This was a retrospective longitudinal cohort study of adults aged 60 years and older.
An increase in polypharmacy severity was significantly associated with a higher likelihood of all-cause hospitalization within 1 year, but not a hospitalization related to IBD. Use of a PIM (potentially inappropriate medication) was also associated with a higher probability of all-cause hospitalization compared with patients without. Hospitalization Risk in Older Adults With IBD Associated With Severe Polypharmacyhttps://www.gastroenterologyadvisor.com/news/hospitalization-risk-in-older-adults-with-ibd-associated-with-severe-polypharmacy/
Statins raise the risks for increased glucose levels and the development of type 2 diabetes among people who don’t have it at baseline, but those risks are outweighed by the cardiovascular benefit, new data suggested.
The meta-analysis of trials in the CTT Collaboration included individual participant data from 19 double-blind randomized, controlled trials with a median follow-up of 4.3 years comparing statins with placebo in a total of 123,940 participants, including 18% who had known type 2 diabetes at randomization. Also analyzed were another four double-blind trials of lower- vs higher-intensity statins involving a total of 30,724 participants followed for a median of 4.9 years, with 15% having diabetes at baseline.
In the 19 trials of low- or moderate-intensity statins vs placebo, statins resulted in a significant 10% increase in new-onset diabetes compared with placebo (rate ratio, 1.10), while high-intensity statins raised the risk by an also significant 36% (1.36). This translated to a mean absolute excess of 0.12% per year of treatment.
Compared with less intensive statin therapy, more intensive statin therapy resulted in a significant 10% proportional increase in new-onset diabetes (1.10), giving an absolute annual excess of 0.22%
In an accompanying editorial, Hertzel C. Gerstein, MD, and Marie Pigeyre, MD, PhD, both of McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada, noted that the decreased absolute annual incidence of life-threatening cardiovascular outcomes with statins in people at high risk for type 2 diabetes “clearly exceeds the 0.1%-1.3% per year increased absolute incidence of type 2 diabetes.”
In The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness, social psychologist and author Jonathan Haidt lays out his argument that smartphones and social media are the key driver of the decline in youth mental health seen in many countries since the early 2010s.
The early 2010s were crucial, Haidt argues, because that was when smartphones really began to transform childhood into something unrecognizable. In June 2010, Apple introduced its first front-facing camera, and a few months later Instagram launched on the App Store. For Haidt, this was a fateful combination. Children were suddenly always online, always on display, and connected in ways that were often detrimental to their well-being. The result was a “tidal wave” of anxiety, depression, and self-harm, mostly affecting young girls.In Haidt’s telling, though, smartphones are only part of the problem. He thinks that children in the West are prevented from developing healthily thanks to a culture of “safetyism” that keeps children indoors, shelters them from risks, and replaces rough-and-tumble free play with adult-directed organized sports or—even worse—video games. For evidence of safetyism in action, Haidt contrasts a picture of a 1970s playground merry-go-round, (“the greatest piece of playground equipment ever invented”) with a modern set of play equipment designed with safety in mind and, thus, giving children less opportunity to learn from risky play.
Next steps? Go back online, find a venture capital backed mental health provider, take a quiz, get a diagnosis that confirms your self-diagnosis, have drugs sent to you in the mail.
Nurse practitioners had the largest increases in prescribing incident prescriptions across the 5 drug classes. This is consistent with a study that found that behavioral health visits among Medicare beneficiaries conducted by psychiatric behavioral health nurse practitioners increased by 162%, whereas those by psychiatrists decreased by 6% from 2011 to 2019.35 Our study, based on incident prescription data, suggests an increasing contribution of nurse practitioners initiating medication treatment of behavioral health conditions compared with other health care practitioners.
Chai G, Xu J, Goyal S, et al. Trends in Incident Prescriptions for Behavioral Health Medications in the US, 2018-2022. JAMA Psychiatry. Published online January 10, 2024. doi:10.1001/jamapsychiatry.2023.5045 — https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2813980
Welcome to our new world of self-diagnosed ADHD, online pill mills, and “shortages” of prescription medications.
