Proton pump inhibitors and B12 deficiency: What to do now

We can now add vitamin B12 deficiency to the growing list of risks of long term use of the proton pump inhibitors (PPIs). The New York Times had an article outlining the evidence that prolonged use of both proton pump inhibitors (PPIs) like Prilosec, Protonix, Prevacid and others, as well as the less potent H2 blockers like Zantac and Pepcid, can lead to vitamin B12 deficiency.  This is in addition to previously documented concerns about reduced calcium absorption that can lead to osteoporosis, increased risk of pneumonia and increased risk of Clostridium difficile colitis. It seems simple to ask patients to just stop their PPIs, but it’s not that easy. It can be hard to stop using a PPI due to rebound hyperacidity, a phenomenon where after using a PPI for as little as 2 months upon stopping the stomach produces more stomach acid than prior to using the drugs.  This tends to result in a big flare-up in the symptoms of heartburn or dyspepsia that prompted use of the drugs in the first place. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Family Physicians Tags: Meds GI Medications Source Type: blogs

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New J. Chem., 2020, Advance Article DOI: 10.1039/D0NJ01509A, PaperKulsum Bano, Srinivas Anga, Archana Jain, Hari Pada Nayek, Tarun K. Panda Synthesis of heteroleptic and homoleptic alkaline earth metal complexes supported by bulky bis-iminopyrrolyl ligands are reported. The catalytic hydroamination of isocyanates and isothiocyanates with aryl amines using calcium complex is presented. To cite this article before page numbers are assigned, use the DOI form of citation above. The content of this RSS Feed (c) The Royal Society of Chemistry
Source: RSC - New J. Chem. latest articles - Category: Chemistry Authors: Source Type: research
Authors: Jeong C, Kim HJ, Lee S, Kang MI, Ha J Abstract Purpose: Denosumab is a monoclonal antibody that prevents the development of osteoclasts. The effect of denosumab in solid organ transplant recipients has been elucidated, but its effect in haematopoietic stem cell transplantation recipients has not been studied yet. The aim of this study was to determine the effectiveness and safety of denosumab in haematopoietic stem cell transplantation recipients. Methods: We retrospectively evaluated 33 female patients with osteoporosis (mean age 52.6 ± 9.8 years) following allogeneic haematopoiet...
Source: International Journal of Endocrinology - Category: Endocrinology Tags: Int J Endocrinol Source Type: research
Conclusions and Relevance: Because there are 74.0 million children 0 to 17 years old in the United States, the projected numbers of severe cases could overextend available pediatric hospital care resources under several moderate CPIP scenarios for 2020 despite lower severity of COVID-19 in children than in adults.
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Conclusions: Our algorithms were good at identifying matches for the prescribing physician according to our reference standard but may have included some false positives. Predicted probabilities from our models could be used in other databases where physician IDs are unavailable to help identify the prescriber.
Source: Medical Care - Category: Health Management Tags: Online Article: Applied Methods Source Type: research
Authors: Ota K, Yamaguchi R, Tsukahara A, Nishida S, Shigekiyo T, Harada S, Kojima Y, Takeuchi T, Arawaka S, Higuchi K Abstract A 68-year-old woman presented with a 2-year history of worsening unsteady gait. Her neurological examination revealed peripheral neuropathy with lower limb sensory dominance. T2-weighted imaging revealed a disorder of the posterior cervical cord. Blood test findings revealed vitamin B12 deficiency, and gastroscopy revealed typical findings of autoimmune gastritis. She received vitamin B12 supplementation, but some peripheral neuropathy symptoms persisted due to longstanding vitamin B12 def...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Conclusions Synovial biopsy is a diagnostic option when suspected CAA is resistant to conventional modes of diagnosis. Crystalline diseases should be considered in the differential diagnosis of musculoskeletal mass lesions mimicking neoplasms.
Source: JCR: Journal of Clinical Rheumatology - Category: Rheumatology Tags: Original Articles Source Type: research
No abstract available
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Conclusions: In summary, the analysis of the complete profile of the pharmacological properties, as well as the elucidation of targets, networks, and pathways, can further illuminate that the underlying mechanisms of MHC in CVD might be strongly associated with its synergic regulation of inflammation, apoptosis, and immune function, and provide new clues for its future development of therapeutic strategies and basic research. PMID: 32454875 [PubMed - as supplied by publisher]
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Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Stereo Chemistry explores new leads to determine whether chief suspect vitamin E acetate was acting alone
Source: Chemical and Engineering News - Category: Chemistry Authors: Source Type: research
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