Saturday, December 6, 2014

Phone System Down Saturday December 6, 2014

We are transitioning our phone system to Verizon Fios today.  If you need to reach the on-call doctor, please call 302-319-3414
Thanks!

Thursday, December 4, 2014

Knee or Shoulder Arthritis?

Having some knee pain that is limiting your exercise program?  Dr Zarek and our Physician Assistants, Abbe Jackson, PA-C and Ashley Kontra, PA-C, are skilled at joint injections.  We have helped patients with knee or shoulder pain by a simple injection in our office.  Please call for an appointment if you need to get moving again. 

Friday, November 21, 2014

Live Long & Prosper Newsletter November 2014

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

Nutrition
1.   Lack of health insurance increases all cause and all cancer mortality in adults: an analysis of National Health and Nutrition Examination Survey (NHANES III) data.
   "There was a 70% increase in risk of all cause death and almost 300% of all cancer death for people without any health insurance coverage". We need to be mindful that those who lack health insurance are in that unfortunate state because of some root causes, which also impact mortality rate. Namely, they tend to be of lower socioeconomic status, and they tend to be sicker. Because that is how the health insurers earn large bonuses - keep sicker, more expensive patients off the books. Let's hope this improves with the Affordable Care Act.
October 23, 2013

2.   Meat consumption and diet quality and mortality in NHANES III.
   This large study found no association between consumption of red or processed meat with mortality. Men who ate more white meat were in a category that had lower overall mortality. For women, white meat was not correlated with mortality.
October 24, 2013

3.   Calcium intake and serum concentration in relation to risk of cardiovascular death in NHANES III.
   You might have read that calcium pills might increase your risk of a heart attack. This study, looking at 1 particular large data set, found no association. However it did find that women with highest levels of calcium (upper 5%) have almost double the risk of heart disease.
October 25, 2013

Exercise
1.   High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis.
   High-intensity interval training "significantly increases CRF [Cardio-Respiratory Fitness] by almost double that of MICT [moderate-intensity continuous training] in patients with lifestyle-induced chronic diseases." So if you have high blood pressure, pre-diabetes, heart disease, then you might consider asking your doctor about switching from the occasional grind on the treadmill, to a program involving periods of high intensitiy activity. You will likely need to have a screening test to make sure your heart is up to it first though.
October 23, 2013

2.   Effect of increased fruit and vegetable consumption on physical function and muscle strength in older adults
   Since fruits and veggies are not protein sources, they might divert your diet from important protein sources (meat and dairy), right? This randomized trial showed that eating more fruits and veggies for 12 weeks actually increased grip strength, though the finding was not quite statistically significant. So we can infer at least that fruits and veggies do not make you weaker.
November 30, 2013

3.   Exercise: Putting Action into Our Epigenome.
   How do we prevent age-causing methylation of your genome? Exercise! "Six months of aerobic exercise alters whole-genome DNA methylation in skeletal muscle and adipose tissue"
October 29, 2013


Lifestyle
1.   Moderate Physical Activity as Predictor of Weight Loss After Bariatric Surgery
September 30, 2013

2.   Changes in fish consumption in midlife and the risk of coronary heart disease in men and women.
   "Our results suggest that increasing fish consumption to at least 2 servings per week in mid- or later life may lower CHD risk in women but not in men."
September 27, 2013

3.   Mortality among African American women with sarcoidosis: data from the Black Women's Health Study.
   Sarcoidosis kills. African American women with this disease have a 2.4 x risk of death compared with those who do not.
September 29, 2013

Thursday, November 13, 2014

Small Dermatology Procedures done in our Office!


Have a mole you're worried about?  Our physician assistants can take a look at it and remove it for you, if necessary.  Abbe Jackson, PA-C & Ashley Kontra, PA-C both had experience training in a dermatology office before starting at Progressive Health of Delaware.   Call us today if you have a mole you wanted checked!

Monday, November 3, 2014

High Dose Flu Vaccines Back in Stock

Our office did received some high dose flu vaccine last week and it's been going fast.  If you are over 65 years old, please come in soon for your high dose vaccine.  We have plenty of regular flu vaccines as well.  Stay healthy!

