside of this evolutionary adaptation was an increase in the likelihood of osteoarthritis.
The Stanford study, published Monday in Nature Genetics, shows how a variation in the GDF5 gene became more prevalent in humans moving out of Africa into colder climates 50,000 to 100,000 years ago.
A 77-year-old Canadian woman suffering from incurable erosive osteoarthritis is one step closer to legally taking her own life after a judge in Toronto ruled she met a key criteria of Canada’s 2016 medically assisted death law.
The CBC reports that Superior Court Justice Paul Perrell ruled last Monday that the woman’s "natural death is reasonably foreseeable," one of four criteria required for medically assisted death under bill C-14.
Eligible individuals must also have a serious and incurable disease or disability, be in an irreversible state of advanced decline, and suffer from intolerable physical or psychological pain, per the Globe and Mail.
For the 38 million Americans suffering from the effects of debilitating, recurring migraines, it may come as a surprise that relief could be hiding in the pantry. Between 30-40 percent of migraine sufferers may actually be susceptible to food triggers, meaning keeping a food diary and making lifestyle changes could result in much-needed relief.
Stephanie Weaver, author of “The Migraine Relief Plan,” was suffering from daily headaches at the time of her diagnosis, and while medications helped she still was in pain.
“I was just so sick, I was so dizzy,” Weaver, 56, told Fox News.
A common culprit, she found, was eating processed foods that are often high in sodium, sugar and soy, which could trigger migraines. Weaver also discovered onions, citrus fruits, avocados, nuts, caffeine and vinegar were offenders when it came to pain.
In her book, Weaver tweaks some of her favorite recipes to swap out inflammatory ingredients to ensure pain-free eating. For instance, in her “Spicy kale and Swiss chard saute,” she uses green onions instead of regular because the younger variety doesn’t bring on a migraine. She also regularly swaps out vegetable oil in favor of coconut oil.
“The problem with these oils is that they’re high in Omega 6 fatty acids, which can be much more inflammatory,” Weaver said. “And we don’t have a good balance in our diet between Omega 6 and 3. So coconut oil is a saturated fat, which a lot of people used to think was a bad thing, but now we know it can actually be very good for us.”
A pillar of the pain-free diet, Weaver said, is being sure you don’t deprive yourself of favorite dishes to avoid pain. For example, if soy is a trigger, rather than give up tasty Asian dishes, Weaver replaces it with sesame oil, maple syrup and dry mustard.
“When you blend those flavors together, it’s pretty close to teriyaki flavor,” she said, adding that the benefit of using dry mustard means skipping out on fermented jar mustard, which typically contains a lot of salt.
And while it may seem difficult to cut out recipe staples, like vinegar in salad dressing, Weaver’s substitutes make up for it with flavor. Her herb-based salad dressing skips the vinegar and instead includes naturally acidic cherry tomatoes.
Making simple recipe swaps and monitoring how much sleep she gets has changed Weaver’s life.
“I went from basically being sick all the time to being able to write a book, to travel, and be out in the world,” she said. “Even though I do get migraines from time to time, it has made such an enormous difference.”
A handful of drugmakers are taking their first steps toward developing marijuana-based painkillers, alternatives to opioids that have led to widespread abuse and caused the U.S. health regulator to ask for a withdrawal of a popular drug this month.
The cannabis plant has been used for decades to manage pain and there are increasingly sophisticated marijuana products available across 29 U.S. states, as well as in the District of Columbia, where medical marijuana is legal.
There are no U.S. Food and Drug Administration (FDA)-approved painkillers derived from marijuana, but companies such as Axim Biotechnologies Inc, Nemus Bioscience Inc and Intec Pharma Ltd have drugs in various stages of development.
The companies are targeting the more than 100 million Americans who suffer from chronic pain, and are dependent on opioid painkillers such as Vicodin, or addicted to street opiates including heroin.
Opioid overdose, which claimed celebrities including Prince and Heath Ledger as victims, contributed to more than 33,000 deaths in 2015, according to the Centers for Disease Control and Prevention.
Earlier this month, the FDA asked Endo International Plc to withdraw its Opana ER painkiller from the market, the first time the agency has called for the removal of an opioid painkiller for public health reasons. The FDA concluded that the drug’s benefits no longer outweighed its risks.
FIGHTING THE EPIDEMIC
Multiple studies have shown that pro-medical marijuana states have reported fewer opiate deaths and there are no deaths related to marijuana overdose on record.(http://reut.rs/2r74Sbe)
But marijuana-derived drugs could take longer than usual to hit the market as the federal government considers marijuana a "schedule 1" substance – a dangerous drug with no medicinal value – making added approvals necessary. Any drug typically takes at least a decade from discovery to approval.
It could be worth the wait.
An FDA-approved marijuana-based painkiller would ensure consistent dosing and potency, and availability across the country, analysts and experts said.
