1 12 rowan jan 2016

January 2016

» How can I be more proactive about my family’s health? » When should parents be concerned about a child who seems hyperactive? » When should I go see my doctor about a cough that won’t go away?

Age-related eye diseases and conditions As you age, you probably notice that your vision is changing. Perhaps you need glasses to see up close or you have more trouble adjusting to glare or distinguishing some colors. These changes are a normal part of aging. These changes alone cannot stop you from enjoying an active lifestyle or stop you from maintaining your independence.

In fact, you can live an active life well into your golden years without ever experiencing severe vision loss. But as you age, you are at higher risk of developing age-related eye diseases and conditions. These include: age-related macular degeneration, cataract, diabetic eye disease, glaucoma, low vision and dry eye.

Age-related Macular Degeneration (AMD) AMD is a disease associated with aging that gradually destroys sharp, central vision.

Central vision is needed for seeing objects clearly and for common daily tasks such as reading and driving.

Cataract A cataract is a clouding of the lens in the eye. Vision with cataract can appear cloudy or blurry, colors may seem faded and you may notice a lot of glare.

Diabetic Eye Disease Diabetic eye disease is a complication of diabetes and a leading cause of blindness.

The most common form is diabetic retinopathy which occurs when diabetes damages the tiny blood vessels inside the retina.

Glaucoma Glaucoma is a group of diseases that can damage the eye’s optic nerve and result in vision loss and blindness. It is usually associated with high pressure in the eye and affects side or peripheral vision.

Dry Eye Dry eye occurs when the eye does not produce tears properly, or when the tears are not of the correct consistency and evaporate too quickly. Dry eye can make it more difficult to perform some activities, such as using a computer or reading for an extended period of time.

January is National Glaucoma Awareness Month Get a comprehensive dilated eye exam Everyone age 50 or older should visit an eye care professional for a comprehensive dilated eye exam.

However, African Americans are advised to start having comprehensive dilated eye exams starting at age 40 because of their higher risk of glaucoma. It’s also especially important for people with diabetes to have a comprehensive dilated exam at least once a year.

Many eye diseases have no early warning signs or symptoms, but a dilated exam can detect eye diseases in their early stages before vision loss occurs. Early detection and treatment can help you save your sight.

Even if you aren’t experiencing any vision problems, visit your eye care professional for a dilated eye exam. He or she will tell you how often you need to have one depending on your specific risk factors.

Key elements of a comprehensive dilated eye examination include dilation, tonometry, visual field test and a visual acuity test.

Dilation This is an important part of a comprehensive eye exam because it enables your eye care professional to view the inside of the eye. Drops placed in each eye widen the pupil, which is the opening in the center of the iris (the colored part of the eye).

Dilating the pupil allows more light to enter

the eye the same way opening a door allows light into a dark room. Once dilated, each eye is examined using a special magnifying lens that provides a clear view of important tissues at the back of the eye, including the retina, the macula, and the optic nerve.

In a person with diabetic retinopathy, the most common diabetic eye disease and a leading cause of blindness in the United States, the exam may show swelling or leaking of blood vessels in the retina, the light-sensitive layers of tissue at the back of the eye. The eye care professional may also see abnormal growth of blood vessels in the retina associated with diabetic retinopathy.

In age-related macular degeneration (AMD), a common cause of vision loss and blindness in people over the age of 50, the exam may show yellow deposits called drusen or clumps of pigment beneath the retina. In some cases, the exam may also show abnormal growth of blood vessels beneath the retina. These AMD-related changes tend to cause deterioration of a small area of the retina called the macula, which is needed for sharp, central vision.

A comprehensive dilated eye exam is also critical for detecting glaucoma, a disease that damages the optic nerve, which carries information from the eyes to the brain. In a person with glaucoma, the dilated exam may show changes in the shape and color of the optic nerve fibers. The exam may also

show excessive cupping of the optic disc, the place where the optic nerve fibers exit the eye and enter the brain.

