Medicalink December 2014

The University Doctors

MedicaLink Celebrating 15 Years

How healthy is Santa Claus?

Want to live to be 100?

I’ve had a cough for five days. Could I have bronchitis?

December 2014

Midlife diabetes linked to memory problems later Blood sugar disorder associated with 19 percent greater decline in thinking skills, study reports

By KATHLEEN DOHENY HealthDay A midlife diagnosis of diabetes or prediabetes may raise the risk of memory and thinking problems over the next 20 years, new research suggests.

Having diabetes in midlife was linked with a 19 percent greater decline in memory and thinking (cognitive) skills over 20 years, according to the new study.

“What we saw was, people with prediabetes, diabetes and poorly controlled diabetes had the higher risks of cognitive decline. The people with the worse cognitive decline were those with poorly controlled diabetes,” said study researcher Elizabeth Selvin, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

However, the study authors acknowledged that this study was only able to find an association between diabetes and prediabetes and an increased risk of memory and thinking problems later in life. It wasn’t able to determine if the blood sugar disorders were the actual cause of the memory and thinking issues.

Findings from the study are published in the Dec. 2 Annals of Internal Medicine. It was funded by the U.S. National Institutes of Health.

About 21 million U.S. adults have diabetes, according to background information in the study. In type 2 diabetes, the body doesn’t use the hormone insulin effectively. Insulin helps get the sugars from foods into the body’s cells to be used for energy. Type 2 diabetes is a risk factor for heart disease, stroke, high blood pressure, blindness and kidney disease, according to the study.

Diabetes has also been linked with dementia risk, but how diabetes relates to earlier declines in memory and thinking is less well known, the study authors wrote.

“We know that cognitive decline occurs five to seven years before dementia. Our goal was to look at how diabetes might be contributing,” Selvin said.

The new research followed more than 13,000 middle-aged adults over 20 years. They came from four states: Maryland, Minnesota, Mississippi and North Carolina. At the start of the study — 1990 to 1992 — the study volunteers were 48 to 67 years old.

Selvin and her colleagues evaluated the study participants’ memory and thinking abilities at three different visits over the years. The researchers also had data on whether the volunteers had diabetes or prediabetes, as well as their blood sugar levels at various times in the study.

The researchers measured declines in thinking and memory on a continuum, so it’s difficult to give exact measures

thinkstock

of the decline linked to the diabetes, Selvin said. But, on average, a 60-year-old who has diabetes has cognitive decline on par with a healthy 65-year-old who is aging normally, according to the researchers.

The study also found that memory and thinking decline was greater for people with prediabetes compared to people with normal blood sugar levels. And, people with diabetes who had higher blood sugar levels (measured as an HbA1C of more than 7 percent) had an even greater risk than those who had lower average blood sugar levels. (HbA1C is a measurement that estimates average blood sugar levels over two to three months, according to the American Diabetes Association).

The researchers also noted that people who had diabetes for a longer time had more significant memory and thinking problems later in life.

Exactly why the two are linked is unclear, Selvin said. But it could be related to common effects on the blood vessel, she said. Diabetes-related damage to blood vessels may also

trigger cognitive changes.

“The study is consistent with other literature we have seen,” said Heather Snyder, director of medical and scientific operations for the Alzheimer’s Association. Snyder reviewed the study’s findings.

Those with diabetes appear to be at greater risk of cognitive problems, she said, but added, “not everyone with diabetes goes on to develop greater cognitive decline.”

The findings demonstrate another good reason to try to prevent diabetes, Selvin said. Losing excess weight, eating a healthy diet and exercising regularly can help prevent type 2 diabetes, she noted.

Source: HealthDay

More information To learn more about the stages of Alzheimer’s disease, visit the Alzheimer’s Association at alz.org.

The University Doctors MedicaLink

Want to live to be 100?

The elusive fountain of youth may soon be within In 1900, the average life expectancy was 49 years reach. By the year 2050, nearly one million Americans with three million people 65 and older. Today, life will have reached their 100th birthday. The good news: expectancy is 78.6 years with 40 million people who there are multiple routes to achieving longevity. are 65 and older. By 2050, there will be 19 million Dr. Thomas A. Cavalieri, dean of the Rowan Americans who are at least 85, and approximately University School of Osteopathic Medicine 834,000 will be 100 years or older.

(RowanSOM) and founding director of the New “Physicians can help enhance a patient’s quality Jersey Institute for Successful Aging (NJISA), recently of life, even when patients are considered ‘old,’” presented “Aging Successfully and Living to be 100,” Dr. Cavalieri said. “For example, if you reach age 90, at The American Osteopathic Association’s Medical research shows you should live another 8.3 years.”

