Summertime Safety and Serenity

When schools close their doors for the summer, kids are released from the shackles of homework and tests to enjoy months of action-packed, nonstop fun. Summer reminds me of my weeklong Boy Scout summer camp experience at dear ole’ Treasure Isle: plunging into that frigid pool at 7 am, earning multiple merit badges to become an Eagle Scout, and singing a dirge over the death of poor Cock Robin (horribly, I would add!), I was constantly reminded of the Boy Scout motto, “Be prepared.”

That motto is my recommendation for parents, caregivers, and children this summer: when summer takes its ugly turn, be prepared to take care of your child, however he or she may be affected.

Although summer consists mostly of laughter and creating fond memories, the season can also be one of the most dangerous times of the year. Dr. James Baker, a physician in the emergency department (ED) at Kaiser Permanente in Baldwin Park, California, noted that there is a 15% to 27% overall increase in ED visits between June and August.1 Although there is a correlating increase in ED visits among children, Baker notes common summer-related injuries that parents, caregivers, and children should be aware of, be prepared to prevent, and be ready to treat, if necessary.

Burns originate from several sources: exposure to the sun’s UV rays, sparks from fires, and touching hot surfaces, to name just a few. They are classified based on the severity of skin and tissue damage, as well as how each burn is treated (see Table 1).1-3

Most sunburns are first-degree burns. However, they can occasionally escalate to a second-degree burn. Points to emphasize for proper skin and sun health during the summer include the following:

  • Stay indoors between 10 am and 4 pm (during the sun’s peak time).
  • Wear long-sleeve shirts and pants that are loose-fitting and lightly colored.
  • Apply sunscreen 15 minutes before going out into the sun, and then reapply at least every 2 hours.

When choosing a sunscreen product, it is important to select one that is labeled “broad spectrum,” as this will protect against UV-A and UV-B rays. Additionally, choosing a product with an SPF between 30 and 50 is advised. Any product with an SPF higher than 50 is not recommended due to there being no additional protection against UV-A and UV-B radiation. Do not expose children 6 months or younger to sunlight or apply any sunscreen product to them.1-4

Spider and Insect Bites and Stings
Summer means camping trips, which may also mean the emergence of bites from ticks, spiders, and other insects. The best way to protect children from stings and bites is to follow these recommendations:

  • Walk in the middle of marked trails.
  • Wear appropriate gear in order to spot insects quicker, such as:
    • Light-colored long-sleeve shirts
    • Light-colored pants
    • Closed-toe shoes and a hat
    • High socks with pants tucked in to them
  • Spray insect repellant on clothes and shoes before entering wooded areas.

If bitten by a tick, use tweezers to gently pull the tick away from the skin until it comes loose and wash the area with soap and water. If either a rash or flu-like symptoms emerge after a few days, talk to your physician. For spider bites, go to the ED if the bite is from a black widow spider or a brown recluse spider; otherwise, washing the area with soap and water will suffice.

For insect stings from a wasp, bee, or hornet, remove the stinger by scraping it out with a knife blade or the side of a credit card; squeezing the stinger will force more venom into the skin. After successful removal of the stinger, apply an ice pack to reduce the swelling. For anyone experiencing anaphylaxis, call 911 or go to the nearest ED.4

Water is essential for nearly every bodily function, including the regulation of core body temperature, and during the summer, its loss is hastened through breathing, sweating, urination, and digestion.

Signs of dehydration may include the following:

  • Severe thirst
  • Dark urine and/ or decreased urine production
  • Fatigue and/or weakness
  • Dry skin and lips
  • Decreased sweating
  • Nausea, faintness, loss of appetite
  • Headache, body aches, muscle cramps
  • Confusion and dizziness

To treat dehydration, encourage children to drink fluids and rest; avoid drinks with caffeine and a high sugar content (eg, soda, energy drinks)1. Move them to a shaded area or an air-conditioned vehicle or building. To prevent dehydration from reoccurring, encourage children to drink plenty of fluids before they feel thirsty.1,2,4,5

Heat Exhaustion and Heatstroke
Although heat exhaustion and heatstroke may sound synonymous, each has different signs (see Table 2) and effective treatment methods. For a child suffering from heat exhaustion, take these steps:

  1. Move the child to an air-conditioned or shady area.
  2. Loosen tight clothing and cool the skin by fanning the child and applying wet cloths.
  3. If the child cannot drink, provide a little cool water and monitor their condition.