"Doctors like to be able to write a prescription and know that whatever they wrote is pure and from a blinded, placebo-controlled trial," California-based Nemus’s CEO Brian Murphy told Reuters.
Nemus is testing its product – a synthetic version of the non-psychoactive CBD compound found in cannabis – on rats with chronic pain and expects to report data later this year.
Rival Axim, whose North American headquarters is in New York, is conducting preclinical studies on a chewing gum containing synthetic CBD and THC, a psychoactive compound found in marijuana. The company expects to submit an FDA application to start a trial on opioid-dependent patients this year.
Leading the pack is Israel-based Intec, which recently announced the start of an early-stage study testing its painkiller made of natural CBD and THC extracts.
OTHER OPTIONS
Independent scientists are also looking to find natural, non-pharmaceutical alternatives to opioids, but many have said it is difficult to access government-approved marijuana to conduct research due to supply restrictions.
"It’s taken me seven years to get the DEA license," said Dr Sue Sisley, who is planning to conduct an FDA-regulated study evaluating whether marijuana can help opioid-dependent patients.
There could soon be other alternatives as well. Pfizer Inc and Biogen Inc are among a clutch of drugmakers developing non-opioid painkillers that are in advanced clinical studies.
Still, opioid painkillers are here to stay and will continue to be widely prescribed, especially for patients with acute and post-surgical pain.
The Republican healthcare bill unveiled on Thursday has proposed a drastic cut to the Medicaid budget and could gut, what advocates say, is essential coverage for drug addiction treatment, potentially hampering the fight against opioid abuse.
To ease low back pain, you may want try a downward dog: A new study suggests that doing yoga may be as effective as physical therapy for reducing low back pain .
The study looked at a specific yoga routine designed by experts. Some yoga poses could be harmful to the back.
About 10 percent of U.S. adults have chronic low back pain, according to the study, published today (June 19) in the journal Annals of Internal Medicine . And around 80 percent of U.S. adults will experience low back pain at some point in their lives, according to the National Institutes of Health (NIH).
Low back pain can have a large effect on people’s lives: It’s a leading reason why people miss work, the NIH says. In addition, low back pain appears to take a larger toll on people of racial and ethnic minority groups and on poorer people, according to the study.
One week before New Jersey implements one of the nation’s toughest regulations of prescription opioids, doctors are raising concerns it could go too far.
The law limits initial opioid prescriptions for acute pain to a five-day supply, though it allows doctors to renew it for another 25 days if a patient remains in pain. But as a measure of the stricter checks and balances, the new rules call for doctors to have a consultation with a patient about a request for a prescription renewal to ensure it is really needed.
New Jersey’s law is tougher than national guidelines for prescribers, which limit initial prescriptions to a seven-day supply.
Doctors agree that the opioid addiction epidemic that has led to hundreds of overdose deaths in New Jersey, and thousands nationwide, must be addressed. But some say the new law could make it difficult for patients who truly are in serious pain to obtain relief.
“The rules are very set in stone, it was rushed through, it was done too fast,” Dr. Louis Brusco Jr., chief medical officer of the Morristown Medical Center, told Fox News after a recent forum where state officials explained the new regulations.
State officials say they’re waging no less than a war against a deadly epidemic.
“When I learned that eight of 10 drug overdose deaths began with prescription painkillers, I knew we had to act right away,” New Jersey Attorney General Christopher Porrino told Fox News. “We promulgated these rules in response to an emergency. There’s no time to waste.”
Joseph Fennelly, an internal medicine doctor who has a practice in the town of Madison, agreed that enforcement must go hand in hand with providing the needed treatment to relieve people who are in great pain.
We promulgated these rules in response to an emergency. There's no time to waste.
– New Jersey Attorney General Christopher Porrino
“Medicine is always caught between following the science and law, and recognizing the human side,” Fennelly said.
Brusco stressed that he fully supports the idea that doctors are a crucial part of addressing the opioid addiction epidemic.
“There is no question that prescribers need to do better job of vetting [patient requests for painkillers], and worrying about alternatives and addiction,” Brusco said. “We have to take a burden of responsibility upon ourselves. But we have to remember that we are treating patients. Enforcement has to be fair patients.”
Gov. Chris Christie, who was named to President Donald Trump’s task force on opioid addiction, has made fighting the opioid epidemic a key cause of his administration. Last year, the state disciplined 31 doctors for related offenses, and is criminally prosecuting some of them.
“Bad doctors are a small minority,” Porrino said. “But a bad doctor is worse than a street corner drug dealer – a doctor is someone who is shrouded in the public trust. A doctor has to be treated more harshly than a street drug dealer.”
Bad doctors are a small minority. But a bad doctor is worse than a street corner dealer — a doctor is someone who is shrouded in the public trust.
