Archive for the ‘Drug-Related’ Category

One of the lesser known risk factors of taking the bisphosphonate class of osteoporosis drugs is osteonecrosis of the jaw bone (ONJ). Osteonecrosis is, quite literally, death of the bone cells. Previous studies already suggested that patients taking bisphosphonates, such as Fosomax, were at increased risk of developing ONJ, but this study shows that the side effect may be more common than had previously been suggested, even with short term use of the drugs since the drugs take so long to leave bone tissue (once stopped it takes 10 years for drug levels to halve). Researchers at University of Southern California’s School of Dentistry say of the 208 patients they identified for the study as having used Fosamax, nine of them had ONJ. That is a significant 4% of patients. The researchers are hoping that further studies will confirm their findings so that more physicians and dentists will be encouraged to speak to their patients regarding this potentially severe side effect.

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Had a “senior moment” lately? You know, those sudden, momentary lapses when you just can’t seem to remember the most common things. For most of us, we will experience what physicians term normal cognitive aging. Now, Columbia University researchers say that elevated blood glucose levels that occur naturally when we age may contribute to age-related cognitive decline. “This is news even for people without diabetes since blood glucose levels tend to rise as we grow older. Whether through physical exercise, diet or drugs, our research suggests that improving glucose metabolism could help some of us avert the cognitive slide that occurs in many of us as we age,” reported the lead investigator. Although regularly checking your blood sugar level isn’t recommended for non-diabetics, daily exercise is recommended for everyone (especially diabetics) because it contributes to normalization of blood glucose.

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Michigan State University researchers are suggesting that improper dieting may result in a weakened immune system that can increase your chances of getting hit hard by the flu. When looking at mice receiving adequate nutrition versus a lower calorie diet, those on the diet were not able to produce the amount of immune cells needed to fight an infection, despite consuming adequate quantities of vitamins and minerals. Although this was a mouse study, we probably didn’t need it to tell us why the results make sense on a human scale. Our bodies need energy in order to fight infections, and although vitamins and minerals are necessary, they do not provide the majority of energy we need to fuel our bodies - that role is reserved for carbohydrates, fats and proteins. This is why I always tell my patients to eat well and sleep well during flu season. Therefore, don’t believe the old saying telling you to “starve a fever.” It simply is not true.

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Smoking is a major risk factor for heart disease, including heart attacks. It is, therefore, no surprise that the CDC reported this week that hospitalizations for heart attacks in Pueblo, Colorado have sustained a 3-year decrease after the city implemented a law making public and work places smoke-free. Multiple studies have shown similar rapid and dramatic decreases within one year after the implementation of smoke-free laws. However, this was the first study to show that the benefits continue years after the initial drop.

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Is it new year resolutions time again? Researchers from Norway report that patients who were scheduled for colonoscopies around the December-January holiday season were one and a half times more likely to keep their appointments. Similarly, patients who were given medical appointments in the weeks immediately subsequent to their birthdays had higher attendance rates. The researchers believe that reminders of aging triggered by annual milestones may be the underlying mechanism for the increased compliance. This certainly sounds logical. Screening programs - and physicians at large - should keep this in mind as a cost-effective way of improving patient compliance.

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The American Chemical Society reports new evidence that humans can make their own salicylic acid (SA), the compound largely responsible for aspirin’s effects on pain, fever, and inflammation. SA is a naturally occurring substance that can be obtained directly from eating fruits and vegetables. Researchers have previously shown that vegetarians have much higher levels of SA in their bodies (sometimes as high as in those who take low doses of aspirin). Now, the same research group claims that new evidence suggest that our bodies can actually manufacture SA from compounds we consume in our diet. Could SA be one of the chemicals responsible for the health benefits of a vegetarian diet? Numerous studies have shown that vegetarians seem to have a lower risk of obesity, coronary heart disease (which can cause heart attacks), high blood pressure, and diabetes.

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Beginning January 2009 the US Medicare system will be offering bonuses to physicians who prescribe medications electronically.  Why the push? The most important reason is patient safety - no more indecipherable handwriting means less risk that your pharmacist will dole out the wrong prescription. Also, e-prescribing sends the prescription instantly, directly to the pharmacy, so scripts do not get lost or stolen. When e-prescribing, computers can remind docs about potential interactions amongst drugs, in addition to helping physicians choose the cheapest drugs which, in the end, saves the patient money. Only about 10 percent of US doctors are actively e-prescribing. This is due, in part, to the cost associated with setting up the necessary technology and apprehension about adopting new technology. However, the benefits are clear. Ever since I personally started e-prescribing, there’s just no going back to paper.

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The FDA has announced warnings against two prescription drugs - Visicol and OsmoPrep - used to cleanse the bowels before colonoscopies. The concern is over the potential of these drugs in causing kidney damage due to their high phosphate content. Similar over-the-counter medications, such as Fleet Phopho-soda, should not be used for bowel cleansing either; however, at lower doses, they are still safe to use as laxatives. Commonly used alternatives - GoLytely and Halflytely - exist and are safe to use for colonoscopy preparation. We know that colonoscopies can save lives, so this should not dissuade anyone from getting one, especially when safe bowel prep regimens exist.

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The CDC reported earlier this year that approximately 32% of US children were overweight, 16% were obese, and 11% were extremely obese. With concerns about weight on the minds of most Americans these days, many food companies have voluntarily began campaigns to combat the obesity epidemic by categorizing a certain amount of their products as “healthy alternatives.” But do these wellness initiatives truly have the consumer in mind? In a recent JAMA article pediatrician David Ludwig and Marion Nestle, professor of nutrition at New York University, argues that makers of popular junk foods ultimately have obligations to their stockholders to encourage children to consume more, not less. In an interview with U.S. News they outlined the top 10 things that the food industry doesn’t want you to know, including the following:

- Junk food makers donate large sums of money to professional nutrition associations.

- Less-processed foods are generally more satiating than their highly processed counterparts.

- The food industry funds front groups that fight antiobesity public health initiatives.

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At this week’s American College of Gastroenterology annual scientific meeting, researchers presented data which supports that women require less exposure to tobacco in order to increase their risk of colorectal cancer. Heavy smokers were almost twice as likely to develop significant colorectal cancer than women who were not exposed to tobacco smoke. The researchers also found that smoking can raise the risk of pancreatic pre-cancerous growths, especially in people who have a strong family history of the pancreatic cancer. Read more. Share your opinion.