Global Health Tribune - July 2012 issue by Global Health Tribune

Global Health J U LY I S S U E - 2 0 1 2

S er vin g: J upiter

Where Obamacare would expand Medicaid most

P alm Beach G ar dens

INSIDE

Area Meteorologist Educates About Hurricanes at West Boca Medical Center PAGE 4

CyberKnife treatment for Prostate Cancer

PAGE 8

Women's Breast Care Center

PAGE 15

TRIBUNE

Royal P alm Beach

Wellington

Belle G lade

You are cordially invited...

Lake Wor th

Lantana

Boynton

Boca Rato n

While the Supreme Court narrowly upheld the core of President Obama's health care law, the justices came down hard against a provision that would have expanded Medicaid to millions more low-income Americans.

President Obama's healthcare law faces political obstacles now that its legal battle is over.

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PALM BEACH ACCOUNTABLE CARE ORGANIZATION One of the New 89 Accountable Care Organizations in the USA

Dr. Yvette Laclaustra.

w w w. g l o b a l h e a l t h t r i b u n e . c o m

Palms West HosPital

Recognizes “National Time Out Day” Supporting Surgical Safety

Kelly Conroy, Executive Director of Local ACO, Palm Beach Accountable Care Organization (PBACO). PAGE 2

Class of 2012

Wellington Regional Medical Center celebrated with their residency graduation dinner and ceremony at Breakers West. PAGE 18

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GLOBAL HEALTH TRIBUNE P.O. Box 213424 Royal Palm Beach, FL 33421

Dr. Kishore Dass and Dr. Patricia Masse. PAGE 16

Another successful event for the Kids Cancer Foundation

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Map: Where Obamacare would expand Medicaid most W hile the Supreme Court narrowly upheld the core of President Obama's health care law Thursday, the justices came down hard against a provision that would have expanded Medicaid to millions more low-income Americans. As passed by Congress, the legislation expanded Medicaid to nearly everyone making up to 133 percent of the federal poverty line, which would have added an estimated 16 million people to state Medicaid rolls over the next seven years. States that refused to comply would run the risk of losing all Medicaid funding.

Seven justices ruled that the move went too far, and that the government can only withhold the funds to expand Medicaid, not existing money that helps states run their pre-expansion programs.

So will more conservative states take advantage of this new leeway and reject the expansion? That's what Nebraska Gov. Dave Heineman, a Republican, suggested Thursday, when he said that he opposed expanding Medicaid in his state. A spokeswoman for Texas Gov. Rick Perry, who has made a show of rejecting federal funds in the past, wouldn't say whether he would block the expansion. Medicaid is often one of the biggest lines in states' budgets, and that share is growing as

Global Health TRIBUNE

Projected change in Medicaid enrollment

Deborah Lynn Staff Writer and Sales Executive (312) 351-2383 deborah@globalhealthtribune.com

Erica Whyman Staff Writer and Sales Executive (561) 308-1428 erica@globalhealthtribune.com

Passed legislation or amendment opposing law No legislation or amendment

health care costs continue to rise. But some of the early opposition may turn out to be saber rattling. The federal government is funding 100 percent of the state expansion for the first few years before reducing their contribution to a permanent 90 percent.

That's a much higher contribution than the government currently makes for Medicaid (at 57 percent), which every state now participates in, even though it is also an optional program. And in addition to the government pro-

viding a sweet deal, the states who sued over the expansion account for most of the country's unemployed people, which might make it particularly difficut for their governors to turn down a chance to insure their residents at a tenth of the cost. In the map above, each state is shaded according to how much its Medicaid program would expand under the new law, according to the higher end of the Kaiser Family Foundation's estimates. Each state is also shaded red or green, based on

whether it has passed a law or constitutional amendment opposing health care reform. (Alabama and Wyoming have proposed amendments on the 2012 ballot.) According to the National Journal's Ron Brownstein, the 26 states that sued over the Medicaid expansion contain 55 percent of the nation's uninsured, a total of 27.6 million uninsured people. Texas alone has 6.1 million uninsured people. Expanding Medicaid in Texas would cover 2.0 million people, the Kaiser Family Foundation.

GRAPHIC DESIGN Sergio Aguilar (561) 797-2325 ads@globalhealthtribune.com

ATTENTION Healthcare Professionals… If you are a physician or healthcare professional and would like to contribute an article or two that you feel would be of interest to our readers. Or, perhaps you have a topic of interest that you would like for us to cover. Please e-mail us at articles@globalhealthtribune.com with any suggestions as we would love to incorporate them in future issues.

ANNOUNCEMENT:

89 New Accountable Care Organizations Palm Beach Accountable Care Organization (PBACO) By Erica Whyman

Palm Beach County--- Global Health Tribune had the privilege of being one of the first publications to speak with Kelly Conroy, executive director of the Palm Beach Accountable Care Organization, (PBACO) about the “hot-off- the-wire” news announced regarding Accountable Care Organizations (ACOs). While news is still in the process of being released, Global Health Tribune is committed to following this important healthcare topic in a series of articles from a national and a local perspective.

Palm Beach Accountable Care Organization, is a wholly physician owned and operated organization, with 110 primary care physicians and 95 specialists from Hobe Sound to Fort Lauderdale and as far west as Belle Glade. The excitement and passion from Kelly was palatable as she discussed Accountable Care Organizations and the benefit of value based care, increased patient satisfaction, and measureable outcomes. Thanks to Kelly’s passion, PBACO, can boast that they have the very 1st provider number in the country.

Kelly Conroy.

“The idea of the ACO is to remove the barriers to allow for better coordinated care and ultimately lead to better outcomes,” said Kelly, by “engaging the physician and engaging the patient.”

News released on July 9th announced that as of July 1st 89 new ACOs began serving 1.2 million people with Medicare in 40 states and Washington DC. The press release announced that “ACOs are organizations formed by groups of doctors and other health care providers that have agreed to work together to coordinate care for people with Medicare.” For more information visit www.pbaco.org

FOR IMMEDIATE RELEASE July 9, 2012

CONTACT: Kelly Conroy (561) 204-4804

Palm Beach Accountable Care Organization to participate as a Medicare Shared Savings Program Accountable Care Organization.

Voluntary, New Care Coordination Program Created to Offer High Quality Service and Care to Beneficiaries Through Partnership with Medicare.

Wellington, fl – Palm Beach accountable Care organization today announced it has been selected to participate in the medicare shared savings Program (shared savings Program) accountable Care organization (aCo), a multifaceted new program sponsored by the Centers for medicare and medicaid services (Cms).

through the shared savings Program, Palm Beach accountable Care organization will work with Cms to provide medicare fee-for-service beneficiaries with high quality service and care, while reducing the growth in medicare expenditures through enhanced care coordination. Helpful links:

for more information about the shared savings Program, visit the Cms aso website at www.medicare.gov/acos.html.

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HAVE YOU LOST THAT SPRING IN YOUR STEP

Arthur Hansen DPM, M.S.

eel pain is one of the most common chief complaints of patients in my office. I see it in the young, the old, the active, and the sedentary. It can be isolated to mostly the bottom of the heel, only the back of the heel, the sides of the heel or all over the heel. The pain is so incapacitating, the patient is usually limping and definitely lacking that “spring in their step.” It usually limits the activity of the sufferer to the point where rest and a visit to the podiatrist are necessary. When faced with a patient having heel pain, many diagnoses are considered. Injury, including fracture of the calcaneus (heel bone) or bone contusion, must first be considered. A thorough history from the patient about recent events, specifically any falls or jumps

from high levels, is obtained. Acute and complete calcaneal fractures are usually identified right away because they are very painful with associated swelling, redness, bruising and follow an identifiable injury. Most of these types of fractures are treated in the Emergency Room because of the pain and inability of the patient to bear weight. Complete calcaneal fractures are easily noticed on a plain x-ray. However, stress fractures of the calcaneus are sometimes more obscure. In the case of a stress fracture, the patient may or may not recall an injury. They relate pain, but not unbearable pain. And, while we do see some swelling and redness, the clinical presentation is not always absolute. Simple x-rays may show the stress fracture, but usually an MRI or CT scan is needed to identify. Treatment of calcaneal fractures ranges from casting and limiting weight bearing to surgical correction and ‘setting’ of the fracture depending on the severity of the injury.

