Blog Posts

Advances, Retreats in the Cancer Battle

September 25th, 2019

At the end of May, the latest Annual Report to the Nation on the Status of Cancer was released, and it offered some encouraging news. The report included cancer statistics from the years 1999 through 2016, the most recent year statistics are available. The report was created by a consortium of the country’s top cancer organizations.

The updated annual report noted that US cancer death rates continued to fall during those years. It stated that overall, cancer death rates decreased 1.8 percent per year in men and 1.4 percent per year in women. This decrease continued am an ongoing trend in declining cancer death rates.

The report also noted that the rate of new cancer cases among men consistently fell between 2011 and 2015, decreasing two percent per year. This is good news after the rate of new cases increased between 1999 and 2008. The rate of new cancer cases in women, however, remained stable from 2011 to 2015.

In addition, the Annual Report to the Nation described progress in the battle against two major cancers, lung cancer and melanoma. Lung cancer gains were attributed to increasing declines in smoking. The reason cited for the improved success against melanoma was the development of new and better treatments for it.

There was some negative news in that report, however. It stated that cancers related to obesity, such as colon cancer, breast cancer in older women and uterine cancer, are on the rise. This should strike a chord in those of us who are struggling with excess weight.

The report also found that the incidence of cancer in women ages 20 to 49 rose an average of 1.3 percent per year. And cancer deaths in this age group were higher for women than for men. Apparently, we’re failing to get the cancer prevention message to these women.  Fortunately, their cancer death rates declined by about 1.7 percent per year from 1999 to 2016.

The American Cancer Society has its own annual report called Cancer Facts & Figures 2019. This report is a companion piece to Cancer Statistics 2019, a scientific paper that was published in January in the American Cancer Society’s CA: A Cancer Journal for Clinicians. In these publications, the Society estimates the numbers of new cancer cases and deaths in 2019.

According to Cancer Facts & Figures 2019, more than 1.7 million new cancer cases are predicted to be diagnosed in the United States in 2019, and approximately 606,880 Americans are expected to die of cancer this year. The number of new cases is the same as last year, but the number of deaths expected in 2019 is slightly lower, down from 609,640 estimated for 2018.

Cancer is the second leading cause of death among children ages 1 to 14 years, second only to accidents. Cancer Facts & Figures 2019 estimates that 11,060 new cases of cancer will be diagnosed in American children ages birth through 14 in 2019, and 1,190 deaths are predicted to occur. The report notes that childhood cancers have increased by 0.6 percent per year since 1975.

Tobacco use remains the most preventable cause of death in the US, despite declines in cigarette smoking. Cancer Facts & Figures 2019 reports that cigarette smoking among American adults ages 18 and older decreased from 42 percent in 1965  to 14 percent in 2017. Among high school students in the US, smoking decreased from 29 percent in 1999 to 8 percent in 2017.

Still, about 30 percent of all cancer deaths are caused by smoking. Cigarette smoking increases the risk of at least 12 types of cancer and may be a factor in two others. Secondhand smoke is also a risk factor for the development of some cancers. In 2014, 5,840 nonsmoking adults in the US were diagnosed with lung cancer as a result of inhaling secondhand smoke.

Most cancers have risk factors. Some are non-controllable, such as age, gender and family history. Other risk factors are controllable, such as smoking, being overweight and having a sedentary lifestyle.

You can reduce your risk of many cancers by modifying your controllable risk factors. This includes stopping smoking, eating a healthy diet, getting regular physical activity and maintaining a healthy weight.

In addition, follow your doctor’s recommendations for getting routine tests and screenings for various cancers. In many cases, uncovering cancer in its early stages means catching it when it’s most treatable and, in some cases, curable.

Gaming: Medical Disorder or Not?

September 15th, 2019

There’s no debate about it. Internet and video games are popular in this country. A Pew survey found that 97 percent of teen boys and 83 percent of teen girls play games on some type of device. And it’s not just kids. A research study estimates that about 160 million American adults play internet-based games.

