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Without a doubt, taking medications can not only be expensive, but also confusing. In the United States, generic prescriptions are widely used, with 9 out of 10 people choosing them over a name brand. Pharmacists are a great resource to help us understand the benefits and side effects of any medication. We asked Adam Porath, PharmD, Vice President of Pharmacy at Renown Health, to answer some common questions about generic drugs. What is a generic drug? A generic drug has the same active ingredients of brand-name drugs. Brand-name drugs have a patent (special license) protecting them from competition to help the drug company recover research and development costs. When the patent expires other manufacturers are able to seek approval for a generic drug. However, the color, shape and inactive elements may be different. Per the U.S. Food & Drug Administration (FDA), a generic medicine works in the same way and provides the same clinical benefit as its brand-name version. Why do they cost less? Generic drug makers do not have the expense of costly development, research, animal and human clinical trials, marketing and advertising. This savings is passed on to the public. Also after a patent expires, several companies will compete on a generic version of a drug, further driving down prices.

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Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place.   According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)

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Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis, answers some common questions about bone fractures. Is there a difference between broken bones and fractures? No, these are two different names for the same injury. Of course the common term is a broken bone. Using either name will describe your concerns. Medical personnel typically describe a broken bone as a fracture to a specific bone. For example, a broken wrist is also a fractured distal radius. To clarify, this describes the injured bone and the precise location. How do I know  if my child has broken their bone? Many times children will fall and complain of their arm or leg hurting. In most cases the pain goes away and the child will return to their activities. When there is a deformity to the limb (curve in arm) and the child is complaining of pain, it is probably a fracture. If the arm or leg looks straight, look to see if there is any swelling or bruising. Both are signs of a possible fracture. Finally, if the limb looks normal but the child continues to complain, gently push on the bone. Likewise if it causes the same pain, then they likely have a fracture and should have an x-ray. My child fractured their growth plate, what does this mean? Growth comes from this area of the bone. In detail, these are located all over the body but typically at the end of the bones. With this in mind, fractures to these areas can result in the bone growing abnormally. Because of potential shortening of the arm or leg, or bones growing crooked, it is important to follow fractures closely (up to 1-2 years or longer). It is better to identify a problem early. Small problems can be treated with small surgeries. What if the bones of the x-ray do not line up? Because children are growing, unlike adults, their bones will remodel and straighten with growth. The amount of remodeling occurring depends on a child’s age, the bone fractured and the location. In many cases an angled bone will grow straight over the course of a year. For this reason, someone with experience in caring for children needs to follow bone growth. How long does it take fractures to heal? Factors deciding when a cast can come off include: Child’s age. Bone fractured. Fracture location. Young children heal faster than teens, teens heal faster than young adults, who heal faster than older adults. In young children most fractures heal in 4-6 weeks. However, teens generally take 6 weeks to heal, and adults can take much longer. Although your child  is out of their cast, it may not be healed completely to return to all activities. Placing a splint is during this time is common. This typically gives them added protection for several weeks after their cast is removed -  in case they forget their limitations. What if my child is still limping? Whether a child is in a walking or non-weight bearing cast, removing it often leaves them stiff and sore. Therefore many children will walk as though they still have a cast in place. In most cases this resolves in about three weeks. Regardless, if your child is still limping or walking abnormally after three weeks, contact the treating doctor. They may benefit from physical therapy or a repeat evaluation.  (This article was original published in the July 2019 issue of South Reno Kids & Sports.)

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You might think worsening eyesight is inevitable as you age. But the truth is, there are easy things you can do to keep your eyes in tiptop shape for years to come. Clear vision is an essential part of overall health and there are daily habits we can adopt to keep our eyes seeing clearly. Mitchell Strominger, M.D., a registered ophthalmologist with Renown Health specializing in pediatric ophthalmology and neuro-ophthalmology, offers some everyday tips to keep you focused on eye health. Know your family’s vision history Look to your parents and grandparents for clues about the future of your eye health. Were they near-sighted at a young age? Do they have a history of eye crossing or a lazy eye? Did they develop glaucoma or macular degeneration (AMD)? Some genes have a strong association with eye health, specifically macular degeneration. AMD is a leading cause of blindness worldwide and the top cause of vision loss and blindness for Americans over 65, according to the Centers for Disease Control and Prevention (CDC). Also be aware certain medical conditions, such as diabetes, high blood pressure and liver disease, increase the risk of long-term eye problems. Receive regular vision screening exams Children under three need vision screening examinations by their pediatrician. A medical concern or family history warrants a comprehensive eye examination by a pediatric ophthalmologist (or general ophthalmologist or optometrist who has experience with children) per the American Academy of Ophthalmology (AAO). Vision screenings should occur every two years throughout adolescence unless pain, eye crossing, difficulty seeing the board or reading, or other eye concerns occur. In adulthood the risk of eye problems increases over age 40, so the AAO recommends regular dilated exams. When your pupils are dilated it allows your eye care professional a more accurate view of your retina and optic nerve, located in the back of your eye. This allows them to look for AMD or other eye problems. Eye diseases can be caught at their earliest stages during a dilated eye exam. “It is especially important to have your child evaluated as soon as possible if there is any concern for eye crossing or lazy eye,” says Dr. Strominger. “The visual system develops in the early years so intervention, whether it be glasses, eye patching to strengthen the vision in one eye, or eye muscle surgery is critical. Children at risk include those who are born premature, have development abnormalities, genetic disorders such as Downs syndrome, or a strong family history and should be evaluated at a young age. Often small problems are not clearly evident and cannot be picked up on routine screening examinations in the pediatrician’s office.” Block the sun, improve your vision Everyone knows not to stare directly into the sun, but indirect ultraviolet (UV) sun rays can cause serious harm over time. According to the National Eye Institute, sunglasses (or a protective UV tint) are a daily must to protect your eyes from: Cataracts (a clouding of the eye’s lens causing blurred vision) AMD - macular degeneration Pterygium (a tissue growth over the white surface of the eye that can cause astigmatism) Look for sunglasses which block 99 to 100 percent of both UVA and UVB rays. You still need sunglasses if your contact lenses block UV rays. Sun rays can damage your eyelids and other tissue not covered by contact lenses. Wearing sunglasses protects your entire eye area. Eat colorful meals Your eyes need vital nutrients to keep them healthy including vitamin C, zinc, beta carotene and copper. A diet filled with citrus fruits and a variety of vegetables provide these essential nutrients. Regularly filling up on fish high in omega-3 fatty acids (salmon, tuna, sardines) may reduce your risk of AMD and help maintain your eye health. Green, leafy vegetables (kale, spinach, collard greens) containing lutein and zeaxanthin are also a must for your dinner plate. Water your eyes Eyes, like the rest of your body, need plenty of water to prevent dehydration. Make sure you stay hydrated and steer clear of smoke to avoid dry eyes and irritation. Hours staring at the computer screen can also make your eyes feel dry or tired. Try regularly refreshing them with lubricating eye drops. Taking frequent computer breaks is also important. Follow the 20/20/20 rule: every 20 minutes, look at an object 20 feet away from you for 20 seconds. Eye makeup can also lead to dry eye as the glands at the base of the eyelashes may become clogged, causing dry eye. Make sure all eye makeup is hypoallergenic and is thoroughly removed with a gentle cleanser for the delicate eye area each day. Stop Smoking (or never start) Smoking is harmful to every part of your body, including your eyes. It's not only linked to cancer and heart disease but also cataracts, AMD, dry eye, optic nerve problems and many other problems. Smoking during pregnancy can also harm the eyes of the unborn child. If you currently smoke take steps to quit and your entire body will benefit.

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