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OCTOBER ISSUE • 2010

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S e r v i n g P a l m B e a c h G a r d e n s , R o y a l P a l m B e a c h , We l l i n g t o n , B e l l e G l a d e , L a k e Wo r t h , L a n t a n a , B o y n t o n a n d B o c a R a t o n

Number of diabetic Americans could triple by 2050 Dr. Maharaj featured guest at Cell Science Systems. PAGE 5

Lizbeth Benacquisto for State Senate PAGE 10

The Centers for Disease Control and Prevention estimate that 1 in 10 have diabetes now, but the number could grow to 1 in 5 or even 1 in 3 by mid-century if current trends continue. PAGE 7

Walking 6 to 9 Miles a Week May Help Save Memory PAGE 12

Office Opening of Palm Beach Brain & Spine PAGE 13

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2 OCTOBER ISSUE • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Obama’s Health Care Reform Brings Back Interest In Hospitals Buying Up Physician Practices

By Dr. Mark Schor Board Certified in Internal Medicine

can remember the craze in the early 1990’s when there was a trend for hospitals and healthcare systems to buy physician practices. Remember all the talk about MSOs? (Medical Service Organization). But after this initial wave, there was a big crash, as most of these practices lost money. Yet interest has revived. A growing numbers of physicians are

selling their medical practices to hospitals and health systems. This is creating a noticeable reduction in the number of private practices in the United States. For example, Crouse hospital of Syracuse NY has bought the area’s biggest primary care doctors’ practice, Internist Associates. This practice has 15 doctors, five nurse practitioners and 90 employees who care for about 40,000 patients. Its doctors have become employees of a new subsidiary created by Crouse, Crouse Medical Group PLLC, Experts say the deal may be just the first in a wave of medical practice acquisitions by hospitals all over the United States and could foreshadow big changes in the way Americans receive health care.

Why The New Interest? A major focus of national health care reform is to integrate what is

now a largely fragmented health care system where there’s often little or no communication among doctors, hospitals and other health providers caring for the same patients. To accomplish this, the Obama government wants doctors, hospitals and other providers to share payments and financial incentives for improving care and cutting costs. “Getting a more integrated delivery system is going to be the way future care will be delivered and paid for,” said Dr. Paul Kronenberg, Crouse’s CEO and a former partner in Internist Associates. “The goal is to get primary care doctors and the hospital working more closely together to care for patients.” With Medicare and other payers looking to bundle costs and tie reimbursement to quality, hospitals are buying up physician practices to put all the players on the same team. With physicians as employ-

ees, hospitals can more easily align financial incentives around quality measures to meet payer goals. Hospitals offer physicians access to sophisticated electronic medical record (EMR) systems and practice management that takes the coding, billing and insurance headaches out of the physician’s purview. A large practice within a hospital system also means physicians spend fewer nights and weekends on call. Young physicians, for whom quality of life is a high priority, find this arrangement more attractive than independent practice. It’s not just young physicians. Established physicians are shopping their practices around to the local hospitals because they would rather be employees than in private practice.

What Can Go Wrong? Remember that by the late 90’s MSO deals were falling apart,

with hospitals saying the now salaried doctors were not working hard enough, and the doctors saying that the hospital administrators mismanaged the practice by driving away loyal staff and telling them how to practice medicine. History can repeat itself. If hospitals pay too much for a practice, don’t get revenue from ancillary services, don’t provide incentive for physicians to work hard, try to use a hospital system for physician billing, and offer hospital level benefits to employees that were costing the practice less, these physician office buyouts will fail again. But this time around hospital administrators are smarter. So are physicians. Obama’s heath care reform pressures can make it work this time if the practice acquisition is gone about with more realistic expectations and viable strategies.

Jeff Atwater for Chief Financial Officer

n Sunday October 24, 2010 a reception was held for Jeff Atwater for Chief Financial Office at the home of Dr. Krishna Tripuraneni. Jeff Atwater's philosophy of balanced budgets, fiscal discipline and tax cuts has helped keep Florida's budget balanced even in a time of deep economic crisis. “When Florida families have had to tighten their belts, it's time for government to do the same,” says Atwater. Under his leadership, the Senate cut a record amount of government spending. Jeff Atwater has been an active member of the community serving on several advisory boards such as United Way of Palm Beach County, Boy Scouts of America, 5-Star Magnet Program of Palm Beach Gardens High School and Roger Dean Stadium. He also served on the Board of Directors of the Northern Palm Beaches Chamber of Commerce and the Children’s Home Society of Broward County. Amarnath Vedere, M.D., Jeff Atwater, Krishna Tripuraneni, M.D., Dr. Javed Mohammed and Dr. Arun Thenappan.

Dr. Tanuja Vedere, Dr. Raj Bansal, Jeff Atwater, Dr. Kishore Dass, Dr. Shekhar Sharma and Mohan Pillai.

Padma Chigurupati, Farrah Javed and Dr. Lori Hansen.

Jeff Atwater, Dr. Shekhar Sharma, Dr. Amarnath Vedere, Dr. Kishore Dass and Dr. Krishna Tripuraneni. SALES & ADVERTISING Grace Edwards Phone: (561) 319-6919 gedwards@floridahealthnews-online.com

Jeff Atwater, Dr. Lori & Dr. Arthur Hansen.

Michael Antoine Phone: (561) 685-3245 sales@floridahealthnews-online.com

PUBLIC RELATIONS Phone: (561) 267-5232 p_relations@floridahealthnews-online.com GRAPHIC DESIGN Sergio Aguilar (561) 716-5054 ads@floridahealthnews-online.com

CONTRIBUTING ARTICLES U.S. Department of Health and Human Services, ARA Content, Hispanic PR Wire, Centers for Disease Control and Prevention, METRO Editorial Services, Family Features, © SEA PUBLICATIONS, INC. ALL RIGHTS RESERVED. Printed in United States.

Florida Health News is a newspaper published every month in Palm Beach county and surrounding areas. Copyright 2010, all rights reserved by SEA Publications, Inc. Contents may not be reproduced in any form without the written consent of the publisher. The publisher reserves the right to refuse advertising. The publisher does not accept responsibility for advertisement error beyond the cost of the advertisement itself. All submitted materials are subject to editing.