Pain in the back of the heel is most often associated with the insertion of the Achilles tendon. After making sure the tendon has not ruptured, tendonitis is a common diagnosis. Tendonitis at the insertion on the heel bone is very painful. There is usually no prior recollection of injury and it hurts worse with the first few

Conservative & Surgical Treatments Available Whirlpool with every visit!

heel pain diagnoses. Pain associated with these is on the bottom of the heel. Most patients describe the pain as sharp and stabbing, worse with the first few steps in the morning and excruciating. There is usually no prior injury with a gradual increase in the pain over time. It may or may not be associated bone spurring on the bottom of the heel bone. Stretching, support, physical therapy, cortisone injections and anti-inflammatories are indicated for pain on the bottom of the foot.

steps or at the beginning of exercise. The pain sometimes extends up the back of the ankle along the Achilles tendon. Calcifications can form in the tendon making it more prone to injury and rupture. Pain in the back of the heel could also be painful bursitis. The area between the skin and the Achilles tendon is very small over the heel bone. Excessive rubbing or friction of the area can cause painful bursitis. Often times we find a ‘bump’ associated with the bursitis, known as a ‘pump bump’ or Haglund’s deformity. Rest, ice, a heel lift, stretching, physical therapy and anti-inflammatory medication are the first line of treatment for

pain on the back of the heel.

Symptoms of pain on the inside of the heel which radiate up the inside of the ankle or down on the bottom of the foot with no associated swelling or redness is classic for tarsal tunnel syndrome. Similar to carpel tunnel syndrome (which happens in the hand/wrist), tarsal tunnel syndrome involves irritation or entrapment of the nerve supplying the inside and bottom of the foot below the ankle. Antiinflammatory medication, cortisone, support, physical therapy and sometimes release of the nerve are common treatments for tarsal tunnel syndrome. Plantar Fasciitis and Heel Spur Syndrome are the most common

Get back on your Feet!

Heel pain can be and is very debilitating to patients. It can interfere with all daily activities including walking, standing, shoegear, working, and exercise. Fortunately, most heel pain is alleviated with conservative measures. A thorough history and exam by your podiatrist can lead to the correct diagnosis and treatment which will get you back to being pain-free in no time. Call to make your appointment

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Area Meteorologist Educates About Hurricanes at West Boca Medical Center

andra Shaw, Meteorologist from WPBF Channel 25 along with Kim Burres, Plant Operations Supervisor and Disaster Team Leader held a seminar on Hurricane Preparedness for the community at West Boca Medical Center. Topics covered included: Getting Ready for a Hurricane:

Staying informed: Hurricane season runs from June 1 through the end of November. During those months, you should stay alert to news of any tropical developments. Local news programs, the radio, the internet and weather channels are great sources of information. Statistically, most hurricanes that make landfall in the United States occur in September, followed by August and July.

Preparing your family: It’s a good idea to make a disaster plan for your family. You should decide where your family will go if an evacuation is necessary. Since hurricanes often change course, you should have several possible locations in mind that will take you and your family to a safer area. Here are some other tips for making your family’s plan: • Make a list of telephone numbers that you might need.

• Have an updated road map in your car. • Locate the safest area of your home, if you decide to stay.

• Plan what you will do with pets if you need to evacuate. Not all hurricane shelters take pets. • Pack a family disaster supply kit. You may want to include:

• At least one gallon of water per person for three to seven days. • Non-perishable food for three to seven days. • Special foods for infants, those on restricted diets and the elderly. • A manual can opener.

• Cooking tools and fuel.

• Paper plates, napkins, plastic utensils.

• Bedding including blankets or sleeping bags and pillows. • Clothing for several days.

• First aid kit.

• Medications (including a list of prescriptions, pharmacy information, and prescribing physician).

• Hygiene items such as toilet paper, baby wipes, and waterless hand cleaner.

• Important documents such as insurance policies, social security cards, deeds, wills, proof of residence, drivers license, birth and marriage certificates, etc. in a waterproof, resealable container. • Cash and credit cards. (Remember, that banks and ATMs may not be available for several days following a storm.) • Battery operated flashlight, radio and extra batteries.

• Books, games and other items to help your family pass the time.

When traveling with an infant, make sure you plan for his or her special needs. You’ll need to remember items like formula, baby foods, bottles, baby wipes, and medications for the baby. You may want to pack items like an over-thecounter fever reducer for infants.

If you are planning to take your pets along, you’ll need food and water for them. You should have a carrier or cage for them. Don’t forget to bring along proof of their immunizations as well as any medications that your pets will need. For dogs, don’t forget to bring a leash. Getting your house ready: Tropical storms and hurricanes mean high winds. You may want to consider having storm shutters installed or purchasing pre-cut outdoor plywood that is at least ½ inch thick for each window of your home. Check trees near your house for diseased or dead limbs, overhanging branches and other possible hazards. Bring in any outdoor furniture, plant containers or other items that can be picked up by the high winds.

Getting your car ready: If a storm is brewing in your area, you may want to keep a full tank of gas in your car. Gas stations often run out of fuel when everyone starts evacuating for a hurricane and they cannot start pumping until electricity is restored after a storm. You may want to plan a summer car check of vital fluids, hoses and belts to make sure your car is in good working order.

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Bethesda Comprehensive Cancer Center Receives Three-Year Accreditation from the Commission on Cancer

Boynton Beach, FL- Continuing to provide the highest level of care for cancer patients, the Bethesda Comprehensive Cancer Center at Bethesda Memorial Hospital has received a threeyear accreditation from the Commission on Cancer (CoC).

The Bethesda Comprehensive Cancer Center complied with all 36 standards to receive the threeyear accreditation. The Center also received four commendations on cancer program standards including clinical trial accrual, prevention and early detection as well as cancer-related quality improvements.

Some of the benefits to cancer patients obtaining care from a CoC accredited cancer center are:

• Comprehensive care offering a range of state-of-the-art services and equipment

• A multidisciplinary team approach to coordinate the best cancer treatment options available

• Ongoing monitoring and improvement of care

• Information about clinical trials and new treatment options

The Bethesda Comprehensive Cancer Center, an Affiliate of the H. Lee Moffitt Cancer Center and Research Institute, offers an array of services including radiation oncology, inpatient oncology, clinical research programs, hospice and palliative care, and support groups for patients and

family members who are facing a cancer diagnosis.

Founded in 1959, Bethesda Healthcare System is a nonprofit healthcare organization serving the medical needs of South Palm Beach County with a mission to

provide quality health services in a caring manner. As the flagship of Bethesda Healthcare System, Bethesda Memorial Hospital is a 401-bed hospital with more than 550 physicians in more than 40 areas of specialty on its medical staff. Bethesda Memorial

Hospital and its affiliates offer a full array of healthcare services, including general, vascular and endovascular surgery, maternity, neonatal and pediatric intensive care, women’s health services and the Bethesda Comprehensive Cancer Center, an Affiliate of the H. Lee Moffitt Cancer Center and Research Institute. The Bethesda Heart Hospital, a 39-bed, all private room facility, provides the most comprehensive level of cardiovascular services and is ranked among the top heart hospitals nationwide by the Society of Thoracic Surgeons. Bethesda Healthcare System is building an 80-bed community hospital on the northeast corner of Boynton Beach Boulevard and US-441. The new Bethesda West Hospital will open in January 2013. Visit us at www.BethesdaWeb.com.

Smart Bed Makes Itself After You Get Up panish furniture maker OHEA has introduced the world’s first automated bed that makes itself. Saving sleepers from the mundane task of making their beds every morning, the smart bed is equipped with a device that enables it to automatically straighten the bedding. In a mere 50 seconds, this bed

from the future activates its mechanical arm with two rollers which pulls the duvet up to the head of the bed. At the same time, the pillows are straightened by cords attached to the pillowcases after which the panels rotate elevating the pillows.

Once the upper coverlet has been stretched to the head of the bed,

the pillows fall back onto it. Best of all, the bed contains a safety feature that will prevent the mechanism from activating when the person is still in bed. A switch on the bed frame offers two settings: manual and automatic, the latter of which will detect will detect when the bed has no occupancy and activate after 3 seconds.

