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Can Tea Help Heartburn?

 by Top Docs of DFW on 02/20/12

Suffering from heartburn is a painful experience. One natural remedy that helps some patients avoid or diminish heartburn pain is drinking ginger tea. It is important not to begin adding any supplements to your diet without discussing their benefits and risks with your physician first. For many people, transoral surgery in Dallas is necessary to overcome the severe discomfort caused by heartburn and acid reflux.

About Ginger Tea

Ginger is a spice used to add a pungent, sweet flavor to recipes. It has also been used as a natural treatment for a range of digestive problems, including upset stomach related to chemotherapy, pregnancy and other conditions. People with heartburn often find relief with ginger. To make ginger tea, grate a teaspoon of fresh ginger and put it in a tea ball. Let this steep it in a pot of hot water for about four minutes, and then it will be ready to drink.

How it Works

Ginger tea soothes the digestive tract and has anti-inflammatory properties. Even the simple fact that it is consumed warm helps patients feel better. Ginger also eases related stomach issues, such as acid indigestion, nausea and gassiness.

Ginger tea is more effective for some patients when it is combined with other natural remedies such as slippery elm bark or goldenseal. Combining these herbs helps digestive linings heal.

Side Effects

Most people don’t experience side effects when they drink ginger tea. However, some do have diarrhea, increased heartburn or mouth irritation. Taking no more than 4 grams of ginger a day limits the chance of side effects so patients can benefit from the soothing benefits of the tea.

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“TOP DOCS OF DFW” WELCOMES ITS NEWEST TEAM OF DOCTORS TO ITS POPULAR TOP DOCS MARKETING PROGRAM”

 by Top Docs of DFW on 02/14/12

 

FOR IMMEDIATE RELEASE:

Dallas, Texas – FEBRUARY 10, 2012 –  Identity Media Services, LLC, announced today that Pama Inc. has joined the Top Docs of DFW team as its newest client.  “We are proud and excited to have Pama and its doctors as part of our team.  With over a hundred and fifty years of professional surgical experience, and their commitment to providing the highest medical care and attention possible in the Dallas Fort Worth area, the organization provides a mission of “Pain Freedom” that continues to be in great demand throughout our area,” said Bill Lee, Executive Producer.

The center expert staff currently includes;

A.L. Shaw, M.D, Dan A. Waddell, D.O. Marcus Newton, D.O., George Farhat, M.D., Stephen J. Troum, M.D., Jason Ahuero, M.D., Robert Myles, MD, Kevin Kaufman, MD and Matthew W Cerniglia, DPM.

The Pama, Inc. and Top Docs partnership will be a long-term and very effective relationship according to the center’s Director of Marketing, Robert Harvey

“All of us at Pama are extremely proud and excited to be represented by Top Docs of DFW. We have an elite team of specialists that are all Board Certified and Fellowship Trained with passion and conviction to help people. We are confident Top Docs will give us an incredible platform to convey our message of Pain Freedom. ”

Top Docs of DFW is now into its second year of operation and shows to have well over 12 million quarterly impressions from its media services provided to its clients.  In addition to the phenomenal growth of the Top Docs television audience, the company’s Social Media outlets continue to show double digit growth each quarter.  The parent company recently announced its launch of Top Docs of Houston, and is currently in process of launching its first out of state operation in Nashville, Tennessee.

For More information contact:  info@topdocsoftexas.com

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Indigestion and Coffee

 by Top Docs of DFW on 02/14/12

http://www.dallasreflux.com/gerd-resources-dallas/indigestion-and-coffee/

Many people rely on a cup of coffee to provide that early morning boost of energy. However, for those who suffer from the discomfort of indigestion in Dallas, it is likely time to find a new caffeinated beverage. Coffee has been shown to contribute to indigestion, whether it is decaffeinated or not, which suggests that some other component in it is irritating the digestive tract. Before naming coffee as the culprit of indigestion, however, it is worthwhile to investigate other causes.

What Causes Indigestion?

The symptom of indigestion is independently related to several conditions, including gastrointestinal reflux disorder (GERD) and overeating. It may occur simultaneously with heartburn, but these two symptoms ultimately have different causes. If there is a frequent experience of heartburn and acid indigestion, then it may be time to see a doctor about a potential diagnosis of GERD, which is an abnormality or weakening of the sphincter that closes off the stomach during digestion.

How Does Coffee Make the Symptoms Worse?

Several of the chemicals contained in a cup of coffee are known to contribute to the risk of high acid gastric secretions. Caffeine may not even be the most active of the list, which also includes N-methyl pyridinium and chlorogenic acid. Cutting back on coffee may reduce the symptoms of acid indigestion, but it alone is not the cause of GERD. It is important to remember that indigestion triggers often vary from person to person, and so it is impossible to say that coffee is a sure cause of heartburn or an upset stomach. In fact, specialists say that an occasional cup may offer health benefits that outweigh the potential risk. The best thing to do is to cut back and see if this leads to a reduction of symptoms.

If GERD is suspected, it is important to get a formal diagnosis for the indigestion in Dallas, because there are medications that can help, as well as a list of other foods and beverages to avoid or use sparingly.

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Injured boomers beware: Know when to see doctor