It’s definitely easy to get caught up in the games, but is playing too much a disease or addiction? That question is up for debate.

In May  2019, the World Health Organization (WHO) officially recognized gaming addiction as a disease. Last year, the organization agreed to include gaming disorder, which includes internet and video gaming, as a condition in its International Classification of Diseases (ICD) 11th Edition.

The ICD serves as the international standard for diagnosing and treating health conditions. It’s used by health care professionals across the globe. The WHO based its decision to include gaming disorder in the ICD on available research and a consensus among a group of international experts in the field.

The ICD describes people with gaming disorder as having a “pattern of gaming behavior characterized by impaired control,” that also involves prioritizing gaming over other daily responsibilities, including school, work and social appointments. If you ignore activities necessary to maintaining good physical and emotional health, you’ve got a problem.

In the US, health care professionals follow the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). That’s the bible for American mental health practitioners.

The DSM-5, published in 2013, doesn’t recognize gaming disorder as a condition, but it did list internet gaming disorder in a section recommending conditions for further research. The DSM-5  notes that internet gaming must cause “significant impairment or distress” in several aspects of a person’s life. It proposes a set of symptoms that includes:

  • Preoccupation with gaming
  • Withdrawal symptoms when gaming is taken away or not available
  • The need to spend more time gaming to satisfy the urge
  • Giving up other activities, loss of interest in activities previously enjoyed
  • Having jeopardized or lost a job or relationship due to gaming
  • Inability to reduce gaming or unsuccessful attempts to quit
  • Deceiving others about the amount of time spent gaming
  • Using gaming to relieve negative moods, such as guilt or hopelessness

According to the DSM-5, a person must have five or more of these symptoms within a year to be diagnosed with internet gaming disorder.

But not all experts agree that gaming, internet or otherwise, should be considered a disorder. Some argue that gaming can’t be separated out from general screen overuse, which includes social media use as well. Others suggest that intense gaming is a symptom of another disorder such as anxiety, depression or ADHD.

There’s research to back that up. One study found that children who had problems with video games were more likely to also have a diagnosis of ADHD or autism spectrum. Those who struggled with social media use often also struggled with depression or anxiety.

One group of specialists recommends referring to problems with gaming as a habit rather than a disorder or addiction. They explain that people feel more empowered to change the behavior of a habit.

These specialists also argue that labeling someone an “addict” and saying they have a chronic disease can have lasting consequences on that person’s life and self-esteem. This is especially true for teens who are in the process of forming their identities.

Whatever you call it, overdoing it on the games to the point of ignoring everything else is not okay. If that’s you and you can’t stop, seek a qualified professional’s help to reduce your urge to play and modify your behavior. Don’t be afraid and don’t wait. Get your life back now!

A Bit About Bleeding Disorders

September 10th, 2019

Normally, if you cut yourself, your body rushes to form a blood clot at the site of the injury to staunch the bleeding. Clots are mostly made of platelets, a type of blood cell, and protein clotting factors that work together to form a fibrin “plug” around the injured area. But if you have a bleeding disorder, this clotting process doesn’t work like it’s supposed to.

Without proper clotting, people with bleeding disorders can bleed excessively. The problem might be too few or abnormal platelets, or low quantities of clotting proteins in the blood. There are different types of bleeding disorders. The most recognized is hemophilia, but the most common is a condition called von Willebrand disease. Both of these disorders occur when the blood lacks certain clotting factors.

The majority of bleeding disorders are inherited, although there are types that form later in life if your body’s immune system rebels against the natural clotting factors. Since there’s a genetic factor involved in most of these disorders, people with a family history of bleeding disorders are at greater risk for having a bleeding disorder themselves.

Some bleeding disorders occur as the result of a medical condition. These include liver disease, a low red blood cell count, a Vitamin K deficiency and as a side effect of certain medications. Medications that interfere with blood clotting are called anticoagulants or blood thinners. Anticoagulants are often used to thin blood to reduce the risk of heart attack and stroke.

