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Also in this issue Feds to allow use of Medicare data to rate doctors ................2 Diabetics need special treatment ................................3 Medical Community Business
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Feds to allow use of Medicare data to rate doctors
Networking .............................4 Ribbon Cuttin & Tour of Butterfly House ......................5 5th Annual Salsa Festival .......6 Are you paying too much for Ribbon Cutting & Tour of Butterfly House PAGE 3
Imaging??? ............................7 Radiation Technology Evolves in Treating Breast Cancer........8 Gastroesophageal Reflux Disease .................................10 The Silent Killer ....................11
5th Annual Salsa Festival PAGE 6
Palms West Hospital and the Children’s Hospital at Palms West .....................................12 Doctors: Test all kids for cholesterol by age 11 ...........14 Harvest Festival ....................15
Federal officials announced that Medicare will finally allow the use of its extensive claims database to rate doctors, hospitals and other medical service providers. PAGE 2
Palms West Hospital and the Children’s Hospital at Palms West PAGE 12
More than one in 10 Americans over the age of 12 takes an antidepressant, a class of drugs that has become wildly popular in the past several decades, U.S. government researchers said. PAGE 2
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2 DECEMBER ISSUE
• 2011
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Feds to allow use of Medicare data to rate doctors
US baby boomers feed need for joint replacements
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ASHINGTON— Trying to find a top specialist to assess potentially troubling findings on a routine mammogram? That nerve-wracking process may soon get easier. Federal officials announced that Medicare will finally allow the use of its extensive claims data-
base to rate doctors, hospitals and other medical service providers. The report cards could be produced by employers, consumer groups or others, and would have to follow valid statistical methods. Individual medical providers would have 60 days to privately challenge a report before its release.
But Medicare acting administrator Marilyn Tavenner calls it "a giant step forward" to making medical decisions less daunting for patients while holding providers accountable for quality. Consumer groups that have long pushed for the release of the data said they are still poring over the fine print.
S baby boomers are fueling a wave of joint replacement surgeries, hoping to use new artificial knees and hips to stay active as they get older. With 76 million baby boomers still kicking, many are rejecting the sedentary lifestyle of their parents' generation, and are using advances in technology and surgical techniques to keep on running, cycling, skiing and engaging in other sports. The 45-64 age group accounted for more than 40 percent of the more than 906,000 total knee or total hip replacement surgeries in 2009, the last year for which figures were available from the American Academy of Orthopedic Surgeons. Boomers will account for a majority of these joint replacements in 2011, according to projections by Drexel University specialist Steven Kurtz. The study projects the 45-64 age group will account for a 17fold increase in knee replacements alone to 994,000 by
2030. Active boomers often accelerate the arthritis which wears down their joints, and obesity is another factor. "We are still doing patients 65 years and up, but the volume is increasing dramatically among 45-64 year-old patients," said Douglas Dennis, a Colorado orthopedist who has performed some 5,000 knee replacements and 4,000 hip replacements over his career. Decades earlier, most replacements were in elderly patients unable to walk. But Dennis said, "We are now performing them in younger age patients. We have made great strides in our ability to revise them should they fail." A number of his patients are avid skiers who have had several attempts to repair knee injuries, but want to keep active. "We encourage the patients to be active," he said. "But I don't favor things like racquet sports, soccer or basketball" which can put extra strain on joints.
Leapfrog Group names top hospitals for 2011 Leapfrog's top hospitals for 2011 are listed by category and in order by state in each category.
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he survey results for all participating hospitals are posted on the Leapfrog website. The site is open to patients and families, the public, and employers and other purchasers of healthcare.
2011 LEAPFROG TOP HOSPITALS
(in order by state, within each category) Kaiser Permanente Antioch Medical Center (CA) Kaiser Permanente Fontana Medical Center (CA) Kaiser Permanente Los Angeles Medical Center (CA) Kaiser Permanente Oakland Medical Center (CA) Kaiser Permanente Panorama City Medical Center (CA) Kaiser Permanente Richmond Medical Center (CA) Kaiser Permanente Riverside Medical Center (CA) Kaiser Permanente Roseville Medical Center (CA) Kaiser Permanente San Diego Medical Center (CA) Kaiser Permanente San Francisco Medical Center (CA) Kaiser Permanente San Jose Medical Center (CA) Kaiser Permanente South Bay Medical Center (CA) Kaiser Permanente South Sacramento Medical Center (CA) Kaiser Permanente South San Francisco Medical Center (CA) Kaiser Permanente Vacaville Medical Center (CA) Kaiser Permanente Walnut Creek Medical Center
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Kaiser Permanente West Los Angeles Medical Center (CA) Kaiser Permanente Woodland Hills Medical Center (CA) Mills-Peninsula Health Services (CA) Stanford Hospital and Clinics (CA) UC San Diego Health System, Hillcrest (CA) Baptist Health South Florida Homestead Hospital (FL) NorthShore University HealthSystem-Evanston Hospital (IL) NorthShore University HealthSystem-Glenbrook Hospital (IL) Northwestern Memorial Hospital (IL) Rush University Medical Center (IL) Baystate Medical Center (MA) Beth Israel Deaconess Medical Center (MA) Brigham and Women's Hospital (MA) Anne Arundel Medical Center (MD) University of Maryland Medical Center (MD) Detroit Receiving Hospital/University Health Center (MI) Spectrum Health Blodgett Hospital (MI) Spectrum Health Butterworth Hospital (MI) St. Joseph Mercy Oakland (MI) University of Michigan Health System (MI) Regions Hospital (MN) St. Mary's Hospital of Rochester (MN) University of North Carolina Hospitals (NC) Hackensack University Medical Center (NJ) The Valley Hospital of Ridgewood(NJ) Presbyterian Hospital (NM) Montefiore Medical Center, Weiler Division (NY) Roswell Park Cancer Institute (NY) The Ohio State University Comprehensive Cancer
Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OH) The Christ Hospital of Cincinnati (OH) University Hospitals Case Medical Center (OH) Lehigh Valley Hospital (PA) Bon Secours St. Francis Health System - Downtown (SC) Vanderbilt University Hospital (TN) Swedish Medical Center First Hill Campus (WA) Virginia Mason Medical Center (WA) 2011 LEAPFROG TOP RURAL HOSPITALS Mariners Hospital (FL) Miles Memorial Hospital (ME) Sebasticook Valley Hospital (ME) 2011 LEAPFROG TOP CHILDREN’S HOSPITAL Children's Hospital Los Angeles (CA) CHOC Children's (CA) Children's National Medical Center (DC) Children's Memorial Hospital (IL) Children's Hospital Boston (MA) Cincinnati Children's Hospital Medical Center (OH) Children's Hospitals and Clinics of MinnesotaSt. Paul (MN) Children's Hospitals and Clinics of MinnesotaMinneapolis (MN) Nationwide Children's Hospital (OH) Cook Children's Medical Center (TX) CONTRIBUTING ARTICLES
Deborah Lynn Staff Writer and Sales Executive
Erica Whyman Staff Writer and Sales Executive
312-351-2383 deborah@globalhealthtribune.com
(561) 308-1428 erica@globalhealthtribune.com
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.