 by Top Docs of DFW on 02/13/12

CHICAGO – It happened to nurse Jane Byron years after an in-line skating fall, business owner Haralee Weintraub while doing "men's" push-ups, and avid cyclist Gene Wilberg while lifting a heavy box.
"It" is that pop, strain or suddenly swollen joint that reminds active older adults they aren't as young as they'd like to think.
Even among the fittest baby boomers, aging bodies just aren't as nimble as young ones, and they're more prone to minor damage that can turn serious if ignored or denied. But not every twist or turn needs medical attention, and knowing when it's OK to self-treat pays off in the long run, in dollars and in health.
Costly knee replacements have more than tripled in people aged 45-64 in recent years and a study released last week found that nearly 1 in 20 Americans older than 50 have these artificial joints. But active boomers can avoid that kind of drastic treatment by properly managing aches and pains.
Injuries that need immediate treatment cause excruciating, unrelenting pain, or force you to immediately stop your activity and prevent normal motion. Examples are a swollen, bent elbow that won't straighten, or a knee that collapses when you try to stand, said Dr. Charles Bush-Joseph, a sports medicine specialist at Chicago's Rush University Medical Center.
Treatment for more run-of-the mill activity-related injuries is less clear-cut.
A good rule of thumb for lower-body injuries is this: "If you're able to bear weight, it's safe to self-treat," at least initially. Even if taking a few steps is painful, just being able to put weight on an injury means it's probably not a medical emergency, Bush-Joseph said.
The key for most injuries is what happens over the next two to three days. If things start to improve — less pain, more range of motion — then there's often no need to see a doctor. But if pain or swelling don't subside with self-help, then it's time to make an appointment.
Common injuries in active boomers include:
—Tendinitis — painful inflamed tendons in the elbow, shoulder or knee. The condition is often caused by repetitive action, such as swinging a golf club or tennis racket, especially when not using the proper form.
—Tears to the meniscus, cartilage that cushions the knee but that becomes more brittle with age and prone to injury, especially from sudden twisting. Tears often cause a "pop" sensation and a feeling like the knee is catching while walking.
—Back pain, often from arthritis or aging discs in the lower spine. Impact exercise including running, and using the back instead of leg muscles to lift heavy weights can contribute.
Most can be treated with things like ice to curb swelling immediately after the injury, hot pads or other heat treatment for pain, over-the-counter painkillers, and rest.
In some ways, Jane Byron exemplifies the best — and worst — ways to handle those injuries.
At 51, the New York City cancer nurse is a self-described exercise "maniac." Her daily workouts often include walking, biking, leg pressing 400-pound weights and stair-climbing at her gym.
All that exercise has kept her extremely fit, and she rejects the idea that she might be overdoing it. So she had some choice words for the doctor who suggested she consider slowing down a bit when her right knee swelled up six years ago.
His diagnosis was torn cartilage likely from a 1999 fall while in-line skating. Byron had never been in pain nor sought treatment for that injury until the swelling began.
She had the cartilage surgically repaired and injections of lubricant medicine for knee arthritis. But she continued rigorous workouts right up until 2010, when she developed hip pain, probably from walking funny to favor her bum knee. By then she needed both knees replaced, but a physical therapist told her that being so fit would speed her recovery. Within a week after both surgeries, she was back riding an indoor bike.
Overdoing it can aggravate minor injuries, but abandoning activity isn't a good solution, either, because exercise has so many health benefits, said Dr. Steven Haas, an orthopedic specialist at the Hospital for Special Surgery in New York City.
Instead, make sure you're well-conditioned and "listen to your body," Haas said. Switching to less rigorous activities is sometimes the answer. "If your knee is killing you every day after you run, you're probably not doing the right sport."
Haralee Weintraub, 58, changed her exercise routine after injuring her back during a "boot-camp" class at her gym two years ago. The first time it happened, the Portland, Ore., online business owner was doing "full-out toe men's push-ups." A few months later the same thing happened during leg squats — pain that started in her lower back and shot down her leg. Because it was hard to stand, she went both times to the doctor, who diagnosed sciatica, common nerve pain likely caused by an aging disc in her lower back, and by overuse.
A physical therapist had her do exercises to strengthen muscles in her abdomen and near the sciatic nerve in her back, and leg exercises to stretch the buttocks' gluteal muscles.
Weintraub has switched to gentler "girls" knee push-ups and stopped doing lunges. But she still likes to snowshoe, bicycle, hike and walk, and is determined to stay fit.
"Hopefully I'll have another 25 years of activity and not be compromised with physical mobility issues," she said.
Unlike Weintraub, Gene Wilberg tried to tough out his injury, which probably prolonged his recovery. The tip-off that he should have gotten treatment sooner was persistent pain that interfered with his usual activities.
The 62-year-old Naperville, Ill., business consultant was helping his daughter move into an apartment two years ago when he felt a sudden pain in his upper right arm while lifting a box. The pain persisted and made it difficult to twist open jars and pursue hobbies including cycling 15-plus miles a week and skiing. He eventually just stopped using that arm.
After a few months Wilberg went to the doctor, who found a partial bicep tendon tear in his upper arm. Surgery was a possibility, but Wilberg wanted to try physical therapy instead. It took about four months to get his arm back in shape, lifting light dumbbells and using resistance bands. Wilberg says he was told not using his arm had allowed the muscles to atrophy.
"If you wait too long, sometimes you actually just end up delaying your overall recovery" and adding to the cost of medical treatment, said Nathan Sels, Weintraub's physical therapist.
Rob Landel, a physical therapist and professor at the University of Southern California, says many of his baby boomer patients try to cram all their exercise and activity into a weekend but do nothing during the week to prepare. That puts extra stress on bodies and raises chances for injuries.
So, for example, for those who like to go on long weekend runs, he recommends treadmill sessions or short jogs during the week, or other leg-strengthening exercises.
There's growing evidence that stretching right before an activity can hurt your performance, Landel said. After a run or tennis match is a better time to stretch, when muscles are warmed up. And routinely doing stretching and strengthening exercises during the week helps keep muscles strong and limber.
Landel knows that from personal experience. He's 53 and has painful tendinitis in both knees from playing volleyball for more than 30 years. That sometimes makes it difficult to get up and down on floor mats while helping patients with treatment.
"It's kind of embarrassing working with patients and you have to kind of crawl up the furniture to stand up. If I just exercise my legs, then I don't have those problems," Landel said.
Leg presses and other exercise that build up strength reduce his pain, and help his volleyball game, too, he said.
"The stronger you are, the better your joints tolerate stress," he said.
———
Online:
NIH information on sports injuries: http://1.usa.gov/qldiJW
Aging America is a joint AP-APME project examining the aging of the baby boomers and the impact that this silver tsunami will have on the communities in which they live.

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More Than 4 Million Americans Have New Knees - Including Younger Adults

 by Top Docs of DFW on 02/10/12

SOURCES: Elena Losina, Ph.D., co-director, Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston; William J. Robb III, M.D., chairman, Department of Orthopaedic Surgery, NorthShore University Health System, Evanston, Ill; Feb. 10, 2012, presentation, American Academy of Orthopaedic Surgeons, annual meeting, San Francisco
Published on: February 10, 2012

FRIDAY, Feb. 10 (HealthDay News) -- More than 4 million Americans now live with an artificial knee, and increasing numbers of younger patients are undergoing knee replacement surgery, new research reveals.

Researchers at Brigham and Women's Hospital in Boston estimate that more than half of adults who are diagnosed with knee osteoarthritis will receive a total knee replacement in their lifetime.

Senior author Elena Losina, co-director of the hospital's Orthopaedic and Arthritis Center for Outcomes Research, said the country's aging population and high rates of obesity are only partly responsible for the rise in total knee replacements.

"We think that as more and more people began participating in active sports, they sustained injuries earlier in life, and therefore developed knee osteoarthritis earlier," Losina said. "And these active people are probably more willing to undergo surgery that will enable them to continue to be active."

Also, with improved success rates over the past 20 years, "surgeons are more comfortable offering it, and patients are more comfortable having it," Losina added.

A shorter postoperative hospital stay has also made the procedure more acceptable, she said. "Ten or 15 years ago, patients stayed in the hospital for a week," Losina said. "Now, they're usually discharged on the third day after surgery."

The number of new-knee procedures doubled over the last decade, reached more than 620,000 in 2009, and the researchers said younger patients -- those 45 to 64 -- accounted for a disproportionate amount of that growth. Their relatively young ages means many are at risk of revision surgery as well as potential long-term complications of surgery, the authors warned.

The researchers estimate that more than 4.2 million Americans currently have an intact total knee replacement, which represents 4.4 percent of the total population aged 50 and over. Prevalence is slightly higher in women versus men.

