Calling Out for Your New Year's Resolution

It's Friday. We [US] are approximately three days away from the New Year and I am frantically working to finish this last quarter (this last year) on a positive note at HealthLine. These next few days will not only be a time for finishing up those last minute TPS reports but they will also be a time (for many of us) of self reflection and building our clichéd New Year's Resolution list. I have already hit the ground running with my list and have no problem admitting that it's shaping up to be the best New Year's Resolution List of 2007. I mean, any resolution list that starts with drinking more wine and ends with getting a motorcycle license is going to be tough to beat.

Having said all that, I would like to invite all of our HealthLine bloggers as well as the general public to post their New Year's Resolutions as comments to this post. I'll call it an unofficial contest to see who has the best list… that way it will be a little more interesting. The winner will receive a Nerf football autographed by me (Kris Keimig) or a $25 gift card for iTunes (I haven’t really worked the prize out yet). If you want to participate for the prize, you’ll have to register for HealthLine as we will need a way to contact the winner… but anyone can post! Either way, it should be fun seeing how everyone plans to improve upon themselves in the New Year. Good Luck!

My New Year's Resolution

1. Drink more red wine… in moderation, of course. I would like to start introducing the occasional glass of wine into a few of my weekly dinners. After all, I heard it was good for you.
   
2. Quit smoking altogether. About two years ago I smoked over a pack of cigarettes a day and, per my soon-to-be-wife’s request, I quit. But the ugly habit has still hung on and I, occasionally, smoke socially. This year, taking the advice of our smoking cessation doctor, I will cut that habit out completely.
   
3. Get in touch with nature. I have been telling myself for years that I will get back to roots of hiking and hitting the outdoors but I put it off because I felt that I would have to have a complete life change to do so… not this year! With the help of our Outdoor Medicine blog and some good old fashion desire for the outdoors, I am going to hit the slopes during ski season and get some trekking boots for spring hiking.
4. Kick saturated and trans fats out! I have been reading a lot about the negative impact such fats have on your body and after reading Cynthia Sass’s Realistic Resolutions (goal #5 is all about saturated and trans fat), I knew it was time to put that on my list.
5. Get my motorcycle license. I have wanted to get my motorcycle license since before I even had my automobile license. When I was younger it was an impossibility (plus I lived in Boston) but now I don’t own a car and I live in San Francisco (weather is very conducive to owning a motorcycle). This year I am taking the test and getting a hog.

Hope you enjoyed my list and I am looking forward to seeing everyone else New Year’s Resolutions!

Happy New Year!

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Heartburn Drugs Linked to Hip Fractures

Use of powerful antacids called proton pump inhibitors puts people over 50 at increased risk of hip fracture, according to a recent study in the Journal of the American Medical Association. Researchers found that taking these drugs for over a year increased risk of hip fracture by 44%. Risk of fracture increased with higher doses, and longer periods of time taking the drugs.

Proton pump inhibitors are commonly used to treat gastroesophageal reflux disease (GERD) and include drugs such as Aciphex, Nexium, Prevacid, Prilosec and Protonix.

Doctor Yu-Xiao Yang of the University of Pennsylvania, one of the offers of the study, thinks they may be too commonly prescribed:

"The general perception is they are relatively harmless. Doctors dispense them without thinking too much about the risks and the benefits. They often are used without a clear or justified indication for the treatment."

The researchers speculate that when taken consistently for over a year, these drugs can make it more difficult for the body to absorb calcium, leading to weaker bones.

An estimated 300,000 Americans over age 65 suffer from hip fractures, one quarter of which will not survive more than a year due to the injury or complications arising from it. Of those that do survive, most experience major reduction in their ability to engage in activities of daily living (ADL), such as walking and dressing, and 15% to 25% will end up in a long-term care facilities at the end of one year.

Major drug companies are already issuing responses to this study. Dr. Doug Levine of AstraZeneca PLC, which makes Nexium and Prilosec, said the study does not prove that proton pump inhibitors cause hip fractures - it merely suggests a potential association. He continued by suggesting that doctors should monitor their patients closely for correct dosage, as well as how long they're on the drugs.

With the global market for these drugs measured in many billions of dollars per year, the infighting between researchers and drug companies is likely to continue. Nexium is the third biggest-selling drug in the world, with global sales in excess of $5.7 billion last year.

Many in the medical community are advocating a more research. "This is a new observation," said Dr. Lawrence Brandt, chief of the Division of Gastroenterology at Montefiore Medical Center, in New York City. "It's exciting on the one hand, and alarming on the other hand. People should be aware that there are some data that show that there may be a higher risk of fracture."

Brandt is not concerned with the safety of over-the-counter versions of these drugs such as Tagamet and Zantac. "Most people who take drugs over-the-counter don't take them in a rigorous fashion," he said. "They take them when they need them, and their dose regimen is not going to be sufficiently compulsive and regimented that this is going to be a problem."

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New Antidepressant Labeling Proposed by FDA

Strong warnings about increased risk of suicide should be extended to include young adults 18 to 24, according to an FDA advisory panel. Currently, warnings only cover teens.

This recommendation came as a result of an FDA review of 372 studies conducted about 11 drugs including Prozac, Zoloft, Lexapro, and Paxil.

Analysis of the combined studies showed a small but significant elevation in risk to young adults - 2 percent reported thoughts of suicide or suicide attempts when on a placebo, compared to 4 percent on antidepressants.

This doubling in risk is "about as unequivocal a result as you can get,” said Dr. Marc Stone, a senior F.D.A. reviewer and an author of the report. "We can't ignore it."

Antidepressents have carried a "black box warning" about the increased risk of suicide for teens since 2004. This warning, located in a black-bordered box above the prescribing information, is the strongest that the FDA can require. Some doctors are worried that including adolescents in this warning will induce a "black-box panic" that could discourage people who need these medications from taking them.

“We’re talking about a devastating, chronic and recurrent disorder, and a black-box warning may serve as another barrier to care that people need,” said Dr. Carol Rabinowitz, president-elect of the American Psychiatric Association. "There is a danger when we paint a medicine as so scary or so potentially dangerous that people avoid it."

Dr. Rabinowitz continued, "Untreated depression causes more loss of life than any of the approved treatments. A black box for adults creates a fear mentality, not only in patients but in doctors...It can limit access to needed care."

Despite such concerns, the committee members are taking the results of these studies very seriously. Remarked Daniel Pine, chief of child and adolescent research at the National Institute of Mental Health and the panel's chairman, "The data are really pretty clear to me and to all the committee members. We need to look at the is issue pretty carefully and the public needs to know more."

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