Sunday, June 28, 2015

Welcome Kacie!

We are delighted to welcome Kacie Campbell, PA-C to our practice!  We are certain you will find Kacie, as we do, to be an uncommonly compassionate and competent provider!


Kacie is a graduate of Lock Haven University’s Physician Assistant Program. Before beginning her Physician Assistant studies, she received an undergraduate degree in Biology and played field hockey at the University of Delaware. She currently resides in Philadelphia and is originally from Hershey, PA.  Outside of the office, Kacie loves to try new fitness classes, experiment with cooking and baking, and is a fan of all sports. As a healthcare provider, she places great value on the patient-provider relationship and aims to build an environment of trust and compassion. 

Farewell Abbe!



We are sorry that Abbe Jackson, PA-C, has left our practice for family reasons.  We are excited about her new life!  We wish to thank Abbe for her three years of excellent care for her patients.  She was a wonderful provider and we will miss her.   

Meanwhile we have been joined by Kacie Campbell, PA-C to our practice...

Monday, June 8, 2015

Live Long and Prosper Newsletter June 2015

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP. 


Nutrition
1.   Nut consumption and 5-y all-cause mortality in a Mediterranean cohort: The SUN project.
   Another study of a Spanish population, based on their responses to questionnaires. "Participants who consumed nuts ≥2/wk had a 56% lower risk for all-cause mortality than those who never or almost never consumed nuts". Wacky numbers keep materializing for nuts - 56% mortality benefit seems almost absurd. Eat your nuts!
July 1, 2014

2.   Higher diet quality is associated with decreased risk of all-cause, cardiovascular disease, and cancer mortality among older adults.
   A comparison of mortality rate based on adherence to different food strategies. Again the Mediterranean Diet score showed the strongest correlation, with a 27% reduction in death rate for the top fifth of Mediterranean Dieters vs. the bottom fifth.
July 8, 2014

3.   Muscle mass index as a predictor of longevity in older adults.
   People 55+ who have more muscle mass have 20% lower death rate than those who have the lower amounts. No proven benefit, but it seems prudent to bulk up!
July 8, 2014


Exercise
1.   Yoga for improving sleep quality and quality of life for older adults.
   People over 60 who did yoga twice weekly for 12 weeks had improved sleep and reported better quality of life.
July 12, 2014

2.   Daily sitting time and all-cause mortality: a meta-analysis.
   People who sit for long periods of the day have increased death rate. A little sitting is not harmful but as people sit more time, each additional hour appears to be more harmful. The authors "estimated a 34% higher mortality risk for adults sitting 10 h/day" These were not randomized trials so we cannot be sure that sitting causes the earlier deathsor not.
July 26, 2014

3.   Life style and longevity among initially healthy middle-aged men: prospective cohort study.
   A new way to think of longevity is to measure the % of people who make it to 85 years or older. This study of middle aged men found that "Among non-smokers with high physical fitness, 48.8% reached the age of 85 years, compared to 27.9% among non-smokers with low physical fitness". So by becoming physically fit, a middle aged man puts himself in a category that is twice as likely to live to be 85.
September 11, 2014

Lifestyle
1.   How height is related to our health and longevity: a review.
   "shorter people are less likely to suffer from age-related chronic diseases and more likely to reach advanced ages"
August 2, 2014

2.   Waist-to-Height Ratio Is More Predictive of Years of Life Lost than Body Mass Index.
   Waist circumference is a more important measure of health than BMI. "This study supports the simple message 'Keep your waist circumference to less than half your height'"
September 10, 2014

3.   Life style and longevity among initially healthy middle-aged men: prospective cohort study.
   A new way to think of longevity is to measure the % of people who make it to 85 years or older. This study of middle aged men found that "Among non-smokers with high physical fitness, 48.8% reached the age of 85 years, compared to 27.9% among non-smokers with low physical fitness". So by becoming physically fit, a middle aged man puts himself in a category that is twice as likely to live to be 85.
September 11, 2014

Prevention
1.   Cardiovascular risk profile of high school students: A cross-sectional study.
   How well are US high school students doing at living healthy lifestyles? Not well. "Physical activity was insufficient in 81% of students. The daily consumption of soup, salad or vegetables, and fruit was, respectively, 37%, 39% and 21%. A minority (6%) took ≤3 and 77% took ≥5 meals a day."
September 17, 2014

