A community for people who want to remain as healthy as possible as we age.

No Link Between Coffee Consumption, Common Type of Irregular Heartbeat

(BioMed Central) There is no association between coffee consumption and an increased risk of atrial fibrillation, according to research… The research includes a meta-analysis of four other studies, making it the largest study its kind, involving nearly 250,000 individuals over the course of 12 years.
Moderate coffee consumption has been associated with a reduced risk of coronary heart disease and stroke. Its association with atrial fibrillation (AF), a heart condition that causes an irregular and often abnormally fast heart rate, has been unclear.
AF is the most frequent form of irregular heartbeat, causing a substantially increased risk of stroke, heart failure and all-cause mortality. It has previously been speculated that high coffee consumption may increase the risk of developing atrial fibrillation.
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Your gut bacteria may begin to eat your intestines without this key nutrient

(Tech Insider) A breakdown of the stomach lining is not good. It can lead to inflammation, irritation, and inflammatory bowel diseases like ulcerative colitis and Crohn's disease.
The multifarious collection of bacteria in our guts generally munch on dietary fiber — the roughage we get from plants, whole grains, nuts, seeds, fruits, and vegetables. Fiber helps with digestion and makes you feel full.
But fiber may play a more important role than we knew. According to a study in humans out of the University of Illinois, the amount of fiber in our diets might impact the structure and function of bacterial colonies in our guts. And when intestinal bugs are starved of fiber, as reported by Scientific American, they either die off or start feeding on the lining of the gut.
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The Fats of Life: It's Still Confusing

(Keith Ayoob EdD, RD) The great fat debate is revving up again. What's greasing the wheels is some recent research that shows that diets high in saturated fat are not associated with increased risk of cardiovascular disease, type 2 diabetes, stroke, and all-cause mortality. It's a meta-analysis that pools the results of many studies...
Most of these reviews looked at observational studies that can only show "associations," and that's not the same as cause-and-effect. There is a big difference between "no association between saturated fat and heart disease" and "saturated fat is good for you."…
[S]omething seems to be amiss with the saturated-fat-causes-heart-disease theory, but just what's going on is still a mystery. Diet and lifestyle do play a role in heart disease risk, but we may still have some work to do to really nail down the causes of that risk...
My advice on saturated fat…: Proceed with caution but not fear. Think about total diet and lifestyle. There's no need to avoid foods with saturated fat and indeed, most foods that have fat contain a mix of fats. Even olive and canola oil, which contain mostly monounsaturated fat, still have some saturated fat and we know they're healthy.
Spend saturated fat calories wisely by choosing foods that have additional nutritional value. Cheese, for example, is loaded with good quality protein and it's a dynamite calcium source, so it trumps butter. Cheese also has calories, so keep portions modest. Even dark chocolate seems to have a neutral effect on cholesterol and may even be healthful in small amounts. And make sure saturated fats keep good company -- have plenty of fruits, vegetables, and high-fiber grains on the plate and in the diet every day.
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Specific Fatty Acids May Worsen Crohn's Disease

(Duke University) Some research has suggested that omega-3 fatty acids, abundant in fish oils, can relieve inflammation in Crohn's disease. But a new study using software developed by Duke scientists hints that we should be paying closer attention to what the other omegas -- namely, omega-6 and omega-7 -- are doing to improve or worsen the disease…
To test whether fatty acid levels in the bloodstream was a cause or a consequence of disease, the researchers turned to a zebrafish model of Crohn's disease that had been developed by Stefan Oehlers, a post-doctoral fellow in David Tobin's group at Duke.
To the researchers' surprise, it wasn't omega-7 (palmitoleic acid) that significantly worsened inflammation but rather its saturated counterpart, palmitic acid, which is found in olive oil, butter, cheese, milk and meat.
Another unexpected finding was that an omega-6 fatty acid (linoleic acid), which is present in vegetable oils, lessened inflammation in the fish. Omega-6 had been shown in a previous study to be lower than normal in the blood of people with Crohn's.
Ko is quick to note that these new findings do not warrant radical dietary changes in people with Crohn's: More studies, including more refined genetic analyses of fatty acids and Crohn's and testing in animal models, are needed.
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Not All Trans Fatty Acids Are Bad for You, New Research Suggests

(European Society of Cardiology) New evidence suggests that low levels of trans fatty acids (TFAs) may not be as harmful to human health as previously thought, even if industrially produced, and may even be beneficial if they occur naturally in foods such as dairy and meat products, according to a study…
Dr [Marcus] Kleber said: "We found that higher concentrations of TFAs in the membranes of red blood cells were associated with higher LDL or 'bad' cholesterol, but also with lower BMI, lower fats in the blood (triglycerides) and less insulin resistance and, therefore, a lower risk of diabetes. We were surprised to find that naturally occurring TFAs were associated with a lower rate of deaths from any cause, and this was driven mainly by a lower risk of sudden cardiac death.
"We were also surprised to see that increases in the concentrations of industrially produced TFAs were not followed by increased mortality, which stands in contrast to observations from the United States. The reason for this may be, that in our group of German patients, TFAs were in general much lower than those found in the United States, so that hardly anybody in the study reached concentrations common to people in the US."
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Fudging the Facts on 'Healthy' Products Is Tempting, but Is It Worth It?

