As we’ve previously discussed, Zohyrdro is a hydrocodone packed painkiller 5 to 10 times as potent as Vicodin or Lortab. Researchers believe the drug is so potent that it can cause serious or even fatal reactions if consumed by children.
What makes this case odd is that the FDA approved Zohyrdro against the advice of it’s own advisory committee. Last October, the FDA’s advisory panel voted 11-2 against the approval of the drug, yet the administration made the recent decision to approve it. Unless something changes, Zohyrdro will be available later this month.
“I’m amazed that the FDA would approve a dangerous new opioid over the strong objection of its advisory panel,” said Dr. Michael Carome, director of Public Citizen’s Health Research Group. “In the midst of a severe epidemic of opioid addiction and overdose deaths, this is the last thing we need.”
Last month, three U.S. senators asked the FDA to explain how the administration will monitor and prevent abuse of the new drug. The FDA responded by re-classifying Zohydro as a schedule II drug, meaning it has stricter prescription constraints and higher penalties for illegal possession or distribution, but the administration still plans to let the drug hit the market.
Needless to say, many adults who have seen the troubling effects of painkillers believe the drug will only lead to more problems.
“I’m worried about their plan to market the drug for back pain and other common problems,” said Judy Rummler, chair of the FED UP! Coalition and president of the Steve Rummler Hope Foundation. Her son Steve died in 2011 when he overdosed on pain pills he was taking to control his chronic back pain.
“The capsules will contain a whopping dose of hydrocodone,” said Pete Jackson, who lost his daughter to an OxyContin overdose. “It’s crazy to let this drug go on the market as it undoubtedly will become the next OxyContin that will fuel the opioid addiction epidemic.”
While these parents may be a little biased based on the tragedies they’ve had in their lives, there’s little doubt that opioid abuse is rampant in America. According to the latest statistics, the United States is home to just 5 percent of the world’s population, but the nation consumes more than 99 percent of the world’s hydrocodone. It’s no surprise that addiction and overdose rates have grown over the past decade.
“In the midst of a severe drug addiction epidemic fueled by overprescribing of opioids, the very last thing the country needs is a new, dangerous high-dose opioid,” the group said in its letter to Hamburg.
Dr. Silverman comments
I’m still amazed the FDA decided to go against the advice of THEIR OWN ADVOCACY GROUP! It’s not like it was an outside recommendation, it came directly from the administration.
The FDA was first developed to protect the public, but this decision will clearly cause more problems than it will prevent. Unfortunately, it won’t be long before we see the headline, “Teen Dies From Accidental Zohydro Overdose.” It’s not a matter of if, but a matter of when.
You won’t find me ever writing a prescription for Zohydro.
Related sources: MedPage Today, Citizen.org
Executives in the athletic shoe industry are always looking for new ways to market their product, but the recent surge in “motion-controlled” shoes that limit foot pronation may actually be doing more harm than good.
The new motion-controlled athletic shoes were created to correct the inward-tilting motion of the legs after they make contact with the ground (also known as pronation) while running. Some running “experts” claimed pronation was the reason some runners were experiencing injuries, but recent studies have proved otherwise. Numerous studies in the past five years have found:
- Normal pronation is not linked to an increase in injuries; and
- Runners with pronated feet do not preform better in motion-controlled shoes.
The latest study to refute the benefits of motion-controlled shoes comes from the Netherlands.
In their study, researchers tracked 927 beginner runners for 12 months after they began a running regimen. Physiotherapists categorized each runner as highly supinated, supinated, neutral, pronated, or highly pronated. They were all asked to wear the same neutral shoe – the Adidas Supernova Glide 3 – while they ran. Runners reported any injuries as they occurred.
- “No significant risk differences between highly supinated, supinated, pronated, and highly pronated feet compared with the neutral feet.”
- The percentage of runners who suffered an injury over the course of the year based on their running styles were: highly supinated (24.5%), supinated (17.9%), neutral feet (17.4%), pronated feet (13.1%) and highly pronated (33.3%). Authors noted that few people in the study had highly pronated feet, which may have limited study data.
“The results of the present study negate the importance of foot posture, especially moderate foot pronation, as a strong indicator of injury among novice runners,” researchers concluded. “Clinicians should focus on guidance in training distance, duration, and intensity rather than guidance in shoe selection on the basis of foot posture.”
Dr. Silverman comments
It’s about time that this notion promoted by so many gets debunked.
The action “pronation” is actually a complex coordinated event that is natural in the foot to accommodate to uneven ground and refers to what appears to be a flattening of the arch. The action “supination” is a complex coordinated event that is natural in the foot to create strong push off forces and propel us forward with a stiffened higher arch.