Tonometry test Tonometry is a test that helps detect glaucoma. By directing a quick puff of air onto the eye, or gently applying a pressuresensitive tip near or against the eye, your eye care professional can detect elevated eye pressure, which can be a risk factor for glaucoma. Numbing drops may be applied to your eye for this test.

Visual field test This test measures your side (peripheral) vision. A loss of peripheral vision may be a sign of glaucoma.

Visual acuity test A visual acuity test will require you to read an eye chart, which allows your eye care professional to gauge how well you see at various distances.

Source: National Eye Institute

More Information: To learn more about age-related eye diseases, visit The National Eye Institute at https://nei.nih.gov and the American Academy of Ophthalmology at www.aao.org.

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Ask Rowan Medicine

How can I be more proactive about my family’s health?

Dr. Christine Kimler, a Rowan Medicine family physician responds: Sometimes, it seems as if our approach to health is a bit backwards. We tend to focus on treating illness, when we should be preventing it. After all, we do call it ‘health care’ and not ‘disease care.’ Keeping healthy sometimes boils down to the kinds of common sense, proactive approaches that you have heard throughout your life. Here are a few examples of what that means: Wash your hands. How many times did your parents remind you to wash your hands before a meal and how many times did you end up just racing through a quick soap and rinse? Cold, flu and other viruses can lurk on the hand you just shook or the door you just opened. Then, touching your eye, mouth or food without washing your hands could cause you to become infected. Washing your hands is your best first line of defense against illness.

Lather your hands for 20 seconds before rinsing the soap – and germs – down the drain. And you don’t need antibacterial soap. Overuse of antibacterial soaps may be contributing to the rise of antibiotic resistant bacteria.

Get immunized. If you are older than six months, you should get a flu vaccine every year.

You can’t catch the flu from the vaccine and getting immunized will limit your ability to pass the virus to others who, for medical reasons, cannot get a flu vaccine. While you are at it, check with your physician to see which other vaccines or booster shots – including HPV, tetanus and pneumonia – that you or a family member should consider.

Stay in bed. Hectic lives are making us a society of tired people, even though getting enough sleep helps to improve health. Adults should get seven to eight hours nightly while teenagers (9-10 hours) and school-aged children (at least 10 hours) need even more. Getting enough sleep has been linked to avoiding heart disease and diabetes and it boosts your immune system and helps you maintain a healthy weight.

Clean your cabinets. The new year is a good time to check your medicine cabinet for both prescription and over-the-counter medications that are beyond their expiration date or are no longer needed. New Jersey’s Project Medicine Drop places secure drop boxes inside local police stations where you can safely dispose of unwanted medications. Drop box locations are listed on the New Jersey Division of Consumer Affairs website (http://www. njconsumeraffairs.gov/meddrop/Pages/ Locations.aspx).

Add color to your meals. If your meals don’t include a variety of dark green and bright colors, then you are likely missing out on the vital nutrients contained in fruits and vegetables. A colorful, wellbalanced diet will boost your immunity and energy levels and help prevent the onset of high blood pressure, diabetes and some types of cancer.

Take a hike. Or a walk, a jog or a bike ride.

Each year, many of us resolve to exercise more only to see that resolution fade away before winter’s end. Choosing an activity that you will enjoy doing,

Introducing

Dr. Christine Kimler We are proud to introduce Dr. Christine Kimler, the newest member of our Family Medicine team. A graduate of both Rowan University and the School of Osteopathic Medicine, Dr. Kimler is board certified in Family Medicine. She is active and involved in the South Jersey community, and looks forward to getting to know you. Dr. Kimler practices in our Stratford location.

To make an appointment with Dr. Kimler, call 856-566-7020. adding it to your daily calendar reminders or finding an exercise partner will help you to keep your commitment to exercise. Weight bearing exercises (walking, jogging and dancing) are good for maintaining muscle and bone strength while boosting cardiovascular health. Strive for 30 to 60 minutes of exercise per day, at least five days each week. However, please be sure to check with your physician before beginning any exercise program.

