Polypharmacy and deprescribing Polypharmacy is an increasing problem in a population, which gets older, is more obese and affected with more diabetes and subsequently cardiovascular problems (see earlier news item). In this short report polypharmacy is the excessive or unnessary use of medications. The polypill is one solution, predescribing is another one. Polypharmacy has several possible consequences: Adverse drug effects such as nausea, confusion, bleeding Drug-drug interactions , when a medication changes the effect of other medications taken together Medication nonadherence Deceased mobility and falls Increased health care use, including visits to a clinic, an emergency department or hospitalization Higher costs both out-of-pocket and for the community How can the risk of polypharmacy be decreased: Bring an up-to-date list of prescriptions and over-the-counter medications or take all medication bottles to each medical appointment and also report if you take dietary supplements, they may interact. Talk with a doctor or pharmacist before starting any over-the-counter medications or dietary supplements to be taken on a regular basis. When a new medication is recommended, ask the doctor or pharmacist how long you should expect to take it. Talk with a doctor or pharmacist if you are taking a medication longer than planned, to […]

Daniel Sereni, France 1. What is the cause of acute Low Back Pain (Backache)? Ninety percent of adults experience at least one episode of backache during their life. In most cases the lumbar pain is acute and resolves in less than one or two days. It may be provoked by an effort or an unusual and brisk movement; but it can also appear suddenly without evident reason. Pain can be intense with a sensation of burning aggravated by bending or walking. Acute Lumbar Pain is not the consequence of any anomaly of the vertebrae or of the vertebral disk. Pain is triggered by a sudden strain in the muscles and ligaments around the intervertebral disk. As the disk is richly innervated this situation results in an acute pain. 2. Is it necessary to visit a doctor? To have x-rays? Low back Pain may be very painful, but it does not mean that it is dangerous. In an adult in general good health the backache will resolve in a few hours or days. There is no need to visit a doctor; x -rays will not show anything relevant and should not be performed.  Yet there are some situations when a call to […]

Jan Willem Elte, The Netherlands For many years we know that patients may continue to have complaints long after an acute infection (mostly viral) has vanished. New research now sheds light on some of the problems associated with the post viral syndrome. Until now no good explanation for these lasting complaints has been found and also no cure. Well-known viral infection diseases such as influenza, Q-fever, Epstein-Barr virus and mononucleosis infectiosa (M.Pfeiffer) have resulted in long-lasting periods of complaints, described as post-viral disease. Nowadays these complaints have been taken together and called myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS). ME/MFS is a complex, chronic condition influenced by multiple factors and it received its name because despite extensive research no definitive cause or tools with which to diagnose it are available. The condition results in debilitating symptoms with extreme fatigue, unfreshing sleep, difficulty in recovering from exertion, cognitive dysfunction and immune system abnormalities. It may last for years with little or no improvement. Moreover, these complaints are quite frequent and are non-specific. Infections may just be one of the causes and indeed after certain infections some persons experience durable symptoms.  Since the start of the Covid-19 pandemic, infection with SARS-CoV-2 […]

Jan Willem Elte, The Netherlands Obesity is one of the most devastating disorders of the present time and its preavalence is rapidly rising. Obesity is a heterogenous condition with multiple different phenotypes. Metabolically unhealthy obesity (MUO) carries a large number of adverse metabolic changes , but metabolically healthy obesity (MHO) is considered to display a relatively favorable metabolic profile. A recent comprehensive review article in the European Journal of Internal Medicine (Tanriover et al Eur J Int Med 111 (2023), 5-20) provides a good overview of the problem and will be summarized in this newsletter. The format of the article will be followed. Although MHO is considered to display a relatively favorable metabolic profile, it is still associated with a number of chronic diseases and has the potential risk of progression into the unhealthy phenotype. Therefore, it should not be considered as an entirely benign or “healthy” condition. Definition A first problem is the definition, as there are more than 30 different definitions of  MHO available. The most commonly used definitions of MHO define it as the absence of any metabolic as well as cardiovascular (cv) disorder in an obese individual (BMI ≥ 30 kg/m²), including hypertension, type 2 diabetes, […]

Jan Willem Elte The Netherlands and Daniel Sereni France Covid 19 new vaccine is indicated for all people at risk of getting severely ill from a covid infection. The vaccines proposed this fall are active against currently circulating variants of covid.  Vaccination is important for you and others. Side effects may occur but are mild in vast majority of people as shown by reports from tens of millions of doses given so far. European national health agencies (European Centre for Disease Prevention and Control = ECDC and Eropean Medicines Agency = EMA) as well as NHS in the UK advice to take both vaccinations for covid-19 and flu well before the winter. The current covid-19 vaccine is the one directed to the new BA.286. There are generally three vaccines available: from Pfizer, Moderna and Novavax. The flu vaccine is one of those developed  this year based on the flu viruses of last year. It appears that both vaccines indeed can be taken at the same time without problems. Coadministration was not associated with substantially inferior immune response or to more frequent adverse events compared with covid-19  vaccine administration alone. It is recommanded to have each vaccine injected in a different […]

Verena Briner, Switzerland Plastics are synthetic products that consist of organic polymers and additives such as bisphenol, ophthalates and flame retardants. Plastic is produced from coal, crude oil and natural gas, and it’s most useful properties are: it is easy to produce, hydrophobic, light, cheap and indestructible. Plastic has been widely used in toys, kitchenware, packaging, construction, electrical industry, machinery and other industries. Due to its properties, the annual production of plastic has increased exponentially worldwide since the 1950s, and reached ca. 400 million tons per year worldwide in 2020. The 7 most used plastics are: polyethylene tetraphthalate (PET), high density polyethylene (PE), polyvinyl chloride (PVC), low density polyethylene (LDPE), polypropylene (PP), polystyrene (PS) and bisphenol (BP). This durability is -on the other hand- the biggest disadvantage of plastic. Littering of single use- plastic products such as PET bottles, coffee cups, plates, bags, etc. results in enormous pollution. Worldwide only 9% of the plastic waste is recycled. Every year more than 2 million tons of plastic reach the sea and the world oceans. Up to 2020 more than 30 million tons of plastic accumulated in the oceans and up to 110 million tons in rivers. The major part of plastic […]