They further estimate that nearly 53 percent of men and 52 percent of women diagnosed with symptomatic knee [osteoarthritis] will receive a total knee replacement in their lifetimes. The risk of subsequent revision is nearly 15 percent for men and roughly 18 percent for women, the authors wrote.

In osteoarthritis of the knee, the cartilage wears down, causing changes in the adjacent bone, resulting in pain, swelling and stiffness.

The study is scheduled for presentation Friday at an American Academy of Orthopaedic Surgeons' meeting in San Francisco. The researchers' data included information from the U.S. Census, two national studies on people with knee arthritis, and a computer model on the history and management of knee arthritis.

One leading orthopedic surgeon, Dr. William J. Robb III, chairman of the department of orthopaedic surgery at NorthShore University Health System in Evanston, Ill., said the findings were useful in that they provided more details about the number of patients now living with artificial knees. But he questioned the estimate of patients who might require revision surgery.

"The study used historical failure and complication rates to predict future numbers of failures that might require revision surgery," Robb said. "The methodology used likely projects the 'worst-case scenario' for total numbers of failures, as implant materials have been improved and those improvements may decrease the overall revision rate."

The study was funded by the U.S. National Institutes of Health's National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Data and conclusions presented at medical meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

For questions on Knee Replacement surgery, ask Dr. Dan Aldrich at info@topdocsoftexas.com.


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Too Few American Adults Getting Needed Vaccinations: CDC

 by Top Docs of DFW on 02/10/12

By Steven Reinberg
HealthDay Reporter

THURSDAY, Feb. 2 (HealthDay News) -- Each year, some 45,000 Americans die from diseases that could have been prevented by vaccines, health officials said Thursday.

Despite this, the number of American adults who get needed vaccines remains low, according to the U.S. Centers for Disease Control and Prevention.

"There were some modest increases in coverage, but for very few vaccines," said Dr. Carolyn B. Bridges, associate director of adult immunization at the CDC and co-author of the report. "Coverage is much lower than we would like to see it."

The data was published in the Feb. 3 issue of the CDC's Morbidity and Mortality Weekly Report.

According to the report, 2010 (the latest year covered by the report) saw only a small increase in the rate of uptake for just three vaccines.

The rate of the tetanus, diphtheria, and acellular pertussis (Tdap) vaccination increased 1.6 percent, to 8.2 percent. Tdap includes protection against pertussis, also known as whooping cough. Among whites aged 60 and older, use of a vaccine that protects against shingles rose more than 5 percent to 16.6 percent.

Among women aged 19-26, those who got at least one dose of the human papillomavirus (HPV) vaccine, which protects against about 70 percent of all cervical cancers, increased 3.6 percentage points, to 20.7 percent, the researchers noted.

For other vaccines, rates remained basically the same. For example, among high-risk adults aged 19 to 64, only 18.5 percent received a vaccine that protects against pneumonia. For adults 65 and older, the rate was close to 60 percent overall.

In 2010, the adult vaccination rate for hepatitis A was 10.7 percent and for hepatitis B the vaccination rate was 42 percent, which is about the same as the 2009 estimate, the researchers reported.

Vaccine rates probably remain low for several reasons, Bridges said. "There is not enough information about which vaccines are needed for adults and unlike children, who have regularly scheduled doctors' visits for vaccines, this is not the case for adults," she noted.

Also, vaccines schedules for adults are more complicated, Bridges explained. "They are not just based on age, like most of the pediatric vaccines. Adult vaccines are recommended only for a certain age or if you have a high-risk medical condition or certain occupation or travel. So, it's a little bit complicated."

Some adults may have also missed vaccines during childhood, like the measles, mumps and rubella (MMR) vaccine and should be vaccinated now, Bridges said.

According to the CDC, ways to improve the rate of adult vaccinations include education, better access to vaccines, physician reminders and recall systems.

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The Most Common Questions About Reflux

 by Top Docs of DFW on 01/27/12

What is GERD or Reflux?


How can GERD be detected?

What are the symptoms of GERD?

Is it heartburn or GERD?  When acidic stomach contents flow backward (reflux) from the stomach into the esophagus, people experience the symptoms of gastroesophageal reflux disease or GERD.

Where can I go for more information? 


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Meet Dr. Glenn Ihde - Leader in Reflux and Bariatric Procedures

 by Top Docs of DFW on 01/11/12

 

Our Top Docs Physician is Dr. Glenn M. Ihde.  Dr. Ihde is a board certified surgeon specializing in bariatric surgery and procedures for treating gastroesophageal reflux disease. Since receiving his medical degree and completing the surgical residency program at the University of Kansas School of Medicine, Dr. Ihde has developed his expertise in minimally invasive (laparoscopic) surgery and natural orifice or incisionless procedures. Dr. Ihde has received extensive specialized training in Transesophageal Incisionless Surgery using the EsophyX device, allowing him to provide GERD sufferers in the Dallas, Fort Worth, and Arlington area with this revolutionary scarless procedure.

 

Appointments

Director of the Bariatric Program at the Medical Center of Arlington

Director of Surgery at Kindred Hospitals Mansfield

Director of Bariatric Surgery Program at Baylor-Waxahachie

 

Education and training

Bachelor of Science in Chemistry: Creighton University 

Medical Degree: University of Kansas School of Medicine

Board Certified by the American Board of Surgery

 

Memberships

American Medical Association

Texas Medical Association

Society of Laparoendoscopic Surgeons

Society of American Gastrointestinal Endoscopic Surgeons

American Society for Metabolic and Bariatric Surgery

Texas Association of Bariatric Surgery (TABS.org) – Vice President, President Elect


For more information, go to Dr. Glenn Idhe's profile page.

 

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Celebrities and Bariatric Surgery: Al Roker

 by Top Docs of DFW on 01/11/12

by Glenn Ihde

Tagged with: Bariatric Surgery Morbid Obesity

For years, he was known as the lovable, overweight weather man on NBC's Today Show. Viewers enjoyed waking up to his morning weather predictions and friendly smile. But while audiences seemed to have no qualms about Roker's weight, the TV personality was hiding a long-time struggle of weight gain and failed diets. At his heaviest, Roker weighed 320lbs. Although he knew that his weight was having serious consequences on his health, it wasn't until he got a wake-up call from his father that he decided to undergo bariatric surgery.

The Decision to Undergo Bariatric Surgery

While Roker had remained quiet about his struggles to lose weight, his dramatic weight loss following gastric bypass surgery in 2002 instantly made him a poster child for the weight loss surgery. Ironically, Roker had tried to keep his surgery a secret rather than step into the role. However, after dropping from 320 pounds to 204 pounds in a short time, Roker opened up to the media about his decision to undergo bariatric surgery. In interviews, Roker recalled that he had always been overweight and always had a love for food. Throughout his teens, he consumed large amounts of food and exercised very little. When he reached college, and had access to even more food at the dining halls, his weight reached 300 pounds.

