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Arthritis News and Treatment

For the Treatment of Rheumatoid Arthritis, Surveyed European Rheumatologists Expect Well-Established TNF-Alpha Inhibitors to Lose Considerable Patient Share to Newer Agents in This Drug Class

Enbrel, Humira and Remicade Will Lose Patient Share Through 2013, According to a New Report from Decision Resources

BURLINGTON, Mass., Oct. 14 /PRNewswire/ — Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that, between 2010 and 2013, surveyed European rheumatologists expect well-established TNF-alpha inhibitors to lose considerable patient share to newer agents in this drug class, most notably Centocor Ortho Biotech/Merck/Mitsubishi Tanabe/Janssen’s Simponi and UCB/Otsuka’s Cimzia. The increased use of newer agents such as Simponi and Cimzia will most likely occur in newly diagnosed patients and/or in patients who do not respond to initial treatment with a biologic agent.

The new European Physician & Payer Forum report entitled Rheumatoid Arthritis in Europe: How Are Physicians and Payers Responding to an Expanding Arsenal of Biologic Agents? finds that the well-entrenched TNF-alpha inhibitors that stand to lose patient share include Amgen/Pfizer/Takeda’s Enbrel, Abbott/Eisai’s Humira and Centocor Ortho Biotech/Merck/Mitsubishi Tanabe’s Remicade. Surveyed European rheumatologists expect a particularly substantial decline by 2013 in the in-class patient share of Remicade — the only currently marketed intravenous (IV) TNF-alpha inhibitor.

“However, Remicade’s lost patient share among TNF-alpha inhibitors will not be fully replaced by uptake of Simponi IV,” said Decision Resources Analyst Martin Quinn. “Additionally, considerably more physicians from France, Germany, Spain and the United Kingdom expect to prescribe subcutaneous Simponi than expect to prescribe Simponi IV. This trend will be least pronounced in Italy, where rheumatologists report high patient share for Remicade.”

The report findings also suggest that the opportunity to gain patient share is set to increase for recently launched and emerging biologics with alternative mechanisms of action. These agents include Bristol-Myers Squibb’s Orencia, Roche/Chugai’s RoActemra and Genmab/GlaxoSmithKline’s Arzerra. Most notably, surveyed rheumatologists from France, Italy, and Spain predict that at least 40 percent of their patients treated with TNF-alpha inhibitors will receive a subsequent biologic with an alternative mechanism of action by the end of 2013.

The report also finds that patient cost-sharing for rheumatoid arthritis drugs does not pose a significant barrier to treatment for patients in France, Germany, Italy, Spain and the United Kingdom. For example, because patients with severe progressive rheumatoid arthritis in France make no out-of-pocket payments for biologics, private insurers — most of whom cover only out-of-pocket costs — do not play a central role in determining access to rheumatoid arthritis drugs.

The report is based on a survey of 250 rheumatologists from Germany (50), France (50), Italy (51), Spain (50) and the United Kingdom (50) and interviews with 16 European payers from Germany (3), France (3), Italy (4), Spain (3) and the United Kingdom (3).

Doctors, patients eagerly await new rheumatoid arthritis medicines

At first, Maria Perez couldn’t identify the severe pain that gripped her in her mid-30s, but she knew it wasn’t routine. She wondered if she had a hand sprain, considered surgery, and then discovered she had rheumatoid arthritis, a debilitating autoimmune disease that attacks a patient’s joints and vital organs.

“There were days when I could not even lift my leg. Like if I were to get out of bed and I were to put my foot on the floor, it would be the most incredible sharp pain up my leg,” said the 40-year-old New Jersey resident. “There were some days when I was just bedridden. I couldn’t be active at all.”

Perez got her life back when she began injecting Humira into her leg once every two weeks. Humira, a drug produced by North Chicago-based Abbott Laboratories, completely eliminated her pain, allowing her to take up new activities like kickboxing and walking her dog. But Perez said she would eagerly drop the injectable drug if she could find a pill that accomplished the same thing.

In several years, a new generation of drugs might give her that option and challenge Humira’s blockbuster status. Humira is in a class of genetically engineered pharmaceuticals known as “biologics,” which have changed the face of treatment for rheumatoid arthritis. Since the Food and Drug Administration approved it in 2002, Humira has been helping patients like Perez manage the disease and increase quality of life. In turn, the drug has evolved into a prominent cash cow for Abbott. This year alone, the drug is expected to rack up $6 billion in sales.

Now, researchers are looking to new remedies that could revolutionize treatment again. Oral drugs called JAK-inhibitors, aimed at blocking the parts of the immune system that perpetuate rheumatoid arthritis, are in the third phase of testing by Pfizer Inc. and Eli Lilly and Co. Rebecca Bader, a researcher with Syracuse University, said an oral medication will likely become the preferred medication for patients.

“If you can find something that’s administered easier, that’s a good thing for the customer,” said Bader. “I think anything that’s taken orally is better.”

Abbott spokeswoman DeAnna DuBose said the company also has an oral drug in preliminary development, but downplays the negative effects these new drugs might have on Humira. She noted that Humira is used by more than 500,000 patients worldwide for rheumatoid arthritis and other diseases and conditions, including Crohn’s, psoriasis and ankylosing spondylitis. The company also points out that Humira has undergone years of trials and patient use, and is well-positioned to remain a front-runner in rheumatoid arthritis treatment.

One percent of the U.S. population is affected by rheumatoid arthritis. Most people are diagnosed when they are middle-aged, according to researchers, but it also affects juveniles and the elderly. Several treatments exist for rheumatoid arthritis including painkillers, anti-inflammatory drugs and immune suppressants in addition to injectable biologics.

Dr. Nathan Wei of the Arthritis Treatment Center in Maryland, has been part of the research trials of the JAK-inhibitor drugs. He said the new drugs are as effective as the injectable ones on the market today. Wei said his biggest concerns are side effects, including decreased white blood cell count, elevated lipids levels, possible effects on kidney function and possibly elevated blood pressure. A Pfizer representative said the company’s drug has not yet been approved by the Food and Drug Administration and is still several years away from the market. Still, Wei has high hopes for these drugs.

I think they will change the landscape [of rheumatoid arthritis treatment], I do strongly believe that,” said Wei. “But in what way, it’s hard to say right now.”

If the drugs hit the market, they won’t become widely used immediately. For this reason, Sara Michelmore, a financial analyst at Cowan Financial Group, thinks companies like Abbott will not be seriously affected by the new drugs for a prolonged period.

“That’s several years away before there’s any significant impact,” Michelmore said. “They [doctors] are very unlikely to substitute a drug like Humira.”

Perez said she’s more than happy to take the injections as long as she must, but she is eager to simplify her life by switching to a pill. She hopes one day she’ll be able to plan airline flights without worrying about missing her scheduled doses and be able to carry her medication in her purse rather than storing it in a refrigerator.

