- Foundation for the Development of Internal Medicine in Europe
July 9, 2024
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 […]
July 31, 2024
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 […]
September 17, 2024
Jan Willem Elte, The Netherlands Recently published results of a prospective crossover trial show that a low-salt diet for just a week provided a reduction in systolic blood pressure of about 6 mm as compared with those with a normal diet (daily intake approximately 4.5 gr) and 8 mm versus the group with high-sodium diet. The trial involved 213 individuals, aged 50 – 75 years, with or without hypertension. A high-sodium regimen (approximately 2200 mg sodium added to usual diet) was compared with a low-sodium regimen (approximately 500 mg daily in total) both during one week. Average 24-hour ambulatory systolic and diastolic pressure and pulse pressure were measured. Among the 213 participants who completed both high- and low-sodium diet visits, the median age was 61 years, 65% were female and 64% black. The low-sodium diet lowered systolic blood pressure in nearly 75% of individuals compared with the high-sodium diet group. So the effects obtained in one week were impressive and consistent in all subgroups (sex, age, race and BMI), including those with or without hypertension or those with antihypertensive medication. In diabetes patients (21 % of the study population) the reduction in blood pressure was even more impressive, close to […]
November 7, 2024
From: Salud (About Health) PABLO PÉREZ MARTÍNEZ, JOSÉ MANUEL RAMOS RINCÓN, ANA MAESTRE PEIRÓ Osteoporosis is a disease that affects the bones, making them more fragile, so that they break more easily and are less resistant to blows. It is estimated that osteoporosis affects 5.6% of the total European population aged over 50 years (22.1% of women and 6.6% of men). The number of new fragility fractures in Europe was estimated at 4.3 million per year. Osteoporosis does not manifest itself with any symptoms until fractures appear. Most people find out they have osteoporosis after they break a bone. The bones that are most often fractured are the vertebrae, hip, and wrist. Fractures can lead to chronic pain, disability, or even death, occasionally. Osteoporosis is diagnosed by quantifying bone mineral density that can be measured with densitometry, making it possible to predict the risk of fracture in patients without any broken bones. Established osteoporosis is defined as the presence of one or more fragility fractures (spontaneous, without a previous direct blow). Some risk factors for osteoporosis are older age, menopause, a family history of hip fracture, or having had a previous fracture from a minor blow, especially after the age […]
December 19, 2024
Recently the AHA (American Heart Association) reported a study on the Life’s Essential 8 (LE 8) and its association with both life expectancy and health span free of chronic diseases such as cardiovascular disease (cvd), cancer, diabetes and dementia. Ths study was performed in the UK and included more than 135,000 adults with a mean age of 55. The study was published in JAMA Internal Medicine (Wang et al. JAMA Intern Med. 2023;183(4):340-349. doi:10.1001/jamainternmed.2023.0015) and summarized in Medscape. The AHA Essential Life’s Essential 8 score includes: Not smoking; Regular physical activity; Healthy weight; Healthy diet; Healthy sleep (defined as an average of 7-9 hours nightly); Blood pressure in a healthy range; Blood glucose in a healthy range; and LDL (bad) cholesterol in a healthy range. In a large cohort study of 135199 adults from the UK Biobank researchers investigated the association of cardiovascular (cv) health levels (as estimated by the AHA Essential Life’s Essential 8 score) with life expectancy free of major disease. The study population was divided into three groups: those with low, moderate and high LE 8 scores, indicating low, moderate and high cv health. The average life expectancy free of chronic disease was estimated (at age 50) to […]