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Every week, the Pharmacy Self Care Program (from the Pharmaceutical Society of Australia) publishes a Health Care Facts column.  This also appears in the Herbert River Express every week.

For your convenience, they will be published here - feel free to browse back over past editions.

 



John Bell Column 14 Apr 2012

Pharmacy Self Care Health Facts Column
By John Bell –14 Apr 2012

 

 

Mosquitoes – more than a minor inconvenience

 

When, later this month, most of us in Australia and New Zealand will be reflecting on the service provided by the men and women in our armed forces, much of the rest of the world will focus its attention on a tiny insect which, over centuries, has changed the course of history and in the process killed more people than all wars put together.

That insect is the so-called Anopheles mosquito which carries the malaria parasite. And 25 April is World Malaria Day.

Whilst it’s difficult to determine the exact number of annual worldwide deaths from malaria (many of the worst affected countries are too poor to have reliable health statistics), a reasonable estimate is around 1 million – mostly in Africa, many of them children.

Most cities of the Western world are now malaria free. However, that wasn’t always the case. Malaria is one of the oldest diseases in human history. There is some evidence that it plagued populations pretty much throughout the world as far back as 6,000 BCE. As recently as several hundred years ago, malaria spread from the Arctic town of Archangel in Russia to Argentina and to what is now Australia in the southern hemisphere.

During the Middle Ages malaria was widespread throughout Europe. Henry VIII suffered malaria as a young man.  Lord Nelson during the Battle of Trafalgar had to contend with the fever of malaria as well as his regular bouts of sea sickness. Another sailor of renown, J. F. Kennedy, contracted malaria, apparently while in the Solomon Islands in the 1940s.

According to the World Health Organization (WHO) Roll Back Malaria website, there are now 103 so-called malarious countries throughout the world – chiefly the tropical and sub-tropical areas of Africa, Asia the Middle East and Latin America.

Half of the world’s population is at risk of malaria, particularly those living in lower-income countries; but travellers from malaria-free areas to disease “hot spots” are especially vulnerable to the disease.

Ancient remedies included the wearing of a large fish tooth to ward off the evil spirits. Later treatments fortunately proved more successful. By far the most significant was the bark of the Peruvian cinchona tree, which was supposed to have been introduced into Europe via Rome by Jesuit priests in the mid 17th century. Despite some quite encouraging results this bark from the “fever tree” was not universally accepted for some time. It did not cure all fevers (only those of malaria), and adulterated or alternative barks were often promoted by unscrupulous dealers.

Quinine, the active ingredient from cinchona is still occasionally used as a treatment today, however, somewhat better, especially against drug-resistant malaria, are the combination products containing artemisinin, originally extracted from the ancient herb “sweet wormwood”. And recently US scientists at the Oregon Health and Science University in Portland have identified a new drug which is likely to be even more effective against the species of parasite causing the most dangerous form of malaria; still, it could be several years before we see it on pharmacy shelves.

Except for the occasional case, Australia is malaria free; but for how long? Climate change, population growth and migrating mosquitoes could alter that situation. Scientists in Victoria, Queensland and Papua New Guinea are currently collaborating on the development of malaria vaccine. Meanwhile, prevention is the best course of action.

If you’re travelling overseas, check whether anti-malarials are recommended. Be sure to apply insect repellent, cover up after sun-down and use bed-nets (preferably insecticide impregnated) at night. No mosquito bite – no malaria.

You can get more information about malaria and other travel health issues from pharmacies providing the Pharmaceutical Society’s Self Care health information. Log onto the website, www.psa.org.au and click on Self Care then Find a Self Care Pharmacy for the nearest location.

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Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.

 
John Bell Column 07 Apr 2012

Pharmacy Self Care Health Facts Column
By John Bell –07 Apr 2012

 

 

Relieving the pressure of heart disease

 

On April 7 each year, the World Health Organization (WHO) selects and highlights a major world health issue. This year the theme is High Blood Pressure.

