Medical News Today: Hundreds of current medical practices may be ineffective

“Medical reversal” is a term that defines instances in which new and improved clinical trials show that current medical practices are ineffective or misguided. New research reveals that there are currently almost 400 medical reversals.
doctor checking medical record, looking concerned
A new meta-analysis finds that almost 400 medical practices may not be effective.

Medical reversals occur when new clinical research shows that a certain medical practice does not, in fact, work or it does more harm than good.

These new studies are superior to their predecessors because of things like better controls, better study design, or larger sample size.

Medical reversals often concern medications but they can also affect surgical procedures.

For instance, more than a decade ago, researchers and healthcare professionals realized that stenting procedures did not work for renal artery stenosis and that routine stenting should not be used to treat stable coronary disease.

Now, a new meta-analysis of 3,000 studies identifies almost 400 cases of medical reversals. The review appears in the journal eLife.

Diana Herrera-Perez, a research assistant at the Knight Cancer Institute at Oregon Health & Science University (OHSU), in Portland, is the lead author of the new analysis.

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Analysis finds 396 medical reversals

Referring to well-known endeavors to assess the validity of clinical practices, such as the Cochrane reviews, Herrera-Perez says, “We wanted to build on these and other efforts to provide a larger and more comprehensive list for clinicians and researchers to guide practice as they care for patients more effectively and economically.”

To do so, she and colleagues examined over 3,000 randomized controlled trials published in three prestigious medical journals over the last 15 years: The Journal of the American Medical Association (JAMA), The Lancet, and The New England Journal of Medicine (NEJM).

The analysis discovered 396 medical reversals: 154 of them in JAMA, 129 in NEJM, and 113 in The Lancet.

Researchers carried out most of these studies (92%) in high-income countries, while 8% were performed in low- or middle-income countries, including China, India, Malaysia, Ghana, Tanzania, and Ethiopia.

Most of the medical reversals occurred in the fields of cardiovascular disease (20%), public health and preventive medicine (12%), and critical care (11%).

Specifically, the most common interventions involved medications (33%), procedures (20%), vitamins and supplements (13%), devices (9%), and system interventions (8%).

Main takeaways from the results

The study’s senior author, Dr. Vinay Prasad, a hematologist-oncologist and associate professor at the OHSU Knight Cancer Institute, comments on the findings.

“There are a number of lessons that we can take away from our set of results, including the importance of conducting [randomized controlled trials] for both novel and established practices,” he says.

Once an ineffective practice is established, it may be difficult to convince practitioners to abandon its use. By aiming to test novel treatments rigorously before they become widespread, we can reduce the number of reversals in practice and prevent unnecessary harm to patients.”

Dr. Vinay Prasad

He adds, “We hope our broad results may serve as a starting point for researchers, policymakers, and payers who wish to have a list of practices that likely offer no net benefit to use in future work.”

Dr. Prasad cautions that the review has some limitations, such as the small number of journals it includes and the limited expertise of the reviewers.

To overcome such limitations, co-lead study author Alyson Haslam, Ph.D., who is also affiliated with the OHSU Knight Cancer Institute, calls for experts from various fields to critically assess the medical reversals identified in the analysis.

She says, “Taken together, we hope our findings will help push medical professionals to evaluate their own practices critically and demand high-quality research before adopting a new practice in [the] future, especially for those that are more expensive and/or aggressive than the current standard of care.”

Source Article from https://www.medicalnewstoday.com/articles/325476.php

Medical News Today: How a lethal toxin might help in the opioid crisis

With the opioid crisis in the spotlight, scientists are searching for new ways to tackle pain. One group has turned its attention to a lethal toxin that occurs naturally in some marine creatures. The latest study in rats provides encouraging results.
blue-ringed octopus
A number of marine animals contain tetrodotoxin, including the blue-ringed octopus.

Opioids are a range of drugs that act on opioid receptors to quickly relieve pain.

Although they are effective and safe when people use them correctly, they are highly addictive.

According to the Centers for Disease Control and Prevention (CDC), in the United States in 2017, two-thirds of drug overdose deaths involved an opioid.

In the same year, 47,000 people died due to opioid overdoses, and prescription opioids played a role in 36% of these deaths.

According to the National Institute on Drug Abuse, in 2017, 1.7 million people in the U.S. had “substance use disorders related to prescription opioid pain relievers.”

The statistics above underline the urgent need for a nonaddictive but still effective replacement for opioids.

Dr. Daniel Kohane, Ph.D., recently led a study by a group of researchers from Boston Children’s Hospital in Massachusetts who believe that they might have found the solution in a lethal ocean-derived toxin. The scientists published their most recent findings in the journal Nature Communications.

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Tetrodotoxin on trial

Several different sea creatures, including pufferfish and blue-ringed octopuses, contain tetrodotoxin. This toxin blocks sodium channels, preventing nerves from carrying impulses.

Following ingestion, it can cause symptoms that include headaches, vomiting, and a tingling sensation in the tongue and lips. If a person consumes enough of it, it can lead to respiratory arrest and death.

Tetrodotoxin is roughly 1,200 times more toxic than cyanide, which, perhaps, makes it an unlikely candidate to treat acute pain.

Dr. Kohane has been interested in the therapeutic potential of this toxic compound for some time. Medical News Today recently asked him why tetrodotoxin interested him, and he said:

“Tetrodotoxin and compounds like it are very potent local anesthetics. Also, unlike conventional local anesthetics, they don’t cause seizures, cardiac arrhythmias, and tissue (nerve and muscle) injury.”

Dr. Kohane had already demonstrated in an earlier study that tetrodotoxin produces anesthesia. The problem, however, is the chemical’s potent toxicity.

In small amounts, pain relief is significant, but in higher quantities, it is lethal. Dr. Kohane has attempted to limit the compound’s toxicity while maintaining its potent analgesia.

For instance, in a previous study, his team packaged tetrodotoxin within a lipid membrane. On the surface of the membrane, they added molecules called sonosensitizers that are sensitive to sound.

Then, they implanted the tiny sacs under the skin of rats. Next, using ultrasound, they triggered the toxin’s release in small doses, relieving pain and minimizing toxicity.

In another study, Dr. Kohane and his team combined two nerve-blocking agents: tetrodotoxin and capsaicin (the chemical that gives chili peppers their punch). They found that the two compounds enhanced each other’s effect, blocking nerve conduction more than the sum of using the two drugs separately.

