MedicaLink May 2015

The University Doctors

MedicaLink Celebrating 15 Years

Rowan University School of Osteopathic Medicine and Graduate School of Biomedical Sciences confer doctoral and master’s degrees What is the best way to treat my recently diagnosed celiac disease?

Is it safe for older people to engage in strenuous exercise?

May 2015

May is National Stroke Awareness Month

How to lower your stroke risk There are a number of ways you can reduce your risk of stroke, a neurologist says.

“Stroke is the fifth leading cause of death in the United States, and a leading cause of disability,” Dr. Jose Biller, chair of Illinois-based Loyola University’s department of neurology, said in a university news release. “Stroke can happen to anyone at any age.”

Stroke risk is increased by lifestyle factors such as smoking, drinking, high blood pressure, high cholesterol, diabetes, obesity, as well as certain heart conditions and mini-strokes (called “transient ischemic attacks”).

When a stroke occurs, brain cells begin to die. That means it’s critically important to be able to recognize the signs of stroke and call 911 immediately.

“Time is brain. Prompt treatment potentially can reduce stroke damage significantly,” Biller said.

A system called FAST can help you recognize stroke symptoms in someone else: FACE. Ask the person to smile.

Does one side of the face droop?

ARMS. Ask the person to raise both arms. Does one arm drift downward?

PEECH. Ask the person to S repeat a simple phrase. Does the speech sound slurred or strange?

TIME. If you observe any of these signs, it's time to call 911.

Neurologist suggests healthier lifestyle, treatment of heart conditions to help prevent brain attack

MORE INFORMATION

The U.S. National Heart, Lung, and Blood Institute has more about stroke at nhlbi.nih.gov

E-Health records

May not boost stroke care

While electronic health records are touted as the holy grail of a transparent health care system, a new study finds they don’t improve treatment results for some stroke patients in the United States.

Patients fared about the same in terms of quality of care and illness progression whether their hospitals had embraced electronic health records or not, researchers report May 4th in the Journal of the American College of Cardiology.

The records “do not appear to be sufficient, at least as currently implemented, to improve overall quality of care or outcomes for this important disease state,” lead author Dr. Karen Joynt, a cardiologist at Brigham and Women’s Hospital and Harvard Medical School in Boston, said in a journal news release.

Electronic health records provide a more comprehensive medical picture than records related to a single hospitalization.

Between 2007 and 2010, researchers looked at 1,236 hospitals, more than 500 of which used electronic health records. They found that the records made no difference to ischemic stroke patients’

MORE INFORMATION

recovery even when they adjusted statistics for various patient characteristics.

However, the researchers did find that patients in hospitals with electronic records were discharged sooner.

Ischemic stroke, which occurs when a blood vessel to the brain is blocked, is by far the most common type of stroke.

Study finds similar results whether or not a hospital has switched to electronic records The new study “is a wake-up call that we should heed,” writes Dr. John Windle, chief of cardiology at University of Nebraska Medical Center, in an accompanying commentary.

Windle said electronic health records haven’t been proven to improve quality of health care, the health of large groups of people, or efficiency.

“An [electronic health record’s] first priority must be support of clinical care, not documentation for billing and reimbursement,” Windle said.

Source: HealthDay

For more on electronic health records, see healthIT.gov.

The University Doctors MedicaLink

Rowan University School of Osteopathic Medicine and Graduate School of Biomedical Sciences confer doctoral and master’s degrees and “unyielding efforts to improve the health For 146 Rowan University students, Commencement of the nation by reshaping graduate was the first day that the names given them at birth medical education.” could be preceded by one of the world’s most respected Dr. Cavalieri also presented this year’s titles: Doctor.

Distinguished Alumnus Award to Dr. Todd As a warm breeze carried echoes of applause and Schachter (Class of 1984), noting his role cheers across the University Green, graduates of Rowan’s as “an assistant professor, School of Osteopathic “For 146 Rowan University students, professional advocate, donor Medicine and Graduate School of Commencement was the first day that and mentor” who has helped preserve the unique qualities Biomedical Sciences the names given them at birth could of osteopathic medicine. proudly strode across be preceded by one of the world’s most the stage to receive their doctoral degrees. respected titles: Doctor.