Of course, having some blood pressure is vitally important. It’s what keeps those life- sustaining, oxygenated red blood cells circulating around our body. But too much blood pressure can result in a catastrophic outcome – just like a pressure cooker on high heat without an escape valve.

Blood pressure is designated by two readings. The higher of these (the systolic) is a measure of the pressure when the heart is beating and the lower reading (the diastolic) is a measure of resting pressure – when the heart relaxes. Blood pressure is usually measured in millimetres of mercury – abbreviated to “mmHg” – and if the systolic reading is equal to or above 140 mmHg and/or the diastolic reading equal to or above 90 mmHg then the blood pressure is considered to be high.

Hypertension (the medical term for abnormally high blood pressure) has been designated by the WHO as one of the most serious risk factors for death worldwide.  It is estimated that about 30% of Australian adults have hypertension; and most of these people are receiving no treatment.

What makes hypertension so serious is that, well before the explosive heart attack or stroke occurs, there is underlying, sometimes irreparable damage done to the cardiovascular system, the kidneys and the brain.  Also, hypertension, especially when combined with diabetes, significantly increases the risk of blindness.

In most cases the actual cause of high blood pressure can’t be identified, but we do know what groups of people are most at risk of developing hypertension; and we do know ways whereby we can reduce the risk.

There are usually no symptoms of hypertension; at least generally not until the blood pressure reaches a sustained dangerous level. So, if there is a history in the family of heart disease, kidney disease or diabetes, a regular – at least yearly – check up with your GP is essential.

If you do have hypertension, regular and long term treatment with medication will most likely be a necessity.  Understanding how these blood pressure medicines work is helpful; and your pharmacist can provide you with so-called Consumer Medicines Information (CMI) which explains the benefits and the occasional problems you may encounter.  Uncomfortable side effects with anti-hypertensive therapy can sometimes be experienced, especially in the early stages of treatment, so it’s nice to know what to expect.

For more information about hypertension ask for the Blood Pressure fact card at one of the nearly 2,000 pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information.  There are also cards on Diabetes, Weight and Health, Exercise and the Heart, and Staying a Non-Smoker.

Taking ownership of a medical condition will often help improve outcomes. With hypertension this can sometimes be achieved by the use of home blood pressure measuring devices.  The modern machines are simple and easy to use.  Check with your doctor whether one of these could be an advantage.  And if you have trouble remembering to take your blood pressure tablets, a “dose administration aid” or medication blister pack could help.

It’s as well to remember that there are some medicines – both prescription and non-prescription medicines – which can cause or worsen hypertension.  This includes some pain relievers, anti-depressants, oral contraceptives, cough and cold products and various herbal preparations.  If you have high blood pressure, always check first with your pharmacist before self selecting another medicine.

Meanwhile, for the location of the nearest pharmacy where you can pick up those Self Care fact cards, phone the Pharmaceutical Society on 1300 369 772 or log on to the website at www.psa.org.au and click on “Self Care” then “Find a Self Care Pharmacy”.

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Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.

 
John Bell Column 27 Mar 2012

Pharmacy Self Care Health Facts Column
By John Bell –27 Mar 2012

 

 

TB continued

 

The World Health Organization (WHO) has declared TB to be a global health emergency and designated 24 March each year as World TB Day. The theme this year was “stop TB in my lifetime”; a very ambitious aim. Certainly, hopes that TB might be eradicated by 2025 have all but evaporated as a variety of medical and social factors resulting in the emergence of multi-drug resistant strains present a new challenge in the battle against TB.

The TB infection is carried by two billion people – almost a third of the world’s population – and there are an estimated two million deaths every year.  TB is a contagious disease which spreads through the air.  When actively infectious people cough, sneeze, talk or spit they propel the TB organisms into the air.  Only a small number of these organisms (called bacilli) need to be inhaled for people to become infected.  In poorly ventilated and enclosed environments bacilli can remain airborne for hours.

Of course TB is not new.  Genetic evidence gathered from archaeological excavations in the eastern Mediterranean has indicated strains of TB existed nine thousand years ago; and fragments of spinal column from Egyptian mummies from 2,400 BCE show definite signs of TB.

