Daily ReCAP March 27, 2017


The latest news on chronic, acute, and preventive care across the health care landscape.

Chronic: Antidepressants Could Help Reduce Neuropathy-Related Pain

Certain antidepressants and anti-seizure drugs can effectively treat diabetic nerve pain, according to a study published inNeurology. The results of the systematic review, which included a total of 106 studies, was that antidepressants duloxetine and venlaxine provided moderate evidence of efficacy in reducing neuropathy-related pain. Furthermore, they found weak evidence that botulinum toxin, the anti-seizure drugs pregabalin and oxcarbazepine, as well as drugs classified as tricyclic antidepressants and atypical opioids, were probably effective in reducing pain. “We hope our findings are helpful to doctors and people with diabetes who are searching for the most effective way to control pain for neuropathy,” said author Julie Waldfogel, PharmD. “Unfortunately, there was not enough evidence available to determine if these treatments had an impact on quality of life. Future studies are needed to assess this.”

Acute: Damaged Livers From Low-Protein Diet Can Regain Normal Functionality

Damaged livers caused by a low-protein diet can regain normal functionality after protein refeeding, according to a study published inNutrition. Included in the study were 2 groups of mice that received either normal levels of protein in the diet or were given low levels of protein for 5 weeks. The investigators used design-based stereology to estimate the volume of the liver and the total number and sizes of cells in 3D. The results of the study showed that the liver of mice given a low protein diet decreased by 65%. There was a 46% reduction in the volume of hepatocytes and a 90% increase in the total number of binucleate hepatocytes, which caused a decrease in functionality of the liver. Furthermore, the low-protein diet led to a 20% reduction in the protein albumin; an important biomarker of nutritional functionality of the organ. After 5 weeks, a normal protein diet was reintroduced to the malnourished group, resulting in an 85% increase in the total number of uninucleate hepatocytes and a 1.5-fold increase in the volume of the liver. The findings indicated the liver’s ability to regenerate itself and reverse the damage caused by the low-protein diet, and the potential for the liver to recover further if given more time, according to the investigators. “It is important not to underestimate the importance in or diet,” said lead author Dr Augusto Coppi. “From building and repairing tissues, to making enzymes and hormones, protein is a vital component of our bodies’ functionality. Too little protein can have a damaging impact on our liver. Our research has shown a worrying atrophy of the liver and of its cells, which can affect the whole body metabolism. However, on the positive side, what we have also found is that this harm is not permanent, and the liver has an amazing capacity to regenerate itself and return to its normal functionality.”

Preventive: Vigorous Exercise Could Improve Cardiometabolic Health in Children

Children who engage in just 10 minutes of high-intensity physical activity can reduce their risk of developing heart problems and metabolic diseases, such as diabetes. In a study published inMedicine & Science in Sports & Exercise, investigators analyzed data from 11,588 individuals aged 4 to 18 years who were included in 11 international Children’s Accelerometry Database studies. The investigators primarily focused on records that included the child’s age, gender, level of physical activity, and at least 1 biomarker of a cardiometabolic risk. The biomarkers included weight circumference; systolic and diastolic blood pressure; and bloodstream levels of HDL cholesterol, LDL cholesterol, triglycerides, glucose, and insulin. The results of the study showed only 32 significant associations out of 360, and all were related to reduced waist circumference and insulin levels. The relationships between high-intensity exercise and other biomarkers were inconsistent, according to the study. “The results suggest that substituting modest amounts of vigorous physical activity for longer-duration light exercise may have cardiometabolic benefits above and beyond those conveyed by moderate activity and the avoidance of sedentary behavior,” said lead author, Justin B. Moore, PhD. “But as vigorous activity was independently associated with only 2 of the markers examined, it may be that its truly meaningful benefits may be limited, relative to less-intense exercise.”

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