MedicaLink March 2015

The University Doctors

MedicaLink Celebrating 15 Years

March 2015

“America’s Best” List again includes Rowan University School of Osteopathic Medicine Are snoring and sleep apnea the same?

Is sleep apnea something to worry about?

How much do you really know about diabetes?

Can endometriosis be prevented?

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3/17/15 12:56 PM

Daytime naps may improve your health

By ROBERT PREIDT HealthDay Brief daytime naps might protect you against the harmful health effects of a poor night’s sleep, a new study suggests.

Specifically, naps appeared to restore hormones and proteins involved in stress and immune function to normal levels in the study.

The small study included 11 healthy men between the ages of 25 and 32.

Researchers restricted the volunteers’ sleep to only two hours for a night. The next day, they had a 2.5-fold increase in levels of norepinephrine, a stress hormone that increases heart rate, blood pressure and blood sugar.

They also had lower levels of a protein called interleukin-6, which fights viruses.

On another night, sleep was limited to two hours again. However, the next day they were allowed to take two 30-minute naps. After napping, the men’s norepinephrine and interleukin-6 levels were normal.

The study was published in the current issue of The Journal of Clinical Endocrinology & Metabolism.

“Our data suggests a 30-minute nap can reverse the hormonal impact of a night of poor sleep,” said study

Nearly three in 10 American adults sleep an average of six hours or less a night, according to the National Health Interview Survey. author Brice Faraut, of the Universite Paris Descartes-Sorbonne Paris Cite in France. “This is the first study that found napping could restore biomarkers of neuroendocrine and immune health to normal levels,” he said in a journal news release.

“Napping may offer a way to counter the damaging effects of sleep restriction by helping the immune and also the

TALKING WHILE SLEEPING?

neuroendocrine system to recover,” Faraut said. “The findings support the development of practical strategies for addressing chronically sleep-deprived populations, such as night and shift workers.”

Lack of sleep can increase the risk of problems such as obesity, diabetes, high blood pressure and depression, and insufficient sleep is also associated with reduced work productivity as well as traffic and industrial accidents, according to the U.S. Centers for Disease Control and Prevention.

Nearly three in 10 American adults sleep an average of six hours or less a night, according to the National Health Interview Survey.

While talking during sleep may not be harmful to your health, it can be disruptive and may be embarrassing.

Here are some possible triggers for sleep talking:

• Feeling depressed or stressed • Running a fever • Drinking alcohol • Having sleep deprivation or daytime sleepiness • Having family members who talk in their sleep • Sleep talking may also be associated with a psychiatric disorder, seizures, sleep apnea, nightmares and REM sleep behavior disorder.

Source: National Sleep Foundation

Study finds an afternoon snooze might undo hormonal damage from lost sleep at night

Healthy sleep tips Healthy sleep habits can make a big difference in your quality of life.

Try to keep the following sleep practices on a consistent basis: Stick to a sleep schedule Keep the same bedtime and wake up time, even on the weekends. This helps to regulate your body’s clock.

Practice a relaxing bedtime ritual A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep.

Exercise daily Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.

Evaluate your room Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool — between 60 and 67 degrees and be free from any noise that can disturb your sleep. Finally, your bedroom should be free from any light.

Sleep on a comfortable mattress and pillows Make sure your mattress is comfortable and supportive. The one you have been using for years may have exceeded its life expectancy; about 9 or 10 years for most good quality mattresses. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens.

Manage your circadian rhythms Avoid bright light in the evening and expose yourself to sunlight in the morning. This will keep your circadian rhythms in check.

Avoid these things in the evening Alcohol, cigarettes and caffeine can disrupt sleep. Eating big or spicy meals can cause discomfort from indigestion that can make it hard to sleep. If you can, avoid eating large meals for two to three hours before bedtime. Try a light snack 45 minutes before bed if you’re still hungry.

Wind down Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity such as reading.

If you have trouble sleeping, avoid electronics before bed or in the middle of the night.

Source: National Sleep Foundation

MORE INFORMATION

The U.S. Centers for Disease Control and Prevention has more about sleep at www.cdc.gov.

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3/17/15 3:13 PM

The University Doctors MedicaLink

“America’s Best” list again includes Rowan University School of Osteopathic Medicine for Successful Aging (NJISA). “In fact, our school the country look to our school as one of the leaders was the first to require all medical students to in creating the best practices in this important receive specific training in geriatrics.” specialty area.”

RowanSOM is one of just a handful of medical For its annual rankings, US News & World Report schools in America that maintains a distinct gathers responses to surveys sent to all fully department of Geriatrics and Gerontology. That accredited United States medical schools. The department is led by Dr. Anita Chopra, the surveys cover research, primary care and eight William G. Rohrer Endowed Chair in Geriatrics specialty care areas, including family medicine, at RowanSOM and the director of the NJISA. pediatrics and geriatrics. The specialty care rankings As a result of the school’s focus on the health are based solely on responses from medical school of older adults, the NJISA has garnered nearly deans and senior faculty who are asked to identify $30 million in funding from state, federal, up to 10 schools offering the best programs in foundation and other sources, including more each area. than $5.5 million in research grants from This was the 14th time that US News & World Report has included RowanSOM as one of America’s government and private foundations in just the best medical schools for geriatric medicine. Along past few years. with RowanSOM, other schools listed for excellence With the largest concentration of geriatricians in geriatrics include Johns Hopkins University, in New Jersey, the NJISA staff provides Harvard, Yale, the University of Pennsylvania and unmatched opportunities for aspiring physicians the University of and health California-Los “This was the 14th time that care workers Angeles (UCLA).