– New Jersey Attorney General Christopher Porrino
State officials say they will closely monitor compliance with a requirement that prescribers register for the New Jersey Prescription Monitoring Program, or NJPMP, which tracks drug prescriptions, a patient’s opioid history, pharmacies involved, among other things.
If they find that a healthcare provider has “indiscriminately prescribed” opioids, they can expect criminal charges, Porrino said.
There is no question that prescribers need to a better job of vetting, and worrying about alternatives and addiction. We have to take a burden of responsibilty upon ourselves. But we have to remember that we are treating patients. Enforcement has to be fair to patients.
– Dr. Louis Brusco Jr.
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Attorney General Christopher Porrino talks to more than 200 doctors about New Jersey’s tough new opioid prescription rules.
(Attorney General Christopher Porrino talks to more than 200 doctors about New Jersey’s tough new opioid prescription rules.)
“We understand that some feel the law is too strong,” Perrino said. “I can argue that it should be even stronger.”
Elizabeth Llorente is Senior Reporter for FoxNews.com, and can be reached at Elizabeth.Llorente@Foxnews.com. Follow her on https://twitter.com/Liz_Llorente
U.S. regulators are strengthening warnings about the dangers of two types of powerful opioid painkillers, codeine and tramadol, due to risks of slowed breathing and death.
The Food and Drug Administration said Thursday it is requiring makers of the pain medicines to change the products’ labels to warn against giving them to children under age 12, and to limit use in older children. The FDA also says breastfeeding women shouldn’t take them because of possible harm to the baby.
The agency in 2013 had warned against use of codeine and tramadol in children and adolescents to treat pain after surgery to remove tonsils.
Some of the products containing these drugs are only available by prescription, but some over-the-counter cough medicines contain codeine.
The risk that surgery patients will become chronic opioid users may be similar after minor procedures or major operations, a U.S. study suggests.
Three to six months after surgery, new chronic opioid use was about 5.9 percent with minor operations and 6.5 percent with major surgery, the study found. The rate was just 0.4 percent in people who didn’t get surgery.
A history of chronic pain appeared to be a better predictor of post-operative opioid use than the type of surgery, the study found. Compared to patients who didn’t become chronic opioid users after surgery, people who did were more than 50 percent more likely to have had arthritis or chronic back pain before their operations.
"This study shows that new chronic opioid use after surgery may be one of the most common complications after surgery," said lead study author Dr. Chad Brummett of the University of Michigan in Ann Arbor.
"Given that the rates of new chronic use did not differ between major and minor surgery, this suggests that patients continue to use their opioids for reasons other than the pain from the surgery," Brummett added by email.
Addressing patients’ acute pain during their recovery from surgery may be a way to prevent them from becoming a statistic in the opioid epidemic, he suggested.
About 50 million people have surgery that doesn’t require an overnight hospital stay each year. The new findings suggest that more than 2 million people may become chronic opioid users after these operations, researchers note in JAMA Surgery. Adding inpatient procedures might make the tally of post-operative chronic opioid users even higher.
For the study, researchers examined insurance claims data from 2013 to 2014 for about 36,000 adults ages 18 to 64 who had not used opioids in the previous year, at least until the month prior to surgery.
About four in five patients had minor surgical procedures for things like removing varicose veins or hemorrhoids or treating carpal tunnel syndrome. Roughly one in five had major operations like weight-loss surgery, hernia repair or hysterectomies.
Patients commonly need pain relief in the days or weeks after surgery. Researchers defined "persistent opioid use" as filling prescriptions for these narcotics between 90 and 180 days after surgery.
People who smoked before surgery were 34 percent more likely to become persistent opioid users after their operations, the study found. With alcohol and substance use disorders, the odds of opioid use after surgery were 34 percent higher.
The study wasn’t a controlled experiment designed to prove how certain types of surgery or a history of certain habits or medical conditions might cause chronic opioid use.
Other limitations include the potential for some chronic opioid prescriptions to be for conditions or operations not included in the study, the authors note. Some surgeries might also have been misclassified as major or minor procedures.
Even so, the findings add to evidence suggesting that prolonged opioid use after surgery might not be due to pain from operations, the authors conclude.
"Smoking and substance misuse have been previously associated with use of greater dosages of opioids and opioid misuse due, in part, to shared neurobiological mechanisms," said Dr. Michael Hooten of the Mayo Clinic College of Medicine in Rochester, Minnesota.
"In this particular study, the findings suggest that patients with pain prior to surgery were possibly treating other non-surgical sources of pain during the postoperative period using (drugs) initially prescribed for postoperative pain," Hooten, who wasn’t involved in the study, said by email.
SOURCE: http://bit.ly/2pbrc3n JAMA Surgery, online April 12, 2017.