OCTOBER ISSUE • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Ten Little Toes.....

Arthur Hansen DPM, M.S.

ou counted to make sure all ten were there, your baby’s toes, that is; and then you commented on how they looked like your spouses. Those little feet were, and still are, precious! They will carry your child through school and every activity he can pronounce. They will proudly sport the loudest sneakers available at Foot Locker. They will carry him into adulthood, hopefully without limitations. The truth is foot health in kids of all ages is sorely neglected unless the problem becomes so severe that the child limps or complains of pain. This can lead to all sorts of little problems that can turn into big ones if not caught early. Parents need a bit of a foot health primer, so below are some common foot problems in children and how they should be treated.

Keep an Eye on those Feet Most serious foot problems are

caught fairly quickly after a baby is born. The really bad things congenitally are picked up almost immediately, so where the parents become important in diagnosing foot problems is when the child is at least 3 or 4 years old. Up to about age 4, kids just pick their feet up and put them down. Around age 4 is when they develop a heel/toe gait. This is when foot problems can begin to manifest themselves. Some things to look for: • Limping • A child not participating at the level that is normal for their age or grade range because their legs get tired • Any discrepancy between the feet, such as one foot turning out more than the other or one foot flatter than the other While the parent needs to start being vigilant when the child is about 4 years old, that doesn't mean that foot problems can't occur or start beyond that point. Here is a list of common foot problems that can occur through adolescence.

Flat Feet Usually, pediatric flatfoot – also known as flexible flatfoot – isn't a problem and often resolves itself by age 10 or 12. However, it should be evaluated and monitored both to be sure it resolves itself and to be sure that it is not causing the child any foot or leg pain or

causing the child to adjust his gait, which can lead to other problems. Treatment is usually pretty simple and is merely a question of the proper support, unless it does not resolve itself. In the latter case, surgery may be indicated.

Heel Pain Also referred to as Sever's Disease, heel pain is very common in children aged 8 to 12. We are see-

Tarsal Coalition

Warts

As the term "coalition" implies, this is when two or more bones in the foot are joined. The condition presents as a flatfoot, but usually just on one side and the foot is rigid rather than flexible. This is most commonly seen from age 8 through the teen years. It's a more serious situation than the traditional flatfoot, and can alter the way a child walks and can lead to stiffening of the foot, difficulties in gait and early arthritis.

Warts are very common in adolescence, especially in those with hyperhidrosis. It has been estimated that 90 percent of kids with warts also have hyperhidrosis.

In-Toeing When I was a kid this was referred to as being "pigeon toed," and my baby brother (now 35!) was in braces from age 3 to 5 to "cure" his pigeon toes. Most of the time, children will outgrow this but on occasion need some ‘help’ to promote a straighter gait.

Hyperhidrosis ing more and more of this condition now that it's become common for children to do a sport 12 months of the year. Depending upon the severity, a hiatus from sports may be necessary to give it a rest. This is most commonly seen in boys, but as girls become more active in athletics, they are also presenting with more foot problems. Also, the habit of putting one's shoes on without untying them is stressful for the foot and heel and should be avoided.

More commonly known as sweaty;smelly feet, this is not necessarily a hygiene issue. It's merely that some people's feet sweat more than others, and that perspiration causes them to smell. Controls include changing socks more frequently and using an antiperspirant on the feet. If that doesn't do it, there's a stronger medication that a podiatrist can prescribe. It's important to treat this condition, because it can lead to other problems from the constant moisture, including the next two.

Warts can be difficult to get rid of because they are caused by a virus. They can be painful if they are on a weight-bearing surface. They can also get too near a nerve and cause pain.

Athlete's Foot Again, hyperhidrosis can exacerbate this. It is a fungal infection of the skin on the feet. As for treatment, there are a number of topical treatments for athlete's foot.

Ingrown Toenail This can be serious if left untreated because it can become infected, and a big cause of infection in teenagers and adults is bathroom surgery. In other words, when they try to dig out an ingrown toenail, it becomes infected. In a case where a child is also diabetic, this can be a disaster. Long term infections of ingrown nails can lead to bone infections requiring surgery and long term intravenous antibiotics. Think about how much your child depends on his feet to get him where he's going. When you do, it's easy to see how taking good care of the feet now can only help your child out later.

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4 OCTOBER ISSUE â&#x20AC;˘ 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Interactive Video Games Linked to Injuries Sports injuries are commonplace, but injuries from playing interactive video games such as Nintendo Wii are now on the rise, new research shows, with even children who are bystanders sometimes getting hurt.

young children. "Know where the children are," she said. "Remember it's only a game." And Schaechter still believes it's better to go outside and play a truly interactive game with children that's "more healthful, better for relationships and doesn't lead to those kind of injuries." The results of the study were to be

owever, one expert said the odds of being injured while playing an interactive video game, or of being injured while watching someone else play, are small and probably not a serious problem. "It would not appear right now that interactive games put anybody at more risk than traditional gaming," said Dr. Judy Schaechter, associate chair of pediatrics and director of the Injury Free Coalition for Kids at the University of Miami Miller School of Medicine, who was not involved in the study. In fact, interactive games may be more beneficial than traditional video games, she added. "I am happy to get people up and moving. I prefer them to do an interactive game if it means that they are physically moving." Schaechter noted that most of the bystander injuries were among

presented Monday at the American Academy of Pediatrics National Conference and Exhibition in San Francisco. For the study, a team led by Dr. Patrick O'Toole, from the division of orthopedics at the Children's Hospital of Philadelphia, used the National Electronic Injury Surveillance System to collect data on all video game-related injuries from January 2004 to January 2009.

