Progress Notes

Important and interesting news items from your health office

A dangerous weed

Posted by on Mar 19, 2018 in Patient Care | 0 comments

A dangerous weed

For psychiatric patients, a link between marijuana and violent behavior

Recreational drugs can wreak havoc on anyone’s life. But for those with mental illness, smoking pot could lead to aggressive behavior—and put their loved ones at risk.

According to a new study published in September in Frontiers in Psychiatry, adults who persistently smoke marijuana following a psychiatric hospitalization are 2½ times more likely to commit violent acts, including assault, battery, or threats with a weapon, than those who do not use the drug.

The study included 1,136 patients from ages 18 to 40 who received five follow-up appointments within a year after discharge from a psychiatric hospital. Not only did the researchers find that cannabis use put these patients at an increased risk for violent behavior, but they also discovered the risk is greater than for those using other mood-altering substances. “An interesting feature of our results is that the association between persistent cannabis use and violence is stronger than that associated with alcohol or cocaine,” Alexandre Dumais, the lead researcher, said in a statement.

The results support neuroimaging studies that show chronic marijuana users develop deficits in the prefrontal cortex, an area of the brain involved in inhibiting impulsive behavior, the researchers said. Problems with the prefrontal cortex have been correlated with antisocial personality and psychopathic traits.

The National Institute on Drug Abuse reviewed numerous studies on the adverse effects of cannabis use. They found that short-term effects may include impaired memory, decreased problem-solving ability, hallucinations, and delusions. Possible long-term effects include breathing problems, increased heart rate (which may raise the risk of a heart attack), onset or worsening symptoms of mental illness, depression, anxiety, and brain and behavioral problems for unborn and nursing babies whose mothers use the drug.

by Julie Borg in World Magazine

Teens starting with E-cigs?

Posted by on Mar 15, 2018 in Patient Care | 0 comments

Teens starting with E-cigs?

E-Cigarettes May Create More Smokers Than Quitters, Research Suggests.

Bloomberg News (3/14, Wolf) reports that researchers at Dartmouth College’s Norris Cotton Cancer Center found that “vaping has led more people to start a real smoking habit, rather than avoid tobacco or quit in favor of e-cigarettes,” according to a study published Wednesday in PLOS One.

The researchers used census data, published literature, and surveys to build a model which showed that while 2,070 cigarette smokers in the US quit in 2015 with the help of e-cigarettes, 168,000 adolescents who had never smoked began smoking after first trying e-cigarettes. The authors suggested that “fruity flavors” have created a draw for younger users, and recommended that “should be the focus of restriction efforts by the” FDA.

Also reporting is HealthDay (3/14, Preidt).

Breast Feeding and Diabetes

Posted by on Mar 6, 2018 in Patient Care | 0 comments

Breast Feeding and Diabetes

The 30-Year CARDIA Study

Question

Is the protective association between lactation duration and progression to diabetes supported by a biochemical evidence basis?

Findings

Among young white and black women in this observational 30-year study, increasing lactation duration was associated with a strong, graded 25% to 47% relative reduction in the incidence of diabetes even after accounting for prepregnancy biochemical measures, clinical and demographic risk factors, gestational diabetes, lifestyle behaviors, and weight gain that prior studies did not address.

Meaning

This study provides evidence to support the hypothesis that lactation may lower risk of diabetes in women; these findings open new avenues into mechanisms leading to glucose intolerance.

As reported in a study by Gunderson, Lewis, Lin; et al in the January 2017 Journal of the American Medical Association (JAMA).

Herbal-Drug Interactions

Posted by on Jan 25, 2018 in Patient Care | 0 comments

Herbal-Drug Interactions

Some Common Herbal Supplements May Have Dangerous Interactions With Common Prescription Drugs, Review Study Suggests.

TIME (1/24, MacMillan) reports some “common herbal supplements, including green tea and Ginkgo biloba, can interact with prescription medications” in “dangerous or deadly” ways, “according to a new research review published in the British Journal of Clinical Pharmacology.” Researchers reviewed “49 case reports of adverse drug reactions, along with two observational studies,” and concluded that herb-drug interactions were “highly probable” in 8% of the reports, “probable” in 51%, possible in 37%, and doubtful in 4%.

