An inexpensive medication long used for depression and migraines now has a clinical trial to back up its off-label use for another condition that lowers quality of life: irritable bowel syndrome (IBS). In the study, British researchers found that those taking amitriptyline were almost twice as likely as those taking a placebo to see an improvement in IBS symptoms. “We were delighted that the drug was both effective and safe for IBS when used at a low dose and titrated [slowly increased],” said Dr. Alexander Ford, a professor of gastroenterology at Leeds Institute of Medical Research at St. James’s at the University of Leeds. About 1 in 20 people worldwide live with the abdominal pain and bowel issues that are hallmarks of IBS, a chronic condition with no known cure. “IBS has a substantial impact in terms of affecting social activity, ability to work, out-of-pocket expenses and quality of life for sufferers,” Ford said. Although there are other treatments, most have only a modest impact, according to the study, with people often still suffering symptoms. “First-line treatments do not work for many patients with IBS, so there is a real unmet need as there are few other available therapies in the U.K. and the impact of IBS on the individual, health care systems and society as a whole is substantial,” Ford said. Amitriptyline is part…  read on >  read on >

Many breast cancer survivors take a hormonal drug after cancer treatment to stave off a recurrence, but new research suggests these drugs may be less effective in women who are obese. Breast cancer cells in hormone-positive breast cancers are fueled by the female sex hormone estrogen. Aromatase inhibitor medications lower estrogen levels by stopping an enzyme in fat tissue called aromatase from changing other hormones into estrogen. When compared to breast cancer survivors of normal weight, women who were obese were 18% more likely to have a recurrence even when taking an aromatase inhibitor, and this increased risk was even higher among survivors who were severely obese, the investigators found. “Postmenopausal women with hormone receptor-positive breast cancer and obesity who are treated with aromatase inhibitors at are increased risk of having a recurrence of their disease,” said study author Sixten Harborg, a researcher in the department of oncology at Aarhus University Hospital in Denmark. However, he added, “Treatment with aromatase inhibitors is still the treatment choice for this patient group and lowers the rate of breast cancer recurrence and [death] in this patient group.” Exactly how, or even if, obesity increases the risk of breast cancer recurrence in women taking aromatase inhibitors is not fully understood yet. “Obesity can affect the response to cancer treatment, as obesity alters drug metabolism and distribution,” Harborg noted. Fat…  read on >  read on >

A breast cancer diagnosis often causes anxiety and depression, but an empathetic doctor can help. Supportive communication is key to reducing patient uncertainty and promoting mental well-being, Rutgers University researchers have found. “Our findings suggest that provider communication is a key component to reducing uncertainty, and thus providers play a key role in helping to facilitate psychological well-being,” said lead researcher Liesl Broadbridge. She’s a doctoral candidate at Rutgers School of Communication and Information in New Jersey. Discussing uncertainties and responding with empathy to patients’ concerns is critical to their healing and recovery, according to the study authors. “Our findings are directly applicable as targets for communication training modules for health care providers, because by continuing to advance skills in empathic communication, clinicians can enhance the health care experiences of their patients,” Broadbridge said in a Rutgers news release. The researchers also investigated how managing psychological well-being differs during and after cancer treatment. Current and former patients have different types of appointments, such as treatment decision-making for current patients and watchful waiting for former patients. They have had different amounts of time to adjust to diagnoses and, potentially, have different relationships with their providers. “Although our findings were true for both current and former patients, the strength of the relationship between uncertainty and psychological adjustment was stronger for former patients than for current patients,” Broadbridge…  read on >  read on >