‘US News & World Report’ has to learn the For more subtleties and included RowanSOM as one of skills they than 25 years, America’s best medical schools will need to RowanSOM has built a reputation help care for for geriatric medicine.” for innovation the country’s and for developing a rapidly aging population. Faculty members strong interdisciplinary also provide clinical health services or serve as approach to caring for medical directors in 25 nursing homes, assisted older individuals and for living facilities and continuing care retirement educating the health communities throughout the region. The clinical care workforce. and academic initiatives are complemented by “Long before it a robust research program that features teams became popular, our actively investigating the impact of Hurricane Our Memory Assessment Program (MAP) is specially designed to school was focused Sandy on older adults and the origins, treatment identify the possible causes of memory loss. Our team evaluates on the importance of and potential cures of Alzheimer’s, Parkinson’s physical and medical conditions, mood, thinking and memory, and providing the health, and other diseases associated with aging. will make recommendations for an ongoing plan of care. education and advocacy resources that will Call to make an appointment today 856.566.6843 help Americans to age successfully,” said University Doctors Pavilion Dr. Thomas A. Cavalieri, dean of 42 East Laurel Road, Suite 1800 RowanSOM and Stratford, NJ 08084 founder of the school’s nationally acclaimed New Jersey Institute

STRATFORD – The annual US News & World Report ranking of America’s top medical schools once again includes the Rowan University School of Osteopathic Medicine (RowanSOM) among the institutions that traditionally top the list, placing RowanSOM #12 in the country for excellence in geriatric medicine.

“I’m thrilled that RowanSOM has again been recognized for “RowanSOM is #12 in the its expertise in geriatrics,” said country for excellence in Rowan University geriatric medicine. ” President Dr. Ali Houshmand.

“We are proud to continue providing access to quality health care for older adults in our region while developing new and exciting research that will improve the lives of older adults across the nation. Our inclusion in the US News & World Report rankings shows that deans and senior administrators at medical schools all across

For when it becomes more than just misplacing keys

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3/17/15 12:56 PM

The University Doctors MedicaLink

Are snoring and sleep apnea the same?

Is sleep apnea something to worry about?

Not everyone who snores has sleep apnea. And to many people, using words like ‘snoring’ and ‘life-threatening’ in the same sentence may seem exaggerated, but when snoring is a sign of sleep apnea, understanding that condition and getting treatment for it could save your life.

Snoring occurs when the muscles around the airway at the back of the throat relax, partially blocking the airway. The smaller opening causes the inhaled air to travel faster as it enters the airway, increasing the vibration of the loose tissue along the throat and creating the familiar snoring sound. The National Sleep Foundation estimates that 37 million Americans snore on a regular basis and that about one-half of people who snore loudly have a form of sleep apnea.

There are two types of sleep apnea – central and obstructive.

Central sleep apnea is relatively rare and occurs when the signals from the brain to the muscles that control breathing, are interrupted.

“The National Sleep Foundation estimates that 37 million Americans snore on a regular basis and that about one-half of people who snore loudly have a form of sleep apnea.”

Obstructive sleep apnea is far more common, accounting for approximately 90 percent of all cases.

Obstructive sleep apnea occurs when the muscles relax enough to completely block the opening to the airway.

This cuts off oxygen, creating a series of reactions in the body. The oxygen level in the blood drops, putting a strain on the heart and forcing the lungs to try to breathe harder to increase oxygen. As the upper airway becomes obstructed, the brain begins waking up and sends signals to the muscles around the airway causing the muscles to tense. Normal breathing is restored, allowing the body to fall back to sleep. This cycle of sleeping and awakening can be repeated up to hundreds of times throughout the night without the affected individuals realizing it.

Because it can cause frequent drops in blood oxygen levels, sleep apnea can be dangerous or even lifethreatening. A drop in blood oxygen level or inadequate sleep can trigger the release of stress hormones into the blood. These hormones raise the heart rate, increasing the risk of high blood pressure, heart attack and stroke. march2015 4TAB.indd 1

The American Sleep Apnea Association estimates of sleep apnea. Some individuals also benefit that as many as 22 million Americans may have from sleeping on their side instead of their back. obstructive sleep apnea. The Several types of condition can occur at any age, devices are effective “Lifestyle changes, including but is most common in men over in treating sleep losing weight, avoiding alcohol and the age of 40, particularly those apnea. These include quitting smoking can help with the continuous positive who are overweight. symptoms of sleep apnea.”

