People with depression may benefit as much from acupuncture as they do from counseling, suggests a new study.

Researchers found one in three patients were no longer depressed after three months of acupuncture or counseling, compared to one in five who received neither treatment.

“For people who have depression, who have tried various medical options, who are still not getting the benefit they want, they should try acupuncture or counseling as options that are now known to be clinically effective,” said Hugh MacPherson, the study’s lead author from the University of York in the UK.

Previous studies looking at whether acupuncture helps ease depression have been inconclusive. Those studies were also small and didn’t compare acupuncture to other treatment options.

“What’s more important for the patient is does it work in practice and that is the question we were asking,” MacPherson said.

For their study, he and his colleagues recruited 755 people with moderate or severe depression. The researchers split participants into three groups: 302 were randomly assigned to receive 12 weekly acupuncture sessions, another 302 received weekly counseling sessions and 151 received usual care only.

About 70 percent of people had taken antidepressants in the three months before the study and about half reported taking pain medications. People did not have to stop taking their medicine to participate in the study.

At the outset, participants had an average depression score of 16 on a scale from 0 to 27, with higher scores symbolizing more severe depression. A 16 is considered moderately severe depression.

After three months, people assigned to the acupuncture group had an average score of about 9 – on the higher end of the mild depression category. Scores fell to 11 among members of the counseling group and about 13 in the usual care group, both considered moderate depression.

Participants who received acupuncture or counseling saw larger improvements over three months than those who had neither treatment. Those benefits remained for an additional three months after the treatments stopped.

However, any differences between acupuncture and counseling could have been due to chance, the researchers reported Tuesday in PLOS Medicine.

They found doctors would need to treat seven people using acupuncture and 10 people with counseling for one person to no longer be depressed.

“What this says is if you don’t get completely better, there are other options,” Dr. Philip Muskin, a psychiatrist at Columbia University Medical Center in New York, told Reuters Health.

“One option would be to take a different medication, but by this study these would be valid options,” said Muskin, who was not involved with the new research.

He cautioned, however, that counseling and acupuncture are not replacements for medication. The majority of study participants were still taking antidepressants at the end of the three months.

Muskin said the study also doesn’t show what types of patients respond best to acupuncture or counseling.

“What I can’t tell from this study is who’s who. Not everybody got better,” he said.

MacPherson said it’s best to ask patients for their treatment preference.

“If you talk to people, they would almost always have a leaning one way or the other,” he said.

Acupuncture is only covered by health insurance in the UK for chronic pain, MacPherson said. In the U.S., some plans also cover acupuncture for pain or nausea.

According to online information from the Mayo Clinic, the risks of acupuncture are low if people hire competent and certified practitioners. Complications can include soreness, organ injury and infections.

“Cleary acupuncture is a new option,” MacPherson said. “This is the first evidence that acupuncture really helps.”

 Source: medindia

 

Glued to your desk at work? Cross that off the list of excuses for not having the time to exercise.

A growing number of Americans are standing, walking and even cycling their way through the workday at treadmill desks, stand up desks or other moving workstations. Others are forgoing chairs in favor of giant exercise balls to stay fit.

Walking on a treadmill while making phone calls and sorting through emails means “being productive on two fronts,” said Andrew Locker bie, senior vice president of benefits at Brown & Brown, a global insurance consulting firm.

Lockerbie can burn 350 calories a day walking 3 to 4 miles on one of two treadmill desks that his company’s Indianapolis office purchased earlier this year.

“I’m in meetings and at my desk and on the phone all day,” he said. “It’s great to be able to have an option at my work to get some physical activity while I’m actually doing office stuff. You feel better, you get your blood moving, you think clearly.”

Treadmill desks designed for the workplace are normally set to move at 1 to 2 mph, enough to get the heart rate up but not too fast to distract from reading or talking on the phone comfortably.

It’s been a decade since scientific studies began to show that too much sitting can lead to obesity and increase the risk of developing diabetes, high blood pressure and heart disease. Even going to the gym three times a week doesn’t offset the harm of being sedentary for hours at a time, said Dr. James Levine, an endocrinologist at the Mayo Clinic.

“There’s a glob of information that sitting is killing us,” Levine said. “You’re basically sitting yourself into a coffin.”

More companies are intrigued by the idea of helping employees stay healthy, lose weight and reduce stress – especially if it means lower insurance costs and higher productivity, said Levine, an enthusiastic supporter of the moving workstations.

“Even walking at 1 mile an hour has very substantial benefits,” Levine said, such as doubling metabolic rate and improving blood sugar levels. “Although you don’t sweat, your body moving is sort of purring along.”