Wednesday, October 29, 2014

Live Long & Prosper Newsletter October 2014

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

Nutrition
1.   Nutrition and Physical Activity Cancer Prevention Guidelines, Cancer Risk, and Mortality in the Women's Health Initiative.
   Women who followed of the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines had 27% lower death rate (and 20% lower rate of death from cancer) than those who did not. What are those recommendations? The usual smattering: "Achieve and maintain a healthy weight throughout life. Be as lean as possible throughout life without being underweight. Avoid excess weight gain at all ages. For those who are overweight or obese, losing even a small amount of weight has health benefits and is a good place to start. Get regular physical activity and limit intake of high-calorie foods and drinks as keys to help maintain a healthy weight. Be physically active. Adults: Get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week. Children and teens: Get at least 1 hour of moderate or vigorous intensity activity each day, with vigorous activity on at least 3 days each week. Limit sedentary behavior such as sitting, lying down, watching TV, and other forms of screen-based entertainment. Doing some physical activity above usual activities, no matter what one’s level of activity, can have many health benefits. Eat a healthy diet, with an emphasis on plant foods. Choose foods and drinks in amounts that help you get to and maintain a healthy weight. Limit how much processed meat and red meat you eat. Eat at least 2½ cups of vegetables and fruits each day. Choose whole grains instead of refined grain products. If you drink alcohol, limit your intake. Drink no more than 1 drink per day for women or 2 per day for men."
January 10, 2014

2.   [Metformin, an antidiabetic molecule with anti-cancer properties].
   This study cites evidence that metformin might be cancer preventing. Who? Metformin is the first drug we reach for, when you get diabetes. It is also used in polycystic ovarian disease, in childhood obesity, and it is occasionally used in the prevention of diabetes. Stay tuned, but we might be using more of this drug.
January 17, 2014

3.   Social isolation and adult mortality: the role of chronic inflammation and sex differences.
   We know that people who are socially isolated have more health problems and die younger. This report cites some evidence that social isolation is also associated with some markers of inflammation. Not clear whether social isolation causes inflammation or vice versa.
January 25, 2014

Exercise
1.   Fatalities of pedestrians, bicycle riders, and motorists due to distracted driving motor vehicle crashes in the U.S., 2005-2010.
   True or false? "The era of smart phones has distracted drivers and made the roads less safe for cyclists and pedentrians." True. This study of US motorists found: "The rate of fatalities per 10 billion vehicle miles traveled increased from 116.1 in 2005 to 168.6 in 2010 for pedestrians and from 18.7 in 2005 to 24.6 in 2010 for bicyclists. Pedestrian victims of distracted driving crashes were disproportionately male, 25-64 years of age."
January 8, 2014

2.   Protective role of resting heart rate on all-cause and cardiovascular disease mortality.
   Your doctor makes a big fuss about blood pressure. But who speaks for the ugly step-sister of vital signs, the heart rate? This study finally gives her day. People with resting heart rate under 60 beats per minute do in fact live longer than those with higher heart rates over 80 beats per minute.
January 28, 2014

3.   Exercise in the prevention and rehabilitation of breast cancer.
   " The relative risk reduction of breast cancer for women who engaged in moderate to vigorous physical activity for 3-5 days peek week ranged between 20-40 %. Furthermore, several studies demonstrated a 24-67 % reduction in the risk of total deaths and 50-53 % reduction in the risk of breast cancer deaths in women who are physically active after breast cancer diagnosis compared with sedentary women."
February 6, 2014

Lifestyle
1.   Diet and cancer: Risk factors and epidemiological evidence.
   Based on epidemiologic evidence, "Moderate physical activity after breast cancer diagnosis contributes to 40% reduction of recurrence/disease-specific mortality".
January 1, 2014

2.   Type 2 diabetes and the risk of mortality among patients with prostate cancer
   "Type 2 diabetes was associated with a 23 % increased risk of prostate cancer mortality and a 25 % increased risk in all-cause mortality"
January 2, 2014

3.   DASH and Mediterranean-Type Dietary Patterns to Maintain Cognitive Health
   We have no pill for Alzheimer's Disease, no surgery for dementia. What can we do to prevent it? Regular exercise clearly benefits (both aerobic exercise and strength training). What about diet? This study reviews the literature and finds strong evidence that the DASH Diet, which is similar to the Mediterranean Diet in its emphasis on plant based nutrition, helps significantly.
January 4, 2014


