Health Watch 04-28-13 by The Times

April 2013 | North Georgiaâ&#x20AC;&#x2122;s Health & Prevention Magazine

IN THIS ISSUE

Autism diagnoses

are on the rise ...page 18

Seasonal allergies

can prompt asthma attacks ...page 2

FEATURING

GAINESVILLE HEART AND VASCULAR GROUP

PAGES 12 &13

Sunday, April 28, 2013

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Seasonal allergies can prompt asthma attacks By Charles Phelps

time of day to be outside is in the morning, because that’s when the pollen count is the highest. “Last year and this year are bad It’s spring, meaning those with (pollen) seasons. A mild winter allergies are getting reacquainted with sneezing and coughing, but leads to a bad allergy season. The for some allergy related respira- most common symptoms of allertory problems can escalate for gies are itchy eyes, runny nose and sneezing. those who have asthma. “Allergies lead to asthma, as well According to Dr.Ronald G.Beebe of Allergy, Asthma and Immunol- as contributing to respiratory inogy at The Longstreet Clinic, tree fections. ... You can have asthma, pollen, including oak, hickory and and not be allergic, but it’s rare. pecan, are the types of pollen that That’s why we encourage allergy can lead someone to have an aller- shots, to hopefully prevent asthma gic reaction or an asthma-related or at least help keep it under control.” attack. Beebe said most people who “Tree pollen in Georgia starts in mid-February and runs through develop asthma are treated with summer,” he said. “Tree pollen is a daily inhaler or daily steroids to the worst allergy (pollen). You try and control it. Some may take have a little grass pollen (as well).” a pill known as Singulair. “Singulair pill is also used in When it comes to allergies and preventing someone with asthma asthma treatment, and is really the from having a bad attack, Beebe only medicine that treats both (alsaid you should try to avoid out- lergies and asthma),” Beebe said. Out of all types of asthma, allerdoor activities and keep windows closed. Those who take medica- gic asthma is the most common tions to control asthma symptoms form of asthma.Allergic asthma is need to be sure and do so during triggered by inhaling things like allergy season, and for some, al- dust mites, pet dander, pollen and lergy shots are the best course of mold. If you experience any of the treatment. “A shot desensitizes you, so asthma symptoms, Beebe said you overtime (a shot) could poten- should see your primary care physician, who can make the determitially cure you,” he said. According to The Longstreet nation as to what could be causClinic’s website, approximately ing the symptoms and then refer 50 million Americans suffer from you to a specialist, like an allergist. But those symptoms don’t alasthma, hay fever or other allergyways mean asthma. For example, related conditions. The most common symptoms chest tightness could be a heart of asthma are chest tightness, problem, and that would be coughing, shortness of breath and looked at first. “(The heart) may be No. 99 on wheezing. a list of 100 things of what someBeebe noted that coughing sometimes is the only symptom thing could be, but it would beexperienced, and that symptoms come the No. 1 thing to be looked can often occur at night or after at to make sure everything is OK exercise. Beebe also said the worst (with the heart),” Beebe said. cphelps@gainesvilletimes.com

Scott Rogers/The Time Dr. Ronald Beebe meets with allergy patient Greg Jones at his office in the Longstreet Clinic

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Sunday, April 28, 2013

Cause of that ringing in your ears could be a mystery By Charles Phelps

cphelps@gainesvilletimes.com Has there been a time when you heard a constant noise in your ear, and then it went away? If so, you may suffer from what’s known as tinnitus, or “ringing in the ear.” The noise can last for seconds, minutes, maybe even a month. However, there is not a known origin of tinnitus; there are only different factors and causes that are observed. “It’s really a mystery. We don’t know where it came from,” said Katie Mawhinney, audiologist of the ENT Institute. “Some medications cause it. ... It’s very common with hearing loss.” Mawhinney said someone with tinnitus would experience a noise similar to a buzzing, humming or chirping noise. “There’s all sorts of ways to describe it. However, it’s a subjective sound. No one else can hear it but the person it’s affecting.” Audiologist Jeanne Barno of the Northeast Georgia Otolaryngology, said some herbal remedies,most commonly seen in late night television ads and radio spots, do sometimes work to treat tinnitus,“but probably 50 percent of the time. Usually when they work, they have to finish out the supplement supply. “A lot of people want to know how to tell if it is a serious problem, or an aging thing,” Barno said. “They can monitor the tinnitus, like when does it happen, is it really bothersome, like range on 1-10 pain scale.” If it is pulsive tinnitus, or the sound seems in tune with with your heart beat, then that could be a sign of something serious in the vascular area, Barno said. Barno also said symptoms of tinnitus can include dizziness, headaches and hearing loss.

“Just monitoring it can guide them to if they need to see a doctor to discuss further,” she said. Both audiologists said loud noises that lead to hearing loss can also lead to tinnitus, and that wearing hearing protection can help prevent this from happening.They said that if you take medications, check to see if tinnitus is a side effect, because that can be a cause for development as well. If someone suffers from tinnitus, Mawhinney says hearing aids can help mask the noise. “Not in every case, but a lot of cases, hearing aids can mask over the sounds,” she said. She also said someone with tinnitus could be more prone to hear the noise at night. “If it’s constant, people need to see an ENT, or audiologist specialist,” Mawhinney said. Barno added that multi-vitamin therapy, lipoflavonoids, can be effective treatments as well. She also said, “tinnitus maskers, like sound generator machines and controlling the blood flow to the brain either through asprin therapy or cervical neck manipulation,” are effective as well. There’s also no predominant age range for people with tinnitus. It can happen to anyone. Barno said she has treated children as young as 9 and 10 years old who have tinnitus. According to a review in 2011 from audiology.org,“Tinnitus Prevalance,” approximately 30 million Americans have tinnitus and the prevalence of tinnitus is generally correlated with a degree of hearing loss. The finding also stated that approximately 1 in 4 tinnitus sufferers report it as loud, and 1 in 5 report their tinnitus is disabling or nearly disabling. Military members and musicians are at a high risk for tinnitus because of the loud noises they are around.