While there are different bleeding disorders, they have many symptoms in common. Here are some of the things to look out for. If you notice any of these symptoms, see your doctor for a thorough evaluation. Common symptoms of bleeding disorders include:

  • Easy bruising
  • Bleeding gums
  • Heavy bleeding from small cuts
  • Unexplained nosebleeds
  • Excessive bleeding following surgery or a dental procedure
  • Excessive bleeding during your menstrual periods

While hemophilia is a well-known bleeding disorder, it’s actually rare. It affects approximately one in 10,000 people. The US Centers for Disease Control and Prevention estimate there are 20,000 people with hemophilia in the US. All races and ethnic groups are affected by it. There is currently no cure for hemophilia, but there are effective treatments.

Hemophilia has two classifications, type A and type B, based on which clotting factor is deficient. With type A hemophilia, clotting factor VIII is lacking, and with type B, it’s clotting factor IX. Blood will not clot properly without these clotting factors. Hemophilia type A is the more common type. It’s about four times as common as type B.

Von Willebrand disease (VWD) is caused by a deficient or defective blood clotting protein called von Willebrand factor. VWD is quite common. It affects up to one percent of the US population, which means about 3.2 million people, or one in every 100 Americans, have the disease.

There are several types of VWD. It’s most commonly divided into type 1, type 2 and type 3. Type 1, which is the mildest form, accounts for 70 percent of all cases of the disorder. VWD occurs equally in men and women, although women are more likely to notice symptoms because they may bleed more heavily during their menstrual periods or after childbirth.

In cases of  type 1 VWD, there are lower than normal levels of von Willebrand factor in your blood. With this type, you likely will also have low levels of clotting factor VIII. With type 2 VWD, you have normal levels of von Willebrand factor, but it doesn’t work properly.

People who have type 3 VWD, the most severe form, have extremely low levels or no von Willebrand factor in their blood. They also have low levels of clotting factor VIII. Type 3 VWD is very rare. Only three percent of people with VWD have this type.

VWD is almost always inherited through a mutation to the gene responsible for its development. However, it’s also possible for the gene to spontaneously mutate, so you can get the disease without having a family history of it. You can also get VWD if your immune system overreacts and destroys the von Willebrand factor in your blood.

Treatment for VWD depends on the type and severity. For some mild cases, no treatment may be needed. For other cases, common treatments include desmopressin acetate injections. Desmopressin acetate is a medicine that makes the body release more von Willebrand factor into the blood. It also helps increase the level of factor VIII in the blood.

Another treatment for VWD is factor replacement therapy. During this therapy, medicines rich in von Willebrand factor and factor VIII are injected to replace the missing clotting factors in your blood. This treatment is typically reserved for people with more severe cases of the disease.

Antifibrinolytic drugs, which slow the breakdown of blood clots, and birth control pills, which increase levels of von Willebrand factor and factor VIII, and reduce menstrual blood loss, are other options for treating VWD.

In addition to von Willebrand factor, factor VIII and factor IX, there are many other clotting factors in the blood. Deficiencies in those clotting factors can lead to other, more rare bleeding disorders. Some of these rare disorders have only been discovered during the past 40 years, as more is learned about clotting factors and the blood clotting process.

OTC Considerations

September 3rd, 2019

By now, you know about the drug crisis facing this nation associated with opioid painkillers. You know opioids are overused, and they can lead to abuse, addiction and even death. Maybe you’ve decided to treat your pain, whether it’s a tension headache or back pain, with over-the-counter pain medicines instead. After all, they’re safer, right?pills

Well, not entirely. While OTC pain medicines don’t generally lead to addiction and death, they do have serious risks if you take too much or take them for too long. And that’s actually become a problem. A study by a Boston University School of Health researcher found that Americans are also abusing OTC pain medications, often exceeding the recommended daily dosage.

A problem noted by the Boston University researcher is that OTC pain medications are taken without a physician’s supervision. Drug makers provide directions on product labels, but, in reality, patients choose their dosage. And most have little knowledge of dosing limits and the dangers of exceeding those limits.