Phobias & Mental Health News

Anxiety, Phobias and Kids: When to Seek Help

According to Dr. Paul Ballas, a child psychiatrist and the medical director at the Green Tree School for children with special needs in Germantown, Penn., anxiety, phobias and mood disorders are common problems for young children and adolescents.
Such anxieties often surface during the fall, when children return to school and experience changes in sleep patterns, stress levels and routines. Environmental factors such as high allergen levels have also been shown to be associated with higher rates of anxiety, Ballas said.

“This time of year is a very anxiety-producing time for many kids,” he said.
The first step in determining whether a child is suffering from a phobia or anxiety disorder is to identify whether the fear is rational. Ordinary anxiety takes place in the context of a situation, or stimulus, such as watching a scary movie or taking a test. On the other hand, phobias and anxiety disorders are characterized as fear without the stimulus, and can cause long-lasting psychological distress. Anxiety disorders often disrupt normal day-to-day function.
The main distinction between adults, adolescents and children is that adults and adolescents often recognize that the fear is irrational. An adult with a phobia of elevators may understand that riding an elevator is safe but still refuse to get on. A child with that same phobia may not understand that the fear is unreasonable or excessive and develop an excuse to not get on the elevator. Young children often confuse anxiety for physical pain and say they have a stomachache or headache to avoid situations that cause anxiety.
Ballas said that parents can help their kids through times of anxiety by first ensuring that their basic needs — adequate sleep, a healthy diet and physical activity — are met.
“You’d be amazed how much of a problem sleep deprivation is for young kids,” Ballas said. “If they get enough sleep, their anxiety might go away.”
In cases where treatment is needed to address the child’s anxiety, therapists may gradually sensitize children to the object of their fear in a controlled setting. An alternative tactic that is generally not recommended for children is known as “flooding,” which means confronting the person with the object of their fear at its worst. For example, if a child is afraid of riding the bus, he would be placed on the bus and forced to deal with it.
Cognitive behavioral therapy is a recognized short-term treatment in which a therapist identifies the cognitive distortions the child is experiencing and appeals to the child’s sense of reason as to why his fears do not make sense. This approach typically works well for children ages 5 and older, Ballas said.
Six categories of phobias common in children include:
Animal phobias: fear of insects, sharks, other animals.
Natural environment phobias: fear of storms, heights, water.
Blood, injections and injury phobias: fear of vaccinations, doctors’ offices.
Situational phobias: fear of flying, riding over bridges.
Social phobias: fear of social situations, public speaking, judgment or criticism from others.
Other phobias: any other specific phobia such as fear of choking or characters in costume.

Virtual Revulsion Therapy: Pixelated Pests Help Treat Cockroach Phobia

For people with katsaridaphobia, or the fear of cockroaches, the common pests are more than nuisances—they are the stuff of nightmares. When some phobics spot one of the skittering beasts they start sobbing uncontrollably, whereas others who have seen them in their homes seriously consider moving. Psychologists can treat such disruptive fears with exposure therapy, in which a therapist gradually presents the feared stimulus to the patient in increasingly intimate scenarios. Recently, some psychologists have successfully combined exposure therapy and virtual reality to treat fears of flying, heights and spiders, asking patients to interact with simulated environments that guarantee their safety.

Now, a team of psychologists has completed the first clinical trial testing the treatment of cockroach phobia with augmented reality—a younger cousin of virtual reality that layers digital animations over video or photos of a real-world environment. The new study, published in the September issue of Behavior Therapy, is the most recent and most significant step toward bringing augmented reality therapy out of the lab and into common clinical practice.

“I am thrilled with the research,” says Stéphane Bouchard, a psychologist at the University of Québec in Outaouais who has studied virtual reality therapy, but was not involved in the new study. “This study shows reliably the feasibility of augmented reality to treat specific phobias.”
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In the study psychologist Cristina Botella of the University of Jaume I in Spain and her colleagues treated six women diagnosed with cockroach phobia, according to criteria in the Diagnostic and Statistical Manual of Mental Disorders IV. The women wore an enclosed helmet comprising a camera and a monitor that allowed them to view their surrounding environment sprinkled with a few digital embellishments—incredibly realistic animated cockroaches, which the therapist could shrink, enlarge, multiply or vanish at will.

“With augmented reality you can modulate the exposure in ways you never could in real life,” says Soledad Quero, Botella’s colleague and a co-author of the paper. “It really shows the potential of new technologies to help people with psychological problems.”

Staring into the helmet viewer, the participants saw cockroaches scrabbling on the floor, encroaching on their personal belongings or crawling all over their fingers. The experimenters asked the phobics to keep the helmet on until their anxiety subsided by two or three subjective units of discomfort, as measured by a standard eight-point, self-reported Likert scale.

After treatment that lasted just under two hours on average all the participants demonstrated a significant reduction in their anxieties. They also reported a lessening of their condition’s severity and its ability to disrupt daily life, which the experimenters measured using similar standard scales. Most participants showed a reduction from a score of 7 or 8 to a score of 1 or 2. At a checkup 12 months later, most participants maintained these drops in angst. Directly after the therapy all the participants had been able to approach a jar containing a live cockroach, open it and place their hands inside for a few seconds. Before the procedure none could bring themselves to even touch the jar. During the checkup all but two participants successfully completed a repeat of the jar test, and three participants each killed cockroaches near their feet with a fly swatter.

“The most important finding is that the patients improve, but not only in reporting that they feel better—the changes affected what they could do in their real lives, too,” Quero says.

The trial’s small size makes it difficult to draw general conclusions about the efficacy of augmented reality therapy, but Bouchard says the results are robust enough to validate further larger studies—especially studies that specifically compare augmented reality therapy with alternative treatments, like virtual reality therapy and the most common technique, in vivo exposure, in which patients confront their fears in reality, whether it be living spiders or standing on the top floor of a skyscraper.

Successfully completed in vivo exposure therapy is usually quite effective, but nearly one quarter of patients drop out because of its intensity. In the new paper the researchers note—and Bouchard confirms—that augmented reality is not only more appealing for many patients, it should cost less than virtual reality therapy because the former involves simulating only the feared stimulus rather than an entire environment. Quero even envisions giving patients “augmented reality” homework to complete on mobile devices: Imagine, for example, using an iPhone or Droid to create the illusion of creeping cockroaches on the kitchen table.

So far, augmented reality therapy only exists in the lab, but Bouchard is encouraged by Botella’s study. “This is a pioneering application,” he says. “I can imagine we will see a diffusion of augmented reality into therapeutic settings just as we have seen with virtual reality.”