In the early eighteenth century it was suggested that TB could be caused by “wonderfully minute living creatures” and 150 years later the actual organism (mycobacterium tuberculosis) was identified by Dr Robert Koch. When he announced his discovery in 1882, TB was raging through Europe and the Americas; and was responsible for one in every seven deaths

Up until then and indeed really until the middle of the last century, so-called sanitorium care – rest, fresh air and good nutrition – provided the only even mildly effective treatment. Real success came in the 1940s with the development of the antibiotic streptomycin. Though streptomycin has potentially side effects; and monotherapy (treatment with one drug) quickly results in resistant strains of the bacteria.

However, with proper treatment almost all cases of TB are curable. Generally a TB patient must take four different antibiotics for at least two months then two antibiotics for four more months. But because the medicines often cause unpleasant side effects and patients start feeling better a month or so, not everyone completes the full course. As well, in many less developed countries where TB is most common, drug supplies may be inadequate.

According to the Global Tuberculosis Institute at the New Jersey Medical School in the US, while wealthy industrialised countries with good public health systems can be expected to keep TB under control, in much of the developing world a catastrophe awaits.

In contrast to most of the rest of the world, Australia is fortunate in having a relatively low but nevertheless constant pattern of TB.  There is an average of about 1,000 cases a year. This is primarily due to re-activation of a dormant infection in people who were first infected in another country before emigrating to Australia; or who may have been originally infected during their childhood in Australia when the TB rates among the general community were much higher.

But wherever TB exists, successful treatment will depend on early and accurate diagnosis, correct selection of medication and patient adherence – that is taking the right dose for the appropriate length of time.

Naturally these principles apply to the treatment of all medical conditions, especially infectious diseases.

For more advice about the use of antibiotics, ask for a fact card at one of the two thousand pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. For the nearest location, log on to www.psa.org.au and click on “Self Care” then “find a Self Care Pharmacy”. And if you want more specific information about World TB Day, go to the WHO website www.stoptb.org

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Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.

 
John Bell Column 20 Mar 2012

Pharmacy Self Care Health Facts Column
By John Bell –20 Mar 2012

 

 

Flu vaccine; who really needs it?

 

Each year in Australia, influenza causes an estimated 3,000 deaths in older people.  There are also the economic costs to the community of more than one and a half million lost work days, 300,000 doctor visits and 18,000 people admitted to hospital.

However, it’s not just older people who are affected by the flu. The fact is, rates of flu infection are highest among young children; although children under the age of five are less likely to show typical symptoms of the flu – the fever and the cough – so you may not know that your child has actually contracted the infection.

Most children cope pretty well with the flu but young children are especially vulnerable to new strains of the flu such as the “swine flu” which was first identified in 2009. Their underdeveloped immune systems can’t manage the invading virus.

So the flu virus picks its victims, singling out those people least able to resist the adverse effects. The greatest concern for doctors and patients alike is the danger, not just of the flu itself, but of severe complications such as pneumonia and the effect of influenza on existing medical conditions.

People with chronic heart, kidney or lung disease, diabetes or other long-term illnesses are particularly at risk.  The stress caused by influenza can worsen these conditions and even cause premature death.

Today, prevention is our major weapon against influenza. You can help protect yourself by making sure your lifestyle is healthy with regular exercise you enjoy and a daily diet that includes the widest possible variety of foods. And, of course, annual vaccination against the flu is recommended for all people in high risk categories.

Everyone 65 years or older should have the flu vaccine. As well, at any age, you should be vaccinated if you have an ongoing illness such as diabetes, kidney disease, asthma, heart or circulation problems, or compromised immunity as a result of HIV, cancer or longer-term steroid use.

Now there is also a special effort to ensure people who might spread the infection to the above groups are vaccinated. This includes health workers – doctors, dentists, nurses, pharmacists, carers and even children. There is mounting evidence that widespread vaccination of children against influenza slashes infection rates in both children and the more vulnerable elderly. This year, once again, only certain brands of flu vaccine are recommended for children under 10 years of age (following evidence of some adverse effects in young children a couple of years ago with a particular brand of vaccine). Your doctor or pharmacist can give you more details.

