Expert Panel Links Popular Bone Drugs to Rare Fracture

An expert panel concludes that bone-strengthening bisphosphonate drugs such as Actonel, Boniva and Fosamax can actually raise risks for a rare type of fracture of the thighbone. The panel is urging the U.S. Food and Drug Administration which has been awaiting the report to add a special warning to that effect on the drugs' labeling. "Bisphosphonates may be related to atypical femur fractures," said Dr. Elizabeth Shane, a professor of medicine at Columbia University's College of Physicians and Surgeons in New York City. She is the lead author of the report, which was compiled by a special task force at the American Society for Bone and Mineral Research.

"These fractures are very unusual," Shane added. "But we are still concerned that patients could still have these fractures. There may well be a link between these fractures and bisphosphonates." The FDA has been given a copy of the panel report for review, she said. The findings are published Sept. 14 in the Journal of Bone and Mineral Research. Bisphosphonates a class of prescription medications use to treat osteoporosis have been shown to lessen the odds of getting common bone fractures of the hip and leg. However, they may also help trigger a weakness that makes a particular type of thigh bone fracture more likely in rare cases, the panelists said.

There has been conflicting evidence on a such a link, however. For example, one study published in 2008 in the New England Journal of Medicine did find a correlation between the long-term use of Fosamax and atypical fractures in postmenopausal women. But a study published this March in the same journal seemed to refute the connection. The FDA had looked to the expert panel to help provide some clarity. The group's new recommendations came after a thorough review of 310 of these atypical thigh fractures. In that review, the panel found that 94 percent of these patients had taken bisphosphonates. Most had taken the drugs for five years or more. Shane noted these fractures are so unusual that they make up less than 1 percent of all hip and thigh fractures.

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Students Warned to Beware of 'Laptop-itis'

The very design of laptop computers encourages bad posture among college students and other heavy users, which can lead to headaches, muscle strain and debilitating neck, shoulder and hand injuries, researchers caution.The issue stems from the unified body construction that defines laptops, researchers at the University of North Carolina (UNC) at Chapel Hill School of Medicine, explained in a university news release. With an inseparable keyboard and monitor, users are not free to configure their equipment in a way that minimizes risk. "When you use a laptop, you have to make some sort of sacrifice," Dr. Kevin Carneiro, a physician in the UNC School of Medicine's department of physical medicine and rehabilitation, stated in the news release.

Such a sacrifice to convenience comes at a price, Carneiro noted. Awkward positioning of the fingers and body can cause nerve injury to the wrist and prompt the onset of carpal tunnel syndrome, while poor neck position and shoulder posture can cause muscle strain and soreness in those areas. Signs of trouble typically come in the form of headaches, wrist pain, tingling in the fingers or thumb, and neck and shoulder pain, he added. Concern about such laptop health issues is driven by their rising popularity, as worldwide sales now exceed those of standard desktop computers. Students are particularly vulnerable, since laptops are a common feature of campus life. That said, Carneiro and his colleagues point out that laptop users can take specific steps to minimize their risk.

* If you are working at a computer, your body should form 90-degree angles at the elbows, knees and hips.

* Use a docking station and cables to hook up to an external monitor and/or separate keyboard that are      moveable to encourage better posture.

* With the help of a docking station, position the computer so you can read the screen without bending your neck.

* Pay attention to the chair you sit in look for one that is adjustable and comes with back support.

* Tilt the screen so you don't need to bend your neck, and place the mouse so that your wrists are in a neutral position .

* Take frequent short breaks every 20 minutes or so this can help rest muscles and encourage position shifting. Do some shoulder shrugs, gentle forward head rolls, and shoulder scrunches to stretch your muscles.

* Stay hydrated drinking plenty of water can help keep discs in your back lubricated.

In addition, watch out for warning signs, including pain and tingling. Carneiro said these may mean you need to use better posture, take more breaks, or see a doctor.

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