Physical illness may affect mental health

MUMBAI: As Sunday marked World Mental Health Day, doctors in the city cautioned Mumbaikars to watch out for those tell-tale signs triggered by minor illnesses. You may have wondered how a small bout of fever can cause extreme sadness, or why even the slightest noise can jar your nerves when you have a cold or a headache. Doctors have the answer-physical illness can lead to psychological problems in patients.

Doctors across specializations say that patients suffering from an illness, especially chronic, tend to develop not just minor mental problems like distress and anxiety, but also major ones like depression, phobias and even sexual dysfunction. About 14-20% of chronically ill patients have psychological problems, apart from minor distress and anxiety, say doctors.

Dr Ganesh Kumar, head of cardiology at L H Hiranandani Hospital, says that at least one in three patients is suffers from mental problems, including anxiety. “Patients suffering from a heart failure or an attack, especially younger ones, develop severe mental problems. First of all, the patients do not want to accept the fact that they are chronically ill. And when they do, they directly start fearing death,” he said. “Many young patients also start believing that having sex will stress out on their heart, which might lead to another attack. This causes sexual dysfunction and frustration in the patient as well as the spouse,” he added.

Dr Ashok Mahasur, chest physician with Hinduja Hospital, says that respiratory problems tend to make patients even more psychologically conscious. “Problems like chronic obstructive pulmonary disease, drug-resistant TB and lung fibrosis can are the ones which cause a lot of distress in the patient. As these are long-term problems, the patient’s thinking gets negative,” he said, adding that mental problems are rampant in 60-70% of patients suffering from respiratory illnesses. “Only around 20% of people-those who are not well educated or those who do not know much about the disease-have little anxiety,” Dr Mahasur added.

It is not just those suffering from cardio or respiratory problems who get worried, but also those with chronic kidney ailments. “Patients suffering from end-stage kidney disease who cannot find a donor, especially those who have to go for dialysis regularly, undergo great trauma. They cannot carry out their regular functions, feel unproductive and believe that they are a burden on the family. Most of the time, affordability of the treatment is also becomes a problem,” said Dr Bharat Shah, nephrologist, Lilavati Hospital.

Psychiatrist Dr Harish Shetty, however believes that depression in the chronically ill is generally misunderstood as anxiety. “If a person is suffering from diabetes and goes into depression, the family thinks it is because of erratic sugar levels. If symptoms of mental problems are taken care of along with the treatment for the physical illness, patients tend to recover sooner,” he said.

Obesity News

Researchers piece together gene, obesity and fat distribution puzzle

EU-funded scientists have identified 18 new gene sites that impact overall obesity and 13 new sites associated with distribution of fat. The researchers from Europe, as well as Australia, Canada and the US, used a near 250,000-strong sample to investigate genetic links with human traits. The findings of the two studies, published in the journal Nature Genetics, shed light on why some people are more susceptible to obesity while others are not.

Part of the Genetic Investigation of Anthropometric Traits (GIANT) consortium, which comprises 400 experts from 280 research institutions worldwide, the scientists carried out a large-scale meta-analysis of genome-wide association studies (GWAS) providing insights on waist-hip ratio (WHR) and body mass index (BMI).

‘Different people have different susceptibilities to obesity,’ explains Dr Joel Hirschhorn from Children’s Hospital Boston and the Broad Institute in the US, one of the senior authors of the obesity paper who was involved in both studies. ‘Some don’t rigorously watch what they eat or how much they exercise and still resist gaining weight, while others constantly struggle to keep their weight from skyrocketing. Some of this variability is genetic, and our goal was to increase understanding of why different people have different inherited susceptibility to obesity.’

These studies succeeded in pinpointing genes that were never before suspected of influencing obesity. The results will help improve the categorisation and treatment of obesity in the future, according to Dr Hirschhorn.

The overall obesity study investigated the genetic determinants of BMI, which is determined by measuring a person’s weight in kilograms over height in metres squared. Data from 124,000 people from 46 studies uncovered 32 sites (of which 18 are new). The team found two novel variants, one of which is in the gene encoding for a receptor protein that responds to signals from the gut to influence insulin levels and metabolism, and another that is located near a gene known to encode proteins affecting appetite.

‘One of the most exciting parts of this work is that most of the BMI-associated variants identified are in or near genes that have never before been connected to obesity,’ comments Dr Elizabeth K. Speliotes from Massachusetts General Hospital and the Broad Institute, lead author of the BMI study and involved in both studies as well. ‘Through this work we are discovering that the underlying biological underpinnings of obesity are many, varied and largely uncharacterised.’

Their findings show that people with more than 38 BMI-increasing variants were about 15 to 20 pounds heavier than those who carried less than 22 such variants.

The second study investigated associations between gene sites and fat distribution. Evaluating the genetic determinants of WHR of 77,000 people in 32 studies, and checking against data of more than 113,500 individuals in 29 studies, the researchers found 14 gene regions associated with WHR, adding 13 new sites. It should be noted that seven of the identified genetic variations have stronger effects in females than in males, hinting that they trigger some of the differences in fat distribution between women and men.

‘By finding genes that have an important role in influencing fat distribution and the ways in which that differs between men and women, we hope to home in on the crucial underlying biological processes,’ says Dr Cecilia Lindgren of the Wellcome Trust Centre for Human Genetics at Oxford University in the UK, a senior researcher on the WHR study, who was involved in both papers.

The results in this study indicate that specific biological mechanisms play a role in regulating where the body stores fat. Genes that regulate cholesterol, triglyceride levels, and insulin and insulin resistance are associated with the regions impacting fat distribution.
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EU funding for the studies came from projects under Fifth and Sixth Framework Programmes (FP5 and FP6), specifically: EURO-BLCS (Biological, clinical and genetic markers of future risk of cardiovascular disease’), which was supported under the Quality of life and management of living resources budget line of FP5; as well as EUROSPAN (European special populations research network: quantifying and harnessing genetic variation for gene discovery’), MOLPAGE (‘Molecular phenotyping to accelerate genomic epidemiology’), PROCARDIS (‘A genome-wide mapping and functional genomics approach to elucidating precocious coronary artery disease’), and EURODIS (‘Functional genomics of pancreatic beta cells and of tissues involved in control of the endocrine pancreas for prevention and treatment of type 2 diabetes’), which between them received over EUR 25 million from the EU under the ‘Life sciences, genomics and biotechnology for health’ Thematic area of FP6. The studies were also backed by an EU Marie Curie Intra-European Fellowship grant.

European scientists that took part in the studies were from Austria, Croatia, Denmark, Estonia, Finland, Germany, Iceland, Italy, the Netherlands, Norway, Sweden, Switzerland and the UK.

Childhood obesity ad likens junk food to heroin

A controversial new ad which compares feeding children junk food to injecting them with heroin has restarted debate about the best way to tackle childhood obesity.

The Sydney-based agency which produced the ad says existing health advertising is not working to curb the problem.

It says it wanted to shock parents into action. But health experts say it has gone too far.

