Monthly Archives: August 2016

Help Ease Chronic Fatigue Syndrome

Patients with chronic fatigue syndrome who participated in programs aimed at helping them overcome their symptoms — a combination of exercise and counseling — improved more than those whose treatment was intended to help them adapt to the limitations of the disease, a large randomized trial found.

Mean fatigue scores among patients treated with graded exercise therapy — a tailored program that gradually increases exercise capacity — were 3.2 points lower than scores in patients who received specialist medical care alone, according to Dr. Peter D. White, of Queen Mary University of London, and colleagues.

Furthermore, fatigue scores were lower by 3.4 points among patients receiving cognitive behavioral therapy, in which a therapist works with the patient to understand the disease, alleviate fears about activity, and help overcome obstacles to functioning.

In contrast, among patients who were treated with a program known as adaptive pacing therapy, which emphasizes energy limitations and avoidance of excess activity, scores differed by only 0.7 points the researchers reported online in The Lancet.

In a press briefing describing the study findings, co-investigator Dr. Trudie Chalder, of King’s College London, said, “We monitored safety very carefully, because we wanted to be sure we weren’t causing harm to any patients.”

“The number of serious adverse events was miniscule,” she added.

Another co-investigator, Dr. Michael Sharpe, of the University of Edinburgh, commented that a difficulty in the management of chronic fatigue syndrome has been ambiguity — about the causes and whether these treatments recommended by NICE actually are effective.

“The evidence up to now has suggested benefit, but this study gives pretty clear-cut evidence of safety and efficacy. So I hope that addresses the ambiguity,” Sharpe said during the press briefing.

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However, the investigators conceded that the beneficial effects of these treatments were only moderate, with less than one-third of participants being within normal ranges for fatigue and functioning, and only about 40 percent reporting that their overall health was much better or very much better.

“Our finding that studied treatments were only moderately effective also suggests research into more effective treatments is needed,” they wrote.

In addition, they stated that their finding of efficacy for cognitive behavioral therapy “does not imply that the condition is psychological in nature.”

The importance of cognitive behavioral therapy was further emphasized by Dr. Benjamin H. Natelson, of Albert Einstein College of Medicine in New York.

“This approach of encouragement of activity and discouragement of negative thinking should be a tool in every physician’s armamentarium,” he said.

“We know that cognitive behavioral therapy and gentle physical conditioning help people cope with any chronic disease — even congestive heart failure and multiple sclerosis,” Natelson said in an interview with MedPage Today.

Chronic fatigue syndrome is characterized by persisting or relapsing fatigue for at least six months that cannot be explained by any other physical or psychiatric disorder.

The fatigue is debilitating, and often is accompanied by joint and muscle pain, headaches, and tenderness of the lymph nodes.

In an editorial published with the study, Dr. Gijs Bleijenberg, and Dr. Hans Knoop, of Radboud University in Nijmegen, the Netherlands, explained the differences in these types of treatment for chronic fatigue.

Group Claims Caramel Coloring Is Toxic

The FDA should ban the use of two compounds widely used in food products, including market giants Coke and Pepsi as well as other soft drinks, because they pose a cancer risk, according to a petition filed by a citizen’s group.

But the American Beverage Association denounced the petition, filed Feb. 16, as “nothing more than another attempt to scare consumers” that is not supported by science.

At issue are caramel colorings that contain 2-methylimidazole and 4-methylimidazole.

According to the petition, filed by the Washington-based Center for Science in the Public Interest, both have been found by the National Toxicology Program to cause cancer in animals.

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And last month, California regulators added one of them — 4-methylimidazole — to the list of chemicals “known to the state to cause cancer.” The state said the safe limit for consumption of the chemical is 16 micrograms a day.

However, a recent study suggested that 12 ounces of cola would contain up to 130 micrograms of the substance, according to the petition.

The coloring substances are made by treating sugars with ammonium alone or ammonium and sulfites under high pressure and temperatures; the two compounds are byproducts of the process.

Feeding studies conducted by the National Toxicology Program showed that high doses of the substances led to lung, liver, or thyroid cancer or leukemia in laboratory mice or rats.

The government researchers concluded there was “clear evidence” that 4-methylimidazole caused cancer in mice, although studies in rats were less clear, with significant increases in leukemia in females but no increase in tumor activity in males.

They also concluded that 2-methylimidazole caused cancer in female rats and argued there was “some evidence” the substance caused tumors in male and female mice.

“Carcinogenic colorings have no place in the food supply,” according to Dr. Michael Jacobson, executive director of the citizens’ group.

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“The FDA should act quickly to revoke its approval of caramel colorings made with ammonia,” Jacobson said in a statement.

The American Beverage Association, however, noted that the National Toxicology Program does not include 4-methylimidazole among compounds on its list of substances “reasonably anticipated to be human carcinogens.”

“No health regulatory agency around the globe, including the Food and Drug Administration, has said that 4-methylimidazole is a human carcinogen,” the association said in a statement.

Have You a Fractured Bone

images-24Any crack or break in a bone is considered to be a fractured bone. Although auto accidents are a common cause of fractured bones, most fractures actually occur inside the home.

The most common fractured bone in children is an arm bone, because kids hold out their arms when they fall. For people over age 65 who fall, the most common fractures are hip, spine, arm, and leg fractures.

Fractured bone symptoms depend on what bone is fractured and the type of break you experience, from a stress fracture in the shin or a compression fracture in the spine. The shin bone is the most commonly broken long bone in the body, but fractured leg symptoms from the shin bone can range from mild swelling to a bone actually sticking out through the skin.

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Symptoms that may occur with most fractured bones include:

  • A misshapen or deformed bone or joint
  • Bruising and swelling around the fracture
  • Severe pain that is worse with movement
  • Broken skin with visible bone showing
  • Loss of sensation or a tingling
  • Limited or complete loss of movement

Types of Bone Fractures

A bone fracture can range from a tiny crack in one spot to multiple complete breaks. Doctors use different terms to describe these types of fractured bones:

  • Greenstick. A greenstick fracture is a crack on one side of a bone that does not go all the way through.
  • Complete. A complete fracture is one that goes all the way through the bone.
  • Stress. A stress fracture is a hairline crack that occurs from overuse. Minor leg fracture symptoms often occur from stress fractures.
  • Compression. A compression fracture is when a bone collapses. This type of fracture usually occurs in the bones of the spine.
  • Open. An open fracture is a fracture that has broken the skin. These are also called compound fractures.
  • Comminuted. A comminuted fracture means that the bone is broken in more than one place.