Sales at Indianapolis-based TreadDesk are expected to increase 25 percent this year as large corporations, including Microsoft, Coca Cola, United Healthcare and Procter & Gamble have started buying the workstations in bulk, said Jerry Carr, the company’s president.

At LifeSpan Fitness, based in Salt Lake City, sales of treadmill desks more than tripled over 2012, said Peter Schenk, company president.

“We don’t see the growth slowing down for several years as right now we are just moving from early adopters, which are educated and highly health conscious, to more mainstream users,” Schenk said.

With bicycle desks or desk cycles, workers can pedal their way through the day on a small stationary bike mounted under their desk.

Treadmill desks can range from about $800 to $5,000 or more, depending on the manufacturer and model. Desks cycles start as low as $149 for models that can fit under an existing desk but can run $1,400 or more for those with a desk built in. Standup desks can run as low as $250 for platforms that can rest on an existing desk.

Some workers have opted for lower-profile – and lower-cost – ways to stay fit at work, such as sitting on giant exercise balls instead of chairs. Using the inflatable balls can help improve posture and strengthen abs, legs and back muscles.

“I’ve got nurses in my operating room who will use one of those balls instead of a chair,” said Michael Maloney, a professor of orthopedics and sports medicine specialist at the University of Rochester Medical Center.

Maloney said anyone trying an exercise ball, treadmill desk or moving workstation should approach it with common sense. Those who have not been exercising regularly should start using the equipment in small time increments to avoid injury, he said.

“They have to just do it with some common sense and not overdo it,” Maloney said. “Just pay attention to how their body is responding to the new activities.”

Georges Harik, founder of the Web-based instant messaging service imo.im in Palo Alto, Calif., bought two treadmill desks for his 20-person office to share three years ago. Employees tend to sort through email or do other work while using the treadmills.

“I do it when I can,” he said. “Sometimes it’s not possible if you’re really thinking hard or programming a lot. But this sort of low-grade activity that keeps people from being sedentary probably helps extend their lives by a few years, and we’re big fans of that.”

The office has also purchased standing desks for most of its employees. The desks can be raised up or down with the touch of a button, and Harik says at least three or four workers can be seen standing at desks to stretch their legs at any one time.

But not everyone wants one, Harik said. Some workers find it too distracting to incorporate standing or walking into their work, and some feel they are just not coordinated enough to multitask as they exercise.

Levine said he was at first skeptical that a standup desk would offer improvements in health comparable to treadmill desks or other moving workstations.

“It appears I was completely wrong,” he said. “Once you’re off your bottom, it’s inevitable that you start meandering around. Within two minutes of standing, one activates a series of metabolic processes that are beneficial. Once you sit, all of those things get switched off.”

Denise Bober, director of human resources at The Breakers, the resort hotel in Palm Beach, Fla., said having a treadmill desk in her office has made a big difference in how she feels after work.

“The more movement and interaction I have, the more energy I have at the end of the day,” she said.

Bober spends one to three hours walking when she’s in the office, usually at 2 mph.

“If I go faster, then I make too many typing errors, but if I’m just reading a report I can go faster,” she said.

Source: Fox News

The children of mothers with post traumatic stress disorder (PTSD) may be at high risk of being traumatized themselves, according to a small new study in urban U.S. neighborhoods.

Inner-city kids whose mothers had PTSD experienced more traumatic events – such as neighborhood shootings, domestic violence, dog bites or car accidents – before age five than kids whose mothers were depressed or had no mental health issues, researchers found.

Mothers with a combination of PTSD and depression were also more likely to report psychologically or physically abusing their child, compared to mothers with just one of those disorders.

“The main take-home message is that when parents are suffering, their children suffer, too,” said Dr. Howard Dubowitz, professor of pediatrics at University of Maryland School of Medicine in Baltimore.

“Those of us who are involved in helping to take care of kids can’t ignore what problems mothers and fathers may be struggling with,” added Dubowitz, who was not involved in the study.

Children exposed to trauma are themselves at greater risk of a mix of health challenges later on in life, such as obesity, drug and alcohol addictions, heart disease, suicide and mental health disorders, experts said.

“Everyone’s been putting the focus on depression, even though PTSD and depression run together,” said the study’s lead author Claude Chemtob, director of NYU Langone Medical Center’s family trauma research program.

He and his colleagues recruited 97 mothers with children between the ages three and five years old from Mount Sinai School of Medicine’s pediatric primary care clinics in New York City to participate in the study.

Most mothers were from ethnic minority groups and had high school diplomas. The women all completed questionnaires designed to detect depression or PTSD symptoms. They also answered questions about violent events their children had witnessed.