For heatstroke, follow the same directions as above and, if available, wrap ice packs in a T-shirt or towel and place them under the child’s armpits and against their neck and groin.1,2,4,5

For additional questions about other summer-related ailments and injuries, such as scrapes, drowning, and foodborne illnesses, contact your pediatrician for more information. Also, sign up to attend a local class on administering proper first aid so that, you too, can follow the Scout motto and truly, regardless of circumstances, be prepared!

Brian J. Catton, PharmD, is the chair of the New Practitioner Network for the New Jersey Pharmacists Association, from which he received the 2014 Distinguished Young Pharmacist Award. His topics of interest include pediatrics, disease state management, professional development, and vaccinations.


  1. Baker J. ER visits peak during the summer months. Kaiser Permanente website. Published July 2, 2014. Accessed May 26, 2015.
  2. Gottschalk J, Perez H, and Mazzuca RJ. First aid. In: Gottschalk J, Perez H, and Mazzuca RJ, eds. The Boy Scout Handbook. 12th ed. Irving, TX: Boy Scouts of America; 2009.
  3. Catton B. Lyme’s disease and drug-induced photosensitivity. Continuing education presentation presented at: Region 6 Meeting of the New Jersey Pharmacists Association; November 7, 2014; Egg Harbor City, NJ.
  4. Cuan D. Let the summer fun begin [press release]. Pasadena, CA: Kaiser Permanente; June 27, 2014. Accessed May 26, 2015.
  5. CDC Office of Women’s Health. Keep kids safe this summer. Centers for Disease Control and Prevention website. Updated June 9, 2014. Accessed May 25, 2015.

Article Written By: Brian J. Catton, PharmD, Pharmacy Times

Why Choose an Independent Pharmacy?

Presentation1These days, shoppers can pick up over-the-counter medicine and prescriptions from any big chain retailer: Target, Wal-mart, Kroger, Walgreens, CVS, Rite-Aid, etc. The convenience of picking up your medicine while shopping for groceries or clothing is appealing to most people.

However, people shouldn’t be so quick to neglect using an independent pharmacy.

There are six reasons why an individual should choose to shop at an independent community pharmacy versus a big chain retailer’s pharmacy. Those six reasons are as follows:

Buying locally from an independent pharmacy supports the local economy.

When customers buy from an independent pharmacy, jobs are created for pharmacists, pharmacy technicians and other staff. Also, a large percentage of the money spent stays in the community as to going to a large chain’s headquarters located in another state.

Customers can get the “Mayberry” experience.

When people think of “The Andy Griffith Show,” one word always comes to mind: friendliness. When you shop at an independent pharmacy, you get this same disposition. In fact, it’s not uncommon for customers to develop personal relationships with the staff. The value is placed on you and not your money – unlike big chain stores, whose service mostly come with rude attitudes and long wait times. You are far more likely do develop a personal relationship with the staff at your local independent pharmacy. A personal relationship ensures great service.

Independent pharmacies have shorter wait times.

Big chain retailers seem to attract big crowds, which in turn, mean long lines. However, independent phartechsmacies will work to have you out in a short time. They realize that you have other things to do besides wait for your medicine.

You can choose from a variety of over-the-counter products.

Despite being major chain retailers, their pharmacy departments don’t always carry that special over-the-counter product you are looking for. Truthfully, you might discover that they carry a limited selection. When you shop at an independent pharmacy, you’ll likely to find a product that helped your mother in her younger years whenever she was sick – now available to heal you as well.

An independent pharmacy offers customers more services.

Have you ever known the big chain retailers to offer free home delivery? Better yet, do they offer home delivery at all? No, they don’t. However, independent pharmacies do. This service is great when you’re too sick to leave your home. Other services you can find at independent pharmacies are blood pressure screenings, prescription compounding, travel immunizations, large supply of durable medical equipment, medication therapy management and a host of other services. Check with your local pharmacy to see what valuable services they offer.

The owner resides in your state and not at another

Chain retailers are headed by corporations in big offices in big cities. Of course, they never meet the people who make their businesses a success. This differs with an independent pharmacy. The owner lives in the same state and likely interacts with the people who make his business successful; particularly since he probably still works there. Furthermore, his business is likely to be family owned.


As you can see, an independent pharmacy has a lot of advantages over large retail chains.

The sad reality is that major retailers only see customers as “business.” Fortunately, an independent pharmacy views its customers as “people they love to serve.” Thus, this is why it’s better to choose an independent pharmacy for your pharmaceutical needs versus the major retail chains.