Conference & Exposition in Seattle.

What is the secret to aging successfully? Good “People don’t necessarily want to live long unless they genes are about one-third of longevity. The rest can maintain their quality of life,” said Dr. Cavalieri. is up to the individual and can be influenced by “Exercise is the single most lifestyle and behavior.

“Dr. Cavalieri explained that those Studies show that the important activity a person can utilize to enhance successful aging. longest living adults who survive to an extreme old age There is an exercise prescription share the following tend to share four common factors: for everyone.” good genes, healthy lifestyle, positive characteristics: regular Dr. Cavalieri explained that those exercise, eating wisely, behavioral and social interactions, who survive to an extreme old age less stress, putting tend to share four common factors: and a little bit of luck.” families first, strong good genes, healthy lifestyle, positive social networks and behavioral and social interactions, and a little bit sense of community, living with a sense of purpose of luck. and a strong belief in God. Life expectancy is already increasing exponentially.

Dr. Cavalieri said that even the Bible has advice

on aging, and puts the human lifespan at 120 years. That is in line with science, as the oldest person ever recorded died at the age of 122.

Healthy aging varies widely based on geography and gender, but optimal aging happens when people have the capacity to function across many domains – from the physical and emotional to the cognitive, social, and spiritual – to their satisfaction and in spite of any medical conditions.

“We cannot always prevent chronic diseases, but we frequently can prevent disabilities associated with those diseases,” said Dr. Cavalieri.

“People are living longer lives with less disability.

While life expectancy has been increasing, the rate of disability has been on the decline, resulting in a better quality of life. This trend may even accelerate in the future.”

To live longer with less disability, Dr. Cavalieri says a healthy lifestyle is important. This includes embracing a healthy diet by taking a multivitamin, replacing saturated fat and eating whole grains. He points out there is some evidence that a glass of red wine daily may help. He also recommends regular exercise, avoiding smoking, getting a good night’s sleep and practicing preventive medicine.

An individual’s behavior and social interactions are also important. Those who minimize stress, have better coping skills, have a good attitude/resilience, have a support system, volunteer, have cognitive stimulation and are spiritual, also have been found to successfully age with limited disability.

Can lifestyle changes even at 50 or 60 years old impact aging?

“There is a lot of evidence that making lifestyle and other changes have a positive impact at a later age,” Dr. Cavalieri said. “With positive lifestyle interventions, no matter what age, there can be positive outcomes. We can always make changes that lead to an improvement in the quality of life.”

To schedule an appointment at The New Jersey Institute for Successful Aging, please call 856.566.6843. The office is located in The University Doctors Pavilion, 42 East Laurel Road, Suite 1800, Stratford, NJ 08084.

The University MedicaLink WIRBDoctors 20131418 #11683727.0

Turning Sniffles into Smiles

The The SSOLSTICE OLSTICE clinical study istudy s evaluating the safety athe nd effectiveness an investigational clinical is evaluating safety andof effectiveness ofdrug an for investigational moderate to severe e ndometriosis p ain s ymptoms. drug for moderate to severe endometriosis pain symptoms.

The study may last up to approximately 20 months and involve about 14 study visits.

You You mmay ay be be able to join study you: if you: able tothe join theif study • Are 49 years and not gone through menopause • Are 18 t18 o 4to 9 years old and old have not have gone through menopause • Have been surgically diagnosed with endometriosis in the past 10 years and past have p10 ain years symptoms • Have been surgically diagnosed with endometriosis in the

our period at other times in your menstrual cycle during andyhave painand symptoms during your period and at other times in your not taking pcycle ain medication to treat a chronic disease other than endometriosis • Are menstrual • Do n ot h ave a

h istory of osteoporosis or other bone daisease • Are not taking pain medication to treat chronic disease other than • Are n ot p regnant o r b reastfeeding o r p lanning to get pregnant within the next 24 months endometriosis • a history orsother bonewill disease There aDo re onot ther have requirements to bof e in osteoporosis the study that the tudy doctor discuss with you to determine • if you aAre re eligible to participate. not pregnant or breastfeeding or planning to get pregnant within

the next 24 months Study participation is voluntary. You will receive all investigational study medications and study-­‐related There are other requirements to be in the study that the study doctor will tests and procedure at no cost. discuss with you to determine if you are eligible to participate.

Study participation You will freceive all investigational study To learn more is or voluntary. see if you may qualify or the study, visit www.TheSolsticeStudy.com, Text and ENDO1 to 87888 or call Rowan Clinical rials office at 856-­‐566-­‐6474. medications study-­ related tests andUniversity procedure at Tno cost.