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Sunday, April 28, 2013

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Bacteria cause of painful ‘swimmer’s ear’ By Charles Phelps

cphelps@gainesvilletimes.com As spring kicks in to high gear and pushes towards summer, one activity sure to pick up in popularity is swimming. Whether it is at a lake, pool or trip to the ocean, many will venture out into the water as the weather warms. For some, a refreshing swim may result in ear pain. According to Dr. Allen P. Butler, M.D. of Northeast Georgia Otolaryngology, the most common cause of an outer ear infection is the retention of water within the ear. “Kids are going to be more affected because they like to be in the pool for longer periods of time,” he said.“Plugs can be helpful (as prevention).” However, Butler said that swimming in a chlorinated pool typically will not affect someone. “It’s normally lake and pond water that put people at risk because of the bacteria,” he said. Butler said swimmer’s ear isn’t the only potential problem for that part of the body this time of the year. Those who suffer from allergies are also at risk of an outer ear infection. Some of the symptoms of outer ear infection include pain in the ear, swelling and drainage. Butler said the ear canal will turn red when there is an infection. “Most times people say ‘I can’t hear, or my ear hurts real bad,’” he said. “If (the) ear is in pain, I recommend alcohol and vinegar drops, two times per day, for two days or so,” he said. “The purpose of the alcohol is to dry up moisture and evaporate the body temperature. The vinegar helps to keep bacteria and fungus from flourishing

(inside the ear).” He said the typical ear drops someone would use to help alleviate the pain from their ears are ZoSol and Acetasol. “If no improvement (after two days), then (the patient) should see a physician.” As far as allergies resulting in ear pain, tree pollen is affecting people the most right now who suffer from allergies. In the summer, it will be grass pollen, and weeds will be the culprit come the fall season, butler said.. He also said a simple way to test if you have an outer ear infection is by applying pressure to the tragus, the fleshy protrusion of cartilage that covers a portion of your ear opening. According to Butler, the tragus is normally not sensitive to gentle pressure, but he said if you touch the tragus and it hurts to put any pressure on it, then that’s a general sign that you have an outer ear infection.

Inspiring the Mind, Body and Spirit

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Sunday, April 28, 2013

Autism diagnoses are on the rise, study finds By Alan Zarembo Los Angeles Times

Control and Prevention and the Department of Health and Human Services. “The increase we see is most U.S. schoolchildren are being dilikely due to better ascertainagnosed with some form of autism at a record rate of 1 in 50, accord- ment,” said Stephen Blumberg, lead author of the study and a ing to a new government study. That rate of 2 percent is based senior scientist at the CDC’s Naon a survey involving tens of thou- tional Center for Health Statistics. The analysis, released Wednessands of children between the ages of 6 and 17. A similar survey day, found large numbers of chilin 2007 found a rate of 1.2 percent. dren who were diagnosed with an Though the increase is likely to autism spectrum disorder years affuel speculation that an expand- ter their symptoms probably being environmental threat is became apparent —especially older hind the rise in autism cases, the boys whose parents gauged their authors said their report did not cases as mild. The wide-ranging disorder support that view. Rather, better detection ap- emerges by age 3 and is diagnosed pears to be driving the surge, ac- by its collection of symptoms, incording to the researchers, from cluding problems with socializathe national Centers for Disease tion and communication as well

as repetitive behaviors or obsessive interests. The number of children diagnosed with autism has been climbing for more than two decades, though it is unclear to scientists whether children today are at greater biological risk than those in past generations. Much of the rise can be explained by a broadened definition of the condition, rising awareness of it and the fact that a formal diagnosis can lead to better access to services, experts say. The most comprehensive assessment of autism prevalence in the U.S. comes from a surveillance network set up by the CDC in the 1990s. It periodically scours school and health records of 8-year-olds in several states, look-

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ing for autism diagnoses and clusters of symptoms. Its most recent analysis, using 2008 data, found an overall rate of 1 in 88, up from 1 in 150 in 2000. Tremendous geographic and racial variation, however, suggested that social factors played an important role in determining whether a child was diagnosed with the condition. The new study is based on the National Survey of Children’s Health, a survey of more than 90,000 households with children that is conducted every four years. Parents were asked whether their children had been diagnosed with autism, when they were diagnosed and whether the cases

Please see Autism page 16

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Sunday, April 28, 2013

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Barefoot days of summer can harm your feet By Meredith Pruitt

mpruitt@gainesvilletimes.com The weather is warming up, and the shoes are coming off. With many headed to the beach or wanting to finally feel the grass between their toes, it is barefoot season. It is not unhealthy to walk around barefoot, but one has to consider health risks and be safe when doing so. “You’ve got to be cautious about when you do it and how much of it you do,” said Dr. Sean Dunn, a podiatrist at the Foot & Ankle Clinic of Oakwood. Dr. Dunn says that there are risks for fungal and parasitic infections when going barefoot. Parasites are more common in sandy areas. He also says that when walking in a public pool area, there is a higher risk for warts. Warts are caused by a virus that thrives in warm, moist areas. Another thing people commonly think about when going barefoot is ringworm. This is a legitimate risk to be considered, along with athlete’s foot. “It’s definitely an issue,” Dr. Dunn said. “It’s the same actual fungus that causes (both ringworm and athlete’s foot).” Different types of people can have different issues when walking barefoot, but those with diabetes need to be extremely careful, Dr. Dunn said. “In a diabetic, a puncture wound can be limb-threatening,” he said. “If you’re a diabetic, the safest thing is to keep your feet protected.” Injuries and wounds aren’t the only concern in protecting your feet. “Besides general injuries such

Tom Reed/ The Times Dr. Patrick Dunn does a foot exam at the Oakwood Foot & Ankle Clinic of Oakwood

as cuts, scrapes and punctures when stepping on something sharp, there can be additional concerns,” said Dr. Kommerina Daling, a family physician at The Longstreet Clinic in Oakwood. According to Dr. Daling, hazards can vary by location and circumstance. In wet environments such as around pools, fungal skin infection (athlete’s foot) is the most common risk. That risk is smaller for a person who goes barefoot all the time, as it helps keep the skin dry. Another potential hazard comes from snakes or other creatures hiding in the woods or tall grass. Dr. Daling says that people who go barefoot all the time develop stronger feet and skin, and may become less prone to small injuries.

