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PTINR.com has officially launched!

PTINR.com is your official anticoagulation resource. Designed to keep physicians up to date on the latest drug interactions, life-style changes and management strategies - PTINR will be a key site for anticoagulation clinics across the country.

Patients will finally have a place to find consistent, current information on important topics including dietary information, fall prevention, over-the-counter drug interactions, life-style tips to stay safe and a monthly crossword puzzle on Coumadin/warfarin therapy.

Come visit us today, bookmark us and let us show you our commitment to patient safety. We at PTINR.com are committed to: Greater Control, Improved Outcomes

From the FDA

FDA Approves Implantable Medical ID Chip

The US Food and Drug Administration recently approved an identification microchip that is implanted under the skin and contains patients' medical histories. Doctors use the chips to quickly "scan" the patient and retrieve a detailed medical history within seconds.

The information would not be contained inside the capsule. The chip would have a unique code, like a bar code, that would allow medical workers to retrieve the patient's information from a central computer. The technology already exists; this just gives it a human application. Such ID chips raise privacy concerns because each person has a unique identification number. But this would be a voluntary program.

Applied Digital Solutions Inc. of Delray Beach, Fla., plans to market the VeriChip systems, the chips, scanners and computerized database, to hospitals, doctors and patients as a way to improve care and avoid errors by ensuring that doctors know whom they are treating and the patient's personal health details

Hospital errors could be the number 3 killer in America, behind heart disease and cancer. It's unknown how many of these deaths are from patients getting medicines they cannot tolerate. The same privacy laws for medical records apply to records contained in a paper folder or in a computer.

washingtonpost.com

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Anticoagulation News

Traffic Increases Heart Attack Risks

Results from a new German study show that exposure to traffic can increase risks for heart attack among susceptible individuals. The effects are similar whether one drives an automobile or uses public transportation.

At this point, it remains unclear to what extent stress or air pollution contribute to this association, according to researchers. They suggest, however, that all at-risk individuals can benefit from efforts to clean the air, especially in more urban areas. The study was designed to take into account other short-term risk factors for heart attack, such as strenuous exercise or anger, but found that these did not change the association between exposure to traffic and heart attacks.

The findings are based on a study of 691 subjects who had survived at least 24 hours after a heart attack and were able to provide information on events that may have triggered the attack. Patient diaries were reviewed to assess activities in the four days prior to their heart attack symptoms. Being involved in traffic nearly tripled the risk of heart attack in the hour that followed. As time spent in cars, on motorcycles or bicycles, or on public transportation increased, so did the risk of heart attack.

Traffic can easily generate a 'fight or flight' response with symptoms such as racing heart, high blood pressure, dry mouth and sweaty palms. If this happens everyday, the risk to health and well being is potentially enormous.

Here are a few suggestions:

• Give yourself more time to get where you're going and mentally picture yourself taking the journey in a peaceful frame of mind.
• Look for opportunities to show courtesy to other motorists during your drive (in some cases, by just getting out of their way !)
• Relax your body and breath deeply in through your nose and out through your mouth.
• Remember, you want to get there alive.

content.nefm.org

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Diabetes News

New Test Advised for Diabetics

From 1980 through 2002, the prevalence of diagnosed diabetes increased in all age groups. In general, throughout this time frame, people aged 65-74 years had the highest prevalence, followed by people aged 75 or older, people aged 45-64 years, and people less than 45 years of age. In 2002, the prevalence of diagnosed diabetes among people aged 65-74 (16.8%) was almost 14 times that of people less than 45 years of age (1.2%).

A new blood test, hemoglobin A1c test, can predict your chances of developing heart disease if you are a diabetic. According to two recent studies, people with diabetes 1 and 2 should take the hemoglobin A1c test regularly, in addition to their normal blood sugar tests.

The hemoglobin A1c test (HA1c Test) identifies glycated haemoglobin (glycosylated haemoglobin) - this is an indicator of how your blood sugar is being controlled.

After studying data on 10,000 N American and European diabetes patients, researchers found that patients with higher levels of glycated haemoglobin had a significantly higher chance of developing heart disease (and artery disease) when compared to the others.

The researchers found that if a patient had a 1% increase in HA1c, his/her risk for total cardiac disease went up by 18%. This 1% increase in HA1c also meant a 28% higher risk of peripheral vascular disease.

Another study in Cambridge, UK, came up with similar findings. Over 10,000 people were studied, aged 45-79, for a period of six years. The study was carried out by scientists at Cambridge University and the Medical Research Council.

