The emerging field of pharmacogenomics holds cost cutting promise
By Dr. Anthony Policastro
When physicians prescribe drugs to treat a patient's condition, they often have a wide range of drugs to choose from. In most cases, it does not really matter which drug they select but in some cases it does. For example, sometimes it is easy to choose an antibiotic. Strep throat always responds to penicillin. Therefore, it is easy picking the right drug. Other infections may respond to many antibiotics. In these cases it does not matter which antibiotic is used. However, some infections are caused by bacteria that are resistant to multiple antibiotics. For this reason it is harder to find the right drug to use. In those instances, we might have to grow the bacteria in the lab and then we can find out what antibiotic it is sensitive to. Another factor that determines which drug we select is drug interactions. There are many drugs that interact with each other and it is important to know the other drugs a person is using before prescribing a new one. There are times when outside factors can interact with the drugs we prescribe. These may include the foods we eat, what we are exposed to in the environment and our age. A new factor to consider when prescribing drugs is pharmacogenomics which refers to the study of how an individual's genetic inheritance affects the body's response to drugs. The term comes from the words pharmacology and genomics and is thus the intersection of pharmaceuticals and genetics. Pharmacogenomics holds the promise that drugs might one day be tailor-made for individuals and adapted to each person's genetic makeup. Pharmacogenomics combines traditional pharmaceutical sciences such as biochemistry with additional knowledge of genes. We already see hints of this in practice. We know that the metabolism of ADHD drugs tends to run in families. What works well in some families may not work as well in others. I have already written in the past about how a certain type of gene in a developing fetus will result in behavior problems later on if the mother takes antidepressants. There are many things that we need to think about in the new field. One of those is drug development. Once we understand the way drugs interact with genes, we can develop drugs for those genes. That means we would be able to focus the drug on its real effects which would allow for a decrease in side effects. The second advantage would be allowing the physician to know which drug to prescribe in the first place. It would be similar to testing bacteria in the lab to find out what antibiotic they are sensitive to. We would be able to check a person's genes to know which drug they will respond better to. We would also be able to check and see which drug would cause fewer side effects. Once we understand how different people metabolize a drug, it would allow us to decide on the correct dose. If their genetics say they burn the drug up quickly, we would give a higher dose. If they burn the drug up more slowly, we would give a lower dose. The study of genes will allow us to create better immunizations. They would be more focused in their effects. They would have less side effects. All of these improvements will ultimately be able to cut the cost of health care. We would not have to try as many drugs that don't work so we would save on drug waste. We would see fewer side effects. The treatments would be more effective. All of these things would be cost effective. This field is still brand new. However, we will all likely be hearing more about it in the future. We may someday go to the doctor and have him/her choose our treatment based on our genes and not on our illness.
Super Bowl parties can ruin a diet When you're at your favorite Super Bowl party in February, you may get flagged for holding too many greasy chicken wings, or may find yourself offsides in the race to reach the nachos. According to Bayhealth Outpatient Dietitian Dawn Santacrocce, MBA, RD, LDN, you should tackle each party by surveying the available party foods the same way Peyton Manning reads the defense when he comes to the line of scrimmage. Which foods are the highest in fat? Which are loaded with calories? Call an audible to avoid these foods, which are sure to sack your diet: Buffalo wings. Six wings translate to 600 calories and 40 grams of fat, and that's before you drown them with Bleu Cheese Dressing. Nachos. One plate of these loaded with beef, cheese, sour cream, and guacamole may carry up to 1,500 calories, eight grams of fat, and up to 1,500 mg of sodium. You shouldn't have more than 2,000 mg of sodium each day! Spinach artichoke dip. One quarter of a cup could give you 350 calories, 20 grams of fat and 700 mg of sodium. Layer dip, including cream cheese, sour cream, shredded cheese, guacamole, and high fat ground beef can carry 4,000 calories per serving. For more information about Bayhealth Outpatient Nutrition, contact Dawn Santacrocce at 744-6828.