“Barefoot walking can lead to blisters or calluses, as a result of undue friction or pressure to an area of skin,” says Dr. Daling. “In fact, these skin reactions can also result from walking in ill-fitted shoes.” As a final note, Dr. Daling cautions people with diabetes to be extra vigilant in protecting their feet from hazards. The reality is that most people will take advantage of the warm weather and walk barefoot, but the health hazards that come along with that are real. It is best to take caution and know when to slip the shoes back on. Tom Reed/ The Times On the right. Dr. Patrick Dunn examines a patient’s foot at the Foot & Ankle Clinic of Oakwood

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Sunday, April 28, 2013

Nourish your skin from the inside out By Carolyn O’Neil

for skin health, too.

MCT Information Services Just in time for spring break beach escapes and shopping trips to buy warmer weather’s skin-baring fashions, here’s advice on what to eat to nourish your skin from the inside out. Nutrition plays a starring role in skin health and anti-aging because skin cells need certain nutrients to repair and regenerate. Inspiration can be found by checking spring fashion trends.The Pantone Color Institute, known for predicting the exact hue and shade of colors to hit runways, chose a palate for spring 2013 that sounds pretty food friendly. Lemon zest, nectarine and tender green shoots are on their top color list, along with poppy red for lips and fabrics. They’re on the top list

COLOR ME HEALTHY Citrus fruit, nectarines and green leafy vegetables are good sources of vitamin C, which is vital for building collagen, which is a spongy network of fibers that keeps skin plump, elastic and wrinkle-free. Other sources of vitamin C include red peppers, tomatoes, strawberries and kiwi fruit. For more skin health, think deep red tomato sauce and red peppers for lycopene. This carotene-like compound may even help blunt sunburn damage. A study in the British Journal of Dermatology showed that lycopene protected against ultraviolet light exposure and reduced premature signs of aging in the skin. Antioxidants found in a wide vari-

When its your heart results matter

ety of plant foods in a kaleidoscope of colors protect against the oxidation or breaking down of cells in the body, including the skin. Don’t want to look like a prune? Eat more of them.

wound healing. Sources of protein include poultry, fish, beef, pork, eggs, fat-free or low-fat milk, soy foods, beans, nuts, seeds and nut butters. Sources of zinc include oysters, legumes or beans, nuts and seeds, SKIN FRIENDLY oatmeal, poultry, wheat bran and There’s something to that “foun- wheat germ. tain of youth.” Drinking water keeps Healthy mono-unsaturated oils in skin moisturized from the inside. olive oil and avocados help keep Overdoing it at the bars or even skin moisturized by regulating wacoffee bars can show on your face. ter content within the cell wall and Avoid excess alcohol and caffeine, help the body absorb fat-soluble viwhich dries and dehydrates skin tamins A, D, E and K.The fats found and causes fine lines to be more in fish and seafood, omega-3 fats, visible. help boost skin health, too. Drink the equivalent of 8 glasses of water a day. Note that some of the (Carolyn O’Neil is a registered fluid can come from water in fruits dietitian and co-author of “The and vegetables. Dish on Eating Healthy and Being Protein and the mineral zinc are Fabulous!” Email her at carolynoalso essential for cell repair and neil@aol.com.)

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Sunday, April 28, 2013

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Report cites health risks of ‘cinnamon challenge’ By Rachael Levy

Chicago Tribune The cough-inducing effects of taking the “cinnamon challenge,” in which thrill-seekers try to swallow a spoonful of cinnamon without water in less than a minute, can be seen all over the Internet. Some health experts have voiced concerns over the dare taken on mostly by teenagers, but the lead researcher in a new report published online this month says it may lead to inflamed and scarred tissue common in lung diseases like pulmonary fibrosis and emphysema. The report, whose results will also be published in an article in the May edition of the Pediatrics health journal, was based on testing with rats. Dr. Steven Lipshultz, the lead researcher, said the rats were made to breathe in cinnamon powder one time, then were followed as they aged. “(The) cinnamon would coat the airways and the lungs (of the animals) and it would lead to inflammation,” Lipshultz said.“It wouldn’t stop there. The inflammation led to scarring in the lungs, something called pulmonary fibrosis.” The lung disease, which causes shortness of breath and chronic coughing, can lead to hypoxia and, eventually, heart failure. Lipshultz, a professor of pediatrics at the University of Miami, said his team of researchers based their report on previous animal studies because they were unable to find any studies of cinnamon inhalation in humans. But the cinnamon challenge is popular among teens, particularly college students. The dare is particularly problematic for those suffering from bronchopulmonary diseases, including asthma, according to Lipshultz. “Anyone who tries to swallow a

tablespoon of dry cinnamon, when they choke on it, it not only goes down their food pipe ... they also breathe in and some of this powder goes in to their airway” and could get drawn into the lungs, Lipshultz said. Lipshultz recalled when he realized how prevalent the dare had become. While eating dinner with his family last March, he recounted his plans to travel to New York for an interview about the cinnamon challenge. His four children, who range in age from 14 to 25, said they had all already heard of the dare. “One of our kids was a freshman at Harvard, and she said, ‘Dad, everybody does this in college.’ And they started pulling up YouTube videos and started laughing. And I thought, as a pediatrician, this is

kind of startling. (The people in the videos) are stuttering; they can’t catch their breath.” Lipshultz said that the challenge, prominent on social media websites, is fueled by peer pressure and popular culture, including celebrities and other well-known figures. Illinois Gov. Pat Quinn, for instance, tried the dare on a radio show last year, though a video on YouTube shows him gulping water to swallow down the spice. For the first six months of 2012, there were 178 calls to the U.S. American Association of Poison Control Centers related to the cinnamon challenge, according to the study. Dr. Scott Goldstein, a pediatrician at The Northwestern Children’s Practice, said he hadn’t seen any cases, nor had he heard of the dare, but he wasn’t surprised of the po-

tential consequences. “If you inhale (cinnamon), that could be pretty dangerous, because it’s like a powder,” Goldstein said. “It’s like when we tell parents not to use baby powder”—because the powder could be inhaled by an infant and get into the lungs, he said. Lipshultz says the number of cases that have been reported nationwide is only the tip of the iceberg. “Those numbers relate to people intentionally calling (in). ... You know as well as I do that if you have a teenager or college student who becomes ill, how common is it for somebody to call a poison control center? Not that common,” he said. Asked whether any of his four children had tried the dare, Lipshultz didn’t think so. But, he added, “I’m their father. I’d probably be the last to know.”