(University of Chicago Booth School of Business) It is easy to fudge facts when making health claims on consumer packaged goods, especially when the health benefits are hard to verify. But are consumers taken in? And is it worth it?
A new study from the University of Chicago Booth School of Business analyzes what happens to the sales of popular consumer products after federal regulators order manufacturers to stop making misleading health claims.
In the working paper, [researchers] find that questionable health claims on consumer packaging lead to a significant drop in revenue if and when regulators force the claims to be removed. The researchers also find that such claims primarily influence consumers who have the least loyalty to the brand and who may have purchased the products precisely because of the contested claims.
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Spotlight on Lebanon

(Mediterranean Foods Alliance) Lebanon is only about the size of Connecticut, yet its cuisine is well known outside of the Middle East for its bold flavors and extensive history. Like other Mediterranean cuisines, the foundation of Lebanese cuisine is made up of grains, pulses, fresh herbs, nuts, olive oil, and seasonal fruits and vegetables. Spices such as cardamom, cinnamon, coriander, and cumin give the food its unique character, along with other key flavoring agents…
Similar to Spanish tapas and Italian antipasti, mezze are small plates of food eaten in Lebanon and throughout the Levant, a region on the eastern coast of the Mediterranean Sea, usually including Israel, Jordan, Lebanon, Palestine and Syria. A couple of dishes can be eaten for a snack, and a dozen or more can make a satisfying meal…
For bigger meals, more elaborate dishes such as stuffed vegetables and stews are served alongside staple mezze dishes. Fatteh is a popular stew because it uses up stale bread; old flatbread is layered underneath a rich stew made of meat, pulses, or vegetables, soaking up all the delicious flavors. A dollop of yogurt and a sprinkle of pine nuts and fresh herbs complete the dish.
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The Latest from The People's Pharmacy

Don’t Fall!
There are numerous trusted sources for Falls Prevention Strategies. 
Magnesium Excels Against Constipation
Magnesium can overcome hard-to-treat constipation but be very careful about the dose. Too much magnesium can cause diarrhea or be hard on the kidneys.
Brittle Nails Point to Thyroid Problem
Brittle nails, hair loss, thinning eyebrows, or dry skin might be indications of undiagnosed thyroid problems. What else can you do for dry, brittle nails?
Beet Juice Strengthens People with Heart Failure
The nitrate content of beet juice has been shown to boost endurance in athletes; a new study shows that people with heart failure also benefit.
New Combination of Old Drugs Calms Agitation in Alzheimer Patients
It can be very difficult to deal with the agitation of Alzheimer's disease, but combining quinidine and dextromethorphan has been shown to help.
Are Your Furious You Will Be Misdiagnosed? You Should Be
A new report from the best doctors in America says diagnostic errors are common and deadly. Protect yourself and your loved ones from diagnostic disasters.
Public Finally Outraged At Extravagant Drug Prices
Drug prices have been out of control for years but it took the 5000 percent increase in the cost of Daraprim to wake up the American public.
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Some Forms of Dizziness After Getting Up May Signal Bigger Problems

(American Academy of Neurology) People who get dizzy several minutes after standing up may be at risk of more serious conditions and even an increased risk of death, according to new research… Feeling dizzy, faint or light-headed after standing due to a sudden drop in blood pressure can be a minor problem due to medication use or dehydration. But when it happens often, it can be a sign of a more serious condition called orthostatic hypotension, which is defined as a drop in blood pressure within three minutes of sitting or standing.
"Our study looked at delayed orthostatic hypotension, when the drop in blood pressure happens more than three minutes after standing or sitting up," said study author Christopher Gibbons, MD, with Harvard Medical School in Boston and a Fellow with the American Academy of Neurology. "Our findings suggest that more than half of people with the delayed form of this condition will go on to develop the more serious form of this disease. This is also the first study to date suggesting the disease is a milder form of the more common and serious disorder."
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Taking Supplements With Yohimbe Is Risky

(Consumer Reports) Looking to enhance sexual performance, cure erectile dysfunction, lose weight, or improve your athletic ability? Dietary supplements listing the botanical ingredient yohimbe claim to provide a “natural” quick fix for all those and more. The ingredient, extracted from the bark of the African Pausinystalia yohimbe tree, is now found in more than 550 supplements.
But taking supplements with yohimbe is risky, according to a new study… Yohimbe has been linked to fatigue, stomach disorders, and even paralysis and death. Yet labels often don't mention those risks, the study found.
Worse, in many cases the products—bought at  CVS, Walgreens, GNC, Rite Aid, Vitamin Shoppe, Walmart, and Whole Foods—contained much more (and sometimes less) of the ingredient than they claimed. Most troubling, the study found that many products contained potentially dangerous levels of a yohimbe-derived drug.
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Yeast Can Now Produce THC, Marijuana’s Infamous Compound

(Discover Magazine) Yeast, the sugar-gobbling microorganism that’s filled our bellies with beer and bread for millennia, has a new, increasingly important, role to play in society: serving as a therapeutic drug factory.
In August, scientists announced they had genetically engineered yeast to produce the painkiller hydrocodone, and even before that breakthrough, modified yeast churned out the anti-malarial drug artemisinin.
Now, scientists have customized yeast to create THC (the marijuana chemical that produces a “high”) and cannabidiol.
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From Farm to … Liver?