The study may last up to approximately 20 months and involve about 14 study visits.

To learn more or see if you may qualify for the study, visit www.TheSolsticeStudy.com,

Text ENDO1 to 87888 or call Rowan University Clinical Trials office at 856-­566-6474.

Primary and preventive care from infancy through adolescence • Well baby and child visits • School, camp and sports physicals • Immunizations • Same-day appointments for illnesses Convenient hours include walk-in morning hours, Saturday morning and evening appointments Most insurance plans accepted

Stratford

Washington Township

856.566.7040

856.582.0033

theuniversitydoctors.com

The University Doctors MedicaLink Information Resources & Technology

Ask The University Doctors

I’ve had a cough for five days. Could I have bronchitis?

Dr. Kelly Anne Schiers, a pulmonologist with The University Doctors, 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 cough could be a lingering symptom of that viral infection because the virus has spread to your lungs or to the airways leading to the lungs. Mucus-producing tissues line those air passages to 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 inflammation.

A cough that follows a cold often indicates acute bronchitis, however. Other symptoms of acute bronchitis can include a low-grade fever (below 100.4 degrees) and fatigue. During physical activity, you may also experience shortness of breath because the inflammation is restricting the amount of oxygen you get through normal breathing.

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 also contain acetaminophen, which can be toxic if taken in excessive amounts.

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 sometimes result in a secondary infection, leading to pneumonia. Although pneumonia is a common illness, it is also a dangerous one. The U.S. Centers for Disease Control and Prevention estimates that about 900,000 Americans contract pneumonia each year, resulting in 400,000 hospitalizations and

more than 50,000 so, please remember it is not too late to vaccinate deaths. against seasonal flu. Pneumonia is a common Pneumonia complication of the flu and, like pneumonia, can be caused by seasonal flu is more dangerous than it sounds. viruses or Early indications are that this year’s season could by bacteria. be severe, and a severe flu season could result in Viral more than 45,000 deaths nationwide. pneumonia will Although this year’s vaccine may not be an cause symptoms exact match to the viruses circulating this season, that are similar getting vaccinated should help lessen the effects to, but more of the virus if you do come in contact with severe than, the flu. acute bronchitis.

To schedule an appointment with Dr. Schiers, For example, please call 856.566.6859. The office is located coughing may at 42 East Laurel Road, Suite 2100, Stratford, bring up a small amount of mucus and the low-grade NJ 08084. 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.

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

We can help with that. Our specialists are trained in the Bacterial pneumonia latest advances in pulmonary medicine, and can diagnose will usually require a and treat your condition, whether it’s asthma, or something course of antibiotics more serious. Make an appointment today, and breathe for recovery and your physician can easy tonight. determine that cause of a persistent cough and prescribe other Pulmonary/Critical Care Medicine interventions to help Stratford 856.566.6859 Voorhees 856.770.1305 ease your symptoms.

42 East Laurel Road, Suite 3100 Pavilions, 2301 Evesham Road, Suite 202 Finally, if you haven’t already done

Difficulty breathing?

Wheezing?

Short of breath?

The University Doctors MedicaLink Ask The University Doctors

How healthy is Santa Claus?

With his reputation To get to the bottom of this medical as a model of good mystery, Dr. Chick and RowanSOM behavior for children medical student Grace Oey took a closer around the world, is look during Santa’s annual it possible that Santa ‘pre-flight physical’ at the Department Claus is also setting of Family Medicine on Rowan’s Stratford a bad example for a campus. Each year, the North American healthy lifestyle?

Aerospace Defense Command provides After all, he does updates to children around the world as engage in some pretty risky behavior– it tracks Santa’s intercontinental journey. racing from rooftop “To get to the bottom of this medical to rooftop in an open sleigh, apparently mystery, Dr. Chick and RowanSOM medical without a seatbelt. student Grace Oey took a closer look during Every December 24th, Santa’s annual ‘pre-flight physical’ at the he stays out all night, zips around the world Department of Family Medicine on Rowan’s and sneaks in and out Stratford campus.” of millions of homes.

