Wellbutryn and Zyban

SPINE SAFETY CAUTIONARY NOTICE:
Information for Healthcare Professionals: Drug Safety Labeling Changes -Wellbutrin (bupropion hydrochloride) Tablets and Sustained-Release Tablets
According to MedWatch, the Food and Drug Administration (FDA) notified healthcare professionals that BOXED WARNINGS, WARNINGS, PRECAUTIONS and MEDICATION GUIDE text for Wellbutrin (bupropion hydrochloride) tables and sustained-release tablets have been updated to address neuropsychiatric symptoms and suicide risk in smoking cessation treatment.

The revised BOXED WARNING indicates the following:
All patients being treated with bupropion for smoking cessation treatment should be observed for neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood, and suicide-related events, including ideation, behavior, and attempted suicide. These symptoms, as well as worsening of pre-existing psychiatric illness and completed suicide have been reported in some patients attempting to quit smoking while taking Zyban in the postmarketing experience. When symptoms were reported, most were during treatment with Zyban, but some were following discontinuation of treatment with Zyban.
In many postmarketing cases, resolution of symptoms after discontinuation of Zyban was reported, although in some cases the symptoms persisted; therefore, ongoing monitoring and supportive care should be provided until symptoms resolve.

Read the complete summary of MedWatch safety labeling changes at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm176817.htm

New Back Pain Guideline for Physicians!

ScienceDaily (May 18, 2009) — The American Pain Society (APS) has issued a new clinical practice guideline for low back pain that emphasizes the use of noninvasive treatments over interventional procedures, as well as shared decision making between provider and patient. The findings are published in the May 1, 2009 issue of the journal Spine.

Based on the data the panel gathered, the APS now recommends:

1. Against the use of provocative discography (injection of fluid into the disc in order to determine if it is the source of back pain) for patients with chronic nonradicular low-back pain.
2. The consideration of intensive interdisciplinary rehabilitation with a cognitive/behavioral emphasis for patients with nonradicular low-back pain who do not respond to usual, non-interdisciplinary therapies.
3. Against facet joint corticosteroid injection, prolotherapy, and intradiscal corticosteroid injections for patients with persistent nonradicular low-back pain, and insufficient evidence to guide use of other interventional therapies.
4. A discussion of risks and benefits of surgery and the use of shared decision making with reference to rehabilitation as a similarly effective option for patients with nonradicular low-back pain, common degenerative spinal changes, and persistent and disabling symptoms.
5. Insufficient evidence to guide recommendations for vertebral disc replacement.
6. A discussion of the risks and benefits of epidural steroid injections and shared decision making, including specific review of evidence of lack of long-term benefit for patients with persistent radiculopathy due to herniated lumbar disc.
7. A discussion of the risks and benefits of surgery and use of shared decision making that references moderate benefits that decrease over time for patients with persistent and disabling radiculopathy due to herniated lumbar disc or persistent and disabling leg pain.
8. Discussion of risks and benefits of spinal cord stimulation and shared decision making, including reference to the high rate of complications following stimulator placement for patients with persistent and disabling radicular pain following surgery for herniated disc and no evidence of a persistently compressed nerve root.

Energy Drinks May Be Harmful To People With Hypertension, Heart Disease

ScienceDaily (Mar. 26, 2009) — People who have high blood pressure or heart disease should avoid consuming energy drinks, according to a Henry Ford Hospital study to be published online Wednesday in the Annals of Pharmacotherapy.

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Researchers found that healthy adults who drank two cans a day of a popular energy drink experienced an increase in their blood pressure and heart rate. No significant changes in EKG measurements were reported.

The increases in blood pressure and heart rate were insignificant for healthy adults, but could prove harmful to people with a heart-related condition, says James Kalus, Pharm.D., senior manager of Patient Care Services at Henry Ford Hospital and lead author of the study.

"Based on our findings, we recommend that people who have hypertension or heart disease and are taking medication for them to avoid consuming energy drinks because of a potential risk to their health," Dr. Kalus says.

Researchers believe the caffeine and taurine levels in energy drinks could be responsible for increases in blood pressure and heart rate. The brand of energy drink used in the study is not being identified because most energy drinks on the market boast similar levels of caffeine and taurine, a non-essential amino acid derivative often found in meat and fish. The caffeine levels in energy drinks are equivalent to at least one to two cups of coffee.

Dr. Kalus says energy drinks should not be confused with sports drinks, which aim to replenish the carbohydrates and electrolytes that a body needs.

"Both caffeine and taurine have been shown to have a direct impact on cardiac function," Dr. Kalus says.

Researchers studied 15 healthy adult participants who abstained from other forms of caffeine for two days prior to and throughout the study. On the first day after a baseline measurement of blood pressure, heart rate and EKG were taken, the adults consumed two cans of the energy drink.

Researchers then measured the participants' blood pressure, heart rate and EKG again at 30 minutes and one, two, three and four hours after consumption. For the next five days, the participants' consumed two cans of the energy drink.

On the study's seventh day, the protocol used on the first day was repeated and the average baseline measurements were compared to the measurements obtained after energy drink consumption. Researchers found that the participants:

• Heart rate increased 7.8 percent the first day and 11 percent the seventh day.
• Blood pressure increased at least 7 percent the first and seventh days.

Dr. Kalus says the participants did not engage in any physical activity during the study, suggesting that the increases could have been higher.

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Journal reference:

1. Leah Steinke, David E Lanfear, Vishnuprabha Dhanapal, and James S Kalus. Effect of "Energy Drink" Consumption on Hemodynamic and Electrocardiographic Parameters in Healthy Young Adults. Annals of Pharmacotherapy, 2009; DOI: 10.1345/aph.1L614

Adapted from materials provided by Henry Ford Health System.