(Gastroenterology & Endoscopy News) Of the 17,000 patients in the United States waiting for liver transplants, 1,500 or so die each year, according to the American Liver Foundation. Consequently, there is a pressing need for more donor livers or alternate ways to treat severe liver disease. Transplantation of healthy liver cells has emerged as a promising strategy either to treat patients waiting for a transplant or as an alternative to liver transplant. However, a viable source of normal liver cells is needed.
Human liver cells farmed in animals are emerging as a viable source of healthy tissue for transplant into patients with hepatic disease.
“This is a promising therapeutic avenue that’s being hampered by lack of availability of transplantable hepatocytes,” said Markus Grompe, MD, professor of pediatrics and molecular and medical genetics at Oregon Health & Science University, in Portland, at the inaugural American Association for the Study of Liver Diseases Midyear Course on state-of-the art hepatology.
Since 1997, a string of case studies and small trials have demonstrated the safety and clinical potential of hepatocyte transplants in patients with liver disease or in children with inborn errors of metabolism, Dr. Grompe said.
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How Hunger Neurons Control Bone Mass

(Yale University) In an advance that helps clarify the role of a cluster of neurons in the brain, Yale School of Medicine researchers have found that these neurons not only control hunger and appetite, but also regulate bone mass…
"We have found that the level of your hunger could determine your bone structure," said one of the senior authors, Tamas L. Horvath, the Jean and David W. Wallace Professor of Comparative Medicine, and professor of neurobiology and obstetrics, gynecology, and reproductive sciences. Horvath is also director of the Yale Program in Integrative Cell Signaling and Neurobiology of Metabolism.
"The less hungry you are, the lower your bone density, and surprisingly, the effects of these neurons on bone mass are independent of the effect of the hormone leptin on these same cells."…
Using mice that were genetically-engineered so their cells selectively interfere with the AgRP neurons, the team found that these same cells are also involved in determining bone mass.
The team further found that when the AgRP circuits were impaired, this resulted in bone loss and osteopenia in mice -- the equivalent of osteoporosis in women. But when the team enhanced AgRP neuronal activity in mice, this actually promoted increased bone mass.
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End Patent Monopolies on Drugs

(Dean Baker, Center for Economic and Policy Research) The United States stands out among wealthy countries in that we give drug companies patent monopolies on drugs that are essential for people’s health or lives and then allows them to charge whatever they want. Every other wealthy country has some system of price controls or negotiated prices where the government limits the extent to which drug companies can exploit the monopoly it has given them. The result is that we pay roughly twice as much for our drugs as the average for other wealthy countries. This additional cost is not associated with better care; we are just paying more for the same drugs.
This is not an issue about the free market. The free market doesn’t have patent monopolies. The monopoly power provided by a patent is a government policy to promote innovation. There are problems with patent monopolies in many areas, but nowhere is the issue worse than with prescription drugs.
Patent protected drugs are often essential for people’s health or even their lives. Allowing a drug company to have a monopoly where it can charge whatever it can force the individual, or more typically the insurer or the government, to pay makes little sense. This is like negotiating the pay of firefighters at the point where they show up at your burning house with your family inside. This would give us much worse fire service and many very wealthy firefighters.
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Rational Drug Pricing

(Jeffrey Sachs, Columbia University) What should be done [about runaway drug prices]? Here are three key principles.
First, private R&D should certainly be protected by patents but only enough to elicit the needed R&D, not to produce outlandish profits. Instead of giving carte blanche to the monopolist patent-holder in setting its prices, the government should negotiate a reasonable price, or set a price ceiling, that recognizes the high costs of R&D, the large social benefits of access, and the varying ability to pay for the drugs by the patient population and the government programs buying the drugs…
Second, when the U.S. government pays for much of the R&D, it should share in the property rights[*]. This should be a no-brainer, but in fact the NIH simply gives away most or all the intellectual property that it has financed, so the taxpayer pays part of the R&D bills but the returns are fully captured by private companies.
Third, when companies like Gilead make profits from their U.S.-based research and U.S.-based production and sales, they should certainly pay U.S. taxes on their profits. The fact that the IRS lets them hide their profits in overseas tax havens is scandalous and without any logical justification whatsoever.
Community: *I’ve been saying this for YEARS!
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U.S. insurance mega mergers could hurt care: psychiatric group

(Reuters) The American Psychiatric Association warned U.S. antitrust regulators this month that two proposed health insurance deals could worsen access to mental health care services, adding to public opposition from several prominent doctors groups.
Anthem Inc would become the largest U.S. health insurer through a proposed $47 billion acquisition of Cigna Corp, announced in late July. Earlier that month, Aetna Inc said it would buy Humana Inc and become the largest provider of Medicare plans for older people.
The American Medical Association, the American Hospital Association and the American Academy of Family Physicians have already appealed to regulators to look at the possible impact on competition.
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'Our Chairs Are Killing Us,' Say Researchers