Hospice Lunch Bunch Lecture Delaware Hospice's Family Support Center will hold a Lunch Bunch Lecture on Friday, Feb. 3, where Dr. Judy Pierson, clinical psychologist, will discuss "Holding On & Letting Go: Sorting through Memories after Loss," at the Delaware Hospice Center, 100 Patriots Way, Milford, from noon to 1:30 p.m. Following a loss, some people clean out the closet as quickly as possible because the memories are just too painful. Others leave entire rooms just the way they were before their loss. How do you decide what to keep and what to let go of when someone you love dies? This workshop will focus on dealing with the emotional challenges of letting go which include renewed feelings of grief and even guilt. Lunch Bunch Lectures are organized by Delaware Hospice's Family Support Center and are open to the public. Registration is required as seating capacity is limited, and the cost of lunch is $5 per person. Register by Wednesday, Feb. 1, by contacting Vicki Costa at 856-7717, ext. 1129 or email@example.com.
Hospice holds grief support group Delaware Hospice will hold a six-week Grief Education Group for widows, widowers and life partners beginning Feb. 7, at the Delaware Hospice office, 315 Old Landing Rd., Millsboro. Specific dates are: Feb. 7, Feb. 21, Feb. 28, March 6, March 13 and March 20. This group will address the struggle that men and women face after the loss of their spouse or life partner. Participants will have the opportunity to examine the challenges they have faced with others who have experienced a similar loss. The group will be led by Midge DiNatale, GC-C, bereavement counselor, who will offer thoughtful and practical ideas to help rebuild your life in the absence of your loved one. Resources and reading materials will be provided at each session. There is no fee for this community outreach program; however, space is limited so registration is required by Friday, Feb. 3. Register or learn more by contacting Midge DiNatale at 302-416-0581 or firstname.lastname@example.org.
Radioactive items removed The Delaware Division of Public Health (DPH) confirms that on Jan. 12 it identified metal tissue box holders containing low levels of cobalt-60 radioactive material at the Bed, Bath & Beyond store on Brandywine Parkway in Wilmington. The items, the Dual Ridge Boutique tissue box, model number (DR9M), were immediately removed from store shelves and secured. The Nuclear Regulatory Commission (NRC) had notified DPH and the Bed, Bath and Beyond on Jan. 11 of potentially contaminated items being shipped to their stores, but only one store in Delaware received the items and store records indicate that none of the contaminated tissue boxes had been sold. The product was available on the Bed, Bath and Beyond website prior to the recall, but has since been removed from the site. Bed, Bath and Beyond has posted information on these products on Bedbathandbeyond.com and urges customers to call the company at 1-800-462-3966 with any questions or concerns. Cobalt-60 is a man-made, radioactive product that has many uses, including sterilizing medical equipment and is a source for leveling devices and thickness gauges used during the production of metal products. It has been used for many years in radiation therapy for cancer patients. The level of radiation exposure from holding this product against the body for one hour would be equivalent to a chest X-ray.
'Soul Collage' workshop The Family Support Center will hold a special workshop, "Soul Collage: A Creative Tool for Self-Discovery," presented by Dr. Judy Pierson, clinical psychologist, on Friday, Feb. 3, from 2 to 5 p.m., Delaware Hospice Center, Milford. Lowered self-esteem and loss of identity are common symptoms of grief, often experienced but not always recognized. Through creating your own Soul Collage, you will discover or re-discover the "real" you. In doing so, self-esteem can be improved just as you begin to recognize your own, unique identity. This workshop is free and open to the public; however, registration is required. Register or learn more by contacting Vicki Costa at 856-7717, ext. 1129, or email@example.com.
First influenza type B confirmed Delaware's Division of Public Health (DPH) reports the state's first laboratory confirmed case of type B influenza for the 2011-2012 flu season in a 56-year-old female from Sussex County. The individual had been hospitalized but was discharged Jan. 8 and is recovering at home. This brings the total number of confirmed flu cases statewide to four; the first three confirmed cases were all type A/H3. There are two main types of influenza (flu) virus: Types A and B, and both are routinely responsible for seasonal flu epidemics each year. DPH monitors the occurrence of influenza-like illness in hospitals, selected long term care facilities and medical clinics to track flu trends in the state. Reports thus far indicate Delaware has sporadic flu activity. "At best, we're in for a bad week when we get the flu," said Dr. Karyl Rattay, DPH director, "and knowing it could have been easily prevented makes it worse. This year's influenza vaccine provides protection against two type A strains and the B strain." DPH urges all Delawareans 6 months of age and older who have not yet been vaccinated against the flu to get a vaccine as soon as possible. The vaccine is readily available through medical providers, pharmacies and some grocery stores. For more information about how to obtain your flu vaccine go to: http://www.dhss.delaware.gov/dhss/dph/index.html.