Oey is a second year And what student at the medical about that school and a U.S Army diet of 2nd Lieutenant. millions of Dr. Chick is a former cookies-andU.S. Air Force Major. milk snacks all “First of all, there is in one night? his weight,” Dr. Chick With a highsaid. “Being overweight fat, high-sugar is one of the leading diet like that, causes of diabetes and no wonder contributes to heart he’s been disease, the number one described in cause of death in the a poem as United States.” “chubby and She suggested that plump.” children around the Given his world could help Santa seemingly maintain a better weight reckless behavior and his penchant by leaving more healthy snacks for him, for sweet treats, should we be worried like carrots and celery sticks or apple slices about his health? with some peanut butter. “These are good “Well, by all accounts, he is over 550 snacks for parents and children to share all years old and still very active, so maybe year round, too,” she said. there’s more to his health habits than Although Santa’s body mass index may immediately meets the eye,” said be off the charts, Dr. Chick reported that Dr. Charlene Chick, a family physician his size might not be as much of a concern with The University Doctors at as it would be for the average person. the Rowan University School of “Despite his size, Santa is still nimble and Osteopathic Medicine (RowanSOM). quick,” she said. “And lifting those endless

Tips for a healthy holiday season sacks of toys seems to have helped him maintain lean muscle mass. Exercise that builds muscle is an important element of a healthy lifestyle for people of all ages.”

And, despite Santa’s advanced age, Dr. Chick noted Santa has obviously made at least one important lifestyle change that has far-reaching health benefits.

“Most adults will remember images from their childhood that showed Santa smoking a pipe, but he seems to have kicked the tobacco habit years ago,” Dr. Chick said. “That’s an important health choice. Tobacco use can lead to heart disease and to oral and lung cancers. No matter how old you are or how long you have smoked, quitting will improve your health.”

Noting that quitting is a popular New Year’s resolution, Dr. Chick pointed out that studies show that people who try to quit on their own are less likely to succeed.

“There are a number of effective methods for quitting and your family physician can help you find the method that works best for you,” she said.

Taking a holistic approach to her examination of Santa, Dr. Chick noted a few more of Santa’s healthy habits.

“Even though he keeps extremely busy checking lists and making gifts all year round, he obviously enjoys his work.

Engaging in work or activities you enjoy helps reduce stress, and that, in turn, helps improve heart health,” she said.

Dr. Chick also pointed to the health benefits of Santa’s social interactions that extend well beyond the holiday season.

“Santa and Mrs. Claus have been married for a long time and several studies connect marriage to better health. Research also shows that married people are more likely to survive cancer. The social connections that are part of married life go a long way toward helping limit the effects of depression and stress,” she said.

Despite some reservations about his weight and his risky behavior, Dr. Chick says, “Santa is in great shape and should have no problems completing his trip around the world on December 24th.”

To schedule an appointment with Dr. Chick, please call 856.566.7020.

The office is located at 42 East Laurel Road, Stratford, NJ 08084.

Have a healthy snack of fruit or raw

Sometimes you need more than an apple

Exercise for at least 30 minutes every day.

• Comprehensive care for you and your family • Same day appointments • Walk-ins welcome

vegetables before going out. Arriving hungry at the mall or holiday party encourages over-eating.

Don’t have 30 minutes? Take multiple, shorter breaks throughout the day. Park farther from where you work or shop, take the stairs or carry packages one at a time from the car to your house.

Add some water. Even in winter, your body

Hammonton 856.704.0185 373 South White Horse Pike Hammonton, NJ

needs to replace about 8 cups of water daily to stay healthy. At a party, alternate water with alcoholic drinks to limit calories and avoid the dehydrating effects of alcohol.

Mt. Laurel 856.380.2400 100 Century Parkway, Suite 140 Mt. Laurel, NJ

Limit your schedule. Stress from too

Stratford 856.566.7020 42 East Laurel Road, Suite 2100 Stratford, NJ

many personal commitments is a constant companion during the holidays. Postpone some socializing until after the New Year when you have more time to relax and enjoy the visit.

Take time to relax. Find a quiet spot every

day to meditate, read or listen to music for a few minutes. Go for an early evening walk to take in the neighborhood sites and enjoy the crisp winter air.

Washington Twp. 856.218.0300 Harbor Pavilions 570 Egg Harbor Road, Suite C2 Sewell, NJ theuniversitydoctors.com facebook.com/theuniversitydoctors twitter.com/universitydocs

Have a health plan for 2015. Instead of

dramatic changes on January 1, plan a series of healthy goals throughout the year. Resolve to catch up on any overdue preventive health screenings.

*Cardiology Services are provided through Lourdes Cardiology Associates, P.C. **Nephrology Services are provided through Nephrology and Hypertension Associates of New Jersey.

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.

The University Doctors MedicaLink Ask The University Doctors

How healthy is Santa Claus?