During that time, the researchers identified 696 video game-related injuries. Among these, only 92 injuries were tied to interactive video games, including 49 among males and 43 in females. Compared with traditional video games, those playing interactive video games were more likely to injure their shoulder, ankle or foot. In addition, they were also more likely to have cuts or bruises, strains or sprains, O'Toole's group found. However, the 65 reported seizures, the eight reported cases of eye pain or visual disturbance, and 23 of the 24 cases of neck injuries were all among those playing traditional video games, the researchers found. Injuries to bystanders occurred in both traditional and interactive video games, but happened significantly more often with interactive games. "This study details injuries sustained while participating in interactive and traditional video games," O'Toole said in a statement. "Younger children under the age of 10 should be supervised while video games are being played to prevent bystander injuries, which are more common with interactive games."

More U.S. Kids Getting Hurt Using All-Terrain Vehicles

mong U.S. children younger than 18, hospitalizations for all-terrain vehicle (ATV) injuries increased 150 percent between 1997 and 2006, new research shows. The most dramatic increases in injury rates occurred in the South and Midwest and among teens aged 15 to 17. Males in that age group have the highest rate of ATV-related hospitalization, but females aged 15 to 17 had the sharpest rise - 250 percent -- in ATV hospital-

izations during the study period. "All-terrain vehicles are inherently dangerous to children," lead author Stephen M. Bowman, an assistant professor at the Johns Hopkins Center for Injury Research and Policy, said in a Hopkins release. "While manufacturers are required to label vehicles with engine sizes greater than 90cc as inappropriate for children younger than 16, our data indicate that a growing number of

children are receiving serious injuries due to ATV use, suggesting that parents are unaware of these recommendations or are choosing to ignore them," he said. The analysis of national data also showed that rates of hospitalizations for ATV-related moderate to severe traumatic brain injury tripled between 1997 and 2006. The researchers called for a renewed effort by public health officials, the ATV industry and the U.S. Consumer Product Safety Commission to tackle the issue.

Mom's Flu Shot May Protect Baby After Birth

hen expectant mothers get a flu vaccination, they not only protect themselves throughout their pregnancy but may also help safeguard their babies against flu for the first few months of life. A study published online in the Archives of Pediatrics & Adolescent Medicine found that when women were vaccinated in the second or third trimester of pregnancy, their babies were significantly less likely to get the flu, and the babies' blood showed evidence of antibodies to the flu.

"Influenza infection among young infants can be a serious illness," said the study's senior author, Dr. Katherine O'Brien, a pediatrician and professor in the department of international health at Johns Hopkins Bloomberg School of Public Health in Baltimore. "There are several ways of protecting young infants against influenza. One is to assure that those in contact with young infants are immunized for influenza. Other ways are to practice good hygiene and hand washing, as well as keeping infants away from people who are known to be ill. And, this study shows if the pregnant mother is immunized during pregnancy, it affords protection to the infant," she noted. Infants under 6 months old are more likely to be seriously ill or to die from flu infections than older children, according to background information in the study. But, the

influenza vaccine isn't approved for children under 6 months of age. Young babies may acquire antibodies against some strains of influenza from their mothers' blood, but this immunity may not match the currently circulating strains of flu often covered in the current year's vaccine. To assess whether a vaccine given to the mother would provide any immunity to her offspring, the researchers followed 1,160 mothers who gave birth during one of three influenza seasons. The researchers found a 41 percent reduction in the risk of labconfirmed flu infection in babies whose mothers received the influenza vaccine. Babies born to mothers who received the flu immunization also had a 39 percent decreased risk of being hospitalized because of flu. When the researchers tested blood samples from the infants, they found that babies whose moms had been vaccinated had higher levels of antibodies against the strains of flu included in the vaccines than babies whose mothers chose not to be immunized. O'Brien said she believes these findings can be generalized to other populations. "There's no reason to believe this wouldn't be an important strategy for protecting all infants," she said.

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OCTOBER ISSUE • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Dr. Dipnarine Maharaj Featured Guest at Cell Science Systems to discuss Reducing Inflammation and Risk for Cancer Speech to focus on inflammation, cancer and healthy stem cells

eerfield Beach, FL – Dr. Dipnarine Maharaj, MD, FACP of The South Florida Bone Marrow/Stem Cell Transplant Institute was the featured speaker at Cell Science Systems / The ALCAT Laboratories on Monday, October 18, 2010. The topic of his speech was How to Reduce Inflammation and Risk for Cancer by Collecting and Storing Healthy Stem Cells. It highlighted the importance of how stem cell therapy can benefit patients.

Roger Deutsch, President and CEO of Cell Science Systems, and author of the book, Your Hidden Food Allergies Are Making You Fat, also spoke at the dinner discussion. “We were delighted to have Dr. Maharaj as our guest to lecture about this increasingly important topic. It is a valuable addition to any regenerative integrative medical practice” said Deutsch. Dr. Maharaj is dedicated to refining Bone Marrow Stem Cell transplant treatments in order to achieve the highest quality of care possible. Dr. Maharaj is also an accomplished author and frequent speaker. He has published several

scientific papers in journals such as, Biology of Blood and Marrow Transplantation, British Medical Journal, and, The Lancet. “I chose to study Hematology/Oncology to make a real difference in the quality of cancer care and to help change people’s lives for the better. My education helped shape me as a doctor and as a person. But for me, learning never ends. My patients are far too important” stated Maharaj. Dr. Maharaj has extensive experience in performing outpatient bone marrow / stem cell transplants since 1995. He has demonstrated that the majority of patients can be treated safely with minimal complications on a totally outpatient basis. This has been achieved by close monitoring and early intervention through all phases of the treatment by the same staff. Patients who receive a totally outpatient bone marrow / stem cell transplant return home following treatments and remain with family and loved ones. Every day, lives are changed as a result of the South Florida Bone Marrow / Stem Cell Transplant Institute. Under the direction of Dr. Dipnarine Maharaj, The South Florida Bone Marrow / Stem Cell Transplant Institute offers a full range of outpatient treatments for many hematologic cancers including: Non-Hodgkin’s Lymphoma, Hodgkin’s Lymphoma, Leukemia, and Multiple Myeloma. There are

Dr. Dipnarine Maharaj discussing about how to Reduce Inflammation and Risk for Cancer by Collecting and Storing Healthy Stem Cells.

Michelle Mohamed of ALCAT and Dr. Maharaj. Roger Davis Deutsch, ALCAT founder and CEO with several participants.

ably to stem cell transplants. This specialized approach helps patients whose cancer has shown little or no response to other methods of treatment.