When taken as directed, most OTC medications are safe. However, this is not the case for every person, especially when they combine a medicine with other OTC drugs or prescription medications. OTC pain medicines, like any medication, also have risks and side effects.

Acetaminophen, which is found in drugs like Tylenol, Excedrin and Midol, is a common OTC medicine used to treat pain and discomfort. However, acetaminophen can damage liver cells and is, in fact, responsible for 50 percent of acute liver failure cases in the US. It’s also the leading reason for calls to poison control centers and is responsible for 50,000 ER visits each year.

The sneaky thing about acetaminophen is that it’s found in a variety of products, including those for allergies, colds, flu, coughs and insomnia, so you can easily take more than intended. If you’re taking more than one medicine, be sure to check the labels. Don’t take more than 3,000 mg of acetaminophen in one 24-hour period. That’s the maximum recommended by the FDA.

There are other OTC pain relievers called nonsteroidal anti-inflammatory drugs, or NSAIDs, that aren’t so hard on the liver. NSAIDs relieve pain by decreasing inflammation in the target area. They do this by inhibiting two enzymes, COX-1 and COX-2, which produce prostaglandins. Those are hormones that create inflammation, which is responsible for many types of pain.

The problems is prostaglandins also do some good. They protect the lining of the stomach and intestines. When there’s fewer prostaglandins, there’s less protection for the stomach lining, and you can develop stomach problems, including ulcers. NSAIDs also make it harder for your blood to clot, which can make ulcers worse.

OTC NSAIDs include Advil and Motrin. These products contain ibuprofen, which is found in many cold and flu remedies, so you have to pay attention to what you’re taking. The maximum daily dose of these medications is 1200 mg, although it’s strongly recommended this not be taken daily. Naproxen, such as Aleve, is another NSAID that can be bought over the counter.

All of these NSAIDS can cause problems when taken in excess or over long periods of time. These side effects include high blood pressure, damage to the kidneys, ringing in the ears, and an increased risk for heart attack and stroke.

The risk for heart problems is further delineated in a 2016 study published in the British Medical Journal that found the use of NSAIDs was associated with a 20 percent higher risk of being hospitalized with heart failure. Ibuprofen and naproxen were among the NSAIDs called out in that study.

For many of us, OTC pain relievers are a godsend. But we shouldn’t take them lightly just because we can buy them in a store without a doctor’s prescription. They’re still medications and should be taken with caution. Always follow the directions on the package label and your doctor’s recommendations.

In general, don’t take OTC pain medicines for longer than 10 days. If you’re pain persists, see your doctor. He or she can discuss alternatives for managing your pain. These might include courses of heat and ice, physical therapy, steroid injections, radiofrequency ablation, which involves heating up the nerves and destroying their ability to send pain signals to the brain, or even medical marijuana.

You don’t have to be in pain, just take pain medication wisely. It’s smart for your overall health.

Florida Hepatitis A Cases Continue To Rise At Alarming Rate

August 22nd, 2019

The annual number of reported cases of hepatitis A in the state of Florida is on the rise yet again and at an alarming rate, according to figures released by the Florida Department of Health.

Stock graphic from Florida Health.

January 1, 2018 – August 17, 2019

After reported cases of hepatitis A in Florida more than doubled between 2016 and 2017 and nearly doubled between 2017 and 2018, the number of cases reported in Florida since then has more than quadrupled.

From January 1, 2018 to August 17, 2019 (the day the department’s report came out), 2,226 cases of hepatitis A were reported across the state. Of those 1,266 cases, 77 were reported during the last week covered by the report.

Hepatitis A is a vaccine-preventable, communicable disease of the liver that is caused by the hepatitis A virus, or HAV. It is typically transmitted from one person to the next through the fecal-oral route or through the consumption of contaminated food or water.

Symptoms of hepatitis A include fatigue, low appetite, stomach pain, nausea and jaundice but usually resolve within two months due to antibodies that are produced in response to the virus and protect against reinfection for life.

Stock graphic from vaccination is the best way to prevent the disease and such vaccinations are recommended by The Advisory Committee on Immunization Practices (ACIP) for all children a year old or older.