In the advertisement, a mother walks into a room carrying a brown paper bag. She sits down at a table next to her little boy who is colouring in.

She takes out some heroin and a syringe and ties a tourniquet around her son’s arm. The words on the screen say: “You wouldn’t inject your children with junk – so why are you feeding it to them?”

The producer of the Break the Habit ad and managing director of the Sydney-based agency The Precinct, Henry Motteram, says not resolving the signs of childhood obesity is “tantamount to child abuse”.

“We wanted the conversation to start. We wanted that conversation to be as big as possible and involving as many people as possible, hence why we decided to go down a shock tactic [path],” he said.

“Both obesity and drugs in general have a similar impact on people’s lives, both physically and psychologically in the long run.

“By no means are we saying that eating a hamburger is the same as taking a hit of drugs. The visual metaphor is about the long-term impact of this.”

The ad was posted on YouTube and attracted more than 500 comments. There was a diverse range of opinions from: “Thank you. Addiction is addiction, no matter what item or drug you put in there. Stop abusing your children!”

But others disagreed:

“Heroin will destroy your life and easily kill you. An occasional hamburger will not do either. They have nothing in common and this video is pure garbage,” said one commenter.

“That was bullshit. Somebody ought to slap the person who came up with that,” said another.

“If they want to do something about fat kids then the parents need to take the kids to a park or do something that involves running. Or maybe they should just get off their lazy arse and do something fun with their kids.”

‘Over the top’

Director of the Public Health Advocacy Institute, Professor Mike Daube, says childhood obesity is a massive problem in Australia, where 25 per cent of kids are now considered obese.

But he says the ad is over the top.

“This ad puts all the emphasis on kids. Then it puts all the blame on parents instead of people writing junk food [ads]. And then just for good measure it shows you how to inject heroin,” he said.

“So I’m not a fan of the ad. I admire anybody who has concerns about the obesity problem which is very real, but I don’t think this ad is the way to deal with it.”

It is a view shared by nutritionist Dr Rosemary Stanton.

“Heroin is dangerous, even in a small dose. And junk food isn’t dangerous in a small dose,” she said.

“But I do think that we need to make parents aware that it’s not safe to give their kids so much junk food [to eat]. And they currently aren’t aware of that.”

Dr Stanton says the first step to tackling childhood obesity is to get rid of junk food advertising.

“Sure it’s the parents who actually buy the junk food, but they buy it because the kids pester them to buy it,” she said.

“The kids pester them to buy it because they’ve seen the ads.

“So I think any society that is serious about doing anything about obesity in children and obesity in adults for that matter should look at stopping these highly persuasive, clever adults from encouraging kids to pester the parents.”

This afternoon, the Break the Habit advertisement was pulled from YouTube.

The agency says the parents of the young boy in the ad were concerned about all the media attention.

Study Says HFCS Does Not Cause Obesity

October 12, 2010

For years, high fructose corn syrup has been erroneously implicated as a prime suspect in the obesity epidemic. Inexact scientific reports and inaccurate media accounts have increased confusion about the sugar made from corn. New research proves otherwise.

A new study, presented on Saturday October 9, at the Obesity Society’s 28th Annual Scientific Meeting, further reinforces the facts about high fructose corn syrup. Results from the double-blind study revealed that fructose containing sweeteners (sugar, high fructose corn syrup) do not uniquely contribute to obesity when consumed as part of a healthy weight maintenance diet. The study also found that high fructose corn syrup no more contributes to caloric intake than table sugar (sucrose).

In the study, overweight or obese adults were placed on a 10-week eucaloric diet (an eucaloric diet provides your body with just the right number of calories necessary to maintain current body weight) which incorporated either high fructose corn syrup or sucrose-sweetened, low-fat milk. Participants’ consumption of low-fat milk accounted for between 10 to 20 percent of the daily allotted calories, representing typical levels of sweetener consumption. Study participants did not experience a change in body weight, percent of body fat, fat-mass, or percent of abdominal body fat. Additionally, there were no statistical differences between people given high fructose corn syrup and those given sucrose.

These results are meaningful for the food and beverage industry because they provide further scientific evidence that products containing high fructose corn syrup do not promote weight gain more than products containing sugar.

Aromatherapy News

Relaxing Ritual of the Week: Aromatherapy Bath Meditation

When it comes to managing stress, it helps to have a variety of techniques to try. Some stress relief practices can help you to calm your physiology and reverse your stress response when it’s been triggered; others help you to manage and minimize the amount of stressors you have in your life. Some strategies take the form of ongoing habits that promote overall calmness and wellness. Trying something new each week can ensure that you’ll be able to hit stress from several different angles to effectively manage it more easily.

This week, I’d like to encourage you to try a strategy called Aromatherapy Bath Meditation. This one works really well as a nightly habit. It provides a way to unwind and relax, to get clean, and to practice meditation while you do it. (One of the many benefits of meditation is that it can help you feel less stressed overall, so this habit can help you with stressors you haven’t even experienced yet!) And if you use lavender as your scent, it can even help you sleep! This week, I challenge you to try this technique at least three times, and see how you like it.

Try The Aromatherapy Bath Meditation

You can also try last week’s relaxing ritual, the Chocolate Meditation. What are your favorite ways to relieve stress? Share in the comments (below), post on the About Stress Management Facebook Page, and pass it on with the ‘share’ button if you want to spread the stress relief.

Vermont Soap ~ Aromatherapy Air Care Fresheners

MIDDLEBURY, Vt.—Vermont Soap introduced an eco-conscious, all-natural line of Aromatherapy Air Fresheners. Scented with natural essential oils, these environmentally-conscious air fresheners offer health-conscious consumers an all-natural alternative to freshen the air. They can be sprayed directly in the air, on skin, fine linens and other fabrics and all water-safe surfaces. They can also be used to freshen personal spaces at home, school, work, in cars, dog beds or anywhere. These air fresheners contain pure essential oil aromas that won’t irritate the skin or nose. Aromatherapy Air Fresheners are free of artificial colors and fragrances, chemical preservatives, animal byproducts and are not tested on animals.

Aromatherapy Air Fresheners are offered in three scents to induce different moods: Country Lavender, Lemongrass Zen and Peppermint Magic. Lavender has a relaxing aroma, while lemongrass is uplifting and peppermint is clarifying and stimulating. Each freshener comes in an 8-oz. or 16-oz. re-usable spray bottle.

Massage Envy Launches Choices Program to Further Customize Massage Therapy

AromaTherapy and Deep Heat Relief Muscle Therapy Enhance Therapeutic Massage

SCOTTSDALE, Ariz., Sept. 30 /PRNewswire/ — Massage Envy, the nation’s largest massage therapy provider and the largest spa chain in America, began offering the new Choices program at its 633 locations this week. Choices provides four AromaTherapy options designed to relieve a variety of therapeutic needs including anxiety, headaches, emotional imbalance and insomnia. Deep Heat Relief Muscle Therapy is ideal for anyone who suffers from chronic pain or limited movement.