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Removing a toxin’s teeth

Despite his earlier work, as it stands, tetrodotoxin’s toxicity limits its use in humans. “A lesson we learned is that with our previous delivery systems, the drug can leak out too quickly, leading to systemic toxicity,” says Dr. Kohane.

Dr. Kohane, however, is persistent. In his most recent study in an animal model, he and his team fused tetrodotoxin to a polymer backbone.

The body can only break down the bonds that hold the backbone to the drug gradually, releasing the toxin slowly.

In this system, we gave an amount of tetrodotoxin intravenously that would be enough to kill a rat several times over if given in the unbound state, and the animals didn’t even seem to notice it.”

Lead author Dr. Daniel Kohane, Ph.D.

With his colleagues, Chao Zhao, Ph.D., and Andong Liu, Ph.D., Dr. Kohane trialed a range of polymers to achieve the longest-lasting nerve block with minimal levels of toxicity.

As Zhao explains, “We can modulate the polymer composition to control the release rate.”

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Chemical safety measure

To improve safety further, the scientists added a third character in the form of a chemical that enhanced the permeability of nerve tissue. In doing this, it allowed the toxin to enter the nerves more easily, and, therefore, the researchers could reduce the dose of tetrodotoxin.

As Dr. Kohane explains: “With the enhancer, drug concentrations that are ineffective become effective, without increasing systemic toxicity. Each bit of drug you put in packs the most punch possible.”

With this concoction of polymer, toxin, and permeability enhancer, a single injection near the sciatic nerve of rats blocked the nerve for 3 days. Importantly, there were no apparent signs of tissue damage or toxicity.

These are still early days, and it is likely to be a long time before tetrodotoxin will take the reigns from opioids, but the wheels of research are turning. Dr. Kohane told MNT that some groups are trialing tetrodotoxin in humans.

He explained that “similar compounds, such as neosaxitoxin, have been used in humans for infiltration anesthesia […] but are still undergoing clinical trials.” When we asked him about the main stumbling blocks, he replied, “The usual: time, money, regulatory processes.”

Because 130 people, on average, die from opioid overdoses every day in the U.S., medical researchers need to follow every line of investigation to its conclusion.

Dr. Kohane told MNT that he has “a lot” of follow-up work planned, so the future looks bright for this unusually potent toxin.

Source Article from https://www.medicalnewstoday.com/articles/325446.php

Medical News Today: Guanfacine vs. Adderall: What is the difference?

Guanfacine, under the brand name Intuniv, and Adderall are prescription drugs that treat attention deficit hyperactivity disorder.

Both drugs help treat the disorder, which people commonly refer to as ADHD, but they work in different ways.

In the case of Adderall, it is a stimulant. Conversely, guanfacine is a nonstimulant. In this respect, they are taken in different ways and may have different side effects.

The best option for each person depends on their specific symptoms, needs, and personal preferences. People usually use guanfacine only if stimulant medications are not appropriate.

This article discusses the differences, side effects, and dosages for guanfacine and Adderall.

What are they?

Woman examining medication pot of Guanfacine or Adderall.
Guanfacine and Adderall are medications that treat ADHD symptoms.

Guanfacine and Adderall are two medications that treat ADHD and several other conditions.

Adderall is the brand name for a combination of amphetamine and dextroamphetamine salts.

Intuniv is the brand name for guanfacine. Both drugs are also available in generic forms.

Adderall is a central nervous system stimulant. Doctors usually use stimulants to treat ADHD in children and adults.

Stimulants work by making it easier for nerve receptors in the brain to communicate, which can help control impulsivity as well as regulate attention and behavior.

Adderall takes effect relatively quickly. Adderall XR, a long-acting form of Adderall, is slower and lasts for longer.

Doctors may prescribe Adderall for conditions other than ADHD, such as the sleep disorder narcolepsy.

Other stimulant ADHD medications include:

  • methylphenidate (Ritalin, Biphentin, Concerta)
  • lisdexamfetamine (Vyvanse)
  • dexmethylphenidate (Focalin)

Guanfacine

Unlike Adderall, guanfacine is a nonstimulant. It is a central alpha agonist. Guanfacine increases and adjusts the number of neurotransmitters in the brain, which can help increase attention span and reduce impulsivity.

Guanfacine impacts nerve receptors in the brain less directly than Adderall, meaning it takes longer to take effect.

People taking guanfacine must keep track of their results while they are taking the medication to make sure they are meeting their treatment goals.

According to the American Academy of Family Physicians (AAFP), children aged 6–17 years of age can use guanfacine, and it may be most effective in children aged 12 years and under.

Tenex, another form of guanfacine, can help treat low blood pressure in people of all ages.

Other nonstimulant ADHD medications are:

  • atomoxetine (Strattera)
  • Clonidine (Kapvay)


Which is best?

Doctors will usually prescribe stimulants as the first-line treatment for ADHD. They may prescribe a nonstimulant, such as guanfacine, if the person cannot take stimulants, does not tolerate them well, or finds they are not effective.

Each person responds differently to ADHD medication, and it is not always possible to know which type is most appropriate before trying them.

Effectiveness

Both guanfacine and Adderall are effective in treating ADHD.

The Centers for Disease Control and Protection (CDC) estimate that 70–80% of children have fewer ADHD symptoms when taking fast-acting stimulants, such as Adderall.

According to the Food and Drug Administration (FDA), Intuniv reduced ADHD symptoms in children aged 6–17 in three well-controlled clinical trials that lasted up to 8 weeks.

Action

While Intuniv is typically slower to act than Adderall, its effects can last much longer, up to 24 hours. Adderall XR lasts longer than Adderall.

Abuse potential

Unlike Adderall, guanfacine use does not carry a high risk of abuse or dependence.

Adverse effects and warnings

People who are concerned about specific side effects or interactions with pre-existing medication can use these to help decide which drug is better for them. The following sections discuss side effects and interactions.


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Side effects

A possible side effect of taking guanfacine is headaches.
A possible side effect of taking guanfacine is headaches.

Guanfacine can cause a wide range of side effects, including:

  • dizziness and drowsiness, especially at first
  • headache
  • irritability
  • low blood pressure
  • nausea
  • stomach pain
  • dry mouth
  • constipation
  • reduced appetite

In rare cases, guanfacine can cause:

Some side effects lessen over time but talk with a doctor about persistent, problematic, or uncomfortable symptoms.