“Trigger warnings” are now widely accepted as away to help people avoid harm from disturbing content. Trouble is, they just don’t work, according to new research. Trigger warnings seem like an obvious good: They alert people that a book, video or other media will depict a fraught topic such as sexual assault, abuse or suicide. Forewarned, consumers can skip the content or at least be emotionally prepared for it. The problem is, trigger warnings appear to be ineffective at best — and maybe even be harmful in some cases, according to the recent analysis of a dozen studies. The researchers found that while there was evidence that trigger warnings sometimes caused “anticipatory” anxiety, they did nothing to relieve the distress of viewing sensitive material. Nor did the warnings deter people from viewing potentially disturbing content; in fact, they sometimes drew folks in. In sum, the studies “almost unanimously” suggest that trigger warnings do not work as intended, according to senior researcher Victoria Bridgland of Flinders University in Australia. Why then are trigger warnings so prevalent, from college classrooms to theaters and art galleries to news articles and social media posts? Once they caught on, they simply kept growing — likely driven by a sense that they seemed like the “right thing to do,” Bridgland said. “This is probably because we have a culturally ingrained notion…  read on >  read on >

Whether or not you have loved ones in the Middle East, the horrors of the violence and suffering in Israel and Gaza are heart-wrenching and difficult to bear. “It’s important to be informed, but don’t stress yourself out,” said Dr. Gary Small, chair of psychiatry at Hackensack University Medical Center in New Jersey. Ration your exposure to what you see, given the impact graphic news reports can have on mental health, Small advises in a hospital news release. “We live every day in a denial of the horrors out there in the world,” Small said, adding that catastrophic events, such as the massacres and kidnappings in Israel and the Sept. 11 terror attacks, put the very worst of human behavior in front of people’s eyes. He recommends finding a balance between being up to date with news and doing calming activities. These might include watching a light television show, spending time with loved ones or reading an engaging book. Brutal events like the attacks in Gaza and Israel can also lead to “social contagion,” where information and images are amplified and a collective stress emerges, Small said. To protect yourself, take breaks from social media, especially if you find yourself watching horrific images repeatedly, he advised. Reports of the violence in the Middle East can also trigger anxiety and depression, both in children and adults,…  read on >  read on >

A new rule allows health care providers to be reimbursed for treating homeless people wherever they are, rather than just in hospitals or clinics. The U.S. Centers for Medicare & Medicaid Services (CMS) began allowing this change for both public and private insurers on Oct. 1, KFF Health News reported. “The Biden-Harris administration has been focused on expanding access to health care across the country,” CMS spokesperson Sara Lonardo told KFF Health News, explaining that federal officials created the new reimbursement code at the request of street medicine providers who weren’t being paid for their work. Now doctors, nurses and other providers can provide reimbursed care in a “non-permanent location on the street or found environment.” Most of the patients who will be helped by this are low-income, disabled and older people on Medicaid and Medicare, KFF Health News reported. “It’s a game-changer. Before, this was really all done on a volunteer basis,” said Valerie Arkoosh, secretary of Pennsylvania’s Department of Human Services, which spearheaded a state-based billing change in July. “We are so excited. Instead of a doctor’s office, routine medical treatments and preventive care can now be done wherever unhoused people are.” Other states had already taken this on, starting with California in 2021. Hawaii also does this, and street medicine teams already do work in big cities like Boston and Fort Worth,…  read on >  read on >

Air pollution from heavy traffic may be driving pregnancy complications and health concerns for infants. Researchers who matched more than 60,000 birth records with air-monitoring data found that pregnant patients living in an urban area with elevated levels of nitrogen dioxide had higher rates of preterm birth. This included delivery before 28 weeks, according to the study from UT Southwestern Medical Center in Dallas. The researchers also saw increases in admission to the neonatal intensive care unit (NICU), infant respiratory issues and other adverse outcomes. Nitrogen dioxide is a major component of motor vehicle exhaust. “These findings suggest that air pollution from heavy traffic is a significant threat to pregnant individuals as well as to their child’s health after delivery,” lead researcher Dr. David Nelson, chief of obstetrics and gynecology, said in a UT Southwestern news release. “The relationship between air pollution exposure and childhood and adult respiratory conditions is well established, but this study is novel in identifying consequences to the perinatal population,” Nelson noted. The study results showed an association between air pollution levels and preterm birth, but do not prove cause and effect. The study included patients in the Dallas metro area who gave birth between January 2013 and December 2021 at Parkland Memorial Hospital. The investigators compared data from the U.S. Environmental Protection Agency (EPA) Air Quality System database with pregnancy…  read on >  read on >