2.   Behavioral Counseling to Promote a Healthy Lifestyle for Cardiovascular Disease Prevention in Persons With Cardiovascular Risk Factors: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force
   New synthesis by the respected USPSTF, based on all research to date: "High-intensity combined lifestyle counseling" reduces diabetes by 42-45%, when given to people with 1 or more cardiac risk factor or early pre-diabetes. Most medical offices in our area are not geared up to do this kind of counseling. You could counsel yourself by working hard at exercise and diet. Find a buddy to help you.
September 19, 2014

3.   A High Dietary Glycemic Index Increases Total Mortality in a Mediterranean Population at High Cardiovascular Risk.
   Much has been made of high glycemic index (sugary) diets. This study found that people who are in the top 25% of eaters of sugary foods, have over double the death rate compared with those who are in the bottom 25%.
September 25, 2014

Friday, April 17, 2015

Live Long and Prosper Newsletter April 2015

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP.


Nutrition
1.   The association of prevalent kidney stone disease with mortality in US adults: the National Health and Nutrition Examination Survey III, 1988-1994.
   People who get kidney stones have double the mortality rate of those who do not. Unclear why. As with all these correlations, it is not clear that this correlation implies causation. However it seems prudent to put yourself into the non-kidney stone forming category. How? Drink 2-2.5 liters of water per day, and eat a diet low in sodium (salt) and low in animal sources of protein. Eat plant foods rich in calcium, like greens, beans, soy, and almonds.
February 25, 2014

2.   [Alcohol intake--a two-edged sword. Part 2: Protective effects of alcohol and recommendations for its safe use].
   These German investigators reviewed the literature and pronounced that the research favors women having about 10-12 gm alcohol per day (about half a glass of wine). For men, their recommendation is twice that.
February 26, 2014

3.   Does obesity associate with mortality among Hispanic persons? Results from the National Health Interview Survey.
   Here is another knock against the Body Mass Index (BMI) as a predictor of health and longevity. In Hispanics under age 60, they found no association between BMI and longevity. Among Hispanics aged 60 and up, they found those in the overweight and obesity grade 1 (BMI 25-35) had a lower mortality rate than those who were "normal". In other studies, waist circumference and % body fat seems to be more important than BMI.
March 4, 2014

Exercise
1.   Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.
   Here's an endorsement for virtual reality games for stroke survivors. As important as physical therapy is, substituting some VR gaming in the rehab process did not detract form rehabilitation. We cannot make any sweeping conclusions but maybe if a loved one has a stroke, VR games might be a better use of their spare time than watching The Price is Right. No wonder stroke victims get depressed.
April 6, 2014

2.   The association between physical activity and gastroesophageal cancer: systematic review and meta-analysis
   "A dose–response analysis of frequency of physical activity and total gastroesophageal cancer risk revealed that the greatest risk reduction [33%] was achieved among those engaging in moderate to vigorous physical activity five times per week"
April 5, 2014

3.   Longitudinal Algorithms to Estimate Cardiorespiratory Fitness: Associations with Non-fatal Cardiovascular Disease and Disease-Specific Mortality.
   Another big cohort (43,000 people) followed for 14 years- The more they exercised the lower their death rate over that time. Nuff said.
April 8, 2014

Lifestyle
1.   Cognitive lifestyle jointly predicts longitudinal cognitive decline and mortality risk.
   This analysis of 6000 people found that one of the most important predictors of longevity is social contentedness in older age.
March 1, 2014

2.   Coffee consumption and prostate cancer risk: an updated meta-analysis
   Researchers have tried to pin bad things on coffee for decades but the main things that have stuck so far has been slight increased rate of osteoporosis, plus reflux disease. This study looked at all studies done to date on coffee and prostate cancer. They found: "Our meta-analysis suggests that high (e.g., highest ≥4 or 5 cups/day) coffee consumption may not only be associated with a reduced risk of overall prostate cancer, but also inversely associated with fatal and high-grade prostate cancer.
March 1, 2014

3.   Oral cavity and oropharyngeal squamous cell carcinoma in young adults: a review of the literature.
   A growing form of cancer is head and neck cancers in young adults, under age 45. These cancers tend to occur in people who have been exposed to Human Papilloma Virus (HPV). Although it is not of proven benefit in preventing these cancers, it seems prudent for many people to go ahead and get the Gardisil vaccine (young adult, sexually active, etc.)
March 4, 2014

Prevention
1.   Optimal body weight for health and longevity: bridging basic, clinical, and population research.
   BMI is a flawed predictor of risk, especially for people who already have diabetes. However in general, there is strong evidence that it is healthiest to have "normal weight" (BMI < 25).
March 19, 2014

2.   Selenium for preventing cancer.
   It doesn't.
April 1, 2014

3.   Extravirgin olive oil consumption reduces risk of atrial fibrillation: the PREDIMED (Prevención con Dieta Mediterránea) trial.
   People who were randomized to eat more extravirgin olive oil had 42% reduction in their rate of atrial fibrillation, a nasty heart rhythm disease.
September 3, 2014

Saturday, March 14, 2015

Live Long and Prosper Newsletter March 2015

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP. 