If someone taking guanfacine has severe symptoms, they must talk to a doctor or seek emergency medical care.

Severe symptoms include:

Adderall can cause a wide range of side effects, most of which tend to lessen over time as the person’s body becomes used to the drug.

The side effects of Adderall and other stimulant medications can include:

  • stomach pain
  • loss of appetite
  • trouble sleeping
  • slightly higher heart rate and increase blood pressure in children
  • slower overall growth in children, which is usually temporary

Talk to a doctor or seek emergency care if someone develops severe side effects that doctors associate with stimulant use, such as:

  • significant increases in heart rate or blood pressure, fatigue, or shortness of breath
  • panic attacks, hallucinations, paranoia, delusions, or mania
  • changes in the feeling or color of fingers or toes
  • signs of dehydration, dark urine, weakness, or severe muscle pain
  • prolonged erection

Anyone who intentionally or unintentionally overdoses on Adderall or guanfacine medication needs emergency medical care.

Call Poison Control on 1-800-222-1222 for immediate advice on how to care for someone who has overdosed on ADHD medications, even if they have only taken a bit more than their usual dose or they seem fine.


Drug interactions

Adderall can interact with the following medications:

Intuniv can interact with the following medications:

  • CYP3A4 inhibitors, such as ketoconazole and fluconazole
  • CYP3A4 inducers, such as rifampin and efavirenz

Can you take both?

Doctors can prescribe Intuniv as an adjunctive therapy alongside stimulant medication.


Dosage

A doctor will often gradually adjust someone’s dosage until they find one that does not cause many side effects.

Adderall is available in both immediate-release (Adderall) and extended-release (Adderall XR) forms:

  • Adderall is available in tablets of 5, 7.5, 10, 12.5, 15, 20, and 30 milligrams (mg).
  • Adderall XR is available in capsules of 5, 10, 15, 20, 25, and 30 mg.

Intuniv is available in extended-release tablets of 1, 2, 3, and 4 mg.

How to take them

Guanfacine and Adderall must be taken in quite specific ways, as follows:

Adderall

Some people take Adderall early in the morning with food.
Some people take Adderall early in the morning with food.

People usually take Adderall and Adderall XR once or twice daily with or without food, usually in the early morning and early afternoon.

  • Swallow Adderall tablets whole, without crushing or dividing them.
  • Swallow Adderall XR capsules whole or open and sprinkle them on food.

If someone misses a dose of Adderall, they should take their medication as soon as possible, unless it is after 5 p.m. as stimulants may make it difficult to sleep.

If someone misses a dose of Adderall XR, they should not take the missed dose after 2 p.m. as it may interfere with sleep.

Guanfacine

People usually take guanfacine once or twice daily, with or without food, ideally at the same time each day.

Taking guanfacine with a high-fat meal may increase how much the body absorbs the drug, which may increase its effects.

If someone misses a dose of guanfacine, they should take the missed dose, as soon as possible, unless it is close to their next dose.

A person must never take more of ADHD medications than prescribed or share medications with anyone else.


Complications

Misuse of stimulants may lead to serious adverse heart events and sudden death.

Stimulants also carry the risk of addiction and emotional or physical dependence, especially if someone has taken them for a long time.

People taking Adderall or guanfacine should avoid using illegal drugs or drinking alcohol because doing so can reduce the benefits of their medication and increase adverse side effects.

Some side effects associated with guanfacine can make people less alert.


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Pregnancy

Researchers know little about the risks of using stimulants during pregnancy. However, stimulant abuse during pregnancy is associated with low birth weight, neonatal withdrawal symptoms, and premature birth.

No well-controlled studies have looked at the impact of guanfacine on pregnancy, though it seems able to pass into breast milk. Stimulants such as Adderall have been shown to concentrate in breast milk and can harm a child.


Outlook

Guanfacine (Intuniv) and Adderall are prescription medications to treat ADHD. Each has benefits and risks.

When discussing medication, a doctor will take many factors into account to find the most appropriate drug for an individual. This includes their symptoms, needs, pre-existing medical conditions or medications, and their preferences. They will also look at how a person has reacted to other ADHD medications in the past.

It often takes several weeks for people to find the right dosage of each medication. They may then start experiencing the full benefits weeks to months after beginning treatment.

Medications, such as Adderall and guanfacine, help manage ADHD symptoms, usually as part of a treatment plan that also involves non-medications therapies, including behavior and complementary health approaches.

Source Article from https://www.medicalnewstoday.com/articles/325481.php

Medical News Today: How long is acid detectable in the body?

Acid is a hallucinogenic drug. Albert Hoffman, a chemist in Switzerland, first developed it in 1938.

Another name for acid is lysergic acid diethylamide (LSD). In the 1950s, doctors used it in psychotherapy and to enhance the effects of antipsychotics. In the late 1960s, people started to use LSD as a recreational drug.

People also refer to LSD by its street names: blotter, dots, and yellow sunshine. It is an illegal drug of abuse and one of the most powerful mood-changing substances.

In this article, we describe how long LSD stays in the body and how long tests can detect it after a person takes a dose. We also discuss the effects and risks.

How long does acid stay in your system?

how long does acid stay in your system
Researchers can use blood and urine tests to detect acid in the system.

When a person takes LSD orally, the gastrointestinal system absorbs it and channels it into the bloodstream. Once the drug is in the bloodstream, it travels to the brain and other organs, such as the liver. The liver breaks down LSD into different chemicals.

Researchers experience many challenges when detecting LSD in human tissue samples. People only ingest small amounts, so detection methods need to be very sensitive.

LSD is also unstable, and the liver breaks it down rapidly. The time that LSD is detectable in the tissues is restrictive, so doctors need to analyze the samples quickly.

Some researchers have attempted to develop detection methods for the byproducts of LSD. However, the amounts of these substances that remain in the tissues are still very low.

Urine

When a person takes LSD orally, the liver transforms it into inactive compounds. In 24 hours, a person excretes only about 1% of LSD unchanged in the urine.

Researchers can use various methods to detect LSD in urine samples, but these techniques are not readily available. Most routine urine drug tests will not detect LSD.