Sleep apnea can also have a airway pressure serious effect on you during (CPAP) devices, normal waking hours. Because their sleep patterns which use a variety of masks that fit over the are constantly disturbed, people with sleep apnea nose and/or mouth and add constant, gentle may also move through the day with an increased pressure to the air you breathe. The devices are level of fatigue or sleepiness. This can affect their adjusted to be just strong enough to keep the ability to concentrate at work or to safely drive or airways from closing during sleep. operate machinery. People with sleep apnea may To schedule an appointment with also experience forgetfulness, anxiety, depression a pulmonologist, please call the Stratford and a decreased interest in sex. office at 856.566.6859 or the Sewell office The first step in treating sleep apnea is to consult at 856.218.0300. a physician who may recommend a diagnostic study at a sleep lab.

This is similar to spending a night at a hotel, with the exception that machines will monitor your heart rate, respiration, blood oxygen levels and the number of times you awaken during sleep.

Although they are sometimes prescribed, neither medications nor We can help with that. Our specialists are trained in the surgery are usually latest advances in pulmonary medicine, and can diagnose needed to treat and treat your condition, whether it’s asthma, or sleep apnea. In fact, something more serious. Make an appointment today, some medications can actually and breathe easy tonight. contribute to sleep apnea.

Pulmonary/Critical Care Medicine Lifestyle changes, including losing Sewell 856.218.0300 Stratford 856.566.6859 weight, avoiding 570 Egg Harbor Road, Suite C2 42 East Laurel Road, Suite 3100 alcohol and quitting smoking can help with the symptoms

Difficulty breathing?

Wheezing?

Short of breath?

3/17/15 1:10 PM

The University Doctors MedicaLink Information Resources

Technology Ask& The University Doctors

How much do you really know about diabetes?

Dr. Elizabeth Helfer, an endocrinologist with The University Doctors, responds: Tuesday, March 24th, is the American Diabetes Association’s annual Diabetes Alert Day, and in acknowledgement of the day, MedicaLink asked Dr. Elizabeth Helfer, an endocrinologist with The University Doctors to discuss some of the facts surrounding diabetes.

How many people have diabetes?

Dr. Helfer: Currently, the American Diabetes Association estimates that about 30 million Americans – including an alarming number of children – have diabetes. Even worse, about eight million of those people with diabetes do not even know they have the disease. Because their disease isn’t being treated, they have an even higher risk of disabling or even deadly complications caused by diabetes.

Are there different types of diabetes?

Dr. Helfer: Type 1 occurs when the pancreas cannot produce insulin. It occurs mostly in children and young adults. Type 2 diabetes was formerly called ‘adult onset’ and is most often the result of genetics. People with type 2 diabetes make insulin, but not enough to keep sugars down.

Lifestyle choices such as tobacco use, a poor diet and a lack of physical activity may exacerbate the problem.

Type 2 diabetes has become more prevalent in children and teenagers. Some pregnant women also develop diabetes, a condition known as gestational diabetes. Many women with gestational diabetes will develop type 2 diabetes later in life.

What are some of the complications of diabetes?

Dr. Helfer: Diabetes can affect virtually every part of your body. Left untreated, it can lead to blindness, kidney disease, nerve damage, heart attacks and stroke. Because diabetes often goes undetected, some mdclnk march2015 tab5.indd 1

people will have the disease – and experience damage to their nerves and blood vessels – for up to a decade before receiving diagnosis or treatment.

Is diabetes related to any other disorders?

Dr. Helfer: Some researchers have begun to refer to Alzheimer’s as ‘type 3 diabetes.’ While the exact connection between the two diseases isn’t clear, several studies in recent years have pointed to a correlation between Alzheimer’s disease and high blood sugar levels.

One study, published in the journal Neurology, showed that men who developed diabetes in mid-life had a significantly higher rate of Alzheimer’s over the next 30 years.

Another study, published in Alzheimer’s & Dementia, demonstrated that people in the early stages of type 2 diabetes already showed high levels of insulin resistance in the brain. There is also an increased risk of autoimmune diseases, including thyroid problems, in people with diabetes.

Don’t people with diabetes feel sick?

Dr. Helfer: With diseases like diabetes, it could be dangerous to think that if you feel fine, you must not be sick. If sugars rise slowly, symptoms, such as excessive thirst, increased urination, fatigue and weight loss, may not be noticed. You may feel fine, but damage is still being done to your kidneys, heart, and eyes. Know your risk factors and ask your physician if you need to be tested.

cholesterol or triglycerides; and carrying any excess weight around the midsection. Women with a history of gestational (pregnancyassociated) diabetes or of giving birth to a baby who weighed over nine pounds also have a higher risk of the disease. Additionally, African Americans, Hispanics, American Indians and Asian Americans all tend to be more prone to develop diabetes.

You can find a quick, seven-question test that scores your risk of diabetes on a 10-point scale on the American Diabetes Association website at: http://www.diabetes.org/are-you-at-risk/ diabetes-risk-test/.

To schedule an appointment with Dr. Elizabeth Helfer, please call 856.770.1305.

The office is located at 2301 Evesham Road, Pavilions, Suite 202, Voorhees, NJ 08043.

What are the risk factors for diabetes?

Dr. Helfer: Factors that increase the risk for diabetes include: age (most cases occur in people older than 45); a family history of diabetes; high blood pressure or elevated levels of LDL (‘bad’) 3/17/15 12:59 PM

The University Doctors MedicaLink Ask The University Doctors

Can endometriosis be prevented?

