Indianapolis Recorder, Indianapolis, Marion County, 11 November 2005 — Page 18

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THE INDIANAPOLIS RECORDER

FRIDAY, NOVEMBER 11, 2005

Pharmacist shortage worsens nationwide

(AP) — Unlike most college students nearing graduation, Clarissa Hall isn’t worried about finding ajob - she’s already considering several offers, including some with possible starting salaries of at least $80,000. Hall is benefiting from a nationwide shortage of pharmacists, which has prompted fierce competition between employers for new pharmacy graduates. The shortage of pharmacists, though, is not good for others in the medical field, or their patients, say those who have been watching the shortage worsen over the last decade. It was fueled by several factors, especially changes in insurance policies and federal regulations of pharmaceuticals, which made drugs available to more people. Add to that an aging population and more drugs being manufactured and advertised to the public, and the number of prescriptions has increased from 2 billion to 3.2 billion in the last decade. That problem is expected to worsen after the new Medicare prescription drug program begins Jan. 1, pharmacy officials said. Independent and chain pharmacies, hospitals and nursing homes are scrambling to find people to fill orders.

The National Association of Chain Drug Stores reported about 5,950 fulland part-time openings in July in its 37.000 member stores. The American Hospital Association reported a 7-4 percent vacancy rate for pharmacists as of December, 2004, with 38 percent of its members saying it was harder to recruit pharmacists last year than in 2003. The National Community Pharmacists Association, which represents independent pharmacies, does not keep track of job openings. A consortium of pharmacy groups called the Pharmacy Manpower Project issued a report in 2002 predicting 157.000 unfilled pharmacy openings by 2020. The need to fill all those new prescriptions has been partially addressed by an increase in technology and the use of pharmacy technicians, said Dr. David Knapp, dean of the School of Pharmacy at the University of Maryland. But that hasn’t addressed increasing pressure on pharmacists to become more involved in helping patients manage their drugs, especially elderly patients who may take several medicines, said Knapp, who coordinated the conference that released the Manpower report. “Every hour of every day, dozens if not hundreds of prescriptions are coming

across the counter,” he said. “They are trying to do that while at the same time counseling patients, calling physicians, helping diabetic patients manage eight or 10 medicines, teaching parents how to help their child use his new asthma inhaler. It’s a real stressed out situation for pharmacists.” Around the country, universities are opening new pharmacy schools or expanding existing programs, but it likely will take years for supply to meet demand. Some schools have reported 10 applicants for every pharmacy opening, although that figure includes people applying to more than one school, said Lucinda L. Maine, executive vice president of the American Association of Colleges of Pharmacy in Alexandria, Va. “It is a great job market for those who get in,” Maine said. “But we also have a lot of disappointed people who are being turned away.” Many universities have opened satellite programs, and about 20 new pharmacy schools have opened in the last five years, Knapp said. That should increase the number of graduating pharmacists to more than 10,000 in 2007, compared to about 8,000 graduates in 2003-04, Maine said.

Stem cell transplant bests chemo [or childhood leukemia

(HealthDayNews) — The worst cases of acute lymphoblastic leukemia, the most common leukemia in children, respond better to a stem cell transplant than to chemotherapy, a new study finds. High-risk acute lymphoblastic leukemia is characterized by various biological markers at onset or by resistance to treatment. Standard treatment is high-dose chemotherapy; in most cases the outcome is poor. To determine whether stem cell transplantation was better than standard highdose chemotherapy, Dr. Adriana Balduzzi, from the Universita’ degli Studi di Milano Bicocca, Italy, and colleagues randomly selected children with acute lymphoblastic leukemia who received either standard chemotherapy or stem cell transplantation. The report appears in the Aug. 4 early online issue of the Lancet. Of the 357 children in the trial, 280 were given chemotherapy and 77 underwent stem cell transplantation

from a compatible, related donor. Balduzzi’s team found that 41 percent of the children who received chemotherapy survived five years without recurrence of the disease, compared with 57 percent of the children who received stem cells. Moreover, 56 percent of the children who received stem cells were alive after five years, compared with 50 percent of the children who received chemotherapy. “This international prospective study, based on treatment allocation by genetic chance, provided evidence that children with very highrisk acute lymphoblastic leukemia benefit from related donor hemopoietic-cell transplantation compared with chemotherapy, and showed that the gap between the two strategies increases as the risk profile of the patient worsens,” the researchers concluded. One expert believes that this study can be of great help to doctors in deciding how to treat children with acute lymphoblastic leukemia.

“These investigators should be commended,” said Louis DeGennaro, vice president of research at the Leukemia & Lymphoma Society. “This is the first prospective study to demonstrate that children with extremely high-risk acute lymphoblastic leukemia benefit significantly from stem cell transplantation from related donors as opposed to standard chemotherapy.” “The value here is that these results provide physicians with important guidance in making difficult treatment decisions for this high-risk population,” DeGennaro said. Physicians are faced with having to choose between two difficult therapies, he noted. “Chemotherapy is pretty toxic, and stem cell transplantation requires a regime of chemotherapy as well,” he said. “These are difficult treatment decisions, and to date there hasn’t been a study like this that clearly allows some guidance in terms of which of the two approaches is better.”

