Pain relievers worked as well as opioids in ER patients

https://goo.gl/QCTo9t

Emergency rooms are where many patients are first introduced to powerful opioid painkillers, but what if doctors offered over-the-counter pills instead? A new study tested that approach on patients with broken bones and sprains and found pain relievers sold as Tylenol and Motrin worked as well as opioids at reducing severe pain.

The results challenge common ER practice for treating short-term, severe pain and could prompt changes that would help prevent new patients from becoming addicted.

The study has limitations: It only looked at short-term pain relief in the emergency room and researchers didn’t evaluate how patients managed their pain after leaving the hospital.

But given the scope of the U.S. opioid epidemic — more than 2 million Americans are addicted to opioid painkillers or heroin — experts say any dent in the problem could be meaningful.

Results were published Tuesday in the Journal of the American Medical Association.

Long-term opioid use often begins with a prescription painkiller for short-term pain, and use of these drugs in the ER has risen in recent years. Previous studies have shown opioids were prescribed in nearly one-third of ER visits and about 1 out of 5 ER patients are sent home with opioid prescriptions.



How the body processes alcohol

https://goo.gl/cR8fyy

There are a lot of factors that can affect this but, on average, the liver can process 1 ounce of alcohol every hour, and it can be detected in the blood for several hours, and in the urine for several days. 

The following is information on how the body processes alcohol and the different factors that can affect that process.



Scientists find key to unwanted thoughts

https://goo.gl/NPDr8A

Scientists could have the secret. They have identified a chemical in the brain's "memory" region that allows us to suppress unwanted thoughts.

The discovery may help explain why some people can't shift persistent intrusive thoughts - a common symptom of anxiety, post-traumatic stress disorder (PTSD), depression and schizophrenia.

Researchers say controlling our thoughts is "fundamental to wellbeing".

Researchers found a particular chemical, or neurotransmitter, known as Gaba, held the key.

Gaba is the brain's main "inhibitory" neurotransmitter. That means, when it's released by one nerve cell it suppresses the activities of other cells to which it is connected.

They found people who had the highest concentrations of Gaba in their brain's hippocampus (or memory hub) were best at blocking unwanted thoughts or memories.

"What's exciting about this is that now we're getting very specific," said Prof Anderson.

"Before, we could only say 'this part of the brain acts on that part', but now we can say which neurotransmitters are likely to be important."


Trying the Feldenkrais Method for Chronic Pain

https://goo.gl/Vzo9Qc

After two hourlong sessions focused first on body awareness and then on movement retraining at the Feldenkrais Institute of New York, I understood what it meant to experience an incredible lightness of being. Having, temporarily at least, released the muscle tension that aggravates my back and hip pain, I felt like I was walking on air.

I had long refrained from writing about this method of countering pain because I thought it was some sort of New Age gobbledygook with no scientific basis. Boy, was I wrong!

The Feldenkrais method is one of several increasingly popular movement techniques, similar to the Alexander technique, that attempt to better integrate the connections between mind and body. By becoming aware of how one’s body interacts with its surroundings and learning how to behave in less stressful ways, it becomes possible to relinquish habitual movement patterns that cause or contribute to chronic pain.

The method was developed by Moshe Feldenkrais, an Israeli physicist, mechanical engineer and expert in martial arts, after a knee injury threatened to leave him unable to walk. Relying on his expert knowledge of gravity and the mechanics of motion, he developed exercises to help teach the body easier, more efficient ways to move.


Midlife Inflammation Tied to Later Brain Volume Loss

https://goo.gl/2CJa1F

Elevated levels of inflammation biomarkers in midlife may be associated with loss of brain volume later in life, researchers found.

These results suggest that inflammation in midlife may be an early contributor to the brain changes that are associated with Alzheimer's disease and other forms of dementia," Walker said in a statement. "Because the processes that lead to brain cell loss begin decades before people start showing any symptoms, it is vital that we figure out how these processes that happen in middle age affect people many years later."

While it is too early to recommend any dramatic changes in practice, Walker said the team's findings "do suggest that reducing the burden of diseases known to cause chronic inflammation should be a priority for dementia prevention throughout adulthood. It is my hope that these findings will direct future research efforts for dementia prevention and treatment."