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Sunday, April 28, 2013

Lasers, creams can help with scars By Meredith Pruitt

mpruitt@gainesvilletimes.com Most don’t like to talk about them, but many people have scars from years past. Whether they are from surgeries or just from small wounds, scars can be hard to remove, if you should choose to try and do so. “There are a lot of different options (for scar removal),” said Dr. Misty Caudell, a dermatologist at Dermatology Associates of Northeast Georgia.” It really would depend on the type of scar and the history of the person.” Caudell said there are many new procedures that use lasers to remove scars. Other treatments include the use of steroids and topiPlease see Scars page 10

Scott Rogers/ The Times Dr. Misty Caudell, of Dermatology Associates of Northeast Georgia, guides an instrument that emits a laser over a patient’s area of skin with a scar. Laser therapy removes a thin layer of skin at the scar exposing the less damaged skin underneath

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Sunday, April 28, 2013

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Scars Continued from page 9 cal silicone. The procedures that require excision or laser surgery are safe, Caudell said. The newest procedures have been proven in medical institutions and the results published in medical journals. Caudell also says that even deep, long-lasting scars are treatable. “Scars are better treated earlier on, but some scars, depending on the type of scar, can be treated once they’ve been there for quite some time.” For those who are skeptical, or squeamish, about medical procedures to remove scars, over-thecounter “miracle creams” might seem like a better option. However, not all of these have been clinically proven to work. There are a few options you can try at home. “The ones that I think are the best are the silicone creams, or simply massaging with petrolatum,” Caudell said. The treatments, of course, really depend on the type of scar. There are many different types of scars, and some are more visible than others. “The most common (scars) that I address are hypotrophic scars, which are thick scars that occur at excision lines that do not exceed the excision line itself,” Caudell said. She said these scars are usually very red, obvious scars, which is why they most commonly are removed. With warmer weather approaching, it is best to be aware of how sun exposure can affect scars. Treatments will only be effective if the scars are protected from the sun. It is best to contact a dermatologist to see what treatment works for a specific type of scar.

Scott Rogers/ The Times Dr. Misty Caudell, of Dermatology Associates of Northeast Georgia uses laser technology to remove a scar from a patient. A simple process for many types of skin disorders, a laser moves along the length of a scar or an area full of scars, and removes the top layer of skin

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Sunday, April 28, 2013

From LASIK to Cataracts, THE Laser Eye Surgery Team for Northeast Georgia

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Sunday, April 28, 2013

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GAINESVILLE HEAR

At Gainesville Heart & Vascular Group, we believe that the patient is the center of our practic We are committed to providing the best possible care through diligent clinical evaluation an appropriate use of state-of-the-art technology. Guided by compassion for each individual, w strive to provide convenience and peace of mind to our patients by providing most servic under one roof. Our ultimate goal — help our patients achieve a better quality of life.

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Sunday, April 28, 2013

RT AND VASCULAR GROUP Cardiovascular disease affects over 80 million people in the United States.

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Risk factors associated with cardiovascular disease include age, diabetes, high blood pressure, high cholesterol, tobacco use and family history of cardiovascular disease. Symptoms associated with cardiovascular disease include chest pain, shortness of breath, arm/leg pain, loss of consciousness and fatigue. We at the Gainesville Heart and Vascular Group specialize in prevention, diagnosis and treatment of cardiovascular disease. Established in 1994, the Gainesville Heart & Vascular Group, formerly known as the Gainesville Heart Group, is recognized as the first cardiology practice dedicated to the care of heart patients in Gainesville and surrounding areas. Its founder, Dr. David P. Johnson is a Gainesville native who had a dream of providing full-time and full-service cardiac care to the community. He and his partners played an integral part in bringing the Open Heart Surgery Program to Gainesville in 2002.

Our staff has a reputation of applying a personal touch to our care and cherishing the relationship we have with our patients. Our staff, including physicians, enjoys residing and being an active part of the Hall County community. Our office has a wide variety of services, including general cardiology consultation, electrocardiography, echocardiography / 2-D Doppler, stress echocardiography, nuclear stress testing and ankle brachial pressure index. Our physicians are staffed round the clock, 365 days a year, at the Northeast Georgia Medical Center. Cardiac catheterizations, including coronary and peripheral artery stenting, stress testing, transesophageal echocardiography and pacemaker devices are performed at the Northeast Georgia Medical Center. We would enjoy an opportunity to meet with you to prevent, diagnose and treat cardiovascular disease.