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Another successful event for the Kids Cancer Foundation onefish Mac's Sports Grille in Wellington was the place to be for the Kids Cancer Foundation's Celebrity Bartending event on June 12. Michelle O'Boyle, the founder of the Kids Cancer Foundation and Jane McLaughlin, the owner of Bonefish Mac's, were both on-hand to make sure the event ran as smoothly and successfully as possible and they accomplished just that. As the supporters filled the bar, it was standing room only. Not to be outdone by the silent auction room, which was always filled with a stream of eager bidders waiting to get their hands on some of those incredible offerings. The Kids Cancer Foundation is a local charity that was chosen for Bonefish Mac's Plaque Club. By

It was standing room only.

donating $50.00, you can choose your spot at the bar and a black plaque will be posted above your seat. For a $200.00 donation,

you will receive a larger gold plaque, again placed above your seat of which all of the proceeds benefit the Kids Cancer

Maggie Zeller and Kids Cancer Foundation Founder, Michelle O'Boyle.

Foundation. If you would like additional information about purchasing a plaque or about the Kids Cancer

Foundation, please contact Michelle O'Boyle at 561-3711298, or go to their website, www.kidscancersf.org.

C O N G R AT U L AT I O N S

Bill Tavernise, Erica Whyman (GHT), and Bob Wolff.

Michelle O'Boyle, Elvis, Jane McLaughlin (owner of Bonefish Mac's) Kids Cancer Foundation Advisory Board and Deborah Lynn (GHT). Members, Oren Hudson and Nancy Melamed

ERIC GOLDMAN To

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JULY ISSUE • 2012 7

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Bethesda Memorial Hospital Welcomes Nova Medical Students Hospital Trains Medical Students from Nova Southeastern University College of Osteopathic Medicine for 7th Straight Year

(Boynton Beach, FL--) With stethoscopes in hand and an eagerness to learn, medical students from Nova Southeastern University College of Osteopathic Medicine will embark on their next medical journey at Bethesda Memorial Hospital.

(Left to right): Back row: Shardul Koppar, Jayesh Patel, James Sorensen and Gareth McGee. Front row: Aaron Shady, Stefanie Furlan, Britani Martinez, Jessica Staller, Dung Nguyen, Joshua Kretchmar, Andrew Pan and David Kang.

Bethesda Memorial Hospital is providing the clinical setting for 24 medical students during their last two years of medical school. The class of 2014 will be com-

pleting their third and fourth year core rotations at Bethesda. Bethesda Memorial Hospital has trained Nova medical students for the past seven years. The students will have one- and twomonth rotations with members of Bethesda's Medical Staff in both hospital and office settings. The areas of rotation include: internal medicine, obstetrics/gynecology, pediatric ER, outpatient pediatrics, family medicine, surgery, psychiatry, geriatrics and emergency medicine.

Palms West Hospital Recognizes “National Time Out Day” Supporting Surgical Safety

oxahatchee, Florida, June 24, 2012- Physicians and Operating Room staff at Palms West Hospital recognized National Time Out Day on Thursday, June 13th. National Time Out Day is a powerful tool that supports surgical nurses’ ability to speak up for safe practices in the operating room. “All of our physicians and staff take their role in Patient Safety very seriously. Not only in our Surgical areas, but in all of our Procedural areas as well. We are pleased to celebrate National Time Out Day, reinforcing the importance of taking the time to verify the right patient and the right procedure at the right time”, explains Chief Nursing Officer, Silvia Stradi. Initiated as an annual awareness campaign by AORN (Association of Perioperative Registered Nurses) in 2004, it has been consistently supported by The Joint Commission, the World Health Organization, and the Council on Surgical and Perioperative Safety (CSPS) for its ability to increase awareness of safe practices that lead to optimal outcomes for patients

undergoing surgery and other invasive procedures.

This year, AORN urges members to evaluate how their time out fits into broader efforts to provide high quality care to every patient, every time. A poorly executed time out or lack of team communication may indicate areas for improvement within a safety culture.

Palms West Hospital’s focus on safety and quality was recently reinforced when the hospital received an “A” rating as their Hospital Safety Score, the first ever national letter grade system ranking medical facilities on their ability to avoid infections, medication mix-ups and other preventable mishaps. The Hospital Safety Score, designed to arm patients with an objective tool to assess performance, was developed by a panel of experts from Harvard and Johns Hopkins universities and The Leapfrog Group, a nonprofit hospital safety advocacy organization. For a full list of South Florida Hospital Safety Scores, visit : http://hospitalsafetyscore.org.

John D. Corbitt, Jr., M.D. diplomate of american Board of surgery

dr. Corbitt is a general surgeon who specializes in breast disease. He performs the latest procedures for breast care and has the largest, longest running study for nipple sparing skin sparing mastectomies for breast cancer in the U.s. He is a graduate of emory University and completed his residency training at emory University, Henrietta egleston Children's Hospital, atlanta V.a Hospital, and grady memorial Hospital. He is also a former major in the United states air force medical Corp. dr.Corbitt has 31 publications and contributions to 14 textbooks on laparoscopic, hernia, and breast surgery, and he is currently working on publishing a paper regarding the Nipple areolar Complex skin-sparing mastectomy for breast cancer patients and patients at high risk for the disease based on family history and genetic testing.

Breast Surgery Laparoscopic Surgery General Surgery We accept most insurances!

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We are located just North of JFK Medical Center 142 JFK Dr. Atlantis, F.L 33462 Phone: (561) 439-1500 • Fax: (561) 439-9902

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CyberKnife treatment for Prostate Cancer

Kishore K. Dass, MD

Board-Certified Radiation Oncologist

he CyberKnife System is a robot that delivers a unique form of radiation known as radiosurgery. The CyberKnife is able to deliver radiation to the prostate with sub-milimeter accuracy through the use of continual image guidance and robotic mobility. Because the prostate can move unpredictably, having this ability to track, detect and correct for motion is critically important. As a result, the radiation is directed to the prostate, not around the healthy tissue that

Mark Perman, MD

Board-Certified Radiation Oncologist

surrounds the prostate, in large doses over a brief period of time. Generally candidates for CyberKnife prostate treatment fall into the low risk category (Low Risk PSA: <=10 ng/mL and a Gleason score of 6 or less and clinical stage T1c or T2a). Patients with more advanced prostate cancer may qualify for CyberKnife treatment combined with other forms of radiation treatments.

Compared to traditional treatments that can take up to 8 - 9

weeks, an entire CyberKnife treatment course can be completed in 4 to 5 sessions. Each treatment session is typically completed in one hour or less. Aside from the placement of tiny gold markers called fiducials into the prostate (a pre-treatment procedure that assists the imaging system to more accurately target the prostate), the CyberKnife treatment process is completely noninvasive. No incisions, anesthesia or hospitalization are required. During the treatment the CyberKnife robot moves quietly around the patient who lies comfortably on the treatment table, usually while listening to his favorite music. Safety mechanisms are in place to make sure that the beam of radiation auto-

matically remains ‘locked on’ to the prostate should it move when a gas bubble moves through the rectum or the bladder starts to fill during treatment. In a CyberKnife survey conducted last year, 304 men were asked to review their experiences with CyberKnife treatment for

prostate cancer. Over 90% of them described their treatment as successful, and did not interrupt their normal life routine. They also indicated they would recommend CK prostate treatment to others and would choose to be treated with CK again.

Pain Relief with Meditation – even for beginners! or long-term consistent practice of meditation to experience the rewards. But a new study from Wake Forest Baptist Medical Center tells us otherwise.

Cindy Collins, Ph.D., R.D.

Experimental Health Psychology / Nutrition

editation has become very popular. It is promoted for general wellbeing, stress relief and even as a solution to specific problems, including pain. Most of us assume that we need to engage in a daily

Researchers there illustrated that even the novice can reap benefits from meditation. Participants were a small group of healthy medical students. They engaged in four- 20 minute sessions of Mindfulness Meditation. The goal in this type of meditation is to acknowledge and then let go of distractions, while maintaining an awareness of the present moment. Pain plays the role of the distraction; in this case, it was applied heat to the back of the calf. The subjects then reported on the intensity and the level of unpleasantness of the pain. The participants reported 40%

control and emotion. In fact, those participants who scored as a ‘better meditator’ had more activation in these areas and less experience of pain.