Dr. Christine Kimler is a Rowan Medicine family physician and a faculty member at the Rowan University School of Osteopathic Medicine. To schedule an appointment at her Stratford office, please call 856-566-7020.

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See how our new look can help YOU get YOUR NEW LOOK in 2016 Our newly renovated fitness center includes state-of-the-art cardio and weight room equipment, including recumbent cross trainers, elliptical trainers, treadmills and more.

Call today for a free tour and membership information! 856-566-6746

Rowan Medicine Wellness and Fitness Center One Medical Center Drive, Second Floor, Stratford, NJ 08084

MedicaLink Ask Rowan Medicine

When should parents be concerned about a child who seems hyperactive?

Michael J. Kinney, MSN, a Rowan Medicine certified pediatric nurse practitioner, responds: It isn’t unusual for a young child to be hyperactive.

Children should be energetic, enthusiastic and inquisitive. While children may appear inattentive or to have a short attention span, their inquisitive minds are being challenged to process a tremendous amount of information they have never encountered before. After all, a lot more of this world is still brand new to a four-year old child.

At the same time, a child with an attention deficit could face significant challenges in navigating the world in and out of the classroom, so I can understand a parent’s concern about a hyperactive child.

According to the U.S. Centers for Disease Control and Prevention, more than six million children in this country have been diagnosed with attention deficit hyperactivity disorder (ADHD), which,

until a few years ago, was called by the similar sounding term of attention deficit disorder (ADD).

In some cases, signs of ADHD may become evident in children as young as two or three years. While symptoms can subside with age, ADHD is not something that a child will simply ‘grow out of.’

The American Psychiatric Association has identified three basic types of ADHD – Inattentive, Hyperactive-Impulsive and Combined – each determined according to the behaviors the child exhibits. Diagnosing Inattentive or HyperactiveImpulsive ADHD relies on the presence of nine potential symptoms, six of which are needed for a diagnosis.

For example, a child with Inattentive ADHD will not listen or pay attention to detail, will be easily distracted and will lose things needed to complete tasks. Children with Hyperactive-Impulsive ADHD will fidget or squirm in their seats, talk excessively or interrupt and blurt out answers.

Combined ADHD is the most common of the three types and, as its name indicates, Combined ADHD includes children with symptoms of both Primary and preventive care Inattentive from infancy through adolescence and Hyperactive• Check-ups • Immunizations Impulsive ADHD. • Well baby and child visits • School, camp and sports physicals It is important to note that many children seem Convenient hours include walk-in morning hours, Saturday morning and evening inattentive. Children appointments. Most insurances accepted. can be naturally energetic, squirm Stratford 856-566-7040 Sewell 856-582-0033 or fidget when in an uncomfortable

situation or can seem easily distracted. All of that is normal behavior for a child. A key determining factor for ADHD, however, is that the child will exhibit ADHD symptoms frequently and to the extent that those behaviors routinely cause difficulties at home and in school. So, a child who appears to have ADHD in a school setting but interacts normally with family or friends outside of the classroom or, conversely, has no problems in school but is inattentive at home, will likely be dealing with some other condition, such as a learning disability, depression, vision or hearing problems, or anxiety disorders.

If you suspect ADHD, schedule an appointment with your child’s pediatrician. If a clear diagnosis can’t be made, your child could then be referred to a specialist who works with children who have ADHD. Although there is no cure for ADHD, physicians can prescribe medications or therapies that can help control the symptoms of ADHD and provide you with a better understanding of practices you can implement to help your child at home and in school.

A quick internet search will yield information about the benefits of certain supplements or the elimination of substances like sugar from the diet of a child with ADHD. So far, none of these alternative treatments have been proven scientifically.

Keep in mind that children with ADHD may need a little extra attention or affection, but can still go on to lead normal, happy lives. After all, ADHD is a condition shared by many famous people throughout history, including Benjamin Franklin, Bill Gates, John F. Kennedy, Abraham Lincoln, Mozart and Sylvester Stallone.

