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80% of world’s pain medication used in U.S.

Yes you read that right, Americans use 80% of the world’s pain medication.  Pain medication prescriptions are up 600% in the last ten years.  Estimated at 110 tons of opiates, enough to give every person in the US the equivalent of 64 percocets.  It’s estimated prescription pain pill abuse is responsible for 14,800 deaths per year, that’s not including medical errors and side effects which can lead to death.

Source: MailOnline  Photo: Public Domain

Not the best source, the information/research was obtained from The American Society of Interventional Pain Physicians.  This is a fascinating phenomenon, even as I watch it unfolding before my eyes.  Even 5 years ago most patients entering my office would not be on any pain medication unless experiencing an acute episode.  But within that time patient now commonly will be on an indefinite pain medication prescription, meaning they are taking some kind of pain medication all of the time regardless if they have pain or are experiencing an acute pain episode.  This interferes greatly with their rehabilitation and their ability to even understand what “pain free” really means.

We are seeing the sequelae of patients wanting a quick fix to their pain, although to some extent this is due to the lack of options when it comes to actually treating their pain.  Take low back pain for example, it can be a long road with lots of work and diligence to rehabilitate a back to become pain free, offering an alternative where you can just swallow a pill is pretty hard to compete with.


Asthma/Allergies, are you TOO clean?

A new paper in Nature Medicine discusses the importance of gut bacteria and the connection to allergies and asthma.  What they found was that high levels of IgE antibodies were partially responsible for triggering asthma and allergies.  They were able to increase IgE levels by killing off “good” bacteria in the gut with antibiotics.  This wasn’t necessarily a new discovery, what they did discover was that the normal gut bacteria could actually inhibit the precursor cells which turned into the cell types which caused asthma and allergies.  Having a system work at such an early level and understanding how it works is very important to finding a cure.

From the study: “These findings suggest that, in addition to regulating immune cells in the periphery, commensal-derived signals can alter mammalian hematopoietic programs in the bone marrow to promote or protect against the development of allergic responses.

Source: Nature Medicine  Photo: CC BY 3.0

But more importantly to understanding how we treat our bodies, especially as children, is so important.  We live in an antiseptic age, as children we are scrubbed clean, given antibiotics for every sniffle, have our hands washed, and not allowed to play in the dirt.  There is more and more research every year showing the detrimental effects of all of these lifestyle choices on our immunities.

Longer recovery noted for women and teens following concussion injuries

A Michigan State University study demonstrated women and teens take longer to recover from concussion injuries.  Females between the ages of 14 to 23 demonstrated worse performance than male counterparts in both cognitive testing and concussion symptoms.

In my own practice it’s common to see a woman have a greater degree of concussion and a longer recovery than a male who may have been in the same auto accident.  Part of the reason is that a woman has a higher risk index of injury due to their head to neck ratio as opposed to a man’s.  This study is important because it draws attention to not only an increased risk for women in general, but more specifically to teen women which the study showed had taken twice as long to recover than college females.

Source: The American Journal of Sports Medicine  Photo: CC BY 2.5

Childhood obesity linked to prenatal exposure to air pollution

A study done in New York City finds that prenatal exposure to higher levels of a group of chemicals called polycyclic aromatic hydrocarbons resulted in two times the likelihood of obesity by the age of 7.  PAH is a common pollutant found in urban areas, especially areas where coal, diesel, oil, gas or other organic substances such as tobacco are burned.

Source: Medical Xpress  Photo: Public Domain

Side effects of medication grossly underestimated

Researchers at the Stanford University of Medicine have created an algorithm which which identified additional drug side effects not on current labels.  This process has uncovered possibly thousands of additional side effects when using more than a combination of drugs.  This is in addition to the database maintained by the FDA which already lists close to 4 million side effects for these medications.

Source: Nature  Photo: CC-BY-SA-3.0

Knee replacements lacking proper research

In 2008 there were 650,000 knee replacement surgeries performed at a staggering cost of 10.4 billion dollars.  Take into account the baby boomers and the incredible amount of elderly who are going to be having knee issues and we can see that number will only increase.  Recently The Lancet found that there is not enough evidence regarding the safety or efficacy of these knee replacements from larger non biases studies.  Although smaller studies do exist they commonly belong to someone with a possible bias towards the product such as a co-owner or inventor.  Although the research authors noted very good results overall with knee replacement surgery they cautioned that there are risks which need to be weighed when considering this surgery.