Although he tried nearly every diet he could think of, they never seemed to work for him. Roker has said that it was his ailing father's request that he lose weight so that he could care for his children that finally made things click. After his father died a few weeks later, Roker vowed to grant his father his last wish and get healthy. Following much research and contemplation, he made the decision to undergo gastric bypass surgery. Viewers and coworkers quickly noticed Roker's shrinking size and commented on his new, healthy look. After going through the surgery, Roker reached 204 pounds, and said that he hopes to reach 199 pounds just to be able to say that he weighs less than 200 pounds.

Life After Bariatric Surgery

Since Roker was one of the first public figures to undergo gastric bypass surgery, viewers and the news media were eager to hear his story. Although he was reluctant at first, Roker decided to share his experiences with bariatric surgery to give people a realistic idea of what the experience is like. One thing that he has stressed is that bariatric surgery is not a quick fix and it isn't an easy way out. Roker has also been adamant about the risks involved in this type of surgery, and encourages others to be well educated on the subject before making the decision.

He also admits to suffering a temporary setback in which he gained 40 pounds after not remaining committed to his lifestyle changes, and reminds others that the surgery is real work. Following surgery, he has stated that he is now more conscious of what he eats, and that he eats much less. "I really believe I appreciate food far more now, because I have to make what I put in my mouth count," he told NBC in 2004. "So it had better be darn good. Before, it was just you know, open my mouth." Roker has also made exercise a part of his daily life, running several times a week prior to taping The Today Show. In fact, in 2010 Roker completed the NYC Marathon with fellow Today Show reporter Meredith Viera. He noted that finishing the marathon simply would not have been possible at his previous weight.

In addition, Roker has incorporated therapy and support groups into his life to deal with the problems that used to cause him to overeat. He has admitted that it was difficult to separate himself from his identity as the "fat and funny" weatherman. "The surgery doesn't change... whatever made you gain weight to begin with," he said. "You have to do some psychological work." Since Roker's experiences with bariatric surgery have been so public, he is often associated with the procedure. He has used this as an opportunity to educate others on the importance of having realistic expectations regarding the surgery. He also provides hope to those who have struggled with weight and are considering bariatric surgery.

Our Dallas bariatric surgery practice offers gastric banding and gastric bypass surgery in Dallas. If you believe you may be a candidate for bariatric surgery and are interested in learning more about the procedure, contact Minimally Invasive Bariatrics today.

Source: http://www.wls-mib.com/blog/2012/01/03/celebrities-and-bariatric-surgery-al-roker-71882

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Only Reflux? You Might be Developing Esophogeal Cancer

 by Top Docs of DFW on 01/11/12

If you suffer from frequent esophageal reflux or GERD in Dallas, you should have your condition monitored by your doctor. In some cases, GERD can develop into a condition known as Barrett’s esophagus, which is a precancerous condition. Only approximately one percent of Americans have this condition. People with Barrett’s esophagus are more likely to develop esophageal cancer.

The churning and burning sensation deep within the chest, commonly referred to as heartburn, often rears itself rather painfully after eating. Heartburn can also attack at night, particularly when lying down or bending over. Backed up stomach acid that travels up the esophageal tube rather than down toward the stomach, as it should, is what leads to the painful symptom of heartburn.

Source: http://www.dallasreflux.com/gerd-resources-dallas/ Dr. Glenn Ihde

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GERD Can Develop Due to Hernias

 by Top Docs of DFW on 01/11/12

If a patient is suffering from indigestion in Dallas and doesn’t know the cause, they should know that GERD can often develop because of hernias. GERD is short for gastroesophageal reflux disease, and a hernia is a protrusion of any internal organ through a weakness or abnormal opening in the muscle around it. The sort of hernia that often causes GERD is hiatal hernia, which protrudes through an abnormal opening in the diaphragm, a broad muscle that separates the chest cavity from the abdominal cavity and helps in breathing. The place where the hernia bulges up from the diaphragm is called the hiatus, and this is also the place where the esophagus passes through to the stomach. The esophagus, which is part of the very long and complicated gastrointestinal tract, is the long tube where food makes its way from the mouth and throat and into the stomach.

Because the hernia and the esophagus are interfering with each other in the same space, a person can suffer symptoms of both GERD and hiatal hernia at the same time, though most people who have a hiatal hernia are symptom free. Sometimes the symptoms of GERD and hiatal hernia are very similar, and often include a feeling of heartburn that develops about an hour after eating, belching and difficulty swallowing.

The hernia can cause acid to flow up into the esophagus from the stomach and irritate the esophagus. Mild symptoms of a hiatal hernia can be treated with a change in dietary and lifestyle habits. Large meals should be avoided and the patient should lose weight if they’re overweight, and shouldn’t eat anything for at least a couple of hours before they go to bed. They should also avoid foods that they know cause their symptoms. The condition is also helped if the head of the bed is raised about four to six inches, which helps to keep stomach acid from rising and causing irritation.

Source: http://www.dallasreflux.com/gerd-resources-dallas/  Dr. Glenn Ihde

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TOP DOCS OF DFW GOES “TAPELESS” AS IT ENTERS THE WORLD OF HIGH-DEFINITION. (HD)

 by Top Docs of DFW on 01/10/12

Dallas, Texas – JANUARY 10, 2012 –  Identity Media Services, LLC, announced today that it’s subsidiary, “Top Docs of DFW” has made a major advancement in the digital world of television production by providing it’s weekly “Top Docs of DFW” television program in high-definition.  According to production manager, Corey Frey, “not only do we now provide our programming in HD, we do so within a totally tapeless environment.  Everything is shot and edited digitally, and shows are electronically transmitted to our stations”.   Executive Producer, Jim Knox explains, “most programs such as ours are still produced in standard definition because of the costs to convert as well as the difficulty of merging past programming into this new format”.  High-definition television (HDTV) is video that has resolution substantially higher than that of traditional television systems standard-definition television. HDTV has one or two million pixels per frame; roughly five times that of SD.

“We feel that it’s very important for us to provide our Physician clients and our viewers the very best in picture and production quality in order to best capture the stories of how lives have been changed by these professionals”, according to Executive Producer, Bill Lee.

The Top Docs program can be seen in the DFW area twice weekly on CW 33 and continues to see strong viewer growth each week.  The show which first launched in the spring of 2010, now represents physicians, dentists, and hospitals in multiple states.

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Colorectal Cancer on the Rise Among Younger Adults

 by Top Docs of DFW on 12/13/11

Posted: December 13, 2011 | Author: |
By Shalmali Pal, Contributing Editor, MedPage Today
Published: December 12, 2011
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Action Points
    • A database study determined that the incidence of colorectal cancer has been rising in individuals under the age of 50 since 2001, at a time of decreasing incidence in older patients.
  • The increasing incidence was found especially in cases involving rectal cancer and more advanced stages of colorectal cancer, as well as in patients of nonwhite race/ethnicity and those lacking health insurance or Medicaid coverage.