Prevention
1.   Nutrition and Physical Activity Cancer Prevention Guidelines, Cancer Risk, and Mortality in the Women's Health Initiative.
   Women who followed of the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines had 27% lower death rate (and 20% lower rate of death from cancer) than those who did not. What are those recommendations? The usual smattering: "Achieve and maintain a healthy weight throughout life. Be as lean as possible throughout life without being underweight. Avoid excess weight gain at all ages. For those who are overweight or obese, losing even a small amount of weight has health benefits and is a good place to start. Get regular physical activity and limit intake of high-calorie foods and drinks as keys to help maintain a healthy weight. Be physically active. Adults: Get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week. Children and teens: Get at least 1 hour of moderate or vigorous intensity activity each day, with vigorous activity on at least 3 days each week. Limit sedentary behavior such as sitting, lying down, watching TV, and other forms of screen-based entertainment. Doing some physical activity above usual activities, no matter what one’s level of activity, can have many health benefits. Eat a healthy diet, with an emphasis on plant foods. Choose foods and drinks in amounts that help you get to and maintain a healthy weight. Limit how much processed meat and red meat you eat. Eat at least 2½ cups of vegetables and fruits each day. Choose whole grains instead of refined grain products. If you drink alcohol, limit your intake. Drink no more than 1 drink per day for women or 2 per day for men."
January 10, 2014

2.   Exercise in the prevention and rehabilitation of breast cancer.
   " The relative risk reduction of breast cancer for women who engaged in moderate to vigorous physical activity for 3-5 days peek week ranged between 20-40 %. Furthermore, several studies demonstrated a 24-67 % reduction in the risk of total deaths and 50-53 % reduction in the risk of breast cancer deaths in women who are physically active after breast cancer diagnosis compared with sedentary women."
February 6, 2014

3.   Eight ways to stay healthy after cancer: an evidence-based message.
   There are 12 million cancer survivors in the United States. I see them react in very different ways to a diagnosis of cancer. Naturally, some are irate and react with defiance, continuing to smoke for instance. This report is in line with the American Cancer Society guidelines. It recommends these measures to prolong life and happiness: '(1) don't smoke, (2) avoid secondhand smoke, (3) exercise regularly, (4) avoid weight gain, (5) eat a healthy diet, (6) drink alcohol in moderation, if at all, (7) stay connected with friends, family, and other survivors, (8) get screening tests and go to your regular checkups."
February 7, 2014

Safety
1.   Fatalities of pedestrians, bicycle riders, and motorists due to distracted driving motor vehicle crashes in the U.S., 2005-2010.
   True or false? "The era of smart phones has distracted drivers and made the roads less safe for cyclists and pedestrians." True. This study of US motorists found: "The rate of fatalities per 10 billion vehicle miles traveled increased from 116.1 in 2005 to 168.6 in 2010 for pedestrians and from 18.7 in 2005 to 24.6 in 2010 for bicyclists. Pedestrian victims of distracted driving crashes were disproportionately male, 25-64 years of age."
January 8, 2014

2.   14-year risk of all-cause mortality according to hypoglycaemic drug exposure in a general population.
   An interesting 14 year study of 3300 French diabetics. The researchers controlled for a host of confounding variables, and found that those who took insulin had a death rate almost 5X that of non-diabetics. Whereas those who took metformin along had a death rate of 2.3X relative to non-diabetics. Surprisingly, the best drugs were the sulfonylurea drugs, now out of vogue because or their risk for causing low blood sugar. Diabetics on these drugs had a relative risk of death of 1.7. That is they had only a 70% increased risk of death in any given year, relative to non-diabetics. Of course, who gets put on insulin? It is people with more severe diabetes.
April 23, 2014

Monday, October 13, 2014

Come Run a Charity 5K!

Progressive Health of Delaware is proud to be a sponsor for the HOPE 5K in Arden, DE on Saturday, October 25th at 9.00am.  Come run with Dr. Donohue, Dr. Zarek, and their kids as they support this worthy cause.  See more information about Premiere Charities at 

Temporarily Out of Flu Shots

We are currently out of the high dose flu vaccines for our patients 65 and older.  We expect them to be back in stock next week.  We will update our website when they have arrived.  We do have our regular flu shots available for our patients under 65.  See walk-in schedule on previous post.  Stay well!