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Cholesterol and Heart Disease

Nearly 2,200 Americans die of cardiovascular disease daily, with an average of one death occurring every 40 seconds. An estimated 7.1 million Americans have experienced a heart attack during their lifetimes. Those who survive a heart attack often go on to have another. More than 7 percent of Americans have some type of cardiovascular disease, and one out of every six deaths in the United States is due to coronary heart disease alone.1 Eating habits and other lifestyle factors play a large role in determining the risk of heart disease and may prevent or even reverse this condition. In this factsheet we examine the link between cholesterol and heart disease.


Atherosclerosis is a common form of heart disease, in which plaques of cholesterol and other substances (similar to small tumors) form in the artery walls and eventually restrict blood flow. This constricted circulation leads to less oxygen for the heart muscle, resulting in chest pain (angina), usually following exercise or excitement. It also stresses the heart muscle to the point of failure, which is what happens during a heart attack.

What Is Atherosclerosis?

Atherosclerosis is not caused by old age. Examination of American casualties during the Korean and Vietnam wars showed significant atherosclerosis by age 18 or 20.2 Their Asian counterparts, raised on diets consisting mainly of rice and vegetables, had much healthier arteries. The elderly are more likely to have heart conditions not because of genetics, but because they may have indulged in unhealthful habits, like smoking and poor diet, for longer periods of time. Your doctor can tell you if you are one of only about 5 percent of the population with a genetic tendency toward heart disease. Many studies show the connection between lifestyle choices and heart health. An article published by Caldwell Esselstyn Jr., M.D., in the American Journal of Cardiology explains that stenting and bypass surgeries may only be a solution for a minority of patients, while a transition to a plant-based diet free of cholesterol proves to be a more effective treatment.3

In 1948, William Castelli, M.D., began to monitor the population of Framingham, Mass., to study what factors influenced the rate of heart disease.4 Castelli’s study showed that a cholesterol level exists, below where coronary artery disease does not occur. Framingham data show that only patients with cholesterol levels of less than 150 milligrams per deciliter (mg/dl) achieve the lowest coronary artery disease risk. In the first 50 years of the Framingham Heart Study, only five subjects with cholesterol levels of less than 150 mg/dl developed coronary artery disease. Rural residents in Asia, Africa, and Latin America typically have total cholesterol levels of about 125-140 mg/dl.4

What Is Cholesterol?

Cholesterol is not the same as fat. If you had a bit of cholesterol on the end of your finger, it would look like wax. The liver manufactures cholesterol and sends it out to other parts of the body for the production of hormones and cell membranes. Based on the results of the Framingham Heart Study and other research, the ideal cholesterol level is below 150 mg/dl. At that point, coronary artery disease is very unlikely. Unfortunately, nearly 107 million Americans have cholesterol levels more than 200 mg/dl,1 dangerously close to 225 mg/dl, which is the average cholesterol level of coronary artery disease victims.5

According to the 2010 USDA Dietary Guidelines, the federal government’s recommended maximum for dietary cholesterol intake is still as high as 300 mg. Both the American Heart Association and the National Cholesterol Education Program recommend less than 200 mg per day for people at risk for cardiovascular disease.6 The amount of cholesterol in one egg exceeds this recommended maximum amount.

Different Types of Cholesterol

When cholesterol is transported in the bloodstream, it is packed into low-density lipoproteins (LDL), sometimes called the “bad cholesterol.” Although LDL is necessary in limited quantities (LDL delivers cholesterol to various parts of the body), a high LDL cholesterol level can dramatically increase yourrisk of a heart attack.

The Centers for Disease Control and Prevention analyzed data from 2005-2008 that examined prevalence, control, and treatment of high LDL levels. Around 71 million American adults (33.5 percent) had high LDL levels, while only 34 million (48.1 percent) received treatment. Twenty-three million (33.2 percent) had their LDL controlled.7 When cholesterol is released from dead cells it is picked up for disposal by high-density lipoproteins (HDL), the “good cholesterol.”

When doctors measure cholesterol levels, they first look at total cholesterol as a quick way to assess a person’s risk. For a more exact guide, they divide the total level by the HDL level. Heart attack risk is minimized by having a lower total cholesterol and a higher proportion of HDL cholesterol. The ratio of total cholesterol to HDL should be less than 4 to 1.

Unfortunately, the average American male’s ratio is much higher than that, at 5 to 1. Vegetarians, on the other hand, average only about 2.8 to 1.3. Smoking and obesity lower HDL; however, vigorous exercise and foods rich in vitamin C may increase it.