Global Health Tribune is a newspaper published every month in Palm Beach county and surrounding areas. Copyright 2011, 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.
DECEMBER ISSUE • 2011
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DIABETICS NEED SPECIAL TREATMENT Diabetics are prone to many problems that affect the feet and legs. Some of them leading to amputation of part of the foot or the entire leg. If you are Diabetic, you need to be having your feet checked by a professional regularly.
Arthur Hansen DPM, M.S.
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oot ulcers and amputations are a major cause of morbidity, disability, as well as emotional and physical costs for people with diabetes. It is important to obtain early recognition and management of independent risk factors for ulcers. This can prevent amputations and/or delay the onset of adverse outcomes. Below are recommendations for people who have yet to encounter foot ulcers. Each segment strives to educate an effective way of identifying and managing risk factors for ulceration in hopes of preventing and ulcer.
nal and cardiovascular disease. Risk identification is fundamental for effective preventive Below are symptoms that are associated with an increased risk of amputation: • Peripheral neuropathy with loss of protective sensation • Altered biomechanics (in the presence of neuropathy) • Evidence of increased pressure (erythema, hemorrhage under a callus) • Bony deformity • Peripheral vascular disease (decreased or absent pedal pulses) • A history of ulcers or amputation
IDENTIFYING RISK Identifying the risks for diabetic ulcerations is key to preventing them. The chance of developing a diabetic ulcer/amputation begins to increase after ten years of being diagnosed with Diabetes, poor sugar control, if you are male, and also having comorbidities such as renal, reti-
• Severe nail pathology. PREVENTION All people with diabetes should receive an annual foot examination to identify high-risk foot conditions. People with any of the mentioned high-risk foot conditions should be examined more fre-
quently. The exam should include assessment of protective sensation, vascularization, foot deformities, and skin assessment. Diabetics with known peripheral neuropathy should have their lower extremities inspected at every professional health care visit. PREVENTION OF HIGHRISK CONDITIONS Equal sensory loss to both feet usually starting at the toes and working up is one of the most important predictors of ulcers and amputation. Neuropathy can be delayed significantly by controlling glucose levels to as near normal as possible. The cessation of smoking should be encouraged
to reduce the risk of vascular disease complications. Appropriate and timely referral to a foot care specialist is gravely important for prevention. PATIENT EDUCATION Patients with diabetes and associated risk factors for foot conditions must be educated regarding these risk factors and how to manage them. Diabetics must fully understand the complications associated with the risk factors. They must inspect their feet daily, clean and dry them appropriately daily, and be aware of their shoe gear. As many diabetic patients have trouble seeing or reaching their feet family members should also be educated on the risks and daily examinations. The patient’s understanding of these issues and their The American Diabetic Association makes the following recommendations: • All individuals with diabetes should receive an annual foot examination to identify highrisk foot conditions. This examination should include assessment of protective sensation, foot structure and biomechanics, vascular status, and skin integrity. • People with one or more highrisk foot conditions should be evaluated more frequently for the development of additional risk factors.
• People with neuropathy should have a visual inspection of their feet at every visit with a health care professional. • Evaluation of neurological status in the low-risk foot should include a quantitative somatosensory threshold test, using the Semmes-Weinstein 5.07 (10-g) monofilament. • Patients with diabetes and highrisk foot conditions should be educated regarding their risk factors and appropriate management. • Initial screening for peripheral vascular disease should include a history for claudication and an assessment of the pedal pulses. For Diabetics, the loss of feet and/or legs is a real concern. Identification of those patients most as risk, education and prevention are key to saving limbs. If you are a diabetic make your appointment today. Call to make your appointment
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4 DECEMBER ISSUE
• 2011
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Medical Community Business Networking
O LIndsey Erekson, Alan Zangen, Scott Herndon, Bland Eng, and Jeff Wisnicai.
n October 27th the Board of Managers of the Palms West Chamber of Commerce Medical Committee, Palms West Hospital and Wellington Regional Medical Center were invited to a Medical Business Networking Event with the doctors of US Hospitalists, Palm Beach Primary Care Associates and Independent Imaging, at Palomino Park located at 3347 State Road 7 in Wellington. The event was attended by area physicians and members of the medical and business community.
Carol O’Neil, Marcello Fabbri, Stan Kushay, and Dana Ray.
Tony Pollack, Jesse Eisenman, and Woody White.
Fred Zrinscak, Kimberly Rodale, Bruce Ciarlariello, Judith Zchumacher, and Debra Vanderhoff.
Carmine Priore III, Dr. Michael Mikolajczak, Dr. Kishore Dass, Dr. Jeffrey Bishop, Bland Eng, Dr. Shekhar Sharma, and Mohan Pillai.
Sharon Mineo, Staci Martin, Dr. Devine, Craig Cuden, Dr. Michael Mikolajczak, Dr. Arthur Hansen and Helen Rengepis.
Elizabeth Prol, Eliana Bejarano, MD, Maria Fernandez and Sergio Fernandez.
Dr. Mazze, Charlene BIshop, and Holly Gordon.
Marlon D. White, Sherri Ann Lopez, and Miguel Muniz.
Dr. Kishore Dass, Katiann Susich, Craig Cuden, Holly Gordon, Frederic Roy, and Chris Radcliffe.
More Exercise Could Make For Better Sleep: Study Those getting 150 minutes' activity a week were less likely to report daytime fatigue.