Dr. Jennifer Hummel, an obstetrician and gynecologist with The University Doctors, responds: Endometriosis is a condition that you don’t hear a lot about, which is unfortunate because it is surprisingly common. While current statistics estimate that approximately five million women in this country are affected, the number may actually be higher. In a 2011 study by the National Institutes of Health, researchers found that 11 percent of women with no reported symptoms actually had endometriosis.

Endometriosis occurs when tissue that normally lines the inside of the uterus, grows in patches outside the uterus, including on the ovaries, fallopian tubes, bowels or bladder, or on the tissues that hold the uterus in place. Because these growths bleed in the same way as the inside lining of the uterus during menstruation, the bleeding can cause pain and swelling. In fact, reports of pain are often the first indications to a physician that a patient may have endometriosis.

Although not all women with the disorder will experience this symptom, endometriosis will commonly cause painful menstrual cramps, chronic low back or pelvic pain, internal pain during sexual activity or painful bowel movements or urination during menstrual periods.

For many years, endometriosis was commonly considered to be a disease of ‘career women’ who voluntarily delayed childbirth, but research over the last few decades has dispelled that belief. Although researchers cannot yet pinpoint a precise cause for endometriosis, the most likely cause is the backward

flow of menstrual blood through the fallopian tubes into the abdomen. Evidence suggests that other possible causes could include genetics, a faulty immune system, hormonal imbalance or complications from abdominal surgery.

Diagnosing endometriosis is not always easy, so you should talk to your gynecologist about any unusual symptoms you are experiencing. Initially, your gynecologist may conduct a pelvic exam to feel for cysts or scars behind your uterus or order a pelvic ultrasound test to check for cysts caused by endometriosis. If no cysts are evident, your physician may prescribe birth control pills or a

medication that lowers the amount of estrogen your body makes. A decrease in pain after taking these medications would indicate endometriosis.

Unfortunately, there is no sure way to prevent this condition. Because the hormone estrogen helps to thicken the lining of the uterus during the menstrual cycle, the first line of defense against endometriosis is to lower estrogen levels. This

can be accomplished by using birth control medication with lower doses of estrogen. There is also some evidence that suggests avoiding large amounts of caffeine or alcohol, as both may act to increase estrogen levels. Regular exercise could also help by reducing body fat which in turn reduces the amount of estrogen cirulating in the blood.

Surgery to remove any patches of endometriosis can be a treatment option for women who continue to have symptoms after trying medication or other means to treat endometriosis. Following the surgery, hormone treatment can often be resumed except in the case of women who are trying to become pregnant.

Women with severe endometriosis who are not planning a future pregnancy can opt for a hysterectomy. If the ovaries have no signs of endometriosis, they can be left intact during the surgery to avoid causing surgery induced menopause.

For women with endometriosis who are also trying to get pregnant, a physician may prescribe a medication that blocks the hormones responsible for ovulation. In essence, this causes a temporary menopause while controlling the growth of the endometrial tissue. Once the medication is stopped, the menstrual cycle resumes.

Because endometriosis can cause infertility in some women, it’s important to speak with your physician if you are planning to become pregnant and you are experiencing any symptoms that you suspect may be related to endometriosis.

To schedule an appointment with Dr. Jennifer Hummel, please call the Mullica Hill office at 856.256.5800

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.

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The University MedicaLink WIRBDoctors 20131418 #11683727.0

TThe he SOLSTICE clinical study is evaluating the safety and an investigational SOLSTICE clinical study is evaluating theeffectiveness safety andof effectiveness ofdrug an for m oderate t o s evere e ndometriosis p ain s ymptoms. investigational drug for moderate to severe endometriosis pain symptoms.

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

study visits.

YYou ou mmay ay be be able to join study you: if you: able tothe join theif study Are 1849 toyears 49 oyears not gone through menopause •• Are 18 to ld and old have and not ghave one 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

period at other times in your menstrual cycle during andyour have painand symptoms during your period and at other times in your • Are not taking pain medication to treat a chronic disease other than endometriosis menstrual cycle •• Do Are not hnot ave ataking history pain of osteoporosis or other bone daisease medication to treat chronic disease other than • endometriosis Are not pregnant or breastfeeding or planning to get pregnant within the next 24 months • aDo a history ofin osteoporosis orstudy other bone disease There re onot ther have requirements to be the study that the doctor will discuss with you to determine i• f 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 willfreceive 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 University Clinical rials office at 856-­‐566-­‐6474. medications study-­ related tests and procedure at Tno cost.

Expect The Best The best choice for your maternity and gynecological care. We also offer midwifery services, as well as maternal/fetal medicine.

Come meet the doctors, midwives and staff; tour the new office; and enjoy light refreshments and giveaways.