They, along with dozens of fellow students who received their master’s degrees today, were escorted onto the Green by Rowan University faculty, administrators and special guests.

Acknowledging the challenging academic path all of the students followed to reach this point, Rowan University President Dr. Ali Houshmand told the graduates of the immense pride he shared with the graduates on this day.

“Several years ago you made a decision that led you on a powerful, complicated, enthralling path,” he said. “Today you head toward a future of unlimited opportunity. You will continue to learn, you will continue to serve. You will make a difference. And, I believe, you will help lead your generation.”

Along with the academic degrees conferred by Rowan University Board of Trustees Chairman Linda Rohrer, several medical students were singled out for departmental awards, and two military students – Matthew Esposito (US Army) and Tanya Lindemuth (US Navy) – were sworn in and received their commissions as officers.

Dr. Thomas Cavalieri, dean of the School of Osteopathic Medicine, and Dr. Houshmand presented the medical school’s Medal of Kafi Rudolph from Camden, will Excellence to Dr. Norman Vinn, the immediate past president of the American Osteopathic return to RowanSOM to begin her Family Association and this year’s keynote speaker.

Medicine residency.

In his remarks, Dr. Cavalieri cited Dr. Vinn’s commitment to seniors and homebound patients

RowanSOM professor and Washington Township resident, Dr. Robert Nagele, congratulates his son, Eric, who graduated from RowanSOM and will continue training in Neurology at Cooper University Hospital.

Cherry Hill sisters and RowanSOM graduates, April and Kim Barnum, will begin Family Medicine residencies at Brown University and Overlook Medical Center, respectively.

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Turning sniffles into smiles Primary and preventive care from infancy through adolescence

• Well baby and child visits • School, camp and sports physicals

• Immunizations • Check-ups

Convenient hours include walk-in morning hours, Saturday morning and evening appointments. Most insurance plans accepted.

To schedule an appointment, call 856-566-7040

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For access to the most advanced OB/GYN and Midwifery specialists, call 856-566-7090 to make an appointment today. theuniversitydoctors.com facebook.com/theuniversitydoctors twitter.com/universitydocs

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Pulmonary/Critical Care Medicine Stratford 856-566-6859 Voorhees 856-770-1305

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Ask& Technology The University Doctors

What is the best way to treat my recently diagnosed celiac disease?

Dr. Richard Walters, a gastroenterologist with The University Doctors, responds:

If you or someone close to you has recently been diagnosed with celiac disease, you will likely be learning a lot about a protein called gluten and will soon become an avid reader of the tiny printed ingredients list on packaged foods.

Gluten is a protein found in the grains such as wheat, barley and rye. When people with celiac disease consume gluten, it causes their immune system to attack the lining of the small intestine, damaging villi, the fingerlike growths found on the intestine’s surface. The resulting damage, which can be permanent, prevents the absorption of nutrients from food.

Gluten is present in many forms beyond the obvious cakes, breads and cereals, so people with celiac disease have to carefully scrutinize food labels to be sure that the ingredients are gluten-free. Although gluten-free products will be labeled as such, “gluten” will not be a listed ingredient of foods that contain it. Instead, gluten is a part of several common food ingredients, including modified food starch, natural or artificial flavoring and hydrolyzed vegetable protein. Some products that you might not consider, such as medications, vitamins, supplements, lipstick and the glue on envelopes, can also contain gluten.

Not all people with celiac disease will react to gluten in the same way. While abdominal cramps and diarrhea are common reactions, some people have no symptoms at all. Irritability can be another symptom and, in fact, is a common indicator found in children with celiac disease. Nutrient deficiencies are another common feature, including iron deficiency and its associated anemia, especially in the absence of gastrointestinal bleeding or heavy menses.

Because celiac disease symptoms are varied, can mimic those of other disorders and only appear after gluten is consumed, people with celiac often contend with their symptoms for years before they are finally diagnosed. Many patients are misdiagnosed with other conditions, most commonly irritable bowel syndrome.