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DNA science points to better treatment for acne By Eryn Brown

Los Angeles Times Ancient Egyptians were vexed by it, using sulfur to dry it out. Shakespeare wrote of its “bubukles, and whelks, and knobs, and flames o’ fire.” Today, acne plagues us still. Doctors can cure some cancers and transplant vital organs like hearts, but they still have trouble getting rid of the pimples and splotches that plague 85 percent of us at some time in our lives —usually, when we’re teenagers and particularly sensitive about they way we look. But new research hints that there’s hope for zapping zits in the future, thanks to advances in genetic research. Using state-of-the-art DNA sequencing techniques to evaluate the bacteria lurking in the pores of 101 study volunteers’ noses, scientists discovered a particular strain of Propionibacterium acnes bacteria that may be able to defend against other versions of P. acnes that pack a bigger breakout-causing punch. As best as dermatologists can tell, zits occur when bacteria that reside in human skin, including P. acnes, feed on oils in the pores and prompt an immune response that results in red, sometimes pus-filled bumps. But the study subjects who had the newly discovered bacterial strain weren’t suffering from whiteheads or blackheads, according to a report published in the Journal of Investigative Dermatology. Someday, the realization that “not all P. acnes are created equal” might help dermatologists devise treatments that more precisely target bad strains while allowing beneficial ones to thrive, said Dr. Noah Craft, a dermatologist at the Los Angeles Biomedical Research Institute who conducted the study with colleagues from the University of California, Los

Angeles and Washington University in St. Louis. Doctors might prescribe probiotic creams that deliver “good” P. acnes to the face the same way a daily serving of yogurt helps restore healthy bacteria in the digestive tract. “There are healthy strains that we need on our skin,” Craft said. “The idea that you’d use a nuclear bomb to kill everything —what we’re cur-

rently doing with antibiotics and other treatments —just doesn’t make sense.” The research is part of a broad effort backed by the National Institutes of Health to characterize the so-called human microbiome: the trillions of microbes that live in and on our bodies and evolve along with us, sometimes causing illness and often promoting good health.

Most of the microbiome attention so far has gone to studying species in the gut, said study leader Huiying Li, an assistant professor of molecular and medical pharmacology at UCLA’s Geffen School of Medicine. But the NIH’s Human Microbiome Project, which funds her research, also looks at microbial communities in the nasal passages, the mouth, the Please see Acne page 15

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Acne Continued from page 14 urogenital tract and the skin. Li said she became interested in studying acne because the skin microbiome seemed particularly understudied. The research team recruited 101 patients in their teens and 20s from dermatology clinics in Southern California.Among them, 49 had acne and 52 had “normal skin” and were not experiencing breakouts but had come to the clinics for other problems. Doctors used adhesive pore strips to remove skin bacteria from patients’ noses. The researchers then collected the waxy plugs —a combination of bacteria, oils, dead skin cells and other stuff —and used DNA to figure out which bacteria were present.

They found that the P. acnes species accounted for about 90 percent of the bacteria in pores, in both healthy patients and acne sufferers. Digging a little deeper into the DNA, they found that two particular strains appeared in about 20 percent of acne sufferers, while a third strain was found only in acne-free patients. “Dogs are dogs, but a Chihuahua isn’t a Great Dane,” Craft said. “People with acne had pit bulls on their skin. Healthy people had poodles.” The team then sequenced the complete genomes —about 2.6 million base pairs apiece —of 66 of the P. acnes specimens to explore in more depth how the good and bad strains differed. The two notable bad strains had genes, probably picked up from other bacteria or viruses, that are thought to change the shape of a microbe to make it more virulent. The researchers hypothesized that the foreign DNA, perhaps by sticking more effectively to human host tissues, may help trigger an inflam-

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matory response in the skin: acne. The good strain, on the other hand, contained an element known to work like an immune system in bacteria, Li said. Perhaps it allows this P. acne to fight off intruders and prevent pimples from forming. Li said the researchers did not know why some people had the bad P. acnes strains and others did not, and whether genetics or environment played a bigger role. Dr. Vincent Young, who conducts microbiome research at the University of Michigan Medical School but wasn’t involved in the acne project, said advances in sequencing technology and analysis made the new study possible. In the past, he said, scientists wouldn’t have tried to sequence dozens of genomes in a single species. “They’d say, why waste the money?” he said. “Now you can do this in a couple of days.” Li and Craft —neither of whom suffered bad acne as teens —plan to keep up the work.

Sunday, April 28, 2013

More research is needed to come up with super-targeted anti-microbial therapies, or to develop a probiotic cream for acne sufferers. Craft continues collecting samples from patients’ pores. He hopes to study whether twins share the same microbial profiles, how acne severity is reflected in bacteria populations, and how things change in a single patient over the course of a treatment regimen. One of the study volunteers, 19-year-old University of California, Santa Cruz student Brandon Pritzker, said he would have loved to have treated his acne without affecting the rest of his body. When he took Accutane, he suffered back pain and mood shifts. Now off the drug, Pritzker said he is at peace with his pimples. “I still have breakouts, but I figure I’m 19, that’s the way it’s going to be,” he said. But, he added,“it hindered my confidence at the time. Kids with clear skin are probably a little happier.”

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said many milder cases were not formally identified until children entered school and it became clear that they required extra services. Sometimes the full extent of a child’s problems is not seen until later grades, as school and social life become more challenging. were mild, moderate or severe. An autism diagnosis can open The diagnosis rate for boys ages 6 to 17 was 3.2 percent, up from the door to behavioral therapy or 1.8 percent in 2007. The rate for help with speech and social probgirls was 0.7 percent, which is not lems. The study did not attempt to a statistically significant change from the previous rate of 0.5 per- verify whether children whose parents identified them as autiscent. The rate among youths 14 to tic met the formal criteria for the 17 more than doubled, from 0.7 disorder. Some autism advocates said the percent to 1.8 percent. Nearly 14 percent of these received their di- new study should be used to highagnoses after 2007, though their light the growing need for autismsymptoms would have been pres- related services. “I’m tired of people worrying ent long before. And nearly 70 percent of these cases diagnosed about why this is happening,” said later were classified by parents as Judy Mark of the Autism Society of Los Angeles.“We need to focus on mild. Laura Schieve, a CDC epidemi- the fact that these people are out ologist and co-author of the study, there.”