March 25th | 10 am to 12 noon 412 Ewan Road, Mullica Hill, NJ RSVP: 856.566.6207 or email sominfo@rowan.edu theuniversitydoctors.com facebook.com/theuniversitydoctors

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

twitter.com/universitydocs

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

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3/17/15 1:13 PM

It’s time to bite into a healthy lifestyle MARCH IS

NATIONAL NUTRITION MONTH

By KATHLENN DOHENY HealthDay Each March, during National Nutrition Month and throughout the year, the Academy of Nutrition and Dietetics encourages everyone to return to the basics of healthy eating by adopting a healthy lifestyle focused on consuming fewer calories, making informed food choices and

getting daily exercise. The goal is to achieve and maintain a healthy weight, reduce the risk of chronic disease and promote overall health.

“Daily physical activity is a crucial part of everyone’s healthy lifestyle, but unfortunately most of us don’t include enough movement in our daily routines,” says registered dietitian nutritionist and Academy spokesperson

Jennifer McDaniel. “Regular physical activity strengthens bones and muscles, reduces the risk of chronic illness and fosters overall well-being.”

Physical activity is a must

Most health benefits come from at least 150 minutes a week of moderately intense physical activity, with added advantages from increased exercise and intensity. Endurance and muscle-strengthening activities like lifting weights, working with a resistance band or doing pushups are also beneficial.

“A physically active lifestyle offers you many rewards, from a slimmer body to a healthy heart,” says McDaniel, who is also a board certified sports dietitian. “And these physical benefits are only the beginning. Additional advantages include stress relief, better sleep and even a more positive mental outlook.”

Ways to get moving

Physical activity is important for everyone at every age. “The key is to find activities that are both sustainable and enjoyable.” For some, this may mean a light yoga class, while for others it may mean training for a marathon. Here are some ways to get moving: • Join a walking group or attend fitness classes.

• Participate in social and competitive sports like soccer or flag football.

• Plan a hiking or canoeing trip instead of a beach vacation.

• Sign up for a 5k run/walk with friends or family.

• Sneak in exercise at your desk like leg lifts and calf raises ­­— or even buy a desk that allows you to stand while working.

• Take a 15-minute walk on your lunch break (or walk up and down the stairs when the weather is bad outside).

• Find an activity monitor to assess movement through the day — gadgets are very motivating for some.

Food is vital for energy

To maintain a physically active and healthy lifestyle, stay nourished before, during and after exercise. “Before exercise, look for foods high in carbohydrates, adequate in protein and moderate in fat and fiber, like oatmeal with bananas, almonds and fat-free milk,” McDaniel says.

“Drink water before, during and after physical activity since dehydration can cause fatigue and impair performance,” McDaniel says.

MORE INFORMATION

Visit The Academy of Nutrition and Dietetics at eatright.org

Veggie-rich diets may lower heart risks People who eat more plant foods than animal products may lower their risk of dying from heart disease or a stroke, a new study suggests.

Researchers found that among more than 450,000 European adults, those whose diets were about 70 percent plant-based — meaning whole grains, beans, vegetables, fruit and nuts — had a relatively lower risk of dying from heart disease.

Their odds were 20 percent lower, compared with people whose diets were over 50 percent meat, dairy, eggs and fish.

The findings do not prove that plant foods deserve the credit, said lead researcher Camille Lassale, an epidemiologist at Imperial College London, in England.

She said her team accounted for other potential explanations, such as people’s weight, exercise habits and education levels. But it’s still difficult to pinpoint these “semi-vegetarian” diets as the reason for the lower rates of heart disease and stroke deaths.

The American Heart Association recommends that people should eat plenty of plant foods, but limit red meat and saturated fat, which is largely found in animal products.

Plus, Lassale said, the heart benefits of the Mediterranean diet RowanMedilink.indd 2

are well-established. That diet includes plenty of plant-based foods and little meat or dairy.

“This isn’t revolutionary,” Lassale said. “It’s a simple message: Replace some meat, eggs and dairy with beans, nuts, [grains] and vegetables.”

However, fish — a true staple of the Mediterranean diet — is a different matter, according to Lassale. She noted that oily varieties of fish contain heart-healthy omega-3 fats, and are also a good substitute for red meat.

The findings are based on more than 450,000 adults ages 35 to 70 who took part in a European study on nutrition and cancer risk. At the outset, they gave detailed information on their diets and lifestyle.

Over the next 13 years, slightly more than 5,000 died of heart disease or stroke.

Lassale’s team studied participants’ diet information and gave each person a score based on how “pro-vegetarian” their eating pattern was. They found that people with a “high” score

were 20 percent less likely to die of heart-related causes than those with the lowest scores.

The good news, Lassale says, is that people who have no interest in becoming vegetarian can still manage a more pro-vegetarian style of eating. Simply looking at your dinner plate and making sure it has more plant foods than meat and dairy is a big step, she said.

Rachel Johnson, a professor of nutrition and medicine at the University of Vermont, agreed with Lassale.

“The results are important because they demonstrate that people do not need to follow a total vegetarian diet to lower their risk for cardiovascular disease,” she said. “Moving toward a more plant-based diet appears to be beneficial without going completely vegetarian. ” Source: HealthDay

MORE INFORMATION

The American Heart Association has more on nutrition and heart health at www.heart.org.