In one case report, a patient who took statins complained of intense leg cramps and pain—a commonly reported side effect—after drinking three cups of green tea a day. The reaction was attributed to green tea’s effects on statin levels in the blood, the researchers wrote, although they say more research is needed to rule out other possible causes.

In another report, a patient died after having a seizure while swimming, even though he was regularly taking anticonvulsant drugs for his condition. His autopsy, however, showed decreased levels of those drugs in his blood, likely due to the way Ginkgo biloba supplements—which he’d also been taking regularly—had affected their metabolism.

Taking herbal supplements has also been associated with worsening depression symptoms in people taking antidepressants, the authors wrote in their paper, and with organ rejection in those who had received kidney, heart or liver transplants. For cancer patients, chemotherapy drugs have been shown to interact with herbal supplements including ginseng, echinacea and chokeberry juice.

The analysis also showed that patients taking warfarin, a blood thinner, reported “clinically significant interactions” after taking herbal medicines containing sage, flaxseed, St. John’s wort, cranberry, goji juice and chamomilla. These herbs may affect the metabolism of warfarin, the researchers hypothesize, which may reduce its anticoagulation abilities or cause bleeding episodes.

Teens Smartphone Risk

Posted by on Jan 23, 2018 in Patient Care | 0 comments

Teens Smartphone Risk

Study Ties Sudden And Large Drop In Teen Happiness With Smartphone Proliferation.

The Washington Post (1/22, Bahrampour) reports researchers have tied “a sudden and large drop in adolescents’ happiness with the proliferation of smartphones and finding that the more hours a day teens spend in front of screens, the less satisfied they are.” Their report, called “Decreases in Psychological Well-Being Among American Adolescents After 2012 and Links to Screen Time During the Rise of Smartphone Technology,” was published online Jan. 22 in the journal Emotion. In arriving at their conclusions, the study authors analyzed data from “a large national survey of eighth, 10th and 12th graders conducted annually by the University of Michigan.” HealthDay (1/22, Preidt) also covers the study.

Save by Rx Shopping

Posted by on Dec 11, 2017 in Patient Care | 0 comments

Save by Rx Shopping

Consumers Find Some Drugs Cheaper Without Insurance

In a front-page article, the New York Times (12/9, A1, Ornstein, Thomas, Subscription Publication) reports that consumers are “increasingly” finding that some drugs are cheaper without insurance than with it. According to the Times, “one industry expert estimated that up to 10 percent of drug transactions” – or 400 million prescriptions each year – could fall into this category.

In a separate article, the New York Times (12/9, Ornstein, Thomas, Subscription Publication) offers advice to readers on how to save money on prescription drugs.

Beating diabetes

Posted by on Dec 9, 2017 in Patient Care | 0 comments

Beating diabetes

Will this plan reverse type 2 diabetes?

The first-year results of a clinical trial have shown that almost half of people partaking in an intensive weight management program delivered through primary care achieved remission of their type 2 diabetes without medication.

The trial, which is called the Diabetes Remission Clinical Trial (DiRECT), builds on earlier work by co-lead investigator Prof. Roy Taylor, director of the Magnetic Resonance Centre at Newcastle University in the United Kingdom. The earlier work showed that a radical change in diet can reverse type 2 diabetes.

The results of the trial, just reported in The Lancet on December 5, suggest that remission of type 2 diabetes may be achievable through intensive weight management programs supported by routine primary care.

The team’s findings revealed that after 12 months of radical weight management, participants lost an average of 10 kilograms (22 pounds), and that 45.6 percent of them went back to being non-diabetic without medication.

‘Long-term maintenance of weight loss’ focus

Prof. Taylor says that significant weight loss reduces the amount of fat in the liver and pancreas so that they can start working normally again.

