Patients with Parkinson’s Disease Are at Risk for Carpal Tunnel Syndrome
Dr. Lara Pullen writing in the Rheumatologist reported patients with carpal tunnel syndrome experience pain, numbness and tingling that can be characterized as an upper limb neuropathy. CTS is more common in women, with a female to male ratio of 3:1. Various studies have described the incidence of CTS in the general population as between 2.5 and 5 cases per 1,000 person years.
Individuals with Parkinson’s disease may be especially vulnerable to CTS. One study suggests that patients with Parkinson’s may be at increased risk of CTS because of the repetitive movement due to tremor.2 Others have noted the peripheral neuropathy that is associated with Parkinson’s and wondered whether peripheral neuropathy is intrinsic to Parkinson’s, a consequence of levodopa exposure or both.3 A body of evidence suggests that a form of small fiber neuropathy is intrinsic to Parkinson’s, and thus, experts have suggested that patients with early and advanced Parkinson’s be strictly monitored for subtle signs of neuropathy.
Depression… it’s already starting in young doctors
Many Medical Students Appear To Struggle With Depression, Research Reveals
Liz Kowalczyk writing in the Boston Globe reported that future physicians appear to “suffer depression, or depressive symptoms, at higher rates than the general population,” a meta-analysis involving “nearly 200 smaller studies from 47 countries” suggests. In fact, about “27 percent” of medical students appear to suffer from “depression in medical school,” the research revealed. The findings were published in the Journal of the American Medication Association.
Comment: I have news for these students… medical practice today can be even more depressing.
Immunotherapy Drugs Sometimes Cause Immune Response Against Healthy Organs
Matt Richtel writing for the New York Times reported that “immunotherapy drugs have been hailed as a breakthrough in cancer treatment.” However, “as their use grows,” physicians are finding that “an unleashed immune system can attack healthy, vital organs: notably the bowel, the liver and the lungs, but also the kidneys, the adrenal and pituitary glands, the pancreas and, in rare cases, the heart.” Physicians “at Yale believe immunotherapy is causing a new type of acute-onset diabetes, with at least 17 cases there so far.”
Comment: All effective therapies have potential side effects so I’m not surprised.
Paula Span writing in the New York Times reported on “an ongoing and vexing public health problem: People once vigilant about vaccinating their children aren’t nearly as careful about protecting themselves as they age, even though diseases like influenza, pneumonia and shingles…are particularly dangerous for older people.” Carolyn Bridges, MD, Associate Director for Adult Immunization at the CDC, said, “Trying to prevent these common and often debilitating conditions is incredibly important for older adults.”
Comment: Shame on you if you aren’t getting your shots.
Too little sleep takes a toll on your heart, according to a new study presented at the 2016 annual meeting of the Radiological Society of North America (RSNA), Nov. 27-Dec. 1 in Chicago.
Alexandra Sifferlin reports, about twenty healthy radiologists had their hearts imaged before and after a 24-hour shift where they got an average of three hours of sleep. The also had their blood pressure and heart rate measured, and they provided blood and urine samples. Comparing the two images showed increases in heart strain, which can be a precursor for heart problems. The doctors also showed increases in blood pressure, heart rate and thyroid hormones, which are released in response to stress.
Comment: Make sure you get your sleep… you life might depend on it!
Drowsy driving almost as bad as being drunk… maybe
AAA Study: Drowsy Driving As Risky As Drunk Driving
Scot Pelley reporting for CBS News stated a new AAA study suggested “that getting behind the wheel on four or five hours’ sleep is just as dangerous as driving drunk.” According to the broadcast, a little over one in three drivers in the US does not get “the recommended seven hours of sleep daily,” and those who do get “just five or six hours” are “almost twice as likely to be involved in an accident.” As a driver’s hours of sleep decreased, the risk of an accident increased exponentially, with “teenagers, older adults, and people who have a sleep debt” at “the highest risk.”
Tocilizumab Receives Breakthrough Designation for GCA
The FDA granted the designation of breakthrough therapy to tocilizumab (Actemra) for treating GCA (Giant Cell Arteritis). This autoimmune disease causes inflammation of arteries both medium and large in size, predominantly in the head, but also in the aorta and branches of the aorta.1
To date, GCA treatment has been limited to high-dose steroids, which are used as an emergency treatment to prevent vision loss and other damage. Long-term, flare-free remission cannot always be maintained with steroids. Because of the variety of symptoms, GCA patients are usually seen by myriad specialists, including rheumatologists.
The FDA gives a breakthrough designation to expedite the development and review of treatments that show early evidence of potential clinical benefit in serious diseases to ensure patients receive access to medication as quickly as possible. Positive results of tocilizumab use in patients with GCA were seen in the Phase 3 GiACTA study. Patients treated with tocilizumab, initially as combination therapy for six months with glucocorticoids, had sustained remission though one year of treatment compared with patients who received only glucocorticoids for six to 12 months.
Comment: GCA is a serious condition and this is great news.
How much weight does wearing a fitness tracker help you lose? Next
Wearable Activity Trackers Don’t Improve Weight Loss
Dr. Jack Cush writing in Rheum now reported that an article in JAMA has reported the results of a 24-month trial showing that obese individuals on a long-term healthy diet and exercise program do not have significantly more weight loss from using a wearable device that tracks their activity.
In a randomized clinical trial conducted at the University of Pittsburgh, 471 adult participants (with a BMI between 25-40) enrolled between 2010 and 2012. All subjects were placed on a low-calorie diet, prescribed increases in physical activity, and had group counseling sessions.
Patients randomized to the intervention group were given wearable device and accompanying web interface to monitor diet and physical activity – BodyMedia Fit Core, a wearable activity tracker worn on the upper arm. The Fit Core tracks steps, hours slept and calories burned and costs about $100.
After 24 months, people who used wearable activity trackers lost 2.4 kilograms (5.29 pounds) less than a group on a similar program but using a website to track their progress.
Both groups had improved their body composition, fitness, physical activity and diet, according to the report in JAMA.
The value and impact of wearable technology remains to be proven, especially with regard to weight loss.
A commonly used medication for heart disease may have another use… next
Statins May Reduce Alzheimer’s Risk, Study Suggests
Muir reporting for ABC World News Tonight stated, “A new study shows that high use of…statins” may be associated with “a lower risk of Alzheimer’s for patients over the age of 65.” The study was published in JAMA Neurology.
Comment: It’s interesting how drugs for one disease may help another.
How bad is the opioid epidemic in the US… worse than you think… particularly for kids…next
Opioids are Like Guns in the Hands of Children
Dr. Jack Cush writing in Rheumnow reported the opioid abuse epidemic is well known and the focus of many regulators and health care personnel. The problem also affects the youngest Americans, according to a recent Washington Post article.
JAMA Pediatrics reports an analysis of pediatric hospital discharges nationwide between 1997 -2012 and found that 13,052 children were hospitalized for opioid overdoses with Oxycodone, Percocet, codeine and the like narcotics.
There were 176 pediatric deaths attributed to narcotic use. And, the data shows a doubling of opioid poisonings in children during those years. Most of the victims (73.5%) are white, and slightly more than half (53 percent) are female.
The authors draw a parallel between guns and narcotics and the need for parents and grandparents to store these safely and out of reach or access to children and adolescents.
Cush adds, mitigating these risks will require comprehensive strategies that target opioid storage, packaging, and misuse.
Comment: A terrible public health issue that requires our attention.