Monday, September 22, 2014

Walk in for flu shot!

Our flu clinics are Mondays, Tuesdays, and Thursdays from 9-12 and from 4-5pm. No appointment necessary!

Live Long and Prosper Newsletter September 2014

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

Nutrition
1.   Therapeutic applications of herbal medicines for cancer patients.
   Well most herbal medicines strike out when subjected to the jaundiced rigour of Evidence-Based Medicine. But there are a few stand-outs. In particular, if I ever get lung cancer or perhaps others, I will start furiously googling "Pan-Asian medicine plus vitamins". One legit appearing study showed impressive results.
August 29, 2013

2.   Dark Chocolate: An Obesity Paradox or a Culprit for Weight Gain?
   Dark chocolate has lots of promising antioxidant phytochemicals that chocolate-loving researchers love to tout and chocolate-loving NIH staffers love to fund. Fortunately, some compelling clinical data point to slight benefits on blood pressure, blood sugar, and weight. I am a fair trade 80-85% cacao junkie myself.
September 5, 2013
Exercise
1.   Low-risk lifestyle, coronary calcium, cardiovascular events, and mortality: results from MESA.
   The more of these you did the lower your death rate: * don't smoke, * maintain a healthy weight, * healthy diet, * regular exercise. What is newish here is that they also found the coronary calcium score correlated with death as well. This is a test you can choose to pay for, as a measure of the plaque in the arteries around the heart. Mounting evidence suggests it can be predictive of your risk for heart disease and death. Of course, a simpler test is to ask yourself how well you are doing with respect to the 4 behaviors above.
September 8, 2013

2.   Usefulness of step counts to predict mortality in Japanese patients with heart failure.
   If you are Japanese and have congestive heart failure (CHF) then walk more than 4,889 steps per day or die!! Well no. Actually you face 2.28 times the risk of death if you are in the group who takes that many steps or less. We can postulate that exercise might reduce death in CHF patients, and it might benefit the rest of us.
September 15, 2013
Lifestyle
1.   Physical activity and other lifestyle factors in relation to the prevalence of colorectal adenoma: a colonoscopy-based study in asymptomatic Koreans
   People who exercise more have half the risk of colon adenomas (nasty pre-cancerous polyps).
August 31, 2013

2.   Depressive symptoms are a risk factor for all-cause mortality: results from a prospective population-based study among 3,080 cancer survivors from the PROFILES registry
   Cancer survivors who get depressed have double the rate of mortality compared with non-depressed cancer survivors.
August 31, 2013
Prevention
1.   Lifestyle and cancer prevention in women: knowledge, perceptions, and compliance with recommended guidelines.
   Study of American women - "Only 9.9% of women who reported eating a healthy diet met minimum fruit and vegetable recommendations; 39.7% of women who reported regular physical activity met the minimum recommendation."
September 27, 2013

2.   High concentrations of a urinary biomarker of polyphenol intake are associated with decreased mortality in older adults.
   People with higher levels of polyphenol in their urine had 30% lower death rate. So add some polyphenols to your urine! You could grind them up and just add to the toilet for lots of healthy toilet goodness. Well assuming there might be an ounce of causation in this relationship, maybe your best strategy is to eat some polyphenols so they end up in your urine. "From whence" you query? Berries, artichokes, coffee, flax meal, dark chocolate, tea, apples.
November 5, 2013
Safety
1.   Touch as an Interpersonal Emotion Regulation Process in Couples' Daily Lives: The Mediating Role of Psychological Intimacy.
   Touching one's boyfriend/girlfriend correlated with better well-being 6 months later. Let that be a lesson to us all.
August 22, 2013

2.   '…I've Found Once the Weight Had Gone Off, I've Had a Few Twinges, But Nothing Like Before'. Exploring Weight and Self-Management of Knee Pain.
   Knee pain very much improves with weight loss.
August 22, 2013

3.   When is acute persistent cough in school-age children and adults whooping cough?
   Do you have an active persistent cough for 2 weeks? According to this New Zealand study, there is a 10% chance you have whooping cough.
August 28, 2013
Personalized Health


   No stories found.
Medication
1.   Heart rate at rest, exercise capacity, and mortality risk in veterans.
   We are familiar with elevated blood pressure being a risk factor for heart disease and stroke and death. But what about the heart rate (number of beats per minute)? It turns out this too is a predictor of cardiovascular disease when elevated. For each increase of resting heart rate of 10 beats per minute, the investigators observed an 11% increase in mortality.
January 8, 2014

2.   Relationship between obesity and obesity-related morbidities weakens with aging.
   Older people have less health benefits from having a lower BMI, than do younger people.
February 5, 2014

Friday, September 5, 2014

Flu Shots Are In!