Because of that, it is worthwhile to follow up with a gastroenterologist for further evaluation if your symptoms are not responding as expected or if any unusual symptoms appear.

Diagnosing celiac disease is a two-step process. beginning with a blood test that searches for increased levels of celiac disease antibodies. While not conclusive, a blood test that finds higher levels of antibodies will indicate that you may have celiac disease. To confirm a diagnosis, your physician will need to refer you to a gastroenterologist for an upper endoscopy to evaluate the small bowel tissue and obtain a biopsy sample to search for damage to the villi that has been caused by celiac disease.

Currently, the only effective treatment for celiac disease is to follow a strict gluten-free diet that carefully screens ingredients to determine which foods to avoid. As indicated, gluten can be a component of a variety of food and non-food ingredients, and is even sometimes used as a binding agent in pills. Whether or not a specific medication contains gluten can vary depending on the location of the factory where it was made.

Dining out presents another challenge for the person with celiac disease because it is sometimes difficult to know all the ingredients used in sauces or seasonings. However, many restaurants now offer a selection of gluten-free menu choices and supermarkets are devoting ever-increasing shelf space to gluten-free foods.

At the same time, a number of pharmaceutical companies are pursuing medications that could help the estimated three million Americans affected by celiac disease. That research extends from testing existing medications for their effectiveness against the disease, to the development of new drugs that either break down gluten or block it from being absorbed by the intestines.

Talk to your physician anytime you experience unusual symptoms. Because it blocks the absorption of certain nutrients, untreated celiac disease can lead to anemia and osteoporosis in adults and to slow growth and weakened bones in children. Other conditions associated with celiac disease include pregnancyrelated complications such as low-birthweight and preterm births; miscarriages; autoimmune conditions Let us help treat your digestive health issues such as diabetes and thyroid disease; and John C. Chiesa, DO, FACOI Drew Chiesa, DO even cancers like small Donald McMahon, DO Richard Walters, DO bowel lymphomas.

To schedule an 856-566-6853 or 856-218-0300 (Option 6) appointment with Dr. Walters, please call 856-566-6853 for We offer G.I. services at these locations: the Stratford Office Marlton • Mt. Laurel • Sewell • Stratford • West Deptford located at 42 East theuniversitydoctors.com Laurel Road, Stratford, NJ 08084, Suite 3500.

We Trust our Gut Instinct

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Research Study

Are you married?

Do you have Type II diabetes?

For when it becomes more than just misplacing keys

Rowan University is studying the effects of spousal support in diabetes management.

To learn more or see if you qualify for the study, please call 856-566-6141 or email jungkj@rowan.edu.

Our Memory Assessment Program (MAP) is specially designed to identify the possible causes of memory loss. Our team evaluates physical and medical conditions, mood, thinking and memory, and will make recommendations for an ongoing plan of care.

COMMUNITY OMM CLINIC Call to make an appointment today 856-566-6843

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New Jersey Institute for Successful Aging University Doctors Pavilion 42 East Laurel Road, Suite 1800 Stratford, NJ 08084

NeuroMusculoskeletal Institute (NMI) 42 East Laurel Road Suite 1700 Stratford, NJ 08084

rowan.edu/som/njisa facebook.com/theuniversitydoctors twitter.com/universitydocs

Contact us to schedule an appointment: OMMclinic@rowan.edu 856-258-0905 Powered by: DISCLAIMER: There is no obligation to use any doctor affiliated with Rowan University School of Osteopathic Medicine or any other OMM doctor after being treated at the OMM Clinic. The OMM clinic is not an alternative to long-term management of an issue. The Clinic can deny treatment to any patient for any reason.

The University Doctors MedicaLink Ask The University Doctors

Is it safe for older people to engage in strenuous exercise?

Dr. Anita Chopra, a Rowan Medicine geriatrician and the director of the New Jersey Institute for Successful Aging at Rowan University, responds: ages of 55 and 73. At the end of the eight-year study, Generally speaking, regular exercise try walking for 10 or 15 minutes and add a few more the researchers found that those adults who had is essential to successful aging with minutes each week. been physically active at the beginning of the study benefits that are almost too numerous For a variety of reasons, walking may not be right and who remained active had the lowest incidence to list. for everyone. In fact, no one type of exercise will be of chronic disease, memory loss and disability.