Autism

Continued from page 5

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Sneezing and wheezing: springtime allergies have arrived! ered a major nuisance in our daily lives. It is the fifth most common chronic disease among adults and the most common chronic disease Longstreet Clinic among children, causing fatigue, Your nose is running, your eyes are poor sleep and loss of concentrawatering and you see a blanket of tion. The cost of allergic rhinitis is yellow pollen everywhere you look. estimated at greater than $3.5 bilThese are all positive indicators that lion annually. Oak trees, hickory trees and pecan springtime allergies are here. While living in North Georgia offers abun- trees produce the pollen that most dant amenities, it also means you live people are sensitive to in this part of the U.S. These pollens are invisin an allergy zone. Hayfever, or allergic rhinitis, af- ible unless viewed through a microfects more than 50 million Ameri- scope, which is why pollen counts cans. It is often most severe in the enthusiastically reported in the mespring when the trees begin to pol- dia can be deceiving. While the pollinate. In Georgia, the tree pollen len count may be high, it could be usually starts in mid-February and due to a particular tree pollen that really does not diminish until well does not cause a lot of trouble. Despite the wrath of Mother Nainto summer. While sneezing and a runny nose ture every spring, we are fortunate may not seem like serious health to have so many good treatments to problems, allergic rhinitis is consid- ward off allergy symptoms. Newer Advertorial provided by Dr. Ronald G. Beebe

antihistamines (Xyzal,Allegra, Zyrtec and Clarinex) work very well to block the sneezing and itching, but have none of the troublesome side effects of older antihistamines. The medication of choice for seasonal allergic rhinitis, according to many allergists, is an intranasal steroid (Dymista, Nasonex, Flonase, Rhinocort Aqua and Nasacort AQ). These are medications that are sprayed directly into the nose. Because they work locally, and are not absorbed into the blood stream, they have very few side effects.Also, studies over long periods of time have shown them to be very safe with no harmful long-term “steroid” effects. Probably the best treatment for allergies over an extended period of time is allergy shots.Allergy shots offer the potential for long-term cure because they actually “desensitize” patients to the adverse effects of

pollen.An allergy specialist can prepare an allergy shot regimen that is specific for an individual’s allergic triggers. While allergies may only cause mild symptoms in some, in others they can lead to more serious health issues. Allergic rhinitis often leads to asthma, and asthma still claims over 5,000 lives each year. Allergies can also lead to chronic sinusitis, recurrent ear infections and chronic pulmonary problems.Therefore, it is important to take allergies seriously and control them as well as possible. Ronald G. Beebe, MD, is a board certified allergist with Allergy, Asthma & Immunology at The Longstreet Clinic. His office is located at 705 Jesse Jewell Parkway, Suite 275 in Gainesville. Contact 770-536-0470 or visit www.longstreetclinic.com/allergy.

Sunday, April 28, 2013

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Bacteria’s role in regulating internal clock studied By Karen Herzog

around Hawaii, challenges conventional thinking. It turns out the squid’s internal Glowing bacteria in the tiny Ha- clock, which tells it when to forwaiian bobtail squid may shed new age for food or to sleep, may not be light on the role bacteria play in the solely governed by external light, human body to synchronize daily but might also depend on the prestasks such as sleeping and eating, ence of the light-generating bacteand keeping the immune system ria that live in its body, Madison healthy, research at the University scientists found. Future research may explore whether both light of Wisconsin-Madison suggests. Circadian rhythms in humans and the light-generating bacteria and animals —responsible for called Vibrio fischeri are necessary sleep cycles and other physiologi- to correctly tell the squid’s intercal and metabolic functions —have nal clock when the animal should long been thought to be regulated eat and sleep. The nocturnal squid has spemostly by exposure to light and darkness. The rhythms are impor- cialized proteins that reflect light tant because disrupting the body’s given off by glowing bacteria that internal clock by traveling to a dif- live in a special organ called the ferent time zone, or by working a light organ in its belly.As the squid night shift, can contribute to sleep hunts near the ocean’s surface at and immune system disorders, or night, its glowing bacteria work as conditions like seasonal affective a cloaking device, beaming light through its underbelly so its body disorder. If there’s a connection between doesn’t cast a shadow on the sea circadian rhythm and bacteria in floor and alert hungry bottomthe human gut, it would provide dwelling predators to a potential further evidence of the need to be meal. The predators see only sky; the careful with antibiotics that kill bacteria which may be important squid is invisible to them. The squid and its glowing bacteto maintaining a healthy immune system, said Elizabeth Heath-Heck- ria have a daily rhythm. In the morning, the squid expels man, a UW-Madison graduate student and co-author of the squid 90 percent of the glowing bacteresearch published this month in ria, which are taken in and grown by other young squids. The squid the journal mBio. “Nobody’s been able to show then buries itself in the sand of the that bacteria may help regulate cir- sea floor, with only its eyes peekcadian rhythms,” Heath-Heckman ing out, using its eight suckered said last week. “There are a lot of arms and two tentacles to scoop people who research circadian up sand around it. While resting during the day, it rhythms in humans and their importance to maintaining immunity. grows a new batch of bacteria that People who disrupt their circadian glow when they reach a certain rhythms have higher rates of heart concentration. The bobtail squid has two genes disease and illness. Everything is that produce proteins which comintertwined.” The Hawaiian bobtail squid, municate the time of day to the which is about 2 inches long rest of the animal’s body —one and swims in the shallow waters in the head, and one in the light Milwaukee Journal Sentinel

organ, Heath-Heckman explained. The squid’s head tells time by the sun, but its light-generating organ might tell time by the glowing bacteria, she said. For their ongoing research, UW-Madison scientists collect adult squid from the wild in Hawaii about every three months and bring them back to Madison to breed them and study the juveniles. In one experiment, the squid were kept outside in Hawaii. Heath-Heckman then brought them back to Madison to measure the cycling of their clock gene in the organ where the glowing bacteria live. Squid that lacked the glowing bacteria, or that had bacteria which could not make light, were unable to cycle expression of the gene associated with the light or-

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gan. Other squid with bacteria that were unable to produce light could still cycle the gene on and off through the day if exposed to blue light, showing that both light and the bacteria were involved with the squid’s internal clock, the researchers found. While it’s speculative to read too much into what a squid’s circadian rhythms may tell us about humans, it’s still an exciting breakthrough, Heath-Heckman said. “We’re beginning to realize that circadian rhythms are really important for health and that microbes are important for everything,” added Margaret McFall-Ngai, a UW-Madison professor of medical microbiology and co-author of the Please see Internal clock page 19

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Internal clock Continued from page 18 research. McFall-Ngai, an authority on the bobtail squid and its glowing symbiotic bacteria, has studied the creature for two decades. The Hawaiian squid is a focus of the Madison research because “it’s cool,” Heath-Heckman said, “and because it’s a good model of how animals and bacteria communicate with each other.” “Everything in the human gut is on a rhythm,” McFall-Ngai said. “Perhaps the thousands of bacteria there also govern the rhythms of the gut, just as the luminous bacteria partner of the squid sets the rhythms in the light organ.”