Breathing exercises alone do not seem to produce the same results. But, it’s good to know that with the correct training in this method, pain relief can be achieved in just a little over an hour and likely to be enhanced with even more practice.

less pain intensity and 57% less pain unpleasantness after the meditation training. In addition to feeling less pain, brain studies revealed changes in pain-related brain activity as measured by

MRI studies of the primary somatosensory cortex.

Interestingly, there was also an increase in the brain activity for those areas related to cognitive

At South Florida Radiation Oncology, we offer Mindfulness Meditation training for our cancer patients with Cindy Collins, Ph.D., R.D. Visit their website at www.sfrollc.com or call your nearest office to inquire about scheduling. For more information on this research, see http://www.npr.org/blogs/health/ 2011/04/08/135146672

Newly discovered immune system molecule could stop melanoma growth

Researchers have discovered a key molecule in the immune system that may effectively inhibit the growth of melanoma – a revolutionary find that could pave the way for new treatments of skin cancer. The study, published in the online issue of Nature Medicine, detailed the cell-signaling molecule, interleukin-9, which scientists at Brigham and Women’s Hospital (BWH) found inadvertently. “It was really kind of an accident,” Dr. Thomas Kupper,

chair of the BWH Department of Dermatology and one of the study’s lead authors. “We were interested in a different kind of T cell – T helper cell 17 (TH17). These so called TH17 cells are pretty recently discovered type of T cells that are supposed to be

important for protecting us against infections by bacteria. But there’s controversy over whether these cells, if directed towards cancer, would be effective against blocking cancer or would not just be ineffective, but give cancer a boost.” To see exactly what effect these T cells had on cancer, Kupper and his colleagues developed a group of transgenic mice lacking a key factor allowing for the production of TH17. After introducing aggressive skin cancer cells in the mice, the researchers

found that tumor growth was inhibited, suggesting that TH17 cells were hindering the rejection of cancer. Further analysis of the mice by Kupper’s colleague Dr. Rahul Purwar revealed that the genetically altered mice expressed high amounts of interleukin-9. “It turns out there’s a class of T cells (TH9) that make lots of interleukin-9,” Kupper said. In order to determine if their discovery could translate to a potential human cancer treatment, Kupper and Purwar went

on to show that TH9 cells are present in normal human blood and skin. “We wanted to be sure that this wasn’t just something unique to mice,” Kupper said. “So we were able to show that… clearly these cells are present in humans. We also went to look at patients with advanced melanoma. In their lesions there were very low levels of interleukin-9. So if we can increase those levels, we might see the same thing we saw in those [mouse] models.”

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10 JULY ISSUE

• 2012

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Brighter Days Ahead After Hair Loss will be opening this summer in Palm Beach Gardens. There, she will be teaching cancer patients how to style their hair, wigs and even how to apply make-up. As the treatment itself is difficult, trying to maintain your appearance while battling the disease is the last thing you want to worry about, now patients will have help.

By Deborah Lynn

very one of us has been touched by cancer in one way or another. Whether it was a relative, friend, or an acquaintance. It’s how you handle that experience and what you bring forward that makes your journey notable. For Wendy Bright, a licensed cosmetologist, her path changed while in her 20’s, when her best friend was diagnosed with cancer. As she watched her friend battle the disease, lose her hair and ultimately her life, she felt compelled to do something more. Since then, Wendy has dedicated much of her life to making women look and feel beautiful. At the beginning of her career, Wendy learned how to perfect her craft while donating much of

her time and efforts to cancer patients through the American Cancer Society. Recently, Wendy was approached by Judy Armstrong, a nurse practitioner from South Florida Radiation Oncology about helping out with the new survivorship clinic that

Wendy offers a wide range of non-surgical services which help those suffering from hair loss to cancer. Those services include; eight types of hair extensions, hair restoration, hair pieces, top closures and hair replacement services. She also offers custom wigs and lace wigs in a private setting. Her work can be viewed at www.stylist1.com, which shows a variety of before and after photos.

CDC: Whooping cough cases may be most in 5 decades

In addition, she has created a line of DVD’s called, Brighthair Extensions (which also includes tools). The videos are perfect for clients and stylists alike. You will learn how to apply three types of hair extensions as well as have the ability to get certified in each technique. In addition, you will learn how to main-

olon and rectal tumors are the same type of cancer, according to researchers who conducted genetic analyses of cancer tissue specimens.

Nearly 18,000 cases have been reported so far - more than twice the number seen at this point last year. At this pace, the number of whooping cough cases will surpass every year since 1959.

"There is a lot of this out there, and there may be more coming to a place near you," Dr. Anne Schuchat of the Centers for Disease Control and Prevention said Thursday.

Wisconsin and Washington state each have reported more than 3,000 cases, and high numbers have been seen in a number of other states, including New York, Minnesota, Kansas and Arizona.

Whooping cough, or pertussis, is a highly contagious bacterial disease. It leads to severe coughing that causes children to make a

The findings, published online in the journal Nature, one day may lead to improved diagnosis and treatment of colorectal cancer, the researchers said.

distinctive whooping sound as they gasp for breath. In rare cases it can be fatal, and nine children have died so far this year.

Children get vaccinated against whooping cough in five doses, with the first shot at age 2 months and the final one between 4 and 6 years. Then a booster is recommended around age 11. The vaccine's protection does wane and health officials have debated moving up the booster shot.

The CDC is urging adults and especially pregnant women to get vaccinated so they don't spread it to infants who are too young to get the vaccine.

Whooping cough used to cause hundreds of thousands of illnesses a year but cases fell after a vaccine was introduced in the 1940s. Starting in the late 1960s, fewer than 5,000 cases were reported annually in the United States, for a stretch of about 25 years. But the numbers started to rise in the 1990s.

Panel: Seniors should get whooping cough shots A federal advisory panel is recommending that all Americans age 65 and older get vaccinated against whooping cough. Health officials believe whooping cough is underreported in older adults. But a goal of Wednesday's recommendation is to prevent older adults from spreading the disease to infants, who are most vulnerable. The shot is already recommended for younger adults and a whooping cough vaccine is included in childhood shots.

Whooping cough is a highly contagious bacterial disease that in rare cases can be fatal. It leads to severe coughing that causes children to make a distinctive whooping sound as they gasp for breath. Recommendations from the Advisory Committee on Immunization Practices are usually adopted by the government, which sends the guidance out to doctors.

If you would additional information about Wendy and the services she offers, you can e-mail her at stylistwendy@me.com or give her a call at 561-348-0399.

Colon, Rectal Cancers Seem to Be Same Disease

The researchers, from the Cancer Genome Atlas project, also identified new genetic mutations that may contribute to colorectal cancer.

ealth officials say the nation is on track to have the worst year for whooping cough in more than five decades.

tain those extensions and how to care for your wig. She also offers private classes in her salon or via webcam.

In the 224 colorectal cancer specimens analyzed, 24 genes were mutated in a significant number of cases. In addition to genes previously identified as potential "drivers" of colorectal cancer when mutated, the researchers identified three new genes that may also be involved in this disease. The researchers also identified two other genes that are mutated or "overexpressed" in colorectal cancer and may prove to be potential targets for new drugs. The National Cancer Institute and the National Human Genome Research Institute, both parts of the U.S. National

Institutes of Health, funded the study.

"This finding of the true genetic nature of colon and rectal cancers is an important achievement in our quest to understand the foundations of this disease," Dr. Francis Collins, director of the National Institutes of Health, said in a government news release. "The data and knowledge gained here have the potential to change the way we diagnose and treat certain cancers." Dr. Harold Varmus, director of the National Cancer Institute, added, "While it may take years to translate this foundational genetic data on colorectal cancers into new therapeutic strategies and surveillance methods, this genetic information unquestionably will be the springboard for determining what will be useful clinically against colorectal cancers."

More than 143,000 people in the United States will be diagnosed with colorectal cancer this year and more than 51,000 will die of the disease. Colorectal cancer is the fourth most common cancer in the United States, according to the National Cancer Institute.