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new study suggests regular physical activity might encourage better shut-eye:
People who met national exercise guidelines reported better sleep and less daytime fatigue than those who didn't. The research doesn't confirm that exercise directly leads to improved rest, and it's possible there may be another explanation for the apparent connection between exercise and sleep. Still, the findings are mostly consistent
with previous research, said Matthew P. Buman, an assistant professor of exercise and wellness at Arizona State University who's familiar with the study. But if you think a daily walk or jog will clear up your sleep problems, that might be a bit too optimistic. "In general, the relationship between physical activity and
sleep is moderate," Buman said. More than one-third of U.S. adults have trouble falling asleep at night or staying alert during the day, according to background information in the study. Inadequate sleep has been linked to depression, cardiovascular disease and other health problems. Another theory suggests that exercise helps the body deal bet-
ter with the cooling down of its temperature during sleep, he said. So should you avoid exercising before bed, as conventional wisdom suggests? The new research doesn't look at the timing of exercise, but the study authors do note that most previous studies haven't shown that late-night exercise disrupts sleep quality.
DECEMBER ISSUE • 2011
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Ribbon Cutting & Tour of Butterfly House
Why Won’t He Commit? DEAR DEBORAH: Why don’t men seem to want to commit? I met what I thought was a great guy online a few months ago and he just wants to date casually. - Wants More
L to R: Wellington Councilwoman Anne Gerwig, Rep. Mark Pafford, Rep. Joseph Abruzzo, County Commissioner Jess Santamaria, Julie Weil, Senator Lizbeth Benacquisto, Dr. Jeffrey Bishop,Nicole Bishop, Director, PBC Victim Services, Dr. David Soria. Back row: Jerel Humphrey, CEO, Wellington Regional, Capt. Carol Gregg, PBSO
By Deborah Lynn
“Where there is a need, there should be action” and Senator Lizbeth Benacquisto did just that – she took action.
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n Thursday, December 1, a ribbon cutting ceremony was held for the first centralized sexual assault crisis center in Palm Beach County, The Butterfly House. Senator Benacquisto, Senator Joe Negron, County Commissioner Jess Santamaria, along with Dr. David Soria, Dr. Jeffrey Bishop,
and Jerel Humphrey, CEO of Wellington Regional Medical Center all spoke at this historic, yet humbling event. The Butterfly House is the result of a year-long effort to secure funding and a location for the service center. The center which is dedicated to rape victims should greatly improve response to victims’ needs. Palm Beach County Victim Services will run the center in conjunction with Wellington Regional Medical Center. The project is funded by the Florida Department of Health, Wellington Regional Medical Center and Palm Beach County. The Butterfly House is located on the grounds of the Wellington Medical Center at 10101 Forest Hill Blvd., in Wellington.
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DEAR WANTS MORE: In my opinion, it does depend on several factors. Let’s start with the fact that you met him online. It’s a wonderful source for meeting men and women that you would not normally have had the opportunity to do so. With that being said, it’s also a way for them to meet a variety of people and explore their possibilities and opportunities. There is nothing wrong with dating casually and I recommend it. It takes time to get to
know someone and what a better way than dating. You have to allow the connection to grow as time goes on. It’s nice to know that you want a commitment, but rushing into one is also not the right move. As I do not know his age or background, it’s difficult to go into more detail. There may be some unresolved issues from former relationships, including divorce. He may have financial difficulties. He may also have young children and is not ready for something serious. As I mentioned, there are numerous factors that play a role. So, my advice to you is to go slow and enjoy.
Dear Deborah is a monthly advice column written by Deborah Lynn with a common sense approach to dating. If you have any questions or comments, please forward them to: questions@globalhealthtribune.com as we would love to help. Senator Lizbeth Benacquisto.
Honestly and professionally giving you the best cleaning services that you never had before.
Marsha Israel, Sandy Reynolds, Melissa McKinlay and Dr. David Soria.
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Hospice of Palm Beach County provides care to all who need and want it, regardless of insurance or financial status. Donations, grants and proceeds from fundraising events supplement the insurance reimbursement to ensure that cost for services is never an issue for our patients or their families. Nearly 900 highly trained employees and more than 600 caring volunteers make this a program that excels in innovative care and quality service to our community.
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6 DECEMBER ISSUE
• 2011
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5th Annual Salsa Festival By Erica Whyman
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REENACRES, FL -- The South Florida sun was not the only thing bringing the heat the weekend of November 19 in Greenacres, the Palms West Chamber of Commerce hosted the 5th Annual Salsa Festival. The two-day family festival celebrating the growing Hispanic population was packed with events, rides, games, and plenty of tasty treats.
Saturday evening, international musical artist Jerry Rivera headlined on the main stage that also hosted other wellknown musical acts. Those in attendance could not help but get up and dance, showing off some impressive Salsa moves. Earlier in the day, the elected officials of Wellington, Royal Palm Beach, Palm Beach, Loxahatchee, and the Indian Trail Improvement District competed for the best salsa in the Sizzling Salsa Showdown. Top honors went to Mayor Ferreri of Greenacres for his Thanksgiving themed Salsa with cranberries. All were entertained throughout the weekend with the annual Chihuahua races, Salsa dancing competitions, carnival games and rides that filled the Greenacres Community Park. Freddie Vega, Chef at Someone’s in the Kitchen, helped out in the Culinary Pavilion where kids could register or stop by for a professional cooking lesson. Thanks to sponsors Republic Services of Palm Beach and Supermercados El Bodegon Grocery, children were able to work with fresh vegetables to make their own healthy homemade salsa.
Many vendors, including local healthcare providers lined the entrance path answering questions, handing out free goodies and providing education to all those who came through. The event was a huge success, thanks to Palms
West Chamber of Commerce, the sponsors, vendors, volunteers and local community who came out to attend what is becoming known as the spiciest family festival in Palm Beach County.
SFRO and Cyber Knife Center of South Florida: Veronica Muniz, Carly Grant, Emily and Nancy Johnson.
Donna H. Kleban, M.D., F.A.C.S, P.A. of Surgery of the Breast, Tami Pogue, Donna Kleban, MD and Daymi Quintana
Marsha Israel of Wellington Regional Medical Center.
Palms Wellington Surgical Center: Autum Rhoades, Chris Deese, Eduardo Pantoja, Laura Ronan, Brittany Duarte and Anabel Pena.
Chef Freddie Vega in the Culinary Pavilion.