AromaTherapy options include:
Aches and Pains – specifically designed to promote circulation, this warming blend of clove, sweet birch, rosemary, and cypress helps aid tissue recovery after physical exertion.
Anxiety Release – known for their calming properties, lavender, chamomile, and vetiver are combined with uplifting aromas of citrus and clary sage.
Lavender Garden – English true lavender is used to both reduce pain and inflammation and act as a mild antidepressant and calming agent. Next, lavandin helps support the respiratory system, aids in natural detoxification, and promotes restful sleep.
Mint & Rosemary – this combination of mint oils and rosemary enlivens the mind and body. Peppermint is high in natural menthol, which aids in pain relief and cools the body while increasing circulation.

Asthma Treatment News

New Asthma Treatment Makes Breathing Easier

A new treatment called Bronchial Thermoplasty could help people with severe asthma breathe easier.

The process involved doctors putting a tiny catheter down breathing tubes to melt away the smooth muscle that can tighten during an asthma attack.

By increasing airflow, patients can respond better to inhalers and oral medications. Doctors warn that this in not a cure for asthma.

The treatment is only for people whose attacks are so severe, they make regular visits to the ER and use rescue inhalers constantly.

The procedure takes three outpatient treatments that last about 30 minutes each.

New Treatment Helps Asthmatics Breathe Easier

About 22 million Americans have asthma. Most are able to control it with medication, but about15-percent of asthma patients have cases so severe they require frequent trips to the hospital. Now there’s a new treatment to help those people breathe easier.

Tony Cook runs 6 to 7 miles a day. But until recently, his severe asthma made it too painful for him to work out for any length of time.

“It feels like a coil is just tightening around your lungs and you can’t get any relief whatsoever,” explained Cook.

In May, Tony underwent a new FDA approved treatment called bronchial thermoplasty. Doctors put a tiny catheter down his breathing tubes to melt away the smooth muscle that can tighten during an asthma attack. By increasing airflow, patients can respond better to inhalers and oral medications.

“We’re not curing asthma with this therapy. These patients will still have a diagnosis of asthma. What we’re hoping to do is bring them down a notch,” explained Dr. David Duhamel, Director of Pulmonary Procedures at Virginia Hospital.

Bronchial thermoplasty isn’t for people with mild or moderate asthma. It’s for people whose attacks are so severe that they make regular visits to the emergency room and need to use rescue inhalers constantly .

Bronchial thermoplasty takes three outpatient treatments that last about a half hour each.

“Right after the procedure I felt that coil loosen. To me, it was amazing,” said Cook.

Tony felt better immediately, but typically, the patients’ asthma gets worse the first few days after treatment then improves.

“I’m not coughing I’m not wheezing. It’s just the quality of life that I’ve always dreamed of having,” said Tony.

Because it’s so new, Tony’s procedure wasn’t covered by his insurance, but patients should check with their own carriers.

The FDA is requiring asthmatx, the company behind bronchial thermoplasty, to conduct a five-year study to determine the long-term effects of the treatment.

Inhaled steroids don’t help asthma flare-ups

(Reuters Health) – Doubling the dose of inhaled steroids doesn’t appear to dampen asthma attacks, despite the practice being recommended by many doctors, Canadian researchers said Thursday.

More than seven percent of adult Americans, and even more kids, have asthma, causing millions of visits to emergency rooms and doctors’ offices every year.

Until recently, national guidelines advised people to double the dose of inhaled steroids when they felt the telltale signs of an asthma flare-up coming on, such as chest tightness and coughing.

Those steroid medications, such as Pulmicort or Flovent, keep airway inflammation under control on a daily basis in asthmatics. So doctors had reasoned higher doses might work in emergencies.

“It is a reasonable thing to try,” said Dr. Andy Nish, an asthma expert at the Allergy and Asthma Care Center in Gainesville, Georgia, who was not involved in the new study, published by The Cochrane Collaboration.

“This article shows that sometimes we do things that seem reasonable and yet maybe aren’t as effective as we would like to think.”

The Canadian researchers pooled the best data available on outcomes with the higher doses, including five clinical trials that assigned 1,250 patients randomly to take either the standard dose of inhaled steroids or an increased dose.
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Overall, doubling or even quadrupling the amount of inhalant at the onset of a flare-up didn’t make patients any less likely to need rescue treatment with swallowed or injected steroids such as prednisone.

While effective, those stronger treatments may cause serious side effects like depression or bone thinning, so patients and doctors prefer to limit their use.

Except for 28 patients, all study participants were adults, so the findings may not apply to children.

“The most important strategy to reduce the rate and severity of flare-ups is to take daily preventive medications for asthma,” Dr. Francine M. Ducharme, who worked on the study, said in an e-mail to Reuters Health.

Ducharme, of the University of Montreal, said it was still common for doctors to recommend high-dose inhaled steroids to stave off attacks.

Instead, she said, patients should try rescue inhalers, which contain short-acting drugs such as albuterol that open up the airways. If that doesn’t work, swallowed or injected steroids may be necessary.

Nish said the best thing to do is try to prevent flare-ups. “Avoid cigarette smoke, stay indoors if it is a high-smog day, avoid exertion if it’s a cold or a hot day, and get your flu shot.”

And with the right medication, he said, many asthma attacks can be prevented.

“We can’t keep you from getting a cold, but hopefully we can keep that cold from causing significant exacerbations in your asthma,” he said.

Alternative Medicine Today

Alternative and complementary therapies abound for breast cancer patients

That’s because the clinical and professional herbalist and certified flower essence practitioner who works out of her home in West Asheville believes more and more people are looking for alternatives to conventional Western medicine.

“Women have been using herbs on themselves for thousands of years,” Frezza said. “Western medicine has its place and can be used in conjunction with alternatives. A lot of people are really getting tired of pharmaceuticals.”

Frezza works in a field that’s getting more and more attention as the cost of conventional treatments continues to rise, and as research into a variety of alternatives yields more confirmed results. At the forefront of that research is the National Center for Complementary and Alternative Medicine. It’s one of the 27 centers and institutes that makes up the National Institutes of Health and is the federal government’s lead agency for scientific research on complementary and alternative medicine.

According to the center, a 2007 National Health Interview Survey found that about 38 percent of adults use the therapies. Complementary medicine is defined as medicine used in conjunction with conventional medicine, while alternative medicine is used in place of conventional medicine.

There are a number of ongoing research studies and clinic trials. For example, there are ongoing trials to study the effectiveness of tai chi and a cardiovascular exercise fitness program in improving the physical fitness and reduction of stress in adult survivors of solid-tumor cancers.