JULY ISSUE • 2012 11

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Sleep Apnea

– It’s More Common than You Think

By Deborah Lynn

hese days, it’s difficult to get a good night of sleep. We blame it on our heavy workload, stress, the kids and a host of other reasons. Unfortunately, this lack of sleep contributes to being exhausted which makes it quite difficult to focus throughout the day.

As studies show, one of the main causes of our lack of sleep may be a form of sleep apnea. This occurs when you have one or more pauses in breathing or shallow breaths while you sleep. Those breathing pauses can last anywhere from a few seconds to minutes. The most common form of sleep apnea is Obstructive Sleep Apnea (OSA), which generally means that your airway has collapsed or is blocked during sleep. The blockage may cause shallow breathing or breathing pauses. Therefore, when the individual tries to breathe, any air that does squeeze through the pathway can cause loud snoring. The snoring is also louder while sleeping on your back.

An individual can have over four hundred of these episodes a night, with each one lasting anywhere from ten seconds to over a minute. According to Dr. Alvaro Betancur, “The body needs oxygen, if it is deprived of oxygen, something bad is going to happen.” “Did you know that the number one reason that people grind their teeth is due to sleep apnea? We used to think it was a result of stress, but now we know that it occurs because of the body’s protective mechanism of moving the jaw forward to open the airway so the patient can breathe. When you treat the sleep apnea

Alvaro Betancur, DDS, has practiced dentistry in Florida since 1990. After receiving his dental degree, Dr. Betancur completed a residency in craniofacial pain and pathofunction at the University of Florida and a fellowship at the University of Florida Pain Center rand the American Academy of Craniofacial Pain. Dr. Betancur is a member of the American Academy of Dental Sleep Medicine.

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using oral appliances, the grinding comes to a halt. Patients don’t wake up in the morning with headaches or sore jaws, plus it protects their teeth, which ends up saving them a great deal of money” notes Dr. Betancur.

As sleep apnea is pushed to the forefront, more and more people are starting to question whether or not they too have this condition. Since there are no blood tests available, it often goes undiagnosed. Sadly, most people don’t even realize they have a problem and it often takes a spouse, family member or close friend to notice some of the symptoms.

SNORING AND DAYTIME SLEEPINES may signal a potentially life threatening disorder:

OBSTRUCTIVE SLEEP APNEA OR OSA OSA can lead to heart attack and reduced libido

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Below are a list of some of the signs and symptoms associated with sleep apnea:

- If you are fighting sleeplessness throughout the day - Loud snoring - Difficulty staying asleep (insomnia) - Intermittent pauses of breathing while asleep - Sleepy while driving - You find yourself dozing off during those peaceful times of day - Morning headaches - Memory or learning difficulties - Lack of concentration - Frequent urination at night - A dry throat when you wake up

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obstructive sleep apnea (osa) affects more than 18 million americans and can lead to hypertension, heart attack, stroke, diabetes, reduced libido, tmJ dysfunction, morning headaches and excessive daytime sleepiness which can lead to work and car accidents.

In children, sleep apnea can cause hyperactivity, poor performance at school, and hostile behavior. They may also experience bedwetting and breathe through their nose during the day. Left untreated, sleep apnea can not only worsen in time, but can also be a matter of life or death. In addition, sleep apnea is associated with a number of comorbidities that can be a factor, such as hypertension, diabetes, obesity, menopause, atrial fibrillation, pace makers and coronary heart disease.

Roughly half of the people that have hypertension are also affected with sleep apnea. Therefore, half of all sleep apnea patients generally have hypertension. Most insurance companies are

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eliminate the CPaP mask and continue using CPaP equipment with the new oral appliance to obtain the benefits of both. OAT is covered by most Medical Insurance and Medicare

If you would like additional information regarding sleep apnea or Dr. Alvaro Betancur, visit www.sleepsnoredentist.com, or call his office in Boca Raton at 561-750-6790, or the Pembroke Pines office at 954392-1851. His practice accepts Medicare and most major insurance plans.

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Dr. Alvaro Betancur hopes to help as many patients that suffer from sleep apnea as possible. He currently works with a number of physicians and pulmonary specialists in order to better serve his patients. He is proactive in his approach and committed to each and every one of his patient’s well-being.

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treatment with oral appliance therapy (oat): for mild and moderate sleep apnea and snoring. Plus severe osa when the patient is intolerant to CPaP or needs to be used in conjuntion with CPaP.

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happy to pay for the treatment of sleep apnea as it’s cheaper for them to take care of that disorder now than to develop other medical issues down the road.

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starting as young as 2 years old, you may help your children to solve ear inflammation symptoms, develop a beautiful face and smile with a more attractive profile as well as prevent sleep apnea and avoid orthognathic surgery; all with funtional appliances and facial focused orthodontics.

We can straighten your teeth at any age, fast and comfortably using invisible technology with or without braces. improve your facial appearance with a beautiful and healthy smile.

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Phone: 561-750-6790

Phone: 954-392-1851

12 JULY ISSUE

• 2012

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Why am I so Tired? weakness and just not feeling well. But, this time without any weight gain. I did an EKG, only to find that he has…?

4. A new patient came to see me while fatigued and just not feeling right for many months. In addition, they had experienced an occasional dry cough? What was the diagnosis?

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

n my practice, I see quite a few of patients who complain about being tired. Feeling tired can be innocuous to many, but not to physicians who take heed to this complaint and face this problem every day in their practice. Normally, I would classify this as Fatigue.

thereby preventing weeks, if not months or years, of loss of focus, attention, productivity and potentially - their job.

Let me walk you through a few interesting scenarios that I have experienced with my patients:

Now what would you do in such a situation?

1. A patient enters my office and is complaining of weakness, feeling tired and had gained weight over the past few months. I asked her an array of questions, just to get an idea as to what could be going on with her. As I had an idea of what the problem may be, I ordered specific blood

My experience has shown that most people go about their usual daily routine, even if they feel tired. Some eventually do see their doctor, but only to find that if they had visited their physician sooner, they could have found an effective treatment

tests and when the results came back, it was exactly as I suspected. What do you think she has?

2. Another patient came in my office complaining of being tired, weak and gaining weight and again after much questioning, a thorough examination and a complete work up, I found that he had something that I routinely see, but could be dangerous if not treated. What did we need to treat immediately?

I can cite many other reasons for Fatigue, but I will explore those at a later date.

3. A patient with no prior medical problems came into my office. He was complaining of

I can go on and on with several more examples of patients experiencing weakness and how I dissected their symptoms and eventually came to their diagnosis. As a physician, you need to target the problem by asking the right questions, intently listening to the patient, and ordering the salient tests.

Please read the answers to above scenarios on the following page.

Dr. Sharma is a Board certified Internist that has been in practice for the past 19 years. His office is accepting new patients: Palomino Park, 3347 State Road 7 Suite 200 Wellington, FL 33449 and for an appointment please call

(561) 795-9087

Dr. Sharma's office in Belle Glade is at 1200 South Main Street, Suite 100 (opposite the Old Glades General Hospital). He will be seeing patients at this location along with Ebonee Johnson ARNP. He is currently accepting New Patients and the office accepts most insurances.

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for an appointment.

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1200 South Main Street Suite 101 Belle Glade FL 33430

Tel: (561) 996-7742 • Fax: (561) 753-8730

JULY ISSUE • 2012 13

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Tobacco use contributes to bladder cancers

Sheryl Gilman B.S., RRT-NPS, CPFT, CTTS

oday, most know that tobacco use causes cancer of the lungs, tongue, esophagus, and mouth. However, the World Health Organization released research showing that 40-70% of all urinary bladder cancers can be attributed to the use of tobacco whether it is smoked, chewed, or snuffed. Women are catching up with men in this area of health. Today, half of urinary bladder cancers diagnosed in women are caused by the use of tobacco. This is a significant increase from previous decades in which only 20-30% of such cancers were attributed to tobacco use. In fact, the National Cancer Institute projects that 1 in 42 men and women born today will be diagnosed with bladder cancer sometime in their life. In 2011, 69,250 new cases of bladder cancer were diagnosed and approximately 14,990 people died of tobacco related bladder cancer, as reported by the National Institutes of Health Cancer Research. Sadly, those numbers are expected to be repeated this year.