2012 Relay for Life Kick-off Party The Relay for Life of West Sussex Delaware will have a kick-off party at the Elks Lodge in Seaford on Tuesday, Jan. 24 at 6:30 p.m.
The kick-off party is open to the community and all are invited. There is no cost to attend and this is not a fundraising event. The kick-off party is to inform the community and increase participation in the night long Relay for Life event held the first weekend in June. The American Cancer Society raises money through the Relay for Life event for cancer research and to support cancer patients, survivors and their families. Relay began in 1985 in Tacoma, Wash., when a doctor walked around a track for 24 hours to raise money for the ACS. Now there are more than 5,000 communities that have Relay for Life events, involving more than 3.5 million people. Relay is a chance to celebrate survivors, remember loved ones lost to the disease and fight back by making personal commitments to taking action and saving lives. Join us for a night of fun, music and celebration as we kick off another Relay season!
Stroke and osteoporosis screenings Residents living in and around Seaford can be screened to reduce their risk of having a stroke or bone fracture. Woodland United Methodist Church will host Life Line Screening on Wednesday, Feb. 8. The site is located at 5123 Woodland Church Rd., Seaford. Four key points every person needs to know:
Screenings identify potential cardiovascular conditions such as blocked arteries and irregular heart rhythm, abdominal aortic aneurysms, and hardening of the arteries in the legs, which is a strong predictor of heart disease. A bone density screening to assess osteoporosis risk is also offered and is appropriate for both men and women. Packages start at $149. All five screenings take 60 to 90 minutes to complete. For more information regarding the screenings or to schedule an appointment, call 1-877-237-1287 or visit www.lifelinescreening.com. Pre-registration is required.
- Stroke is the third leading cause of death and a leading cause of permanent disability
- 80% of stroke victims had no apparent warning signs prior to their stroke
- Preventive ultrasound screenings can help you avoid a stroke
- Screenings are fast, noninvasive, painless, affordable and convenient
Diabetes Support Group offered Nanticoke Memorial Hospital, Seaford, will hold a free diabetes support group on Monday, Jan. 23 from 5 to 6 p.m., at the hospital. Are you struggling to make positive behavior changes in your life or would you just like to share with others coping with diabetes? Come join our free support group for individuals with diabetes. On Jan. 23, the group will feature Dr. Francisco Padilla, endocrinologist, speaking on the topic "How An Endocrinologist Can Help Someone With Diabetes." There will also be a question and answer period. Registration for this support group is required. To register for this free group and to obtain additional information, contact Nanticoke Memorial Hospital's Diabetes Education department at 629-6611, ext. 2446.
Alzheimer's Support Group Nanticoke Memorial Hospital's next Alzheimer's Support Group meeting is at 1:30 p.m. on Tuesday, Feb. 14, at LifeCare at Lofland Park's first floor Resident Lounge, 715 E. King St., Seaford. This group provides support and information about Alzheimer's and dementia to families, caregivers and anyone who is affected by this disease. Refreshments will be provided. Pre-registration is not required for this free support group. For more information, contact LifeCare at Lofland Park at 628-3000, ext. 8302.
CPR classes offered Nanticoke Memorial Hospital will offer community CPR classes to anyone interested in learning CPR at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn how to perform the basic skills of CPR on adults, children, and infants and how to help an adult, child or infant who is choking and use of the AED. This classroom-based, video and instructor-led CPR course offers families, friends and community members the opportunity to learn CPR and need a course completion card. Classes are open to participants 12-years-old and up. This program is specifically designed for those who prefer to learn in a group environment with feedback from an instructor. The target audience is those who have a duty to respond to a cardiac emergency because of job responsibilities or regulatory requirements. Cost is $40. Payment and registration is required by no later than five business days prior to the class. Late registrations may be accepted if seating is available. To register and to obtain a listing of class dates/times, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.