Our regular and high dose flu shots have now arrived.  Our flu clinics are Mondays, Tuesdays, and Thursdays from 9-12 and from 4-5pm. No appointment necessary during these times. Please stop by!

Friday, August 22, 2014

High Dose Flu Shots Available for 65+

Our high dose flu shots have arrived. This vaccine is for patients over the age of 65, and research has shown it to be more effective in that population than the standard flu shot. 

Please ask us at your office visit if you would like to receive this vaccine. 

Our regular flu vaccines should arrive around September 10th. We will be starting our walk-in flu clinics around September 15th. Stay healthy everyone!

Live Long and Prosper Newsletter August 2014

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

Nutrition
1.   Is there a reverse J-shaped association between 25-hydroxyvitamin D and all-cause mortality? Results from the U.S. nationally representative NHANES.
   what is the optimal level of vitamin D in your blood? It turns out that people with a vitamin D level of about 81 live the longest. Mortality rate increases as your vitamin D level gets above 100 or less than 40. About 85% of people with body mass index over 30 have a low vitamin D level (less than 30). Does taking vitamin D supplements make you live longer? Not as clear.
October 2, 2013

2.   Obesity and early mortality in the United States.
   "CONCLUSIONS: For healthy nonsmokers young- and middle-aged adults who constitute about one-third of American adults, being obese is likely to hasten mortality by 9.44 years"
October 2, 2013

3.   Lifestyle factors and mortality risk in individuals with diabetes mellitus: are the associations different from those in individuals without diabetes?
   People who have diabetes have a 62% higher mortality rate. If you are getting diabetes, it is best to aggressively change your lifestyle and not get it. "Intake of fruit, legumes, nuts, seeds, pasta, poultry and vegetable oil was related to a lower mortality risk, and intake of butter and margarine was related to an increased mortality risk"
October 18, 2013



Exercise
1.   Association between various sedentary behaviours and all-cause, cardiovascular disease and cancer mortality: the Multiethnic Cohort Study.
   Sitting at work for more than 10 hours per day had a harmful effect on women, increasing their mortality rate by 19% relative to those who sat less than 5 hours. Sitting watching over 5 hours per day of TV was associated with 19% higher rate of cardiac death in men and 32% higher in women, relative to abstainers.
September 27, 2013

2.   Examining the Behavioral Processes through which Lifestyle Interventions Promote Weight Loss: Results from the PREMIER Trial.
   Not many things reliably help people lose weight. This study (like many others) found that adherence to a weight loss program and self-monitoring of weight both make a big difference. If you want to lose weight, probably best to eagerly participate in a program, and weigh yourself every day.
October 15, 2013

3.   Association of walking speed in late midlife with mortality: results from the Whitehall II cohort study.
   Researchers have been studying how walking speed is a measure of longevity, among people above say 50. This study confirmed this (89% higher mortality for those in the slower 1/3 of people).
October 18, 2013

Lifestyle
1.   The metabolic syndrome.
   Many people have not heard of "The Metabolic Syndrome". It has been all the rage in recent years in primary care. It goes by a number of different names: insulin resistance, glucose intolerance, pre-diabetes. It is thought to be both a risk factor for heart disease and a warning sign that you are about to get diabetes. How can you tell if you have it? Supposedly you have it if you have 3 or more of the following: * waist circumference greater than 40 inches in men or 35 in women, * serum triglycerides > 150, * HDL ("good") cholesterol l< 40 in men or < 50 in women, * blood pressure > 130/85, * fasting blood sugar > 100
August 25, 2013

2.   Better Diet Quality and Decreased Mortality Among Myocardial Infarction Survivors.
   After having a heart attack, those who ate a Mediterranean-style diet lived a little longer.
September 5, 2013