Robyn Maharaj from the Institute and Lee Rolnick of ALCAT.

also other treatments such as immunotherapy for cancers. Patients are cared for by a team of highlyskilled professionals with extensive training and experience in treating cancers that react favor-

Cell Science Systems., Corp. (CSS), located in Deerfield Beach, Florida, is a life sciences company and the worldwide market leader in food sensitivity testing as the manufacturer of the ALCAT Test. ALCAT identifies cellular reactions to over 350 foods, chemicals and herbs. These inflammatory re-

actions are linked to chronic health problems like obesity and diabetes, as well as skin, heart, joint, and digestive disorders. CSS is expanding research into the area of cellular activity related to nutrition, immune function and other aspects of regenerative medicine. For more information on Cell Science Systems visit www.ALCAT. com. For more information on The South Florida Bone Marrow / Stem Cell Transplant Institute visit www.BMSCTI.org.

SOUTH FLORIDA BONE MARROW STEM CELL TRANSPLANT INSTITUTE AT BETHESDA HEALTH CITY Have you or a loved one been recently diagnosed with a hematological cancer such as leukemia, Non-Hodgkin’s lymphoma, or multiple myeloma? Do you know that the chances of developing a hospital-acquired infection are higher in patients diagnosed with a hematological malignancy? Do you know that there is a completely outpatient treatment center for patients with these kinds malignancies in the State of Florida fully operational in this location since 2001? The South Florida Bone Marrow Stem Cell Transplant Institute under the medical direction of Dr. Dipnarine Maharaj provides treatment for patients using chemotherapy and autologous stem cell transplant.

THE SOUTH FLORIDA BONE MARROW STEM CELL TRANSPLANT INSTITUTE 10301 Hagen Ranch Road, Suite 600, Boynton Beach, Florida, 33437. Please call 561-752-5522 to make an appointment. Visit www.bmscti.org for more information.

6 OCTOBER ISSUE â&#x20AC;˘ 2010

FLORIDAHEALTHNEWS-ONLINE.COM

A Message from Nancy G. Brinker Founder and CEO of Susan G. Komen for the CureÂŽ

y sister Suzy was born in Peoria, Illinois, in the fall of 1943. The very moment the American dream was about to come true. She was three years old when I was born. Mom says Suzy peeked over the edge of the bassinet and said, â&#x20AC;&#x153;Well! Sheâ&#x20AC;&#x2122;s quite a character!â&#x20AC;? We were best friends from that moment on. Suzy and I grew up watching our parents put faith into action. We learned the importance of volunteering and people coming together with a purpose. Suzy was the queen bee of the neighborhoodâ&#x20AC;&#x201D;very sweet, but she had her mischievous streak. When Suzy was grounded, I was the hostage negotiator. When Suzy exceeded her curfew, I was the peace envoy. When Suzy died, my lifeâ&#x20AC;&#x2122;s work was born. Millions of people know the name Susan G. Komen. Her name has become an icon for breast cancer awareness. But I wanted you to know the real Suzyâ&#x20AC;&#x201D;the Suzy I lovedâ&#x20AC;&#x201D;a bright little girl, the homecoming queen in her dress with pink ribbons, the young woman who loved art and longed to see the world, the dedicated mother who fought for every last moment with her children. Her death set a dramatic series of events in motion, but first and foremost, I wanted to share her life.

â&#x20AC;&#x153;Promise me, Nanny. Promise me youâ&#x20AC;&#x2122;ll change it so other families wonâ&#x20AC;&#x2122;t have to go through this.â&#x20AC;? I told her, â&#x20AC;&#x153;I promise. If it takes the rest of my life.â&#x20AC;? I didnâ&#x20AC;&#x2122;t realize at the time that it actually would.

This was a real woman, just like your sister, your daughter, your best friend. When Suzy was diagnosed with breast cancer in her early thirties we faced this thing with such limited information. There were no websites, no support groups, very limited treatment options. The lessons learned are so important. We are the CEOs of our bodies. From the beginning, Susan G. Komen for the CureÂŽ has sought to empower women with knowledge, access to care, and better treatment that comes from a wider understanding of this disease. Working as a team with your physicians and caregivers, you can develop a strategy that works for you. Just before Suzy died, she said,

However, in the wake of all the work left to be done, I am reminded daily how much family matters. I am blessed to have my mother by my side who remains sharp and spry at the age of 89. Along with my son, Eric, who now serves on the Susan G. Komen for the CureÂŽ board of directors. What started as a small group of committed women in my living room in Dallas has grown to a movement that reaches around the world. Our local Affiliatesâ&#x20AC;&#x201D;from Illinois to Italyâ&#x20AC;&#x201D;are peopled with remarkable volunteers. The Susan G. Komen Race for the CureÂŽ marches on, tens of thousands strong. These are the people who redefined grassroots while our corporate partnerships redefined cause related marketing. We lit up the White House in pink. We lit up the great Pyramids in pink. Together we changed the culture and science of breast cancer in America. Now weâ&#x20AC;&#x2122;re reaching out to women around the world. You can join us in the global movement to end breast cancer forever. Learn more at komen.org.

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Celebrity Bartender Night On October 22th, 2010 was held a Happy Hour to raise money for Save the Tataâ&#x20AC;&#x2122;s, on White Horse Tavern, sponsored by South Florida Radiation Oncology, All 4 One Home Care & Independent Imaging. Save the Tataâ&#x20AC;&#x2122;s was raising money for the making Strides against Breast Cancer, A 5K non competitive walk sponsored by The American Cancer Society. As Celebrity Bar Tenders were: Dr. J. Zeltzer, Dr. Shekhar Sharma, Dr. Kishore Dass, Dr. Anthony Addesa, Ravi Patel, Brian gross and Dr. Arthur Hansen.