Mauricio Gomez and Katina Karl of Independent Imaging
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DECEMBER ISSUE • 2011
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Are you paying too much for Imaging??? By Staci Martin
When it comes to selecting a facility to have diagnostic imaging needs met, patients often are faced with the decision between the hospital and a freestanding, outpatient imaging center. Finding the highest quality service at the lowest price is the mission of many patients today. It is important to note that there is a cost savings to be realized locally, without giving up any measure of quality, technology and superior service. Patients seeking the most afford-
able imaging services should be aware that hospitals and their affiliated facilities are usually more expensive than freestanding outpatient centers. This is in part because hospitals are allowed to charge Medicare and most other commercial insurers a facility fee. It can cost up to 1/3 less to have an imaging exam at a freestanding imaging facility such as Independent Imaging in Wellington, Lake Worth, Belle Glade and Palm Beach Gardens. Another positive feature of Independent Imaging is experiencing less wait time and more
Modality mrI ct Ultrasound radiography mammography Nuclear medicine Pet/ct
Hospital Cost $832.46 $626.66 $241.23 $106.45 $121.44 $634.71 $2,898.95
Madeline Nava Joins Palms West Hospital as Chief Operating Officer
personalized service for patients, technologists that are all certified through The American of Radiologic Registry Technologists (ARRT), a facility that is ACR accredited, as well as extended hours, complimentary valet parking, and some of the most advanced technology on the market. Below, please find a graph published in the July 2011 edition of Radiology Business Journal illustrating the average expenses per procedure in the hospital setting versus that of the freestanding imaging facility. Outpatient Imaging Center cost $460.95 $245.83 $87.01 $44.55 $78.07 $181.72 $1,243.64
Note: rates are blended and include all commercial and government payors for each provider, excluding professional revenues. outpatient imaging center global revenue was reduced by estimated professional percentages using the following reductions: mrI, 18%; ct, 19%; ultrasound, 20%; radiography, 30%; mammography, 30%; nuclear medicine, 19%; and Pet/ct, 18%.
Independent Imaging has the following locations to serve you: Wellington Facility Lake Worth Facility Belle Glade Facility Palm Beach Gardens Facility Palomino Park 5051 South Congress Ave 701 South Main St 3385 Burns Road-109 3347 State Road 7 For questions, or to schedule an appointment, please call 561.795.5558
Loxahatchee, Florida Palms West Hospital is pleased to announce that Madeline Nava has joined the hospital as Chief Operating Officer. Madeline comes to Palms West Hospital from a local affiliate HCA facility, JFK Medical Center, where she was Vice President of Operations since 2008. Madeline has over 17 years of healthcare experience and started her healthcare career as a Respiratory Therapist. She has a proven track record of demonstrating operational improvements, management of construction projects, implementation and restructuring of key service lines and strategic planning.
Madeline received her BA Degree and Masters of Health Services Administration from Iona College, New Rochelle, NY and her Respiratory Therapy at Northwestern degree University Medical School in Chicago, Illnois. Bland Eng, CEO of Palms West Hospital explains, “We are pleased to have Madeline join the executive team. We welcome her extensive knowledge of hospital operations, experience with construction projects, and partnering with Physicians. Her background is a great fit for Palms West Hospital and our current growth in the community.”
ALL F OR O NE Home Health Care, Inc.
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OFFICE
2326 S. Congress Ave. Suite 2-E West Palm Beach, FL 33406 Phone: (561) 433-5677 • Fax: (561) 433-8191 PALM BEACH COUNTY
ST. LUCIE COUNTY
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Phone: (561) 433-5677 Fax: (561) 433-8191
Phone: (772) 403-2563 Fax: (772) 403-2564
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w w w. A l l Fo r O n e H H C . c o m
8 DECEMBER ISSUE
• 2011
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Kishore K. Dass, MD.
Anthony E. Addesa, M.D.
Board-Certified Radiation Oncologist. Has been trained at Cleveland Clinic, Ohio
Board-Certified Radiation Oncologist Completed his fellowship at Harvard Joint Center for Radiation Oncology
While traditional radiation therapy continues to grow more advanced, women may be eligible for another option that combines quicker overall treatment time with comparable results.
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ccording to the National Cancer Institute, over 230,000 American women were diagnosed with breast cancer in the past year. While researching treatment options can be an overwhelming process, the area of radiation therapy has gained many breakthroughs. “The future is quite promising for women with newly diagnosed breast cancer,” emphasizes Eugene C. Shieh, MD, a board-certified radiation oncologist with South Florida Radiation Oncology. “We’re able to do more for patients than we could five or ten years ago. A multidisciplinary, evidence-
based appro-ach, with early involvement of all the medical specialists, allows us to achieve the best possible outcomes for our patients. This is an approach that we firmly embrace.” South Florida Radiation Oncology offers conventional whole breast radiation therapy, with 3-D Conformal radiotherapy, or intensity-modulated radiation therapy (IMRT). “We are excited to have implemented the Varian TrueBeam at our Jupiter and Boca Raton locations,” reveals Dr. Shieh. “This is the absolute latest-generation technology for external beam
radiation, allowing us to achieve unprecedented accuracy and much faster treatment delivery than the other linear accelerators.” Fast, effective radiation A select number of patients with smaller tumors have the option to undergo a new alternative called accelerated partial breast irradiation (APBI). While it boasts comparable outcomes to traditional external radiation therapy, APBI treatment is a significantly shorter process that offers more convenience and comfort. “This allows women to either start chemotherapy or get back to their normal lives quickly,” notes Dr. Shieh. “The vast majority of patients say they would choose this type of treatment again or would recommend it to a friend.” APBI works by delivering radiation directly to the lumpectomy cavity (space left behind after tumor removal) and to surrounding tissue where cancer is most likely to recur. “The surgeon places a breast catheter into the cavity, with a portion of the catheter exposed,” he explains. “We then perform CT planning to precisely determine where to deliver the radiation dose.
delivered two times daily for just five days on an outpatient basis. catheters “Newer-generation allow us to have much better control over radiation dosage to avoid irradiating normal tissue like skin and ribs,” informs Dr. Shieh. “We are now able to offer this treatment to women who otherwise wouldn’t have qualified five years ago, such as those with smaller cup sizes.” "APBI does not treat the whole breast. The past 15-20 years of treating breast cancer has taught us many important things about early stage breast cancer. They rarely come back following surgery and radiation. But, if they are going to recur, most will do so within 1 to 2 cm of the original site. So, the question arose, why treat the whole breast? APBI only treats the surgical cavity, thereby preserving the rest of the breast and skin from radiation side effects." - A. E. Addesa, MD According to Dr. Shieh, APBI has been available since the early 2000s, and over 50,000 women have been treated nationwide.
