• Doctors Repeatedly Overprescribe Antibiotics And Narcotics

    From =?UTF-8?B?4oqZ77y/4oqZ?=@21:1/5 to All on Thu Feb 9 21:45:28 2017
    Doctors Repeatedly Overprescribe Antibiotics And Narcotics
    “We need to start concentrating on high-value care.”


    Dec 06, 2016
    Lisa Rapaport

    SELECTSTOCK VIA GETTY IMAGES
    Twenty-seven percent of doctors identified overprescribing antibiotics, and 7.3 percent of doctors identified overprescribing opioids and narcotics as common problems in a new survey.
    Antibiotics and narcotics are often prescribed when they aren’t the best option for patients and may do more harm than good, a survey of U.S. physicians suggests.

    The survey asked doctors to identify treatments that they see routinely used despite guidelines recommending against the interventions and little or no value for patients.

    Overuse of antibiotics topped the list, with 27 percent of doctors identifying this as a common problem. Prescribing narcotics and opioids for chronic pain was another treatment of limited value, according to 7.3 percent of physicians surveyed.

    “We need to start concentrating on high-value care,” said lead study author Dr. Amir Qaseem, vice president of clinical policy and chair of the high value care task force for the American College of Physicians.

    This isn’t just about money.

    “The value of any intervention is when you look at the benefits and harms and cost together,” Qaseem said in a telephone interview.

    “For example, HIV treatment is very expensive but that doesn’t mean it’s low value because it’s very effective,” Qaseem added. “Antibiotics can be very cheap but they can be low value because they often aren’t necessary.”

    His team’s findings, from an online survey completed by 1,582 doctors, were published online December 5th in Annals of Internal Medicine.

    Participants were asked to identify the two treatments they most often observed being used for patients that were unlikely to offer high value.

    Overuse of aggressive care in patients with limited life expectancy was identified as a problem by 8.6 percent of participants, making it second only to overuse of antibiotics.

    This mostly included life-support measures near the end of life such as feeding tubes, intubation and resuscitation; treatments to prevent long-term complications in patients with little time left to live, such as dialysis or invasive heart procedures;
    and chemotherapy for patients with advanced or metastatic cancer.

    About 5 percent of doctors also identified overuse of dietary supplements including vitamin D, niacin, fish oil, calcium, multivitamins and folic acid.

    Roughly 5 percent of doctors also cited overuse of statins and other cholesterol-lowering medications in the elderly or to prevent health problems.

    Other low-value interventions cited in the survey include invasive cardiac procedures, diabetes treatments other than the drug metformin, and overuse of bisphosphonates to treat osteoporosis, and over-managed or inappropriately controlled blood pressure.

    One limitation of the study is its cross-sectional design and self-reported survey data, which makes it impossible to assess how closely the results mirror actual overuse of low value interventions in the real world, the authors note.

    Even so, the results suggest that general internists are aware of clinical guidelines and on board with the concept of avoiding low-value care, said Dr. David Levine, a researcher at Brigham and Women’s Hospital and Harvard Medical School in Boston who
    wasn’t involved in the study.

    “Clinicians who stray from guidelines may, or may not, have good reasons for doing so,” Levine said by email. “The guidelines may not be applicable to the patient in front of them, or they may not realize the newest recommendations now counsel
    against a treatment or procedure they learned in medical school.”

    Patients shouldn’t be shy about questioning doctors, said Dr. Sharon Levine, executive vice president of The Permanente Federation at Kaiser Permanente in California.

    “Every one of us should feel comfortable asking any one of a series of questions when a physician proposes a therapy,” said Levine, who wasn’t involved in the study. She listed them: “Why are you recommending this treatment? What are the
    potential risks associated with it, and what is the likely benefit? Are there other approaches you considered, including no treatment? And what would be the risks and benefits compared to what you are recommending? What should I look for in terms of side
    effects or adverse reactions?”

    “These types of questions promote a healthy dialogue about the probability that a recommended therapy will result in an outcome that is high value for the patient,” Levine added by email.

    Also on HuffPost

    5 Ways Doctors Avoid Getting Colds

    More: opioid epidemic antibiotics

    http://m.huffpost.com/us/entry/us_5846f467e4b0fe5ab69322e0

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  • From Jake@21:1/5 to All on Sun Jun 14 20:34:44 2020
    Diet for prostatitis

    Diet should be one of the cornerstones of treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Examining your diet is part of a whole-body approach to your health, especially since many causes of CP/CPPS and pelvic tension stem from
    problems that take place outside of the prostate. Certain foods and allergies to foods can create reactions in your body in the form of inflammation, and this can contribute to pelvic tension and pain. That is why looking at diet when diagnosing and
    treating CP/CPPS can help to eliminate inflammation.