(Elsevier Health Sciences) Prolonged sitting time as well as reduced physical activity contribute to the prevalence of non-alcoholic fatty liver disease (NAFLD) in a study of middle-aged Koreans. These findings support the importance of both reducing time spent sitting and increasing physical activity, say researchers…
Physical activity is known to reduce the incidence and mortality of various chronic diseases. However, more than one half of the average person's waking day involves sedentary activities associated with prolonged sitting such as watching TV and using the computer and other devices…
"The data from [this study] add to the strong and alarming evidence that sitting too much and moving too little has significant negative consequences for cardio-metabolic health," commented Michael I. Trenell, PhD, Professor of Metabolism & Lifestyle Medicine at Newcastle University, UK, and an expert on how lifestyle influences lifelong health and wellbeing and chronic disease.
"The message is clear, our chairs are slowly but surely killing us. Our body is designed to move and it is not surprising that sedentary behavior, characterized by low muscle activity, has a direct impact on physiology. With a dearth of approved drug therapies for NAFLD, lifestyle changes remain the cornerstone of clinical care. The challenge for us now is to 'stand up' and move for NAFLD, both physically and metaphorically," Professor Trenell added.
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Fidgeting Can Cancel Out the Bad Effects of Sitting All Day

(TIME) An ever-growing body of research is showing that being sedentary and sitting for long periods of time are linked to poor health consequences, including a laundry list of risks for conditions ranging from obesity to heart disease. Even exercising doesn’t make up for the negative health effects of being stuck in your seat.
But before you beg your boss for a standing desk, a new study suggests that moving a little throughout the day—also known as fidgeting—can actually counteract the problems that come with sitting for extended periods of time.
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Target Sitting Time, Not Getting More Exercise, Study Finds

(King's College London) Targeting sitting time, rather than physical activity, is the most effective way to reduce prolonged sitting, according to the first comprehensive review of strategies designed to reduce sitting time…
Prolonged sitting has become a serious public health concern, with modern lifestyles becoming increasingly sedentary and many professions requiring workers to sit for most of the day. Previous studies and reviews have shown that higher levels of sitting are linked with cancer, diabetes, heart disease and even an early death, independently of whether a person takes regular exercise. Public health interventions have the potential to reduce prolonged sitting, but until now, little has been known about what makes certain sitting reduction strategies effective.
For the first time, this new study has shown that increasing levels of physical activity is likely to be much less effective at reducing prolonged sitting than directly attempting to decrease sitting time.
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Lose Weight Faster with Enjoyable Workouts

(SouthBeachDiet.com) Do you think of your workout as a pleasurable diversion or a dreary obligation?
If you’re a person who thinks of it as fun, you might actually lose weight more quickly than an individual who doesn’t enjoy exercising, according to findings by French researchers and Cornell University’s Food and Brand Lab…
If you find exercise a drag and you use food to compensate, make a real effort to make sure your workout is fun. Here are some ways to do that:
·         If you walk inside on a treadmill for exercise, watch your favorite TV show, play some music, or invest in a book rack to attach to the handlebars so you can read the newest book by your favorite author.
·         If you walk outside, plan an interesting route, and change it up often. If you’ve just been doing boring laps around a track, strike out on a new route that takes you past a stretch of beautiful countryside or some interesting shops (no dawdling though)…
·         Switch up your exercise routine with something new. If you like swimming, consider signing up for water aerobics. If you like biking, take a spin class.
·         Ask a friend to join you. Take a yoga class, enlist in Pilates, or sign up for kickboxing together.
Community: I combine my errands with my exercise. Living in downtown Chicago, almost everything I need is within hoofing distance. It means I can take advantage of the lowest prices, too.
Also, I listen to books while I’m walking. I download them, so they’re free, and I don’t even have to go to the library—which is only two blocks from where I live.
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Tai Chi Linked to Improved Physical Capacity in Chronic Conditions

(BMJ) The ancient Chinese exercise Tai Chi is linked to improved physical capacity among older adults with certain common long term conditions, indicates a pooled analysis of the available evidence…
Among people with breast cancer, heart failure, osteoarthritis and chronic obstructive pulmonary disease (COPD), these improvements were not at the expense of worsening pain or breathlessness, the findings show.
Tai Chi consists of slow, gentle, flowing movements that aim to boost muscle power, balance, and posture. It also includes mindfulness, relaxation, and breath control.
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Getting active after a cancer diagnosis may extend life

(Reuters Health) For people diagnosed with cancer, the risk of cancer death falls as physical activity rises, according to a new analysis of more than 70 existing studies.
Researchers found the same holds true for everyone – supporting the current World Health Organization recommendation of moderate physical activity to combat the risk of chronic disease, they write…
The WHO recommends two and a half hours of moderate exercise per week for some health benefit and five hours of moderate exercise per week for additional benefit. Half as much time per week of vigorous physical activity, like running, may confer the same benefits.
There are no specific recommendations for physical activity levels to combat cancer risk, although more activity has been tied to lower risk of death from breast, colorectal and prostate cancers, the authors note.
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More people die from selfies than shark attacks

(New York Post‎) Just a year after the word was added to the dictionary, the selfie is claiming more lives than shark attacks, according to a report by Condé Nast Traveler.
There have been dozens of deaths related to tourists taking selfies, according to Condé Nast research, compared with just eight confirmed shark-related deaths this year through August. And that’s just the widely reported cases involving tourism — there are likely far more non-tourist-specific cases, such as people taking selfies and Snapchat videos while behind the wheel of a car.
There is now an entire Wikipedia page devoted to selfie-related injuries and deaths.
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Non-antibotic drug shows promise in deadly C. difficile infections

