Ebola: Don't Believe The Hype

There's a lot of news about Ebola lately. It's tough to separate concern from hyperbole. The Medical Society of the State of New York has provided this presentation by Dr. William Valenti, an Infectious Disease specialist, on Ebola. This was originally a webinar geared toward physicians so please forgive me if it seems overly technical. However, if you're a physician, this is definitely must see.



I do hope you find this helpful.

Vitamin D: Let The Sunshine In

As a follow-up to my previous post on sunscreens, I need to point out that there is a downside. We are in the midst of a global epidemic of vitamin D deficiency.

Vitamin D ... regulates the functions of over 200 genes and is essential for growth and development. There are two forms of vitamin D. Vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D status depends on the production of vitamin D 3 in the skin under the influence of ultraviolet radiation from sun and vitamin D intake through diet or vitamin D supplements. Usually 50 to 90% of vitamin D is produced by sunshine exposure of skin and the remainder comes from the diet. Natural diet, most human consume, contain little vitamin D. Traditionally the human vitamin D system begins in the skin, not in the mouth. However, important sources of vitamin D are egg yolk, fatty fish, fortified dairy products and beef liver.

Vitamin D3 deficiency can result in obesity, diabetes, hypertension, depression, fibromyalgia, chronic fatigue syndrome, osteoporosis and neuro-degenerative diseases including Alzheimer’s disease. Vitamin D may even contribute to the development of cancers, especially breast, prostate, and colon cancers.

Why is sun avoidance important?

...Exposure to sunshine each day helps human body to manufacture the required amount of vitamin D. However, due to fear of developing skin cancer most people avoid the sun exposure. To prevent vitamin D deficiency, one should spend 15 to 20 minutes daily in the sunshine with 40% of the skin surface exposed. High concentration of melanin in the skin slows the production of vitamin D; similarly aging greatly reduces skin production of vitamin D. Use of sunblock, common window glass in homes or cars and clothing, all effectively block UVB radiation – even in the summer. People who work indoors, wear extensive clothing, regularly use sunblock, are dark skinned, obese, aged or consciously avoid the sun, are at risk of vitamin D deficiency.

Balance, Daniel san - Balance.

For more information, or to schedule an ultrasound, call: (718) 925-6277.

Hepatitis C: To Screen Or Not To Screen, That Is The Question

Recently, NY State passed a law requiring screening for Hepatitis C be offered to all patients born between 1945 - 1965. Hepatitis C is a potentially fatal disease which can attack the liver silently over time. It is thought that as many as 1 in 30 "Baby Boomers" could be infected with the virus. For these reasons, screening this group makes sense. But of course, as always, there is a catch. It seems the cost of treatment for those infected is prohibitive for all but those on research protocols, better than platinum insurance plans, or those with incomes in the Warren Buffett range. Sovaldi, a new drug for Hep C treatment, costs about $84,0000 for a 12 week treatment.

What can be done about the cost? Right now, not much save to check with your insurer about treatment coverage and copay, etc. Still think screening asymptomatic folks is a good idea? For each individual, the answer may be different. Before asking a question, it's always best to know what you'll do with the answer.

A Killer In The Community

What would you say if you knew an infectious disease which kills more people annually than AIDS, spreads by both skin to skin and airborne routes, and is resistant to all commonly used antibiotics was loose within the community? You'd doubtless want to know what public health authorities were doing about this. Well, Methicillin Resistant Staphylococcus Aureus or MRSA causes such infections and has gone from a predominantly hospital - acquired to a community - acquired infection as well. Despite the recent stories from the NFL about players infected with MRSA, the disease gets far too little attention, especially when compared with the brouhaha over Obamacare or the latest exploits of Miley Cyrus. The real scary news is that tracking by public health authorities is not universal. This seems absurd.

How did this condition get out of hand? It did so over many years, as we got complacent over the ease with which infectious diseases were handled by antibiotics. To be sure, there were outbreaks of occasionally resistant bugs but by and large, this was not a widespread problem. So we tended to reach for the Z-Pak or Amoxicillin for almost any respiratory illness, abandon old-fashioned topical antiseptics like iodine for neosporin ointment for cuts and scrapes, secure in the knowledge that our antibiotics would be successful. Unfortunately, bacteria are nothing if not resourceful and developed resistance over many generations as the susceptible strains fell by the wayside, leaving only the hardier strains intact. Moreover, antibiotic overuse, not only for illness but also in animal feed, played havoc with the body's normal flora, upsetting a balance which formed another line of defense.

While new promising treatments are on the horizon and work continues apace on vaccines, there are many who need help today and many more others potentially in harms way. What can we do? First, don't ask your doctor to prescribe an antibiotic for a cold. First, it won't work and second, this is what got us here in the first place. And don't think your physician a bad doctor because he or she won't reach for that prescription pad. Your doctor's trying to help you. In the long run, you'll thank him.

If you get a cut, wash it out with soap and water, one of our best antiseptic combinations. Grandma's iodine from the medicine cabinet would be a far better antiseptic than that new tube of neosporin.

If you belong to a gym, ask the manager about their cleaning regimens. Ideally, equipment and mats should be wiped down between uses to lessen the likelihood of skin to skin contact between patrons. It might pay to bring your own lysol wipes too, as well as your own clean towel, etc.

Finally, if ever there were a condition in need of a celebrity spokesperson, it's MRSA. This disease has been under the radar for far too long. We had and have countless celebrities raising AIDS awareness, but MRSA now kills more than AIDS. We need a MRSA spokesperson, a MRSA global fund, a MRSA telethon. Bill and Melinda Gates, please call your office.

Flu Shots For The Expectant Mom?

It's that time of year again and the drug store chains are all advertising flu shots. But for expectant moms, safety is a prime consideration. So what about flu shots in pregnancy? Are there any special risks during pregnancy? And are these vaccinations safe for mom and baby?

The CDC has a great deal of useful information on Flu Shots in Pregnancy.

Influenza is more likely to cause severe illness in pregnant women than in women who are not pregnant. Changes in the immune system, heart, and lungs during pregnancy make pregnant women more prone to severe illness from influenza as well as hospitalizations and even death. Pregnant women with influenza also have a greater chance for serious problems for their unborn babies, including premature labor and delivery.

But are they safe? Again, the CDC has the answer

Yes. The seasonal flu shot has been g.iven safely to millions of pregnant women over many years. Flu shots have not been shown to cause harm to pregnant women or their babies.

There is one caveat - the nasal spray vaccine is not recommended for use during pregnancy.

The CDC has more at the link.  Read the whole thing.