OCTOBER ISSUE • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Number of diabetic Americans could triple by 2050 ATLANTA – As many as 1 in 3 U.S. adults could have diabetes by the year 2050, federal officials announced in a dramatic revision of earlier projections.

he Centers for Disease Control and Prevention estimate that 1 in 10 have diabetes now, but the number could grow to 1 in 5 or even 1 in 3 by mid-century if current trends continue. "This is alarming," said Ann Albright, director of the CDC's Division of Diabetes Translation. The agency's projections have been a work in progress. The last revision put the number at 39 million in 2050. The new estimate takes it to the range of 76 million to 100 million.

An estimated 24 million Americans have diabetes currently. The new CDC calculation accounts for people who have diabetes but are undiagnosed — a group that wasn't figured into earlier estimates, explained Edward W. Gregg, chief of the CDC branch that handles diabetes epidemiology and statistics. Also, the researchers used new population growth estimates for the elderly and minorities, who have higher rates of Type 2 diabetes, he said. One more factor: Diabetics are liv-

Many obese people see no need to lose weight

EW YORK – A substantial proportion of obese people don't think they're too fat, new research shows. Among more than 2,000 obese

ing longer, thanks to improvements in medical care, he added. Diabetes is a disease in which the

body has trouble processing sugar. It was the nation's seventh leading cause of death in 2007.

In the classic form of diabetes, traditionally diagnosed in children or young adults, the body does not produce enough of a hormone called insulin to help sugar get into cells. That's Type 1 diabetes. Another form of diabetes, Type 2, now accounts for about 95 percent of cases. In that kind, the body's cells resist insulin's attempts to transport sugar. Type 2 is most common in people who are overweight and obese, in people 60 and older, and in African-Americans and other minority groups. The growth in U.S. diabetes cases has been closely tied to escalating obesity rates. Recent CDC data suggests obesity rates may have recently leveled off. But the new estimates should hold up even if obesity rates remain static, CDC officials said. The new estimates were published by the journal Population Health Metrics.

Dallas County residents surveyed in 2000-2002, 14 percent of African Americans and 11 percent of Hispanics -- but just 2 percent of whites -- believed that they did not need to lose weight, Dr. Tiffany M. Powell of the University of Texas Southwestern Medical Center in Dallas and her colleagues found. People who misperceived their body size were happier with their health, and felt healthier, than those who did recognize their obe-

sity; they were also more likely to think they were at low risk of developing high blood pressure or diabetes or having a heart attack during their lifetimes. In fact, twothirds of people with body size misperception thought they were at low risk of becoming obese. The study "points to really a lack of understanding about the effects of obesity," Powell told Reuters Health. At the same time, she added, "you walk a fine line, because you don't want people to

necessarily have an unhealthy body image, but you also want people to understand that they need to lose weight." It's possible, according to Powell, that heavy people's self-perceptions are changing because overweight and obesity are becoming so much more common. "There is this tendency that if everyone around you looks a certain way, you either want to look that way or you're comfortable looking the way you are," Powell said.

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8 OCTOBER ISSUE • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Should you see the doctor o not???

Shekhar V. Sharma, M.D. Board Certified in Internal Medicine

After the age of 40 one should think of running, jogging, or brisk walking to maintain and improve cardiovascular fitness. As long as you have a strong heart it is never too late to start an exercise program. As we grow older our muscle fiber shrinks in number and size. This may result in a decrease in cardiovascular endurance, strength, balance and coordination. Even most athletes experience a decline around the age of 40. If you are 40 plus female and you

ou wake up in the morning. It is your 40th birthday and you feel you may be over the hill as they say!! If you are a woman you should think of having a mammogram at the age of 40 as this is recommended by the United States Preventive services Task Force and the American Cancer Society. The ACS also recommends an MRI for women who are at a high risk of having breast cancer. Part of the downside of annual mammograms is identification and testing of suspicious lumps and masses that end up being non cancerous. Sometimes these extra tests are patient directed, and at other times these tests stem from a physician’s fear of a lawsuit threat. If you are a male you would definitely want to have a Prostate Surface Antigen Test or PSA Screening. Men who want to be screened for prostate cancer should also have a digital rectal examination once a year.

are undergoing early menopause and there is a family history of osteoporosis, and you have had a fracture in your adult years, I would recommend a Bone Mineral Density Test (BMD). The U.S. Preventive Services Task Force recommends a Bone density Test for all 65 and older at least once a year. At 50 years of age a lot of people are not aware that this is an age one has to have a screening colonoscopy to rule out colon cancer. Annual Physicals are a must and this entails drawing blood for lab tests. These lab tests should screen for diabetes mellitus, hypercholesterolemia, kidney and liver diseases and anemia. Tests for various ailments that match the complaints can be done by your physician. An annual physical exam also screens for hypertension. This is why your primary care physician is the captain of your health and will guide and direct you to having a healthy life.

Dr. Sharma has relocated his office in Belle Glade to 1200 South Main Street, Suite 101 (opposite the Old Glades General Hospital). Dr. Sharma will be seeing patients at this location along with his nurse practitioner Grace VanDyk. He is currently accepting New Patients and the office accepts most insurances

Please call 561-996-7742 for an appointment.

Chronic Pain Part of Life for Many Americans, Survey Finds Experts call this a serious, unaddressed public health issue.

early 70 percent of Americans say that they or someone they care for experienced pain in the previous 30 days, a recent survey shows. Release of the American Osteopathic Association (AOA) poll is part of its public education campaign to encourage people with chronic pain to seek help and resources. More than 76 million Americans live with pain every day, and chronic pain affects more Americans than cancer, diabetes and heart disease combined, according to the group. "Chronic pain is a very serious and unaddressed public health issue, and many people are reluctant to speak to their physician for fear of feeling hope-

less, or simply not knowing how to initiate the conversation," Dr. Robert I. Danoff, of Aria Health System in Philadelphia, said in an AOA news release. "It is important for physicians and their patients to work together to address the issue of pain." Among the other survey findings: 48 percent of respondents don't believe that proper treatment can ease chronic pain. 41 percent believe pain is a normal part of aging, and 10 percent simply ignore the pain. 36 percent would refuse doctorrecommended or doctor-prescribed pain medication for fear of becoming addicted. 34 percent believe pain medications that cause side effects are worse than pain itself. 31 percent would not speak to a doctor about their pain for fear they could not afford treatment. Only 18 percent would speak to a specialist if they were suffering chronic pain.