When “experts” use the term loosely they are essentially using the word to describe the arch position when standing. Basically, they describe a standing foot with a flat arch as pronated, and an arched foot as being supinated.
The terminology is used incorrectly, and it’s a ridiculous premise in the first place. We don’t know what the perfect foot is, thus hypothesizing that “a pronated foot” leads to more injuries is the height of ridiculousness. Not only is the wording incorrect and nonsensical, the logic is faulty and based on pseudoscience.
Thank goodness someone is starting to call out the obvious.
Related source: Runner’s World
Avner Ben-Ner, a Work and Organizations professor at the Carson School of Management, conducted the study which sought to uncover the benefits of treadmills in the workplace. As one can imagine, working while on a treadmill only lends itself to certain professions, so Ben-Ner limited his study to a local financial services company with roughly 40 employees.
The company provided its employees with a computer, telephone, and writing space on a desk attached to the treadmill, and they programmed the treadmills to go no faster than 2 miles per hour to ensure employees could keep pace even though they were focusing on other activities. The decision to walk on the treadmill was completely voluntary.
Ben-Ner and colleagues tracked the company for a year. After complying the data, Ben-Ner’s findings suggest more companies may be adding treadmills to the workplace in the near future. They found that treadmills increased productivity by nearly 10 percent, which Ben-Ner said was “a substantial increase.”
Although further studies are needed, Ben-Ner believes treadmills increase productivity because it keeps a person’s brain from getting complacent.
“The employer benefits from the employee being active and healthy and more smart because more blood is flowing to the brain,” Ben-Ner said. He added that the initial investment of installing treadmills in the workplace could pay off after only a few months with the added boost in productivity.
“There is a very simple cost-benefit analysis here,” said Ben-Ner. “You sit long, you start dozing off because you don’t do anything other than thinking.”
Dr. Silverman comments
This is a very-thought provoking article. Anyone can surmise that adding treadmills to a sedentary office setting will likely lead to better employee health, but the key part here is that it also leads to an increase in productivity.
Now, instead of trying to convince your boss to add treadmills as a way of reducing health insurance costs, an employee can point to this study as say that treadmills, when used in the right setting, can boost productivity. If you’re a company that fits the bill, how can you not consider adding treadmills to the work place?
As much as I’d like to see this idea become mainstream, it will only work in a few industries. You know I’m a huge health proponent, but I don’t think my patients would be too thrilled to learn I will be preforming their ankle fusion while walking on a treadmill. I guess I’ll have to stick with the post-work routine.
Related source: Star Tribune
Dr. Silverman recently converted one of his previous posts into an interactive slideshow that shares some tips for speeding up your recovery time after foot surgery. Check out the slideshow below, and feel free to share it with any of your friends who are having surgery in the future!
A new study published in Mayo Clinic Proceedings discovered that while many doctors regularly and rigorously wash their hands and change gloves throughout the day, many forget to clean a crucial instrument in their arsenal; their stethoscope.
Didier Pittet, director of the Infection Control Program at the University of Geneva Hospital and lead author of the study, said doctors often forget to clean off their stethoscope between patients, which can lead to the transfer of bacteria.
“While the doctor’s hands are cleaned after each patient, their stethoscope is not, so then they apply the stethoscope to the second patient, and the third, carrying bacteria from each patient’s skin,” Pittet said.
Researchers wanted to see which objects harbored the most bacteria after physician-conducted checkups. To understand bacteria growth and movement, researchers asked 83 patients to undergo a routine exam by one of three licensed physicians. Each physician wore sterilized gloves and used a sterilized stethoscope during the examination.
After the exam was over, researchers measured the amount of bacteria that was found on the stethoscope tube, the cool part that touches the patient’s skin, and four areas on the physician’s hands. In 71 of the 83 cases (86 percent), the stethoscope had a higher concentration of bacteria than all parts of the physician’s hands, except for the fingertips.
“We found that the stethoscope was highly contaminated to a level close to the fingertips,” Pittet said.
Pettit added that stethoscopes can’t be blamed for causing infections to spread, but he believes they most likely play some role in transmitting bacteria. He concluded by saying that doctors should view their stethoscope as an extension of their hands, and they should sanitize their tools after every patient.
“It’s clear cleaning hands with alcohol-based gel is most important to prevent cross contamination with bacteria,” Pittet said. “But if your hands are clean and your stethoscope is not, it’s counterproductive.”
Dr. Silverman comments
This is an interesting study. I’m sure there are plenty of doctors out there who don’t regularly cleanse their stethoscope after each patient. Even if they do, sometimes they’ll stick the instrument back in their pocket or in a desk drawer, which is undoubtedly filled with germs.
It’s a good practice to cleanse your tools once you’re finished, and again before you use it on a patient. This will dramatically reduce the spread of bacteria.
