Kernersville Primary Care is proud to announce our recognition by the National Committee on Quality Assurance as a Patient Centered Medical Home, Level 3. This title, the highest level awarded, recognizes our commitment to a care delivery model whereby patient treatment is coordinated through their primary care provider to ensure the patient receives the necessary care when and where they need it, in a manner they can understand. Kernersville Primary Care and our medical director William S. Kelly, MD would like to thank our newest staff member Katie A. Scott, AGNP-C for leading the effort which involved every member of our office staff.
Influenza is reported in the North Carolina as well as the Kernersville community. Flu shots for the 2016/2017 flu season are still available. Influenza symptoms can be treated within the first 48 with Tamiflu. The CDC recommends annual influenza vaccination for all persons aged ≥6 months who do not have contraindications. To see the full recommendations click here:
Please call ahead to schedule your immunization to avoid long wait times.
A rapidly increasing number of men in the United States are turning to testosterone therapy to treat a variety of symptoms including erectile dysfunction, fatigue, weakness, and depression. This is despite a relative absence of evidence supporting the effectiveness of testosterone supplementation. Now researchers are questioning the safety of testosterone therapy as well as its effectiveness. In a recent study, published in the open access peer-reviewed scientific journal Plos One, researchers examined the risk of non-fatal heart attack in over 55,000 men treated with either testosterone or a different class of medications that includes Cialis and Viagra. They found men receiving testosterone therapy had an overall 36% increased risk of having a heart attack in the first 90 days of treatment as compared to the previous 90 days. This risk increased to 119% for men over 65 and to 243% for men over 75. No statistically significant increase in risk was associated with the use of the other class of drug examined in the overall study population. For men under 65 the increased risk from testosterone therapy was only statistically significant for men with a prior history of heart disease, although this risk was a substantial 190%. These findings are consistent with other recent studies, including large multi-study analyses, that link testosterone therapy and the risk of potentially life altering cardiovascular events. While research has also linked low testosterone levels themselves with adverse cardiovascular events and more research still needs to be done, this data should give pause to any man considering testosterone therapy, particularly men over 65 years old or at high risk of cardiovascular disease. Kernersville Primary Care encourages our patients who believe they may be suffering with the effects of low testosterone to discuss these symptoms with their providers so that a safe and effective treatment strategy can be implemented.
Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Therapy Prescription in Men. Finkle WD, Greenland S, Ridgeway GK, et al.
PLoS One 2014;9:e85805
Colorectal cancer is the 2nd leading cause of cancer related death in the U.S. and is responsible for more than 50,000 deaths per year. Regular screening, beginning at age 50, is the key to preventing colorectal cancer. The U.S. Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer using high-sensitivity fecal occult blood testing, sigmoidoscopy, or colonoscopy beginning at age 50 years and continuing until age 75 years. People at higher risk of developing colorectal cancer should begin screening at a younger age, and may need to be tested more frequently. The decision to be screened after age 75 should be made on an individual basis. For more information, read the current colorectal cancer screening guidelines from the USPST.
If you are a Kernersville Primary Care patient and are over 50 or have a family history of colorectal cancer and have not been screened please contact our office and we will be happy to assist you in obtaining these potentially life-saving procedures.
If you are over 60 years old and have never had a colonoscopy now is the perfect time! Novant Health Oncology Specialists is enrolling patients in a research study and is offering a $35.00 gift card for those over the age of 60 getting first-time colonoscopies. All you have to do is complete a short survey, have a tube of blood drawn, and collect two stool specimens before your procedure. Peace of mind and a little cash in your pocket. Kernersville Primary Care patients who are interested in participating should contact our office for details.
Statins are a class of medication used to lower cholesterol and have been shown to reduce risk of death in individuals with cardiovascular disease. They are also currently recommended for use in patients at high risk of developing heart disease who have high cholesterol. A number of statins are currently available on the market including: simvastatin (Zocor), atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mavacor), pitavastatin (Livalo), pravastatin (Pravachol), and rosuvastatin (Crestor). In February of 2012, the FDA issued a warning that statins may have a negative effect on brain function. However, this warning, which was based mostly on individual reports, seemed to contradict evidence from research such as clinical trials.