3.   The contribution of diet and lifestyle to socioeconomic inequalities in cardiovascular morbidity and mortality.
   It has long been known that people of more privileged socioeconomic background live longer on average. For example, the more years of school you have had and the more stable your employment, the longer you live. This study investigated why. They found that most (70%) of the benefit of education on preventing heart disease is because people with more education tend to have better diets and exercise habits. So education causes better eating and exercise which causes less heart disease which causes less death. That's most of the story anyway.
September 5, 2013

Prevention
1.   The “New Deadly Quartet” for Cardiovascular Disease in the 21st Century: Obesity, Metabolic Syndrome, Inflammation and Climate Change: How Does Statin Therapy Fit into this Equation?
   The authors cite evidence that particulates in the atmosphere are driving a significant amount of cardiovascular disease.
December 16, 2013

2.   Recent progress on nutraceutical research in prostate cancer
   Those who drank soymilk daily had 70% lower rate of prostate cancer than abstainers. men with prostate cancer who ate more fruits and veggies reduced their risk of progression by 59% relative to those who are the least. Green tea reduced the rate of widespread prostate cancer. In short, eating a plant-based diet and avoiding the usual suspects (meat, dairy, and eggs) is our best medicine against prostate cancer. Far tastier than PSA tests and digital rectal exams (yuck).
December 27, 2013

Safety
1.   Choice of motorcycle helmet makes a difference: a prospective observational study.
   In emergency room circles, they call them donorcycles, because that's where organ donations come from. For every mile ridden on a motorcycle, the rider has 35 times the risk of dying relative to riding in a car. But if you in that demographic of safety-conscious motorcycle riders, hear this: Riders who wear Full Face Helmets enjoy about 1/5 the risk of having a facial fracture.
September 5, 2013

2.   A prospective study of carpal tunnel syndrome: workplace and individual risk factors.
   Carpal tunnel syndrome (CTS) occurs most commonly with forceful hand exertion. Obesity triples your risk of CTS.
September 11, 2013

3.   Randomised clinical trial: sodium alginate oral suspension is non-inferior to omeprazole in the treatment of patients with non-erosive gastroesophageal disease.
   Sodium alginate oral suspension was as affective as omeprazole (Prilosec), for regular-old espohageal reflux (GERD), without ulcers or other erosions. Omeprazole and other proton-pump inhibitors (PPIs) are know to increase risk of some infections and of bone thinning. 
September 14, 2013

Wednesday, August 13, 2014

Our Phone Restored

The problems with our phone system have been resolved.  It is now operating properly.

Monday, August 11, 2014

Live Long & Prosper Newsletter August 2014

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

Nutrition
1.   Fruit and vegetable consumption and all-cause mortality: a dose-response analysis.
   Study of Swedes and their fruit & vegetable (FV) intake: There was a dose-response effect, meaning the more FV eaten per day, the lower the death rate (up to a point). "Those who never consumed FV lived 3 y shorter and had a 53% higher mortality rate than did those who consumed 5 servings FV/d".
September 25, 2013

2.   A comparative study of phytochemical composition of genetically and non-genetically modified soybean (Glycine max L.) and evaluation of antitumor activity.
   Consumption of soy products is associated with lower rates of colon cancer, and this study found that non-GMO soybeans had higher concentrations of the putative anticancer compounds that they tested.
September 27, 2013

Exercise
1.   The effect of selected lifestyle factors and diet on mortality of men with documented physical fitness in the city of Łódź
   Some interesting findings in men from Lodz, Poland: "The probability of death was more than fourfold higher in the case of individuals who eat "beef or pork meat", as compared to those who consumed these products rarely or never. On the other hand, the subjects who declared regular consumption of yellow cheese had nearly fourfold lower death probability. Current smoking was found to be a significant negative risk factor while moderate consumption of beer a protective one. The level of physical fitness ... did not significantly influence mortality."
September 22, 2013

2.   Infant Feeding in America: Enough to Break a Mother's Heart?
   Mothers to be, another reason to plan to breastfeed! "A growing body of literature indicates that mothers who prematurely discontinue lactation face increased risk of visceral adiposity, hypertension, hyperlipidemia, diabetes, and subclinical cardiovascular disease, as well as cardiovascular morbidity and mortality. Breastfeeding is not always easy, but neither is dieting, exercise, smoking cessation, or treating hypertension."
October 12, 2013