Two techniques that researchers can use to detect LSD in urine are liquid-liquid extraction and ultra-high-performance liquid chromatography-tandem mass spectroscopy (UHPLC-MS/MS).

Studies have demonstrated that some inactive byproducts of LSD are present in urine at concentrations 16–43 times higher than LSD. Researchers are uncertain how these findings can help detect LSD use, however.

Blood

Doctors can also use liquid-liquid extraction and UHPLC-MS/MS to detect LSD in blood samples.

In a recent study, researchers took 13 blood samples within 24 hours of administering LSD. They kept the samples at below freezing temperatures and analyzed them within 12 months.

The researchers could detect LSD in samples taken up to 16 hours after administration in all the participants who had received 200 micrograms (mcg) of LSD.

In those who had received 100 mcg of LSD, the researchers could detect the drug in samples taken up to 8 hours after administration.

The amount of detectable LSD in the samples decreased over time in both groups. In the group who had received 100 mcg of LSD, the researchers could only detect the drug in 9 out of 24 samples after 16 hours.

These detection methods are highly sensitive and specialized, and they may not be readily available to doctors.

Hair

Hair samples are useful for detecting drugs that a person used a long time ago. They are also useful when blood or urine samples are unavailable.

Depending on the drug, researchers can estimate the time and duration of ingestion by analyzing the hair’s growth rate and the position of the drug’s evidence on the hair shaft.

Research from 2015 looked at three documented cases of LSD traces in human hair samples. The amount of LSD in the samples was between 1 and 17 picograms per milligram.

However, the researchers performed these tests on hair treated with LSD, rather than from hair samples of people who had taken the drug.

One major challenge that researchers have when using hair samples to detect LSD is that the drug is active at very low doses. If a person had to take a higher dose to feel any effect, the drug might be easier to detect.

There is very spare data on LSD in hair samples. Researchers are even unsure whether the drug is stable and detectable in these samples.

A negative result from a hair sample does not mean that the person has not taken LSD. Pubic hair samples, however, may have been contaminated with LSD from urine.

Other tissues

Researchers have analyzed tissue samples in mice that had received intravenous injections of LSD. They found LSD in the blood, brain, liver, kidneys, adrenal glands, thymus, lungs, and salivary glands.

Autopsy reports may also be able to detect LSD in humans. The journal Forensic Science International published findings from three autopsy reports that included LSD.

According to the researchers, this was the first analysis of LSD and its inactive compounds in human brain tissue. They found evidence of LSD in brain tissue samples, but it was not the cause of death in any of the cases.


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Factors that influence detection

how long does acid stay in your system urine test
Current tests are unable to detect LSD in the urine after 72 hours.

Many things can influence how long LSD is detectable, including a person’s overall health, their age, and how much of the drug they have taken.

One of the most important factors is the timing of the sample. LSD leaves the blood after about 24 hours.

Current tests are not able to detect LSD or its byproducts in urine samples after 72 hours.

In addition, other drugs that are similar in structure may interfere with the detection of LSD, depending on the test — some are more accurate than others.

For example, some tests have high false-positive rates, which means that they detect LSD when it is not present.


How long do the effects last?

After a dose of 1–3 mcg per kilogram of body weight, most people will experience a moderate effect of LSD.

People can expect to start feeling the effects 30–60 minutes after taking the drug. The effects may last 8–12 hours or more, depending on the dose.

While on LSD, people may experience altered awareness of surrounding objects, conditions, thoughts, and feelings.

One person may have a completely different experience from someone else after taking the same amount of the drug.

A person on LSD may have a “good trip,” which can be filled with bright hallucinations and a feeling of euphoria. Or, they may have a bad trip, involving hallucinations that cause anxiety, panic, fear, depression, despair, disappointment, or a combination.

Some people report flashbacks when using LSD. Stress, fatigue, and taking other drugs at the same time can make these flashbacks more likely. Also, a person who has used LSD in the past may have a flashback to a trip.

Other effects of LSD can include:

  • increased heart rate
  • increased blood pressure
  • increased breathing rate
  • rise or decrease in body temperature
  • sleeplessness
  • loss of appetite
  • shaking
  • sweating

In the 2016 National Survey on Drug Use and Health, researchers estimated that 1.4 million people aged 12 years or older were currently using hallucinogens, including LSD, in the United States.

In 2015 and 2016, the most commonly used hallucinogens were LSD and ecstasy. People usually take LSD orally, in a tablet or capsule.


Risks

how long does acid stay in your system when pregnant
It is inadvisable to use LSD when pregnant.

LSD usually does not cause addiction.

Some people experience prolonged psychiatric reactions, such as psychosis, though this is rare. LSD and other hallucinogens have low toxicity to organs, including the brain, even at high doses.

There have been no studies of flashbacks in clinical settings, so doctors are unsure whether they are due to LSD alone.

The most significant risk of taking LSD is the dangerous behavior that can result from the effects of the drug. When a person’s perception of the world is altered, they may not pay as much attention to their safety or the safety of others.

Certain other risks can make LSD use inadvisable, including:

Withdrawal

People do not typically take LSD daily because of its intense psychological effects. Someone who has been using LSD for a long time will develop a tolerance and require higher doses to experience any effects.

Within a few days of LSD use, a person’s emotional, mental, and physical states usually return to normal. People do not usually get cravings for LSD after stopping, so there are no withdrawal symptoms.


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Summary

LSD is a powerful, mood-altering chemical and street drug. People usually do not use LSD every day because of its strong psychological effects.

Using certain tests, doctors can detect LSD and its byproducts in urine samples up to 72 hours after a person has taken the drug.

Within 24 hours of taking LSD, some tests can detect it in blood samples. Hair samples are not yet as reliable as urine or blood samples.

Source Article from https://www.medicalnewstoday.com/articles/325480.php

Medical News Today: What is the difference between veganism and vegetarianism?

Vegans and vegetarians choose not to eat meat. However, veganism is stricter and also prohibits dairy, eggs, honey, and any other items that derive from animal products, such as leather and silk.

Both veganism and vegetarianism are growing in popularity. However, some people may find the differences between these two diets a little confusing, particularly as there are several variations of vegetarianism.

In this article, we explore the similarities and differences between veganism and vegetarianism. We also discuss health benefits, which diet is more healthful, which is better for weight loss, and risks and considerations.

What is vegetarianism?