A recent meta-analysis, a study of all available trials, led by Brian R. Ott, MD, Director of the Alzheimer’s Disease and Memory Disorders Center at Rhode Island Hospital and Professor of Neurology at the Warren Alpert Medical School of Brown University, sought to further investigate this issue. The study found no significant relationship between cognitive decline or adverse cognitive events and the use of any stain drug in either cognitively healthy people or those with dementia. In addition, no other systematic review has ever linked statins to impaired brain function as of today.
While significant side effects from statin use, such as muscle damage, do exist, these effects are rare and are offset by the significant benefits of statin therapy in preventing heart attacks and strokes. If you are considering taking a statin medication or a statin has been recommended to you by a medical professional, the potential benefit must be weighed against any potential negative effects, as is the case when taking any medication. The potential for statins to have a negative effect on brain function however is NOT supported by the current body of research.
As part of an ongoing effort to help physicians curtail the rising cost of health care by preventing the ordering of unnecessary tests and procedures, the AAFP (American Academy of Family Physicians) has released its second Choosing Wisely list of recommendations. This list details various tests and treatments physicians should think twice about before performing, ordering, or prescribing.
Given the rise of multidrug resistant bacteria in recent years and links between antibiotics and a number of side effects the over prescription of antibiotics is particularly concerning. The Choosing Wisely list includes guidelines for treatment of sinus infections with antibiotics and states that antibiotics should NOT be routinely prescribed for acute mild-to-moderate sinusitis unless symptoms last for seven or more days, or symptoms worsen after initial clinical improvement. Symptoms must include discolored nasal secretions and facial or dental tenderness when touched. Most sinusitis in the ambulatory setting is due to a viral infection that will resolve on its own. Antibiotics are not effective for treatment of viral infections and can have serious side effects. Despite consistent recommendations to the contrary, antibiotics are prescribed in more than 80 percent of outpatient visits for acute sinusitis and sinusitis accounts for 16 million office visits and $5.8 billion in annual health care costs.
Please review the entire list Choosing Wisely list and help us keep the cost of healthcare down by working with us to decrease the number of unnecessary tests, procedures, and medicines.
Getting immunized is a lifelong, life-protecting job that not only protects you but your loved ones from preventable life-altering and potentially deadly diseases. The CDC has released new guidelines for adult immunizations including: hepatitis A, hepatitis B, HPV, influenza, measles, mumps, rubella, meningococcal infection, pneumonoccal infection, tetanus, diphtheria, pertussis (whooping cough), varicella (chicken pox), and zoster (shingles). Click the following link for more details: http://www.immunize.org/catg.d/p4030.pdf
Pertussis, also known as whopping cough, is making a resurgence right in our back yard! This highly contagious disease is usually spread by coughing or sneezing while in close contact with others. It is life-threatening to newborns and infants who are too young to be fully vaccinated. 11 cases of pertussis had been confirmed in Forsyth County as of February including a 2-month-old who died. The CDC recommends that all adults receive the Tdap vaccine (the adult whooping cough vaccine) and women need to get a dose during each pregnancy.
If you are planning to travel outside the United States you may need additional vaccines. Visit CDC website at www.cdc.gov/travel or call 1-800-CDC-INFO (800-232-4636) for more information.
We at Kernersville Primary Care are committed to keeping our patients and our community safe. If you have questions or believe you may need to be immunized don’t hesitate to contact us.
A recent study published in the British Medical Journal has found that prescription sleeping pills, such as Ambien and Restoril, are associated with increased risks for cancer and death.1 In the study, individuals who were prescribed 1 to 18 doses of insomnia drugs per year were 3.6 times more likely to die during the study period of 2.5 years than individuals who did not use these drugs. The risk of death was 4.4 times higher for individuals who were prescribed 18-132 doses and 5.3 times higher for individuals prescribed >132 doses per year. Individuals who were prescribed more than 132 doses per year were also found to have 1.4 times more risk of developing cancer.