With his reputation To get to the bottom of this medical as a model of good mystery, Dr. Chick and RowanSOM behavior for children medical student Grace Oey took a closer around the world, is look during Santa’s annual it possible that Santa ‘pre-flight physical’ at the Department Claus is also setting of Family Medicine on Rowan’s Stratford a bad example for a campus. Each year, the North American healthy lifestyle?

Aerospace Defense Command provides After all, he does updates to children around the world as engage in some pretty risky behavior– it tracks Santa’s intercontinental journey. racing from rooftop “To get to the bottom of this medical to rooftop in an open sleigh, apparently mystery, Dr. Chick and RowanSOM medical without a seatbelt. student Grace Oey took a closer look during Every December 24th, Santa’s annual ‘pre-flight physical’ at the he stays out all night, zips around the world Department of Family Medicine on Rowan’s and sneaks in and out Stratford campus.” of millions of homes.

Oey is a second year And what student at the medical about that school and a U.S Army diet of 2nd Lieutenant. millions of Dr. Chick is a former cookies-andU.S. Air Force Major. milk snacks all “First of all, there is in one night? his weight,” Dr. Chick With a highsaid. “Being overweight fat, high-sugar is one of the leading diet like that, causes of diabetes and no wonder contributes to heart he’s been disease, the number one described in cause of death in the a poem as United States.” “chubby and She suggested that plump.” children around the Given his world could help Santa seemingly maintain a better weight reckless behavior and his penchant by leaving more healthy snacks for him, for sweet treats, should we be worried like carrots and celery sticks or apple slices about his health? with some peanut butter. “These are good “Well, by all accounts, he is over 550 snacks for parents and children to share all years old and still very active, so maybe year round, too,” she said. there’s more to his health habits than Although Santa’s body mass index may immediately meets the eye,” said be off the charts, Dr. Chick reported that Dr. Charlene Chick, a family physician his size might not be as much of a concern with The University Doctors at as it would be for the average person. the Rowan University School of “Despite his size, Santa is still nimble and Osteopathic Medicine (RowanSOM). quick,” she said. “And lifting those endless

Tips for a healthy holiday season sacks of toys seems to have helped him maintain lean muscle mass. Exercise that builds muscle is an important element of a healthy lifestyle for people of all ages.”

And, despite Santa’s advanced age, Dr. Chick noted Santa has obviously made at least one important lifestyle change that has far-reaching health benefits.

“Most adults will remember images from their childhood that showed Santa smoking a pipe, but he seems to have kicked the tobacco habit years ago,” Dr. Chick said. “That’s an important health choice. Tobacco use can lead to heart disease and to oral and lung cancers. No matter how old you are or how long you have smoked, quitting will improve your health.”

Noting that quitting is a popular New Year’s resolution, Dr. Chick pointed out that studies show that people who try to quit on their own are less likely to succeed.

“There are a number of effective methods for quitting and your family physician can help you find the method that works best for you,” she said.

Taking a holistic approach to her examination of Santa, Dr. Chick noted a few more of Santa’s healthy habits.

“Even though he keeps extremely busy checking lists and making gifts all year round, he obviously enjoys his work.

Engaging in work or activities you enjoy helps reduce stress, and that, in turn, helps improve heart health,” she said.

Dr. Chick also pointed to the health benefits of Santa’s social interactions that extend well beyond the holiday season.

“Santa and Mrs. Claus have been married for a long time and several studies connect marriage to better health. Research also shows that married people are more likely to survive cancer. The social connections that are part of married life go a long way toward helping limit the effects of depression and stress,” she said.

Despite some reservations about his weight and his risky behavior, Dr. Chick says, “Santa is in great shape and should have no problems completing his trip around the world on December 24th.”

To schedule an appointment with Dr. Chick, please call 856.566.7020.

The office is located at 42 East Laurel Road, Stratford, NJ 08084.

Have a healthy snack of fruit or raw

Sometimes you need more than an apple

Exercise for at least 30 minutes every day.

• Comprehensive care for you and your family • Same day appointments • Walk-ins welcome

vegetables before going out. Arriving hungry at the mall or holiday party encourages over-eating.

Don’t have 30 minutes? Take multiple, shorter breaks throughout the day. Park farther from where you work or shop, take the stairs or carry packages one at a time from the car to your house.

Add some water. Even in winter, your body

Hammonton 856.704.0185 373 South White Horse Pike Hammonton, NJ

needs to replace about 8 cups of water daily to stay healthy. At a party, alternate water with alcoholic drinks to limit calories and avoid the dehydrating effects of alcohol.