Higher insulin levels may conhibule lo Alzheimer's

(HealthDay News) — Elevated insulin levels may contribute to the development of Alzheimer’s disease, and investigators hope this new finding will lead to more effective treatment strategies, according to a report in a recent issue of the Archives of Neurology. Researchers at the University of Washington in Seattle raised blood insulin levels in 16 healthy older adult volunteers and then measured changes in the volunteers’ levels of inflammatory markers and beta-amyloid (a protein associated with Alzheimer’s disease) in their cerebrospinal fluid and plasma. “Moderate peripheral hyperinsulinemia (increased levels of insulin) provoked striking increases in CNS (central nervous system) inflammatory markers,” the study authors

wrote. “Our findings suggest that insulin-re-sistant conditions such as diabetes mellitus and hypertension may increase the risk for Alzheimer’s disease, in part through insulininduced inflammation.” The research team concluded: “Although this model has obvious relevance for diabetes mellitus, hyperinsulinemia and insulin resistance are widespread conditions that affect many nondiabetic adults with obesity, impaired glucose tolerance, cardiovascular disease and hypertension. Our results provide a cautionary note for the current epidemic of such conditions, which, in the context of an aging population, may provoke a dramatic increase in the prevalence of (Alzheimer’s disease).”

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Rodents give dieting clues (HealthDay News) — Observations of overstressed rats may help explain why dieters so often fail and binge-eat instead. A combination of stress, deprivation and exposure to tempting food pushed the rats to overeat, according to two studies in the October issue of Behavioral Neuroscience. Onestudybyresearchers at the University of Bordeaux 2, in France, tested three aspects ofeatingbehaviorinrats: motivation (how bad they want it); anticipation (how excited they were in advance); and intake (how much they ate). These three aspects of eating behavior were tested in relation to food type (ordinary lab chow or yummier chocolate cereal) and satiety/hunger. The second study examined the link between binge eating and opioids - neurological “feel good” chemicals that play key roles in food response in both the rat and human brains. Rats binged on a particularly favorite food - Oreo cookies - when they were both overstressed and forced to diet. Either condition alone did not lead to binge-eating, according to researchers at the University of Alabama at Birmingham. However, giving the rats an opioid-blocking drug reduced binge eating in the stress /dieting rats. The findings may explain why some people on diets relapse into previous poor eating habits and why even one slip - such as eating a single cookie - can trigger “pigging out” in people already predisposed to binge-eating. The research could also help in the development of methods to help people avoid overeating, control their weight and improve their health.

HEALTH BRIEFS ► Continued from Cl Edna Martin 1970 Caroline Ave. Monday-Friday, 4:305 p.m.

Redeemer Hospitality 3421 N. Park Ave. Monday-Thursday, 4:30-5 p.m. Westminster Neighborhood Outreach 445 N. State Monday-Friday, 44:30 p.m.

Melanoma support group The Wellness Community of Central Indiana has partnered with Out Run The Sun Inc., to start a monthly drop in support group for melanoma patients and their loved ones the first Monday of each month from 6-8 p.m. Registration is not reguired. The support group will take place at the Wellness Community, 8465 Keystone Crossing, Suite 145. For more information call (317) 257-1505.

Viagra fighfs blood vessel disorder

(HealthDay News) — Viagra may ease symptoms of a circulatory disorder called Raynaud’s phenomenon, a small German study finds. Raynaud’s phenomenon, which affects 3 million to 5 million people worldwide, occurs when cold temperatures or stress cause small blood vessels in the skin to constrict, resulting in numbness, tingling and pain in toes and fingers. In severe cases, there’s a risk of ulcerations. As reported in the Nov. 8 issue of Circulation, researchers at the University of Saarland compared outcomes in 16 patients (mostly women) with severe Raynaud’s who did not respond to standard treatment with drugs used to help dilate blood vessels. The patients received either Viagra or a placebo for four weeks, and were then switched to the opposite treatment for another four weeks. Viagra reduced the frequency and duration of

Raynaud’s attacks, improved capillary blood flow, and helped heal chronic toe and finger ulcerations, the study found. Patients taking Viagra had an average of 35 Raynaud’s attacks compared to an average of 52 among patients taking the placebo. Total duration of attacks averaged 581 minutes among patients taking Viagra, compared to 1,046 minutes among patients taking the placebo. During treatment with Viagra, average capillary blood flow velocity more than quadrupled, and patients taking the drug reported less pain. This is the first evidence from a controlled study that Viagra is effective in patients with treatment-resistant Raynaud’s. Viagra works by causing blood vessels to dilate, using a mechanism that’s different from that of other vasodilator medications.

NaHonal survey shows nearly 10 percent of 8lh graders used inhalants

Special to the Recorder The good news is that overall drug abuse by teenagers is still down, but the use of prescription drugs and inhalants has increased. The results of the 2004 Monitoring the Future Study showed that annual use of inhalants by 8th grade students has increased to 9.6 percent, up from 7-7 percent just two years ago. The survey is conducted annually by the National Institute of Drug Abuse (NIDA) to assess drug use among 8th, 10th and 12th grade students. The latest information from the Drug Abuse WarningNetwork(DAWN), which tracks drug-related emergency department admissions, showed an increase of 187 percent of inhalant mentions from 2001 to 2002. The total number of new inhalant users in 2002 was about 1 million Americans, with 78

percent of them under the age of 18. Inhalants are generally classified into three categories - solvents, gases and nitrates. Examples of these chemicals include paint thinners, glue, gasoline, butane, nitrous oxide, ether, cleaning products and aerosol sprays for paint, hair and deodorant. Most of the chemicals that are sniffed or “huffed” are commonly found in the household, where young children and adolescents can easily obtain them. Use of inhalants brings many negative effects on a person aside from the initial high they may feel. Adverse effects of sniffing toxins include damage to the liver, lungs, kidneys and brain, which opens up to a variety of symptoms and illnesses. Sniffing high concentrations of some chemicals can cause heart failure and even death.

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