Nutrition
1.   The association of prevalent kidney stone disease with mortality in US adults: the National Health and Nutrition Examination Survey III, 1988-1994.
   People who get kidney stones have double the mortality rate of those who do not. Unclear why. As with all these correlations, it is not clear that this correlation implies causation. However it seems prudent to put yourself into the non-kidney stone forming category. How? Drink 2-2.5 liters of water per day, and eat a diet low in sodium (salt) and low in animal sources of protein. Eat plant foods rich in calcium, like greens, beans, soy, and almonds.
February 25, 2014

2.   [Alcohol intake--a two-edged sword. Part 2: Protective effects of alcohol and recommendations for its safe use].
   These German investigators reviewed the literature and pronounced that the research favors women having about 10-12 gm alcohol per day (about half a glass of wine). For men, their recommendation is twice that.
February 26, 2014

3.   Does obesity associate with mortality among Hispanic persons? Results from the National Health Interview Survey.
   Here is another knock against the Body Mass Index (BMI) as a predictor of health and longevity. In Hispanics under age 60, they found no association between BMI and longevity. Among Hispanics aged 60 and up, they found those in the overweight and obesity grade 1 (BMI 25-35) had a lower mortality rate than those who were "normal". In other studies, waist circumference and % body fat seems to be more important than BMI.
March 4, 2014

Exercise
1.   Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.
   Here's an endorsement for virtual reality games for stroke survivors. As important as physical therapy is, substituting some VR gaming in the rehab process did not detract form rehabilitation. We cannot make any sweeping conclusions but maybe if a loved one has a stroke, VR games might be a better use of their spare time than watching The Price is Right. No wonder stroke victims get depressed.
April 6, 2014

2.   The association between physical activity and gastroesophageal cancer: systematic review and meta-analysis
   "A dose–response analysis of frequency of physical activity and total gastroesophageal cancer risk revealed that the greatest risk reduction [33%] was achieved among those engaging in moderate to vigorous physical activity five times per week"
April 5, 2014

3.   Longitudinal Algorithms to Estimate Cardiorespiratory Fitness: Associations with Non-fatal Cardiovascular Disease and Disease-Specific Mortality.
   Another big cohort (43,000 people) followed for 14 years- The more they exercised the lower their death rate over that time. Nuff said.
April 8, 2014

Lifestyle
1.   Cognitive lifestyle jointly predicts longitudinal cognitive decline and mortality risk.
   This analysis of 6000 people found that one of the most important predictors of longevity is social contentedness in older age.
March 1, 2014

2.   Coffee consumption and prostate cancer risk: an updated meta-analysis
   Researchers have tried to pin bad things on coffee for decades but the main things that have stuck so far has been slight increased rate of osteoporosis, plus reflux disease. This study looked at all studies done to date on coffee and prostate cancer. They found: "Our meta-analysis suggests that high (e.g., highest ≥4 or 5 cups/day) coffee consumption may not only be associated with a reduced risk of overall prostate cancer, but also inversely associated with fatal and high-grade prostate cancer.
March 1, 2014

3.   Oral cavity and oropharyngeal squamous cell carcinoma in young adults: a review of the literature.
   A growing form of cancer is head and neck cancers in young adults, under age 45. These cancers tend to occur in people who have been exposed to Human Papilloma Virus (HPV). Although it is not of proven benefit in preventing these cancers, it seems prudent for many people to go ahead and get the Gardisil vaccine (young adult, sexually active, etc.)
March 4, 2014

Prevention
1.   Optimal body weight for health and longevity: bridging basic, clinical, and population research.
   BMI is a flawed predictor of risk, especially for people who already have diabetes. However in general, there is strong evidence that it is healthiest to have "normal weight" (BMI < 25).
March 19, 2014

2.   Selenium for preventing cancer.
   It doesn't.
April 1, 2014

3.   Extravirgin olive oil consumption reduces risk of atrial fibrillation: the PREDIMED (Prevención con Dieta Mediterránea) trial.
   People who were randomized to eat more extravirgin olive oil had 42% reduction in their rate of atrial fibrillation, a nasty heart rhythm disease.
September 3, 2014

Wednesday, February 18, 2015

Live Long and Prosper Newsletter February 2015

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP.