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Age Related Memory Loss

Memory and aging: What’s normal, what’s not

Forgetfulness is a common complaint among older adults. You start to talk about a movie you saw recently when you realize you can’t remember the title. You’re giving directions to your house when you suddenly blank on a familiar street name. You find yourself standing in the middle of the kitchen wondering what you went in there for.

Memory lapses can be frustrating, but most of the time they aren’t cause for concern. Age-related memory changes are not the same thing as dementia.

As we grow older, we experience physiological changes that can cause glitches in brain functions we’ve always taken for granted. It takes longer to learn and recall information. We’re not as quick as we used to be. In fact, we often mistake this slowing of our mental processes for true memory loss. But in most cases, if we give ourselves time, the information will come to mind.

Memory loss is not an inevitable part of the aging process

The brain is capable of producing new brain cells at any age, so significant memory loss is not an inevitable result of aging. But just as it is with muscle strength, you have to use it or lose it. Your lifestyle, health habits, and daily activities have a huge impact on the health of your brain. Whatever your age, there are many ways you can improve your cognitive skills, prevent memory loss, and protect your grey matter.

Furthermore, many mental abilities are largely unaffected by normal aging, such as:

  • Your ability to do the things you’ve always done and continue to do often
  • The wisdom and knowledge you’ve acquired from life experience
  • Your innate common sense
  • Your ability to form reasonable arguments and judgments

What causes age-related memory loss?

  • The hippocampus, a region of the brain involved in the formation and retrieval of memories, often deteriorates with age.
  • Hormones and proteins that protect and repair brain cells and stimulate neural growth also decline with age.
  • Older people often experience decreased blood flow to the brain, which can impair memory and lead to changes in cognitive skills.


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10 Things Your Doctor Won’t Tell You About Your Blood Tests

Typical routine blood tests include the complete blood count, also called CBC, to measure your red and white blood cell numbers as well as hemoglobin and other numbers. This test can uncover anemia, infection, and even cancer of the blood.

Another common blood test is the basic metabolic panel to check your heart, kidney and liver function by looking at your blood glucose, calcium, and electrolyte levels. And to check for heart disease risk, you may have a lipoprotein panel that measures levels of fats in your blood, like good cholesterol (HDL), bad cholesterol (LDL), and triglycerides.

Here are 10 things that your doctor may not tell you about results of blood tests like these, unless you ask.

1. Doctors often skip the good news. Your doctor should discuss all blood test results with you. But often the rule is, “No news is good news.” If your CBC, blood chemistry, and cholesterol results fall within normal ranges, the doctor’s office probably won’t reach out to you about your report. Or they may send you a copy with little or no explanation. Even if things appear normal, be sure to follow up and discuss your blood test with your doctor, nurse practitioner, or nurse, recommends theNational Heart, Lung and Blood Institute. Ask if there have been changes since the last test of the same type, and what those changes mean.

2. What’s considered “normal” differs between men and women. If you compare your blood test results with someone elses, you might be surprised to find differences. For example, the normal reference range for the number of red blood cells in a complete blood count, or CBC test, is between 5 million and 6 million cells per microliter for a man. The normal range is lower for women before menopause, between 4 million and 5 million, likely because of blood loss during menstruation.

3. Results can mean different things depending on your age. Normal levels of hemoglobin, part of the CBC test, vary by age — lower for children and higher for adults. For children, a hemoglobin level of 11 to 13 grams/deciliter (gm/dl) is normal, while for men, a value of 13.5 to 17.5 gm/dl is normal, and it’s 12 to 15.5 gm/dl  for adult women. Age matters for your cholesterol numbers, too. While most people should aim for LDL cholesterol levels below 130 milligrams/dl, levels of 160 to 190 mg/dl or above point to a risk for heart disease and are riskier if you are a man over 45 or a woman over 55, notes the Mayo Clinic.

4. A “positive” test result may not be positive news. Some blood tests look for diseases by searching for molecular markers in your blood sample — among them the sickle cell anemia test, the HIV test, the hepatitis C test, and the BRCA1 or BRCA2 gene test for breast and ovarian cancer risk. Results are considered “positive” when the test finds the disease marker — DNA or protein — that it is looking for. In these cases, a positive test result means you may have the disease or disorder or that you may have been exposed to it in the past.