Michael J. Kinney, MSN, is a Rowan Medicine certified pediatric nurse practitioner and a faculty member at the Rowan University School of Osteopathic Medicine. To schedule an appointment, please call the Rowan Medicine Pediatrics offices in Stratford (856-566-7040) or Sewell (856-582-0033).

MedicaLink Ask Rowan Medicine

When should I see my doctor about a cough that won’t go away?

Dr. Peter Saccone, a Rowan Medicine pulmonologist, responds: A cough that hangs on for days isn’t an unusual symptom, but it could be cause for concern.

For example, if you are recovering from a cold, a lingering cough could indicate that the cold virus has spread to your lungs or to the airways leading to the lungs. Those airways are lined by mucusproducing tissues that help combat against infection.

If a virus from a cold has spread there, the resulting irritation will cause inflammation and stimulate the production of the mucus that helps fight off further infection. Coughing is your body’s reaction as it tries to clear the excess mucus or struggles with the restricted airflow caused by the inflammation.

A cough that follows a cold could also indicate acute bronchitis.

Other symptoms of acute bronchitis can include a lowgrade fever (no higher than 100.4 degrees) and fatigue.

During physical activity, you may also experience

shortness of breath because the inflammation is restricting the amount of oxygen that can enter the lungs.

You can treat acute bronchitis with acetaminophen for fever reduction and with an over-the-counter cough medicine. Look for a cough medicine that contains guaifenesin, a type of expectorant that works by thinning out mucus. Please remember to check the label if you are also taking acetaminophen separately. Some cough medicines already contain acetaminophen, which can be toxic if taken in excessive amounts.

Coughing is your body’s reaction as it tries to clear the excess mucus or struggles with the restricted airflow caused by the inflammation.

Do I need a flu vaccine?

The Centers for Disease Control (CDC) recommends everyone age six months and older get a flu vaccine. Since flu activity usually peaks between December and February, it’s not too late to help prevent catching this year’s virus.

It’s really important to get a flu shot if you: • Have a chronic health condition such as diabetes or asthma • Have heart or lung disease • Are age 65 or older • Care for someone in a high-risk population • Are pregnant The flu virus can hit hard – even turning into pneumonia or other illnesses. Talk to your health care provider about your vaccination options.

MedicaLink A nagging dry cough can persist for weeks following acute bronchitis, but a persistent mucus-producing cough or fever that doesn’t respond to over-the-counter medications should lead you to make an appointment with your physician.

Acute bronchitis can It takes about two weeks sometimes result in a secondary infection, from the time of your vaccine leading to pneumonia. to become fully protected Although pneumonia against the flu, but it’s not too is a common illness, it is also a dangerous late to vaccinate. one. The U.S. Centers for Disease Control and Prevention estimates that, each year, about one million Americans seek care for pneumonia in a hospital. On average, about 50,000 people in this country die from pneumonia each year.

Pneumonia can be caused by viruses or by bacteria.

Viral pneumonia will cause symptoms that are similar to, but more severe than, acute bronchitis. For example, coughing may bring up a small amount of mucus and the low-grade fever may be more persistent and accompanied by chills, a sore throat and chest pain.

Bacterial pneumonia will cause a high fever, chills and chest pain that worsens with deep breaths.

Bacterial pneumonia will also cause a noticeable shortness of breath when climbing stairs and a cough that may yield green, yellow or rust-colored mucus.

Contact your physician if you have a cough that continues to hang on or if you have any of the symptoms that indicate you may have pneumonia.

Your physician can determine the cause of a persistent cough and prescribe interventions to help ease your symptoms. If you are diagnosed with bacterial pneumonia, you will usually require a course of antibiotics to cure the infection.

Pneumonia is a common complication of seasonal flu, so please arrange to get a flu shot if you haven’t already done so. It takes about two weeks from the time of your vaccine to become fully protected against the flu, but it’s not too late to vaccinate. Flu season will continue in our area until late April or early May. Already, for the week ending January 2, the CDC reported that New Jersey was experiencing high levels of influenza-like illness.