Mt. Laurel 856.380.2400 100 Century Parkway, Suite 140 Mt. Laurel, NJ

Limit your schedule. Stress from too

Stratford 856.566.7020 42 East Laurel Road, Suite 2100 Stratford, NJ

many personal commitments is a constant companion during the holidays. Postpone some socializing until after the New Year when you have more time to relax and enjoy the visit.

Take time to relax. Find a quiet spot every

day to meditate, read or listen to music for a few minutes. Go for an early evening walk to take in the neighborhood sites and enjoy the crisp winter air.

Washington Twp. 856.218.0300 Harbor Pavilions 570 Egg Harbor Road, Suite C2 Sewell, NJ theuniversitydoctors.com facebook.com/theuniversitydoctors twitter.com/universitydocs

Have a health plan for 2015. Instead of

dramatic changes on January 1, plan a series of healthy goals throughout the year. Resolve to catch up on any overdue preventive health screenings.

*Cardiology Services are provided through Lourdes Cardiology Associates, P.C. **Nephrology Services are provided through Nephrology and Hypertension Associates of New Jersey.

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.

Experts say steroid shots for back pain can continue

By STEVEN REINBERG HealthDay

A

n expert advisory panel to the U.S. Food and Drug Administration decided on Tuesday not to recommend the agency issue a strong warning against the general use of steroid injections for back pain.

The shots are commonly used to treat back pain, but they have never been approved for this use by the FDA, and whether their risks outweigh their benefits has long been a matter of debate.

Tuesday’s vote, from the FDA’s Anesthetic and Analgesic Drug Products Advisory Committee, essentially leaves the continued use of steroid shots for back pain largely unchanged.

As reported by The New York Times, the panel of experts said that only in one type of procedure –– a specific type of neck injection — could the risks of the shots possibly outweigh a possible benefit.

That procedure is one where the needle comes very close to a grouping of small, important arteries in the neck. Those types of injections could raise the odds of a blocked artery, and have already been abandoned by most doctors, the Times reported.

However, experts have been divided for years on whether steroid shots actually ease back pain.

One study published earlier this year in the New England Journal of Medicine found that people who have lower back pain caused by spinal stenosis –– a common condition among those over the age of 60 in which the open space in the spinal canal narrows from inflammation –– are unlikely to get relief from steroid shots.

Study author Dr. Janna Friedly, an assistant professor of rehabilitation medicine at the University of Washington in Seattle, said at the time that, “These steroid injections aren’t helpful. There is no added benefit to the steroid itself, so if people are considering these injections, I would recommend that they consider an alternative.”

However, Dr. Houman Danesh, a specialist in pain management and rehabilitation and

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physical medicine at Mount Sinai Hospital in New York City, said he believes these injections are both safe and effective.

“Steroid injections have been practiced longer than we have had a vaccine for polio, and after six decades the FDA has decided to review the safety and efficacy of these injections,” he noted.

Danesh believes the FDA’s current interest is based on an incident in 2012, when more than 700 people contracted fungal meningitis and other infections that resulted in more than 60 deaths, all the result of a single compounding pharmacy distributing steroids contaminated with a fungus that caused these complications.

He added that effectiveness of steroid injections has been studied in multiple clinical trials in the past. “One of the first studies, in 1977, was a placebo-controlled, randomized study. This study showed up to 70 percent improvement in pain with steroid injections, compared with 43 percent with placebo,” he said.

In 2008, studies showed as many as 91 percent of people getting these injections reported significant pain relief, Danesh said.

“Steroid injections are a safe and effective means of treating nerve irritation in the spine,” he added.

Source: HealthDay

More information

Visit the U.S. National Library of Medicine for more on steroid shots at www.nlm.nih.gov.

‘Trouble in Toyland’ report targets hazardous gifts for kids Consumer watchdog group says many playthings can choke or poison

Take the button battery safefy test The tiny batteries that add music to greeting cards and make hearing aids work can pose a hazard to children or seniors who mistake one for a piece of candy or a prescription pill.

Take this True or False test to determine your safety knowledge with regard to these batteries.

By ROBERT PREIDT HealthDay

T

his holiday season, all kids on Santa’s list are vulnerable to toys that can pose real health risks, a new report finds.There are toys with toxic chemicals, small toys that are choking hazards, toys that are so loud they can damage hearing, and toy magnets that can cause serious injury if swallowed, says the annual “Trouble in Toyland” report from the Public Interest Research Group (PIRG).

“We should be able to trust that the toys we buy are safe. However, until that’s the case, parents need to watch out for common hazards when shopping for toys,” Sean Doyle, a campaign organizer, said in a news release from the group’s Connecticut branch.