Another study is examining the effectiveness of the combination of mistletoe extract and gemcitabine in patients with solid tumor cancers. The FDA has approved mistletoe extract for use in cancer treatment studies, and mistletoe extract has been used either alone or together with conventional anti-cancer drugs to treat cancer in thousands of patients in Europe.

Frezza says she educates her clients on recent studies, points to resources such as a PubMed, a service of the National Library of Medicine that includes brief summaries of articles from scientific and medical journals, and can explain the folk history of plant medicine.

For someone with breast cancer, Frezza said that although every case is different, she might suggest the use of red clover or violet oil. She also said she would target the physical well-being of a client, as well as their emotional health and their energy level.

“I like to think of myself as a spokesperson for plants,” Frezza said. “What I’m really doing is helping people help themselves.”

Alternative Therapies for Ulcerative Colitis

People with IBD are very likely to have tried complementary and alternative medicine (CAM) to treat their symptoms. There are several reasons for this, not the least of which is that many of the prescription medications for IBD carry unwanted side effects. But CAM isn’t always the easiest route to take, either, because what worked for one person may not work for another, and just because something is marketed to treat IBD doesn’t mean that it will actually help. In fact, for some CAM, there’s not much evidence to recommend their use. Some of the CAM therapies associated with ulcerative colitis include: Aloe Vera
Boswellia
Butyrate
Licorice Root
Omega-3 Fatty Acids
Slippery Elm

Alternative Biomedical Treatments for Autism: How Good Is the Evidence?

Parents who research treatments for autism are confronted with a bewildering array of options, almost all of which have never been tested for safety and effectiveness. Organizations like The Cochrane Collaboration, which reviews the quality of evidence for medical treatments, are putting more effort into evaluating popular alternative treatments.

So far, the most comprehensive review of alternative autism treatments comes from two pediatricians: Susan Hyman of the University of Rochester School of Medicine Golisano Children’s Hospital at Strong and Susan Levy, a clinical professor of pediatrics at the University of Pennsylvania School of Medicine and The Children’s Hospital of Philadelphia. Their 2008 analysis gave each treatment a letter grade for the quality of the research conducted up to that point; the mark, however, is not a ranking of the treatment’s safety or effectiveness.

The two pediatricians based the grades on the amount of testing done on the treatments, which in most cases was skimpy at best. Research that got an “A” grade included randomized control trials, the gold standard for medical research, and meta-analyses, which compare research from different labs. A “B” went to treatments that had been studied in “well-designed controlled and uncontrolled trials,” according to Hyman. The “C” grades, the lowest category (there were no “D”s or “F”s), were based on case reports, theories and anecdotes, which are not considered acceptable for mainstream medical research.

Research on just one treatment, secretin, was good enough to earn an A. In short, there is a lot more work that needs to be done toward testing popular alternative treatments and getting more potential treatments into development at research institutions and pharmaceutical companies.

Dietary supplements

B6/Mg++—Grade: B

Vitamin B6 and magnesium have been a popular treatment for autism over the past 20 years. The Cochrane Review identified three studies that compared outcomes of B6 and magnesium treatment with those for placebo or no treatment, but just 28 subjects were treated altogether. One study found no improvements; another reported improvement in IQ and social behaviors. But all the studies suffered methodological weaknesses aside from the small sample size.

DMG—Grade: B

Dimethylglycine (DMG), an antioxidant and derivative of the amino acid glycine, is marketed as an immune system booster. Two small double-blind studies of DMG found it had no effect on autism symptoms.

Melatonin—Grade: B

Melatonin is a hormone produced by the pineal gland that regulates sleep. Melatonin supplements are popular for self-treating insomnia or jet lag. Many people with autism-spectrum disorders report sleeping problems, and at least one study has found improvements in falling asleep and staying asleep.

Vitamin C—Grade: B

Vitamin C, an antioxidant, is often part of vitamin supplements given to children with autism. One study reported less repetitive behavior in a double-blind, placebo-controlled trial of vitamin C in 18 children with autism.

Amino Acids—Grade: C; L-Carnosine—Grade: B

Neurotransmitter abnormalities have long been a focus of autism research. Some amino acids act as neurotransmitters or prompt their production, so amino acids like tryptophan have been tried as alternative treatments. No trials have studied the benefits of supplementation with tryptophan, taurine, lysine or GABA. L-carnosine, a molecule made of two amino acids that has antioxidant properties, is marketed as an anti-aging remedy. One double-blind, placebo-controlled trial of L-carnosine in 31 children with autism found improved expressive and receptive vocabulary.

Allergies News and Treatment

Parasitic Worms: A Retro Cure for Autoimmune Diseases?

By Jessica Ryen Doyle Published October 06, 2010 | FoxNews.com

Tired of suffering from Crohn’s disease, Michael, a 31-year-old financial planner from New York City, turned to a last resort – an underground network of “worm pushers” in cyberspace.

Michael, who asked that his last name not be revealed, chose to undergo helminthic therapy – infecting himself with Necator Americanus, or microscopic hookworm larvae, in order to put his autoimmune disease into remission. Helminthic therapy, also called worm therapy, is not approved by the Food and Drug Administration, but it has seen significant success around the world.

Worms as medicine? Sounds crazy, but it’s consistent with the hygiene hypothesis — the theory that the organisms we consider harmful today were protecting our immune systems before modern medicine.

Prior to the 20th century, autoimmune diseases like Crohn’s, multiple sclerosis and lupus, as well as asthma and allergies, were virtually nonexistent. People didn’t bathe frequently, and they were exposed more often and for longer periods to animal dander and animal feces. Advocates of helminthic therapy suggest that exposure to those organisms immunized people to their bad effects.

Seeking a “cure” for his “incurable” disease, Michael contacted Jasper Lawrence, owner of Autoimmune Therapies and moderator of a Yahoo group of helminthic therapy, to arrange a meeting outside of the U.S.

Lawrence, who used to suffer from severe allergies and asthma – and was dependent on the anti-inflammatory drug prednisone to survive – self-infected himself with hookworms after traveling to Cameroon in 2006.

“At the time, I didn’t know whether I’d been successful or not,” Lawrence, an American citizen, who runs his business out of Central America to avoid interference with the FDA, told FoxNews.com. “But after an examination, I was in fact infected, and after 16 weeks, I no longer had allergies or asthma.”

Michael, who spent most of his 20s in and out of the hospital, undergoing several surgeries and taking a host of different medications, had followed Lawrence’s Yahoo group for three years and spoken to many of its followers. Symptoms of Crohn’s, an inflammatory bowel disease, include, but are not limited to, abdominal pain, diarrhea, weight loss, arthritis and fatigue. When he simply couldn’t take it any longer, Michael decided to take the plunge.