Dr. Saccone is a pulmonologist with Rowan Medicine and a faculty member of the Rowan University School of Osteopathic Medicine. To schedule an appointment in his Sewell office, please call 856-218-0300.

Join us for a FREE Community Lecture

“How to Lose Belly Fat”

Saturday, January 30 at 10 am Academic Center, Multipurpose Room, One Medical Center Drive, Stratford, NJ Learn how to lose that stubborn spare tire once and for all! Representatives and information about The Healthy Lifestyle Center, Rowan University’s FREE student-run program, will be also be available. Spots are limited – call 856-566-6207 to register.

Presented by Dr. Adarsh Gupta, Associate Professor, Family Medicine and Director, Center for Medical Weight Loss & Metabolic Control, Rowan University School of Osteopathic Medicine and Dr. Greg Biren, Assistant Professor, Health & Exercise Science, Rowan University.

Walking problems following a stroke?

The MILESTONESM Study is looking at the safety and effectiveness of a potential new medication for the treatment of walking problems in people who have had a stroke.

You may be able to take part if you: • are 18 years of age or older • have had an ischemic stroke • have walking problems as a result of the ischemic stroke The study will last about 5 months and will involve approximately 10 visits to a study center.

All study-related visits, assessments, and study medication will be provided at no cost to you. In addition, compensation for time and travel may be provided.

To learn more about the MILESTONESM Study, please contact the Office of Clinical Trials Management

856-566-2305

Brain wiring changes might help guard against bipolar disorder

By ROBERT PREIDT HealthDay

Naturally occurring brain wiring changes might help prevent bipolar disorder in people who have a high genetic risk for the mental illness, a new study suggests.

The discovery about these brain wiring changes could help efforts to develop better treatments for the disorder, according to Mount Sinai Hospital researchers in New York City.

People with bipolar disorder experience severe swings in mood, energy and activity levels, and the ability to perform daily tasks. Genetics are a major risk factor, and people with a parent or sibling with bipolar disorder are much more likely to develop it than those with no family history of the mental illness.

Researchers used functional MRI to monitor the brains of bipolar disorder patients, their siblings who did not have the illness (resilient siblings) and unrelated healthy volunteers. The bipolar disorder patients and their resilient siblings had similar abnormalities in brain wiring that handles emotional processing, but the resilient siblings had additional changes in that wiring.

“The ability of the siblings to rewire their brain networks means they have adaptive neuroplasticity that may help them avoid the disease even though

they still carry the genetic scar of bipolar disorder when they process emotional information,” study lead author Dr. Sophia Frangou, a professor of psychiatry, said in a Mount Sinai news release.

The study was published online Jan. 5 in the journal Translational Psychiatry.

“A family history remains the greatest risk factor for developing bipolar disorder and while we often focus on risk, we may forget that the majority of those who fall into this category remain well,” Frangou said.

“Looking for biological mechanisms that can protect against illness opens up a completely new direction for developing new treatments. Our research should give people hope that even though mental illness runs in families, it is possible to beat the odds at the genetic lottery,” she concluded.

Source: National Alliance on Mental Health

How to talk about mental health Do you need help starting a conversation about mental health? Try these questions.

I’ve been worried about you.

Can we talk about what you are experiencing? If not, who are you comfortable talking to?

What can I do to help you to talk about issues with your parents or someone else who is responsible and cares about you?

What else can I help you with?

I am someone who cares and wants to listen. What do you want me to know about how you are feeling?

Who or what has helped you deal with similar issues in the past?

How to offer support

Sometimes talking to someone who has dealt with a similar experience helps. Do you know of others who have experienced these types of problems who you can talk with?

If a friend or family member is showing signs of a mental health problem or reaching out to you for help, offer support by:

Asking questions, listening to ideas, and being responsive when the topic of mental health problems come up

to invite him or her without being overbearing, even if your friend or family member resists your invitations

Finding out if the person is getting the care that he or she needs and wants— if not, connect him or her to help

Reassuring your friend or family member that you care about him or her

Educating other people so they understand the facts about mental health problems and do not discriminate

It seems like you are going through a difficult time.

