Pak Doktor a.k.a. Mr Doctor!

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By Dr. Karissa Kim,

UC Health

3:07 PM Tuesday, June 28, 2011

Do you ever consult your pharmacist regarding medicines? Pharmacists can provide care beyond just dispensing your medicines. For example, at the Pharmacy Anticoagulation Management and Pharmacotherapy Services at UC Health West Chester Hospital, clinical pharmacists will work with you and help you achieve the best outcomes with your medicines.

Anticoagulants, also called “blood thinners,” keep blood clots from growing and also prevent new clots. Patients need a “blood thinner” for many reasons. The most commonly used anticoagulant is warfarin. 

Blood clots in the legs and lungs are a major cause of disease in the United States. More than 2 million Americans experience a blood clot every year; possibly leading to death or long-term complications. Up to 17 out of 100 patients can die after a diagnosis of a lung clot. 

Atrial fibrillation is an irregular heartbeat that many older people develop; about 2 million Americans have atrial fibrillation. Because the heart beats ineffectively, blood pools in the chambers of the heart and clots can form as a result. A piece of the clot can break off and travel to the brain, leading to a stroke. Warfarin can significantly reduce your chances of a stroke.

There may be other reasons for being placed on a blood thinner, including heart valve replacements, peripheral arterial disease and after a heart attack.

The West Chester Hospital Pharmacy Anticoagulation Management Service specializes in monitoring patients who take blood thinners. This type of clinic improves patient outcomes. For example, one study found that patients who received care in a specialized clinic had lower bleeding, fewer visits to the emergency room, fewer incidents of warfarin-related hospitalization and a decreased risk for another blood clot. 

Our goal is to maximize the benefits of blood thinners and minimize adverse events, such as excessive bleeding. Pharmacists will provide individualized education, complete review of medications including drug interactions, fingerstick blood sample with immediate results, timely adjustment of anticoagulation therapy, if necessary, and complete and thorough instructions. 

Taking medicines as directed by the health care provider is called adherence. Unfortunately, many people do not take their medicines as prescribed for various reasons. Some describe medication non-adherence as America’s “other drug problem.”

As stated by C. Everett Koop, former U.S. surgeon general, “Drugs don’t work in patients who don’t take them.” Last month, the National Consumers League launched a national “Script Your Future” campaign. This campaign is designed to “help you take back your future by helping you take your medicine as directed.”  Our service can help you manage your medicines and get the most benefit from them.

If you are interested in finding out more about our Pharmacy Anticoagulation Management and Pharmacotherapy Services, call (513) 298-7790.

Karissa Kim, PharmD, is a UC Health clinical pharmacist and associate professor at the University of Cincinnati James L. Winkle College of Pharmacy.

By MarketWatch

Don’t miss these top stories:

• 
  Your health is calling: Get that screening test

• 
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You soon may get a phone call from someone urging you to take your medication or get a needed health screening — and it won’t be your mother calling.

As Kristen Gerencher writes in her Vital Signs column today, some insurers and other health-care companies are starting to call patients to remind them about their medications, any screening tests they need, and other preventive-health-care to-do’s. It’s all in the name of reducing ever-rising health-care costs.

Speaking of keeping costs down, what about those energy bills? As summer temperatures push your air conditioner into overdrive, read Amy Hoak’s Home Economics column today for tips on how to keep down your cooling costs.

Here in San Francisco, we don’t have that particular problem. In fact, many of us don‘t even have air conditioners.

—
Andrea Coombes
, Personal Finance editor

Your health is calling: Get that screening test

If you got a telephone call from a stranger asking why you hadn’t gotten a recommended health screening, what would it take to keep you from hanging up, or better yet, committing to getting the screening?

Read more: Your health is calling: Get that screening test.

REAL ESTATE

How to keep your home cool and not heat up bills

It’s expected to be a scorcher of a summer in some parts of the country. But that doesn’t mean homeowners need to deal with exorbitant power bills.

Read more: How to keep your home cool and not heat up bills.

By Genevra Pittman

NEW YORK |
Mon Jun 27, 2011 5:32pm EDT

NEW YORK (Reuters Health) – Taking vitamin D may help protect women who have already had non-melanoma skin cancers against a much deadlier form of the disease, suggests a new study.

But researchers caution that the results need to be confirmed with further studies, given that the number of women in their study who got melanoma – the most dangerous type of skin cancer – was low to begin with.

“We’re not recommending super high doses” of vitamin D, study author Dr. Jean Tang, from Stanford University School of Medicine in Redwood City, California, told Reuters Health.

However, she added, “I feel good about saying if you’ve already had a non-melanoma skin cancer, you’re already at risk for developing melanoma in the future, (and) taking a little bit of calcium and vitamin D, while other studies need to be done, seems reasonable and not harmful.”

Some evidence has suggested that vitamin D might help protect against skin cancer and other cancers by influencing cell growth, and perhaps stopping cells from turning into cancer cells, researchers explained.

Tang and her colleagues wanted to see if that might be the case in a group of women participating in the Women’s Health Initiative trial, a study whose main focus was to look at the effects of diet and hormone therapy on disease risks.

The researchers looked back at data that had been collected on about 36,000 women between the ages of 50 and 79. Half of those women took supplements with 1,000 milligrams of calcium and 400 international units of vitamin D3 each day, while the other half took an inactive placebo supplement.

Using questionnaires and reports from doctors’ visits, the researchers were able to track how many women got skin cancer over the next 7 years, on average.

They found no difference in how frequently women in either group were diagnosed with non-melanoma skin cancers or with melanoma, according to the findings published in the Journal of Clinical Oncology.