After purchasing the worms from Lawrence for $3,000, Michael infected himself by applying a bandage packed with worms to his arm. The worms seeped into his skin within several hours; the only side effect he felt was some minor itching, which was relieved by using Benadryl.

“I started feeling better after three months,” Michael said. “I stopped taking my medicine, and I usually get sick two weeks after a skipped dose. I also didn’t have food allergies anymore.”

Scientific Evidence
Miracle? Coincidence? Luck? Maybe, but a group of doctors, including Dr. Joel Weinstock, professor and director of gastroenterology at Tufts Medical Center in Boston, lend credence to the hygiene hypothesis.

Weinstock, who has been studying this concept since the early 1990s, has found that parasitic worms have a calming effect on their hosts’ immune systems. He took what he had learned and applied it to the hygiene hypothesis and, several years later, he and his colleagues started testing helminthes in mice with asthma, Type 1 diabetes, MS and inflammatory bowel disease. Sure enough, the diseased mice got better.
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Weinstock started a round of human trials, which Michael was a part of, but this was a different kind of worm – Trichuris suis, or pig parasite, which can stay alive in a human’s body for only two weeks. This time, in order to consume the worm, Michael drank a glass of water teeming with the invisible, tasteless creatures.

But here’s the catch: Because these worms stay alive for a few weeks – Michael felt better only for a short time, which ultimately led him to contact Lawrence for help.

Weinstock published results from the helminth study in 2005, which said that 23 out of 29 Crohn’s patients went into remission.

Similar studies like Weinstock’s are popping up around the globe, and he suspects a “worm-based” pill may one day — and not too far off — help patients like Michael.

Environment vs. Genetics
If infected with too many hookworms, you can become anemic, or worse – die, which is why Weinstock does not want patients with autoimmune disease running off to Central America to get worms.

“Most people who go for helminthic therapy do it as a last resort, as all conventional treatment failed them,” Michael said. “They usually have an autoimmune illness for many years, did a lot of research in their field, and are experts in their disease and its treatment.”

But Weinstock thinks there are greater lessons to be learned from all of this: One, the environment plays a greater role in autoimmune disease than genetics, and two, Americans may be going overboard when it comes to hygiene.

“I think we need to re-examine the elements of healthy hygiene and whether it improves life and what aspects are necessary,” Weinstock said. “Is it harmful for kids to get soil in their mouth? Maybe not. Are we using too much hand sanitizer? Perhaps we are going against evolution.”

Adding celebrity to the theory is actress Kellie Martin — famous for her roles as Becca Thatcher on “Life Goes On,” and Lucy Knight on “ER” — who is starting to speak up about the hygiene hypothesis as well.

Martin, who lost her sister, Heather, at the age of 19 to lupus, is the spokeswoman for the American Autoimmune Related Diseases Association. She recently heard Weinstock speak at a conference titled “The Global State of Autoimmunity Today” at the United Nations.

“For me, it confirmed my suspicion that I need to give my family, especially my daughter, organic foods, free of toxins, and keep our lives as stress-free as possible,” Martin said.

Martin said she was excited to hear about the research on worms. Though no one advocates living in “filth,” she said allowing one’s body to react to healthy “flora” in and out of the body makes sense to her.

“When we are too clean, we can strip away beneficial bacteria that is essential to the normal functioning of our bodies,” said Martin, who wants to do what she can to protect her 4-year-old daughter Maggie from developing an autoimmune disease – even though she may be genetically predisposed.

“I guess we can chalk it up to: moderation is key. Let your kid get dirty and be a kid, and don’t douse them with hand sanitizers every five minutes.”

ISTA Pharmaceuticals reports preliminary positive results for seasonal allergy nasal spray

ISTA Pharmaceuticals (Nasdaq: ISTA) announced Wednesday its positive preliminary results from a Canadian phase 1/2 clinical study of bepotastine besilate nasal spray, a treatment for symptoms associated with seasonal allergies.

The findings, based on a placebo-controlled study of 82 patients, demonstrated two of the three bepotastine besilate concentrations tested were effective in relieving patients’ nasal symptoms after exposure to seasonal allergens, the company said. The most rapid improvement was seen in sneezing and nasal itching, according to ISTA.

The data also showed the drug to be well-tolerated, with mild adverse events consistent with those observed in other antihistamine nasal sprays.

Based on the positive results, ISTA plans to submit an Investigational New Drug (IND) Application to the U.S. FDA and to initiate phase 2 clinical studies of the nasal spray before the end of the year, using one of the most potent allergens, Mountain Cedar pollen.

The company expects to report preliminary phase 2 data during the first half of 2011.

According to the American Academy of Allergy Asthma & Immunology, approximately 60 million Americans are affected by allergic rhinitis, an inflammation of the nasal passages caused by exposure to certain allergens, such as pollen from trees, grass and plants, animal dander, feathers, dust mites and molds.

It is characterized by a number of symptoms, including sneezing, nasal congestion, nasal itching and runny nose. Based on data from IMS Health in the U.S., approximately 43.3 million prescriptions were filled for nasal allergy treatments in 2009, resulting in sales of approximately $2.2 billion.

Bepotastine besilate has been approved in Japan for systemic use in the treatment of allergic rhinitis since 2000 under the brand name TALION. In 2006, ISTA licensed the exclusive North American ophthalmic rights to bepotastine besilate and in 2007, ISTA licensed exclusive North American rights to nasal dosage forms.

ISTA’s eye drop formulation of bepotastine besilate, BEPREVE 1.5%, was approved by the U.S. FDA in September 2009 for the treatment of ocular itching associated with allergies.

Based in Irvine, California, ISTA is the fourth largest branded prescription eye care business in the United States, with an expanding focus on allergy therapeutics. The company currently markets four products, including treatments for ocular inflammation and pain post-cataract surgery, glaucoma and ocular itching associated with allergic conjunctivitis.

Rich have more allergies

Affluence and city life have been added to the growing array of factors thought to be driving Australia’s rapidly rising rate of food allergy.
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An assessment of sales of allergen-free infant formula as well as EpiPen injectors has shown how demand from parents is concentrated in the nation’s cities, and richest postcodes.

“In city versus country, formula rates were five times higher in city and EpiPens were double the rate,” said Canberra-based allergy specialist Dr Ray Mullins.
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“… Formula rates were over double comparing the highest socio-economic areas versus lowest socio-economic, while (sales of) EpiPens were three times higher.

“It was certainly dramatic.”

The analysis found, for example, sales of allergen-free infant formula in the nation’s richest suburbs approached 48,000 tins per 100,000 in the population during 2008-09.

This was compared to just over 21,300 tins in the poorest suburbs.

Dr Mullins also assessed hospital admissions, and found children who required treatment for anaphylaxis were also more likely to come from affluent areas.

While the data suggests higher rates of allergic kids in cities and affluent areas, with unknown “lifestyle” factors behind this, Dr Mullins also cautioned the research could be skewed by a lack of access to specialist health care in the bush.