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OCTOBER ISSUE โ ข 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Andrew Schaller for County Commissioner District 6

fundraiser was held for Andrew Schaller at the Polo Country Club on October 20th 2010. Andrew Schaller is running for County Commissioner, District 6 as an independent candidate. His goal is to make sure other citizens seeking the representation of the District 6 Commissioner have the quality representation they deserve and positive results they desire.

Angela Baker and John Walsh.

William Grear, Mayor Bowen, Andrew Schaller, David Swift and Michelle demone.

Brandon Allert, Chris Schwartzwalde, Tina & Alan Seymor.

Laura Hanley, Heather Landstrom and Cheryl CarpenterKilmak.

Dr. Shekhar Sharma, Dr. McClellan, Grace Edwards and Dr. Dana Desser. Bryan Artigas and Shephany Demaria.

Mike Stone, Mayor Bowen, Michael Sexton, David Swift, Andrew Schaller, Dr. Shekhar Sharma and Giluio Panzano.

Cindy Bovay and Felicia Sauers.

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Elzie Dawson, Giluio Panzano and Cheryl Glass.

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10 OCTOBER ISSUE â&#x20AC;˘ 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Lizbeth Benacquisto for State Senate

n Friday October 1, 2010 a reception was held for Lizbeth Benacquisto for State Senate at the home of Dr. Shekhar and Ranjita Sharma. Lizbeth Benacquisto was first elected Wellington Councilwoman in 2002 to represent the Village of Wellington, and was re-elected through the conclusion of her term in 2010. She is running to represent State Senate District 27; the seat Senator Dave Aronberg is vacating to seek the office of Floridaâ&#x20AC;&#x2122;s Attorney General.

Amber Ackerman, Dr. Joshua Ackerman and Bobbi Ackerman.

Mrs. Cheryl & Victor Genchi, Dr. Shekhar & Ranjita Sharma, Jeff Atwater and Lizbeth Benacquisto.

Craig Cuden, Lizbeth Benacquisto and Dr. Ellis Webster.

Louis Morgenier, Kevin & Gina Staten.

Eric and Erin Nova.

Deanna Miller and Beth Berkowitz.

Dr. Lori Hansen, Mohan Pillai, Lizbeth Benacquisto, Sharon Mineo, Staci and David Martin.

Lizbeth Benacquisto and Dr. Benny Menendez.

Dr. Kishore Dass, Bland Eng, Ravi Patel and Sharon Mineo.

Bland Eng, Dr. Arthur Hansen, Lizbeth Benacquisto, Dr. Lori Hansen and Harvey Montijo.

Dr. Bill and Sherine Hansen.

Cheryl and Dr. Victor Genchi and Dr. Chandra Venugopal.

Anand Patel, Mina Patel, Ravi Patel, Lata Patel and Kiran Patel.

Therese Andrews and Dr. Diane Reisinger.

Maria Becker, Lizbeth Benacquisto, Dr. Eddie Becker, Heidi and Dr. Martin Harland

Jyetsna and Arvind Ajinkya.

Jhawed Khayoumi, Katiann Susich and Holly Gordon.

Barbara Tarantino and Heather Carmichael ARNP.

Sharifa & Dr. Ishan Gunawardene with Lizbeth Benacquisto.

Dr. Anthony and Mrs. Adessa.

OCTOBER ISSUE â&#x20AC;˘ 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Soy May Reduce Breast Cancer Recurrence: Study But benefit was only seen in postmenopausal women and the trial was small.

or women past menopause who have had breast cancer, a higher intake of soy may help reduce the risk of the disease's recurrence, a new study of Chinese women suggests. The same link was not found in premenopausal women with breast cancer, whatever their soy intake, the study authors said. The study, while called intriguing by U.S. experts, was not large and included only women with breast cancer receiving care in China. It's not known if the results would apply to other groups of women, said Marji McCullough, a spokeswoman for the American Cancer Society. "Chinese women may have been likely to have a lifelong high consumption of soy," she said. "We don't know whether starting on a diet high in soy after a breast cancer diagnosis would have the same effect as eating a lifelong diet high in soy." For the study, Dr. Qingyuan Zhang of the Cancer Hospital of Harbin Medical University in

Vigilance Against Skin Cancer May Lead to Lack of Vitamin D But the sun-sourced nutrient can be obtained through a supplement, experts note.

Harbin, China, evaluated 524 women who had undergone breast cancer surgery between August 2002 and July 2003. They were receiving endocrine therapy such as anastrozole (Arimidex) or tamoxifen to reduce cancer recurrence risk. The researchers measured the women's dietary intake of soy isoflavones at the start of the study, and then followed them for about five years to see if breast cancer recurred. For the premenopausal women, soy had no apparent effect on the risk of subsequent breast cancer. But postmenopausal women with the highest intake of soy -more than 42.3 milligrams of soy isoflavones a day -- had a 33 percent reduced risk of cancer recurrence. For patients receiving anastrozole and whose breast cancer was estrogen receptorpositive and progesterone receptor-positive, the risk reduction link was even stronger. The study findings were published in CMAJ (the Canadian Medical Association Journal).