In all, about 1,700 women in each group were diagnosed with non-melanoma skin cancer, while 82 women taking calcium and vitamin D and 94 in the placebo group got melanoma.

However, women who reported previously having non-melanoma skin cancer – which would mean they were at higher risk for getting melanoma later – were less likely to get melanoma if they were taking the extra calcium and vitamin D.

The overall numbers were small – 10 women out of about 1,100 with a history of non-melanoma skin cancer got melanoma in the supplement group, compared to 24 out of a similarly-sized placebo group.

Tang said she expects any link between the supplement combo and skin cancer would probably be a result of vitamin D.

The Institute of Medicine recommends that most adults get 1,000 to 1,200 mg of calcium per day and 600 to 800 IU of vitamin D. It sets a recommended upper limit at 2,000 mg of calcium and 4,000 IU of vitamin D.

Getting too much vitamin D is rare, but has been linked to kidney stones and an increased risk of other liver and kidney conditions.

Despite the limited nature of this particular study, “I think there is no reason for women not to increase their vitamin D intake,” said Dr. Michael Holick, who studies vitamin D and calcium at Boston University and was not involved in the new study.

Holick told Reuters Health that vitamin D’s role in reducing the risk of colorectal and breast cancer is “pretty compelling,” and that it could potentially protect against other diseases – such as type 2 diabetes and infectious diseases – as well. There is also good evidence that both calcium and vitamin D can help prevent osteoporosis.

The link between vitamin D and cancer is a controversial one, said endocrinologist Dr. Joan Lappe, of Creighton University School of Medicine in Omaha, Nebraska – and especially for skin cancer, there just isn’t enough evidence to make a claim about its benefits, she said.

“I think we’re going to see that vitamin D does have an effect on cancer, but the short answer is there are not enough rigorous trials out there,” Lappe, also not linked to the new research, told Reuters Health.

And because the Women’s Health Initiative study used relatively low doses of vitamin D, it’s still possible that higher doses will make a difference for skin cancer risk in a wider population, she said.

Tang said that her team is now recruiting women for another study on the link between vitamin D and skin cancer using higher vitamin doses to see if the connection holds.

Until more evidence is available, Lappe concluded, “I think everyone should be aware that vitamin D is important for your health and either take some supplements or talk to their doctor about it.”

SOURCE: bit.ly/gPtMdm Journal of Clinical Oncology, online June 27, 2011.

Reduce blood pressure and stroke risk

Researchers who tracked 201 people as they underwent either Transcendental
Meditation or health education classes found that those who meditated had
lower blood
pressure and a 47% reducation in strokes, deaths and heart attacks,
which they calculated together as one result.

Relieve pain

Meditation can have greater pain
relieving effects than morphine, a study earlier this year found.
Researchers found that just one hour of meditation training could reduce
pain by nearly half.

Study participants’ brain activity was examined as they were subjected to a
painful heat-emitting device applied to one of their legs. They were
monitored both before and after meditation training and pain ratings were
reduced by between 11 and 93 per cent while meditating.

Meditation had the effect of reducing activity in an area of the brain that
processes pain stimuli, while increasing activity in areas where the brain
stores its experience of pain and comes up with coping mechanisms.

Relaxation

Meditation has always been touted as a way to relax, but a study least year
found evidence to show that it really does work. Increased neuron
connectivity was found in parts of the brain that were important for
regulating emotional behaviour and dealing with conflict.

Reduce anxiety

Another study found that meditation decreases the levels of the stress-causing
hormone, cortisol. Study subjects who were taught to meditate for 20 minutes
a day for five days had measurably less anxiety and lower levels of the
hormone than a group who were taught other relaxation techniques. Those who
meditated also had lower levels of anger and fatigue.

And it’s not just for humans…

…a study found that cats
that were unwell became less stressed when they listened to yoga meditation
music. The poorly felines calmed down and began to breathe more slowly when
they were played the tunes.

“The only way to find out if you have HIV infection is
to get tested. Knowledge of HIV status is essential. If
you test positive for HIV, you can access necessary
treatment and take precautions to prevent infecting
others,” Garrett said.

No appointment is needed for the testing, which
produces results in approximately 20 minutes.

Nine new cases of HIV were identified in Davis County
in 2010. Approximately 2,500 Utah residents have been
diagnosed and are living with HIV, the virus that causes
AIDS, or AIDS itself, county health officials said.

That figure under-represents the actual number of
individuals who are infected with HIV because it does not
include those who are infected and have not been tested,
Garrett said.

Almost 40 percent of people with HIV are not diagnosed
until they have progressed to AIDS, and that can happen up
to 20 years after they first became infected with the
virus, Garrett said.

The virus may spread to other people because they
don’t know they have it.

“For those at risk, finding out your HIV status is the
first step to improving your health and the health of your
partners,” Garrett said.

Free STD/HIV testing is a service regularly offered by
the Midtown Community Health Center from 8 a.m. to 12:30
p.m. and 2-5 p.m. Monday-Friday. Results from those tests
take between five and 10 days.

Beginning in July, the Davis County Health Department
will offer free rapid HIV testing on a regular basis.
Individuals wanting same-day results can visit the clinic
from 3-6 p.m. on the fourth Wednesday of each month.

Additional information about HIV testing is available
by calling the Davis County Health Department Disease
Hotline at 801-525-5200 or by visiting www.daviscountyutah.gov/health. All
calls are confidential.

For more information about National HIV Testing Day,
visit www.hivtest.org.

Email:jpage@ksl.com