(Reuters) A non-antibiotic drug already tested in people for other uses may be active in treating Clostridium difficile, a superbug that preys on people whose protective gut bacteria have been wiped out by antibiotics…
The team searched through a federal library of compounds for drugs that targeted C. difficile’s toxins.
They settled on ebselen, an antioxidant tested in late-stage trials by Daiichi Sankyo as a stroke treatment, but never reached the market and is now off patent.
In studies in mice, the compound curbed infections, including those caused by a drug-resistant strain of C. difficile, blocking both inflammation and colon damage in treated mice.
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Scientists say car emissions rigging raises health concerns

(Reuters) Volkswagen's admission that it rigged car emission tests has prompted environmental and health experts to ask whether such deception could have hampered progress in reducing death and disease from air pollution.
Volkswagen's Chief Executive Martin Winterkorn resigned on Wednesday over the falsification of test data from diesel cars in the United States, the latest twist in a scandal that has rocked the global car industry and raised concerns about what it may mean for the environment and public health…
Carmakers argue that diesel vehicles account for only a fraction of pollutants in the air, but experts say the health risks are greater because most cars are driven in urban areas where large numbers of people live and breathe.
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Brain-computer link enables paralyzed California man to walk

(Reuters) A brain-to-computer technology that can translate thoughts into leg movements has enabled a man paralyzed from the waist down by a spinal cord injury to become the first such patient to walk without the use of robotics, doctors in Southern California reported on Wednesday.
The slow, halting first steps of the 28-year-old paraplegic were documented in a preliminary study published in the British-based Journal of NeuroEngineering and Rehabilitation, along with a YouTube video.
The feat was accomplished using a system allowing the brain to bypass the injured spinal cord and instead send messages through a computer algorithm to electrodes placed around the patient's knees to trigger controlled leg muscle movements.
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Telehealth visits may be an option after surgery

(Reuters Health) People may happily, and safely, forgo in-person doctors' visits after surgery by opting instead for talking with their surgeons by phone or video, suggests a small study of U.S. veterans.
Most patients preferred the virtual visits and the doctors didn't miss any infections that popped up after surgery, the researchers report in JAMA Surgery.
"These kinds of methods are really important in the climate we’re in now," said lead author Dr. Michael Vella, of Vanderbilt University Medical Center in Nashville. "So I think anything you can do to save money, see more patients and improve access to care is really important."
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Reforms needed to address medical diagnostic errors: U.S. report

(Reuters) Most Americans will fall victim to at least one diagnostic error in their lifetime, and when this occurs, it often can be deadly, according to a new report released on Tuesday by the Institute of Medicine, which advises the U.S. government and policymakers.
The report called for greater emphasis on improving diagnoses in the United States and reducing the number of errors, which they defined as either an inaccurate or delayed diagnosis.
"Diagnostic errors are a significant contributor to patient harm that has received far too little attention until now," said National Academy of Medicine President Victor Dzau.
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How an obscure drug’s 4,000% price increase might finally spur action on soaring health-care costs

(Wonkblog, Washington Post) New York-based Turing bought the drug called Daraprim for $55 million this summer. It is used to treat toxoplasmosis, a parasitic infection that can be severe in patients with compromised immune systems, such as HIV, and for pregnant women. Earlier this month, the head of the Infectious Diseases Society of America and the HIV Medicine Association condemned the price increase from $13.50 a pill to $750, noting that the average cost per year for a patient weighing more than 132 pounds would be $634,500…
Uwe Reinhardt, a noted health-care economist from Princeton University, said that, in a way, what Shkreli did may have been a service to the discussion about health-care spending in the United States.
"He bought this patent and he's milking it for all it's worth. In a way, I thank him, because it's really sort of like putting a sign on your back saying, 'Kick me,'" Reinhardt said. "Sometimes you need some sentinel effect that wakes people up."
It’s especially galling that the drug companies charge through the nose here, and make deals for reduced prices in other countries:
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How Medicare’s 'chronic care management' payments could affect primary care

(Reuters Health) Medicare’s new “chronic care management” (CCM) payment program could make it more financially feasible for physicians to deliver services between visits.
Under the new program, Medicare could reimburse primary care practices about $40 month for such things as medication management and communication with other doctors for patients who have two or more chronic medical conditions. Patients would have to agree to be enrolled and would have a 20 percent copay.
“Patients who have multiple complex medical problems like heart failure diabetes, chronic debilitating arthritis, Parkinson’s, and dementia frequently visit multiple providers in different organizations. They and their families frequently face multiple, sometimes conflicting decisions. CCM has the potential to organize the coordination under one provider, help make the patient’s care reflect their values and choices, streamline the process, and by paying physicians, make it more effective and efficient,” Dr. Fitzhugh C. Pannill from the University of Connecticut School of Medicine in Farmington, who wrote an editorial related to this report, told Reuters Health by email,
“Most importantly, CCM requires that each patient’s personal goals for their health care and medical decisions be routinely and systematically solicited, recorded, and communicated as part of the ‘Patient-Centered Care Plan,’” Pannill said.
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U.S. says 17.6 million Americans gained health insurance through law

(Reuters) The U.S. national healthcare reform law has extended health insurance coverage to 17.6 million Americans, according to a new government report on Tuesday, up from its previous estimate of 16.4 million.
The number of uninsured has decreased because of changes in the law that allowed young people to stay on their parents' health plans for longer, the expansion of Medicaid in 29 states and the District of Columbia, and the sale of subsidized health insurance to individuals, U.S. Department of Health and Human Services (HHS) Secretary Sylvia Burwell said in a speech.
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Weight of the union: Obesity by state

