The overwhelming feeling is that the key is in prevention. The fact that people are living longer and diabetes patients are living longer after diagnosis are two more reasons that the incidence of the disease is expected to greatly increase. Weight loss through both diet and exercise is the only hope to correct this dangerous trend.

Weight loss and exercise can prevent or at least delay the patients with prediabetes from developing Type II diabetes. People at risk due to their weight, family history, ethnic background, and other factors need to get screened. bjmdjd

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The research was done using the cups measuring water and then measuring the same liquid in an accurate scientific cylinder. The testing was done by the researchers under controlled conditions and not by an untrained person. It was felt that an untrained person  holding a screaming baby at 4 A.M. might get an even more inaccurate result than the researchers.

The type of dosing cup, how the numbers and lines were printed on the cups, and the color of the liquid used all affected the accuracy of the results. The average result in the cylinder was 0.33 milliliters greater than in the dosing cups.

Whether these findings make any difference clinically or not is not known but dosing medications in a very young infant would seem to be clinically significant as 0.33 mL is not a small amount in these patients. I might suggest to have your pharmacist check your measuring cup against one of the scientific cylinders that they keep in their work area. bjmdjd

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Thursday the Food and Drug Administration cleared the way for a painless laser treatment to get rid of that cellulite. Four pads are placed on the skin overlying the affected area and left in place for ten to twenty minutes. Supposedly the fat cells open up and release fat which is then transported to areas of the body where it can be dissolved and released during exercise. It is suggested that the patient exercise for twenty to thirty minutes immediately after the treatment if possible but it can be delayed for up to twelve hours if needed. Eight to ten treatments over a four week period is suggested.

The FDA also recently approved a cold laser for cellulite reduction treatments. Get out your wallets girls (and boys). bjmdjd 

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The study included people at least 40 years of age. It also found that the pneumococcal vaccine (pneumonia shot) had no affect on the occurrence of heart attacks.

Just one more reason to get the all important flu shot! bjmdjd

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The view of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practice is that all women who are going to be pregnant from October through May should get the vaccine. This is supported by the COP.

The authors of the opinion stated that the flu vaccine is an integral part of prenatal care. bjmdjd

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The restricted access plus the fact that there is another drug available like Avandia without the same cardiac risks may signal the end of the popular diabetes drug. Restricted access means among other things that:

• in order to prescribe the drug doctors must be part of a registry that certifies that they are familiar with the cardiac risks involved with the use of Avandia
• they are prescribing it only because their patient has exhausted all other medications to try and control their blood sugar
• patients also have to understand the cardiac risks involved in taking the drug 

Patients currently on Avandia should be hearing from their doctor’s office soon to discuss their use of Avandia. If they don’t they should give them a call. bjmdjd

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Updated guidelines for the use of the vaccine were recently printed in the Morbidity and Mortality Weekly Report (MMWR). Specific recommendations include:

• Adults from 19 to 64 years of age with chronic medical conditions including asthma or anything compromising their immune system should receive the vaccine.
• Adults from 19 to 64 years of age who smoke should receive the vaccine and smoking cessation information.
• Routine administration of the vaccine is no longer recommended for Alaska Natives or American Indians younger than 65 years old. However, for those in these two groups who are 50 to 64 years old and who reside in areas where the risk of invasive pneumococcal disease is increased, authorities may recommend vaccination.
• All persons should receive the vaccination at 65 years of age. If a person got the vaccination before age 65 and 5 years or more have passed since they received it a second dose should be given at 65 years of age or later. If the vaccination was received at age 65 or later only one dose is required. No re-vaccination should be given.
• For people 19 to 64 years of age who have no spleen or a non functioning spleen or a immunocompromising condition a second dose should be given 5 years after the first. There is no indication for further re-vaccination.

Pay particular attention to the last two bulleted points since there has always been confusion as to when or if someone should receive a second dose of the vaccine.

Chronic medical conditions in persons 19 to 64 years of age where the vaccine is recommended include: chronic heart disease except hypertension, chronic lung disease including COPD, emphysema, and asthma, diabetes, CSF leaks, cochlear implants, alcoholism, cigarette smoking, and chronic liver disease including cirrhosis.

Be sure to ask your physician about the pneumococcal vaccine (pneumonia shot). bjmdjd

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As usual the vaccine will protect against the three most likely strains of flu expected to be prevalent this flu season. This years shot will include coverage for the H1N1 virus that caused so much illness last season. With more manufacturers than before there is not expected to be a shortage of vaccine this season.

Vaccination is particularly important for those who are at high risk of flu complications including young children, pregnant women, people with chronic health problems like diabetes, asthma, heart and lung disease, and people 65 years of age and older. While children younger than 6 months of age are at a high risk they are too young to be vaccinated. It is important to vaccinate the people that take care of them and will be around them instead.

And once again…THE FLU SHOT DOES NOT AND CANNOT CAUSE THE FLU!!!  bjmdjd

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One of the most interesting findings is that most of the salt comes from processed foods that don’t even taste salty rather than from adding or cooking with salt at home. In school I was always taught that the easier the food was to prepare (i.e. the more processed it was) the more salt it contained.

The recommended salt consumption is 2,300 mg/day for healthy folks and 1,500 mg/day for those with high blood pressure. Many food companies have pledged to lower the salt content of their processed foods but admit that it will only be in some selected foods and it will be a very slow process.

The best way to lower food intake is to cook at home but in our rushed lifestyles that is unlikely to happen. Slowing down might have health benefits in areas we haven’t even thought about. bjmdjd

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Even though it’s not funny, one of the jokes in an emergency room I worked in was all of the trouble that some folks went to when trying to find an instrument to get some attention through a suicide gesture. Some thought they would try to “fake” it by using the readily available acetaminophen. Little did they know that this inexpensive over the counter medication is one of the most dangerous drugs you can take if you take too much.

A recent study at the University of Rochester in New York has found that a majority of teenagers and young adults take over the counter medications without even knowing what the medicine actually is or the possible dangerous side effects.

Even though various studies document that acetaminophen toxicity is the cause of more cases of acute liver failure than viral hepatitis, few adolescents realized the possible dangers of taking that drug or many others that are freely available to them.  In this study it was found that 77% of those studied that were determined to be “health literate” did not even know the maximum daily dose of acetaminophen.

While this study focused on young people the findings for adults are not much better. It is imperative that people educate themselves about the medications that they take and become familiar with the dosage instructions printed on the bottle. bjmdjd  

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