Source: Scientific American Photo: Knee Replacement CC BY-SA 3.0

Prior brain injury linked to Post Traumatic Head Disorders

Research has previously shown a connection between TBI (traumatic brain injury) and PTSD (post traumatic head disorders).  New research demonstrates that prior TBI’s will change an area of the brain called the Amygdala and put them at risk for developing PTSD.  In essence this is saying, in the absence of other variable factors, if two people both suffered TBI’s but only one of them had prior TBI’s the person with multiple TBI’s would be at higher risk for developing PTSD.

Source: Wired Photo: Public Domain

Very interesting research aimed primarily at the military.  I found the study interesting to consider with both whiplash patients and athletes undergoing concussions.  Both of these groups suffer Diffuse Axonal Injuries (DAI) and I have seen cases of PTSD with some repeat whiplash patients.  The Amygdala has also been suspected of being dysfunctional, this part of the brain is associated with processing of memory associated with emotions, in a very simplified sense it evaluates the emotional meaning of incoming sensory input and it seems in these cases over-evaluates the emotional importance.  Fear of driving and anxiety after whiplash injuries are more common than reported in the literature and this research certainly gives us something to think about not only on the battlefield but in the doctors office.


This year is shaping up to be a good one for health-related gadgets, thanks to the new Bluetooth 4.0 specification and profiles. The $79 Wahoo Blue HR is among the first of these devices to take advantage of this low-powered wireless capability, and I took it for a 5-mile test run. There’s no need to charge the heart-rate monitor because it runs on a fairly standard watch battery that should last for at least a year.

It’s great to see my heart-rate data after a run, but even more important to see it during a training session. The Wahoo Blue HR works with a number of apps, including a free native app. For now, you can only use this monitor with the iPhone 4S(s aapl) because most handsets aren’t yet using Bluetooth 4.0. That should change during 2012, however. And I foresee uses other than exercise tracking for these types of…

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Keep moving or die!

Well, maybe a bit sensationalistic but researchers at the University of Missouri conducted a study examining a group who cut the number of steps they took in half.  What’s interesting is that the test subjects were all moderately healthy in terms of their physical fitness, they averaged 10,000 – 13,000 steps per day.  During the study their blood glucose levels were measured before and after.  The subjects restricted walking to less than 5,000 steps per day.  Significant blood glucose spikes were found after eating when subjects walked less than 5,000 steps per day, these findings were not found when they walked their normal amount.

These findings show a propensity towards decreased health and possibly disease attributed to high blood sugar such as heart disease and type II diabetes in those who are inactive.  What is scary is that these results were seen in otherwise healthy individuals and were seen before they had a chance to have any sedentary changes such as increased fat.

Source: NYTimes Study: Study  Photo: Björn Láczay CC BY 2.0

“Sitting disease” may eventually kill you

This is an interesting article I came across.  A Mayo Clinic doctor calls today’s common sedentary seated lifestyle the “sitting disease” and has proposed the installation of treadmill walking workstations where you would walk while you work instead of sitting.  He talks about the increased risk of cardiovascular disease from prolonged sitting and how walking while working can help to burn more calories, better breakdown fats and sugars, and manage blood sugar more effectively.

Source: Live Science

It’s quite interesting, especially the part about helping to manage blood sugar.  It’s well known that both after fasting and after exercise there is an increased insulin sensitivity as your body wants to refuel itself.  It’s interesting to note that this effect may be perpetuated all day long by working out continuously, although it’s a far stretch to say this is what’s going on without more research.  The article does note that in a study the sedentary group had larger blood sugar spikes after eating than when they worked out.

Of importance is also spinal health.  Sitting or really any prolonged trunk flexion activity just puts a huge demand on the spine.  The flexed trunk takes a lot of compression, it also takes a lot of shear force which is one vertebrae wanting to slip forward over another.  A common mistake is to consider a macro injury event, but in reality most low back pain is due to micro injuries.  They could be due to flexing and compressing the spine all day long for years, or possibly a job which requires repeated trunk bending but not necessarily lifting of heavy weights.  This repeated compression of the spinal discs, vertebral end plates, and constant stress on the ligaments and muscles which compensate for this flexion is what eventually breaks down the biomechanics of the spine and causes injury.