Aerobic exercise improves your the best choice. The type of exercise you do should Surprisingly, those who didn’t begin regular exercise cardiac and respiratory health, and has be something you enjoy so that it will be easier to until after the study began fared nearly as well. been shown to help protect against continue with your program. Whether you choose In fact, this second group was seven times less diabetes and some forms of cancer. walking, bike riding, swimming, tennis, weight likely to suffer from chronic disease or disability Exercise that builds muscle strength, increases balance lifting, dancing or some other exercise, finding a than those individuals who never began an or improves flexibility will help prevent falls and friend who enjoys the same activity is also a good exercise program. will increase freedom of movement, making it easier way to help you stick to your program.

So what kind of exercise and how much should to accomplish everyday activities that can help you to Keep in mind, too, that the kind of physical you be doing? continue to live independently. activity you already do, such as gardening, The U.S. Centers Recent research appears to show vacuuming or raking leaves also counts as exercise.

“So what kind of exercise and how for Disease Control that it doesn’t seem to matter how But unless you are doing those same activities five and Prevention old you are when you start exercising. much should you be doing?” to seven days per week, you aren’t going to benefit suggests that An article published in the British as much as you 30 to 60 minutes of moderate to vigorous Journal of Sports Medicine in late 2013 reported on would with “...please be sure you walking on most days could reduce the risk a study involving more an exercise speak to your physician of some chronic diseases by as much as half, than 12,000 Australian program. before beginning any new while adding nearly five men who were between Finally, exercise program. Our bodies years to the average the ages of 65 and 83. The please be sure lifespan. If you men were assessed at the beginning of the you speak to are capable of all kinds of haven’t exercised study and monitored over a period of 10 to 13 your physician activity, but not everyone’s in a while, years. The researchers found that those men who before body can handle all types however, please exercised more than 150 minutes per week beginning any be prepared to of exercise.” were more likely to still be living at the new exercise start slowly study’s end and were better able to program. Our and gradually add function independently than those who bodies are capable of all kinds of activity, but not to your routine. had everyone’s body can handle all types of exercise.

For example, been sedentary.

Your physician can advise you on what activities you instead of That study, however, raised questions about can safely do, any precautions you need to take and walking for whether the benefits of exercise were felt any warning signs that would suggest you need to 30 minutes, only by those who already exercised at the curtail your exercise program or seek medical help. beginning of the study and who continued To schedule an appointment with exercising throughout the study years.

Dr. Anita Chopra, please call 856-566-6843.

Other research, published earlier The Stratford office is located in The University this year in the same journal, provided Doctors Pavilion, 42 East Laurel Road, Suite 1800, some answers. In that study, researchers Stratford, NJ 08084. examined results from more than 3,400 healthy men and women who were between the The University Doctors MedicaLink is an Advertorial Supplement published by Rowan University School of Osteopathic Medicine (RowanSOM). RowanSOM staff: Mary Louise Bianco-Smith (editor), Julia Swope, Gerald Carey, Lynne Yarnell, Lucy McGorry, Bernardine Jones. Please send inquiries via email to: sominfo@rowan.edu or RowanSOM Marketing Department, University Doctors Pavilion, Suite 1300, 42 East Laurel Road, Stratford, NJ 08084, 856-566-6191.

May is Skin CancerAwareness Month

Don’t forget your back!

By RANDY DOTINGA HealthDay

said Dr. Joshua Zeichner, assistant professor of dermatology at the A new survey finds that many people in the Icahn School of Medicine at Mount Sinai, United States are forgetting their backs when in New York City. they try to be forward-thinking about skin "We also need to encourage our friends cancer prevention. and family members to do the same," Experts at the American Academy of he said.