Vaccinations are also recommended for anyone who is homeless or living in an unstable housing situation or anyone who is at an increased risk of infection, including people using injection and non-injection drugs, people with chronic liver disease or blood clotting disorders.

The outbreak of the virus in the state of Florida began in 2017, when the number of reported cases of hepatitis A jumped from 122 a year earlier to 276. That number nearly doubled in 2018 to 548 cases.

Stock graphic from Florida Health.

Counties that reported a hepatitis A case in week 33 (8/11/19–8/17/19) are outlined in black. Since January 1, 2018, 98% of cases have likely been acquired locally in Florida.

With that number already exceeded, the surgeon general of the state of Florida, Scott Rivkees, declared a public emergency on Aug. 1, 2019, saying the declaration was a “proactive step to appropriately alert the public to this serious illness.”

Rivkees encouraged people to be vaccinated against the virus, which had spread the most through Pasco (374 cases), Pinellas (344) and Volusia (208) counties at the time the report was released.

Orange County, Hillsborough County, Marion County, Manatee County and Hernando County had all reported more than 100 hepatitis A cases at the time of the report, with Lake County falling just shy of that number with 98 reported cases.

Cancer Vaccines Offer Hope

August 20th, 2019

Vaccines, as you probably know, are medicines that help your body fight disease. If you’re like most people, you received vaccinations against a bunch of disorders – from chickenpox to whooping cough – when you were a kid. Vaccines work with your immune system to recognize and destroy harmful substances, such as disease-causing viruses, that attack your body.

Scientists today are exploring new and better ways to boost the power of the immune system, using vaccines aimed at battling cancer. Cancer vaccines can be used to prevent or treat cancer.

Preventive vaccines currently available include the HPV vaccine, which protects against human papillomavirus (HPV). An HPV infection can lead to cervical, vaginal, vulvar and anal cancer. The hepatitis B vaccine is another preventive cancer vaccine. Hepatitis B infection can cause liver cancer.

Vaccines to treat cancer are a type of immunotherapy because they work directly with your body’s immune system. Cancer treatment vaccines can do several things. These include destroying residual cancer cells after other treatments, stop a tumor from growing or spreading, and prevent cancer that was treated from coming back.

Currently, there are only a handful of active immunotherapies that are approved for treating cancer. There are, however, hundreds more being investigated in clinical trials, in which cancer patients can participate. Clinical trials are research studies that test the safety and effectiveness of new medications, therapies or devices.

While there are numerous cancer clinical trials ongoing, estimates suggest only three percent to six percent of eligible cancer patients participate in them. This not only slows the progress of new treatment development, it also means more than 90 percent of cancer patients may be missing out on potentially life-saving new treatments.

An example is a vaccine developed by researchers at the University of California San Diego Health and the La Jolla Institute for Allergy and Immunology, which is currently in clinical trials. This vaccine, which is for people with deadly metastatic cancer, is specifically created to match each patient’s cancer mutations and immune system.

Study researchers begin by testing patients’ tumors and identifying the neoantigens, or mutations, that cause their immune systems to respond. Researchers then culture the neoantigens with the patients’ T-cells, a type of immune system cell, and give patients a series of three vaccines of the modified T-cells.

To ensure the T-cells remain activated once they reach patients’ tumors, researchers also give patients the immunotherapy medication Keytruda. The bolstered T-cells then go to work destroying the tumor cells.

Another clinical trial, led by researchers at Stanford University School of Medicine, tested a combination immunotherapy for the treatment of two types of non-Hodgkin’s lymphoma, a type of blood cancer. The two types are diffuse large B-cell lymphoma and follicular lymphoma.

The treatment tested was a combination of an experimental antibody developed by researchers at Stanford and a commercially available anti-cancer antibody called rituximab.

The experimental antibody works by blocking CD47, a protein that inhibits immune cells called macrophages from attacking and devouring cancer cells. Rituximab amplifies signals to the macrophages to do their job of consuming the cancer cells.