Protandim® Increases Antioxidant Factor

01/15/2009

SAN DIEGO—Results of a new peer-reviewed study published online in the journal Free Radical Biology and Medicine demonstrated the synergistic impact of the active ingredients used in Protandim® dramatically increased the body's production of glutathione, a key antioxidant and anti-aging factor.

Protandim, a patented product developed by LifeVantage Corp., consists of five ingredients, namely, ashwagandha, bacopa extract, green tea extract, silymarin and curcumin. The new study confirmed Protandim's gene induction approach to antioxidant therapy provides much broader and more powerful benefits to the body than those provided by vitamins such as E and C, according to the Company.

The study, conducted at the University of Colorado, Denver and Ochsner Medical Center, showed even low doses of Protandim induced human cells to increase their production of many antioxidant enzymes, and other anti-aging factors.

Learn more...

Fitness may shield the aging brain

Fitness may shield the aging brain

Last Updated: 2009-01-22 13:48:46 -0400 (Reuters Health)

By Amy Norton

NEW YORK (Reuters Health) - Staying physically fit with age may help protect people from mental decline by maintaining a healthy flow of blood to the brain, new research suggests.

A number of studies have found that regular exercise may help prevent or delay age-related cognitive decline and full-blown dementia, but the reasons are not fully clear.

For the new study, Canadian researchers looked at the relationships between physical fitness, brain blood flow and cognitive-test performance in 42 women between the ages of 50 and 90.

They found that those with the highest fitness levels generally showed better blood flow to the brain during exercise. This, in turn, was related to better scores on tests of memory, reasoning and other cognitive skills.

The findings are published in the journal Neurobiology of Aging.

"Our results suggest that the vascular benefits of exercise that have been reported previously in the heart and muscles are also conferred to the brain," senior researcher Dr. Marc J. Poulin, of the University of Calgary in Alberta, told Reuters Health.

"Basic fitness -- something as simple as getting out for a walk every day -- is critical to staying mentally sharp and remaining healthy as we age," said Poulin, who is also a scientist with the Alberta Heritage Foundation for Medical Research.

The study included 42 healthy postmenopausal women, some of whom regularly got aerobic exercise and some of whom were sedentary. All of the women took fitness tests on an exercise bike and had ultrasound scans to gauge their cerebral blood flow.

In general, fitter women showed better blood flow to the brain and greater responsiveness of the blood vessels to increased circulation.

"Our study identified strong and significant associations between physical fitness and cognition, and between physical fitness and vascular function in the brain," Poulin explained.

This, according to the researcher, suggests that the benefits of exercise on mental function are at least partly explained by its effects on blood vessel function.

The results, Poulin said, "provide a strong scientific basis for future studies to examine how exercise improves cognition in older adults."

"The implications are huge," he added, "given the aging population and age-related diseases like Alzheimer's disease and stroke."

SOURCE: Neurobiology of Aging, January 2009.

Heart Attacks getting less severe in the U.S.

Reuters Health reports this week that heart attacks are getting less severe. While we haven't improved on getting to the hospital any sooner after the onset of symptoms (still about 33% of people make it in under 2 hours) we have less heart muscle damage with a heart attack.

Before we start the party, realize a couple things. First, heart disease is still the #1 cause of death in the U.S. (followed by cancer and stroke, in that order). Second, we're getting MORE OBESE as a nation. So how can you reconcile these two, apparently disparate, facts?

Sedentary life leads to an "older" heart, which develops more "collateral circulation" -- smaller vessels that feed more heart muscle because of the lack of exercise. So our chunky, couch-potato, gaming, inactivity is giving us hearts that have more, smaller vessels. So our hearts sustain less damage per heart attack episode. That's no reason to celebrate.

I've mentioned elsewhere that I got to meet Jack LaLanne in Long Beach this year -- I followed him on the podium after he gave a 7:00 am lecture. Before he spoke he and his wife had walked on the beach for an hour. Jack is 94. He is proof that regular exercise and good nutritional habits count, and count big!

Home for the holidays...

Many of our patients will be traveling this holiday season -- may you all return home safely! In the meantime, we've got our holiday clinic schedules put together. Good news! Looks like we'll have full chiropractic coverage through January 2, including emergency care for those unfortunate spines, and their owners, who may need it.

Now is the time take care of any residual symptoms, aches and pains. Deductibles are met, and a new cycle starts January 1, 2009. If you need a holiday tune, give us a jingle (bells). (Couldn't resist...) :0) Call us at (303) 675-3009!

Our immune systems get pummeled about now through March. If you're a patient of ours, be sure to check your email for our HealthCoach Newsletter and Holiday Flyer for significant savings on therapy to support and strengthen your immune system -- our Winter Wellness Package. (If you aren't a patient yet, go to our home page at www.center4spine.com, then follow the link on the right to "CSP Patient Info Central." There's a downloadable newsletter waiting there for you!)

It's a bit disconcerting to know that when we sneeze, viruses travel up to 100 mph and can be effectively deposited 12 feet away. Then the little buggers live for 2 days! So, DO cover your sneeze, but don't sneeze into your hands (unless neck pain prevents you from covering a sneeze or cough any other way.) Sneeze into the inside of your bent elbow, or better yet, a Kleenex (or a Puffs, to be commercially neutral.) And if your upper respiratory infection or flu is hanging on, remember that an antiobiotic will do NOTHING for your viral infection. You need an immune boost. You need our Winter Wellness Package!

Merry Christmas, Chag Sameach, and Happy Holidays to all!

Dr. C