Woman carrying basket full of veg
Vegetarians do not eat the products of animal slaughter.

According to the Vegetarian Society, vegetarians are people who do not eat the products or byproducts of animal slaughter.

Vegetarians do not consume:

  • meat, such as beef, pork, and game
  • poultry, such as chicken, turkey, and duck
  • fish and shellfish
  • insects
  • rennet, gelatin, and other types of animal protein
  • stock or fats that derive from animal slaughter

However, many vegetarians do consume byproducts that do not involve the slaughter of animals. These include:

  • eggs
  • dairy products, such as milk, cheese, and yogurt
  • honey

Vegetarians typically consume a range of fruits, vegetables, nuts, seeds, grains, and pulses, as well as “meat substitutes” that derive from these food types.

Vegetarianism is generally less strict than veganism, so there are several well-known variations of the vegetarian diet. These include:

  • Lacto-ovo-vegetarian. People who follow this diet avoid all types of meat and fish but do consume dairy products and eggs.
  • Lacto-vegetarian. People on this diet do not eat any meat, fish, or eggs but do consume dairy products.
  • Ovo-vegetarian. Individuals following this diet do not eat any meat, fish, or dairy products but do consume eggs.
  • Pescatarian. Those who follow this diet avoid all meats expect fish and other types of seafood. However, this does not meet the traditional definition of vegetarianism, and many people refer to the pescatarian diet as being semi-vegetarian or flexitarian.


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What is veganism?

Veganism is a stricter form of vegetarianism. Vegans avoid consuming or using any animal products or byproducts. The Vegan Society define veganism as “a way of living, which seeks to exclude, as far as is possible and practicable, all forms of exploitation of and cruelty to animals for food, clothing, or any other purpose.”

Vegans strictly avoid consuming any foods or beverages that contain:

  • meat
  • poultry
  • fish and shellfish
  • eggs
  • dairy products
  • honey
  • insects
  • rennet, gelatin, and other types of animal protein
  • stock or fats that derive from animals

Strict vegans also extend these principles beyond their diet and will try, where possible, to avoid any product that directly or indirectly involves the human use of animals. These products can include:

  • leather goods
  • wool
  • silk
  • beeswax
  • soaps, candles, and other products that contain animal fats, such as tallow
  • latex products that contain casein, which comes from milk proteins
  • cosmetics or other products that manufacturers test on animals

Many vegetarians also apply some of these principles to their lifestyle, for example, by avoiding leather goods and products that involve animal testing.

Health benefits

Girls shopping for veg
Studies suggest that a vegetarian or vegan diet may help reduce cholesterol and BMI levels.

Scientific research suggests that vegetarian and vegan diets may offer several health benefits.

A 2017 study examined the effectiveness of a plant-based diet in 49 adults who were overweight or had obesity and also had at least one of the following conditions:

The researchers randomly assigned participants to either normal diet and care or a low fat, plant based diet program comprising low fat whole foods, which did not involve calorie counting or mandatory regular exercise. The intervention also included two 2-hour sessions each week, which provided the participants with cooking training and education by doctors. The nonintervention group did not attend any of these sessions.

At the 6-month and 12-month follow-ups, participants in the diet group had significant reductions in body mass index (BMI) and cholesterol levels compared with those in the normal care group.

A 2017 systematic review and meta-analysis found evidence to suggest that plant based diets can help lower levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol. The researchers did not analyze how the changes in cholesterol influenced heart disease outcomes.

Another 2016 observational study found that vegetarians living in South Asia and America were less likely to develop obesity than nonvegetarians.

A 2019 review cites evidence suggesting that plant-based diets may offer a number of cardiovascular health benefits for endurance athletes. These benefits include:

A 2019 study also found an association between a healthful plant based diet and a lower risk of developing chronic kidney disease. Interestingly, those who followed an unhealthful plant based diet with a higher proportion of sugar-sweetened foods and refined grains had a significantly higher risk of chronic kidney disease.


Which is more healthful?

Both diets offer similar health benefits and generally encourage people to eat more antioxidant-rich and nutrient-dense whole foods.

It is difficult to say which diet is more healthful because both diets have advantages and disadvantages.

For example, unlike vegans, lacto-vegetarians get calcium, phosphorus, and vitamin D from dairy products. However, avoiding dairy and eggs may help vegans keep their cholesterol levels down.

Vegans are also at risk for an essential omega-3 fatty acid deficiency, specifically in EPA and DHA, even if they consume plant sources of these nutrients. DHA is necessary for brain function and cognition and to avoid brain fog, memory difficulty, and more. Vegetarians and pescatarians can obtain EPA and DHA more easily from eggs and seafood.

According to a 2019 study, adults from Argentina who identified as vegan adhered more closely to a healthful vegan lifestyle than vegetarians and nonvegetarians.

The authors defined a healthful vegan lifestyle as:

  • consuming a whole food, plant based diet
  • exercising daily
  • drinking more than eight glasses of water a day
  • getting regular sunlight exposure

However, following a plant based diet does not guarantee good health. It is still possible for vegetarians and vegans to lead unhealthful lifestyles or to eat a diet of processed “junk” food.

Which is better for weight loss?

A cross-sectional study from 2006 involving 21,966 participants and a 2014 review of three prospective cohort studies involving Adventists in North America both suggest that vegans generally have a lower BMI than vegetarians and meat eaters.

A possible explanation for this trend might because vegans do not consume eggs or dairy products.

The 2006 study also found that vegans gained less weight than both vegetarians and meat eaters over 5 years. However, people who changed their diet to reduce their intake of animal products gained the least weight during the study.

In a 2018 study involving 75 adults who were overweight, researchers randomly assigned participants to either follow a low fat, vegan diet or continue their current diet, which could include animal protein. After 16 weeks, participants in the vegan group had lost significantly more fat around the abdomen than those in the control group.


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Risks and considerations

person pouring b vitamin nutritional supplements from bottle into palm
Healthcare providers may recommend vitamin supplements for people eating a vegetarian or vegan diet.

According to the authors of an article in the Journal of the American Dietetic Association (now the Journal of the Academy of Nutrition and Dietetics), carefully planned vegetarian and vegan diets are “healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases.” However, it is important for vegetarians and vegans to ensure that they are eating a balanced and healthful diet that meets all of their nutritional requirements.