“A targeted dose of radiation is delivered through the catheter by a radiation afterloader. The treatment is quick, between five and ten minutes, and no radiation is left inside the patient.”
“Our patients have experienced great outcomes with very low rates of cancer recurrence,” he reports. “Choosing the best methods for treating breast cancer should be a multi-disciplinary decision made with patient involvement. Here at South Florida Radiation Oncology, we offer the full range of breast cancer treatments and our goal is to provide the best care possible.”
Conventional radiation therapy treatments typically last as long as seven weeks, but APBI is
Learn more about South Florida Radiation Oncology by visiting the website at www.sfrollc.com.
Men More Likely to Skip Cancer Screenings: Study
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The researchers suggested several reasons why men are less willing than women to undergo cancer screening: most cancer awareness campaigns in the media are for women's breast cancer; there is a lack of government-sponsored men's cancer awareness campaigns; and studies indicate that women see their primary care doctor more often than men. But the study also found that when men are provided with the details of cancer screening procedures, they're slightly more likely than women to participate in cancer screening.
"This strongly suggests that men will participate in screening when given more information about screening procedures," Davis said. "This means that health educators, physicians and communitybased organizations should make a concerted effort to educate men on exact screening procedures, explain how cancer is detected, and communicate what to expect during screening." The study will appear in an upcoming print issue of the American Journal of Men's Health.
Radiation Oncologist – South Florida Radiation Oncology, LLC
Eugene C. Shieh, MD, is a Diplomate of the American Board of Radiology. he is a board-certified radiation oncologist. Dr. Shieh completed his medical internship at george Washington university in Washington, DC, and his radiation oncology residency at Kaiser Permanente Medical Center in Los Angeles. he received his Bachelor’s degree and medical doctorate through the combined degree program at new York university’s College of Arts and Sciences and School of Medicine. A consummate patient advocate, Dr. Shieh was recognized as a physician leader in the Cancer Center at Jupiter Medical Center. he has served on the board of the north Palm Beach American Cancer Society since 2006, and has spoken at numerous community and physician educational seminars.
Best Antidepressant May Depend on Patient
en are less willing than women to be screened for cancer, even though men have higher cancer death rates, a new study shows.
Researchers conducted a telephone survey of nearly 1,150 adults in New York City, Baltimore, and San Juan, Puerto Rico, who answered questions from the Cancer Screening Questionnaire. Most of the participants were aged 30 to 59, and 35 percent of them were men. "This study examined beliefs and attitudes held by men and women about cancer screening. Our aim was to gain insight for improving existing cancer health promotion practices," study corresponding author Jenna Davis, of the department of health outcomes and behavior at the Moffitt Cancer Center in Tampa, Fla., said in a center news release. "Our findings indicate that there is a need for better health and cancer screening promotion among men," she said.
Eugene Shieh, MD
Large evidence review finds newer brands work equally well.
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ewer antidepressants seem to be about as effective as one another, a new analysis indicates. This suggests that the choice of which drug is appropriate for which patient should be made on the basis of such considerations as side effects, cost and patient preference. "They're all equally effective," said Dr. David Schlager, a clinical assistant professor of psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine. "They're interchangeable except for side effects," he added, so
psychiatrists do tend to "exploit the side-effect profile" to find suitable medications for individual patients, he added. According to the background information in the new study, appearing in the Dec. issue of Annals of Internal Medicine, some 27 million people in the United States had taken antidepressants as of 2005. Cost, of course, is another consideration. "If one drug costs $200 a month and another costs $20, I don't see any reason why not to go with the latter," said Dr. Radu Saveanu, a professor of psychiatry at the University of Miami Miller School of Medicine. Dosing is also important, he said, "because studies have shown that if patients have to take the drug less frequently, compliance is higher, which will make a big difference in terms of efficacy." But given the similarity in effectiveness, prescribing antidepressants is still largely a trial-anderror process. It's hoped that the next series of studies will provide guidance on which medications to try first. "The real heart of the matter is, if they don't respond to one type of antidepressant, is there any guidelines about what you should try next?" Schlager said.
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10 DECEMBER ISSUE
• 2011
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Flu-Free Gastroesophageal HowfortotheStayHolidays Reflux Disease T backup from the stomach into the esophagus. This backwash of stomach contents irritates the lining of the esophagus and causes signs and symptoms of GERD. GERD is a global condition, affecting people of all ages and races.
Srinivas Kaza, M.D. Graduate of St. George University School of Medicine. After completing an intership and residency at the Brooklyn Hospital Center—Cornell University, Dr. Kaza went on to complete a fellowship and serve as clinical instructor at University of Texas Southwestern Medical Center. Dr. Kaza has practiced in the community since 2008.
GERD: A review Background: astroesophageal Reflux Disease (GERD) is a chronic digestive disease due to an incompetent lower esophageal sphincter, which regulates the passage of food from the esophagus into the stomach. Episodes of transient lower esophageal sphincter relaxation cause stomach acid or bile to
G
Symptoms of GERD: • Frequent heartburn usually more than 2 episodes per week • Regurgitation • Dysphagia • Atypical symptoms include dry cough, asthma like symptoms, and non-cardiac chest pain. Risk Factors: • Hiatal hernia (a condition in which part of the stomach moves above the diaphragm into the chest) • Obesity • Smoking • Pregnancy • Alcohol use • Medications (i.e.: BetaBlockers and Calcium Channel Blockers) Complications If Left Untreated: • Barrett’s Esophagus • Esophageal Carcinoma Treatments: Lifestyle Changes: • Weight loss
• Smoking cessation • Small frequent meals • Wear loose fitting clothing • Avoid lying down for 3 hours after eating • Raise head of the bed 6-8 inches. Extra pillows alone will not help. Medications: • Foaming agents such as Gaviscon • Antacids (Maalox, Mylanta) • H2 Blockers (Zantac) • PPI’s (Aciphex, Nexium) • Prokinetics (Reglan) Surgical Options: Surgery is an option when medications and lifestyle changes do not help, or can be a reasonable amendment to a lifetime of drugs and discomfort. • Robotic/Laparoscopic Nissen Fundoplication- The upper part of the stomach (fundus) is wrapped around the lower esophageal sphincter to strengthen it. The surgery is accomplished through tiny incisions and requires 1-2 days of hospitalization. • Trans Oral Incisionless Fundoplication (TIF) - Repair of a small hiatal hernia usually less than 2 cm. This is accomplished endoscopically without any incisions.
he overlap of the cold and flu season with the holiday season can make it a challenge to stay healthy as you go to parties and get together with family and friends.