Lifestyle
1.   Mortality in middle-aged men with obstructive sleep apnea in Finland
   Sleep apnea (OSA) kills. At least it kills middle aged Finnish men. "The overall mortality in the moderate to severe OSA group was 26.4 %, while in the normal group it was 9.7 %". If you are overweight and snore you most likely have sleep apnea, and should get a sleep study.
August 31, 2013

2.   Obesity and Low Back Pain: Is There a Weight of Evidence to Support a Positive Relationship?
   Obesity and back pain are correlated. For each pound you lose, your risk or severity of back pain goes down by 1% (roughly)!
August 31, 2013

Prevention
1.   Diet and vitamin D as risk factors for lung impairment and COPD.
   Chronic lung disease. Add it to the list of things that seem to be helped by eating a diet rich in plant-based foods like fruits. Also, "Higher intakes of vitamin D have been associated with better lung function and a lower prevalence of COPD".
November 13, 2013

2.   Prevention of Colorectal Cancer: The Future Is Now
   Wow interesting paper. There is more you can do to prevent colon cancer than I knew about. For example aspirin, NSAID drugs, and the diabetic drug metformin significantly reduce your risk of colon cancer, like 30-50%. The evidence is strong that red and processed meats increase your risk. A sedentary lifestyle is a huge risk factor. Get physically active and reduce your colon cancer by as much as 46%. Let's not forget the important role of colon screening. If you were going to pick 1 cancer to screen for, this would be the one. Many people are unaware that in addition to the standard colonoscopy, stool card testing is an alternative approved screening method.
December 9, 2013


Safety
1.   The effectiveness of helmets in bicycle collisions with motor vehicles: a case-control study.
   Cyclists who got in accidents with a car were 74% less likely to have a head injury if they were wearing a bike helmet.
August 29, 2013

2.   Occupational safety and health enforcement tools for preventing occupational diseases and injuries.
   Review of the 23 studies: "Inspections decrease injuries in the long term but not in the short term.... First inspections, follow-up inspections, complaint and accident inspections resulted in higher compliance rates... There is an urgent need for better designed evaluations" Maybe DuPont could publish a study on the effectiveness of its safety culture and its inspections to prevent injury.
September 4, 2013

Device
1.   Note: High frequency vibration rejection using a linear shaft actuator-based image stabilizing device via vestibulo-ocular reflex adaptation control method.
   Say that 3 times fast.
September 8, 2013

Monday, June 23, 2014

Live Long & Prosper Newsletter #5

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

Nutrition
1.   Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis.
   Based on 16 studies, people who eat > 1 egg/day have a 42% greater risk of getting diabetes, relative to those who eat less than 1 egg per week.
August 28, 2013

2.   Effect of the vegetarian diet on non-communicable diseases.
   The science overall is very favorable for vegetarian vs omnivorous diets. E.g. "RRs for all cancers were 0.82 (0.73-0.93) in pescetarian and 0.88 (0.81-0.96) in vegetarians". However "vegetarian diets may lead to an inadequate intake of several important nutrients, particularly Fe, Zn, vitamin B12 and n-3 PUFA, which are associated with some disadvantages and health risks" So perhaps don't be strict and perhaps take a supplementary multivitamin containing just a little zinc, iron, B12 and omega-3s.
August 29, 2013
Exercise
1.   A non-exercise testing method for estimating cardiorespiratory fitness: associations with all-cause and cardiovascular mortality in a pooled analysis of eight population-based cohorts.
   Ho hum another big study shows people who are physically fit live longer.
August 25, 2013

2.   The role of physical activity in cancer prevention, treatment, recovery, and survivorship.
   With all these studies the question is: is this association causal or not? For this review, they found " all-cause mortality in cancer survivors decreases with increasing amounts of exercise". Does the exercise reduce your risk of cancer recurrence? Or are people who are not likely to get cancer recurrence for other reasons, happen to walk more? We don't know but I figure better to put yourself in the lower risk category if you can!
August 29, 2013
Lifestyle
1.   Multicenter, Randomized Controlled Trial of Yoga for Sleep Quality Among Cancer Survivors.
   Cancer survivors have a high incidence of sleep problems. Yoga helps these problems.
August 15, 2013