The incidence of colorectal cancer (CRC) among adults younger than 50 has increased by 2.1% in the past decade, according to results from a study of the National Cancer Database.”The median age for young-onset CRCs was 44 years, with most (75.2%) occurring between ages 40 and 49 years,” wrote Yi-Qian Nancy You, MD, of MD Anderson Cancer Center in Houston, and colleagues, in a research letter published online in the Archives of Internal Medicine.

The authors identified 64,068 cases of young-onset (before age 50) invasive adenocarcinoma of the colon and rectum between January 1998 and December 2007. The increase was greater for young-onset rectal cancers (annual percentage change [APC] 3.9%, 95% CI 3.1% to 4.7%) compared with colon cancers (APC 2.7%, 95% CI 2% to 3.3%).

These results contrasted with those of people over the age of 50, in whom the incidence of CRC has been falling.

Geography, ethnicity, and financial status also played a role in the distribution of CRC incidence among this population.

“Compared with later-onset disease, young-onset CRCs were more prevalent among patients with nonwhite race/ethnicity (29.5% versus 17.6%, P<.001) who were not insured or insured by Medicaid (16.5% versus 4.7%, P<.001) and who lived in the southern and western parts of the U.S. (56.2% versus 50.3%, P<.001),” the investigators wrote.

In addition, advanced-stage disease (stage III/IV) was diagnosed more commonly in young patients, with an occurrence of 63% for colon cancer and 57% for rectal cancer.

The researchers found that one of the independent risk factors for advanced-stage disease was younger age:

  • Ages 30 to 39 versus 40 to 49 years: hazard ratio 1.21, 95% CI 1.1 to 1.4
  • Ages 18 to 29 years versus 40 to 49 years: HR 1.4, 95% CI, 1.2 to 1.6

Race also was an independent risk factor, with an HR of 1.2 for African Americans versus whites (95% CI 1.1 to 1.3).

Insurance status was another factor:

  • Lack of insurance versus insured: HR 1.2, 95% CI 1.1 to 1.3
  • Lack of Medicaid versus insured: HR 1.6, 95% CI 1.5 to 1.8

The authors commented that contributing factors to these trends may include a reluctance on the part of young adults to seek medical care and the large percentage of young adults without insurance or ready access to care.

Also, there may have been an underappreciation of the increasing risk for young-onset CRC, which led clinicians to overlook or dismiss nonspecific symptoms that may have been consistent with CRC. These symptoms included rectal bleeding, abdominal pain or cramping, and a change in bowel pattern.

Limitations of the research were that it could not establish the mechanisms underlying the observed sociodemographic disparities, nor did it explore the molecular basis of young-onset CRC. In addition, familial adenomatous polyposis was excluded, the authors noted.

The study was funded by a grant from the MD Anderson Cancer Center.

Co-author Barry Feig, MD, reported links with Genomic Health.

To ask one of our Top Docs about this article, please contact either Dr. Robert Cloud or Dr. Edward Franko.  You can also email them via info@topdocsofdfw.com

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Wonderful Cause: “Sounds of the Season Gala” Gives Hearing, December 17, 2011

 by Top Docs of DFW on 12/06/11

Imagine how life would be if you could not hear…

  • Your favorite song
  • Prayers
  • Your child’s laughter
  • Friendly conversations
  • Your name being called
  • Birds singing
  • Rain Falling…

See Video

A Message from Dallas Hearing Foundation President, B. Robert Peters, M.D.

The Dallas Hearing Foundation would like to extend an invitation to attend the 2011 “Sounds of the Season” Fundraising Gala on December 17th, 2011 at our new venue for this year, The Adolphus Hotel. Your presence and financial contributions will give the gifts of hearing and speech to children and adults with hearing loss. The Dallas

Hearing Foundation is a 501c3 non-profit organization that supports all aspects of hearing services: medical, rehabilitative, education, counseling, and research. Priority is given to children who do not have insurance or other financial resources. Through DHF, these precious children receive hearing aids, cochlear implants, auditory-verbal therapy, educational services, and counseling. Our specialized team consists of an otologic surgeon, audiologists, a speech-language pathologist, an educational consultant, and a psychologist. With the services we provide, children and adults with hearing loss can pursue their own interests and dreams, rather than being restricted in a world of silence with severe limitations on their educational and employment opportunities.

Without intervention, the majority of deaf children face a well-documented adulthood of limited abilities to read, write, and speak English. Subsequent employment opportunities are severely restricted for this population. The Dallas Hearing Foundation individualizes each child’s treatment and provides the extraordinary attention needed to optimize their potential to hear, speak, and receive a quality education. We have children in our program that were born profoundly deaf and yet are being educated with their hearing peers in mainstream schools after receiving cochlear implants and auditory-verbal therapy. Mainstreaming deaf children into regular classrooms saves the public school system up to $200,000 per child during K-12 education. In addition, these individuals who are well-educated and verbally competent are much more likely to achieve gainful employment and independence in adult life.

Many lives have been profoundly changed by the services provided by the Dallas Hearing Foundation. Our goal is to be able to give the miracle of hearing and speech to every deaf child and adult who needs our assistance. Please help us to assist these deserving individuals through our main fundraising effort, the Sounds of the Season gala. Only you can forever change the life of a deaf person.

On behalf of the deaf children and adults who are waiting for a miracle, thank you for your time and consideration. 

With Sincere Appreciation, B. Robert Peters, MD

Facts About Deafness

  • There are 31 million individuals with hearing loss in the United States.
  • 4,000 children in the United States are born with hearing loss each year.
  • 90% of children with hearing loss are born to normal hearing parents.
  • Parents with normal hearing communicate through speaking, and most do not know how to use sign language to communicate with their deaf child.
  • Deaf education programs in the public schools usually teach some form of sign language in order to communicate with and educate the students. As a result, few deaf students become proficient in the English language.
  • An average reading level of 3rd grade is typical of graduates of deaf education programs in the U.S.
  • 45% of deaf individuals do not graduate from high school and only 5% graduate from college.
  • A small minority of deaf students complete deaf education programs prepared for independence in adulthood; 60% face either unemployment or severe underemployment.
  • Deaf individuals earn only 50% to 70% of what their hearing peers earn, losing an average of $320,000 in earnings during their lifetime.
  • Over 50% of deaf adults earn less than $25,000 per year.
  • 42% of deaf adults between 18 to 44 years of age are unemployed.
  • 70% of deaf individuals rely on government insurance programs such as Medicaid and Medicare.
  • Deafness is the most costly single disability in terms of special education costs, averaging $25,000 per year per child, compared to $5,100 for a normally hearing child.
  • The average lifetime cost to society of a child born deaf in terms of medical, educational, and productivity losses is $1,020,000

You can give the gift of hearing and make dreams come true for deaf children and adults who do not have financial resources for the hearing technologies that will enable them to hear and speak. Your tax deductible donation will be used to provide cochlear implants, hearing aids, and related services to those who would otherwise be isolated in a silent world.