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Teen ‘thigh gap’ obsession is dangerous By Jessica Yadegaran

Contra Costa Times If you can stand straight with your knees together and see a space between your upper thighs, you have what thousands of teen girls are willing to starve themselves for. The thigh gap, as it is known, is a small, hollow cavity with a huge following on social media. You can follow supermodel Cara Delevingne’s thigh gap on Twitter or peruse thousands of thigh gaps on Tumblr with images of ultrathin women in bikinis, hiked up skirts, and lingerie, all baring thighs so thin they don’t touch.The photos, shared by young women, come with captions like, “Three more inches to go” and “All I want in life

is a thigh gap.” Women have long been bombarded with unrealistic images of beauty and digitally altered bodies. A decade ago, teens flocked to pro-anorexia websites which shared similar photos and tips for disordered eating. But the thigh gap is the first “thinspiration” voice in social media, where sharing with friends spreads and fuels the obsession. The thigh gap’s social media presence is, in fact, a “perfect storm,” says Berkeley, Calif., licensed clinical social worker Debra Milinsky of the Feminist Therapy Connection. “Girls are at a developmental stage where their bodies are changing, and when it comes to what they’re supposed to look

like, they’re most likely to listen to their peers,” Milinsky says.“That’s what the Internet is all about. Seeking community.” Of course, not all girls want to join that particular one. Maya Sweedler of Los Gatos, Calif., calls the thigh gap trend “awful.” “I can’t believe what some girls are encouraging each other to do, to be so unhealthy and all look the same,” says Sweedler, 16. She also points out that nature plays a role. “I think some people have the bone structure for a thigh gap just like some people have high cheekbones,” she says.“In general, I don’t think the human body is supposed to look like that.” In fact any number of factors play into whether a woman has a significant thigh gap, including

genetics, ethnicity, pelvic size and width, says Laura Tosi, a pediatric orthopedist and director of the bone health program at Children’s National Medical Center in Washington, D.C. Weight loss is proportional, so most girls who don’t have a natural gap —one bigger than a peephole —would have to lose a lot of weight to achieve the kind of thighs coveted on social media, she says. And that can be particularly dangerous during puberty. “Weight gain is actually a natural and very important signal that a young woman is entering womanhood and starting her periods,” Tosi explains. “It is absolutely essential to helping girls build the Please see Thigh gap page 21

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Thigh gap

to this issue,” says Hemmen, who are contradictory. Sixty-five peris the mother of two teenage girls. cent of the 1,000 girls surveyed “I feel like thigh gap is just the think that the body image reprenewest incarnation of a ridiculous sented by the fashion industry standard that’s depicted in the me- is too skinny and unrealistic (63 dia. It used to be a concave stom- percent) but nearly half wish they ach. Next, it’ll be a dimple here or were as skinny as those models and even strive to be. there.” “The girls have a cognitive disTo combat the spread of thigh best possible skeleton so they gap worship, Hemmen says par- sonance,” explains Kimberlee will have strong bones as they ents must teach their daughters Salmond, a senior research stratage. Delaying the onset of menses media literacy and hang around egist at the Girl Scout Research by severe weight loss can impair when their teenager is trawling Institute. “They know it’s wrong a young’s woman’s skeletal devel- Tumblr or watching a YouTube for them and yet they continue to opment and lead to fractures even video so they can say, “Honey, aspire to it.” Meanwhile, a small, anti-thighthat’s been digitally enhanced. No as a young adult.” gap movement is developing onone looks like that.” Try telling that to an impresline. Tumblrs like Touching Thighs “We need to encourage irreversionable girl who has consumed and No Thigh Gap give Hemmen ence in girls about a media that unattainable images of beauty since age 5, says Lucie Hemmen, doesn’t give an (expletive) about hope, she says. They also remind a Santa Cruz, Calif., psychologist their health and wellness,” she her how much teenagers love to and author of “Parenting a Teen says. If everyone over 50over or at50 risk If everyone or atpush riskback against the status quo. “We need more people to post That has been a central goal at Girl: A Crash Course on Conflict, got screened for colonforcancer... got screened colon cancer... Communication, and Connection the Girl Scout Research Institute anti-thigh gap pages,” she says. eryone If everyone Ifover everyone over 50 or over 50 ator risk 50 ator risk at risk with Your Teen Daughter” (New in New York. In 2010, researchers “And more celebrities, like Bescreened got screened gotHarbinger, for screened colon for colon cancer... for colon cancer... cancer... released a study on body image yonce and Adele, representing di$20). “That’s how early girls fall prey among girls 8 to 17. The findings verse and realistic body images.”

Continued from page 20

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Sweedler thinks there needs to be a collective movement to adjust the current beauty ideal. “Some group needs to stand up and say,‘Yeah, we wear mom jeans and we’re going to fill them,’” the 16-year-old says.