The results of this small, multicenter clinical trial are promising. Half of the 22 people enrolled in phase 1 of the trial had a positive response to the therapy, and about one-third went into complete remission.

These are just two examples of clinical trials looking at new cancer treatments that take advantage of patients’ disease-fighting immune systems. Researchers are hosting many more trials to test vaccines for other types of cancer.

These include cancer of the bladder, breast, cervix, colon, rectum, kidneys, lungs, pancreas and prostate. Other clinical trials are investigating treatments for brain tumors, leukemia, melanoma and myeloma.

If you’re interested in participating in a clinical trial, talk with your doctor about appropriate studies for your situation. You can also look for clinical trials being conducted in your area at

By participating in a clinical trial, you may discover a life-altering treatment that works for you when others have failed. You may also help make a new therapy available to others with cancer who previously had no hope. Talk to your doctor and consider taking part in a clinical trial.

August is National Immunization Awareness Month

August 13th, 2019

Why a vaccine this year may be more important than ever

The hottest days of the summer traditionally occur during a span of days that begins in early July and ends in the middle of August. Better known as the “Dog Days of Summer,’’ this period ends this year on the day just before school begins across the state of Florida.

The beginning of the school year also falls in the middle of National Immunization Awareness Month, an annual observance held every year in the middle of August to highlight the importance of vaccinations for all people, no matter their age.

The goal of National Immunization Awareness Month is to raise awareness and educate people on the role vaccines play in preventing a variety of serious and sometimes deadly diseases, and it is taking on added importance this year.

With nearly a thousand cases already reported, the measles outbreak of 2019 already stands as the largest outbreak since 1994 and the largest since measles was declared eliminated by the US Centers for Disease Control and Prevention in 2000.

That outbreak has affected people in 26 states, including Florida, and public health officials say the spread is due in no small part to a lack of information regarding vaccines, which some believe to be a cause of autism.

Scientific studies have proved there is no link between vaccines and their ingredients autism and that with very few exceptions, vaccines are safe.

The rise in measles cases this year is not due solely to a lack of vaccines, of course. The virus has also been picked up and spread from people traveling from countries where measles remains a common malady.

That, though, is one reason getting a vaccine this year may be more important than ever. With measles cases already on the rise, the chances of someone unknowingly getting the measles virus while on summer vacation has increased.

Consequently, the days and weeks leading up to the start of the school year are the best time to get vaccinated, and it’s not just small children attending school for the first time who may need to be vaccinated.

The Human Papillomavirus, or HPV virus, is one of the most common, affecting nearly all men and women at some point in their lifetime. Nearly 80 million people in the United States alone are currently infected with HPV, which attacks about 14 million Americans annually.

Teenagers and pre-teens are among those often infected by the disease, which can be spread through intimate skin-to-skin contact. The issues associated with HPV often go away on their own after a year or two, but the HPV virus can linger and lead to certain cancers.

HPV is annually the cause of about 30,000 cancer cases, including cancer of the vagina, cervix and vulva in women and cancer of the penis in men. Thankfully, a simple vaccine can prevent those and other cancers from developing.

The CDC recommends that before their 12th or 13th birthday, all boys and girls get two doses of the HPV vaccine. Because the HPV vaccine works best when administered prior to someone getting HPV, doctors says the HPV vaccine can be given as early as age 9.

Because of the measles outbreak, some older adults are even being encouraged to receive a vaccine booster shot this year. People born between 1963 and 1967, for example, may have received an ineffective vaccine, health officials have said.

As with any medicine, people should always consult with a doctor before receiving any vaccinations. But given the measles outbreak and growing cases of HPV, this year, more than most, is a year in which that consultation could prove critical to good health.


St. Petersburg Surgeon Performs First 3D-Printed Finger Bone Operation in the United States

August 6th, 2019

Three dimensional, or 3D, printing has had many notable software and technology advances in recent years, and one of the more notable implementations in that progression was recently engineered by a St. Petersburg surgeon.