Dermatology, which sponsored the recent The poll also found that too few survey, note that the back is a common site for Americans are checking their backs for melanoma, a potentially deadly skin cancer. signs of skin cancer. More than half (57 However, of the more than 1,000 Americans percent) said they know how to do a selfpolled, over a third said they rarely or never check (women were more likely than men apply sunscreen to their backs when they're to understand the procedure), but only half in the sun. Almost half (43 percent) also said inspect themselves at least once a year. that they never or rarely ask anyone to assist Only 36 percent of those surveyed check for patients to be educated on the simple applying sunscreen to their backs. their backs for skin cancer at least once a skin cancer and benefits of sunscreen, the Men weren't as willing as women to year, and only 35 percent ask someone else to ways to check one's skin for signs of skin importance of these actions will outweigh the cancer, and to perform these self-examinations potential barrier of simply asking for help," apply sunscreen to their backs or help, the survey found. frequently, as well as to schedule regular ask someone else for help, and "We need to take charge she added. visits with a dermatologist to check all those they were twice as likely to be of our own health and According to the American Cancer 'hard-to-reach' or 'hard-to-see' places," said uncomfortable about the whole monitor our skin for new Society, skin cancer is one of the most idea. Overall, 40 percent of men or changing spots," Zeichner Dr. Katy Burris, a dermatologist with the North common malignancies, with more than 3.5 Shore-LIJ Health System in Manhasset, N.Y. and 33 percent of women surveyed said, because "the best million cases of basal and squamous cell And, "while many people may feel said they rarely or never apply way to cure skin cancer is skin cancer diagnosed in the United States uncomfortable asking someone else to apply sunscreen to their backs. early detection." each year. Another 73,000 cases of the most many people don't use sunscreen to their back, hopefully as the public deadly form of skin cancer, melanoma, are One expert said he wasn't Another expert agreed. sunscreen on this area, becomes more educated on the dangers of surprised by the finding.

"It is incredibly important diagnosed annually. or check it for cancer "It is important to apply sunscreen not only to our fronts, but MORE INFORMATION Find out more about skin cancer at the American Cancer Society at cancer.org. also to our backs regularly,"

SURVEY BY DERMATOLOGISTS' GROUP FINDS

Immune-focused drugs show promise against melanoma

By DENNIS THOMPSON HealthDay Drugs that supercharge the body's immune system show promise in treating advanced melanoma, according to a pair of clinical trials.

The trials both involve drugs called immune checkpoint inhibitors, which essentially prod the immune system to attack and destroy cancer cells, said Dr. Suzanne Topalian, director of the Melanoma Program at Johns Hopkins' Sidney Kimmel Comprehensive Cancer Center in Baltimore.

In one trial, researchers found that an immune checkpoint inhibitor called Keytruda (pembrolizumab) outperformed the current frontline treatment for advanced melanoma, another immune-boosting

drug called Yervoy (ipilimumab).

The other trial showed that patients responded better to a combination of two different types of immune checkpoint inhibitors than to Yervoy used on its own.

The new drugs provide hope for patients with advanced melanoma, which up to now has proven a swift and fatal disease, said Dr. Gary Schwartz, chief of the division of Hematology/ Oncology at Columbia University Medical Center in New York City.

"We were lucky if patients lived nine to 11 months," said Schwartz, who also is an expert for the American Society of Clinical Oncology. "Now we have patients living five or 10 years with metastatic disease, and that was unheard of in melanoma."

Schwartz said the immune-boosting

drugs now being tested have the potential to help curb many other forms of cancer.

"The potential here is really limitless with immune activation. Now we can effectively turn on these immune switches and kill cancer cells," he said. "This is the beginning of a new age of oncology, and it is starting with melanoma."

The U.S. Food and Drug Administra-

Keytruda,Yervoy and other medications harness immune cells to target cancers, experts say

tion approved Yervoy in 2011. The drug targets an immune system "switch" called CTLA4, which acts to rein in the body's immune cells so they don't run amok.

Cancers normally take advantage of controls like CTLA4 to avoid detection and destruction by the immune system.

"It turns out these immune checkpoint molecules help the tumor create a shield around itself, preventing the immune cells from destroying it," Topalian said.

The FDA subsequently has approved a second-generation set of immune checkpoint inhibitors that target a more cancer-specific "switch" called PD1,

MORE INFORMATION

Schwartz said. These drugs currently are used if patients do not respond to Yervoy.