The majority of mothers were not clinically depressed or suffering from PTSD, Chemtob’s group reports in JAMA Pediatrics. Of the 97 mothers, 11 had diagnosable depression, six had PTSD and 10 had a combination of both.

Chemtob pointed out that the study population had slightly elevated levels of depression and PTSD diagnoses compared to national averages.

The researchers also found that mothers with PTSD and depression reported far greater parenting stress. “In short, their experience of parenting is that it is more difficult and less rewarding,” Chemtob said.

Last year the American Academy of Pediatrics urged pediatricians to take steps to reduce childhood “toxic stress” that can occur when parents or caregivers suffer from poor mental health.

In the current study, the children of mothers with PTSD witnessed an average of five traumatic events.

Their peers whose mothers were only depressed or had no mood disorder experienced an average of only one traumatic event. A third group of kids with mothers suffering both PTSD and depression experienced nearly four events.

Previous research suggests that nearly half of women with PTSD may also suffer from depression.

“We know that the effects of maternal mental health difficulties can be especially problematic in early life, from pregnancy to age 5,” Michelle Bosquet of Boston Children’s Hospital in Massachusetts told Reuters Health in an email.

Bosquet, who was not involved in the new study, added that much previous research has focused only on depression and less is known about how PTSD may influence parenting.

Researchers noted that the study is limited by its small size.

“These results have been found among certain families,” Dubowitz said. Future studies could look for the same results in different populations, such as whites, he said.

The authors encourage screening mothers for PTSD alongside depression in pediatric primary care settings. “This might be an effective way to intervene on child maltreatment,” Chemtob told Reuters Health.

In his research on child abuse, Dubowitz has created a questionnaire for parents to complete before arriving for a pediatric appointment. It contains two questions to detect depressive symptoms.

“It may be most efficient to use just two questions to identify possible depression, and, in so doing, identify parents with that condition and … help them get evaluated,” Dubowitz said.

“Aside from time, and time is very important, there is the whole challenge of changing health professionals’ practice and behavior,” he said.

Source: Fox news         

The U.S. Food and Drug Administration has proposed stronger safety language on labels of long-acting and extended-release opioids in response to an epidemic of overdoses and deaths from the widely used pain medicines.

The labels need to highlight dangers of abuse and possible death, as well as risks to newborns of mothers taking the medicines, the agency said on Tuesday.

Opioids include formulations of morphine, oxycodone and fentanyl. One of the best-known opioids is Oxycontin, a long-acting form of oxycodone.

Some 16,651 people in 2010 died from overdose deaths related to opioid abuse, the FDA said, including long-acting formulations.

In a conference call, FDA officials said long-acting forms of opioids have played a “disproportionate role” in drug abuse and deaths.

The FDA said the drug labels currently are indicated for patients with moderate to severe pain, but in the future will indicate they should only be used for severe pain.

“The FDA is invoking its authority to require safety labeling changes and postmarket studies to combat the misuse, abuse, addiction, overdose and death from these potent drugs that have harmed too many patients and devastated too many families and communities,” FDA Commissioner Margaret Hamburg said in a release.

Updated language in the drug labels will stress the medicines are meant for pain severe enough to require daily, round the clock, long-term opioid treatment, and only for those who have not had adequate pain relief from alternative medicines.

The labels will also include prominent boxed warnings that chronic maternal use of the drugs can result in potentially fatal opioid withdrawal syndrome in newborns.

The agency will require extra studies of the drugs to assess known risks of abuse, overdose and death.

Janina Kean, chief executive of High Watch Recovery Center, an addiction treatment facility in Kent, Connecticut, said stronger safety language by itself won’t make a noticeable dent in the numbers of addictions and overdoses of opioids.

She said the drugs are being prescribed for countless uses, many of which are far from severe, with no apparent oversight.

“Doctors are prescribing them for dental work, for chronic back pain and every ache and pain you can imagine,” Kean said. “The FDA would be better served by trying to regulate when doctors prescribe those drugs.”

Kean said about 20 to 25 percent of her substance-abuse clients are addicted to opioids, up from just 1 to 4 percent a decade ago.

“It’s getting worse,” she said, noting that many clients are teenagers or young adults who became addicted by going into their parents’ medicine cabinets and taking their legally prescribed opioids.

“But now, when they go to the street they can’t afford the opioids. So they go to heroin, which is also an opioid, because it’s cheaper.”

Morgan Liscinsky, an FDA spokesman, said the agency’s hands are largely tied. While the FDA has authority to regulate drugmakers and drug labeling, he said it cannot intervene with doctors.

“The FDA does not have the authority to regulate the practice of medicine, and health care practitioners may choose to prescribe a legally marketed drug, based on their clinical assessment,” Liscinsky said.