Pain management
New guidelines suggest opioids for older patients
New pain management guidelines issued by the American Geriatrics Society in April 2009 removed nonsteroidal anti-inflammatory drugs (NSAIDs) from the list of drugs recommended for patients age 75 and older with constant pain. Although acetaminophen (Tylenol) remains the top choice for treatment of chronic pain, the guidelines suggest that opioids should be used instead of NSAIDs because the high doses of NSAIDs needed to treat chronic pain may be too dangerous for older patients.
The controversial guidelines indicate that older patients would be safer taking opioids than high doses of NSAIDs for long periods of time and that the risk of addiction in these patients appears to be low. The risks of high doses of NSAIDs include ulcers, gastrointestinal bleeding, and an increased risk of heart attacks or strokes; they may also increase high BP and affect kidney function.
The guidelines don't affect recommendations about taking baby aspirin to protect the heart because the amount of aspirin recommended is very small, just 81 mg.
Cancer
Urban dwellers have a higher risk of late-stage cancers
A new study published in the June 15 issue of the journal Cancer has found that people who live in urban areas are more likely to develop late-stage cancer than those who live in suburban and rural areas.
The study looked at data from the Illinois State Cancer Registry from 1998 to 2002 (they used Illinois because it has a diverse range of geographic regions). The researchers assessed late-stage cancer diagnoses of four major cancers-breast, colorectal, lung, and prostate-throughout the state and compared data from cities with data from less-populated areas. They found that for all four cancers, risk was highest in Chicago, the most densely populated area, and decreased as areas became more rural. Risks were low among people living in large towns in rural areas, but were high in the most isolated rural areas.
The results of the study indicate a need for more extensive cancer screening and education programs in large cities and isolated rural areas, targeting the most vulnerable populations and neighborhoods.
Diabetes
Antioxidants may reduce some benefits of exercise
Researchers have found that antioxidant supplements may interfere with the increased insulin sensitivity benefits of exercise.
A study published in the Proceedings of the National Academy of Sciences looked at the benefit of exercise in increasing insulin resistance in 39 young men. About half of the men were taking supplemental vitamins C and E. The study found that the men taking the supplements had no change in their insulin resistance, but those who weren't taking the vitamins had an increase in free radicals, which increase insulin resistance. When the men taking the supplements stopped taking them, their insulin sensitivity was restored in about 1 month.
The study suggests that people who are exercising to reduce diabetes risk shouldn't take vitamin C and E supplements because they will block some of the benefits of exercise. Because this was small, short-term study, further research is needed as uncertainty still exists about the benefits of antioxidants. To date, healthy eating and regular physical activity are still the best lifestyle management.
Did you know?
Exercising throat muscles may relieve sleep apnea symptoms. A new report has found that tongue and throat exercises may help reduce the severity of mild to moderate obstructive sleep apnea. According to the report, which was published in the American Journal of Respiratory and Critical Care Medicine, a 3-month program improved symptoms such as low oxygen saturation levels in the blood, sleepiness, poor sleep quality, and snoring.
Sixteen people diagnosed with mild to moderate sleep apnea were asked to perform daily and weekly tongue and pharyngeal exercises. A control group of 15 people diagnosed with sleep apnea were asked to perform a placebo treatment of deep breathing and nasal rinsing with saline solution. After 3 months, the control group showed no change in their condition, but those who performed the tongue and pharyngeal exercises showed a 40% reduction in symptom severity.
The researchers haven't determined how the exercises caused the change and if all of them were effective, and further research is needed.