While the study does not prove these drugs cause death or cancer, it serves as a caution on their use and highlights the need for individuals to explore other remedies for insomnia before resorting to drug therapy. For example, any underlying conditions that can contribute to insomnia, such as depression, restless leg syndrome and hyperthyroidism, should be treated first. Other non-drug based treatments should also be explored before turning to prescription sleeping pills. These include: eliminating caffeine and nicotine 4-6 hours before bedtime; avoiding alcohol as a sleep aid; avoiding exercise within 3 hours of bedtime; creating a comfortable environment with noise, light and extreme temperatures controlled; maintaining a regular time to wake up each day; getting out of bed and going to another room if unable to fall asleep or fall back to sleep within 15-20 minutes; and avoiding daytime napping. For those who have tried all other available treatments and still suffer from significant insomnia, prescription medications may still be beneficial as untreated insomnia has significant mental and physical health consequences. However, given the results of this study, we should all think twice before taking these medications.
Nate Kelly, MPH, RD, LDN
1. Kripke DF et al. Hypnotics’ association with mortality or cancer: A matched cohort study. BMJ Open 2012 Feb 27; 2:e000850.
Recent research has shown that consuming too much red meat (beef, pork, and lamb) may significantly increase the risk of early death, especially from heart disease and cancer.1 According to the results of the study, substituting one serving of red meat per day with other foods (including fish, poultry, nuts, legumes, low-fat dairy, and whole grains) decreases the risk of early death from all causes by 7-19%. This decrease in risk may be even higher in men. Overall, the study suggests that individuals should try to limit red meat consumption to less than 4 servings per week. One serving of unprocessed red meat such as steak or pork chops is approximately equal in size to a deck of cards. For processed red meats the serving size is smaller (2 slices of bacon, 1 hotdog, 1 slice of salami/bologna).
Nate Kelly MPH, RD
1. Pan A, Sun Q, Bernstein AM; et al. Red meat consumption and mortality: results from 2 prospective cohort studies [published online March 12, 2012]. Arch Intern Med. doi:10.1001/archinternmed.2011.2287.
The revised USPSTF recommendations — which were reviewed by the Academy’s Commission on Health of the Public and Science — call for biennial screening mammography for women ages 50-74 years and state that the decision to start regular, biennial screening mammography before the age of 50 should be an individual one that takes patient context into account, including the patient’s values regarding specific benefits and harms.
“It enables family physicians in particular to know the patient, know their history and help patients make decisions for themselves guided by a thoughtful discussion.”
The U.S. Preventive Services Task Force, or USPSTF, recently released new recommendations for the screening of breast cancer. These new recommendations have generated a large amount of criticism and concern among women, physicians, and other research groups. What exactly is so controversial about these recommendations and what do they mean for you? Let’s first take a closer look at the recommendations themselves.
Summary of Recommendations:
1. The USPSTF recommends screening mammography for women aged 50 to 74 years every other year.
2. The decision to start regular, biennial screening mammography before the age of 50 years should be an
individual one and take patient context into account, including the patient’s values regarding specific
benefits and harms.
3. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and
harms of screening mammography in women 75 years or older.
4. The USPSTF recommends against teaching breast self-examination (BSE).
5. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and
harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older.
6. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and
harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as
screening modalities for breast cancer.
The first two recommendations represent a significant shift from the recommendations issued in 2002 and are where most of the controversy is centered. Previously, the USPSTF recommended screening mammography, with or without clinical breast examination, every one to two years for women ages 40 and older. The new recommendations also differ from what is currently recommended by the American Cancer Society, American College of Obstetricians and Gynecologists, American College of Radiology (ACR), and the Society of Breast Imaging (SBI) who all recommend annual screening mammography starting at age 40 for most women, and even earlier in those with high risk. So, what does this mean if you are a woman in your 40s or over 75? The decision about whether mammography is right for you should be based on your family history, general health, and personal values. There are risks associated with screening mammography such as over treatment and exposing the breast to radiation, so careful consideration of what is right for you is warranted. Perhaps, the only thing that the recommendations and the controversy surrounding them make clear is that there is a need for further research in breast cancer prevention. We at Kernersville Primary Care encourage you to discuss the risks and benefits of screening mammography with your doctor and decide what measures are best for you.