Related source: USA Today
Federal health authorities shared some encouraging news yesterday when they announced that the obesity rate among 2- to 5-year-old children has dropped 43 percent over the past decade. Officials said the decrease marked the first broad decline in the epidemic that has been linked to lifelong health issues like heart disease, stoke and hypertension.
The findings were somewhat surprising to researchers, who have recently been focused on determining the long-term effects of obesity when it develops during early childhood. According to the most recent data, only 8 percent of 2- to 5-year-old children are categorized as obese, down from 14 percent in 2004.
“This is the first time we’ve seen any indication of any significant decrease in any group,” said Cynthia L. Ogden, researcher for the Centers for Disease Control and Prevention, and lead author of the study. “It was exciting.”
Still Work To Be Done
Although the figures are encouraging among the nation’s youth, Ogden cautioned that young children make up a very small portion of the American population, and as a whole, obesity rates have remained fixed over the last decade. Roughly 33 percent of adults and 17 percent of youths are categorized as obese.
Ruth Loos, a professor of preventative medicine at the Icahn School of Medicine said the results show that young children are trending in the right direction, but there’s still work to be done.
“This is great news, but I’m cautious,” said Loos. “The picture will be clearer when we have a few more years of data.”
Why The Decline?
Officials say there could be numerous reasons why obesity rates have fallen among 2- to 5-year olds, including:
- Children consuming fewer sugary beverages than they did in the late 90’s.
- More mothers are breast-feeding, which has been linked to healthy weight gain in children.
- Children are simply consuming fewer calories (down 7 percent in boys and 4 percent in girls).
- Changes in environmental and cultural habits promote a healthier lifestyle.
- New subsidy programs that provide low-income families with healthier food options.
- Federal programs, like the exercise programs promoted by Michelle Obama, are having a positive affect on our nation’s youth.
Dr. Silverman comments
This is encouraging news, especially when many stories of late seem to suggest that we as a nation are moving in the wrong direction when it comes our health.
One group that should be commended for their role in lowering obesity rates in young child is parents. At such a young age, children are incapable of regularly feeding/preparing meals for themselves, so that task falls on the shoulders of the parents. It’s clear that a large portion of parents are taking the extra time to prepare a healthier meal for their children than taking the easy route and throwing a Lunchable on their plate.
There have been times on this blog where I have pointed out how parents are failing their children, so it’s only appropriate I do the same when parents do right by their kids.
Kudos, parents. Keep it up!
Related source: New York Times
A new study suggests that consistent spikes in blood sugar caused by excess carbohydrates can be harmful to a person’s brain health.
Along the lines of similar research, the study suggests that carbohydrate calorie-rich diets have been linked to an increased likelihood of:
- Brian shrinkage
- Impaired cognition
- Other mental disorders
Dr. David Perlmutter, author of the book “Grain Brain,” said people should be aware that not all calories are the same.
“We live with this notion that a calorie is a calorie, but at least in terms of brain health, and I believe for the rest of the body as well, there are very big differences between our sources of calories in terms of the impact on our health,” said Dr. Perlmutter. “Carbohydrate calories, which elevate blood glucose, are dramatically more detrimental to human physiology, and specifically to human health, than are calories derived from healthful sources of fat.”
Dr. Perlmutter added that excess carbohydrates can be detrimental throughout all stages of life.
“In the clinical arena, when we see children with ADHD, or elderly individuals with depression or dementia, we may see improvement in these clinical presentations simply by removing gluten, reducing carbohydrates, and adding healthy fats back into the diet,” said Dr. Perlmutter. “We understand the benefits of doing this from both the literature and clinical observation.”
Gluten-Free Not The Answer
When asked whether people should strive for a low-carbohydrate or gluten-free diet, Dr. Perlmutter noted that those who go gluten-free still often end up with excess carbs in their system.
“People who are gluten-sensitive may suddenly become attracted to the gluten-free aisle in the grocery stores and gravitate toward gluten-free pastas, breads and crackers. These people are not doing themselves a favor because they are still dramatically pounding their bodies with high levels of carbohydrates,” Dr. Perlmutter explained.
He concluded by saying the best thing people can do is limit their intake of foods like breads, pastas and crackers that have extremely high glycemic indices. Doing so may not guarantee a life free from dementia, but the research “is certainly much more significant than we have ever thought about in the past.”
Dr. Silverman comments
I’ve said it before and I’ll say it again. One of the pillars of a healthy lifestyle is maintaining balance. Eat a balanced diet, get regular exercise, and continually work to develop both your mental and physical health.
Eating any food loaded with sugars or carbs is obviously bad for your health, but I am glad researchers are working on tangible links to promote awareness. Hopefully people use this information to make better dietary decisions.
Related source: Counsel Heal