eople with a genetic predisposition to basal cell carcinoma -- the most common form of skin cancer -- may trade one health risk for another, a new study suggests. Because people with basal cell nevus syndrome (BCNS) tend to develop multiple basal cell skin cancers in early adulthood and so take more precautions against sun exposure, they may also run a higher risk of being deficient in vitamin D, report researchers in the October issue of Archives of Dermatology. "We found that patients with skin cancer who practice very good photoprotection [sun protection] have lower vitamin D levels," said Dr. Jean Tang, lead author of the study. "This makes sense because they're avoiding sunlight and sun is required to synthesize vitamin D." But having healthy levels of the nutrient may be necessary to protect against cancer, broken bones, heart disease and even some autoimmune diseases. The study authors looked back at the medical records of 41 patients with BCNS who had previously been involved in a trial to see if the non-steroidal anti-inflammatory drug Celebrex (celecoxib) might prevent against basal cell carcino-

mas. According to the authors, Celebrex is not known to affect vitamin D levels in the body. These individuals were matched against 360 men and women who did not have the cancer syndrome but who were of similar ages, similar weight, similar UV (ultraviolet) exposure and who lived in similar geographic areas Eighty percent of the BCNS patients said they used sunscreen every day, avoided the sun during its hottest hours in the middle of the day and wore long-sleeved clothing. And in this sample, 56 percent of participants with BCNS had toolow levels of vitamin D -- three times as many as in the control group. "Most likely," said Tang, "the fact that skin cancer patients avoid sunlight is probably the number-

one contribution to why they have low vitamin D levels, because the major difference between the two groups was that the skin cancer patients were practicing good photoprotection." But at this point, the evidence for a link between sun protection and vitamin D deficiency is still an indirect one, said Dr. Vijay Trisal, an assistant professor of surgical oncology at City of Hope Cancer Center in Duarte, Calif., who was not involved in the study. He also noted that a large number of people both with and without histories of skin cancer have vitamin D levels that are deficient. Rather than basking in the sun or trading long-sleeved shirts for sleeveless, the authors suggest that wider screening of vitamin D levels would be a first step in resolving this problem. Vitamin D supplementation for those who are deficient could follow, said Tang, who is assistant professor of dermatology at Stanford University Medical Center. Right now, the recommended daily allowance of vitamin D is 400 international units, but the Institute of Medicine is currently revisiting those numbers. A new report is expected at the end of November, Tang said. The bottom line, according to Trisal: "It's easy to get adequate doses of vitamin D by taking a tablet."

12 OCTOBER ISSUE

â&#x20AC;˘ 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Walking 6 to 9 Miles a Week May Help Save Memory Brain's gray matter doesn't seem to shrink with this amount of exercise, study finds.

alking about six miles a week appears to protect against brain shrinkage in old age, which in turn helps stem the onset of memory problems and cognitive decline, new research reveals. "We have always been in search of the drug or the magic pill to help treat brain disorders," noted Kirk I. Erickson, an assistant professor of psychology at the University of Pittsburgh and the study's lead author. "But really what we are after may be, at least partially, even simpler than that. Just by walking regularly, and so maintaining a little bit of moderate physical activity, you can reduce your likelihood of developing Alzheimer's disease and [can] spare brain tissue." A report on the research, which was supported by the U.S. National Institute on Aging, is published in Neurology. Erickson and his colleagues began tracking the physical activity and cognitive (or thinking) patterns of nearly 300 adults in 1989. At the start, all participants were in good cognitive health, they averaged 78 years old and about two-thirds were women. The researchers charted how many blocks each person walked in a week. Nine years later, they were given a high-resolution MRI scan to measure brain size. All were deemed to be "cognitively normal."

But four years after that, testing showed that a little more than one-third of the participants had developed mild cognitive impairment or dementia. By correlating cognitive health, brain scans and walking patterns, the research team found that being more physically active appeared to marginally lower the risk for developing cognitive impairment. But more specifically, they concluded that the more someone walks, the more gray matter tissue the person will have a decade or more down the road in regions of the brain -- namely the hippocampus, the inferior frontal gyrus and the supplementary motor area -- that are central to cognition. And among the more physically active participants who had retained more gray matter a decade out, the chances of developing cognitive impairment were cut in half, the study found. However, the researchers stressed that the relationship between walking and gray matter volume appears to apply only to people who regularly walk relatively long distances that equal about six to nine miles a week. Walking more than the six- to nine-mile range, however, did not have cognitive benefit, the study found. "That's because the size of our brain regions can only be so large," Erickson said,

adding that the opposite isn't true. "So with no exercise, there can be significant deterioration and decay with age." However, he added, "what we often tend to think of as an inevitable component or characteristic of aging -- memory decline and brain decay -- is clearly not inevitable. There's plenty of evidence now, and this study is part of that, that shows that we can retain our brain tissue and retain our memories well into late adulthood by maintaining an active and engaged lifestyle." Dr. Steven V. Pacia, chief of neurology at Lenox Hill Hospital in New York City, described the study's finding as both "intriguing" and an "undoubtedly positive message to send to the public." "My first reaction to studies like this is that only in America do we have to prove to people that it's good to walk," he said with a chuckle. "But it stands to reason that being active as we age is going to have a beneficial effect on the brain, just as being inactive is going to have a negative impact," Pacia noted. "Because the brain lives in the environment of the body." But there may be a catch. "This is just an observational study," Pacia noted. "And while we may assume that the relationship between the brain and activity is a prevention-of-atrophy issue -- just like it is with muscle and bone -- this study doesn't actually prove that. We don't yet know enough about the use-it-or-lose-it notion with respect to brain and exercise. So we do need more research to look at that."

OCTOBER ISSUE • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Office Opening of Palm Beach Brain & Spine Photos by Grace Edwards

n October 7th 2010 Dr. Amos Dare and Dr. Faris Fakhoury opened their new location for Palm Beach Brain and Spine at 1447 Medical Park Bolevard Suite 101 on the campus of Wellington Regional Medical Center. Dr. Dare has over ten years experience in all types of brain & spine surgery. Dr. Dare’s specialty is using minimally invasive neck & lower back spine surgery.

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14 OCTOBER ISSUE • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

8 Instant energizers - any time of day! Having a low-energy day? Sometimes the problem is lack of sleep, but even if you’re well rested, certain diet or exercise habits or other lifestyle choices can bring on a slump. And surprisingly little things—like the size of your Starbucks order—can hurt or help your energy levels. Make some of these tweaks to recharge your batteries and power through your day.

Have bran for breakfast Eating a morning meal rich in fiber may make you more alert during the day. A Cardiff University study found that subjects who ate a high-fiber cereal in the morning showed a 10% reduction in fatigue, lower incidence of depression, and better cognitive skills. One theory: Fiber helps slow down the absorption of food in the stomach, which keeps your blood sugar levels steady to sustain energy levels for a longer period of time.