For example, plant-based foods do not naturally contain vitamin B-12, which is an essential mineral that supports the nervous system and cardiovascular health. Vegans and vegetarians can get vitamin B-12 from fortified foods, such as breakfast cereals and some types of plant based “milk.”

Vegetarians and vegans can also take vitamin B-12 supplements. However, some B-12 supplements can contain animal products, so it is important to check products labels carefully and only purchase from reputable manufacturers.

According to a 2017 study from Switzerland, some vegetarians may not get enough vitamin B-6 and niacin from their diets, while vegans may have a higher risk of zinc and omega-3 deficiency than those who eat some animal products.

A range of multivitamin supplements suitable for vegetarians and vegans are available to purchase from pharmacies, health stores, and online.

As we mentioned above, eating a plant based diet does not guarantee good health. A large 2017 study found that plant based diets consisting of unhealthful foods can increase a person’s risk of coronary heart disease.

Examples of unhealthful plant foods include:

  • French fries
  • sweetened beverages
  • refined grains
  • candies
  • processed or prepackaged snack foods

This unhealthful plant based eating often results in a lower intake of fiber, vegetables, and micronutrients alongside an increased intake of sugar and processed ingredients.

Summary

Both vegetarians and vegans choose not to eat meat and fish. However, veganism is a stricter form of vegetarianism that prohibits the consumption or use of any products that come from animals, including dairy, eggs, honey, leather goods, wool, and silk.

Vegetarians may eat dairy products, eggs, honey, and other byproducts that do not involve the slaughter of animals. However, there are several variations of the vegetarian diet. For example, some vegetarians choose to eat eggs but not dairy products.

Vegan and vegetarian diets generally include a range of fruits, vegetables, nuts, seeds, grains, and pulses, as well as “meat substitutes” that derive from these food types.

Both vegetarian and vegan diets may provide health benefits, including reduced body weight, lower cholesterol levels, and decreased risk of cardiovascular disease.

However, it is important for vegetarians and vegans to ensure that they are meeting all of their nutritional requirements. For example, plants do not naturally contain vitamin B-12, so vegans and vegetarians may need to consume fortified foods or take dietary supplements to get enough vitamin B-12.

Source Article from https://www.medicalnewstoday.com/articles/325478.php

Medical News Today: How does humidity affect asthma?

Humidity is a measure of how much moisture there is in the air. Many people with asthma find that humid weather makes their symptoms worse.

People can prevent humidity-related asthma symptoms using a range of strategies, including taking medication, controlling indoor humidity levels, and avoiding exercising in humid conditions.

Keep reading to learn how humidity and the weather can affect asthma symptoms and what to do to prevent a flare. We also look at the best and worst weather conditions for asthma.

Humidity and asthma

Woman with asthma sweating and affected by humidity.
Humidity can affect asthma symptoms.

Humidity refers to how much moisture or water vapor is in the air.

People may notice their asthma symptoms get worse on humid days when there is a lot of moisture in the air. This is especially true when exercising in humid conditions.

High levels of humidity may play a role in asthma symptoms in a variety of ways.

The increased moisture can directly irritate the airways, and humidity can increase the levels of other substances in the air that irritate the bronchial tubes, such as pollen and pollution.

High humidity can trigger asthma symptoms, including:

  • coughing
  • wheezing
  • chest tightness

Small-scale research has looked into how humid weather affects a person’s lungs. The researchers tested airway resistance — a measure of how easy it is to breathe — in six people with asthma and six people without.

After experiencing hot, humid air (49°C and 75–80% humidity) for 4 minutes, people with asthma had a 112% increase in airway resistance as opposed to the healthy group that only had a 22% increase in airway resistance.

Why does humidity affect asthma?

Humidity likely causes asthma symptoms because it triggers bronchoconstriction, which is a narrowing of the airways.

Bronchoconstriction may occur because hot, humid air activates C fibers, which are sensory nerve fibers in the airways. Stimulation of C fibers may narrow the airways and stimulate coughing, which makes it difficult to breathe.

High humidity levels create the perfect breeding ground for mold and dust mites, which often trigger asthma. Higher levels of humidity may also increase air pollution. For example, ozone, which is an air pollutant, rises when humidity levels increase.

Increased levels of humidity also often mean higher temperatures. The highest humidity levels usually occur during the summer months. The combination of heat and humidity can irritate the airways making breathing more difficult.


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How to manage symptoms

While it is not possible to control the weather and humidity levels outdoors, people can manage humidity-related asthma symptoms by:

Staying indoors on humid days

Get the weather report from your local news station and check the humidity levels. When high humidity advisories are in effect, try to stay indoors as much as possible.

Recognizing signs of an asthma flare

Recognizing symptoms as soon as they start can prevent an asthma flare from becoming worse. Signs include:

  • coughing
  • wheezing
  • shortness of breath
  • chest tightness

When symptoms start, people should follow the asthma action treatment plan they developed with their doctor.

Taking fast-acting bronchodilators

Fast-acting bronchodilators relax the muscles in the airways, which opens them up. As the narrowing decreases, breathing becomes easier. Common fast-acting inhalers to treat asthma include albuterol and Xopenex.

Prevention

In some cases, people can prevent humidity-related asthma symptoms from developing by:

Checking the air quality

Smog and air pollution in sunset city skyline
Pollutants can cause poor air quality.

The air quality index (AQI) indicates the daily level of pollutants, such as smog. Air quality levels vary daily and between locations. The more pollutants in the air, the harder it can be for a person with asthma to breathe.

The AQI measures air quality on a scale from 0–500. The higher the number, the worse the air quality. Air quality tends to be worse on hot and humid days. Staying inside when the air quality is poor might prevent asthma symptoms developing.

Controling humidity indoors

Humidity does not only develop outdoors. Humidity levels can also rise inside. However, it is possible to control humidity levels indoors.

According to the Environmental Protection Agency (EPA), it is best to keep humidity levels between 30–50%.

Lower humidity decreases mold growth, dust mites, and cockroaches, all of which can trigger asthma symptoms.

Check indoor humidity levels with a humidistat, available at many hardware or home improvement stores, or online.

People can reduce indoor humidity by:

  • opening windows in the bathroom while showering or bathing
  • using a dehumidifier
  • running an air conditioner
  • fixing leaky pipes

Avoiding exercising outdoors when humidity levels are high

Exercising outdoors when the weather is warm and humid can lead to airway irritation. However, people can still exercise in a gym, pool, or somewhere else that has air conditioning.