Getting a flu shot is important, but other precautions can also reduce your risk of getting sick or of spreading illness to others, according to a Ryerson University news release. Here are some tips for a healthy holiday: n When you have to cough or sneeze, do it in your sleeve or the inside of your sweater or jacket. That will prevent the spread of viruses to those nearby. n Wash your hands regularly and always after using the restroom, before eating, and after blowing your nose. n Use the air kiss or fake peck on the cheek instead of a kiss on the lips when greeting family and friends. n Always use serving spoons or forks -- never your fingers -- to put food on your plate. If you're hosting a party, be sure to supply plenty of serving utensils and provide people with alternatives to reaching into bowls, such as making individual servings.
n Find creative ways to personalize cups so that people don't accidentally mix them up. Don't serve beverages in their original containers because people might get confused about which bottle or can belongs to them. n Carry hand sanitizer with you and use it before you eat any food or touch your face, particularly your nose and mouth. This will help protect you against viruses you may have picked up from doorknobs, shopping cart handles, handrails and faucets. n When you attend religious services, try to stay three to six feet away from others and don't share the communion wine goblet. Instead of shaking hands and hugging, use a friendly wave or elbow tap to greet others. n Make sure you get adequate sleep, which is important for keeping your immune system strong. n If you develop a flu, stay at home until you feel better.
Most U.S. Drivers Engage in 'Distracting' Behaviors: Poll Cellphone talk, texting, even applying makeup: Most know it's dangerous, but many do it anyway.
n Eating/drinking: 86 percent said they had done it at some point, and 57 percent said they do it "often or sometimes."
W
n Sending/receiving text messages: 37 percent have done so, and 18 percent do it regularly.
n Setting/changing GPS: 41 percent have ever done it while at the wheel, while 21 percent do it more frequently.
hether it's talking on cellphones, fiddling with food and drink or doing some last-minute grooming, a large majority of adult drivers in the United States admit to being dangerously distracted while behind the wheel, a new poll shows.
dozing off." Smaller percentages (7 and 12 percent, respectively) said they drive this way "sometimes or often."
According to the new Harris Interactive/HealthDay poll, most adults who drive on a regular basis admitted to having at some point engaged in distracting behaviors, be it eating/drinking (86 percent), talking on a nonhands-free cellphone (59 percent), setting their GPS device (41 percent), texting (37 percent) or applying makeup (14 percent).
"The number of drivers who engage in potentially dangerous, in some cases extremely dangerous, behaviors while driving is terrifyingly high, particularly when you remember that every 1 percent of drivers polled represents more than one-and-threequarters of a million people," said Humphrey Taylor, chairman of The Harris Poll.
Large minorities of drivers also admitted to driving while less than fully alert. For example, a quarter of respondents said they have driven after having two or more drinks, and 44 percent said they've felt sleepy while driving, "sometimes even momentarily
"While we have some information on how dangerous some of these behaviors are (driving after drinking, talking on cellphones, falling asleep, texting) we can only speculate as to the numbers of accidents and deaths that are caused by the many millions of
people who drive while setting their GPS, eating or drinking, surfing the Internet, watching videos, combing their hair, reading or applying makeup," added Taylor. Prior research has examined the dangers of distracted driving, with one 2010 study finding that texting alone was implicated in more than 16,000 deaths from 2001 to 2007. The study, published in the American Journal of Public Health, also found that auto deaths involving cell phones and texting while driving rose 28 percent between 2005 and 2008. According to the new online poll, which surveyed more than 2,800 U.S. adults between Nov. 10 to 14, distracted driving isn't just limited to cellphone use. Other major distractions include:
n Reading a map: 36 percent admitted doing so, and 10 percent do it often or sometimes. n Combing/styling hair: one in five drivers acknowledged doing this at least once; nearly 1 in 10 does it more regularly. n Applying makeup: 14 percent have done it at least once, 7 percent say they do it frequently. n Surfing the Internet: 13 percent have done so while driving, and 9 percent do it often/sometimes. n Watching videos (on a mobile device or in-board system): 7 percent say they do this "often or sometimes." Certain drivers were more apt to indulge in risky distractions than others, the poll found. For exam-
ple, drivers over the age of 65 were less likely than their younger counterparts to engage in distracting behaviors. And when it came to gender, men were more likely than women to drive while drowsy, consult a GPS navigation system, look at maps, drive after drinking alcohol, surf the 'Net or watch videos. For example, 77 percent thought that texting increases the odds of a car accident "a lot." Forty-four percent thought the same about talking on a (non-hands-free) cellphone, and two-thirds thought it was dangerous to apply makeup while driving. "Despite all of the attention paid to cell phone distractions in the past few years, this survey highlights the broader problem that drivers do a lot of things behind the wheel that distract them," said Russ Rader, a spokesman for the Insurance Institute for Highway Safety in Arlington, Va. "People have driven distracted long before there were cellphones." While technology has helped create new driving hazards, it might also be a means of minimizing the risk, too, Rader said. He pointed to "crash-avoidance technologies" that automakers are installing on vehicles.
DECEMBER ISSUE • 2011
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The Silent Killer
How Much Salt Is Best for the Heart?