One of the anti-PD1 drugs, Keytruda, showed better results with fewer side effects in a phase III trial that compared it against Yervoy, researchers recently reported.

About 33 percent of patients responded to treatment with Keytruda, compared with 12 percent for Yervoy, the study found.

Furthermore, only 12 percent of patients taking Keytruda suffered from side effects, compared with 20 percent in those who received Yervoy.

For more on melanoma, visit the U.S. National Institutes of Health at nih.gov.

May is ArthritisAwareness Month New research

reveals clues to disease severity, potential outcomes

Gene discoveries could help rheumatoid arthritis treatment

By STEVEN REINBERG HealthDay Genetic variations may hold clues to rheumatoid arthritis — suggesting not only who will develop the painful condition, but also predicting its severity and even who might die from it, a new study says.

"Genetic factors predisposing to disease, to disease severity, and response to treatment will allow tailoring treatment to individual patients' needs," said lead researcher Dr. Sebastien Viatte, a research fellow at the University of Manchester in England.

Using data from several sources on thousands of patients in the United Kingdom, researchers found that gene mutations at a location on a chromosome called HLA-DRBl were associated with rheumatoid arthritis severity and the response to treatment with tumor necrosis factor (TNF) inhibitor drugs.

This study, Viatte said, is a potentially important first step toward personalized medicine for patients with the challenging autoimmune disease.

In rheumatoid arthritis, the body's immune system mistakenly attacks the joints, causing inflammation that

can damage joints and organs, such as the heart, according to the Arthritis Foundation. About 1.5 million people in the United States have the often disabling condition.

Viatte said the new findings, published April 28th in the Journal of the American Medical Association, must be replicated before they can influence patient treatment.

Still, Dr. David Felson, a professor of medicine and epidemiology at Boston University School of Medicine, welcomed the report.

"This newly discovered genetic abnormality that is associated with the risk of developing rheumatoid arthritis seems also to be associated with the severity of the disease and maybe with risk of dying from rheumatoid arthritis," said Felson, co-author of an accompanying journal editorial.

He added that although the risks associated with this mutation are modest, they appear to be real. "Every little bit helps," Felson said.

There isn't just one gene associated with rheumatoid arthritis, however, Felson said. Also, outside factors such as smoking may play a part, he said.

Advances have been made in identifying genetic susceptibility for autoimmune diseases, but not much is known about how this might affect disease prognosis and treatment, according to background information in the study.

To explore the association between HLA-DRBl gene mutations and rheumatoid arthritis, Viatte's team used imaging data collected on more than 2,100 patients to evaluate the severity of the disease. They evaluated the risk of death in more than 2,400 patients and the effectiveness of TNF inhibitor drugs on more than 1,800 patients.

The findings may help doctors and scientists better understand rheumatoid arthritis, Felson said. This also opens the door to further research, he added.

"To the extent that we can come up with new treatments, these treatments ought to take into account this gene mutation," Felson said.

Also, knowing who has this mutation might help identify which patients will need aggressive treatment, Felson said.

"We can now use all this to tell roughly how well a patient with rheumatoid arthritis is going to do, or how poorly they are going to do," Felson said.

MORE INFORMATION For more on rheumatoid arthritis, visit the Arthritis Foundation at arthritis.org.

Some arthritis meds cost seniors thousands annually Arthritis medications known as biologic disease-modifying drugs can cost Medicare patients more than $2,700 in co-payments a year, a new report finds.

Researchers say the tab is an immense burden on patients with disabling conditions such as rheumatoid arthritis, a chronic disorder that affects an estimated 1.3 million Americans.

Biologic anti-rheumatic medications — which include drugs such as adalimumab (Humira), anakinra (Kineret) and etanercept (Enbrel) — have allowed patients to gain better control of rheumatoid arthritis when taken early in the course of disease, the researchers explained. But some of the new drugs top $20,000 annually, according to an online report published last month in the journal Arthritis & Rheumatology.

“Many patients face a growing and unacceptable financial burden for access to treatment,” said study lead author Dr. Jinoos Yazdany of the division of rheumatology at the University of California, San Francisco.