Best weather for asthma

There is no optimal weather condition for people with asthma, but many find that consistency in temperatures and conditions is better for symptoms.

Allergens and pollutants in the air are two of the most significant factors that affect asthma symptoms. Certain types of weather may increase both air pollution and common allergens.

Some people with asthma experience problems in very cold or hot temperatures, which can increase airway irritation. Mild temperatures and low levels of humidity might decrease the risk of airway irritation.

Worst weather for asthma

Cold, dry air can trigger asthma symptoms.
Cold, dry air can trigger asthma symptoms.

Not only is humidity a problem for people with asthma, but other weather conditions can also lead to symptoms.

The weather conditions most likely to trigger asthma include:

  • Extreme heat: When temperatures climb, pollution levels may also rise, which can trigger asthma symptoms.
  • Cold, dry air: Cold, dry air can irritate the airways and lead to bronchospasm. This often results in common asthma symptoms, including coughing, wheezing, and trouble breathing.
  • Windy conditions: Common allergens, such as pollen, blow around in the wind. Add rain into the mix, and it can lead to an increase in mold spores. Both pollen and mold are common triggers for people with asthma.
  • Rapid changes in temperature: Some people are also sensitive to a quick change in weather conditions, such as heat one day and cold the next.


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Summary

Although everyone with asthma has different triggers, humidity and asthma symptoms go hand in hand for many people.

Increased moisture in the air, especially in high temperatures, can trigger bronchospasm and asthma symptoms. Other weather conditions, such as cold, dry air, can also lead to asthma flares.

Monitoring humidity and air quality are helpful to prevent humidity-related asthma symptoms from developing.

Source Article from https://www.medicalnewstoday.com/articles/325474.php

Medical News Today: What to know about steroids and MS

Multiple sclerosis attacks the protective coating around the nervous system. People with the condition often experience periods of severe symptoms, or flares. The flares may become more frequent over time as the condition progresses.

Although there is no cure for multiple sclerosis (MS), some treatments — including steroids — can help slow the progression of the condition and reduce symptom severity during flares.

Read on to learn more about steroids for MS.

Steroids and MS

A senior man experiencing steroid side effects holds his glasses and rubs his eyes.
Doctors may prescribe steroids for people who experience visual disturbances and other severe symptoms during an MS flare.

A doctor may prescribe intravenous or oral steroids when a person with MS experiences a flare. However, although steroids can be effective for reducing the severity and duration of a person’s symptoms during the flare, they can cause unpleasant side effects.

For this reason, a doctor may only recommend steroids when a person has a severe flare that interferes with their ability to function.

Doctors may be more likely to prescribe a round of steroids for a person with an MS flare if they are experiencing any of the following symptoms:

  • visual disturbances
  • severe weakness
  • extreme balance issues
  • difficulty breathing
  • severe muscle spasms and cramps


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Which types are best?

The steroids that doctors use to treat MS flares are glucocorticoids. These reduce inflammation, which is a trigger for MS symptoms.

Doctors often use glucocorticoids to treat other health conditions in which inflammation plays a role, such as asthma and severe allergy attacks.

For treating MS flares, a doctor will often suggest intravenous methylprednisolone once per day for 3–5 days. Sometimes, they choose to follow the intravenous steroid treatment with steroid pills, which the person will take in a tapering dosage for an additional 1–2 weeks.

In the past, many doctors presumed that intravenous forms of steroids were the best. However, a recent study showed that high dosages of oral steroids are just as effective.

Who should use them?

A woman with MS asks her healthcare provider if she should take steroids.
Healthcare professionals can offer a person with MS advice on whether steroids might be a suitable treatment for them.

Doctors typically use steroids to help a person experiencing a symptom flare. Steroid treatment will help a person with MS recover from the acute symptoms of the flare.

However, steroids do not have a lasting or profound impact on the overall treatment of MS. So, healthcare providers do not consider steroids a primary form of treatment for MS.

Often, the symptoms that a person experiences during a flare will gradually get better on their own. Not everyone who has a flare will require steroids to recover. A person should speak to their healthcare provider to determine whether steroids are a suitable treatment option for them.

It is important to note that people with an active infection should not take steroids. Infections, such as colds or urinary tract infections, can make MS symptoms worse.

Steroids can also make an infection worse, so people should let their doctor know if they are sick before taking steroids.

After treating the infection, MS symptoms may also start to fade.


Dosage

Steroids for MS are available in the form of injections and oral medications.

Although the actual dosages that people take may vary, one study defined high-dose methylprednisolone as higher than 500 milligrams (mg) per day and low-dose as lower than 48 mg per day. It concluded that high dosages, around 500–1,000 mg per day, taken intravenously for 3–5 days are the most effective.

The injectable form of steroids typically comes as a powder that healthcare professionals mix with a liquid. They will administer the injection directly into either a vein or muscle.

The oral form of steroids often comes as a tablet, which a person will need to swallow whole. A person should also take the medication with food to help prevent an upset stomach.

Tablets are much easier for people to take than regularly coming in for appointments to receive an injection.

A person should follow their healthcare provider’s instructions for how long to take steroids for and the dosage they should take. If someone accidentally skips a dose, they should take it as soon as they remember and let their doctor know.

Effectiveness

Steroid injections are reportedly quite effective in high dosages. However, they tend to be more expensive and an unpleasant way to receive medication.

One recent study determined that high-dose oral steroids can be just as effective as injections. Also, they are usually less expensive and offer a more comfortable way to take medication.


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Side effects, warnings, and risks

A man taking steroids for MS lies awake with insomnia.
Steroids can cause adverse side effects, including insomnia.

Both oral and injectable steroids come with some risks.

