Lifestyle « Weekly Gravy

Offering both the promise of better patient compliance with health care, but also fears of a medical “Big Brother,” a newly approved “digital pill” allows physicians to track whether or not it’s been ingested by patients. The U.S. Food and Drug Administration has given the nod to Abilify MyCite, for use in patients with schizophrenia, an add-on treatment for depression, and to help control episodes of either manic or “mixed” episodes for people with bipolar disorder. As explained in an FDA news release, the pill contains a sensor that communicates with a wearable patch. This patch in turn sends signals to the patients’ smartphone, telling them whether or not they’ve taken the pill, along with the pertinent dates and times. “Patients can also permit their caregivers and physician to access the information through a web-based portal,” the FDA noted — opening the possibility that others can track a patient’s adherence (or lack thereof) to drug therapy. “Being able to track ingestion of medications prescribed for mental illness may be useful for some patients,” Dr. Mitchell Mathis, director of psychiatry products in the FDA’s Center for Drug Evaluation and Research, said in the news release. “The FDA supports the development and use of new technology in prescription drugs and is committed to working with companies to understand how technology might benefit patients and prescribers.” Otsuka Pharmaceutical… read on >

Even if researchers were to find a groundbreaking new treatment for Alzheimer’s disease, millions of people might not benefit from it, new research reveals. That’s because the U.S. health care system doesn’t have the ability to quickly implement a newly approved treatment on a widespread scale, according to a report from the RAND Corporation. For instance, there aren’t enough doctors to diagnose all the people with early signs of dementia who would be good candidates for such a treatment, the researchers explained. In addition, scanners used to detect the disease are in short supply, and there aren’t enough treatment centers that could administer the therapy to patients. An estimated 5.5 million Americans are currently living with Alzheimer’s disease. By 2040, that number is expected to jump to 11.6 million, according to the study authors. “While significant effort is being put into developing treatments to slow or block the progression of Alzheimer’s dementia, little work has been done to get the medical system ready for such an advancement,” said study lead author Jodi Liu. She is a policy researcher at RAND, a nonprofit research group. “While there is no certainty an Alzheimer’s therapy will be approved soon, our work suggests that health care leaders should begin thinking about how to respond to such a breakthrough,” Liu explained in a RAND news release. At least 10 therapies… read on >

If you love to while away a weekend watching a season’s worth of episodes from a favorite TV series, you may inadvertently put yourself at risk for developing a dangerous blood clot. When researchers compared people who reported watching TV more often to those who seldom or never watched TV, the risk of a venous thromboembolism (VTE) jumped by 70 percent. A VTE is a type of blood clot that can block blood flow in a vein, according to the American Heart Association. “I don’t think TV watching itself is an evil thing, but everything in moderation,” said study co-author Dr. Mary Cushman. She’s a professor of medicine at the University of Vermont’s Larner Medical College. “Think about how you’re spending your time, and see if you can take advantage of your TV time to get some activity in,” advised Cushman. Her own solution? Walking on her treadmill when she watches TV. Cardiologist Dr. James Catanese concurred. He said when he watches TV, he rides a stationary bike. If you’re not going to exercise while watching TV, he recommended watching an episode and then doing something physical for 20 minutes. “Physical inactivity is a risk factor for every cardiovascular disease, including VTEs,” said Catanese, chief of cardiology at Northern Westchester Hospital in Mount Kisco, N.Y. He wasn’t involved in the research. The study included more… read on >

Need another reason to keep your weight under control? Excess weight can cause dislocation of your knee and may even lead to a complication that results in amputation of your leg. A new study attributes a surge in dislocated knees to the U.S. obesity epidemic. “Obesity greatly increases the complications and costs of care,” said study lead author Dr. Joey Johnson, an orthopedic trauma fellow at Brown University’s Warren Alpert Medical School. “As the rate of obesity increases, the rate of knee dislocations increases. The total number of patients who are obese is increasing, so we are seeing more of these problems,” Johnson explained. Knee dislocations result from multiple torn ligaments. Vehicle crashes or contact sports, such as football, are common causes. For the study, the researchers analyzed more than 19,000 knee dislocations nationwide between 2000 and 2012. Over that time, people who were obese or severely obese represented a growing share of knee dislocation patients — 19 percent in 2012, up from 8 percent in 2000. Obesity is also linked to more severe knee dislocations, longer hospital stays and higher treatment costs, according to the study published recently in the Journal of Orthopaedic Trauma. And the chances that a knee dislocation would also injure the main artery behind the joint and down the leg were twice as high for obese patients than for those… read on >

Exposure to air pollution can increase the risk for osteoporosis and broken bones in older adults, a new U.S. study suggests. Researchers analyzed data on 9.2 million Medicare enrollees in the Northeast/Mid-Atlantic area who had been hospitalized for fractures from 2003 to 2010. The investigators found that even a small increase in exposure to air pollution particulate matter called PM2.5 was associated with an increase in fractures among older adults. PM2.5 is the label for fine inhalable particles with a diameter of 2.5 micrometers or smaller, according to the U.S. Environmental Protection Agency. The researchers also examined eight years of follow-up among 692 middle-aged, low-income adults in the Boston health survey. The findings showed that people who lived in areas with higher levels of PM2.5 and black carbon — a type of air pollution from vehicle exhaust — had lower levels of an important calcium and bone-related hormone, and greater decreases in bone mineral density than did those exposed to lower levels of the two pollutants. The study was published Nov. 9 in The Lancet Planetary Health. “Decades of careful research has documented the health risks of air pollution, from cardiovascular and respiratory diseases to cancer and impaired cognition [thinking skills], and now osteoporosis,” said senior author Dr. Andrea Baccarelli. He chairs environmental health sciences at Columbia University’s Mailman School of Public Health in New… read on >