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Healthy kidneys mean a healthier you It is estimated by the Centers for Disease Control that 10 percent of adults in the United States—more than 20 million people — may have Chronic Kidney Disease (CKD), of varying levels of seriousness. Your chances of having CKD increase with age; it increases after age 50 years and is most common among adults older than 70 years.

Most people know that a major function of the kidneys is to remove waste products and excess fluid from the body. These waste products and excess fluid are removed through the urine. The production of urine involves highly complex steps of excretion and re-absorption. This process is necessary to maintain a balance of body chemicals.

The critical regulation of the body’s salt, potassium and acid content is performed by the kidneys. The kidneys also produce hormones that affect the function of other organs. For example, a hormone produced by the kidneys stimulates red blood cell production. Other hormones produced by the kidneys help regulate blood pressure and control calcium metabolism.

The kidneys are powerful chemical factories that perform the following functions: • Remove waste products from the body • Remove drugs from the body • Balance the body’s fluids • R elease hormones that regulate blood pressure • P roduce an active form of vitamin D that promotes strong, healthy bones • Control the production of red blood cells The kidneys perform their life-sustaining job of filtering and returning to the bloodstream about 200 quarts of fluid every 24 hours. About two quarts are removed from the body in the form of urine, and about 198 quarts are recovered. The urine we excrete has been stored in the bladder for anywhere from 1 to 8 hours.

Causes of chronic kidney disease

Chronic kidney disease is defined as having some type of kidney abnormality, or “marker”, such as protein in the urine and having decreased kidney function for three months or longer.

There are many causes of chronic kidney disease.

The kidneys may be affected by diseases such as diabetes and high blood pressure. Some kidney conditions are inherited.

Others are congenital; that is, individuals may be born with an abnormality that can affect their kidneys. The following are some of the most common types and causes of kidney damage.

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More than 20 million Americans may have kidney disease and many more are at risk.

•D iabetes is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. This results in a high blood sugar level, which can cause problems in many parts of your body. Diabetes is the leading cause of kidney disease.

•H igh blood pressure (also known as hypertension) is another common cause of kidney disease and other complications such as heart attacks and strokes. High blood pressure occurs when the force of blood against your artery walls increases. When high blood pressure is controlled, the risk of complications such as chronic kidney disease is decreased.

•G lomerulonephritis is a disease that causes inflammation of the kidney’s tiny filtering units called the glomeruli. Glomerulonephritis may happen suddenly, for example, after a strep throat, and the individual may get well again.

However, the disease may develop slowly over several years and it may cause progressive loss of kidney function.

• P olycystic kidney disease is the most common inherited kidney disease. It is characterized by the formation of kidney cysts that enlarge over time and may cause serious kidney damage and even kidney failure. There are other inherited diseases that can affect the kidneys.

• Kidney stones are very common, and when they pass, they may cause severe pain in your back

KIDNEY DISEASE

FAST FACTS:

and side. There are many possible causes of kidney stones, including an inherited disorder that causes too much calcium to be absorbed from foods and urinary tract infections or obstructions.

Sometimes, medications and diet can help to prevent recurrent stone formation. In cases where stones are too large to pass, treatments may be done to remove the stones or break them down into small pieces that can pass out of the body.

•U rinary tract infections occur when germs enter the urinary tract and cause symptoms such as pain and/or burning during urination and more frequent need to urinate. These infections most often affect the bladder, but they sometimes spread to the kidneys, and they may cause fever and pain in your back.

•D rugs and toxins can also cause kidney problems. Using large numbers of over-the-counter pain relievers for a long time may be harmful to the kidneys. Certain other medications, toxins, pesticides and “street” drugs such as heroin and crack can also cause kidney damage.

Detecting chronic kidney disease

Early detection and treatment of chronic kidney disease are the keys to keeping kidney disease from progressing to kidney failure. Some simple tests can be done to detect early kidney disease. They are: A test for protein in the urine Albumin to Creatinine Ratio (ACR), estimates the amount of albumin that is in your urine. An excess amount of protein in your urine may mean your kidney’s filtering units have been damaged by disease. One positive result could be due to fever or heavy exercise, so your doctor will want to confirm your test over several weeks.

A test for blood creatinine Your doctor should use your results, along with your age, race, gender and other factors, to calculate your glomerular filtration rate (GFR). Your GFR tells how much kidney function you have.

It is especially important that people who have

an increased risk for chronic kidney disease have these tests. You may have an increased risk for kidney disease if you: • Are older • Have diabetes • Have high blood pressure •H ave a family member who has chronic kidney disease •A re African-American, Hispanic, Asian and Pacific Islander or Native American.

If you are in one of these groups or think you may have an increased risk for kidney disease, ask your doctor about getting tested.

Treating kidney disease

Many kidney diseases can be treated successfully. Careful control of diseases like diabetes and high blood pressure can help prevent kidney disease or keep it from getting worse. Kidney stones and urinary tract infections can usually be treated successfully.

Unfortunately, the exact causes of some kidney diseases are still unknown, and specific treatments are not yet available for them.

Sometimes, chronic kidney disease may progress to kidney failure, requiring dialysis or kidney transplantation. Treating high blood pressure with special medications called angiotensin converting enzyme (ACE) inhibitors often helps to slow the progression of chronic kidney disease. A great deal of research is being done to find more effective treatments for all conditions that can cause chronic kidney disease.