Please join the Dallas Hearing Foundation in our mission to give the miraculous gift of hearing!  Whether you join us at our “Sounds of the Season Gala” on December 17th, or go to the web or Facebook page to make a $1 donation, every effort makes a tremendous difference in the lives of those unable to hear.

For more information, or to donate, please contact the Dallas Hearing Foundation:

Call (972) 424-7711

Email Jennifer.clark@dallashearingfoundation.org

Visit www.dallashearingfoundation.org or www.facebook.com/pages/Dallas-Hearing-Foundation

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FDA Yanks HCG Weight-Loss Agents from Market

 by Top Docs of DFW on 12/06/11

By John Gever, Senior Editor, MedPage Today

The FDA and the Federal Trade Commission said over-the-counter weight-loss products containing human chorionic gonadotropin (HCG) are fraudulent and illegal, and the agencies have told seven manufacturers to stop selling them.

Noting that the product labels call for the pellets, liquids, and sprays to be taken in conjunction with a very low-calorie diet, an FDA official said it did not appear that oral HCG offers any extra benefit.

“There is no substantial evidence HCG increases weight loss beyond that resulting from the recommended caloric restriction,” said Elizabeth Miller, acting director of the FDA’s fraud unit for OTC products, during a conference call with reporters.

The recommended diets call for daily calorie intake as low as 500 calories, low enough to create a risk of malnutrition, electrolyte imbalance, cardiac arrhythmias, and gallstone formation, Miller said.

The warning letters sent to manufacturers of the products note that HCG has not received FDA approval for any weight-loss indication. The substance is approved as an injectable drug for certain forms of female infertility and is therefore clearly subject to FDA regulation.

HCG weight-loss products are typically sold over the Internet, often promoted with unsolicited “spam” emails, with such claims as “Lose 26 pounds in 26 days” and “Resets your metabolism.”

According to one of the letters, sent to HCG Diet Direct of Tucson, Ariz., “The claims made on your product labeling and website … clearly demonstrate that this product is a drug as defined” by federal law.

The companies have 15 days to inform the FDA of the steps they have taken to correct the violations. Theoretically, the firms could seek FDA approval for the weight-loss claims, but the agencies expect that they will simply stop selling the products.

If the companies do not do so voluntarily, the FDA and FTC threatened to forcibly halt their operations.

Many of these products are labeled as homeopathic remedies, but they are illegal whether the word “homeopathic” is used or not, said Richard Cleland, assistant director of the FTC’s advertising practices division.

If the product is marketed or meets federal standards to qualify as a drug, but is not FDA approved, it cannot be sold legally, Cleland said.

Officials from both agencies were unable to estimate how many people have bought HCG weight-loss products, but Cleland said they were the current hot item in the lose-weight-fast category.

“Four years ago, the miracle weight-loss ingredient was Hoodia gordonii, and then it was acai berry, and now it’s homeopathic HCG,” he said.

“Almost more than any other, the weight-loss industry is fad-driven,” he added. “Unfortunately, all too often, it is also fraud-driven.”

The seven companies receiving the warning letters, in addition to HCG Diet Direct, included Nutri Fusion Systems, Natural Medical Supply (doing business as HCG Complete Diet), HCG Platinum, Theoriginalhcgdrops.com, and HCG-miracleweightloss.com.

The FDA and FTC emphasized that the letters were a “first step in halting sale” of HCG weight-loss remedies. Other companies that market such products “should also read these letters carefully and take appropriate action,” Cleland said. 

http://www.medpagetoday.com/ProductAlert/OTC/30042?utm_source=breaking-news&utm_medium=email&utm_campaign=breaking-news

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FOR IMMEDIATE RELEASE: “TOP DOCS OF DFW” REPORTS RECORD VIEWERSHIP

 by Top Docs of DFW on 11/29/11

Dallas, Texas – NOV.28, 2011 –  Identity Media Services, LLC, reported today that its television program, “Top Docs of DFW” had a record viewership at its early morning Saturday time-slot during the Thanksgiving weekend.  “We have seen a steady increase in the viewership at this time slot, however the numbers for Saturday, November 26, where phenomenal.  Not only did we win our time slot, we beat just about every early morning program that aired”, accordingly to Executive Producer, Bill Lee.  Earlier media reports showed good numbers at this early slot, which the company explained as a partial result of the new work culture with active employee’s in all three work shifts.  Further reports now show young audiences are showing up more and more in the early time slots, which just a few years ago were dominated by older audiences.

Mr. Lee adds, “we are thrilled at the continued success of the early Saturday time period, which is the same show that airs in our anchor Sunday 10am slot, so our clients are getting more than double the exposure from when our show first began in 2010”.

Except for football, the four major networks showed overall viewership down which is traditionally the case on Holiday weekends; however this was not the case for Top Docs.  Accordingly to Mr. Lee, “we think it’s very fitting that a weekend dedicated for family gatherings would be one of our strongest weekend audiences, since our show features doctors that can change the lives of individuals and families.

The Top Docs concept has now expanded into the Houston area with a December launch planned, and is making plans for more Texas expansion to include San Antonio and Austin.

For more information, contact:

info@topdocsofdfw.com

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Relatives, Alcohol, Knives, and Other ED Thanksgiving Tales

 by Top Docs of DFW on 11/28/11

How was your Thanksgiving?  We hope it was better than what some ER doctors might have experienced this year!

By John Gever, Senior Editor, MedPage Today
 

Asked how people can avoid illness and injury on Thanksgiving Day, an emergency physician in Detroit may have said it best: "People need to minimize their alcohol consumption. But if they don't, stay away from relatives and carving knives."

During major holidays when just about everything else is closed, the local ER is the only place for people with health problems to go. And every holiday has its unique health risks, whether it be spoiled eggs at Easter, mishandled fireworks on the Fourth of July, or short-circuiting light strings at Christmas.

MedPage Today and ABC News polled emergency physicians around the country to ask about cases they've treated on Thanksgivings past, and for their suggestions for safer Turkey Days -- or other holidays -- yet to come. Here's what they told us.

Relatives and Sharp Objects

Daniel Morris, MD, of Henry Ford Hospital in Detroit, supplied the advice regarding relatives and knives as well as the anecdote behind it: It began with a fight over who would carve the turkey and ended with "an intoxicated patient" transported to the ER. Morris gave no other details, but from his recommendation for avoiding future episodes, we can guess what went down.

Another story from the same hospital was told by physician assistant Judy Wagensomer. EMTs arrived at a house to find a man lying on the floor after having been stabbed, by his brother, with a carving fork. But his injury did not stop the man from "eating as much turkey as he could ... because he knew once he got to the ER he wasn't getting any more food," Wagensomer said.

Watch What You Eat

Most physicians we contacted noted that overindulgence, with pain and sometimes vomiting as the immediate sequelae, are probably the most common health events associated with Thanksgiving. Rahul Khare, MD, of Northwestern Memorial Hospital in Chicago, noted in an email that eating too much can sometimes be life-threatening.