Dr. Daniel Penello, a surgeon with Alexander Orthopedic Associates, became the first doctor to use a 3D printer to replace a finger bone after a welder named Robert Smith lost virtually all use of his middle finger when a steel beam fell on it and crushed it at work.

While Smith was making the difficult decision of what, precisely, to do with his crushed finger (i.e., leave it uncared for or have it amputated), Dr. Penello contacted Additive Orthopaedics, a 3D printing company that develops advanced orthopedic devices, to see if employees there could create the software and technology necessary to perform the first-of-its-kind procedure.

Additive Orthopaedics responded by obtaining a CT scan of Smith’s opposite uninjured middle finger from Dr. Penello. From that it manufactured a replacement part made of a surgical grade metal that contains a rough inner surface that allows it to attach firmly to the existing bone.

While Additive Orthopaedics worked its magic, Dr. Penello began the long process (five months) of gathering and mastering the precise information he needed to successfully perform the procedure.

Dr. Penello explained to a writer that “my primary concern was our ability to develop an implant that would fit anatomically, while being strong enough to withstand the tremendous forces that it would be exposed to during any pinching, gripping, or lifting activities.”

The surgery was performed this past spring, and Dr. Penello deemed it a success as Smith is now doing physical therapy to regain complete usage of both the rejuvenated finger and his hand.

The successful surgery and the ongoing work at Additive Orthopaedics suggests 3D printing may soon impact the medical field in a far greater way, particularly in the area of custom implants, which could become more affordable through this process.

“I picture a 3D printer, sitting at the hospital, and when someone comes into the hospital with a broken wrist, someone will go to the printer and type it in,” Dr. Penello told the Tampa Bay Business Journal. “Almost like ‘Star Trek,’ where they type in what they need.” Image courtesy of Tampa Bay Business Journal

That Dr. Penello performed the inaugural 3D printed finger bone operation – at least the first known in the United States – should not come as a surprise to anyone. In an interview in February for “Becker’s Spine Review,” he told a writer:

“I am most excited about the emerging trend of additive manufacturing (commonly known as 3D printing) in the development of patient-matched devices and superior implants. … The additive manufacturing process has the ability to develop custom implants and patient-specific jigs and targeting devices in a much more cost-effective and scalable way.”

Dr. Penello, who is board certified in both Canada and the United States, graduated from the medical school of the University of Toronto in Canada, and later worked at the Cleveland Clinic, is well known in his profession.

He has a YouTube video telling viewers of his professional experiences that includes an explanation of how his life vocation was influenced by his father “who sustained a pretty tragic injury in the right hand (that) really altered the course of his life. It led me to the career of my dreams because I love hand surgery.”


Welcome to Florida: The Lightning State

July 11th, 2019

Florida’s has long been referred to as “The Sunshine State,” but anyone who sees the proverbial glass as being half-empty instead of half-full would be justified in calling it “The Lightning State.”

With an average of more than 3,000 lighting strikes per day and more than a million lightning strikes per year, Florida ranks fourth in the nation behind Texas, Oklahoma and Kansas in the number of recorded lightning flashes each year.

However, because of its vast population and the fact many of its residents and visitors spend a good deal of their time outdoors, Florida traditionally ranks first in the nation each year in the number of lightning-related deaths and injuries.

That’s the bad news. The good news is that due to an increase in awareness regarding this potentially instant killer, the number of deaths attributed to lighting strikes in the state of Florida has been on the decline in recent years.

Since 2001, when the National Lightning Safety Council launched its first National Lightning Safety Awareness Week, the number of deaths attributed to lightning nationally has been cut almost in half, from about 50 a year to about 30 per year.

That’s still too many, of course, which is why the National Lightning Safety Council continues its effort to educate people regarding lighting and its dangers, particularly here in the state of Florida.

In accordance with the National Weather Service, the National Lightning Safety Council reminds us that if you are outdoors and in a place where you can hear thunder, then you are in a place where you could be struck by lightning.

Simply put, there is no safe place outside when thunderstorms are in the area. That’s why the National Weather Service has come up with the motto, “When Thunder Roars, Go Indoors!”