Source: The National Kidney Disease Education Program

MORE INFORMATION

The National Kidney Disease Education Program go to www.nkdep.nih.gov.

• Early kidney disease has no signs or symptoms. • Kidney disease usually does not go away. • Kidney disease can be treated. The earlier you know you have it, the better. • Blood and urine tests are used to check for kidney disease.

• Kidney disease can progress to kidney failure. • African-Americans have a higher rate of kidney failure than any other group of people.

3/17/15 3:13 PM

Exercise may boost regions of your brain

By RANDY DOTINGA HealthDay Exercise may increase the size of brain regions that contribute to balance and coordination, preliminary research suggests.

The small new study in twins found that those who exercised more had increased brain volume in areas of the brain related to movement.

These changes “may have health implications in the long-term, such as possibly reducing the risk of falling and mobility limitations in older age,” said study co-author Dr. Urho Kujala, professor of sports and exercise medicine at the University of Jyvaskyla in Finland.

However, the study authors can’t definitively say that more exercise caused more brain volume. Also, it’s not clear what benefit these bigger brain regions might offer, and the researchers don’t know how much exercise is needed to prompt a change in size.

Physical activity has been linked to a number of improved outcomes, such as lower levels of body fat, reduced heart disease risk factors, better memory and a lower risk of type 2 diabetes, according to background information in the study.

Kujala said the researchers launched the current study because they wanted to better understand how physical activity in leisure time affects the brain.

For the study, the researchers chose 10 pairs of identical twins. The participants were all men aged 32 to 36 years. The study focused on identical twins because they share the same DNA, allowing researchers to study how the environment affects their bodies.

In each pair of twins, one brother had exercised more over the past three years than the other. The twins reported getting about the same levels of exercise at earlier times in their lives.

“On average, the more active members of twin pairs were jogging 3 hours more RowanMedilink.indd 4

per week compared to their inactive co-twins,” Kujala said.

All of the twins had MRI scans of their brains so that the researchers could see what impact exercise had on the size of the brain and specific regions of the brain.

Exercise didn’t seem to affect the size of the entire brain, but there was a connection between more exercise and more brain volume in areas related to movement, Kujala said.

The researchers also found that the twins who exercised more did a better job of controlling blood sugar, potentially reducing the risk of diabetes. That finding isn’t particularly surprising because physical fitness has previously been linked to lower rates of diabetes.

Rong Zhang, an associate professor who studies exercise at the University of Texas Southwestern Medical Center at Dallas, said the study is interesting, but he cautioned about its weaknesses. It only looks at a very small number of men and doesn’t follow the participants over time to see what happens to them, he said.

For that reason, it’s impossible to know if factors other than exercise may be affecting the brain regions, he explained.

Zhang added that the study doesn’t make it clear if having larger brain regions is helpful in any way, although it’s possible that they may provide a kind of reserve brainpower that could be good to have in old age.

Brad Roy, executive director of the Kalispell Regional Medical Center’s Summit Medical Fitness Center in Montana, also noted that the study is small, and he added that it says nothing about women.

Still, “the study results are one more important validation in regard to the positive influence physical activity has on the brain, its function, and overall personal health and well-being,” Roy said.

“This study reinforces a greatly underappreciated fact, that regular exercise has a powerful health impact throughout the body, including the brain,” Roy said.

“The take-home message: move!”

The study is published in the March issue of the journal Medicine & Science in Sports & Exercise.

MORE INFORMATION

For more about the benefits of exercise, visit the U.S. National Library of Medicine at www.nlm.nih.gov.

TIPS FOR EXERCISING

SMART

Your workout may inspire your spouse to workout Adults should get at least 150 minutes of moderate exercise or at least 75 minutes of intense exercise a week.

American Heart Association

“W

hen it comes to physical fitness, the best peer pressure to get moving could be coming from the person who sits across from you at the breakfast table,” study co-author Laura Cobb, a doctoral student at Johns Hopkins Bloomberg School of Public Health, said in a recent Hopkins news release.

Researchers examined data from more than 3,200 married couples in Maryland, Minnesota, Mississippi and North Carolina who provided information about their physical activity levels at an initial visit, and again six years later.

At the first visit, 45 percent of husbands and 33 percent of wives met the American Heart Association’s recommendation that adults get at least 150 minutes of moderate exercise or at least 75 minutes of intense exercise a week.

Husbands of wives who did the recommended amount of exercise at the first visit were 70 percent more likely to meet those levels at the second visit, compared to husbands of wives who weren’t as physically active.

Wives of husbands who did the recommended amount of exercise at the first visit were 40 percent more likely to meet those levels at the second visit, the researchers found.

“There’s an epidemic of people in this country who don’t get enough exercise, and we should harness the power of the couple to ensure people are getting a healthy amount of physical activity,” Cobb said.

MORE INFORMATION

The U.S. National Heart, Lung, and Blood Institute offers a guide to physical activity at www.nhlbi.nih.gov.

• Check with your doctor before you start exercising. Start out with short workout intervals of just five to 10 minutes. • Protect yourself with safety gear, such as a helmet or sturdy running shoes.