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or people with heart disease or diabetes, too little salt may harbor almost as much danger as too much salt, researchers report. Reducing salt is still very important in people consuming more than 6,000 or 7,000 milligrams of sodium per day, said Dr. Martin O'Donnell, lead author of a study in the Nov. 23/30 issue of the Journal of the American Medical Association. But people who already consume moderate or average amounts of salt may not need to reduce their intake further, added O'Donnell, an associate clinical professor at McMaster University in Hamilton, Ontario, in Canada. "We're seeing more and more that there may be an optimal moderate amount of salt that people should be eating," said Dr. John Bisognano, professor of medicine and director of outpatient cardiology at the University of Rochester Medical Center, in New York. "This is reassuring for people who eat a diet that is moderate in salt." Bisognano was not involved with the study, which was funded by pharmaceutical company Boehringer Ingelheim. After years of seemingly happy agreement that people should lower their salt intake, experts recently have begun debating whether or not lower salt intake is actually good for everyone. One recent study found that although cutting back on salt does lower blood pressure, it may also increase levels of cholesterol, triglycerides and other risk factors
for heart disease. Another study found that lower sodium excretion (sodium excretion is a way to measure how much salt is consumed) was associated with an increased risk of heartrelated deaths, while higher sodium excretion was not linked with increased risks for blood pressure or complications from heart disease in healthy people. However, in the latest study, results were somewhat different. These authors looked at how much sodium and potassium were excreted in urine in a group of about 30,000 men and women with heart disease or at high risk for heart disease. Participants were followed for an average of more than four years. In this study, sodium excretion levels that were either higher or lower than the moderate range were each associated with increased risk. For example, people who excreted higher levels of sodium than those with mid-range values had a greater risk of dying from heart disease, heart attack, stroke and hospitalization for heart failure, the report found. On the other hand, people who excreted lower levels than mid-range were at a raised risk of dying from heart disease or being hospitalized for heart failure. When the researchers assessed potassium levels, they found that a higher level of excretion of the nutrient was associated with a lower risk of stroke.
Shekhar V. Sharma, M.D. Board Certified in Internal Medicine
T
here are several medical conditions in some people that may not manifest itself. In other words, certain people may have hidden medical conditions that are not diagnosed because they are asymptomatic which means that they do not have any symptoms of their hidden medical condition. In my practice I have encountered patients who may have diabetes mellitus, hypertension and hypercholesterolemia without even knowing it. The following are two scenarios from my practice.
A 60 year old female patient calls and complains of heartburns and wants to be prescribed Zantac. I tell her over the phone that she needs to see me ASAP since there could be an underlying heart condition. She is skeptical of this situation and states that her neighbor has the same condition that goes away with Zantac, and therefore why couldn't she get the same. I tell her that each person's case history differs. She anyway refuses to seek medical attention. The next day I receive a call from the hospital ER physician who tells me that my patient has had a heart attack. The outcome of this scenario speaks for itself.
The next scenario is about a gentleman who has uncontrolled hypertension. On examination he is found to have high blood pressure. This patient has no symptoms whatsoever. I advise him to increase his anti-hypertensive medication dosage. He believes that since he feels fine he does not need to increase his dosage for fear of side effects. I tell him that the very reason that these medications are manufactured is to prevent complications of hypertension. I feel that the benefits of an increase in dosage in some cases far outweighs the risks of some side effects. He tells me that he just needs to stay on a low salt diet and this will correct the problem. He is informed that a low salt diet is surely the way to go, but that would not bring the blood pressure down immediately and that there is a possibility of a stroke. A few weeks later he has a stroke with paralysis of one side of the body. One can definitely learn from the above scenarios and heed the advice of one's physician. To stay healthy is the ultimate goal that we all need to strive for. Dr. Sharma's office in Belle Glade is at 1200 South Main Street, Suite 100 (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.
Call 561-996-7742 for an appointment.
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12 DECEMBER ISSUE
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Palms West Hospital and the Children’s Hospital at Palms West By Erica Whyman
Loxahatchee, FL---Palms West Hospital will kick off 2012 by breaking ground on a $16 million dollar expansion project. Lisa Gardi, Marketing Director of Palm West, joked that a “raise the roof” ceremony may be more appropriate since this project will be a vertical expansion, that adds a fourth floor to the east tower. The expansion will increase the hospital capacity from 175 to 204 operational beds. “We are excited about this expansion project and look forward to the benefits that this will bring to our patients and the community for many years to come,” says Palms West Hospital CEO, Bland Eng. The expansion project will create an estimated 50 new local jobs and will focus in the areas of the Adult Medical/Surgical Department, Adult Intensive Care Unit, Pediatrics, Pediatric Intensive Care Unit and the Laboratory. The continued growth of Palms West Hospital and The Children’s Hospital at Palm’s West is due to the quality care and innovative services that consistently exceed patient and community expectations. Palms West Hospital is on the fore-
(Left to Right): Silvia Stradi, CNO, Bland Eng, CEO, Michael McCumber, ED Director, Scott Herndon, CFO, Madeline Nava, COO
front of technological innovation; expert physicians using robotic technology allow once complex and invasive surgeries to be done with less pain and time in the hospital, due to smaller incisions and enhanced precision. Expertly trained physicians are producing excellent outcomes in the field of gynecology, urology and general surgery at Palms West. Children are an important and growing demographic of Palm Beach County. Focusing on this demographic, The Children Hospital at Palms West having an affiliation with renowned Miami
Children’s Hospital since 2010. The alignment with Miami Children’s Hospital, along with the highest number of fellowship trained pediatric physicians on staff in the county; has allowed the hospital to build a reputation leading to referrals from a five county region. In today’s fast paced society, hospitals have turned to billboards to constantly stream average wait times in emergency rooms. “We have an app for that,” says Palms West CEO Bland Eng, and he is not kidding.
Palms West Hospital meets consumer demands for immediate access to care, but with a focus on the patient and the patient experience. They employ Child Life Specialists who work with families and patients through the process and help them understand the procedures and manage the stress that comes with being in emergency care. From robots to apps to patient focus groups, Palms West Hospital meets their mission of being the hospital that combines “latest medical advances with an old-fashioned personal touch.”
Can Facial Flaws Cost You the Job? Birthmarks, scars and other facial blemishes may make it harder for people to land a job, new research suggests. this is because interviewers can be distracted by unusual facial features and recall less information about job candidates, according to the investigators at rice University and the University of houston. "When evaluating applicants in an interview setting, it's important to remember what they are saying," mikki hebl, a psychology professor at rice University, said in a university news release. "our research shows if you recall less information about competent candidates because you are distracted by characteristics on their face, it decreases your overall evaluations of them." "the bottom line is that how your face looks can significantly influence the success of an interview," hebl said. "there have been many studies showing that specific groups of people are discriminated against in the workplace, but this study takes it a step further, showing why it happens. the allocation of attention away from memory for the interview content explains this." the findings were recently published online in the Journal of applied Psychology.