RELATED: 10 Cancer Screenings Every Woman Should Know About

5. A “negative” test result is usually good news. Negative is not the same as bad when it comes to blood tests. A negative result means that the test did not detect what it was seeking, whether a disease marker or a risk factor for a health condition. When you’ve had a blood test to check for an infectious disease — a rapid blood test for hepatitis C, for example — getting back a negative result is good news — it means the test found no evidence of an infection.

6. False-positive test results happen more often than you might think. The first screening test for a condition often has to be checked by a second, more specific test to find out whether the results are accurate and meaningful for your health. An example is the rapid HIV test, for which false positives are common. In communities where about 1 percent are infected with the virus, two false positive HIV rapid test results are expected for every 10 true positive results, according to the U.S. Centers for Disease Control and Prevention.

7. False-negative test results happen too.Sometimes a test doesn’t pick up evidence of a disease or condition even though you actually do have it. For example, if you had a blood test for hepatitis C and the results came back negative, but you wereexposed to the virus in the past few months, you could still have an infection and not realize it. Getting tested again is a good idea, recommends nurse Lucinda K. Porter, RN, if you think you were recently exposed to this infectious disease.

8. Test values can be different from lab to lab. Lab technicians’ reports compare your blood test results to a range that is considered normal for that laboratory. The lab’s reference range is based on test results from many people previously tested in that lab. This normal range may not be the same as another lab’s, notes the U.S. Food and Drug Administration, so don’t be surprised if you find that a prior blood test report varies from newer reports — the difference could be in the lab.

9. Abnormal results might not be due to a disease. A test result outside the normal range of expected lab values could lead to diagnosis of a disease or disorder. But test outcomes can also be abnormal for other reasons. If you had a blood glucose test and you ate something before the test, or were drinking alcohol the night before or taking certain medications, your result could be temporarily abnormal.

10. Mistakes happen. Although mix-ups of patient blood test samples are rare, they do happen, like in the case of an HIV patient’s sample that was switched with another person’s, accidentally, as reported on ABC News. How your blood sample is handled even before it’s analyzed can affect results, too. For example, if the technician shakes your blood sample in the collection tube, blood cells break open, releasing their contents and potentially changing the test results.


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Treating Gum Disease Might Help Prostate Symptoms

By Robert Preidt

    FRIDAY, May 22, 2015 (HealthDay News) — Treating gum disease may help reduce symptoms of prostate inflammation, which can make urination difficult, a small study suggests.

Previous research has shown a link between gum disease and prostate inflammation — called prostatitis.
The study included 27 men, age 21 and older, who had prostatitis and moderate to severe gum disease. The men underwent treatment for gum disease and showed significant improvement in their gums within four to eight weeks, the study authors said.

The men received no treatment for their prostatitis, but symptoms of the condition improved in 21 of 27 of them after their gum disease was treated, according to the study published recently in the journal Dentistry.

“This study shows that if we treat the gum disease, it can improve the symptoms of prostatitis and the quality of life for those who have the disease,” corresponding author Dr. Nabil Bissada, chair of periodontics at Case Western Reserve University in Cleveland, said in a university news release.

Gum disease affects more than the mouth. It also can cause inflammation in other parts of the body, Bissada said. Previous research at Case Western had found a link between gum disease and fetal deaths, heart disease and rheumatoid arthritis, the researchers said.

Bissada said he wants to make gum disease treatment a standard part of treatment for prostate disease, much like dental checkups are advised before heart surgery or for women who are pregnant or considering pregnancy.


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Hand Grip Could Predict Heart Health

A doctor making the shape of a heart with their hands.   Researchers are considering a simple, low-tech screening test that may predict your risk for death,heart attack or stroke: the strength of your hand. A new study of approximately 140,000 patients ages 35 to 70 from 17 countries indicates that grip strength is a reliable indicator of death from any cause, but particularly heart disease. The findings were published in The Lancet.

“Grip strength could be an easy, inexpensive test to assess an individual’s risk of death and cardiovascular disease,” Dr. Darryl Leong, study author and assistant professor of medicine at McMaster University in Hamilton, Ontario, told Yahoo News.  “Doctors or other health care professionals can measure grip strength to identify patients with major illnesses such as heart failure who are at particularly high risk of dying from their illness.”

Each 11-pound decline in grip strength was linked to a 16 percent increased risk for death from any cause, 17 percent increased risk for cardiovascular death and a 17 percent greater risk for death not associated with heart disease. The findings also suggest a 7 percent increased risk for heart attack and 9 percent increased risk for stroke. Further research is being conducted to determine whether or not improved hand strength could reduce the risk for death or heart disease.


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