“Rather than determining which drug is best for the patient, we find ourselves making treatment decisions based on whether patients can afford drugs,” Yazdany said in a journal news release.

Patients on Medicare — the publicly funded insurance program for the elderly — must pay about one-third the total drug cost in the initial phase of coverage. Once they reach the “donut hole” coverage cap (usually early in the year), they must pay 45 percent of drug costs until they qualify for catastrophic coverage and pay much less, the researchers said.

Previous research has suggested that one in six patients lowers his or her medication level because of cost, the researchers added.

The study results are based on an analysis of the drugs allowed to be prescribed to patients in 2,737 plans under Medicare Part D. “Insurance payment reforms have been suggested by the U.S. government, but are not widely implemented in the health care system,” Yazdany said in the news release.

“Americans, especially those patients with chronic conditions such as [rheumatoid arthritis], may be better served by payment and drug coverage reforms that look to decrease rising out-of-pocket costs for patients while keeping total costs in check,” she concluded.

Source: HealthDay

Out-of-pocket expenses keep many Medicare patients from taking needed drugs, study suggests.

MORE INFORMATION

For more about rheumatoid arthritis, see the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases at niams.nih.gov.

May is National Osteoporosis Awareness and Prevention Month

Lifestyle plays a key role in preventing osteoporosis

By RANDY DOTINGA HealthDay Osteoporosis is a disorder that involves weakening of the bones. It most often develops in people as they age, but it can develop in younger people, too. In someone with osteoporosis, the bones actually develop tiny holes that weaken them. Millions of Americans have

osteoporosis, and many more are at risk because they have low bone density.

RISK FACTORS FOR OSTEOPOROSIS Age is the biggest risk factor for osteoporosis, with most cases developing after age 50. Women have a greater risk than men because some of the changes women's bodies go through after menopause make osteoporosis more likely. A family history of the condition also enhances risk, as does having a low body weight or having a small or thin build.

Lifestyle factors can play a role in osteoporosis, as well. Smoking, drinking, not exercising and eating an unhealthy diet — one low in calcium, vitamin D and other vitamins and minerals — can all contribute to a higher risk for osteoporosis.

SYMPTOMS AND COMPLICATIONS Initially, osteoporosis presents no symptoms. But over time, the weakening bones can affect mobility, posture and overall health. People with osteoporosis may begin to lose height, or they can develop a hunched or stooped posture as the spine begins to weaken. Broken bones are a major concern for people with osteoporosis. Osteoporosis makes a bone far more likely to break, and recovering from a broken bone with osteoporosis is much more difficult than it is for someone who doesn't have the condition.

PREVENTION AND TREATMENT Though osteoporosis risk increases with age, there are steps that can be taken to protect the body from osteoporosis.

Especially important is eating a wellbalanced diet rich in fruits and vegetables as well as ample sources of calcium and vitamin D. Supplements can sometimes help, but it’s best to ask your doctor about this. Regular exercise is also key to keeping the bones healthy and strong.

Finally, smoking should be avoided completely, and alcohol intake should be limited.

Source: N ational Osteoporosis Foundation

HEALTH TIP

Help Prevent Osteoporosis

A healthier lifestyle can help ward off osteoporosis, a disease that causes brittle, thin and weak bones.

The American Council on Exercise offers these tips: • Perform weight-bearing exercises four days per week and strengthening exercises two or three days per week.

•E at a diet rich in calcium and fiber, and low in fat.

• Get some safe sun exposure to promote vitamin D production.

• Don’t smoke.

HEALTH TIP

Osteoporosis in Men

While women may be more focused on bone health, men are also at risk for osteoporosis.

The American Academy of Orthopaedic Surgeons explains these risk factors for osteoporosis in men: • Being over age 75.

• Having a low body-mass index.

•H aving lost more than 5 percent of total body weight in the last four years.

•B eing a current smoker.

• Living a sedentary lifestyle.

•H aving a male family member with osteoporosis.

Source: HealthDay

Spring allergy season is a bloomin' nightmare

By SERENA GORDON HealthDay After a long, cold, wet winter, trees and flowers all seem to be blooming at once, and that means a sudden, big burst of all different types of pollen at the same time.