(CNN) New numbers from the Centers for Disease Control find that while adult obesity rates remain steady, they are still high around the country.
In a state-by-state analysis, Arkansas, West Virginia and Mississippi were states with the highest adult obesity rates. Hawaii, the District of Columbia and Colorado had the lowest rates. While the Midwest had the greatest prevalence of obesity, the South was not far behind and was home to seven of the states with the highest obesity rates in the nation. Obesity rates have been steadily rising since the 1990s. In 2013, Mississippi and West Virginia were the first two states to ever report more than 35% of their adult population as obese.
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Obesity Care Model Calls for Primary Care, Public Health Integration

(American Academy of Family Physicians) The Patient Protection and Affordable Care Act (ACA) has sparked increased support for integrating primary care and public health to enhance care for patients, especially those with chronic diseases such as obesity…
[Lead author William] Dietz and his co-authors, including representatives from leading managed care organizations such as Kaiser Permanente and HealthPartners, propose that this new model include
§  a system that is centered on individual patients and family engagement. The authors note that successful obesity treatment models often require behavioral changes such as preparing nutritious foods or increasing physical activity, and families play a key role in these efforts.
§  restructured clinical services provided by physicians who are sensitive to the stigmatization of people with obesity. Physicians and staff need to learn behavioral strategies that can motivate patients to change their dietary habits and start exercising.
§  better integration between clinical services and community systems that can make it easier for patients to lose or maintain their weight. For example, partnerships between clinics and YMCAs or other community-based resources can provide opportunities for structured regular exercise and/or nutrition counseling.
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A High Fat Diet Leads to Overeating Because of Faulty Brain Signaling

(Elsevier) Defective signaling in the brain can cause overeating of high fat foods in mice, leading to obesity, according to [a] research article…
The body controls food intake by balancing a need for food to survive with a desire for food for pleasure. By shifting the balance between these systems, defective brain signaling can cause pleasure to take over, resulting in overeating and obesity…
"Our findings reveal a system that is designed to control eating of rewarding foods that are high in fat and possibly sugar," said [Dr. Aurelio Galli, one of the authors of the study]. "This system can be hijacked by the very foods that it is designed to control. Eating a high-fat or high-carbohydrate diet feels rewarding, but also appears to cause changes in the brain areas that are involved in controlling eating, by causing for example insulin resistance. Our study shows that when specific signaling in these areas of the brain is disrupted, it leads to a vicious cycle of increasing, escalating high-fat diet intake that likely further cements changes in these brain areas."
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For controlling weight, not all fruits and vegetables are created equal

(Los Angeles Times) [A] new study finds that starchy veggies such as peas, corn and potatoes are vegetables that occupy a decidedly less elevated plane than many others. Higher consumption of a whole range of fruits and vegetables does help prevent weight gain over time, the new research finds. But satisfying our vegetable requirements with starchy vegetables, alas, will not keep the pounds from adding up.
One exception: soybeans and tofu. Though both contain some starch, people who boosted their intake of soy products during the study period reaped substantial protection against weight gain…
Some of the magic conferred by [non-starchy] fruits and vegetables may lie in their polyphenol content, the plant-based phytochemicals that reduce the damage caused by oxidation in our cells. But some of their benefits, the researchers say, may be far simpler: When we increase our consumption of these foods, they usually crowd out foods that are denser in fat and calories, such as meats and gooey desserts.
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People who see themselves as overweight are more likely to gain weight

(Reuters Health) People who perceived themselves to be overweight were at greater risk of gaining weight in recent studies from the U.S. and the UK.
This was true whether or not their perceptions were correct.
They also were more likely to overeat in response to stress, which explained a large part of the weight gain, researchers say…
Jane Wardle, a clinical psychologist at University College London, … who studies weight perception, noted that people who believe they are overweight may delay their weight loss efforts. She said that, “a person might decide they should definitely start a diet tomorrow and meanwhile finish the cookies.”
Wardle advised that healthcare professionals can help people identify practical steps to lose weight that are not too difficult.
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Text Reminders Help People Make Healthy Choices

(Shots, NPR) Getting texts with motivating and informative messages led patients with coronary heart disease to make behavior changes like exercising more and smoking less, according to a study… By the end of the six-month study, patients who had received the text messages had reduced their cholesterol, blood pressure and body mass index.
"I have to say, we were pretty surprised that it worked," says Clara Chow, lead author of the study and program director of community-based cardiac services at Westmead Hospital in Sydney, Australia.
And it worked to improve not just one risk factor for heart disease, but many. "These are the things that medications usually do, not text messages," says Chow, who is also an associate professor at Sydney Medical School at the University of Sydney.
Community: Text messages may also help with motivation for weight loss and exercising. It could be that these messages help counter the barrage of advertising we see, enticing us into unhealthy behaviors.
There are many practical things we can do to improve impulse control.
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9 Ways to Burn More Calories