The first time many patients in the United States take prescription opioid painkillers is following surgery. But not everyone puts away the pills: In a new study, researchers found that 6 percent of patients continued to use the drugs for at least three months after surgery.
The researchers wanted to know more about why some people continue to use the drugs while others don’t, so they looked at the types of surgery people had. But it turned out that it didn’t matter whether someone had a major operation, such as bariatric surgery or a hysterectomy, or a minor procedure, such as varicose vein removal; there was no difference in how likely people were to continue to use opioids past the three-month mark.
However, the findings showed that the people who were more likely to continue to use the painkillers were those who smoked, drank alcohol, had certain mood disorders or had chronic pain.
The findings suggest that whether a person continues to take prescription painkillers long after his or her surgery "is not due to surgical pain but addressable patient-level" risk factors, the researchers wrote in the study.
After a night out with friends, a British woman began suffering from a headache she attributed to a hangover. Over a week later, she went to the doctor and was eventually diagnosed with cancer.
Hope Stringer, 24, of Essex, had chronic pain in her left temple, tiredness and blurred vision. Her doctor initially told her she was suffering from migraines and prescribed her painkillers on three separate occasions, news.com.au reported. Stringer demanded an MRI scan, which is when doctors found the soft tissue sarcoma in the base of her skull.
“I’d been completely healthy up until that point and couldn’t believe that what I originally thought was a hangover could be something so serious,” Stringer told news.com.au.
Sarcoma is cancer that develops from certain tissues, like bone or muscle, and can also develop from soft tissue like fat, muscle and nerves.
The tumor in her neck had to be removed, and Stringer underwent six rounds of chemotherapy and radiation. Then, a second tumor was found, forcing doctors to remove a nerve, affecting her left vocal cord to extract the tumor.
Now, Stringer’s voice sounds permanently strained, she told news.com.au, but she expects it to return to normal with vocal coaching and an implant.
She is currently cancer free, and is trying to raise awareness of the signs and symptoms of sarcomas.
A 911 call allegedly made from a survivor of a plane crash turned out to be an actual nightmare. The 75-year-old caller, who has not been identified, had taken Ambien earlier in the night before dialing 911 on May 12, Komo News reported.
The disoriented man called at 2 a.m. to say he was a passenger in a small cargo plane headed to Renton to Oregon when it crashed. He told the 911 operator that he was pinned inside the plane that crashed in a field with trees.
According to the report, the man said three other passengers in the plan were not conscious, and that he couldn’t see anything out the window.
When reached by Komo News, the caller declined to comment but wanted to warn others about the side effects of Ambien. He said he had only taken a half a pill after having trouble sleeping due to a prior surgery.
“It must have seen really real to him for him to call 911,” Dr. Ganis Mazeika, a sleep expert at Sound Sleep Health, told Komo News. “It must have been like a real hallucination for him and that does speak to some of the potency of Ambien.”
Mazeika said a person should only take Ambien if it’s prescribed by a doctor.
People with recurring episodes of binge-eating can be helped with talk therapy or medication, according to a new review of previous studies.
People with binge-eating disorder have brief, psychologically distressing binge-eating episodes multiple times a week for at least three months. The disorder is linked to mental health problems, chronic pain, obesity and diabetes, the researchers write in Annals of Internal Medicine.
Binge-eating disorder will affect about 3 percent of people in the U.S. during their lifetimes, according to lead author Kimberly Brownley, of the University of North Carolina at Chapel Hill, and her colleagues.
Brownley’s team analyzed data from nine studies of psychological treatments and 25 studies of medications in patients with binge-eating disorder.
A type of psychotherapy called cognitive behavioral therapy, a class of drugs known as second-generation antidepressants and the amphetamine known as lisdexamfetamine, or Vyvanse, all helped reduce binge-eating, the researchers found.
The medications also reduced obsessions and compulsions related to the disorder.
CBT can teach people to identify thoughts associated with binge-eating, and help them change their behaviors, Brownley said.
Additionally, lisdexamfetamine and second-generation antidepressants can help decrease people’s impulses to eat.
Examples of second-generation antidepressants include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). The study can’t prove whether one second-generation antidepressant is better than the others, however.
Lisdexamfetamine and topiramate (Topamax) also led to weight loss among people with binge-eating disorders.
"We can’t say if any of these treatments is fundamentally better than the other," Brownley said. "There have been no head-to-head (comparisons) and that’s really essential."
The review shows, however, that treatments are available and people don’t have to suffer through the disorder alone, she added.
In an editorial accompanying the new review, Dr. Michael Devlin, of the Columbia University College of Physicians and Surgeons in New York City says doctors can have a hard time recognizing binge-eating disorder.
"Greater than expected weight dissatisfaction, large weight fluctuations, and depressive symptoms in individuals of any size all should raise the practitioner’s index of suspicion," he suggests.