“Allergic disease seems to be a disease of the rich and affluent,” Dr Mullins said.

“My concern about the data is that it may also be explained, in part, by barriers to accessing appropriate medical care … almost all allergy and immunology services are in major cities.”

Earlier research by Dr Mullins shows how infant formula and EpiPens were also in more demand in Australia’s southern states, indicating a lack of vitamin D from insufficient sun exposure could also play a role in promoting food allergy.

There were other theories, he said: from rising rates of Caesarean birth to children growing up in increasingly disinfected homes which promoted overly-sensitive immune systems.

While a clear picture of the cause of food allergy was yet to emerge, Australia’s incidence of childhood bad reactions to peanut has roughly doubled over the past decade.

“What it suggests is that there are a number of potential factors influencing the development of allergic disease,” Dr Mullins said.

“There won’t be one factor. It is a whole range of them.”

Dr Mullins’ research is published in the October edition of the journal Clinical & Experimental Allergy.

A University of Melbourne study, also released this week, found children exposed to cooked eggs – scrambled for example – at four to six months of age were up to five times less likely to develop an egg allergy.

This was compared to children who were introduced to cooked eggs after they turned one year old, according to the study of 2,500 children.

Back Pain News

Report highlights chronic back pain link to unemployment

One in five Europeans with chronic back pain are unable to work at all as a result of their chronic pain, according to new research sponsored by Pfizer.

The Pain Proposal, funded by the pharmaceutical company and presented to the European Parliament today, includes a survey of 2,019 people with chronic pain across 15 European counties. It suggests that of those able to work, 61% said their condition had impacted directly on their employment status.

According the report, inefficiencies in the treatment of chronic pain are resulting in “increasing healthcare costs and prolongued patient suffering”.

Musculoskeletal problems are a major cause of claims for group income protection and group private medical insurances. Insurers have developed a number of strategies for tackling this, from open access to physiotherapy to supporting self-management of pain.

Previous studies have shown that chronic pain costs Europe billions of Euros every year, with national costs ranging from €1.1 billion to nearly €50 billion. On average, one in five adults in Europe suffer from moderate to severe chronic pain.

Causes of chronic lower back pain

What is ‘chronic lower back pain’?

Lower back pain is a condition which affects millions of Americans as well as people around the world and is not merely confined to the elderly as we assume most of the time. But, it is true that the condition is seen at a higher frequency among the elderly individuals. The chronic back pain is an entity of the spectrum of lower back pains which would last for more than 3 months and would have an effect on the patients’ day to day activities. Chronic lower back pain can be associated with certain other manifestations including sleep disturbances, depression, tiredness, irritability, morning stiffness as well as with an inability to maintain the same posture for prolonged time duration.

AAOS: Vertebroplasty Not Recommended for Back Pain

New guideline strongly recommends against surgical fix for spinal compression fractures.

Based on a lack of scientific evidence supporting the efficacy of vertebroplasty for the treatment of spinal compression fractures, the American Academy of Orthopaedic Surgeons is strongly recommending against the popular procedure, which involves injecting bone cement into the spinal vertebrae.

“When you look at the science and research to-date, there is very strong Level 1 evidence to suggest that vertebroplasty does not provide the types of benefits it was previously thought to provide,” says Stephen I. Esses, MD, the Houston, Texas-based orthopedic surgeon who led the AAOS workgroup that developed a new clinical practice guideline on the treatment of symptomatic osteoporotic spinal compression fractures. In a press release, AAOS clarified that Level 1 evidence “refers to studies done under the strictest scientific guidelines, including blinding randomization.”

The work group, which began researching this issue in 2008, largely based its recommendation on 2 randomized, controlled clinical trials published in the New England Journal of Medicine last year, which showed no statistical difference in back pain levels among patients who underwent vertebroplasty and the control group. The work group did not find published criticisms of the 2 trials to be scientifically compelling.

“Previous studies have touted the benefits of vertebroplasty, however our scientific research suggests this surgical procedure does not offer any advantages, over the placebo control,” says Dr. Esses. He notes, however, that patients who have already undergone the procedure don’t need to worry: “There are no reported negative side effects.”

Wellness Today

Fair To Promote Mental Wellness

The Mental Health Association of Santa Barbara will host the 17th annual Mental Health Arts Festival this weekend to encourage discourse about mental illness in the community and provide those affected with a platform for expression.

The festival will be held from 11 a.m. to 4 p.m. on Saturday, Oct. 2 at De la Guerra Plaza downtown. The event will feature artwork, crafts, paintings, sculptures, jewelry and music created by local people affected by mental illnesses.
According to Annmarie Cameron, executive director of the Mental Health Association in Santa Barbara County, the festival is intended to eradicate social stigmas surrounding mental illness.

“Stigma is a major barrier to people seeking help with their mental illness when they need it, and that is why education is so important,” Cameron said. “The Mental Health Arts Festival not only helps raise awareness, but it also gives our participants a time to creatively express themselves in unique and beautiful ways and to share that directly with our community.”

The Mental Health Association is a nonprofit, private organization that provides housing and support for persons with severe mental illnesses. The group receives approximately 1,000 calls every year from individuals seeking mental health resources.

The festival attracts hundreds of people each year and advertises the Mental Health Association’s resources, such as the Family Advocate Program, Recovery Learning Center and housing opportunities.

The Recovery Learning Center at the Fellowship Club is the only rehabilitation and social center for people with mental illnesses in Santa Barbara, providing a space for peer-to-peer support, resources and craft spaces. Many of the people that frequent the club will have their art featured at this weekend’s festival.

“We are proud to host an event filled with self-expression and creation that provides people in our community living with mental illness with a feeling of accomplishment and a means for healing,” Cameron said.

N.C. Health Plan Selects ActiveHealth for Wellness Initiative

North Carolina’s State Health Plan for Teachers and State Employees, headquartered in Durham, N.C., has selected New York-based ActiveHealth Management to provide disease management, case management and wellness services for its members beginning January 1.

ActiveHealth’s CareEngine system will power the disease management and wellness programs for the plan’s NC HealthSmart initiative. ActiveHealth will work with provider groups and networks across the state to integrate a patient-centered medical home model of care for members. Providers and groups that engage in the PCMH model will have access to a set of online tools through Active CareTeam — they will be able to access patient information, including data from electronic medical records, lab tests, clinical alerts and pharmacy data, and communicate with other clinicians on a member’s care team.

“Improving the quality of health for our members requires change on an individual level and throughout the health care delivery system,” Jack W. Walker, PhD, executive administrator for the plan, says in a statement. “ActiveHealth will help drive our transformation, supporting and empowering physicians who are offering or are interested in implementing a community-based PCMH model. This includes the delivery of case management and disease management services through the practices.”