Blog Posts

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 iStockphoto.com.A 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 clinicaltrials.gov.

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.

#Ivax2Protect

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 Patch.com 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:

http://www.hopehealthfnp.com/index.php/cancer/know-your-abcdes-of-skin-cancer/

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.

Are Men More Likely To Develop Osteoporosis Than Women?

June 9th, 2019

New Study Reveals Stunning Trend

The precursor to osteoporosis, a silent yet potentially disabling disease that can cause bones to weaken and break unexpectedly, is osteopenia.

Like osteoporosis, osteopenia is a disease most often found in women, but new research suggests middle-aged men may be more likely to develop the disease.

That is the conclusion drawn from a recent study of the bone mineral density in the necks and hips of 173 men and women between the ages of 35 and 50.

The study found that 28 percent of the men studied showed significant signs of osteopenia while 26 percent of the women studied showed those signs.

Osteoporosis is defined clinically as a potentially severe condition in which new bone growth fails to keep pace with bone degeneration.

About 54 million Americans have osteoporosis, and according to the study, a fracture caused by osteoporosis occurs every three seconds.

Osteopathic fractures are also on the rise, per the study, with the worldwide incidence of such fractures expected to increase by 310% in men and 240% in women by the year 2050.

Osteopathic fractures occur most often in the spinal vertebrae and femoral head or hip, but other bones, such as the wrist bone, can break as well. But fractures are not the only damaging result of osteoporosis.

Osteoporosis can also result in a loss of height as the effects on the vertebrae, or the bones of the spine, often lead to a stooped or hunched posture.

According to the study, published in The Journal of the American Osteopathic Association, osteoporosis can drastically decrease mobility, lessen the quality of one’s life and even lead to death.

Given the dangers associated with this growing health concern, it’s no wonder doctors have sought to find ways to halt or reverse the effects of osteoporosis.

One such solution is a revolutionary exercise program called OsteoStrong, which helps rebuild bone through once-a-week, 15-minute workout sessions using specialized equipment that includes four bio-mechanical machines.

These machines allow the user to perform resistance-based pushing and pulling exercises with their arms and/or legs. During these sessions, the user can safely exert pressure four to 12 times their body weight.

The concept is the culmination of twelve years of research that looked into the body’s response to growing new bone and muscle structure and improving the density of the bones,” says Mark Brady, president of OsteoStrong in South Pasadena.

“As a result of that research, it is a known medical fact that when you put certain forces on the bones, the body responds by growing new bone tissue. We do this through our short sessions on bio-mechanical equipment, and the results are absolutely amazing.

“Our studies show that on average, OsteoStrong workouts improve people’s bone density levels from three to seven percent a year. In addition, people typically increase their strength by an average of seventy-three percent during their first year at OsteoStrong.”

OsteoStrong has already helped more than 25,000 people reverse the negative effects of both osteopenia and osteoporosis and should remain a critical tool in the fight against this silent disease for years to come.

 

 

The da Vinci Debate

June 6th, 2019

Medical theories abound over what caused the great master to leave so many works, including his most famous, undone?

For all of its beauty, mystery and technical expertise, the Mona Lisa has long been considered an unfinished masterpiece. It remains a subject of debate even today, and not just among artists and art historians, but among medical professionals as well.

In early May, as the art world began to recognize the 500th anniversary of the death of the Mona Lisa’s creator, Leonardo da Vinci, several doctors began questioning the long-standing beliefs regarding da Vinci’s failure to complete the work, which was first discovered in his studio immediately after his death.

One of those beliefs is that da Vinci suffered a stroke that robbed him of the use of his right hand, which is the hand the ambidextrous artist painted with. Another suggests da Vinci’s right hand became deformed as a result of a condition known as Dupuytren’s contracture.

Two Italian physicians – one a plastic surgeon, the other a neurologist – were the first to question those theories, arguing in The Journal of the Royal Society of Medicine that da Vinci may have simply suffered a fall that resulted in nerve damage to his right hand.

They based their theory on a drawing created by a contemporary of an elderly da Vinci in which da Vinci’s right arm is wrapped in “folds of clothing, as if it was a bandage, with his right-hand suspended in a stiff, contracted position.

The doctors go on to say that, in the drawing, da Vinci’s right hand does not appear to be gnarled or clenched in the way that it would have been had it been disabled by a stroke and otherwise suggest the disabling cause may have been a palsy known as claw hand.

The authors used another drawing, this one a 1505 depiction of a man identified as an older da Vinci playing a lyre, to rule out Dupuytren’s contracture as the cause of the late-life disability in da Vinci’s right hand.

Dupuytren’s contracture is a progressive disease that gnarls the hand slowly over time. The authors argue that if da Vinci suffered from the disease, its symptoms would have been present in the 1505 drawing, which they are not.

The art world was still digesting the two Italian author’s findings when, in late May, a paper published in the journal Brain suggested yet another reason why da Vinci continued to teach and draw until his death but left many paintings unfinished.

According to Marco Catani, a King’s College of London psychiatrist, and Paolo Mazzarello, a medical historian at the University of Pavia, da Vinci suffered from attention deficit and hyperactivity disorder, or ADHD, and was a chronic procrastinator who struggled to finish projects.

“Even when Leonardo was finally commissioned with the important project of building a bronze statue of Ludovico’s father, the future Duke asked his allied Lorenzo il Magnifico if he could indicate a more apt Florentine artist for the project because he ‘doubted Leonardo’s capabilities to bring it to completion.’”

Catani and Mazzarello used accounts of da Vinci’s behavior and work habits culled from writings about da Vinci in reaching their conclusion, noting that da Vinci struggled to remain focused on tasks from early childhood on.

They refer to stories of how da Vinci regularly wowed people with his ambitious ideas and projects but often disappointed them because he failed to complete the project he was hired to do. A statue of the father of Ludovico il Moro, the future Duke of Milan, was one such project.

“Even when Leonardo was finally commissioned with the … project … the future Duke asked … if …  a more apt Florentine artist (could be found) because he doubted Leonardo’s capabilities to bring it to completion,” Catani and Mazzarello wrote.

The authors go on to suggest that evidence of ADHD can be found in the history behind the creation of other great works by da Vinci, including The Last Supper, which is painted on a wall in the dining hall of the Santa Maria delle Grazie in Milan, Italy.

They also suggest that ADHD negatively affected da Vinci’s relationships, career and income, but they note that it may have been at the root of his virtually unsurpassed creativity and imagination.

The difficulties linked to his extraordinary wandering mind caused him deep regrets but did not prevent him from learning and exploring the wonders of human life and nature,” the authors wrote.

 

 

 

 

 

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