"For example, if someone has an inflammatory bowel disease such as Crohn's or ulcerative colitis, a large amount of turkey combined with gravy and mashed potatoes, along with pumpkin pie, can cause intestinal blockage," Khare said. "We definitely see an increase in emergency department visits and patients who develop intestinal blockage."

Sometimes, people also ingest things not meant to be ingested. Gary Vilke, MD, chief of staff at the University of California San Diego Medical Center, said a colleague had once treated a patient in January who was complaining of rectal pain. "She had one of the small metal skewers used to hold the turkey legs together stuck in her anus, which she recalled was missing from her turkey during her Thanksgiving dinner two months prior," Vilke said.

New Recipes, New Dangers

Deep-fried turkey has become a holiday favorite in recent years. MedPage Today has been told it's tastier than the oven-roasted variety, but it requires immersing the bird in gallons of boiling oil. Khare said his department had seen a big increase in burns in the past five years.

"The difficulty comes when the cook removes it from the boiling oil," he said. "We see a significant amount of second-degree burns due to the tipping over of the pot; handling of the hot, fried turkey just after removal from oil; and significant grease burns from the splashes. Burns can ruin that turkey meal quickly."

He also indicated that drinking while deep frying was frequently a factor in such incidents.

Travel Tragedy

The Wednesday before and the Sunday after Thanksgiving are traditionally the highest-volume traffic days of the year. Thomas Tallman, MD, of the Cleveland Clinic, related a sad story from earlier in his career that actually took place on Thanksgiving day.

An elderly woman, just arrived from the U.K., was driving to her son's house hoping to surprise him. Accustomed to driving on the left, she was in the wrong lane on the highway and smashed head on into another car. "She did not survive," Tallman said.

And the driver of the other car? It was the woman's son who was running a quick errand. He was not seriously injured, but "I have never felt so badly as I did [explaining] to him and his family what had happened," Tallman said.

The Upside

Vincent Mosesso Jr., MD, of the University of Pittsburgh, said the interaction of family and holiday sometimes is beneficial.

"During the holidays many persons are cajoled, or even forced, to come to [the emergency department] by family (or friends) who haven't seen them in a long time," he told MedPage Today and ABC News in an email. "The person often seems much worse to the visitor than when last seen and there is concern for acute illness or serious deterioration of chronic disease."

This may be an overreaction or may reflect the relative's guilt at not visiting more often. But "sometimes there are real issues that do need to be addressed," Mosesso added.

He recalled one older woman who was brought in with "a large, deep, gangrenous ulcer in a breast." Not only was it infected but it was related to a malignant tumor.

"If that had gone much longer she would have become septic and most likely died. So that was one case where the out-of-town relative visit did save the day."

How to Stay Out of the ER

Recommendations from emergency physicians for next year's Thanksgiving were simple and straightforward:

  • Eat and drink in moderation
  • Drive carefully and defensively
  • Be extra careful with knifes and other sharp implements. "Buy bagels pre-sliced," Tallman advised.

Now the key will be remembering them for a whole year.

This article was developed in collaboration with ABC News.

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Cochlear Implants Can Lead to Normal School, Work Life

 by Top Docs of DFW on 11/25/11

 Dr. Bob Peters shared an incredible story of pediatric cochlear implants.  Not only is it amazing to see a young child respond to sound, but their lives are forever changed.  Watch the video at http://www.topdocsofdfw.com/Dr_Bob_Peters.html.
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: April 20, 2010
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Severely hearing-impaired youngsters who get cochlear implants may not catch up to their peers right away in language comprehension or general schoolwork, but their ultimate educational and employment expectations can be good, two independent studies have found.Both concluded that earlier implants are better than later ones.

In a prospective French study of children who received their cochlear implant before age 6, some 53% failed at least one grade at school.

But among those followed to college age, half entered university with their normal-hearing peers and the rest got vocational training, according to Frederic Venail, MD, PhD, of the Centre Hospitalier Universitaire Gui de Chauliac in Montpellier, France, and colleagues.

An earlier start — with implantation at a younger age — appeared important, they reported in the April Archives of Otolaryngology — Head & Neck Surgery.

Action Points
  • Explain to interested patients that neither study included children with sensorineural hearing loss who didn’t get cochlear implants, which precludes drawing causal conclusions that the implants led to better outcomes that the children would have had with hearing aids alone.

That endorsement was echoed by a second prospective study showing more rapid acquisition and comprehension of speech with earlier implantation.

The gains were greater than would have been expected from preimplantation scores, John K. Niparko, MD, of Johns Hopkins, and colleagues reported in the April 21 Journal of the American Medical Association.

“Early implantation may take advantage of neuronal flexibility inherent in critical periods of auditory-based learning,” they wrote. But until sufficient long-term data are available, though, timing of implantation will remain an unsettled issue, they cautioned.

Their Childhood Development after Cochlear Implantation (CDaCI) study of spoken language outcomes included 188 children with severe to profound sensorineural hearing loss who got an implant before age 5 at one of six U.S. centers.

Compared with 97 hearing children of similar ages at two preschools, the implant recipients did not reach age-appropriate spoken language scores on the Reynell Developmental Language Scale after three years (mean deficit 22.3 points in comprehension and 19.8 in expression).

However, the implants were associated with greater improvement than predicted by preimplantation baseline scores in speech (8.4 versus 5.8 predicted points per year) and speech comprehension (10.4 versus 5.4 predicted points per year).

Each year of younger age at cochlear implantation predicted a 1.1-point-per-year greater gain in comprehension and 1.0-point-per-year steeper rise in expression scores.

Likewise, each one-year shorter duration of hearing deficit for a child was associated with steeper rate increases in speech and comprehension (0.6 and 0.8 points per year shorter, respectively).

In fact, the trajectories for those implanted before 18 months of age were similar to those with normal hearing.

In multivariable analyses, higher rates of language improvements were linked to greater residual hearing prior to cochlear implantation, higher ratings of parent-child interactions, and higher socioeconomic status.

The researchers cautioned that their study was limited in making causal conclusion by its observational design and absence of a control group of deaf children without implants.

They recommended close monitoring of performance with hearing aids to see if it is sufficient to allow spoken language acquisition to progress.

But, they said their findings “suggest that delaying implantation to extend hearing aid use for children with severe to profound hearing loss may be detrimental to language development following cochlear implantation.”

Venail’s group agreed.

“In an ideal situation, cochlear implantation should also allow recipients to integrate into the hearing world and improve their quality of life,” they wrote in the Archives.

Since education and employment are two key long-term measures of this integration, they prospectively examined outcomes for 100 prelingually deaf children who got an implant before age 6 at a tertiary care center in France and who had at least four years of follow-up.

Among the 74 without additional disabilities, 26% had delayed reading and writing skill acquisition and 53% failed at least one grade at school (most were at mainstream schools full-time), “perhaps reflecting the language impairment remaining during the first years after cochlear implantation.”

Compared with the age-matched French population, implant recipients ages 16 to 18 were more likely to be in the workforce (11% versus 6.3%).