    Diet for prostatitis is part of the NPAT treatment program for CP/CPPS. NPAT stands for:

    Natural treatments (ALCAT, elimination diets, and wheat-free diets) Phytotherapy (pollen and quercetin together with probiotics)
    Alternative Treatments (acupuncture, prostate massage, pelvic rehabilitation and therapy)
    Total body (exercise, chronic stress management, lifestyle)
    It is important for you to figure out and avoid foods that can exacerbate your symptoms. Common foods that have been found to exacerbate prostatitis symptoms include the following:

    Spicy foods
    Hot peppers
    Alcoholic beverages
    Acidic foods
    Wheat
    Gluten
    Caffeine
    Hot peppers derive their spiciness from capsaicin, which can increase rectal sensitivity in people with irritable bowel syndrome, a condition frequently found in men with CP/CPPS. Read more on Foods to Avoid.

    Bowel health and prostatitis seem to be connected. That is why eating foods containing probiotics or taking quality probiotic supplements is part of a healthy diet for prostatitis. Probiotics are the beneficial, or helpful, gut microflora and include
    bacteria that normally reside in balance with other bacteria in the intestinal tract.

    Other dietary causes of prostatitis could be related to a zinc deficiency or environmental pollutants like BPA (bisphenol-A), an ingredient in many plastic products and food containers such as canned foods, that seeps into the food supply.

    Food intolerance or food allergies can also contribute to prostatitis. The symptoms of a food intolerance or allergy may include vomiting, diarrhea, nausea, or abdominal pain. If you have a food intolerance you may also experience gas, bloating, headache,
    cramps, irritability, and nervousness. A food allergy is an immune system response, and the symptoms generally can affect the entire body. In addition to the symptoms already named, a food allergy can cause hives, itchy skin, shortness of breath, a
    sudden drop in blood pressure, and difficulty swallowing. Food intolerance symptoms can be uncomfortable, but food allergy symptoms can be life threatening.

    It can be challenging to identify an allergy or food intolerance. You may not react to a particular food for a few hours or even days. Your reaction may be a worsening of prostatitis symptoms instead of the common symptoms you would associate with an
    intolerance or allergy.

    If you think that a food allergy or intolerance could be contributing to your prostatitis symptoms, try an elimination diet or consider undergoing allergy testing. Some tests like the ALCAT test do throw out false positives and can be costly, so trying
    an elimination diet might be a good start.

    Many men find that going on a wheat-free diet or trying a gluten-free diet can help them manage their prostatitis symptoms. Wheat and a protein in wheat called gluten can cause inflammation, which can damage the body and cause illness. A gluten-free diet
    avoids barley, malt, triticale, and wheat.

    In general, it is important to eat a healthy diet as part of managing your prostatitis. Avoid foods that commonly are associated with triggering prostatitis and try to include plenty of whole and natural foods such as the following:

    Vegetables, especially cruciferous vegetables
    Fruits (but avoid acidic fruits if they affect your prostatitis)
    High-quality protein (plant protein is better than animal)
    Foods high in zinc or zinc supplements
    Omega-3 fatty acids and healthy fats found in the Mediterranean diet
    Foods high in fiber
    Following the Mediterranean diet can help you reduce inflammation in your body. Reduce the red meat you eat and instead opt for fish, beans, lentils, and nuts, which are all low in saturated fat and cholesterol. Eat foods high in zinc, omega-3 fatty
    acids, and lycopene, but if acidic tomatoes or fruits are a problem for your prostate try eliminating them. It is important to stay well hydrated with water, but you should avoid drinks like soda and caffeinated coffee or tea, which have been shown to
    exacerbate prostatitis symptoms. You should also limit or avoid alcohol, which can make symptoms worse.

    Studies have shown that certain foods may help improve prostatitis symptoms. Foods and supplements that may help with prostate and urinary health include the following:

    Calcium glycerophosphate (neutralizes acidic foods)
    Docusate (softens stools)
    Psyllium (fiber), polycarbophil (laxative)
    Water
    Baking soda
    As you can see, some of the things that have helped prostatitis patients in studies also affect bowel health, which is why daily use of probiotics is also key when considering diet for prostatitis. By getting your diet under control and eliminating foods
    that could be causing your prostatitis symptoms, you are going to feel a lot better as a whole.

    Editor’s comment:
    Generally following a diet like the Mediterranean diet will help reduce inflammation and promote healthy bacteria and immunity. The Mediterranean diet also has many other benefits for heart, prostate, and general health. Try and limit alcohol to 1-2
    glasses a day. Any more than that has been shown to negatively affect prostate health. Eat organic as much as possible within your budget. Make it a point of getting regular exercise to keep your weight under control as that will also help reduce
    inflammation.




