Amersham Osteopathic Clinic

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Look after your liver, don’t take too much paracetamol

The US Food and Drug Administration (FDA) is finally asking Physicians / Doctors and other healthcare professionals to stop prescribing combination prescription pain relievers that contain more than 325 mg of paracetamol (acetaminophen) per table due to the potential risk for liver damage.

Many prescription analgesics have both paracetamol (up to 750 mg of acetaminophen per dose) as well as another ingredient (like codeine)

The FDA stated: “There are no available data to show that taking more than 325 mg of acetaminophen per dosage unit provides additional benefit that outweighs the added risks for liver injury.”

“Further, limiting the amount of acetaminophen per dosage unit will reduce the risk of severe liver injury from inadvertent acetaminophen overdose, which can lead to liver failure, liver transplant, and death,” they added.

Severe liver injury in patients taking paracetamol have occurred when patients  took more than the prescribed dose in a 24-hour period or took more than 1 paracetamol-containing product at the same time; or drank alcohol as well as had medicine that contained paracetamol.

Look after the pain – low level laser therapy and osteopathy can help with that in some cases – as well as looking after your liver!

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Understanding your newborn’s sleep / crying patterns helps

Teaching mums about typical  sleeping and crying patterns in newborns / babies and giving information on how to settle  little ones was seen to improve maternal depression scores in  recent study published online January 6 2014 in Pediatrics. It also helped daytime sleep issues.

Having support in caring for your newborn is so important. Family support helps, as can Health Visitors and GP’s.

Your qualified paediatric osteopath can also give you information on helping little ones settle to sleep, getting help with baby’s crying  and understanding what is ‘normal’.

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Constipation and probiotics

There is now fair evidence to suggest that probiotics reduce certain constipation-related symptoms.

A new study looked at a specific strain of probiotics: Lactobacillus casei as a treatment for functional constipation in otherwise-healthy subject. There was a small but significant improvement in constipation severity at week 4 – this was seen to  grow over time.

For some reason the authors used a milk drink containing a mix of  sugar, skimmed milk powder, glucose, calcium, vitamins, and permitted flavourings. This would not have been especially useful in patients with lactose intolerance – interestingly, they did exclude patients with milk protein allergy.

However, some studies show that multi-strain probiotics have greater efficacy than single strains, including strains that are components of the mixtures themselves – so it might have been better for the authors to do a multi-strain probiotic. It may also have been useful to compare the result with a probiotic capsule that would have not contained the sugar and glucose and skimmed milk powder that the drink contained.

The Study: Journal of Gastroenterology and Hepatology. Effects of a Probiotic Fermented Milk on Functional Constipation: A Randomized, Double-blind, Placebo-Controlled Study.Mena Mustapha Mazlyn, Lee Hun-Leong Nagarajahl Arshad Fatimah, A Karim Norimah, Khean-Lee Goh. J Gastroenterol Hepatol. 2013;28(7):1141-1147. 

other refs: European Journal of Nutrition. Health benefits of probiotics: are mixtures more effective than single strains?
C. M. C. Chapman, G. R. Gibson, I. Rowland February 2011, Volume 50, Issue 1, pp 1-17

 

 

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Overdoses of Prescription Opioid Pain Relievers in the USA

KEY POINTS from a recent paper by the US Centers for Disease Control and Prevention:

Death from opioid pain relievers  (like Tramadol and Vincodin) is an epidemic in the USA.

http://www.cdc.gov November 4, 2011 / 60(43);1487-1492)

Sales of opioid pain relievers quadrupled between 1999 and 2010.

Enough opioid pain relievers were prescribed last year to medicate every American adult with a dose of 5 mg of hydrocodone (Vicodin and others) taken every 4 hours for a month. Abuse of opioid pain relievers costs health insurers approximately $72.5 billion annually

In 2007, nearly 100 persons / day died of drug overdoses in the US. The death rate of 11.8 per 100,000 population in 2007 was roughly three times the rate in 1991. Prescription drugs have accounted for most of the increase in those death rates since 1999.

In 2009, 1.2 million emergency department (ED) visits (an increase of 98.4% since 2004) were related to misuse / abuse of pharmaceuticals. opioid pain relievers now account for more overdose deaths than heroin and cocaine combined.

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Plagiocephaly – get it checked

Research is emerging on the effect of positional / deformational plagiocephaly / flat head syndrome:

 

Article from JAMA Pediatrics. 2011 July; 165(7): 653–658. doi: 10.1001/archpediatrics.2011.92. Development in Toddlers With and Without Deformational Plagiocephaly. Collett, BR, Starr, J et al.

Deformational / positional plagiocephaly is flattening of a baby’s skull, typically considered  to be a cosmetic condition.

Parents are recommended to see their GP, a paediatrician or a qualified health professional early if there are any signs of flat head / plagiocephaly or torticollis / wry neck for this to be checked.

A qualified paediatric osteopath will also check your baby’s neck and spine and may give exercises and home care advice.

Remember, most babies with plagiocephaly are absolutely fine, they just have a slightly wonky head from lying on their back for long stretches.

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As well as being principal at Amersham Osteopathic Clinic, I am also Consultant in Charge at the Osteopathic Centre for Children's London clinic (part of the Foundation for Paediatric Osteopathy) and teach theory and practical techniques on the current Diploma course. I am on the Sutherland Cranial College of Osteopathy Teaching Faculty. I teach … Read more...