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17/Jul/2009

The UV Lights at Your Local Nail Salon May Cause Skin Cancer. 

The lights used to quickly dry your nails at your local nail salon may cause skin cancer. As published in the April 2009 issue of the Archives of Dermatology report that 2 healthy middle aged women developed skin cancers on the dorsum of their hands, both women had no risk factors for skin cancer and reported exposure to UV lights at nail salons. My advice use the dryer.


08/Jul/2009

A study published in the July 9th issue of the New England Journal of Medicine reveals a way to make medical abortions (not surgical) safer. The data comes from Planned Parenthood Centers throughout the country. By switching medication administration from the vagina to the mouth the rate of infections after medical abortions declined 73%. Subsequent addition of routine antibiotics further reduced the rate of infections by 76%. Women seeking medical abortions should insist on only oral medications and a prescription for antibiotics or testing for sexually transmitted diseases to reduce their risk of infection.


27/Jun/2009

There was a great article in today’s WSJ about a medical condition called Fibromuscular Dysplasia. This condition is more common in women then men and is thought to occur in up to 5% of the population. It can cause high blood pressure, headaches, abdominal pain and even heart attacks, stokes, aneurysms, and sudden death.

What is Fibromuscular Dysplasia (FMD)?

The word “dysplasia” simply means abnormal cellular development or growth. In people with FMD, the dysplasia involves the walls of one or more arteries in the body. Areas of narrowing, called stenosis, may occur as a result of abnormal cell development. If enough narrowing causes a decrease in blood flow through the artery, symptoms may result. Many people with FMD do not have any symptoms or signs on physical examination and are diagnosed by accident during a radiology scan for another problem.

FMD is most commonly found in the arteries that supply the kidneys with blood (renal arteries). Up to 75% of all patients with FMD will have disease in the renal arteries. The second most common artery affected is the carotid artery, which is found in the neck and supplies the brain with blood. Less commonly, FMD affects the arteries in the abdomen (supplying the liver, spleen and intestines) and extremities (legs and arms). More than one artery may have evidence of FMD in 28% of people with this disease.

What causes FMD?

The cause of FMD is not yet known, but several theories have been suggested. A number of case reports in the literature have identified the disease in multiple members of the same family including twins. There is a very strong likelihood that there is a genetic basis for the development of FMD. However, a relative may have different artery involvement, different disease severity, or not develop FMD at all. In fact, not all individuals with FMD have a family member with the disease. In a series from France, about 11% of family members had FMD.

FMD is also more commonly seen in women than in men resulting in the theory that hormones may play an important role in disease development. This theory is further supported by the fact that most women are premenopausal at the time of diagnosis. However, with better imaging available, an increasing number of patients are now being diagnosed later in life. In small population studies, one’s reproductive history (the number of pregnancies and when they occurred) as well as the use of birth control pills did not correlate with the development of FMD.

Other possible causes of FMD include abnormal development of the arteries that supply the vessel wall with blood resulting in inadequate oxygen supply; the anatomic position of the artery within the body; and tobacco use. It is likely that many factors are involved in the development of FMD. This area requires further research.

What are the signs and/or symptoms of FMD?

Many people with this disease do not have symptoms or findings on a physical examination. The signs and/or symptoms that a person with FMD may experience depend on the arteries affected and the degree of narrowing within them. The two most common areas affected by FMD are the renal arteries (arteries carrying blood to the kidneys) and the carotid arteries (arteries carrying blood to the brain). Common manifestations related to the artery involved are shown below.

FMD of Renal Arteries (Kidney):

  • High blood pressure [>140/90 mmHg]
  • Abnormal kidney function as detected on blood tests
  • Flank pain from dissection or infarction of the kidney
  • Kidney failure (rare)
  • Shrinkage (atrophy) of the kidney

FMD of Carotid Arteries:

  • Bruit (noise) heard in neck with stethoscope
  • Swooshing sound in ear
  • Ringing of the ears
  • Vertigo (room spinning)
  • Dizzyness
  • Headache
  • Transient ischemic attack
  • Stroke
  • Neck pain
  • Horner’s syndrome
  • Dissection

People with carotid FMD have a higher risk for intracranial aneurysms (abnormal dilations of the arteries in the brain). An intracranial hemorrhage (bleeding in the brain) may occur if an aneurysm ruptures. FMD involving the mesenteric arteries (arteries that supply the intestines, liver and spleen with blood) can result in abdominal pain after eating and unintended weight loss. FMD in the arms and legs can cause limb discomfort with walking or arm use (intermittent claudication), cold limbs, weakness, numbness or pain.