Vocational education was also more likely in those who had received a cochlear implant (17% versus 2.4% in the general population ages 12 to 15 and 44% versus 26.6% ages 16 to 18).

The eight participants over age 18 were also more likely to have a high school diploma (62% versus 53% among the general population) despite the fact that half had failed at least one grade at school.

Children with additional disabilities who got a cochlear implant had more varying trajectories. Only half were able to enter mainstream schools and 73% failed at least one grade at school.

Among them, 19% continued to use sign language as their everyday form of communication with family compared with only 1% in those without additional disabilities.

“Although these students may underachieve as measured in academic terms, most do reach some degree of social and communicative autonomy, an improvement that demonstrates the benefit of cochlear implantation in this population,” Vernail’s group wrote in the paper.

Venail’s group reported no conflicts of interest.

The CDaCI was supported by a grant from the National Institute on Deafness and Other Communication Disorders, the CityBridge Foundation, and the Sidgmore Family Foundation.

Warranties on the implant devices used by children with implants in this study were discounted by 50% by the Advanced Bionics Corporation, Cochlear Corporation, and the MedEl Corporation.

Niparko reported serving on advisory boards without remuneration for two cochlear implant manufacturers, Advanced Bionics Corporations and the Cochlear Corporation, and serving on the board of directors for a school for children with hearing loss that has received gifts from cochlear implant manufacturers.

External advisers received honoraria for their review of the study protocol and progress reports.

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FDA Warns About GERD Drugs...Again

 by Top Docs of DFW on 11/25/11

With increased scrutiny surrounding PPIs (such as Nexium, among others), it’s important to know your options.  PPIs only mask the problem of chronic reflux, but we’re reading more and more about the problems they cause long term.  We’ve read the articles on PPIs causing thinning bones, or osteoporosis, and now we’re seeing more articles like the one below.  If you suffer from chronic reflux, please take a look at the new video from Dr Glenn Idhe (dallasreflux.com).  You can watch it this Sunday, November 27, 2011, on the CW33, at 10:00 AM in Dallas, Fort Worth.  And after the show, you can watch it online at www.topdocsofdfw.com and www.the33tv.com.

By Peggy Peck, Executive Editor, MedPage Today
Published: March 02, 2011

WASHINGTON — Use of proton pump inhibitors (PPIs) regularly for a year or longer may lead to low levels of circulating magnesium, which may increase the risk of leg spasms, arrhythmias, and seizures, according to an FDA warning.

The FDA noted that PPI-associated hypomagnesemia was generally reversed with magnesium supplements, but in about 25% of cases “magnesium supplementation alone did not improve low serum magnesium levels and the PPI had to be discontinued.”

The FDA’s notice included the prescription drugs: esomeprazole magnesium (Nexium), dexlansoprazole (Dexilant), omeprazole (Prilosec), omeprazole and sodium bicarbonate (Zegerid), lansoprazole (Prevacid), pantoprazole sodium (Protonix), rabeprazole sodium (AcipHex) and the combination product esomeprazole magnesium/naproxen (Vimovo).

Also included were OTC formulations of the drugs: Prilosec OTC, Zegerid OTC, and Prevacid 24-hour.

The FDA warning follows reports that PPIs given to patients who undergo stenting and other percutaneous cardiovascular events may increase the risk of heart attack or stroke.

Moreover, there have been reports linking PPI use to increased risk of Clostridium difficile diarrhea.

The latest alert from the FDA says physicians “should consider obtaining serum magnesium levels prior to initiation of prescription PPI treatment in patients expected to be on these drugs for long periods of time.”

The risk of hypomagnesemia may be greater when PPIs are given to patients who are already taking drugs that are known to deplete magnesium, including digoxin and diuretics.

“For patients taking digoxin, a heart medicine, this is especially important because low magnesium can increase the likelihood of serious side effects,” the FDA said.

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Hair Salon Serves as Skin Cancer Screening Stop

 by Top Docs of DFW on 11/25/11

Skin cancer can be deadly and many locations are just hard to spot.  This article gives a unique perspective to some unlikely skin cancer helpers.  If one of these helpers finds skin cancer on your scalp, then look to one of our Top Docs…Dr William Posten, Mohs Skin Cancer Surgeon.  Just go to http://www.topdocsofdfw.com/Dr_William_Posten.html for more information!
By Kristina Fiore, Staff Writer, MedPage Today
Published: October 17, 2011
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

As hair stylists are snipping, they’re also screening for skin cancer.Nearly 40% of hair professionals surveyed said they look for suspicious lesions on their customers’ scalps, Alan Geller, MPH, RN, of Harvard, and colleagues, reported in the October issue of Archives of Dermatology.

“Hair professionals are currently acting as lay health advisers for skin cancer detection and prevention and are willing to become more involved in skin cancer education in the salon,” they wrote.

Melanoma of the scalp and neck accounted for 6% of all melanomas and 10% of all melanoma deaths in the U.S. between 1973 and 2003, the researchers said. The high fatality rate is likely related to the difficulty in finding suspicious lesions in these locations.

Hairdressers, however, are in a unique position to spot these lesions.

So Geller and colleagues conducted a survey of professionals from 17 salons in a single chain in the Houston area; 203 of 304 surveys were returned.

Overall, 37.1% of hairdressers said they had looked at more than 50% of their customers’ scalps to screen for suspicious spots during the preceding month.

Fewer (28.8%) said they’d looked at more than half of their customers’ necks.

Just 15.3% said they had checked out the majority of their clients’ faces for lesions during that time.

“Hair professionals have a more natural view of the back of the head and the neck than they do the face during a salon visit,” Geller and colleagues wrote. “They may be more aware of skin on the scalp and posterior neck than the face.”

Almost 60% of hair stylists said they had recommended at least once that a customer see a health professional.

Although most reported having basic skin cancer knowledge, few hairdressers — 28.1% — had actually received formal skin cancer education.

Still, most — 49% — said they were either “very” or “extremely” interested in participating in a skin cancer education program.

Certain factors were associated with screening, the researchers found.

For instance, stylists screened more frequently if they reported being comfortable discussing health information (P<0.001) and if they had better skin protection practices themselves, such as using sunscreen or doing self-exams (P=0.05).

The frequency of observation was not associated with skin cancer knowledge, Geller and colleagues reported.

“Hair professionals’ health communication practices and personal skin protection practices are important predictors of the frequency of observation of customers’ lesions in the salon,” they wrote.

They said the study provides evidence that hairdressers would be receptive to skin cancer education. Such a program could potentially increase early detection of skin cancers on “high-risk anatomic areas among individuals who are unaware of their suspicious lesions.”

These programs could also apply to massages therapists, nail technicians, “and other professionals who have the opportunity to look closely at individuals’ skin,” the researchers wrote.

The survey was limited by its cross-sectional design, and by the fact that it may also lack generalizability given that the participants were older and more likely to be white.

Geller and colleagues added that further investigation into hair stylists’ role in skin cancer prevention is needed.

The researchers reported no conflicts of interest.

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