Lots of chronic diseases cause inflammation. We need to take them more seriously and not just learn to live with them.....

How do you get rid of blushing?

https://goo.gl/C6eTVn

Blushing is a natural bodily response that is triggered by the sympathetic nervous system — a complex network of nerves that activate "fight or flight" mode.

Those who are easily stressed or have anxiety disorders or social phobias may blush more than others. While it can cause people to feel self-conscious, blushing is not in itself harmful.

This article addresses the causes of blushing and lists 12 ways to prevent it.

This natural reaction occurs in the face of a perceived threat, and it can also be triggered by the onset of a powerful emotion such as stress, shame, or embarrassment.

Blood vessels in the face get wider and increase blood flow to the skin, which leads to the characteristic redness of blushing.

In fact, some research has found that just by telling someone they are blushing is enough to induce it.

Here are some ways to stop severe or frequent blushing:

1. Breathe

Breathing deeply and slowly will tell the brain to relax. Once relaxed, the body will stop releasing stress hormones, the heartbeat will slow to normal levels, and blood pressure will return to normal.

These events will reduce the level of blood rushing to the face, thereby preventing blushing.

3. Smile and laugh

Research suggests that smiling may reduce stress levels and regulate the body's natural stress responses.

According to a 2012 study, people who carry out stressful tasks while smiling have lower heart rates following the task than people who do not smile while carrying out the same chores. Participants who smile also report feeling better during the activity than those who maintain a neutral expression.


Addressing Compassion Fatigue and Burnout in Integrated Care

https://goo.gl/E2hfQR

For the integrated care workforce, addressing the complex needs of individuals with numerous and serious behavioral and physical health difficulties increases staff risk of experiencing symptoms associated with burnout and compassion fatigue. Christina Maslach, a researcher with extensive professional experience studying the field of work burnout, defines burnout as “feelings of exhaustion, a cynical attitude toward the job and people involved in the job, and a reduced personal accomplishment or work efficiency. Burnout can be thought of as 'taking away a person’s spirit and will.'”

Burnout may be the result of workload demands, poor organizational practices, intense time pressures, unsupportive relationships with supervisors and co-workers, and lack of control across work environments. In addition to organizational factors, healthcare and social services providers face unique challenges associated with addressing the needs of people with serious behavioral and/or physical health difficulties. The frequent listening to and/or direct observation of the suffering of others may elicit strong emotional, psychological, and physical reactions that lead to emotional exhaustion, a cynical attitude towards one’s work, and a loss of empathic connections to others.

The Symptoms of Burnout and Compassion Fatigue
  • Emotional coping difficulties
  • Anxiety
  • Dreading working for or taking care of another person and feeling guilty as a result
  • Feelings of irritability and anger
  • Hypersensitivity or complete insensitivity to emotional material
  • Depression and PTSD-related symptoms
  • Loss of self-worth
  • Insomnia
  • Alcohol or substance abuse

Physical Symptoms and Increased Vulnerability to Illnesses

  • Fatigue
  • Heart disease
  • High cholesterol
  • Type 2 diabetes, especially in women
  • Stroke
  • Obesity
  • Depersonalization
  • Headaches
  • Weight loss

Functional Difficulties

  • Impaired decision-making
  • Feelings of inequity toward the therapeutic or caregiver relationship
  • Problems in personal relationships
  • Poor work-life balance
  • Diminished sense of career fulfillment

The Mayo clinic lists the following burnout related problems: http://www.mayoclinic.org/healthy-lifestyle/adult-health/indepth/burnout/art-20046642?pg=2

To Combat the Opioid Epidemic, We Must Be Honest About All Its Causes

https://goo.gl/KfWjA1

The opioid epidemic is a source of deep national anguish in the United States: It now kills almost 100 Americans each day, more than motor vehicle accidents. President Donald Trump today officially declared the epidemic a national public health emergency. Although he hasn’t allocated any additional federal funding to address the crisis, the announcement could accelerate efforts at the federal, state, and local levels to identify and implement ways to combat it. As his administration strives to galvanize efforts, it would benefit from drawing on the growing body of research that examines the medical and economic origins and effects of the crisis.