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Health by the numbers, lots of numbers By Allie Shah

ing. While many acknowledge its proven results in areas such as weight loss, they caution that the Jared Sieling’s first experiment volumes of information netted by new technologies could become was on his diet. For weeks, he diligently recorded overwhelming. Yet that hasn’t dimmed the eneverything he ate until the data revealed a nutritional gap: not thusiasm of Sieling and other memenough protein. Next, he strapped bers of the Quantified Self Minneon a device to monitor his activ- apolis group. While a group for self-tracking ity level.The numbers revealed the may seem extreme, 7 out of 10 software engineer was a slug, averaging fewer than 1,000 steps a day American adults say they track —well below the recommended some aspect of health, either for themselves or for someone else, 10,000-step mark. “That was the big ‘aha’ moment according to the Pew Research when I realized, ‘Oh, this is a big Center. In the first national study of its problem,’ and started to fix it,” he kind, Pew found that most people said. Sieling, 27, of Maple Grove, track things such as weight, diet or Minn., is part of the rapidly grow- exercise routine.And about a third ing “quantified self” movement of those surveyed said they also —the practice of collecting data track their blood pressure, blood on everything from diet to blood sugar, headaches, sleep patterns or sugar to sleep patterns and mood other health indicators. The study found that 46 percent levels.Also called self-tracking, biohacking or “qs,” it involves measur- of trackers said the activity has ing and analyzing the body’s inner changed their overall approach to maintaining their health or the workings for optimum health. Once used only by elite athletes, health of someone they care for. self-tracking is becoming more ac- In addition, 40 percent of trackers cessible to everyday folks as track- said it led them to ask a doctor new ing devices go high-tech. Instead questions or to get a second opinof single-use pedometers, devices ion from another doctor. Consider the computer scientist such as Fitbit, Jawbone UP, Nike+ FuelBand and others can monitor in California who, in analyzing his heart rate, calculate calories and stool samples, noticed a disturbcount the number of stairs you ing pattern that led to an early climb or the quality of your sleep. diagnosis of Crohn’s disease. That For some, it’s merely a quirky scientist, Larry Smarr, is a legend in hobby, born out of a fascination quantified-self circles who shares with numbers that borders on his story on websites and with obsession. Others, whom Sieling groups. He started out like most trackcalls “elite livers,” see it as a way to take charge of their own health ers do, gathering data on his nutri—a powerful new tool that could tion and exercise habits. He added lead to early detection of diseases sleep and ratio of fatty acids to his and better management of chronic self-examination regimen, even signing up for a personal bloodones. Health professionals, however, testing service. Then, he began remain guarded about self-track- studying his poop. After noticing Star Tribune (Minneapolis)

abnormalities, he pressed for more testing and eventually doctors diagnosed him with Crohn’s. Scott Mark is another selftracker. The Minneapolis ultra-runner who also works in Medtronic’s innovation department, says that the quantified self movement is in the pioneer stage and that its adherents resemble the organic computer dabblers working out of garages in the 1970s and ‘80s. “They were laughingstock early adopters at the time, and look at where we are now. I’m totally convinced that this is the same thing happening with the quantified self,” Mark said. “They are paving the way of where we are going to be heading with health at some point.” Mark, who started out as a computer programmer, says his love of

data drove his interest in recording his body’s performance during his runs. “When I had the opportunity to throw a GPS on my arm and a heartrate monitor on my chest, it was really kind of fun from a pure geek standpoint to be able to see all this data that I could capture,” he said. And he has a son who uses a continuous glucose monitor to manage his Type 1 diabetes. “My interest in qs gives me more of an interest in digging the details of the glucose sensor stuff I get from him,” Mark said.“I run the reports. It’s much more helpful to look for trends.You can now overlay seven days of those curves and say ‘OK, he’s going up every day right after lunch; we need to do Please see Numbers page 23

WELCOMING THE NEWEST ADDITION TO OUR FAMILY

northeast GeorGia physicians Group heritaGe oB/Gyn it is tradition to celebrate exciting new additions in our lives. that’s why it only seems fitting that northeast Georgia physicians Group (nGpG) invites you to join us as we welcome heritage obstetrics and Gynecology to the group. With the addition of oB/Gyn services, nGpG can ensure a future of exceptional care, every step of the way.

front row (L to R): Clayton Cox, MD, FACOG; Stephen Little, MD, FACOG. back row (L to R): Jeffrey Ward, MD; Francis T. Lake, Jr., MD, FACOG; Holt Harrison, MD, FACOG

Services include: • comprehensive gynecological care • routine and high risk obstetric care • in-office permanent sterilization • 3D/4D ultrasound • in-office ablation for heavy menses • advanced laparoscopy and treatment for pelvic relaxation and urinary incontinence • robotic gynecological surgery • nurse midwives: Tiffany Tucker, CNM; Lauren Wood, CNM

Offering services at two locations: Gainesville, 770-531-1515 Braselton, 770-965-4170

www.ngpg.org/heritage-obgyn

The Times, Gainesville, Georgia |

Numbers Continued from page 22 something about the lunch dose.’” Doctors are taking notice of the boom in apps and other technology to help trackers collect bio data. “There’s a lot of discussion about whether these things could be used for chronic diseases.There’s a big interest in home monitoring,” said Dr. Michael Joyner, professor of anesthesiology at the Mayo Clinic and a physiologist. Joyner, who describes himself as an “agnostic” on the quantified-self movement, said there are conflicting reports about its effectiveness and many questions. But, he added, “There’s a lot of hope that it will work.” Still, he says of dedicated self-trackers:“ Are they living life or are they tracking life?” Erin Klegstad,33,of St.Paul,Minn.,

is training for her first ironman competition and is using tracking to chart her body’s performance. She uses TrainingPeaks, a website, to log data from her workouts. For example, she keeps track of her times during a swim workout. She wears a heartrate monitor while running and biking. She connects her Garmin to her computer and it shows her heart rate throughout a workout. Studying the results one day, she was able to pinpoint a drop in her heart rate, deducing that it happened as she stopped at a stoplight during a run. “You can look at fancy graphs and charts,” Klegstad said. “I can look back at when I was training for my first marathon. I can compare times to see how far I’ve come. “For me, it’s more curiosity. I just like to see the numbers and (it’s) fun to watch it all. It’s taught me what my body can do and makes me push harder.”

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Sunday, April 28, 2013

Richard TsongTaatarii/MCT Jared Sieling of Maple Grove, Minnesota keeps close track on his health and fitness through electronics. He uses a scale that sends his weight and body fat to his smart phone and the phone also tracks the number of steps he takes each day.

Sunday, April 28, 2013

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