• Warm up before starting each workout. • Make sure you drink plenty of fluids, even if you aren’t thirsty.

• If exercising outdoors, wear sunscreen. • Stop exercising if you feel dizzy, nausea or pain.

Source: HealthDay 3/17/15 3:13 PM

Dangers of poisons and prevention Poisons are all around us and can affect anyone, anywhere at any time of life. Protect yourself and others from being poisoned by learning what a poison is, who is at risk, and how to prevent a poisoning from happening so you can help ensure the safety of children and adults in your home.

What is a Poison?

A poison is anything that can harm someone if it is used in the wrong way, used by the wrong person, or used in the wrong amount. Some poisons may be harmful if they come into direct contact with your eyes or skin. Others may be toxic if you breathe them or swallow them.

Poisons can come in four forms: solids (such as pain medicine pills or tablets), liquids (such as household cleaners, including bleach), sprays (such as spray cleaners) and gases (such as carbon monoxide.)

Who is at risk?

You may think that poisoning affects only a certain group of people — such as young children or older adults. This, however, is not true. Anyone, regardless of their age, race, ethnicity, or career, can be poisoned.

Poisonings happen more often than you think. More than 2 million poisonings are reported each year to the 57 poison control centers across the country. More than 90 percent of these poisonings occur in the home.

The majority of non-fatal poisonings occur in children younger than six years old. And, poisonings are one of the leading causes of death among adults.

Some common poisons

Certain kinds of poisonings are common among specific age groups.

For example, older adults specifically need to be aware of the poisoning risks involved with prescription medications. Children are commonly poisoned through painkillers, cosmetics, personal care or cleaning products, pest killers, and plants.

Preteens through older adults are commonly poisoned through herbal products, prescription drugs, alcohol, over-the-counter medicines, and

More than 2 million poisonings are reported each year to the 57 poison control centers across the country. spoiled food. People of all ages may be stung by a bee, splashed with a chemical, or exposed to carbon monoxide in their homes.

Source: The American Association of Poison Control Centers

MORE INFORMATION

Learn more from The American Association of Poison Control Centers at www.aapcc.org.

Keep watchful eye on children Most child poisonings occur when parents or caregivers are at home but not paying attention to youngsters, according to the American Association of Pediatrics (AAP). Medicines, pesticides, cleaning products, furniture polish, antifreeze, windshield-wiper fluid, gasoline, kerosene and lamp oil are among the most dangerous potential poisons in or near the home. It’s important to be especially watchful when there is a change in household routine, such as holidays, visits to and from relatives, and other special events.

The AAP offers advice on preventing and treating poisonings.

• Store medicines, pesticides, cleaning and laundry products, and paints and varnishes in their original packaging in locked cabinets or containers that are out of sight and reach of children.

• Check the label every time you give a child medicine to ensure the correct dosage. When giving children liquid medicines, use the dosing device that came with the product. Never call medicine “candy” or other appealing names and be sure to throw out unused medicines. Never put poisonous items in food or drink containers.

• If your child has swallowed or come in contact with poison and is unconscious, not breathing or having convulsions, call 911 or your local emergency number immediately. If your child has swallowed poison, have the child spit out any remaining substance, but do not make the child vomit and do not use syrup of ipecac.

If a child’s skin has come into contact with poison, remove the • child’s clothes and rinse the skin with lukewarm water for at least 15 minutes.

• If poison has gotten into a child’s eyes, flush their eyes by holding the eyelid open and pouring a steady stream of room-temperature water into the inner corner of the eye for 15 minutes.

• If a child has been exposed to poisonous fumes, take the child outside or into fresh air immediately. If the child is not breathing, start CPR and do not stop until the child breathes on his or her own, or until another person can take over CPR.

! ABOUT POISON HELP RowanMedilink.indd 5

Spring cleaning safety tips

H

ere are some tips for preventing poisonings during spring cleaning.

• Keep cleaning products in their original bottles or containers. Don’t store them in cups, bottles or jars.

• Never sniff containers to determine what’s inside.

• Keep cleaning products locked up and out of sight and reach of children.

• Read the label before you use a cleaning product.

• Never mix products together; doing so could create a dangerous gas.

• Open windows and turn on fans when using cleaners or other chemicals.

• Wear protective clothing if you’re spraying pesticides or other chemicals.

• Stay away from newly sprayed areas for at least an hour, or until the spray has dried.

Source: T he U.S. Department of Health and Human Services

Source: The American Academy of Pediatrics

Poison Help is a free phone service connecting callers to their local poison centers. When accidents happen with chemicals or medicine, call Poison Help (1-800-222-1222).

3/17/15 3:13 PM

The University Doctors MedicaLink

Because Your Health Matters Make an appointment with one of our ‘Top Docs’ today The University Doctors is a committed team of physicians and health care professionals dedicated to serving the South Jersey community. With expertise in multiple disciplines, we focus on treating your health care needs at all stages of life. As faculty members at Rowan University School of Osteopathic Medicine, we are in tune with the latest treatments and advances in medicine. theuniversitydoctors.com | 856.309.DOCS Convenient hours. Most insurances accepted.

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