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14 DECEMBER ISSUE
• 2011
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Doctors: Test all kids for cholesterol by age 11 n Half of children with high cholesterol will also have it as adults, raising their risk of heart disease.
Every child should be tested for high cholesterol as early as age 9 -- surprising new advice from a government panel that suggests screening kids in grade school for a problem more common in middle age.
n One third of U.S. children and teens are obese or overweight, which makes high cholesterol and diabetes more likely.
The idea will come as a shock to most parents. And it's certain to stir debate. The doctors on the expert panel that announced the new guidelines this week concede there is little proof that testing now will prevent heart attacks decades later. But many doctors say waiting might be too late for children who have hidden risks.
Until now, cholesterol testing has only been done for kids with a known family history of early heart disease or inherited high cholesterol, or with risk factors such as obesity, diabetes or high blood pressure. That approach misses about 30 percent of kids with high cholesterol.
Fat deposits form in the heart arteries in childhood but don't usually harden them and cause symptoms until later in life. The panel urges cholesterol screening between ages 9 and 11 -- before puberty, when cholesterol temporarily dips -- and again between ages 17 and 21.
"If we screen at age 20, it may be already too late," said one of the guideline panel members, Dr. Elaine Urbina, director of preventive cardiology at Cincinnati Children's Hospital Medical Center. "To me, it's not controversial at all. We should have been doing this for years."
The panel also suggests diabetes screening every two years starting as early as 9 for children who are overweight and have other risks for Type 2 diabetes, including family history.
The new guidelines are from an expert panel appointed by the National Heart, Lung and Blood Institute and endorsed by the American Academy of Pediatrics. Some facts everyone agrees on: n By the fourth grade, 10 to 13 percent of U.S. children have high cholesterol, defined as a score of 200 or more.
Elizabeth Duruz didn't want to take that chance. Her 10-year-old daughter, Joscelyn Benninghoff, has been on cholesterol-lowering medicines since she was 5 because high cholesterol runs in her fami-
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ly. They live in Cincinnati. Dr. Roger Blumenthal, who is preventive cardiology chief at Johns Hopkins Medical Center and had no role in the guidelines, said he thinks his 12-year-old son should be tested because he has a cousin with very high "bad" cholesterol who needed heart bypass surgery for clogged arteries in his 40s. Dr. William Cooper, a pediatrics and preventive medicine professor at Vanderbilt University, said expanding the testing guidelines "would seem to me to make sense." But, he added: "One of the risks would be that we would be treating more kids, potentially, and we don't know yet the implications of what we're treating. Are we treating a number or are we treating a risk factor?" That's the reason a different group of government advisers, the U.S. Preventive Services Task Force, concluded in 2007 that not enough is known about the possible benefits and risks to recommend for or against cholesterol screening for children and teens.
Multitasking Stresses Out Working Moms More Than Dads
E
ver unload the dishwasher while helping with a child's homework? Ever keep one eye on soccer practice while checking your voice mail and trying to figure out what to make for dinner? That's called multitasking, and in a fastpaced world, American working moms do a whole lot of it -- and seem more stressed by it than working dads, a new study shows. According to the research, working mothers spend 9 more hours a week multitasking than do working fathers, or about 48 hours per week for moms compared with 39 for dads. And, when they have to multitask, women don't particularly enjoy it. The research found that when women are trying to do multiple things at once, they report feeling stressed, while men don't seem to mind it as much. Researchers say it could be because men's multitasking at home more often involves work, while women's involves combining household chores and child-rearing, which may leave them feeling conflicted and guilty. Among working mothers, 53 percent of multitasking at home involves housework compared with 42 percent among working fathers. Additionally, 36 percent of women's multitasking at home involves child care compared with 28 percent for fathers. "The hours men spend in household labor have increased, but when you include multitasking, then you are able to see women are still shouldering more of the household responsibilities than men," said study coauthor Barbara Schneider, a professor of sociology and education at Michigan State University. The study is published in the December issue of the American Sociological Review.
DECEMBER ISSUE • 2011
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15
Harvest Festival By Deborah Lynn
G
reat weather, great food and great company truly sum up Harvest Festival. This event took place at John Prince Park on Saturday, November 19. With twelve amazing sponsors participating, you certainly
could not ask for a more family friendly atmosphere. Thank you to the following sponsors that made the event a huge success – South Beach Orthotics and Prosthetics, Inc., Charles Wadlington Independent Financial Advisors, All For One Home Health Care, Inc., Wood Lake Nursing & Rehabilitation,
Coral Bay Healthcare and Rehabilitation, Renaissance Health and Rehabilitation, Unique Medical Supplies, Alan S. Zangen (Attorney at Law), PNC, Hospice by the Sea Inc. Cresthaven East and Vitas. A special thank you to Maria Castillo from Wood Lake Nursing & Rehabilitation for making me feel right at home.
Poor Sleep May Lead to Fibromyalgia in Women Sleep problems are associated with an increased risk of fibromyalgia in women, especially those who are middle-aged and older, a new study says.
fibromyalgia among women over 45 who often or always had sleep problems, and a nearly three-fold rise for women aged 20 to 44 with similar sleep woes.
Fibromyalgia is a chronic musculoskeletal pain condition that affects more than 5 million adults in the United States. Women account for up to 90 percent of people with fibromyalgia, which typically begins in middle age.
The study appears online in the journal Arthritis & Rheumatism.
Previous research has found that insomnia, nighttime awakening and fatigue are common symptoms experienced by fibromyalgia patients, but it wasn't known if sleep problems contribute to the development of fibromyalgia. Norwegian researchers enrolled 12,350 healthy women, 20 years and older, with no musculoskeletal pain or movement disorders and followed them for 10 years. At the end of that time, 327 (2.6 percent) of the women had developed fibromyalgia. The study found a more than fivefold jump in the risk for
"Our findings indicate a strong association between sleep disturbance and fibromyalgia risk in adult women," Dr. Paul Mork, from the Norwegian University of Science and Technology, said in a journal news release. "We found a dose-response relation, where women who often reported sleep problems had a greater risk of fibromyalgia than those who never experienced sleep problems." While the study found an association between poor sleep and fibromyalgia, it did not demonstrate a cause and effect. Further research is needed to determine whether early detection and treatment of sleep problems can reduce fibromyalgia risk in women, the researchers said.
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