How can I help you to find help?

How can I help you find more information about mental health problems?

Expressing your concern and support

Offering to help your friend or family member with everyday tasks

Reminding your friend or family member that help is available and that mental health problems can be treated

Including your friend or family member in your plans—continue

Treating people with mental health problems with respect, compassion, and empathy

MORE INFORMATION The U.S. National Institutes of Mental Health has more about bipolar disorder at www.nimh.gov

I’m concerned about your safety.

Have you thought about harming yourself or others?

Source: National Alliance on Mental Health

Toothlessness a clue to deadly heart disease

By ROBERT PREIDT HealthDay Toothless heart disease patients are nearly twice as likely to die as those who have all their teeth, a new study suggests.

Gum disease is the most common cause of tooth loss, and gum disease-related inflammation is believed to play a role in the narrowing of arteries, the researchers said.

“While we can’t yet advise patients to look after their teeth to lower their cardiovascular risk, the positive effects of brushing and flossing are well established.

The potential for additional positive effects on cardiovascular health would be a bonus,” said study lead author Dr. Ola Vedin, a cardiologist at Uppsala University Hospital and Uppsala Clinical Research Center in Sweden.

The study included more than 15,000 heart disease patients in 39 countries. They were assessed for tooth loss and followed for an average of 3.7 years.

Those with the fewest teeth were older, smokers, female, less active and more likely to have diabetes, high blood pressure, more body fat and a lower level of education, the study found.

After adjusting for certain factors, the researchers concluded that every increased level of tooth loss was associated with a six percent increased risk of major cardiovascular events, and a roughly 15 percent higher risk of cardiovascular death, death from any cause and stroke.

Compared to patients with all their teeth, those with no teeth had a 27 percent higher risk of major cardiovascular events. The researchers also found toothlessness was

Should I see my dentist?

Regular dental checkups may spot problems before they become serious, but there are signs you should visit your dentist sooner than your next scheduled exam.

The American Dental Association cites these warning signs:

associated with an 85 percent higher risk of cardiovascular death, 81 percent higher risk of death from any cause, and a 67 percent higher risk of stroke.

The study only found a link, not a causeand-effect relationship, between dental health and heart health. It was published Dec. 16 in the European Journal of Preventive Cardiology.

“The risk increase was gradual, with the highest risk in those with no remaining teeth,” Vedin said in a journal news release.

“For example the risks of cardiovascular death and all-cause death were almost double to those with all teeth remaining. Heart disease and gum disease share many risk factors such as smoking and diabetes, but we adjusted for these in our analysis and found a seemingly independent relationship between the two conditions,” Vedin explained.

Among study participants, around 16 percent had no teeth, and roughly 40 percent were missing half of their teeth, Vedin noted.

“This was an observational study so we cannot conclude that gum disease directly causes adverse events in heart patients. But tooth loss could be an easy and inexpensive way to identify patients at higher risk who need more intense prevention efforts,” Vedin said.

More information The U.S. National Institutes of Health has more information about preventing gum disease at www.nih.gov.

• You have pain or swelling in the mouth, face or neck; jaw pain; or bleeding or swelling of the gums.

• It’s become difficult for you to chew or swallow.

• Your mouth is constantly dry.

• You notice sores or spots inside your mouth

Dry skin? It must be winter D ry skin is a very common skin problem and is often worse during the winter when environmental humidity is low (i.e., "winter itch"). It can occur at all ages and in people with or without other skin problems.

entering the body. Both the skin oils and the dead skin cells hold a certain amount of water in the stratum corneum and it is this stratum corneum water that helps keep the skin soft, pliable and smooth.