(SouthBeachDiet.com) Regular exercise combined with a healthy diet is hands-down the best way to burn calories. So if you're not already on a healthy meal plan like the South Beach Diet and you haven't carved out at least 20 minutes a day most days of the week to exercise, get started now. Once you're committed to a healthy diet and regular workout routine, here are nine more ways you can keep your metabolism revved up and burning the maximum amount of fat and calories throughout the day.
Eat breakfast daily…
Exercise early…
Start interval walking…
Strengthen your core…
Move more…
Snack smartly…
Drink water…
Get your caffeine fix…
Get more zzzs…
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The Latest from The People's Pharmacy

Luteolin from Vegetables Reduces Breast Cancer Risk
Parsley and thyme contain luteolin, which can lower the likelihood of breast cancer in women exposed to postmenopausal hormone replacement therapy.
Cranberry Pills Prevent Urinary Infections
Would cranberry pills be just as good as cranberry juice for preventing urinary tract infections? Recent research says yes.
Banana Peel for Warts
One of our favorite home remedies for warts is using a small piece of banana peel.
Novel Use of Biotin to Tame Tinnitus
Smearing biotin on the scalp eased tinnitus for this reader and made it less intrusive. Will biotin work for other tinnitus sufferers?
Milk of Magnesia (MoM) Banishes Breast Rash
Women often suffer from breast rash in silence. It is nothing to hide. Readers share a lots of breast rash remedies from liquid laxatives to Listerine.
Will the Soap Remedy Really Prevent Leg Cramps?
The soap remedy for nighttime leg cramps is amusing, but it can also be helpful in keeping painful muscle spasms from disturbing your rest.
Cetirizine (Zyrtec) Withdrawal & Unbearable Itching
Cetiriizine (Zyrtec) eases allergic symptoms like itching and hives so who would have ever guessed it could trigger such symptoms when stopped suddenly.
Lymphoma as a Side Effect of Remicade
Patients with rheumatoid arthritis, psoriatic arthritis or ulcerative colitis need to be aware of lymphoma as a side effect of the TNF blocker Remicade.
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Many people try probiotics to solve digestive problems. But do they work?

(Washington Post) One in 5 Americans with digestive problems seeks out probiotics, according to market research. They can be found in the supplements aisle as well as the dairy case. (Fermented foods — notably, yogurt — can contain naturally occurring and added probiotics.) But do they work?
That depends. Some studies that tout their benefits have been small, poorly designed or sponsored by those with a vested interest in the outcome. “The quality of the research has probably not been as good as it should have been over the years,” notes Patricia Hibberd, a professor at the Harvard Medical School.
But there’s some evidence that probiotics might shorten a bout of diarrhea caused by antibiotics, a virus or contaminated food, and studies suggest that they help manage irritable bowel syndrome. An analysis of 23 clinical trials found that taking probiotics with antibiotics can substantially cut the risk of diarrhea caused by Clostridium difficile, a serious infection. Consumer Reports’ advice: Consider probiotics if you’re on antibiotics for more than a few days, if you’re taking two simultaneously or if you’ve switched from one to another.
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Non-prescription device may ease urinary incontinence

(Reuters Health) Some women suffering from stress incontinence who don't want to have surgery or see a physician for a vaginally inserted device they can use at home may get symptom relief from Impressa, an option on drugstore shelves that doesn't require a doctor visit…
Impressa is a disposable device inserted into the vagina that's designed to stop leaks by putting pressure on the urethra. Like some tampons, it's inserted with an applicator, has a string on the end for removal, and comes in a variety of sizes. It consists of a flexible core with support poles made of resin to prevent movement within the vagina and a porous nylon mesh cover that functions like a sling to support the bladder.
In some ways, Impressa is a variation on devices known as pessaries that doctors may offer to women for urinary stress incontinence.
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When Does an Image Become a Health Claim?

(British Psychological Society) Images on food and dietary supplement packaging might lead people -- appropriately or inappropriately -- to infer the health benefits of those products.
A study, led by Naomi Klepacz of the University of Surrey and Dr Robert Nash of Aston University, has shown that people often misremember written health claims on product packages, but that this problem is worse when the packages also feature a health-related image.
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Coca-Cola says spent nearly $120 million on health research

(Reuters) Coca-Cola Co said it has spent almost $120 million on funding scientific research, a disclosure that comes at a time when the company is facing criticism for trying to downplay the role of sugary drinks in the spread of obesity.
The company also launched a website on Tuesday to update details about its research efforts and the experts it has worked with in the past five years.
The move follows a New York Times report in August that the cola maker was funding scientists who claim Americans are overly fixated on how much they eat and drink and not paying enough attention to exercise. (nyti.ms/1UyAMUG)
U.S. sales of carbonated soft drinks have been declining for nearly a decade due to increasing public backlash against full-calorie as well as diet sodas.
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New Court Docs: Maker of Tylenol Had a Plan to Block Tougher Regulation

(ProPublica) Recently filed court documents show the makers of Tylenol planned to enlist the White House and lawmakers to block the Food and Drug Administration from imposing tough new safety restrictions on acetaminophen, the iconic painkiller’s chief ingredient.
An executive with McNeil Consumer Healthcare – which counts Tylenol as its flagship product – told the board of directors for parent company Johnson and Johnson about a campaign to “influence the FDA” and block recommendations made by an agency advisory panel in 2009…
“’We’re going to involve key opinion leaders, and we’re going to get them to help us influence the FDA to disregard what the advisors said,’” a plaintiff’s lawyer told a New Jersey court late last month, describing the contents of internal corporate documents.
The previously unreported lobbying campaign was disclosed as part of a trial scheduled to start today in Atlantic City that promises to draw new scrutiny to McNeil’s efforts to protect its painkiller from additional regulation and disclosures about the full extent of its risks.
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Former peanut company CEO sentenced to 28 years for salmonella outbreak