In this second study, scientists said every 1% increase in hemoglobin A1c above 5 percent meant a 21% increased risk of a cardiovascular event. Those least at risk were the ones whose HA1c concentrations were under 5%. This was all regardless of weight, age or blood pressure.

reutershealth.com

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New Study

Major Alzheimer's Study Unveiled

The National Institute on Aging and industry partners plan to launch a multi-year study of Alzheimer's disease. Researchers will use brain-scanning MRIs and other tests to track people who have either early stage Alzheimer's or a milder type of memory loss known as "mild cognitive impairment." Over several years, they'll compare biological changes deep within those patients' brains to the aging that takes place in the brains of cognitively healthy seniors.

The goal is to find early warning signs that can identify people at highest risk of developing Alzheimer's, and markers to help test the effectiveness of new therapies faster than can be done today. Plans for the $60 million, five-year study were announced by the National Institute on Aging. While mostly funded by the government, about a third of the study's financing will come from pharmaceutical companies and the nonprofit Alzheimer's Association.

Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities. The most common form of dementia among older people is Alzheimer's disease (AD), which involves the parts of the brain that control thought, memory, and language. Although scientists are learning more every day, right now they still do not know what causes AD, and there is no cure.

Scientists think that as many as 4.5 million Americans suffer from AD. The disease usually begins after age 60, and risk goes up with age. While younger people also may get AD, it is much less common. About 5 percent of men and women ages 65 to 74 have AD, and nearly half of those age 85 and older may have the disease. It is important to note, however, that AD is not a normal part of aging.

AD is named after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. He found abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary tangles). Today, these plaques and tangles in the brain are considered signs of AD.

Scientists also have found other brain changes in people with AD. Nerve cells die in areas of the brain that are vital to memory and other mental abilities. There also are lower levels of some of the chemicals in the brain that carry messages back and forth between nerve cells. AD may impair thinking and memory by disrupting these messages.

In April, researchers will begin recruiting 55- to 90-year-olds-some healthy, some with MCI, some with Alzheimer's-to participate in the study.

alzheimers.org

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Life Style

Obesity Surgery Helps More than Appearances

To most people, the term "obesity" means to be very overweight. Health professionals define "overweight" as an excess amount of body weight that includes muscle, bone, fat, and water. "Obesity" specifically refers to an excess amount of body fat. Some people, such as bodybuilders or other athletes with a lot of muscle, can be overweight without being obese.

Obesity tends to run in families, suggesting a genetic cause. Yet families also share diet and lifestyle habits that may contribute to obesity. Separating these from genetic factors is often difficult. Even so, science shows that heredity is linked to obesity.

In one study, adults who were adopted as children were found to have weights closer to their biological parents than to their adoptive parents. In this case, the person's genetic makeup had more influence on the development of obesity than the environment in the adoptive family home.

Obesity surgery not only helps people lose weight, but also curtails diabetes, reduces high blood pressure and high cholesterol and improves sleep apnea. That's what researchers from the University of Minnesota found when they analyzed 136 studies on the surgery, published in last week's Journal of the American Medical Association.

Researchers perform bariatric surgeries on morbidly obese patients who struggle with weight loss. The surgery reduces the stomach's size and shortens the intestinal tract so that patients can't eat as much. It's not a cosmetic procedure, and it's not without risks-of infection, stomach problems, malnutrition and even death.

The long-term success rate is about 85 percent. Patients must follow a strict eating plan, exercising regularly and attending support group meetings. The Minnesota researchers tallied the experiences of 22,094 patients and found: Diabetes was eliminated in 77 percent of patients and eliminated or improved in 86 percent; High blood pressure was eliminated in 62 percent of patients and eliminated or improved in 79 percent; High cholesterol was improved in 70 percent of patients; and Obstructive sleep apnea was eliminated in 86 percent of patients, and eliminated or improved in 84 percent.

ama-assn.org

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Flu Vaccine

Providers Concerned with Flu Vaccine Price Gouging

Some flu vaccine wholesalers are offering to sell desperately needed shots for up to 10 times the normal price. The allegations of price gouging come after alarmed U.S. health officials reported that this year's supply has been cut in half due to a British factory's production problems. Since the flu shot shortage was announced, more than half of hospital pharmacists have been contacted by vendors offering vaccine at inflated prices, according to a survey by the American Society of Health-System Pharmacists of Bethesda, Md.A vial of flu vaccine includes shots for 10 people and normally costs hospitals about $80 to $100.