Nutrition
1.   Adiposity rather than BMI determines metabolic risk.
   The Body Mass Index (BMI) has come under some fire for painting an inaccurate picture of a person's "fatness" and risk of disease. Probably better to measure body fat, which can be done with a special DEXA machine (used more commonly for determining bone mineral density/osteoporosis). Stay tuned.
February 13, 2014

2.   Association of low serum 25-hydroxyvitamin D levels and sepsis in the critically ill.
   Low vitamin D levels correlate with all sorts of bad things. For example, 80% of obese people are "vitamin D deficient". Most studies that test whether a vitamin D pill cures what ails you come up blank. It seems that vitamin D deficiency is more a marker for suboptimal health than a quick-fix. That said, vitamin D supplementation has been found to be of small benefit for some conditions, like bone thinning and frailty.
February 20, 2014

3.   The Mediterranean-style dietary pattern and mortality among men and women with cardiovascular disease.
   Another study testing the Mediterranean Diet against death from heart disease. This one found a 19% reduction in mortality rate for those who ate the Mediterranean Diet. Add this to the growing list of pro-Mediterranean Diet studies.
February 25, 2014



Exercise
1.   Factors influencing the decline in stroke mortality: a statement from the American Heart Association/American Stroke Association.
   Stroke (brain attack) has moved down on the list of top killers in the US, from #3 to #4. Chronic lung disease is now #3. Whi did they swap? Because stroke rate has dropped greatly over the last half century, probably due to improved control of blood pressure.
February 24, 2014

2.   Effectiveness of home-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a meta-analysis of randomized controlled trials.
   Do you know someone who have COPD or emphysema? Pulmonary Rehabilitation has been found to be quite helpful. This study found that it also works when done at home.
March 8, 2014

3.   The Role of Health Behaviours Across the Life Course in the Socioeconomic Patterning of All-Cause Mortality: The West of Scotland Twenty-07 Prospective Cohort Study
   We have long known that one of the most reliable predictors of how long a person will live is their socioeconomic status. More disadvantaged generally have more than double the death rate of wealthier people. This study tried to identify what aspects of socioeconomic status impact lifespan. Their findings: smoking accounted for 49% of the higher death rate of the disadvantaged, diet 43%, alcohol 13%. Want to live as long as a rich person? Don't smoke, eat a healthy diet, and don't drink much.
March 31, 2014

Lifestyle
1.   Pooled cohort study on height and risk of cancer and cancer death
   Controlling for weight, taller people get more cancer. For each 5cm (2 inch) of extra height, your body packs on extra cancer risk (7% in women per 5cm, 4% in men per 5cm). Which cancer was most affected? Melanoma unsurprisingly.
January 31, 2014

2.   Vitamin D and the Cardiovascular System: An Overview of the Recent Literature
   Vitamin D levels definitely correlate with better health and longevity. However that does not mean that taking a vitamin D supplement will "curewhatailsya" as we say in internal medicine. "there is no clear evidence for a role of vitamin D other than that strictly associated with bone health". Stay tuned, more studies are being done.
January 31, 2014

3.   Marital status shows a strong protective effect on long-term mortality among first acute myocardial infarction-survivors with diagnosed hyperlipidemia - Findings from the MONICA/KORA myocardial infarction registry.
February 1, 2014

Prevention
1.   Telomere length loss due to smoking and metabolic traits.
   We have known for years that the length of the telomeres in your cells (the tips of the chromosomes) is a predictor of how much you have aged and how long you can expect to live. Here is evidence that 2 risk factors increase the rate of shortening of your telomeres/aging of your DNA: smoking and the metabolic syndrome. Metabolic syndrome is a constellation of risk factors: abdominal overweight, elevated blood pressure, low HDL, and high triglycerides.
March 14, 2014

2.   An increase in the incidence of hip fractures in Tangshan, China
   With its rapid pace of industrialization, Chinese are seeing steep increase in the rates of all Western diseases, including heart disease, cancers, diabetes, and (per this study) osteoporosis.
March 31, 2014

3.   What should we tell prostate cancer patients about (secondary) prevention?
   Has you or a loved one been diagnosed with prostate cancer? The investigators of this study reviewed the literature and conclude "Patients should be counseled not to use tobacco products; to engage in daily physical activity; to minimize sedentary behavior; to consume plenty of healthy fats (i.e. fish, nuts, vegetable oils, soybeans, avocados, and flaxseed) and vegetables; to focus on getting nutrients from foods rather than supplements; and to limit refined grains, sugars, processed meat, and high-fat dairy."
March 17, 2014

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