Oral steroids may cause the following side effects:

When taking an oral steroid for MS, a person should call their healthcare provider immediately if they experience any of the following symptoms:

  • swollen face, lower legs, or ankles
  • skin rash
  • vision problems
  • a cold or infection that lasts longer than normal
  • black or tarry stool
  • muscle weakness

Injectable steroids also carry a degree of risk. Some side effects to be aware of include:

  • slower healing of cuts and bruises
  • headaches
  • dizziness
  • inappropriate happiness
  • depression
  • red or purple blotches or lines under the skin
  • thin, fragile, or dry skin
  • irregular or absent menstrual periods
  • extreme tiredness
  • acne
  • increased body fat
  • fat movement to different areas of the body
  • skin depressions at the site of injection
  • extreme changes in mood and personality
  • increased sweating
  • hiccups
  • difficulty falling or staying asleep
  • muscle weakness
  • joint pain
  • increased appetite

If a person taking injectable steroids notices any of the following symptoms, they should call their healthcare provider immediately:

  • vision problems
  • numbness, burning, or tingling in the face, arms, legs, feet, or hands
  • a sore throat, fever, chills, cough, or other signs of infection
  • abnormal skin patches in the mouth, nose, or throat
  • sudden weight gain
  • seizures
  • confusion
  • swelling of the face, tongue, eyes, lips, hands, throat, arms, feet, lower legs, or ankles
  • difficulty breathing or swallowing
  • shortness of breath
  • itching
  • skin rash
  • hives

Some other considerations for people receiving steroid injections include:

  • They come with a higher risk of developing cataracts or glaucoma when people receive them for long periods.
  • They may stunt a child’s growth.
  • They may increase the risk of developing osteoporosis.
  • They may cause other unusual side effects.

If people use steroids long-term, they should not stop them suddenly. A doctor and patient can develop a plan to safely taper off the steroids.

Summary

For acute MS flares, steroids are usually an effective treatment option. Typically, people should not take them long-term.

Steroids come in two forms: oral and injectable. Both can be effective in high enough dosages to treat an MS flare.

A person should be aware of potential side effects and call their doctor if they experience any severe symptoms.

Source Article from https://www.medicalnewstoday.com/articles/325473.php

Medical News Today: How to use an inhaler with a spacer

Using an inhaler with a spacer: How to use, benefits, and tips

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Medical News Today: What to know about MS in children

Multiple sclerosis is a progressive disease that can severely damage nerves throughout the body. Symptoms tend to worsen, and as the disease progresses, it can cause impaired speech and motor skills.

Multiple sclerosis (MS) can lead to significant difficulties in performing daily tasks and can greatly affect a person’s quality of life.

There is no cure, and treatments focus on preventing and reducing MS symptoms.

MS is not as common in children as it is in adults. When it does develop in children, they and their parents and caregivers may feel fear and uncertainty about the disease.

Keep reading for more information about how MS affects children. We also describe symptoms and the range of treatments.

Prevalence

Child with MS in doctor's office with parent looking at notes
MS is a progressive condition that requires management of symptoms.

According to the National Multiple Sclerosis Society, nearly 1 million people in the United States have MS.

The number of children with MS is much smaller, with the same organization estimating that there are 8,000–10,000 people younger than 18 who have MS in the country.

The National Multiple Sclerosis Society also report that 10,000–15,000 young people in this age bracket have experienced at least one MS symptom. They cite research indicating that about 2–5% of people with MS in the U.S. experienced a symptom before the age of 18.


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Babies, children, and teenagers

MS in babies, children, and teens is similar to MS in adults. However, there are some differences:

  • Compared with adults, children likely experience more frequent relapses — during which symptoms worsen significantly — one study suggests.
  • Another study reports that children with MS take more time to reach motor disability milestones than adults with MS.
  • However, the same study notes, children with MS still reach the milestones at a younger age than people who receive a diagnosis in adulthood.
  • According to one study, lesions on the brain that result from MS were more inflamed in children with the disease, compared with adults.
  • Children and juveniles with MS tend to experience difficulties with functions such as memory, concentration, and language within about 2 years of their diagnosis.
  • The same research indicates that fatigue and depression may also arise during this time frame.

Learning about these characteristics can help children, parents, and caregivers better understand the disease and its progression.

The medical community is still unsure about what causes MS.

Some potential risk factors include:

Symptoms

Child having eye exam check at opticians.
A person may experience vision changes as an early symptom of MS.

Symptoms of MS in children are similar to those in adults. Some common symptoms include:

In addition, young children are more likely to experience confusion and coordination problems.


Treatment

Treatments for MS in adults and children do not vary greatly, and a doctor may prescribe several of the same medications.

One of the first treatments that healthcare providers typically try involves using interferon beta 1-alpha or glatiramer acetate. These are self-injected medications that help with limiting or eliminating symptoms associated with MS.

The Food and Drug Administration (FDA) have not approved either interferon beta 1-alpha or glatiramer acetate for use in children, but doctors often recommend these medications for off-label use.

When first-line therapies do not work or are not sufficiently effective, a doctor may recommend additional treatments.

In 2018, the FDA approved the use of fingolimod, an oral medication, for children aged 10 or older who had relapsing-remitting MS.

The FDA first approved this drug for use in adults with the condition in 2010. It helped increase the amount of time between relapses and reduced the activity of the disease.

Researchers are looking into additional oral medications for children and adolescents. For example, some are investigating MS-related uses of rituximab, a medication that can help treat autoimmune disorders in children.

Children and teenagers who have MS may also benefit from therapy that addresses mental health. MS is a life-long condition and symptoms tend to get worse. This can be a source of anxiety and may lead to depression.

It is important for parents and caregivers to encourage children and teens to speak about any fears and concerns and to help provide supportive therapy, when necessary.


Diagnosis

A pediatrician may assess a child to rule out other conditions.
A pediatrician may assess a child to rule out other conditions.

MS is not easy to diagnose. First, the doctor will ask about symptoms, perform an exam, and consider the child’s family history.

To meet the criteria for MS, a child must have experienced at least two discrete demyelinating events. These events indicate that there has been damage in separate areas of the central nervous system at different times.

In addition, a pediatrician needs to rule out other conditions that could be causing the symptoms. They may order tests to help with this part of the diagnosis.

Anyone concerned about potential symptoms of MS in a child or teen should speak to a pediatrician.


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Outlook

MS symptoms are the same in children and adults. While there is no cure for MS, treatments focus on reducing or eliminating the symptoms and limiting the number of relapses that a child or adult experiences.

If a child reports any symptoms of MS, including numbness, weakness, or changes in muscular control, it is important to consult a pediatrician.

Supporting the mental health of children and teens with MS is crucial. Counseling, for example, can help.

Source Article from https://www.medicalnewstoday.com/articles/325467.php

Medical News Today: What to know about surgery for MS

Surgery for MS: What to know and risks

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