Run to the Plunge 5k The Run to the Plunge 5K to benefit Special Olympics Delaware is Saturday, Feb. 4 at 1 p.m., at Rehoboth Avenue and the Boardwalk, Rehoboth Beach. Entry is $20 ($25 day of). Amenities include long-sleeve t-shirts and refreshments. Awards to the top three overall male and female champions, top male and female masters, and top three in 5-year age classes. For more information, call 302-831-4653 or email firstname.lastname@example.org. Register online at www.plungede.org.
Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. To learn more, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.
Tobacco relapse support group Bayhealth Medical Center is pleased to offer a new support group for individuals who recently quit using tobacco products. The "Tobacco Relapse Prevention Support Group" will meet from 5:30 to 7 p.m., on Jan. 25, March 20, May 22, July 24, Sept. 11 and Nov. 8, 2012. The group will meet in Bayhealth's BETT Conference Room at 208 W. Water St. in Dover. This support group is designed to help individuals focus on relapse prevention and provides networking opportunities for participants to share their unique experiences and success stories with others. There is no need to register in advance for this support group For more information, contact Bayhealth Educator Terry Towne, MSN, RN-BC, NE-BC, at 302-744-6724.
NAR-ANON support group "Take Heart, Be Strong" is a support group available to those family members and friends who are concerned about the drug/alcohol addiction of a loved one. We find people in NAR-ANON who understand what we are going through and are ready to share their experience, strength and hope to help us. This group meets at 7 p.m. every Thursday in the Youth Room at Crossroad Community Church, 20684 State Forest Rd., Georgetown. If you are interested or know someone who might be, call Beth at 302-745-0466. This is an anonymous program and there are no obligations. Attendance is welcome with no prior arrangements. For more information and other meeting locations, visit www.nar-anon.org.
Relay for Life fundraiser Dr. Marie Wolfgang is again sponsoring a 12 night Winter Getaway Cruise to the Southern Caribbean as a fundraiser for Relay for Life, sailing from Cape Liberty, N.J. on Feb. 10. The itinerary includes St. Thomas, St. Kitts, St. Johns (Antigua), St. Lucia and St. Maarten (Philipsburg). Transportation to and from the dock is available. For a brochure, call or visit Dr. Wolfgang's office at One Cedar Ave. in Seaford, 629-4471. Space is limited.
Bereavement luncheons Delaware Hospice's "New Beginnings" bereavement luncheons are an informal way to meet and talk with others, who have had similar loss experiences. Lunch begins at noon and is followed by a brief program. The location rotates each week of the month throughout Sussex County. "New Beginnings" luncheons are open to the public. Registration is not required. There is no fee except the cost of your lunch. For more information, call Midge Dinatale or Paul Ganster at 856-7717.
New depression support groups If you have been diagnosed with depression, are currently receiving treatment and need extra support, join the Mental Health Association in Delaware's newest depression support groups. The support groups provide a safe and comfortable environment for adults who may be struggling with depression to find others who may be going through similar experiences, learn coping skills and take back control of their life by being proactive. A support group meets in Seaford every Wednesday from 6 to 7:30 p.m. The location of the meeting is provided only to registered members. To register, contact the Mental Health Association in Delaware at 302-654-6833 or 800-287-6423. These new groups are made possible due to a grant received from Blue Cross Blue Shield of Delaware's BluePrints for the Community program.
Black & White Gala is Jan. 21 It will be an evening of elegance and entertainment to benefit the central and southern Delaware communities. The 2012 Black & White Gala will be held on Saturday, Jan. 21, at the Dover Downs Conference Center from 6 to 11 p.m. The Kent General Hospital Junior Board will donate its proceeds from this event towards the construction of new welcome areas at the Kent General Hospital Cancer Center, while the Milford Memorial Hospital Auxiliary will donate its proceeds towards the purchase of new ventilators in the Milford Memorial Hospital Respiratory Therapy Department. The gala will feature entertainment by the Funsters, hors d'oeuvres, cocktail hour, dinner and a cash bar. A live auction will include a 14 karat yellow gold Citrine quartz and diamond pendant donated by Sayers Jewelers and Gemologists in Smyrna. Cost is $100 per person. Sponsorships are also available. Tickets may be purchased online at www.bayhealthfoundation.org or by calling 302-744-7015.