The formulation of influenza vaccine for use in Australia is determined by the Australian Influenza Vaccine Committee based on information and recommendations from the World Health Organization  (WHO). The composition of the 2013 vaccine includes killed strains of the viruses first identified in Wisconsin in 2010 and in Victoria in 2011 as well as the so-called H1N1 swine flu.

As in previous years, the Australian Government will provide flu vaccine free of charge to everyone 65 years plus; and those people qualifying for the “free allocation” also include pregnant women, indigenous people 15 years and over, all residents of nursing homes and long care facilities and anyone six months of age and over with a condition “pre-disposing to severe influenza illness” – such as heart or lung diseases.

You can get more advice about whether the flu vaccine is right for you from pharmacies around Australia providing the Self Care health information. Phone the Pharmaceutical Society (PSA) on 1300 369 772 for the nearest location, or visit the website at www.psa.org.au and click on "Self Care" then "Find a Self Care Pharmacy".

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Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.

 
John Bell Column 13 Mar 2012

Pharmacy Self Care Health Facts Column
By John Bell –13 Mar 2012

 

 

Keeping well whilst getting older

 

The prime objective of the Council on the Ageing (COTA) is to promote, improve and protect the circumstances and wellbeing of older people in Australia.

COTA claims to be the voice of seniors over the age of 50; although in the 21st century most 50 year olds wouldn’t consider themselves old or even ageing. Regardless of our own age, we generally think of someone else as being old if they’re about 10 years older than we are.

The Australian Seniors Card is provided to people over the age of 60 (subject to certain criteria if offers some discounted products and services), but from a medical point of view, the definition of a “senior” seems to be 65 – when for instance free flu vaccine is available.

Whatever definition of ageing we use, we know our population is ageing.  That is people in older age groups are increasing in number as a proportion of the total population. As an example, people in the 70 plus age group currently account for about 10% of our population in Australia; by 2050 this is expected to increase to about 20%.

From a personal point of view longer life expectancy is generally a good thing; but sometimes a costly thing for the community. Unfortunately, one of the side effects of living longer is that we are more likely to suffer with illness. Heart disease, kidney disease, diabetes and some types of arthritis are all more common in older people

Medicines are often the best way to manage the symptoms of these conditions; so it’s probably not surprising that the oldest 10% of the population use more than 20% of all prescribed medicines.  That’s enough to give any government a financial headache; and bound to put health firmly on the political agenda – especially in an election year.

Of course, old age doesn’t have to mean ill health.  A study in the USA has shown that on average elderly people are growing healthier, happier and more independent; and according to a report in New Scientist magazine, the diseases of old age are actually affecting fewer people and, when they do strike, it is much later in life.

Whatever our age or physical condition, there is no doubt that we benefit most when we personally take control of our health as much as possible.  This includes making informed decisions – decisions based on the answers to questions we should ask doctors, pharmacists, nurses and other health providers.

For instance, when we go to the doctor we could ask: “What is wrong with me and how long will it last?”  “What can I do to help myself get better?”  “If I need a medicine, what is its name, what does it do, and how long should I take it?”

These questions and quite a few others are listed on the Wise Use of Medicines Fact Card, which is available from pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. Your pharmacist can print out a copy of the card for you.

 

There are also fact cards available on some other topics which could be of special interest to us as we get older – topics such as Arthritis, High Blood Pressure, Osteoporosis, Prostate Problems, Preventing Falls, Carer Support and Sleeping Problems.

COTA programs are implemented by way of state and territory-based affiliates, two of which celebrate Seniors Week 17 to 24 March. Of course, there are opportunities for all older Australians to stay fit and well all year round. The COTA website provides some good suggestions.

And to get a copy of those all important fact cards, check out the Pharmaceutical Society’s website at www.psa.org.au and click on “Self Care” then “Find a Self Care Pharmacy” or call 1300 369 772.

Article courtesy of the Pharmacy Self Care Program, an initiative of the Pharmaceutical Society of Australia.

 
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