Some experts are even predicting a "pollen vortex."

The one bright spot? Because the pollen season started later, it's likely to be shorter, according to Dr. Joseph Leija, an allergist with the Loyola University Health System's Gottleib Memorial Hospital in Chicago. Leija has also been in charge of measuring the Midwest's official pollen count for the U.S. National Allergy Bureau for the past two decades.

"The allergy season has been slow to start this year, but now we're seeing a high pollen count from trees. They're all pollinating together. This will be a heavy season, but since the pollination started quite late, it will be shorter," Leija said.

Dr. Beth Corn, director of Clinical Immunology Faculty Practice Associates at Mount Sinai Hospital in New York City, said it's difficult to quantify from year-to-year exactly how bad an allergy season might be, particularly from a patient's perspective.

"Allergy season was bad last year, and it will be bad this year. People are very symptomatic now. But, remember, up until a few weeks ago, we were still in coats in New York. People are noticing the stark contrast. Things have abruptly

changed and people notice it," she said.

The cities hit hardest by rough weather this winter may not see the worst of allergy season, according to the Asthma and Allergy Foundation's Top Five Spring Allergy Capitals list. To make the allergy capitals list, a city has to have higher than average pollen counts along with higher than average medication use.

The cities given this dubious distinction

Doctors predict a shorter but rougher stretch of coughing, sneezing and wheezing.

for 2015 are: Jackson, Miss.; Louisville; Oklahoma City; and Memphis and Knoxville, Tenn.

But, no matter where you live or what the pollen count might be, you can take steps to ease your allergy symptoms.

The first step, said Corn, is to see an allergist and get tested so you know exactly what causes your allergy symptoms.

"It's important to know what it is you're treating, and when you're seen by a specialist, they can tailor your treatment.

You'll get the most effective cocktail of medications," Corn said.

Both over-the-counter and prescription allergy medicines are also available. And steroid nasal sprays can help relieve allergies, while eye drops can help control eye symptoms, according to Corn.

Leija pointed out that "controlling your environment as much as possible is important. Keep your windows closed and run the air conditioner inside the house, and when you're driving, too. If you get pollen in your hair and clothing, don't bring it into the bedroom."

Leija also said it's a good idea to change clothes before you come inside, or at least not in your bedroom.

And, if possible, wash pollen out of your hair before getting into bed.

Source: HealthDay

MORE INFORMATION

Learn more about what causes allergies from the Allergy and Asthma Foundation of America at aafa.org.

ff ff TIPS to help prevent

ALLERGIES

•

UST TO CONTROL MITES. By dusting surfaces D and washing bedding often, you can control the amount of dust mites in your home.

•

ACUUM OFTEN. Although cleaning can sometimes V trigger allergic reactions, with dust in the air, vacuuming once or twice a week will reduce the surface dust mites.

Wear a mask when doing housework and consider leaving for a few hours after you clean to avoid allergens in the air.

You can also make sure your vacuum has an air filter to capture dust.

•

EDUCE PET DANDER. If you have allergies, you R should avoid pets with feathers or fur like birds, dogs and cats. Animal saliva and dead skin, or pet dander, can cause allergic reactions. If you can’t bear to part with your pet, you should at least keep it out of the bedroom.

•

HUT OUT POLLEN. When you clean your windows, S do you see a film of pollen on the frame or sill?

One easy way to prevent pollen from entering your home is to keep windows and doors closed. Use an air filter and clean it regularly or run the air conditioner and change the filter often.

•

VOID MOLD SPORES. Mold spores grow in moist A areas. If you reduce the moisture in the bathroom and kitchen, you will reduce the mold. Fix any leaks inside and outside of your home and clean moldy surfaces. Plants can carry pollen and mold too, so limit the number of houseplants. Dehumidifiers will also help reduce mold.

Source: The Allergy and Asthma Foundation of America

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With expertise in multiple disciplines, we focus on treating your health care needs at all stages of life. As faculty members of Rowan University School of Osteopathic Medicine, we are in tune with the latest treatments and advances in medicine.

Make an appointment with one of our Family Medicine Physicians

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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.