Fifty-five percent of the 650 hospital pharmacists who responded to the survey reported being contacted by "opportunistic vendors." Of those, more than 80 percent reported being offered vaccine at more than four times "original market value.". Nearly 20 percent were offered the vaccine at $800 or more.

Seventy-five percent of the hospitals reported that they will not have enough flu vaccine to meet new federal guidelines for vaccinating high-risk patients and hospital workers. Hospitals said the solicitations had come via faxes and e-mails from vendors who normally don't supply them. The companies are not manufacturers, but act as wholesalers and specialize in drugs in short supply.

About 84 percent of the hospitals said they don't plan to buy vaccine at the inflated prices offered by "secondary" vendors. But some hospital pharmacists are nonetheless buying the vaccine to protect patients and employees likely to be exposed to seasonal influenza, which kills 35,000 Americans annually.

The Centers for Disease Control and Prevention (CDC) and the only remaining manufacturer of flu vaccine, Aventis Pasteur, announced a plan to allocate vaccine in response to the shortage. The plan, announced by CDC Director Dr. Julie Gerberding and Aventis Pasteur, will distribute in phases 22.4 million doses of unshipped vaccine to identified areas of need throughout the country. The vaccine will be allocated over the next six to eight weeks through Aventis Pasteur to hospitals, long-term care facilities, nursing homes and private providers who care for young children.

newsday.com

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Fitness Watch

New Device Reduces High Blood Pressure

According to recent estimates, one in four U.S. adults has high blood pressure, but because there are no symptoms, nearly one-third of these people don't know they have it. In fact, many people have high blood pressure for years without knowing it. Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure or kidney failure. This is why high blood pressure is often called the "silent killer." The only way to tell if you have high blood pressure is to have your blood pressure checked.

People with high blood pressure who practice slow breathing with the aid of a regulating device find their blood pressure drops, according to a new study from Rush University Medical Center in Chicago. The device, called RESPeRATE, is about the size of a paperback book, and is hooked up to an elastic belt placed around the chest. As explained in a university press release, the unit monitors the breathing rate of the wearer, calculates the preferred rate and "synthesizes a personalized melody comprised of two distinct tones -one for inhalation and one for exhalation," which is played through headphones. Previous studies using the device have shown its effectiveness in reducing blood pressure, but how long it has to be used in order to have an effect has not been determined.

Researches investigated whether there was a minimum duration of slow, device-guided breathing to obtain a significant lowering of blood pressure in a study of 149 people with hypertension. They were randomly assigned to use of the device or simply monitor their blood pressure at home. Participants who used the device for at least 180 minutes over the 8-week study (approximately 23 minutes per week) experienced an average drop of 15 points in the top (i.e., systolic) blood pressure reading.

That compared with a 7-point drop among those who used the device less than 180 minutes during the study and a decrease of 9 points for those who just monitored their blood pressure. Even among high users, the device was used only about half the recommended time of 45 minutes/week.

There is no "ideal" blood pressure reading. However, there is a range of "normal" blood pressure reading. Generally, a reading that is less than 140 over 90 indicates that you don't need to worry. If either or both numbers are equal to or greater than 140 over 90 for an extended period of time, you have high blood pressure, or hypertension.

Hypertension is dangerous because it causes the heart to work extra hard. This strain contributes to heart attacks and stroke. When the heart is forced to work extra hard for an extended period of time, it tends to enlarge. A slightly enlarged heart can function well, but a significantly enlarged heart cannot. High blood pressure also causes damage to the arteries, causing arterial disease..

Hypertension can be treated. Mild cases of hypertension can be treated through behavior modification like changing diet and increasing exercise. More severe cases of hypertension require medications like diuretics and beta blockers. Diuretics rid the body of excess fluids and salt. Beta blockers reduce the heart rate and the heart's output of blood.

medscape.com

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Product of the Month

It's your choice in November. Choose a winner for your diabetes management from QAS.

Diabetes is a disease that impairs the body's ability to absorb and use food properly. The small intestine normally removes the sugar, or glucose from digested food and transfers it into your blood. The glucose is burned as fuel to give your cells energy for their normal functions. Insulin acts like a key to open the cells and transport the glucose to the blood. Insulin

When this vital process is impaired due to lack of insulin, close monitoring must occur to prevent the body from shutting down due to lack of fuel. Some diabetics test as often as 3 times per day and require fast, easy to use monitoring devices just like these.


Take your blood sample from the finger or forearm with the FreeStyle glucose monitor with fast results in about 15 seconds.

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