Order a small latte— and sip it slowly Experts say it's best not to rely too heavily on caffeine, but if you're an unapologetic java junkie, try spreading your intake out more evenly over the day. Mini servings of caffeine (8 ounces of coffee or less) every few hours keep you awake, alert, and focused for longer than a single jumbo one would, according to sleep experts. "When you quickly drink a large coffee, the caffeine peaks in your bloodstream much sooner than if you spread it out over time," says Harris R. Lieberman, PhD, a research psychologist with the US Army Research Institute of Environmental Medicine.

6 3

Gulp some water "Half of the people who come to me complaining of fatigue are actually dehydrated," says Woodson Merrell, MD, executive director of the Continuum Center for Health and Healing at Beth Israel Medical Center in New York City. Staying hydrated is one of the simplest ways to keep energized and focused. A recent study of athletes found that 92% felt fatigued after limiting fluids and water-rich foods for 15 hours; they also had lapses in memory and reported difficulty concentrating. Aim to drink every hour or two so you don't feel thirsty.

Or steep a cup of tea A recent report found that pairing caffeine and the amino acid L-theanine, both present in tea, decreased mental fatigue and improved alertness, reaction time, and memory. What's more, black varieties can help you recover from stress, according to researchers at University College London. In their study, adults who drank tea four times a day for 6 weeks had lower levels of the stress hormone cortisol after a tense moment, compared with those who drank a tealike placebo.

Copy your kid's lunch ... If it's a banana and peanut butter sandwich. Bananas pack potassium, a mineral your body needs to convert sugar in your blood into energy, says energy expert Susan Lark, MD, author of The Chemistry of Success: Six Secrets of Peak Performance. The peanut butter is high in magnesium, which gives your cells much-needed energy. Aim for 320 mg of magnesium and 4,700 mg of potassium daily. Other good sources of potassium and magnesium: fruits, vegetables, beans, and nuts.

Cue up your iPod Feeling dazed at your desk? Consider listening to music while you work. One study found that employees who donned headphones while they worked were 10% more productive than without them.

Order the seaweed salad If your go-to Japanese appetizer is miso soup or edamame, consider rotating seaweed salad into the mix. It's packed with iodine, a chemical that helps maintain sufficient levels of the thyroid hormones that regulate your weight, energy level, and mood—and a new study finds you may not be getting enough of it. We tend to get our biggest dose of iodine from table salt, but among 88 randomized samples of common iodized salt brands, 47 didn't contain the FDA's recommended iodine concentration, say scientists from the University of Texas at Arlington. Adults should get 150 mcg of iodine daily (220 mcg if you're pregnant, 290 mcg if breastfeeding). Iffy on the seaweed? Other food sources include fish and yogurt.

Take a 10-minute walk A short stroll can invigorate the rest of your day, suggests research presented to the American Heart Association. Women who walked briskly for 70 minutes a week (or 10 a day) reported 18% more energy than their sedentary peers after 6 months. They also felt more clearheaded and confident, had fewer aches, and hoisted groceries and climbed stairs more easily.

Can Vitamin B12 Reduce Alzheimer's Risk? Finnish study hints at a link, but experts call the trial small and preliminary.

eople who eat a diet rich in vitamin B12 may be protecting themselves from Alzheimer's disease, a small, preliminary study suggests. The findings add to the debate about whether vitamins can reduce the risk of developing Alzheimer's disease. While this new study appears to support

the role of vitamins, other studies have yielded mixed results, the researchers said. "Previous studies have reported that vitamin B12 deficiency is a common condition in the elderly," said lead researcher Dr. Babak Hooshmand, a research assistant with the Aging Research Center at the Karolinska Institute in Stockholm, Sweden. "Our results indicate that vitamin B12 and related metabolites may have a role in Alzheimer's disease, but more research is needed before we can get conclusions on the role of vitamin B12 supplements on neurodegenerative diseases such as Alzheimer's disease," he added. The report is published in the issue of Neurology.

For the study, Hooshmand's group looked at homocysteine levels in the blood of 271 Finns 65 to 79 who did not have dementia at the beginning of the study. The team looked at homocysteine because high levels of this protein have been linked to stroke. The

researchers also looked at levels of holotranscobalamin, which is the active protein of vitamin B12 and lowers blood levels of homocysteine, the researchers said. During seven years of follow-up, 17 people developed Alzheimer's. The researchers found that for each small increase of homocysteine, called a micromolar, the risk of Alzheimer's disease rose 16 percent. However, with each small increase in vitamin B12, called a picomolar, the risk of Alzheimer's dropped 2 percent. The results remained constant after the researchers compensated for other factors, such as age, sex, education, smoking, blood pressure and weight.

Vitamin B12 is found in eggs, fish, poultry and other meats. A balanced diet -- not supplements -- is the best way to get the vitamin B12 you need, Hooshmand said. Alzheimer's expert Greg M. Cole, a professor of medicine and neurology at the University of California, Los Angeles, said "this new study is too small to say that it adds a lot to the association of Alzheimer's disease and dementia with high homocysteine." "But it is interesting that higher B12 appears protective given the recently published report that B vitamin supplements appeared to reduce brain shrinkage," he said.

OCTOBER ISSUE • 2010

FLORIDAHEALTHNEWS-ONLINE.COM

Americans Charity Tennis Tournament

Sandra Joul and Adriana Romay of Chase Bank.

All participants played tennis while they made possible supported our Veterans.

Matt Lantz, Dr. Gene Shieh and Dr. Kishore Dass.

Jack Lu and Dr. Alex Mirakian.

Deanna Miller, Danielle D’Nardo, Justin Miller, Isa Sawiq and Beth Berkowitz.

charity Tennis Tournamen t was held at Breakers West Country Club on Sep 11,2010 to support our Veterans.Some of the sponsors were Ameri Home Health Care and CornerStone Funding Group. All proceeds were donated to the West Palm Beach VA Medical Center.

AmeriHome Healthcare table sponsor.

Javier Baquero of Cornerstone Funding Group.

Classified

Dr. Shekhar Sharma, Alex Ringwald and Neal Sharma.

(561) 753-8730 Email: ads@floridahealthnews-online.com To advertise call: (561) 319-6919 • (561) 267-5232 Fax:

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