    Living with Prostatitis
    Learning to Live with Prostatitis
    Dealing with the Pain of Prostatitis
    Can I Have Sex With Prostatitis?
    Overcoming Depression with Prostatitis
    Diet for Prostatitis
    Products and Devices to Help With Prostatitis
    Wheat-Free Diet for Prostatitis
    Foods to Avoid for Prostatitis
    Chemicals That Can Cause Prostatitis

    Prostatitis and Pelvic Pain News

    How Does Prostatitis Affect a Man’s Sexual Function?


    What Professions Have the Highest Risk of Prostatitis?


    What’s the Risk of Abscess in Prostatitis Patients?


    Aggressive Prostate Cancer Rates Up Nearly 100%


    Can A Pelvic Wand Treat Prostatitis?


    http://prostatitis.net/living-with-prostatitis/diet-for-prostatitis/



    On Thursday, February 9, 2017 at 11:45:29 PM UTC-6, ⊙_⊙ wrote:
    Doctors Repeatedly Overprescribe Antibiotics And Narcotics
    “We need to start concentrating on high-value care.”


    Dec 06, 2016
    Lisa Rapaport

    SELECTSTOCK VIA GETTY IMAGES
    Twenty-seven percent of doctors identified overprescribing antibiotics, and 7.3 percent of doctors identified overprescribing opioids and narcotics as common problems in a new survey.
    Antibiotics and narcotics are often prescribed when they aren’t the best option for patients and may do more harm than good, a survey of U.S. physicians suggests.

    The survey asked doctors to identify treatments that they see routinely used despite guidelines recommending against the interventions and little or no value for patients.

    Overuse of antibiotics topped the list, with 27 percent of doctors identifying this as a common problem. Prescribing narcotics and opioids for chronic pain was another treatment of limited value, according to 7.3 percent of physicians surveyed.

    “We need to start concentrating on high-value care,” said lead study author Dr. Amir Qaseem, vice president of clinical policy and chair of the high value care task force for the American College of Physicians.

    This isn’t just about money.

    “The value of any intervention is when you look at the benefits and harms and cost together,” Qaseem said in a telephone interview.

    “For example, HIV treatment is very expensive but that doesn’t mean it’s low value because it’s very effective,” Qaseem added. “Antibiotics can be very cheap but they can be low value because they often aren’t necessary.”

    His team’s findings, from an online survey completed by 1,582 doctors, were published online December 5th in Annals of Internal Medicine.

    Participants were asked to identify the two treatments they most often observed being used for patients that were unlikely to offer high value.

    Overuse of aggressive care in patients with limited life expectancy was identified as a problem by 8.6 percent of participants, making it second only to overuse of antibiotics.

    This mostly included life-support measures near the end of life such as feeding tubes, intubation and resuscitation; treatments to prevent long-term complications in patients with little time left to live, such as dialysis or invasive heart procedures;
    and chemotherapy for patients with advanced or metastatic cancer.

    About 5 percent of doctors also identified overuse of dietary supplements including vitamin D, niacin, fish oil, calcium, multivitamins and folic acid.

    Roughly 5 percent of doctors also cited overuse of statins and other cholesterol-lowering medications in the elderly or to prevent health problems.

    Other low-value interventions cited in the survey include invasive cardiac procedures, diabetes treatments other than the drug metformin, and overuse of bisphosphonates to treat osteoporosis, and over-managed or inappropriately controlled blood
    pressure.

    One limitation of the study is its cross-sectional design and self-reported survey data, which makes it impossible to assess how closely the results mirror actual overuse of low value interventions in the real world, the authors note.

    Even so, the results suggest that general internists are aware of clinical guidelines and on board with the concept of avoiding low-value care, said Dr. David Levine, a researcher at Brigham and Women’s Hospital and Harvard Medical School in Boston
    who wasn’t involved in the study.

    “Clinicians who stray from guidelines may, or may not, have good reasons for doing so,” Levine said by email. “The guidelines may not be applicable to the patient in front of them, or they may not realize the newest recommendations now counsel
    against a treatment or procedure they learned in medical school.”

    Patients shouldn’t be shy about questioning doctors, said Dr. Sharon Levine, executive vice president of The Permanente Federation at Kaiser Permanente in California.

    “Every one of us should feel comfortable asking any one of a series of questions when a physician proposes a therapy,” said Levine, who wasn’t involved in the study. She listed them: “Why are you recommending this treatment? What are the
    potential risks associated with it, and what is the likely benefit? Are there other approaches you considered, including no treatment? And what would be the risks and benefits compared to what you are recommending? What should I look for in terms of side
    effects or adverse reactions?”

    “These types of questions promote a healthy dialogue about the probability that a recommended therapy will result in an outcome that is high value for the patient,” Levine added by email.

    Also on HuffPost

    5 Ways Doctors Avoid Getting Colds

    More: opioid epidemic antibiotics

    http://m.huffpost.com/us/entry/us_5846f467e4b0fe5ab69322e0

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