The bladder is a hollow organ that stores the waste (urine) produced as the kidneys filter and cleanses the blood. Urinary bladder cancer develops when the process of replacing bladder cells goes wrong and new cells are formed when not needed and/or old and damaged cells don’t die as they should. The buildup of these extra cells forms a mass of tissue which continues to grow and becomes a tumor. The cancer begins in the inside layer of the bladder and grows into the walls thus becoming more difficult to treat. Often there are no symptoms until the disease has advanced. Cancer causing agents (carcinogens) are excreted through the urine regardless of the how they enter the body. After these carcinogens are processed through the kidneys, they are stored in the bladder until eliminated at a later time. At this time, for superficial bladder cancers the five year survival rate is 85%. If the cancer is of the invasive type, only 5%

will survive for two years after diagnosis. The World Journal of Surgical Oncology notes that bladder cancer is the 4th leading cancer diagnosed in men and the 8th leading cancer in women with tobacco use and smoking the primary cause of bladder cancer in the western world. Tobacco tars have been shown to induce bladder papilloma and carcinoma in mice. Those who use tobacco products have an increased risk of up to 400% of developing bladder cancer over non-smokers. This high risk remains for years after the user quits tobacco. Even one cigarette a day increases the risk of developing urinary bladder cancer. Also exposure to environmental tobacco smoke known as second-hand and third-hand smoke

during childhood increases the risk of developing bladder cancer in adulthood by 40%. The journal Cancer, Epidemiology, Biomarkers, and Prevention published the results of a large study undertaken in Spain measuring the length of time and daily amount of tobacco use in the development of bladder cancer. This study confirmed that the increase risk of bladder cancer was directly connected to increased amount of tobacco use on a daily basis and increased number of years of use. Through the detection of mutagens (external agents causing adverse changes in cells) in the urine of non-smokers who live with a smoker, it was determined that they too were at an increased risk of bladder cancer. Another study reported on in the Journal of the American Medical Association of August 17, 2011 verified these results. Finally, the World Journal of Surgical Oncology reported that the most harmful cancer causing agents are tobacco-specific nitrosamines (TSNA) formed during the growing, curing, fermenting, and aging process of tobacco.

Answer 2. He has Congestive Heart Failure and on further ques-

tioning, he had shortness of breath which was the "weakness" he had been experiencing. He was also retaining fluid in his body which caused the weight gain.

Answer 3. The EKG showed the patient had severe heart block called 3rd degree Heart Block! He was sent to the emergency room by ambulance.

For July 10 – August 10, 2012 July 12

Brandon Flowers Charity Weekend. Celebrity Cocktail Party at the Omphoy Ocean Resort in Palm Beach. Meet NFL players from 6:30 pm until 8:30 pm with an open bar and silent auction. Tickets are $100.00, or $175.00 for all three weekend events. For more information, please e-mail cmiller@calmillerassociates.com.

Sheryl Gilman has been practicing respiratory care for 14 years in Palm Beach County. For the last 5 years she has been the Clinical Supervisor of the Cardiopulmonary Department at Lakeside Medical Center, the hospital in Belle Glade serving the residents of the Western Communities. She has specialty certifications in Neonatal and Pediatric care, Pulmonary Function Testing, and is a Certified Tobacco Cessation Specialist as well as having a Bachelor degree in Health Care Services Management.

There are many good reasons not to ever begin tobacco use and even more to quit using tobacco products now and there is help available for those who would like to quit. The federal government hosts a web site guide to quitting smoking at smokefree.gov (http://www.smokefree.gov). This provides you with a stepby-step guide on how to quit and includes sections such as “Talk to an expert”, “Find tools to help you quit”, and “Learn about topics related to quitting.” Also, the state of Florida provides a “Quitline” at 1-877-U-CANNOW. Locally, the state funds Quit Smoking Now and Tools to Quit classes. Quit Smoking Now classes are one-hour a week for six weeks and the Tools to Quit classes are a onetime two-hour class. Both are free to the public and provide free nicotine replacement products such as patches, lozenges, and gum to eligible participants. More information on these classes can be obtained at the Everglades Area Health Education Center at 1-877-8192357. Why not call today and begin a new tobacco-free lifestyle. The people who love you will be glad you did!

Answers to “Why am I so Tired?” Answer 1. She has a condition called Hypothyroidism that is in layman’s terms means a weak and sick thyroid gland located in the neck. Here, the gland does not secrete enough hormones to keep your metabolism right. This can easily be treated.

Upcoming Medical Fundraising Events

Answer 4. After performing a thorough exam of his lungs and doing a Spirometry test in my office, I concluded that he has Bronchial Asthma. He was oblivious to the fact that he had asthma as it had been simmering for some time under the radar. After a few whiffs on a fast-acting bronchodilator, he felt like a new man!

July 13

Brandon Flowers Charity Weekend. NFL Mix and Mingle Pool Party. Omphoy Ocean Resort in Palm Beach. The event is located in the pool and spa area from 7:00 pm to 10:00 pm with an open bar and barbeque. Tickets are $100.00, or $175.00 for all three weekend events. For more information, please e-mail cmiller@calmillerassociates.com.

July 14

Brandon Flowers Charity Weekend. Sixteen high school teams from around the country will compete in the Brandon Flowers 7 on 7 high school tournament. Spectators include NFL players. The event is scheduled between 4:00 pm until 10:00 pm and the cost is $5.00, or $175.00 for all three weekend events. For more information, please e-mail cmiller@calmillerassociates.com.

July 18

Bethesda Hospital Foundation and Bethesda Next. Happy hour at SoLita Italian in Delray Beach. The event takes place from 5:30 pm to 7:30 pm and the cost is $10.00 per person at the door. This event benefits Bethesda Memorial Hospital.

July 21

Hospice of Palm Beach County Foundation. 13th Annual Horizons Fishing Tournament Catch One for the Kids. The event begins at 6:30 am and ends at 4:00 pm at the Riviera Beach Marina. For more information, please contact Lauryn Barry at 561-494-6884 or specialevents@hpbcf.org.

July 26

Jacklyn Tucker Fundraiser. This adorable little girl lost part of her face due to a dog attack. She will need a series of surgeries to reconstruct her face. On July 26, Park Avenue BBQ in Wellington will donate 25% of all proceeds to the trust fund set up in Jacklyn’s name. The law office of William Abramson will also have a raffle to help the Tucker family with their mounting bills. The top prize is an iPad 3, second prize is a 32-inch flat screen TV, donated, and the third prize is a $100 gift card to Park Avenue BBQ Grille. Tickets are $5.00 and can be purchased by calling Abramson’s office at (561) 650-1898. If you wish to make a monetary donation, you can do so by visiting any Chase Bank, where a trust fund has been created for Jacklyn.

July 28

Kids Cancer Foundation. Golf outing with all proceeds benefitting the foundation. Boca Greens Country Club in Boca Raton. Cost is $45.00 for an adult and $35.00 for a junior. For additional information, call 561-414-9800.

July 30

WHITE COATS-4-CARE. Second annual event to benefit FAU’s Charles E. Schmidt College of Medicine’s incoming students. The Bridge Hotel (Carmine’s at the Top of the Bridge), Boca Raton. There is limited seating and the minimum donation is $100.00 per person. To register and make your gift online, visit https://fauf.fau.edu/WC4C.

If you would like to add a medical event or fundraiser to our Upcoming Events section, please e-mail your information to info@globalhealthtribune.com. This is a free section.

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University of Miami Miller School of Medicine 2012 Graduation

alm Beach County--- The residents, faculty and families dazzled the evening of June 15th at the Graduation ceremony for UMMSM Palm Beach Regional Campus Internal Medicine and Hospital & Palliative Care Fellowship class. The fellows completed their residency at JFK, VA Medical Center and Hospice of Palm Beach County.

The ceremony was hosted at the West Palm Beach Marriott, with Stuart Bagatell, M.D, Director of Ambulatory Education and Patient Care delivering the keynote address. Graduation certificates were presented to the well deserving graduating senior residents and chief residents. Honors were also awarded for Faculty Teaching to Kenneth Ness, WPB VA Medical Center and Danny Lichstein, UM Regional Deal for Palm Beach

Regional Campus. The Resident Teaching award was bestowed upon Mostafa Shalaby. Katie DelaCruz and Joao Braghiroli were awarded Residents of the Year, and last but certainly not least, Camilo Ortega was recognized as Intern of the Year.

