Monthly Archives: June 2015

As I’ve written elsewhere “physician-assisted suicide (PAS) laws in Oregon, Washington, and Vermont permit doctors to prescribe a life-ending medication to adults who are found to have decision-making capacity and a terminal illness that will lead to death within six months. But now groups such as the Society for Old Age Rational Suicide (SOARS) are advocating that people without terminal conditions also be granted means for committing suicide.” A recent New Yorker article describes how this is already happening in Belgium. With the Britney Maynard case sparking a movement to give people more autonomy end to their lives, it’s worth examining how this is playing out in the European countries that are doing so. Here’s the link to the New Yorker article. http://www.newyorker.com/magazine/2015/06/22/the-death-treatment

I’m resolving to keep this blog alive with at least 1 post a week. An easy way to do this is a brief comment on a medical study that’s been in the news that week.

Today, I read about a study about a class of medications called proton-pump inhibitors (PPIs). Millions of people take a PPI such as Prilosec, Prevacid, or Nexium to treat heartburn and other complications of gastroesophogeal reflux disease (GERD). Now a group of researchers from Stanford are raising the possibility that PPIs might increase people’s risk of having a heart attack. The investigators reviewed more than 16 million clinical documents on 2.9 million individuals and found that people with GERD who took PPIs had a 16% higher risk of having a heart attack.

Although researchers acknowledge that PPI usage may be serving as a marker for a sicker population, they believe this is unlikely since people taking antacids such as Pepcid and Zantac didn’t have a higher heart disease risk. The studies authors theorize that PPIs might increase the risk of heart disease by inhibiting an enzyme called DDAH that is necessary for cardiovascular health.

Dr. Nicholas Leeper, lead author of the study states that “we’re not recommending that people stop the drug (PPIs) at this point.” But he did suggest that patients reconsider their need for the specific class of medications as well as their individual risk.

To clarify if PPIs truly increase the risk of heart disease, we will need a prospective, randomized study. In the meantime, I will reassess if people with GERD truly need to PPIs or if they could get sufficient symptom relief through lifestyle measures or another class of antacids such as Zantac or Pepcid. I will be especially careful about recommending PPIs to people with vascular disease or at a high risk of developing it.

Here’s a link to an article I wrote on the microbiome, the one hundred trillion bacteria that live on or in the human body. I focus on possible links between the microbiome and obesity, immune disorders, and mental illness.

http://www.worldmag.com/2015/04/inner_life