Every part of the country is battling opioid addiction, but the worst-hit states include Ohio, West Virginia, and New Hampshire. The most recent definitive data on the prevalence of the problem comes from the National Survey on Drug Abuse and Health, which surveyed 51,200 Americans in 2015. Based on weighted estimates, 92 million, or 37.8%, of American adults used prescription opioids the prior year (2014); 11.5 million, or 4.7%, misused them; and 1.9 million, or 0.8%, had a use disorder. The epidemic is spreading so rapidly that it’s likely the numbers are higher now.

By comparison, there are 17.1 million heavy alcohol users among adults over 18, according to the 2015 survey. But the opioid epidemic’s rapid rise, lethality, and protean effects on American society have galvanized the nation.

Researchers estimate the economic cost of the U.S. opioid epidemic may be as high as $80 billion a year, even excluding the economic value of a lost life. For those living with addiction, it’s very difficult to maintain regular employment: Nearly one-third of prime-working-age men who are not in the labor force take prescription pain medication on a daily basis, Princeton economist Alan B. Krueger found in 2016.

Building on this research, Krueger recently estimated that opioids could account for about 20% of the decline in labor-force participation from 1999 to 2015. This reduction in the proportion of working-age Americans who are employed is alarming. Krueger’s evidence: Participation in the labor force fell more in counties where relatively more opioid medication is prescribed. While this research isn’t definitive, the connection between opioids and economic productivity is certainly suggestive.

Wave of addiction linked to fentanyl worsens as drugs, distribution, evolve

https://goo.gl/EYFx3i

Michelle MacLeod died in a tough part of town known as the Tree Streets, where many of the streets have names like Ash, Palm, Chestnut and Walnut. Kevin Manchester, who provided the fentanyl that killed her, lived on Pine.

After MacLeod’s death, Nashua police wired her fiance and recorded him telling Manchester that MacLeod had overdosed and died. Manchester kept selling the powerful synthetic narcotic anyway.

Manchester, 27, went to prison for selling drugs that proved lethal — a “death-resulting” charge that prosecutors are using more frequently as they battle the opioid epidemic.

“He had no pause from what he had done, knowing full well he had killed that girl,” said Jon DeLena, the assistant special agent in charge in New Hampshire for the U.S. Drug Enforcement Administration. “It didn’t slow him down at all.”

The DEA points to the Manchester case as a victory, but it also highlights the challenges for law enforcement agencies as they seek to curb the spread of fentanyl. Manchester, a small-time dealer who was using his own product, was part of a wave of addiction that has worsened as the drugs have evolved, with fentanyl posing special problems because it is extremely potent, easily transported and highly desired.


Myasthenia Gravis Treatment Gets First FDA Approval Since 1950s

https://goo.gl/Hw1oBo

For more than 60 years, steroids and acetylcholinesterase inhibitors have been widely used as therapeutic options for patients with myasthenia gravis (MG), mostly because alternative means of immunotherapy have always been associated with serious adverse events (AEs).

Last night, Alexion Pharmaceuticals, Inc. announced that the U.S. Food and Drug Administration (FDA) has approved Soliris (eculizumab) as a new treatment for adult patients with generalized myasthenia gravis (gMG) who are anti-acetylcholine receptor (AchR) antibody-positive. The drug exhibited clinical benefit for these patients who had previously failed immunosuppressive treatment and continued to suffer from significant unresolved disease symptoms.

gMG is a debilitating, chronic and progressive autoimmune neuromuscular disease that can occur at any age. In patients with the condition, antibodies block, alter, or destroy the acetylcholine receptors at the neuromuscular junction. Symptoms most commonly revolve around weakness in an array of muscles, causing difficulties in seeing, walking, talking, swallowing, and breathing.

Soliris is a complement inhibitor. The complement cascade, when activated in an uncontrolled manner, plays a pivotal role in gMG, as well as serious ultra-rare disorders like paroxysmal nocturnal hemoglobinuria (PHN) and typical hemolytic uremic syndrome (aHUS)—the other indications that Soliris is approved for.