Dr. Frederick Williams, M.D., the Head of the Program and Associate Professor of Clinical Medicine referred to the graduating residents as "pioneers” embarking in a new program and being part of its success. He was very proud of everyone in attendance and the continued success of the innovative program. JFK serves as the main teaching site or the Internal Medicine residency alongside the extremely valuable partner, West Palm Beach VA Medical Center. Congratulations to the Class of 2012!

Gina Melby, CEO JFK Medical Center, Daniel Lichtstein, M.D., Sr. Associate Regional Dean for Medical Education University of Miami Miller School of Medicine, Fredric k Williams, M.D., Associate Professor of Clinical Medicine University of Miami Miller School of Medicine, Joan St. Onge, M.D., Designated Institutional Official, Charleen Szabo, CEO West Palm Beach VA Medical Center.

New Study Says “Light to Moderate Drinking in Pregnancy May be Safe”

n pregnancy circles, there is a fair amount of discussion around whether it is okay to have alcohol while pregnant, and for the most part, the opinions are clearly divided. Some believe there is no harm in an occasional glass of wine, while the other side does not understand why one would take the risk. Regardless of which side of the baby gate you are on, chances are, if you are pregnant, you have engaged in such a debate. A new Danish Study released last month, has sparked these discussions and debates into overdrive.

The study released last month looked at over 1600 women who drank 1-8 glasses of alcohol a week during their pregnancy and statistically evaluated how varying levels of drinking affected

their children five years later. The study compared five groups of pregnant women, those who drank 0, 1 to 4, 5 to 8, and more than 9 drinks per week. The study then assessed their children’s IQ, attention span and capacity for things such as organizational and planning skills five years later.

The study found that the children of those mothers who drank 1 to

4 or 5 to 8 drinks while pregnant did not perform any worse on tests measuring IQ or certain executive functions such as organizational and planning skills, than the children of mother’s who abstained from alcohol altogether during their pregnancy. A surprising piece of the study even found that “occasional” binge drinking, which means five or more drinks in one sitting, did not have any significant affect on children, five years later.

So, what is the magic number of cocktails? According to the study, those children whose mothers drank more than 9 drinks per week while pregnant showed lower attention span. A drink was defined in the study as having 12 grams of pure alcohol.

for poor birth outcomes including fetal alcohol syndrome, birth defects, and low birth weight.

So, does this study give momsto-be the okay to “belly up to the bar”? Not so fast, even the authors of the study clearly point out, “pregnant women should still err on the side of caution and avoid alcohol altogether, since no safe level of alcohol consumption has been established.”

The CDC, the U.S. Surgeon General, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics advise pregnant women not to drink alcohol at all.

The Center for Disease Control reports that drinking during pregnancy continues to be a problem in the United States, with 1 in 8 women reportedly drinking while pregnant. The CDC says that drinking while pregnant is a known risk factor

For the complete study: http://www.bjog.org/view/0/index .html for BJOG: An International Journal of Obstetrics and Gynaecology

Dr. Jennifer Ashton, OBGYN, simply states, “Alcohol is a toxin and definitely can affect neurological development.”

There is no doubt that the debate will continue, and as for me, I am just glad that there is so much continued discussion from the science and medical community about what is best for pregnant women and their babies.

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Women's Breast Care Center

Dr. Kishore Dass, Mary Martinez, Dr. Yvette Laclaustra and our favorite Sommelier.

r. Yvette Laclaustra held an open house for the Women's Breast Care Center for her Wellington location. Everyone truly had the most enjoyable time with some of the top local physicians in attendance. In addition, Dr. Luis Vinas and Lori Anthony held several drawings for free cosmetic services - you have got to love those events!!!

Staff from Nurse On Call.

Lori Anthony and Dr. Luis Vinas.

Chrissy Rothwell, Judy Armstrong, Dr. Alex Mirakian, Mary Martinez and Holly Gordon.

Mary Martinez, Dr. Humberto Caldera, Dr. Yvette Laclaustra and Chrissy Rothwell.

Lori Anthony, Dr. Kishore Dass, Ravi Patel and Dr. Luis Vinas.

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You are cordially invited...

Mayra Diaz, Marilyn Reyes, Gracy Joshua, Dr. Seetal Mewar, Dr. Patricia Masse and Martha Vargas.

Kristi Hartman and Gene Lipscher.

r. Patricia Masse welcomed her colleagues and friends at her open house at 10115 W. Forest Hill Blvd. on June 14.

Dr. Kishore Dass and Dr. Patricia Masse.

Linda Bradford and Lisa Grasso.

Mary Martinez and Tony Pollack.

Cheryl Passino, Samir Qureshi and Ruthie Greenberg.

JFK Medical Center Physicians Perform Region's First Aortic Valve Replacement via Catheter

tlantis, FL --- Cardiologists and Heart Surgeons at JFK Medical Center have begun offering transcatheter aortic valve replacement (TAVR) with the Edwards SAPIEN Valve. JFK Medical Center is one of the select hospitals in the United States to offer this treatment to patients. This new way to perform heart valve replacement enables the placement of a collapsible aortic heart valve

into the body via a catheter that is inserted through the leg, and threaded up to the heart. JFK Medical Center is the first Heart program in Palm Beach and the Treasure Coast to offer this nonsurgical therapy outside a research study.

The TAVR procedure is currently only approved for people with life threatening valvular disease, and are not surgical candidates. Because of its curative nature,

the TAVR procedure represents a major advance for inoperable patients. In other words, patients who would have otherwise had no surgical options now have a way to cure their valve disease. The TAVR procedure is performed in a Hybrid Cardiac Operating Suite. This Hybrid OR allows for advanced procedures utilizing cardiac catheterization equipment combined with the amenities of a full service operating room. Cardiologists and

cardiac surgeons make up the multidisciplinary team who perform these procedures.

Unlike the traditional open heart surgery, TAVR patients require a leg incision through which a catheter is passed. Patients do not require the use of a bypass machine and recovery is typically one to three days in the hospital. Once home, patients are able to get around better than before the procedure.

The Edwards SAPIEN valve received FDA approval in November and doctors and surgeons at JFK Medical Center are the first in the region to begin offering this therapy to appropriate patients.

For more health information and the latest news, visit JFKMC.COM or follow us on Facebook and Twitter

JULY ISSUE • 2012 17

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Bethesda Memorial Hospital Honors Survivors

t was time to kick up your heels and join in for a little celebration... of line dancing. On June 15, Bethesda Memorial Hospital celebrated National Cancer Survivor's Day. The room was filled with survivors and several members of the hospital staff all enjoying some entertainment and lunch.

Celebration of Life – Survivors’ Day

our lives are unpredictable, so little we control so much is still a mystery, our origins, our soul We often pause to wonder why things happen as they do We all must face our challenges; it could be me or you

But how we play the cards we’re dealt, is something we control We’re often really unprepared to play our given role We often learn right on the job, the job that must be done in caring for someone we love, a mother, friend, or son

Dr. Jerome Spunberg opened the event as well as his heart, by reading two poems that he had written. Both were incredibly beautiful and therefore, we decided to reprint one for all to enjoy.

Now With With With

all of you know what i mean, since you have had to deal obstacles to overcome, with struggles all too real outward pain and inner fears, with feelings of despair times when it all seemed too much, too much for you to bear

With times when you felt giving up was better than to fight With times when you felt lonely, lost, awakening at night Wondering why the punishment, thinking that you’ve sinned those times your loved ones rallied round, to give you second wind

Tammy Gallo with Marissa.