Laboratory tests revealed that some toys contained toxic chemicals, including lead, chromium and phthalates. All of these chemicals are thought to be able to cause serious harm to children’s health.

A badge playset and a toy tambourine were among the items with high levels of toxic chemicals, the report said.

Despite a federal ban on small parts on toys for children younger than 3 years old, toys that pose a choking hazard are still being sold, the group found. There are also toys that can harm children’s ears and hearing, as

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well as small, powerful magnets that can be extremely dangerous to kids if swallowed.

And while some stores adhere to national toy safety guidelines, many others do not.

“Our report includes unsafe toys found in dollar stores, big box stores and online,” Doyle said.

“Over 250,000 children were treated in emergency departments for toy-related injuries last year,” Dr. Steven Rogers said in the news release. He is an attending physician at the Connecticut Children’s Medical Center emergency department, in Hartford.

“The most deadly injuries are usually due to choking hazards like small toy accessories intended for older children. These injuries are preventable, so as parents we need to make sure our children are safe this holiday season,” Rogers said.

An easy way to check if something might be a choking hazard is to use a common item found in every household. “If something is small enough to fit inside a toilet paper roll, it is a choking hazard” Dr. Scott Schoem, division chief of otolaryngology at Connecticut Children’s Medical Center, said in the news release.

Source: HealthDay

1. I should not worry if my child swallows a button battery. The battery will likely pass through the intestines like a coin.

2. The battery compartments on my kid’s toys are secured with a screw, so I do not need to be concerned with my children gaining access.

3. If I am careful not to leave small items like individual button batteries where my child can reach them, this will not be an issue for my family.

4. My mom wears a hearing aid with a button battery, but she should not worry because this is a child-related hazard.

Answers:

1. False: In some instances a button battery will pass. However, the button battery could become stuck or lodged in the throat. When this happens, the battery can cause chemical burns in as little as two hours. If you suspect that your child has swallowed a button battery, immediately seek medical attention.

Immediately call the 24-hour

More information

National Battery Ingestion Hotline at (202) 625-3333 or your poison center at 1-800-222-1222.

2. False: It is true that the battery compartments on children’s toys are secured with a screw, but adults must ensure that they are secured properly. Adults also should be aware that other non-child related items that are commonly left within a child’s reach do not have screw-secured backs. Some items with button batteries that are commonly left within a child’s reach include: • remote controls • bathroom scales • musical greeting cards • video games 3. False: While that is a great first step in protecting your children from this hazard, it is not the only concern. A recent study found that in more than 60 percent of the incidents involving children, the child was able to access the battery directly from the product. Children’s toys and products are required to have screw locked battery compartments to prevent access.

However, other products such as remote controls, game controls and light-up pens and watches do not have to meet those same requirements. These products should be kept out of reach from children.

4. False: Adult consumers, particularly seniors, also have unintentionally swallowed button batteries. In these instances, the battery often was mistaken for a pill.

Source: U.S. Consumer Product Safety Commission

The U.S. Consumer Product Safety Commission has more about toy safety at www.cpsc.gov.

Holiday overindulgence risky for people with type 2 diabetes Carbohydrate-heavy meals can send blood sugar levels soaring, expert warns

Tips on how to avoid overindulging

By ROBERT PREIDT HealthDay

O

verindulging in holiday food can pose serious risks for people with type 2 diabetes, an expert warns.

“If you are someone who is not in good control of your diabetes throughout the year, the holiday season can really make your situation worse,” Dr. Laila Tabatabai, an endocrinologist with Houston Methodist Hospital, said in a hospital news release.

“If you are not mindful, eating foods with too many carbohydrates or sugars can send your blood sugar levels into a dangerously high range,” she cautioned.

There are a number of ways that people with diabetes can prevent their blood sugar levels from soaring during the holidays.

“Try to eat two or three special things that you only see during the holiday season, like grandma’s dressing or your aunt’s special dessert, and avoid sampling everything,”

thinkstock

Tabatabai said. “If you have to bring a dish, fix something healthy that you like. This way you know there will be at least one healthy thing for you to eat.”

It’s a good idea to avoid “white” carbohydrates such as pasta, bread, rice and potatoes, according to Tabatabai. Healthy substitutes include whole grains, brown rice, fruits and vegetables. It’s also important to limit portion sizes.

“For those who choose to drink alcohol, a few adult beverages are OK if you alternate your drinks with water, seltzer, diet soda, etc.

Be aware of mixed drinks because many contain juices or high sugar additives that you might not realize and they could cause a spike in your blood sugar levels,” Tabatabai said.