“What we’re seeing from DiRECT,” he remarks, “is that losing weight isn’t just linked to better management of type 2 diabetes: significant weight loss could actually result in lasting remission.”

“Our findings suggest that even if you have had type 2 diabetes for 6 years,” adds trial co-leader Prof. Michael Lean, chair of Human Nutrition at the University of Glasgow in the U.K., “putting the disease into remission is feasible.”

He says that their approach differs from the conventional way of managing type 2 diabetes in that it focuses “on the need for long-term maintenance of weight loss through diet and exercise and encourage[s] flexibility to optimize individual results.”

Addiction Treatment

Posted by on Dec 4, 2017 in Patient Care | 0 comments

Addiction Treatment

New Open Access Treatment Center

There is a new 24/7 Open Access Center in Rochester. The center, located at 1350 University Avenue, is open 24 hours a day, 7 days a week, and will deliver immediate engagement, assessment, and referral services for people suffering from a substance use disorder. The current hours of operation are Monday to Friday 4:00 – 10:00 pm and Saturday and Sunday 9:00 am – 10:00 pm. Read the brochure (in English and Spanish) for the most up to date information.

Center staff are available around the clock to assess people in need of treatment, and refer them to the appropriate level of care. This Open Access Center is a collaborative project of RecoveryNet, a coalition of nine community-based, OASAS-certified providers, which is led by Delphi Drug and Alcohol Council. It is an  innovative model of care, and the first of its kind in New York State. In addition to providing assessments and referrals to care, the center will also work to collaborate with local law enforcement to direct low-level offenders to treatment.

Open Access

1350 University Avenue, Rochester, NY 14607
(585) 627-1777
Seven days a week, 4:00-10:00 p.m

See the following summary for more information on Monroe County OASAS-certified Treatment Providers.

A Generational Effect?

Posted by on Nov 30, 2017 in Patient Care | 0 comments

A Generational Effect?

Daughters Of Women Exposed To Childhood Trauma May Be At Increased Risk For Serious Psychiatric Disorders, Study Indicates.

In “Well,” the New York Times (11/29, Bakalar, Subscription Publication) reports, “The daughters of women exposed to childhood trauma are at increased risk for serious psychiatric disorders,” researchers found after studying some “46,877 Finnish children who were evacuated to Sweden during World War II, between 1940 and 1944.” Investigators also “tracked the health of their 93,391 male and female offspring born from 1950 to 2010.”

The study revealed that “female children of mothers who had been evacuated to Sweden were twice as likely to be hospitalized for a psychiatric illness as their female cousins who had not been evacuated, and more than four times as likely to have depression or bipolar disorder.”

According to HealthDay (11/29, Preidt), “the risk for hospitalization for mood disorders was not higher than normal among sons or daughters of men who had been evacuated as children,” the study also found. The findings were published online Nov. 29 in JAMA Psychiatry.

Smartphone Risk in Teens

Posted by on Nov 26, 2017 in Patient Care | 0 comments

Smartphone Risk in Teens

Smartphones a Likely Culprit in the Recent Decline in Teen Mental Health

Around 2012, something started going wrong in the lives of teens.

In just the five years between 2010 and 2015, the number of U.S. teens who felt useless and joyless — classic symptoms of depression — surged 33 percent in large national surveys. Teen suicide attempts increased 23 percent. Even more troubling, the number of 13-to-18-year-olds who committed suicide jumped 31 percent.

In a new paper published in Clinical Psychological Science, my colleagues and I found that the increases in depression, suicide attempts and suicide appeared among teens from every background: more privileged and less privileged, across all races and ethnicities, and in every region of the country. All told, our analysis found that the generation of teens I call “iGen” — those born after 1995 — is much more likely to experience mental-health issues than their millennial predecessors.

What happened so that so many more teens, in such a short time, would feel depressed, attempt suicide and commit suicide? After scouring several large surveys for clues, I found that all of the possibilities traced back to a major change in teens’ lives: the sudden ascendance of the smartphone.

Click here to read the entire article by Jean Twenge in the November 19, 2017 issue of The Washington Post.