Of course, heading indoors when thunder roars is sometimes easier said than done. For those situations when immediately heading indoors is not possible, it’s good to keep a few simple safety rules regarding thunder and lightning in mind.

To minimize the potential of injury when lightning is in the area, it’s best to stay away from wide open areas such as fields, hilltops and parking lots. It’s also best to stay as far away as possible from tall trees, even when in the woods.

You also want to stay away from standing water and avoid handling or touching anything that may be wet such, especially golf clubs, tools and metal fences or poles because water and metal are conductors of electricity.

These simple steps can greatly decrease a person’s chances of being struck by lightning, but if someone is struck, there is no need to fear touching the victim because lightning victims do not carry an electrical charge.

Should someone around you be struck by lightning, call 911, monitor the victim as best as possible and perform CPR if necessary until professional help can arrives to attend to the victim.

Melanoma: The Mother of Skin Cancers

June 16th, 2019

Skin cancer is the most common type of cancer in the US, affecting about one in five Americans by age 70. In fact, more people in the US are diagnosed with skin cancer each year than all other cancers combined. Fortunately, skin cancer is highly curable if detected early and treated properly.

Skin cancer starts in the three main types of skin cells: basal cells, squamous cells and melanocytes. Melanocytes, found in the skin’s middle layer, or epidermis, make the pigment melanin, which gives your skin its color.

Melanoma skin cancer develops when the DNA in melanocytes is damaged, usually by the ultraviolet radiation from the sun or tanning beds, and that triggers mutations in the genes. These mutations cause the melanocytes to grow out of control and form tumors.

Melanoma is less common than other types of skin cancers. It is almost always curable if caught and treated early, but if allowed to grow and spread, it can be deadly. In 2019, more than 192,000 Americans are expected to be diagnosed with melanoma, and more than 7,000 are expected to die from it.

Melanoma can develop anywhere on the body, but it is more likely to show up in certain areas. In men, it is most commonly found on the chest and back, while in women, the legs are most often affected. It also commonly occurs on the face and neck.

The exact cause of the genetic mutations responsible for the development of melanoma is still being studied. But researchers do know there are certain factors that put you at a higher risk for this skin cancer. These factors include:

  • Having a lot of freckles, moles, age spots or large birth marks
  • Having light skin that burns easily as well as light-colored eyes
  • Having red or light-colored hair
  • Being older (Risk increases with age.)
  • Having a personal or family history of melanoma
  • Getting a lot of sun exposure

According to the American Cancer Society, unusual moles, sores, lumps, marks or changes in the way an area of the skin looks or feels may be a sign of melanoma or another skin cancer. These changes may also be a warning that skin cancer might occur.

This biggest warning signs of melanoma are a new spot on the skin and an existing spot that’s changing. There are two common ways to evaluate a spot on your skin. One is the ugly duckling sign. Does the spot in question look different from all the other spots on your skin? If so, you should have it checked by a dermatologist.

The other way to evaluate a spot is the ABCDE method. Look for the following features in a  mole or spot on your skin:

There are several ways to treat melanoma. These include surgery, chemotherapy, radiation therapy and targeted therapy. Targeted therapy uses medicines to stimulate your immune system to recognize and destroy cancer cells more effectively. Several types of immunotherapy are available to treat melanoma.

Your best bet is to prevent melanoma in the first place. There are a few steps you can take toward that goal. An import first step is to limit your exposure to ultraviolet radiation. That includes exposure to the sun’s rays and tanning beds.

If you have to be in the sun, try to find shade between 11 a.m. and 3 p.m., when the sun’s at its highest intensity. And before you go out, remember this catchphrase “Slip! Slop! Slap” and Wrap. Slip on a shirt, Slop on sunscreen, Slap on a hat and Wrap on sunglasses to protect your eyes and the sensitive skin around them.

And don’t forget to regularly examine your skin for any new, unusual or changing moles or spots. Anything out of the ordinary that you discover should be further examined by your doctor or a dermatologist.

Take care of your skin, and it will take care of you.

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