We all are born with instincts, chief among them to survive there is a force within us pushing us to stay alive a force we’re not aware of until threat of death appears a force that helps us overcome our squeamishness and fears

a force a force a force a force

that says you must go on, you feel like turning back that keeps you on the path, like horses on a track that makes you stronger than you ever thought you’d be that’s inspirational, that sets your spirit free

a force that cannot be explained, a force we all possess a driving force that’s dormant, underutilized unless We’re forced to face reality, as all of you well know reality that takes us where we never thought we’d go

and all of you are testament to courage at its best the courage to put pessimism, hopelessness to rest the courage to wake up each day, and try to wear a smile the courage that inspires you to go that extra mile

Dr. and Mrs. Spunberg, Katiann Susich, Samir Qureshi and Jen Kelly.

the the the the

courage courage courage courage

to to to to

come in that day, when you would rather quit get up and walk, when you would rather sit sit down to eat, when food has no appeal go on with life, no matter how you feel

Now there are shows that try real hard, real hard to recreate a world where one’s survival skills can influence one’s fate But all of you survivors know that life is not a game You all are true survivors, that’s the reason that you came

Dr. Matthew D'Alessio and Angelie Palahunik.

Mort Kuff, Dr. Jerome Spunberg, Angela Kuff and Susan Toovell.

to share with us a moment and appreciate your life forget about the X-rays, all the drugs, the surgeons’ knife to put it all behind you, and not dwell upon the past to make the most of every day, to live your life at last

to celebrate how far you’ve come, how much you have endured so much doubt, uncertainty, the outcome not assured to reach this point, to stand up proud, knowing that the way the secret to survival is to take it day by day

and so i now salute you, for you all i do admire Your presence here is moving, you encourage, you inspire You are a prime example of the heroes we can be the strength that we discover as we face adversity

let’s raise our glasses high and toast the heroes that you are ordinary people with the strength to get this far living proof to everyone that we all have the drive to live life to the fullest, yes, above all, to survive!!

Written by Jerome J. Spunberg, M.D. any reprint or reproduction without prior written consent is prohibited.

Survivors enjoyed some line dancing.

GOLF TOURNAMENT TO BENEFIT THE “KIDS CANCER FOUNDATION”

HELP US HELP KIDS FIGHT CANCER

the Kids Cancer foundation is a non-profit charity whose mission is to provide hope and support to children and their families.

Saturday, July 28, 2012 Check-In: 12:00 pm, Shot Gun Start 1:00 pm (scramble) BOCA GREENS COUNTRY CLUB

individual golfer: $ 45.00 adult/ $ 35.00 junior

Player# 1: _____________________ / email: ____________ / phone: __________

Player# 2: _____________________ / email: ____________ / phone: __________

Player# 3: _____________________ / email: ____________ / phone: __________

Player# 4: _____________________ / email: ____________ / phone: __________

method of Payment: make check payable to Kids Cancer foundation mail to: 9569 New Waterford Cove, delray Beach, fl 33446

Prizes:

- 4 round of golf-2 golf carts at Polo Club, Boca raton - 4 round of golf-2 golf carts at Hunters run, Boynton Beach Hole 19 multiple raffles. informal reception.

Fax this form to (305)-704-3120, email to: axlboca10@hotmail.com Or etelvinograd@yahoo.com, or call (561)-414-9800 for info

18 JULY ISSUE

• 2012

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Wellington Regional Medical Center Class of 2012

n June 20, the culmination of hard work, patience, dedication and complete commitment was clear as Wellington Regional Medical Center celebrated with their residency graduation dinner and ceremony at Breakers West.

It was an exciting and memorable evening, not only to those students that have worked so hard and achieved so much, but for those physicians that have given their time and expertise in teaching them the skills and techniques that they will carry with them for a lifetime. The Director of Medical Education and Chief Medical Officer, Dr. Jeffrey Bishop, was elated as he presented the diplomas to the graduates. Graduating Dermatology Residents: Dr. Mary Elizabeth Leveritt Dr. Danielle Manolakos

Graduating Internal Medicine Residents: Dr. Farhan Rashid Israr Dr. Kanwal Akhtar-Kamal Dr. Adam Oliver McDaniel Dr. Melissa Rose Mora Dr. Alissa Tomaiolo Lamoureux

Dr. Bishop, Dr. Widdows and Dr. Gunawardene with the WRMC Class of 2012.

Charlene Bishop, Former Wellington Mayor, Tom Wenham and Regis Wenham.

Graduating Traditional Rotating Interns: Dr. Stephen Derrington Dr. Marcia Hoffheimer Dr. Keith Thompson

The following residents are continuing in their training: Dr. Swati Chalavarya, Dr. Arpit Patel, Dr. William Stechschulte, Dr. Kelvin Akhigbe, Dr. Marianna Zelenak, Dr. Gregory Polar, Dr. Suzanne Horwitz, Dr. Matthew Zarraga, Dr. Frank Don and Dr. James Landero. In addition to the awarding of diplomas, there were also several awards given to the following recipients:

Dr. Stephen Derrington, Dr. Marcia Hoffheimer, Dr. Keith Thompson and Dr. Jeffrey Bishop.

Dr. Mohammed Yaqub, Dr. Adam Bromberg, Dr. Howard Busch, Dr. Alissa Tomaiolo Lamoureux and Dr. Bishop.

Golden Apple Award - Dr. Adam Bromberg Residents Choice Award - Dr. Mohammed Yaqub Andrew B. Egol Award - Dr. Howard Busch Most Valuable First Year Resident Award - Dr. Arpit Patel Most Valuable Senior Resident Award - Dr. Alissa Tomaiolo Lamoureux Resident Teacher of the Year - Dr. Keith Thompson Attending Physician of the Year - Dr. Steven Sacks

Again, we would like to thank congratulate the Class of 2012 and wish them all the success in the coming years.

Wellington Regional Medical Center has been training residents for over 20 years and currently trains residents in Internal Medicine, Dermatology and traditional rotating internships. If you would like additional information, please visit their website at www.wellingtonregional.com. DEAR DEBORAH: I have been dating someone for a short period of time (couple months) and he wants me to get breast implants. I've always thought about it, but he is insisting that I get a size larger than I am comfortable with. What should I do? - Buxom Beauty

Dear Buxom Beauty: There is a lot to consider here. First, if YOU want to get breast implants, that’s one thing. However, if you are going to get them done because your boyfriend wants you to, that is another story. You need to consider that any surgery is major surgery. If you want larger breasts, you need to think about your body frame. If you go too large for your frame, you may develop medical problems and be in the operating room again. If you are tiny and he wants

Maria and Dr. Mikolajczak.

you to get implants that are too large, I would say, no. Getting breast implants is a personal choice and you should be the only person making that decision for the right reasons and not for anyone else. Whatever you decide, please do your research regarding the surgery and to find a good plastic surgeon in your area.

DEAR DEBORAH: I'm engaged and recently found out that my fiancé is still communicating with his ex. fiancée frequently. He insists that he is over her and that it is nothing. However, she says that he is the one always contacting her first. What does this mean? - Frustrated

Dear Frustrated: Is there any reason for them to continue communicating? Such as children, bills, money, or

Graduating Internal Medicine Residents with Dr. Joanna Widdows and Dr. Bishop.

work? If there is no reason and it makes you feel uncomfortable, you need to discuss it with your fiancé. If he has a problem and does not want to cease communication, than he has no regard for your feelings and that in itself will present problems in the future.

DEAR DEBORAH: I found my finance’s profile on a dating website. He says it was from before he met me and I wasn't able to see his last login on the website. Should I trust him or look into it further? We have been together only six months, so I guess it is possible that it was from before he met me. - To Trust OR Not To Trust

Dear To Trust OR Not To Trust: He may very well have had a profile online before you met.

Dea r Deborah However, as you are now engaged, his profile needs to be removed – immediately!!!

DEAR DEBORAH: I'm engaged to be married. We have been together for seven months and I am 15 years his junior. I have two young boys from a previous marriage and he has never made it down that aisle, although he has been engaged four times before me. We recently set a wedding date and started planning our big day. However, I am a little concerned about his past and why the other engagements did not work out. Should I see this as a red flag? - Is Five a Charm? Dear Is Five a Charm? How long have you known him? How long did he know them before getting engaged? How

long has it been since his LAST engagement? So many questions and just one answer... YES! There is definitely a pattern here. It’s great to fall in love and it can happen very quickly, or develop over time. That being said, with his history, I do not feel that you have known him long enough to be planning a wedding. You need to sit down with him and have a discussion about why these prior relationships did not work out and why he feels this one is different. Remember, he will be giving you his side of the story as well, so keep an open mind. I would certainly wait for at least a year and preferably longer – not only for yourself, but for the sake of your children.

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.

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