Who has FMD?

Anyone can have FMD. However, it is much more common in women. Most women are typically diagnosed between the ages of 25-50. Some types of FMD are more common in children or teenagers (See Pediatric FMD). And there are an increasing number of individuals who are being diagnosed later in life (after age 60).

How common is FMD?

It is difficult to determine how common FMD is in the general population. This is due to several reasons. Individuals with mild disease are often asymptomatic and so the disease often goes undetected. Most studies examining the prevalence of FMD have looked at specific patient populations in whom individuals may have already suffered from serious consequences of the disease. Since the disease is often not diagnosed, it is likely that FMD is more common than previously thought.

How can FMD be diagnosed?

There are a number of methods that can be used to detect FMD. These include computed tomographic angiography (CTA) and magnetic resonance angiography (MRA), ultrasound, and catheter based angiogram. The experience and expertise available at your medical institution will play an important role in what diagnostic options are available to you.

In the most common form of FMD (medial fibroplasia), a characteristic “string of beads” appearance is seen in the affected artery. This appearance is due to changes in the cellular tissue of the artery wall that causes the arteries to alternatively become narrow and dilated. A less common, but more aggressive form of FMD may cause an area of severe concentric narrowing of the blood vessel (intimal fibroplasia) or long smooth narrowing.


25/Jun/2009

Michael Jackson died suddenly today. It is known that he hadn’t been feeling well and his personal physican was at his home this morning and tried to resuscitate him. Michael apparently had a sudden cardiac arrest. This simply means that his heart stopped beating. SCA (sudden cardiac arrest) is a common cause of death accounting for more than 325,000 deaths each year in the United States. The most common cause is underlying coronary heart disease, which often goes undiagnosed. Other causes can be underlying structural heart disease, drug overdoses, airway obstruction, drowning and pulmonary emboli. These medical conditions commonly cause an irregular heart beat called ventricular fibulation where blood is not pumped effectively. This causes a rapid loss of conscienceness. This rhythm can be reversed with a defibulator which delivers an electrical current to the heart. However, it must be done quickly, basic cpr is not typically effective. Stress, and drugs such as alcohol, amphetamines or cocaine can also contribute to the problem. A definitive answer is not likely until toxicology and autopsy reports are released.


15/Jun/2009

A Study Published in the June 16, 2009 edition of the Annals of Internal Medicine showed that calcium supplementation in overweight and obese patients have no effect on weight. Overweight or obese (BMI>30) patients were split into two groups, one group took 1500mg of calcium carbonate a day for two years, the other group was given a placebo. After two years there were no differences between the two groups in terms of weight or body fat.


15/Jun/2009

A recent study published in the June 16, 2009 issue of the Annals of Internal Medicine shows the efficacy of Red Yeast Rice in lowering cholesterol. 62 patients with elevated cholesterol levels and the side effect of myalgias while on statin therapy were randomized to 1800mg twice daily of red yeast rice or placebo. Patients were followed for 24 weeks. Red yeast rice significantly decreased LDL and total cholesterol compared to placebo and did not increase the incidence of myalgias over a 24 week period.


28/May/2009

Vogue Editor Feels “Newly Taut” In Her Jeans thanks to VelaShape

In an article on achieving body perfection, beauty editor Catherine Piercy explores the latest surgical and non-surgical fixes for body flaws: liposuction, injections, skin tighteners, and cellulite treatments.

“The treatment that really gets my attention, though, is VelaShape,” says Piercy.  She received VelaShape treatments “…with zero downtime and little risk…I decided this is the one I must try.”

The result? There was some bruising which faded after a few days, but overall, she says “I feel tighter if not thinner, and those painstakingly precise measurements show a 2.5 cm reduction of my waist, thighs and lower back.  Just enough to have me feeling newly taut in my jeans.”

VelaShape is a non-invasive medical device based on el?s™ technology – a combination of heat, light, suction and massage – and is specifically designed to improve skin texture, reduce the appearance of cellulite and target localized fat deposits. Experience the most popular non-surgical alternative to liposuction with VelaShape!