She added that family and friends are likely to be accommodating about your food choices if you’re open and honest with them about your diabetes.

1. Even though it’s holiday time, it doesn’t mean it’s an excuse to over eat — there are plenty of smart choices you can make during this time. On Christmas day for example, ensure you are still eating your veggies, choose leaner meats such as turkey breast, swap in sweet potatoes for regular white potatoes, and avoid overeating sauces and starchy foods such as Yorkshire puddings.

2. If you are going to drink alcohol, you have a couple of options. You can either

try to drink in moderation (i.e. one or two glasses of your chosen drink) or stick with a less sugary option. Steer clear of creamy or sugary cocktails and instead choose something like gin and tonic or vodka and sugar-free lemonade. All those extra calories will really add up, so choose smarter options if you want to have a drink.

3. A lot of gyms may be closed over the holiday season, but there are still things you can do to get your daily fix of exercise. Go for a brisk walk or a jog, workout at home, take your dog for a walk. The important thing is to remain active. Take some time off so that your body can rest and recover.

4. Make sure you are staying hydrated and eating regularly. Staying hydrated will ensure that you don’t confuse hunger for thirst and reach for a treat. Eating regularly will keep your metabolism fired up and stop you from becoming so hungry that you eat everything in sight. Make sure you aren’t skipping breakfast to try to bank calories for later. Instead, stick with a protein-rich breakfast such as scrambled eggs with toast.

5. If your calendar is full of parties, NEVER ARRIVE TO A PARTY HUNGRY! This is a recipe for disaster. At least have a snack before you leave, such as a peanut butter sandwich or chicken salad. This will level out your blood sugar and allow you to just have a satisfying amount of food at the party rather than over eating.

6. Instead of buying calorie and sugar laden cakes from the shops, why not try baking something from scratch? That way, you know exactly what has gone into it and you can swap out unhealthy ingredients for healthier alternatives.

“There is no reason for a person with type 2 diabetes to miss out on the joy of eating around the holidays,” Tabatabai concluded. “Planning ahead and being smart with your choices will give you the chance to eat the foods you want while maintaining healthy glucose levels.”

Source: HealthDay

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diabetes management at www.niddk.nih.gov.

Is HIV becoming less contagious?

The research has caveats. It relies on research from just two countries, both in Africa, and might not apply to the rest of the world...Still, the study is “good news.”

By RANDY DOTINGA HealthDay New research in Africa suggests that the AIDS virus is getting smarter about evading the immune system while evolving into a less contagious and less lethal infection overall.

In the country of Botswana, at least, “anyone who is newly infected now with HIV is less likely to suffer disease than if they had been infected 20 or 30 years ago,” said study co-author Philip Goulder, a research immunologist with the University of Oxford in England. “If this process continues, HIV will cause less and less disease.”

The research has caveats. It relies on research from just two countries, both in Africa, and might not apply to the rest of the

world. And some of its findings are based on mathematical models of how HIV, the virus that causes AIDS, is evolving. Still, the study is “good news,” Goulder contended.

Thanks to natural selection, some viruses actually evolve to make the host less sick over time, Goulder explained.

“One might intuitively imagine that the most successful viruses are the ones that cause maximum disease and kill their hosts most rapidly,” Goulder said. “However, this is not necessarily the case, since if the hosts die quickly, the chances of the virus being transmitted reduce very rapidly. So, in fact, the most successful pathogens tend to be the ones that have evolved over time to cause very little disease.”

virus to become less virulent.

“These findings are most likely to apply to Botswana and sub-Saharan Africa, where the global epidemic is concentrated,” Goulder said. Things could be different in other places like the United States, he said.

Christian Brander, a research professor with the Institute for AIDS Research in Barcelona, Spain, called the study “outstanding.”

Scientists should wonder whether the thinkstock same thing — a virus that becomes less transmissible over time — is happening to The study, published Dec. 1 in Proceedings Ebola, Brander said.

“The virus has to change,” he said, “but of the National Academy of Sciences, was these mutations have ramifications.” launched to see if that’s happening to HIV. The researchers focused on the evolution of the virus in two countries severely hit by AIDS Source: HealthDay — Botswana, where the disease infected people earlier and more widely, and South Africa.

In Botswana, the researchers found, the virus has become more adept at bypassing the immune systems of people infected by it. However, this “appears to be beneficial in More information that there is a cost to HIV from this process The University of California, of adaptation,” Goulder said. “The cost is that Berkeley, has more HIV replicates less efficiently than before.” information on the evolution In addition, the researchers suggest that of the AIDS virus at powerful anti-HIV drugs are also pushing the berkeley.edu.

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