(Reuters) The former owner of a peanut company in Georgia was sentenced to 28 years in prison on Monday for his role in a salmonella outbreak that killed nine people and sickened hundreds, a rare instance of jail time in a food contamination case.
Stewart Parnell, 61, who once oversaw Peanut Corporation of America, and his brother, Michael Parnell, 56, who was a food broker on behalf of the company, were convicted on federal conspiracy charges in September 2014 for knowingly shipping salmonella-tainted peanuts to customers.
Contamination at the company's plant in Blakely, Georgia, led to one of the largest food recalls in U.S. history and forced the company into liquidation.
Community: This is EXACTLY how we should treat business owners who knowingly hurt and kill people, all in the name of the almighty profit. Fines don't hurt them. The Chinese execute them.
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Jury still out on e-cigarettes as cessation aid, U.S. doctors say

(Reuters Health) There isn’t enough evidence yet to say whether e-cigarettes are safe or effective for helping people quit smoking, new U.S. guidelines on tobacco cessation conclude.
The conclusion, issued by the U.S. Preventive Services Task Force (USPSTF) today as a part of updated recommendations on smoking cessation, adds to an emerging consensus in the medical community that e-cigarettes come with too many unknowns for them to be recommended to current smokers looking to kick the habit.
“There is not enough evidence to evaluate the effectiveness, safety or benefits and harms of using e-cigarettes to help people quit smoking,” said Dr. Francisco Garcia, a task force member and researcher at the University of Arizona.
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3-D Printed Guide Helps Regrow Complex Nerves After Injury

(University of Minnesota) A national team of researchers has developed a first-of-its-kind, 3D-printed guide that helps regrow both the sensory and motor functions of complex nerves after injury. The groundbreaking research has the potential to help more than 200,000 people annually who experience nerve injuries or disease…
[R]esearchers used a combination of 3D imaging and 3D printing techniques to create a custom silicone guide implanted with biochemical cues to help nerve regeneration. The guide's effectiveness was tested in the lab using rats.
To achieve their results, researchers used a 3D scanner to reverse engineer the structure of a rat's sciatic nerve. They then used a specialized, custom-built 3D printer to print a guide for regeneration. Incorporated into the guide were 3D-printed chemical cues to promote both motor and sensory nerve regeneration. The guide was then implanted into the rat by surgically grafting it to the cut ends of the nerve. Within about 10 to 12 weeks, the rat's ability to walk again was improved.
"This represents an important proof of concept of the 3D printing of custom nerve guides for the regeneration of complex nerve injuries," said University of Minnesota mechanical engineering professor Michael McAlpine, the study's lead researcher.
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Digestible Batteries Needed to Power Electronic Pills

(Cell Press) Imagine a "smart pill" that can sense problems in your intestines and actively release the appropriate drugs. We have the biological understanding to create such a device, but we're still searching for electronic materials (like batteries and circuits) that pose no risk if they get stuck in our bodies… Christopher Bettinger of Carnegie Mellon University presents a vision for creating safe, consumable electronics, such as those powered by the charged ions within our digestive tracts…
Ingestible devices that are used now are powered by off-the-shelf batteries, just like what you'd find in a watch. Bettinger challenges whether a segmented battery is necessary, as the natural liquids within the body can be the electrolytes that move current through the device. Labs have already proven that electronics built using this method can disintegrate in water after 2-3 months.
There's also evidence that manufacturing biologically inspired "smart pills" can be cost-effective and pass regulatory approval. Ingestible medical devices and even 3D printed pills have been given the green light for patient use in recent years despite their atypical properties. Regarding cost, one of the reasons medications cost so much is that only a small percentage of a pill actually makes it to where it needs to be used in the body. Bettinger argues that if an electronic pill can make better use of expensive medications, then the amount needed for each patient can be reduced.
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On Drug Prices

(Reuters) Americans are paying way over the odds for some modern cancer drugs, with pharmaceutical companies charging up to 600 times what the medicines cost to make, according to an independent academic study.
The United States also pays more than double the price charged in Europe for these drugs - so-called tyrosine kinase inhibitors (TKIs), a potent class of cancer pills with fewer side effects than chemotherapy.
(Reuters) U.S. Democratic presidential candidate Hillary Clinton proposed on Tuesday a $250 monthly cap on out-of-pocket prescription drug costs and other measures to stop what she called "price gouging" by pharmaceutical companies…
Under Clinton's plan, the monthly cap would limit what insurance companies could ask patients to pay for drugs that treat chronic or serious medical conditions.
(Reuters) Turing Pharmaceuticals, a small company that generated outrage over raising the cost of an old anti-infective drug by more than 5,000 percent, said on Tuesday it would roll back that increase to make sure it remains affordable.
Turing and its Chief Executive Officer Martin Shkreli became the new face of the U.S. drug pricing controversy this week, after the New York Times reported that the company had raised the price of Daraprim, a 62-year-old treatment for a dangerous parasitic infection, to $750 a pill from $13.50 after acquiring it. The medicine once sold for $1 a pill.
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