28/May/2009

I tell my patients all the time, don’t waste your money on vitamins. No large scale study has proven that they have any beneficial effects. A recent study published in May 2009 supports this. Researchers in Germany gave half of the studies participants moderate doses of vitamins C and E and had them exercise. They then measured sensitivity to insulin as well as indicators of the body’s natural defenses to oxidative damage. The group taking vitamins had no improvement in insulin sensitivity and almost no activation of the body’s natural defense mechanism against oxidative damage. It seems that the vitamins block our bodies own mechanisms to combat free radicals.


29/Apr/2009

What are swine flu symptoms?

Flu symptoms

The flu is characterized by a collection of symptoms that can often occur suddenly, including:

  1. Fever (higher than 100° F)
    A fever occurs when your body temperature increases in response to illness or injury. Your temperature is considered elevated when it is higher than 100°F.
  2. Chills
    Body chills that are not related to a cold environment can be a sign of the flu.
  3. Headache
    A headache associated with the flu may appear suddenly, and be related to body aches or nasal congestion you’re experiencing.
  4. Extreme tiredness
    It’s normal to feel tired at the end of a long day or when you don’t get adequate sleep, but unexplained tiredness can be a sign of the flu.
  5. Dry cough
    Know your cough. A productive cough (coughing up mucus) is common with a cold, while a non-productive or dry cough (with no mucus) is associated with the flu.
  6. Sore throat
    Swelling in the throat can lead to a sore throat.
  7. Runny nose
    Runny nose may also occur but is more common in children than adults.
  8. Muscle aches
    While it is normal to feel body aches from physical overexertion, body aches that are sudden and unexplained can be a sign of the flu.
  9. Stomach symptoms
    Stomach symptoms such as nausea, vomiting and diarrhea are more common in children than in adults
  10. Chest discomfort
    Chest discomfort is often severe with the flu.

Swine Flu Philadelphia

According to the CDC, the swine flu is spreading in the United States and internationally. Today, the CDC reported additional confirmed human infections, hospitalizations and the nation’s first fatality from this outbreak. The more recent illnesses and the reported death suggest that a pattern of more severe illness associated with this virus may be emerging in the U.S. Most people will not have immunity to this new virus and, as it continues to spread, more cases, more hospitalizations and more deaths are expected in the coming days and weeks. As of this morning a total of 91 cases have been reported in the US, with 51 cases confirmed in New York. I suspect this is a low number as it takes time for test results to come back and some states had not submitted results yet. There has been one fatality, a 23 month old boy from Mexico, it seems as if he was taken to the hospital too late. When he arrived he was already in critical condition. So far it appears that given the modern medical care in the U.S., patients who come down with the virus should fare much better than patients in Mexico.It’s unclear what will happen with this outbreak, the best case would be that it would die out in a few weeks, however the virus could mutate and become more virulent and cause widespread serious illness and death. If you come down with a fever and severe cold symtoms call you doctor or report to the emergency room. Don’t wait until your breathing is compromised to seek medical attention. 4/30/09 10:28am

Antioxidant found in berries prevents wrinkles and sun damage

Another study presented this week supports the use of antioxidants in preventing wrinkles and premature aging of the skin. Using a topical application of the antioxidant ellagic acid, found in berries, nuts, pomegranates, researchers at Hallym University in the Republic of Korea markedly prevented collagen destruction and inflammatory response – a major causes of wrinkles — in both human skin cells and the sensitive skin of hairless mice following continuing exposure to UV-B, the sun’s skin-damaging ultraviolet radioactive rays. So continue to eat a diet rich in fruits and vegetables, avoid the sun, apply a high spf sunscreen and use an antioxidant serum. See http://www.nbcphiladelphia.com/health/tips_info/Before_Botox__Try_Berries_Philadelphia.html

Are you sneezing and itching?: An Update on Seasonal Allergies

Have you been experiencing itching eyes and nose, runny nose, nasal congestion, sore throat, cough, difficulty sleeping…it could be seasonal allergies. With the warm weather starts the spring allergy season which is a result of allergies to tree pollen. How to feel better, limit your time outside, keep windows closed and shower off after outdoor activities, rinsing your nasal passages with saline also helps. If you are still having symptoms, try an over the counter antihistamine, or see your doctor for a prescription for a steroid nasal spray.  http://cbs3.com/video/?cid=6091


A Note from RWWC

“Since our founding in 2008, our goal has been to provide primary care for women. Our team of physicians and nurse practitioners are dedicated to providing preventive care, diagnosis and treatment of acute and chronic disease(s) and coordination of care with specialists.”

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