Dry skin results when there is not enough water in the stratum corneum for it to function properly. One way this can happen is when protective oils in the stratum corneum are lost and the water that is normally present in the skin is allowed to escape. Too much soapy water, exposure to Dry skin problems harsh chemicals, the normal aging process Dry skin very commonly produces itching, Causes of dry skin and certain types of skin diseases are some which can be severe and interfere with of the causes of decreased amounts of The outermost layer of the skin is sleep and other daily activities. Repeated protective skin oils. As the stratum corneum called the stratum corneum (this is the rubbing and scratching can produce areas dries out it shrinks and, as it shrinks, small layer that peels off after a sunburn).

The of thickened, rough skin (lichenification). cracks can occur. This exposes the underlying stratum corneum consists of dead skin cells Dry, thickened skin can crack, especially in living cells to irritating substances and germs embedded in a mixture of natural oils (lipids) areas subject to chronic trauma (e.g., hands in the environment. that are made by underlying living skin cells. and feet), causing painful cracks in the skin These natural skin oils keep the water inside (fissures). Dry skin and scratching may result our body from escaping into the air and also Long-term prevention in a dermatitis when the skin becomes red (inflamed) in addition to dry and scaly. keep irritating substances and germs from and control Dry skin is usually a long-term problem that recurs often, especially in winter. When you notice your skin beginning to get dry, resume your moisturizing routine and avoid the use of harsh soaps. If the itchy, dry, skin rash returns, use both the moisturizers and the prescription steroid cream or ointment.

There are basically two types of moisturizers: facial moisturizers and body moisturizers. Most facial moisturizers on the market relate largely to makeup and cosmetic concerns.

There are four basic classes of body moisturizers: ointments, oils, creams and lotions (listed in decreasing order of moisturizing power). It should be noted that all of the moisturizer products mentioned in this article are available without prescription.

Dry skin’s appearance

The normally fine lines in the skin become more visible, the skin feels rough and appears dull and flaky. In more advanced cases, fish net-like cracks resembling the fine fracture lines of cracked porcelain can occur.

Dry skin occurs most commonly on the arms and legs, but can also affect the trunk of the body. Dermatologists often call dry skin "xerosis" or "asteatosis".

Round, scaly, itchy, red patches scattered over the legs, arms and trunk (nummular eczema) may also appear.

The appearance of yellow crusts or pus in these areas indicates that a bacterial infection is developing. This would require specific antibiotic therapy from your dermatologist or family physician.

If your skin is very dry, or if you have an associated red dermatitis, it is a good idea to seek the advice of your dermatologist or family physician.

Source: University of Iowa Hospitals and Clinics Department of Dermatology

TLC FOR WINTER SKIN Since hot water can make skin lose moisture, take shorter warm showers and baths.

Use a gentle, light exfoliator to slough off dead skin cells.

Don't pick at or peel dry skin.

Switch to an oil-based moisturizer that includes sun protection factor.

Reapply throughout the day if you'll be outside.

Run a humidifier to keep home air moist.

If your clothes get wet, remove them as soon as possible to avoid irritating the skin.

Source: The American Osteopathic Association

MORE INFORMATION To learn more about keeping your skin healthy visit the American Academy of Dermatology at www.aad.org.

Cutting sugar from diet boosts kids’ health immediately

By DENNIS THOMPSON HealthDay

Cutting most of the sugar from a child’s diet can immediately improve health, even if the diet still contains the same amount of calories and carbohydrates as before, a new study suggests.

Researchers put a group of 43 obese kids on a nine-day diet that severely restricted sugar intake, but replaced added sugars with starchy foods to maintain the children’s intake of calories and carbs.

That diet caused immediate reductions in their high blood pressure and improvement in their blood sugar and cholesterol levels, the investigators found.

“Every aspect of their metabolic health got better, with no change in calories,” said study author Dr. Robert Lustig, a pediatric endocrinologist at UCSF Benioff Children’s Hospital in San Francisco. “This study definitively shows that sugar is metabolically harmful not because of its calories or its effects on weight. Rather, sugar is metabolically harmful because it’s sugar.”