The past couple of decades have seen a continuous increase in attention deficit hyperactivity disorder (ADHD) diagnoses. National population surveys reflect an increase in the prevalence from 6.1% to 10.2% in the 20-year period from 1997 to 2016 and experts continue to debate and disagree on the causes for this trend.1
I was doing my usual Saturday morning routine, catching up on whatever was catching my attention and I came across this Scary Chart looking for ADHD incidence in Millennials. Whoa…check out the early CAD percentage increase.
Adverse events are common in those using GLP-1 agonists, but the vast majority of these are minor. GI adverse effects are most common (20-70% of patients). Greater rate of GI effects with higher doses.
Most common problems: nausea (overall most common), vomiting, and diarrhea. Others included abdominal pain, dyspepsia, and constipation.
Symptoms are typically more severe within the first four weeks of therapy or with sudden escalation of therapy and tend to decrease over time.
Thought to be due to reduced gastric emptying and activation of centers involved in appetite regulation and nausea.
Severe diarrhea and vomiting may lead to volume loss, dehydration, and hypotension (not common).
There is an association with pancreatitis. GLP-1 agonists may stimulate pancreatic islet beta cells and exocrine duct cells leading to overgrowth and smaller duct size, which increase the pancreatic weight and risk of ductal occlusion.
Retrospective study published in 2022 of 81,752 adverse events associated with GLP-1 agonist therapy found an increased risk of pancreatitis, particularly with liraglutide (ROR 32.67; 95% CI 29.44-36.25). 2023 observational study found increased risk of pancreatitis (adjusted HR of 9.09, 95% CI 1.25-66).
Other GI issues include gallbladder and biliary tract disease (usually after 26 weeks of therapy and included cholelithiasis, cholecystitis, cholangitis), elevated LFTs, hepatitis, liver injury.
The recent analysis in JAMA focused on serious stomach disorders and GLP-1 agonists.
Researchers in Canada compared safety outcomes for GLP-1 agonists and bupropion-naltrexone, an older class of weight-loss medication. The retrospective analysis included 4144 people with obesity who were prescribed liraglutide, 613 prescribed semaglutide, and 654 prescribed the older treatment. People with a diabetes code in their health record were excluded from the study.
The GLP-1 group had a 9 times greater risk of pancreatitis, a 4 times greater risk of bowel obstruction, and a more than 3 times greater risk of gastroparesis, which causes stomach paralysis. The absolute risks in the GLP-1 group, however, were all about 1% or less per year of GLP-1 use. And semaglutide and liraglutide were not associated with biliary disease, which affects the gallbladder and bile production.
In a 2010 review published in Clinical Toxicology, an international team of researchers labeled colchicine a drug with a “dark side” and laid out the three stages of poisoning: The first is a gastrointestinal phase, the first 24 hours after the poisoning, in which damage to gastrointestinal mucosa leads to nausea, vomiting, diarrhea, abdominal discomfort. It might look like severe food poisoning or cholera. Then there’s the second, multi-organ phase, from one to seven days after poisoning, in which the toxic effects spread around the body. There can be a variety of multi-organ dysfunction and metabolic derangements. Death often takes the form of faltering cardiovascular function and cardiac arrhythmia or arrest, but respiratory distress, liver failure, kidney failure, brain swelling, and secondary sepsis can also occur. For the lucky, the third phase is the recovery phase, which can last from seven to 21 days after the poisoning. In this phase, failing organs rebound, but patients might experience alopecia (hair loss) and other complications, including delirium, stupor and coma, convulsions, adrenal hemorrhage, and pancreatitis. In some rare cases, patients’ skin blisters and peels off…
Connor Bowman, 30, was arrested last Friday and charged Monday with second-degree murder in the death of Betty Bowman, 32, who worked as a pharmacist at the Mayo Clinic.
In an investigation that followed her suspicious death on August 20, police learned that the two were having marital problems, including a deteriorating relationship and infidelity, and were talking about a divorce. They also learned that Connor Bowman was in debt and stood to gain $500,000 in life insurance upon his wife’s demise.
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