Is your shopping cart filled with heavily processed foods? Some might seem to be time-savers, yet cost more than fresh foods and offer few nutrients. Others might actually harm your health. The first foods to avoid are processed meats from hot dogs to deli cold cuts, including salami and bologna. Even those labeled “low calorie” are likely to have questionable preservatives, such as salts and nitrates. Studies show that these are the worst types of meats for your heart. Try freshly prepared turkey and chicken instead. In a hurry? A rotisserie chicken cooked at your favorite market is a good alternative. Next, pass on processed foods made with refined flour. These include typical breakfast cereals, white breads and similar baked goods. For the most nutrition, look for stone-ground whole-grain breads and steel-cut oats. Substitute a mashed slice of avocado for typical sandwich spreads. You’ll get great taste and great nutrition. Instead of bagged chips and other packaged snacks, crunch an ounce of nuts. For only a slight difference in calories, you get protein, healthy fats and fiber. Bottled salad dressings — even diet or low-fat versions — often have corn syrup along with many additives. Whisk up your own vinaigrette with extra virgin olive oil and vinegar, or try nonfat yogurt with lemon juice, herbs and garlic. If you’re short on time during the week… read on >

It’s a frequent occurrence: A single, childless older man without a designated caregiver suffers a debilitating stroke, and is sent to a nursing home for the remainder of his life. New research shows that male seniors who find themselves in this situation have triple the odds of being sent to a nursing home within five years of their attack, compared to men with a caregiver. A similar risk wasn’t seen for women. The study “highlights older adults as being vulnerable to the loss of independent living if they cannot identify anyone to care for them,” said study author Justin Blackburn, of the University of Alabama at Birmingham. “This is particularly true for older men, who may be unable to access or reluctant to use formal services delivered within their home or community,” Blackburn said. He spoke in a news release from the Journal of the American Geriatrics Society, which recently published the findings. One New York City geriatrician said this scenario is all too familiar. “We see this on Staten Island when there are no other caregivers to help and support patients in need — like after a stroke, when nursing home placement may be the only option left,” said Dr. Theodore Strange. He is associate chair of medicine at Staten Island University Hospital. Strange believes that “men are likely at an increased risk because,… read on >

Many patients overestimate the amount of pain they’ll experience after surgery, resulting in needless anxiety, a new study reports. “We believe providers need to do a better job of counseling patients on realistic pain expectations,” said study co-author Dr. Jaime Baratta, director of regional anesthesia at Thomas Jefferson University Hospital in Philadelphia. The research included 223 patients. Their average age was 61. All had orthopedic, neurological or general surgery. Of these, 96 received some form of regional anesthesia (spinal, epidural or peripheral nerve block). The remaining 127 patients received only general anesthesia. Before their surgery, the patients estimated what level of postoperative pain they expected on a 0-10 scale (10 being the most painful). After surgery, they were asked about their level of pain in the post-anesthesia care unit one hour following surgery and again on the first day after surgery. The patients’ average expected pain rating immediately after surgery was 4.7, while their actual pain rating was 2.6. The average expected pain rating on the first day after surgery was 5.5, compared to an actual pain rating of 4.3. Patients who had regional anesthesia had an average expected pain rating immediately after surgery of 4.6, while their actual pain rating was less than 1. The average expected pain rating for these patients on the first day after surgery was 5.5, compared to an actual… read on >

Complaining of burnout and job dissatisfaction, many U.S. doctors plan to reduce their work hours or leave medicine altogether, a new study reveals. “Our findings have profound implications for health care organizations,” according to the researchers from the American Medical Association (AMA), the Mayo Clinic and Stanford University. The study found that about one in five doctors intends to reduce work hours in the next year. And about one in 50 intends to leave medicine for a different career within the next two years. The demands of electronic health records were among the challenges leading to job dissatisfaction. If only 30 percent of those doctors follow through on their plans to leave medicine, that would mean a loss of nearly 4,800 doctors. That’s about the same as losing the graduating classes of 19 U.S. medical schools in each of the next two years, the researchers explained. Replacing physicians is expensive for institutions. One recent analysis estimated the cost at $800,000 or more per doctor. “In addition, turnover is disruptive to patients, staff and organizational culture,” the study authors wrote. “An energized, engaged, and resilient physician workforce is essential to achieving national health goals,” said Dr. David Barbe, president of the American Medical Association. “Yet burnout is more common among physicians than other U.S. workers, and that gap is increasing as mounting obstacles to patients’ care… read on >

The American dream of success is a lot harder to attain for teenagers who use pot and alcohol, especially if they become substance abusers, a new study reports. Teen pot smokers and drinkers struggle to achieve some of the hallmarks of adult success, including obtaining a college degree, getting married, holding down a full-time job and earning a good living, the researchers found. “Parents should try to delay their children’s onset of use as much as possible,” said research supervisor Victor Hesselbrock, chairman of addiction studies at the University of Connecticut. “If you can push regular use back well into adolescence, the kids do a lot better.” The researchers have been tracking the life course of 1,165 young adults from across the United States, most of whom come from a family with a history of alcoholism, Hesselbrock said. Participants’ habits were first assessed at age 12. After that, the researchers checked in on them at two-year intervals, up through age 25 to 34 for many of the subjects. Kids from families with alcohol abuse followed patterns of first substance use and frequency of use that are typical of U.S. high school kids, Hesselbrock said. But as they got older, the paths of those who used or became dependent on alcohol or pot as teens deviated from those of kids who stayed clean for the most… read on >