The finding raises serious concerns about the health effects of sugar, and calls into

question the longstanding belief that “a calorie is a calorie is a calorie,” regardless of its food source, said Dr. Jeffrey Mechanick, director of metabolic support in the division of endocrinology, diabetes and bone disease at Mount Sinai Icahn School of Medicine in New York City.

“It’s an important study that adds to the weight of evidence, and really calls out for us to examine the fact that eating patterns, and what a healthy eating pattern is for the American public, are as important as total caloric intake,” said Mechanick, who is president-elect of the American College of Endocrinology and a past president of the American Association of Clinical Endocrinologists.

For the study, researchers recruited kids ages eight to 18 who were obese and had at least one other chronic metabolic problem, such as high blood pressure, elevated cholesterol levels or signs of insulin resistance.

The study only involved African-American and Hispanic children, because of their higher risk for certain conditions associated with metabolic syndrome, such as high blood pressure and type 2 diabetes.

The researchers provided the study participants with nine days of food, including all snacks and drinks.The menu was crafted to be kid-friendly, but restricted foods loaded with added sugars such as high-sugar cereals, pastries and sweetened yogurt.

All of the foods – which included turkey hot dogs, potato chips and pizza – came from local

supermarkets, and researchers provided starchy carbs from foods such as bagels, cereal and pasta to replace the carbs that normally would have come from sugary treats.

The end result: kids consumed the same amount of carbs, but their total dietary sugar intake dropped from 28 percent to 10 percent.

The children were given a scale and told to weigh themselves every day. If they started to drop weight drastically, they were given more low-sugar foods so that weight loss could be discounted as a factor in any positive health effects that might occur.

Beverages are the major source of added sugar, accounting for 47 percent of all added sugars consumed by Americans. These include soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic beverages and flavored waters, according to the U.S. Food and Drug Administration After just nine days on the sugar-restricted diet, virtually every aspect of the participants’ metabolic health improved without a huge change in weight. Blood pressure began to move toward normal, and levels of triglycerides and LDL (“bad”) cholesterol decreased. Fasting blood glucose went down by five points, and insulin levels were cut by a third, the findings showed.

“We took kids who are sick and we made them healthy,” Lustig said. “We didn’t completely reverse it, but within 10 days we went a very long way in reversing their

MORE INFORMATION For more on dietary sugar, visit the U.S. National Institutes of Health at www.nih.gov.

metabolic dysfunction, with no change in calories and no change in weight.”

The sugar industry took issue with the findings, however. “Dr. Lustig’s most recent study fails to give scientific accuracy to important questions that need legitimate answers,” The Sugar Association said in a statement.

“The study was set up to ensure that the subjects maintained their body weight,” the group said, but “as the study unfolded, the subjects didn’t. Thirty-three of the 43 participants lost weight — a significant average of two pounds per person over nine days. This makes it impossible to separate the effects of weight loss from dietary changes on the health variables measured.”

The association added that the study had insufficient data on what types of sugars — fructose especially — were contained in the children’s diets, and the study relied on self-reported information, which the association called “unreliable.”

But Lustig countered that other studies have shown that sugar can have bad metabolic effects outside of promoting weight gain through additional calories.

The sugar contained in foods is made up of two simple sugars called glucose and fructose, and studies have found that fructose can promote cellular aging, he said.

Fructose also acts directly upon the reward system in a person’s brain, causing them to crave more sugar. “The more sugar you get, the more you want,” Lustig said.

These findings show that people would do well to follow dietary guidelines that already encourage them to limit sugar intake and eat more fruits and vegetables, Mechanick said.

However, he noted that the study involved only a handful of kids over a short amount of time, and needs to be replicated in a larger group.

“It’s an important study to file along with the total weight of evidence,” Mechanick said. “Obviously, it’s going to need to be corroborated in a different setting and a different population.”

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Kennedy Health is the principal hospital of the Rowan University School of Osteopathic Medicine. Other affiliated hospitals and health systems include Lourdes Health System, Inspira Health Network, Cooper University Hospital, Meridian Health System, Christ Hospital and Atlantic Health System.