2.   Smoking status, physical health-related quality of life, and mortality in middle-aged and older women.
   Women who smoke have lower quality of life and higher mortality. The more you smoke, the bigger the effect.
August 15, 2013
Prevention
1.   Mediterranean Diet and Cardiovascular Disease: Historical Perspective and Latest Evidence
   "Contrary to the pharmacological approach of cardiovascular prevention, the adoption of the Mediterranean diet has been associated with a significant reduction in new cancers and overall mortality". If you have high cholesterol, it might be just as important to switch to a Mediterranean-style diet as it is to take medications to lower your cholesterol.
October 8, 2013

2.   The joint association of physical activity, blood-pressure control, and pharmacologic treatment of hypertension for all-cause mortality risk.
   "Physical activity may be as or even more important than pharmacotherapy for reducing the risk of mortality in adults with hypertension. However, the risk of mortality remained higher for physically active adults with treated and controlled hypertension than did the risk of mortality for physically active normotensive populations. Prevention of hypertension is therefore imperative for reducing the all-cause risk of premature mortality in adults. " We have been telling patients to think of physical activity as the most important medication you can take. Take it every day.
October 23, 2013
Safety
1.   Light physical activity is a better determinant of lower adiposity during the menopausal transition.
   Starting menopause? Lighter-intensity physical activity was best to prevent fat gain.
August 22, 2013

2.   Diet and food allergy development during infancy: Birth cohort study findings using prospective food diary data.
   More helpful tools for nagging your daughter-in-law: "An infant diet consisting of high levels of fruits, vegetables, and home-prepared foods is associated with less food allergy by the age of 2 years."
August 22, 2013

3.   [Cognitive behavioral therapy for chronic insomnia].
   Have insomnia? Consider seeing a therapist. Cognitive Behavioral Therapy improved insomnia in 80% tested.
August 22, 2013

Tuesday, April 22, 2014

Return Old Prescription Drugs April 26


Have old prescription drugs that expired?  Or ones that you don't take anymore?  Saturday, April 26th is the day to safely discard these medications.  See link for more information and to find a site near you:

Sunday, April 6, 2014

Live Long and Prosper Newsletter #4

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

Nutrition
1.   Relationship of sedentary behavior and physical activity to incident cardiovascular disease: results from the Women's Health Initiative.
   Women who sit over 10 hours per day have 18% higher risk of cardiovascular disease relative to those who sit less than 5 hours.
August 15, 2013

2.   Morbidity prior to a diagnosis of sleep-disordered breathing: a controlled national study.
   Sleep apnea is thought to make us sick in many ways. This study found that people with sleep apnea had more health problems, from head to toe, for 3 years prior to their diagnosis. Is this because undiagnosed sleep apnea was eating away at their health for years before anyone knew? Or whatever causes sleep apnea (especially overweight) is also causing other problems. Unclear from this study.
August 16, 2013


Exercise
1.   Physical activity, cardiorespiratory fitness, and exercise training in primary and secondary coronary prevention.
   If you have coronary artery disease, you should go for cardiac rehabilitation and exercise training program. You will probably live longer.
August 14, 2013

2.   Healthy lifestyle behaviors and decreased risk of mortality in a large prospective study of U.S. women and men.
   Very large 13 years study, following over 2 million person years of Americans' lives. Findings are compelling. Achieving any of these key health goals reduces your mortality significantly. * abdominal leanness (waist under 34 inches in women or 40 inches in men) * nonsmoking * regular exercise (60 minutes vigorous/week or 150 minutes moderate) * Mediterranean diet People who achieved all 4, had a whopping 73% of reduction of their mortality relative to those who achieved none.
August 15, 2013

Lifestyle
1.   Consequences of Nocturia.
   Get up to pee at night? We have a word for you people: nocturic. It is a significant source of sleep problems and other health problems. Frequent nighttime awakenings in general can be a sign of SLEEP APNEA, a common, underdiagnosed problem that very much affects quality and quantity of life.
August 12, 2013

2.   Vegetarian dietary patterns and mortality in adventist health study 2.
   73,000 7th Day Adventists followed for 5 years: Pescatarians had the lowest mortality rate. "The adjusted HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73-1.01); in lacto-ovo-vegetarians, 0.91 (95% CI, 0.82-1.00); in pesco-vegetarians, 0.81 (95% CI, 0.69-0.94); and in semi-vegetarians, 0.92 (95% CI, 0.75-1.13) compared with nonvegetarians"
August 12, 2013

Prevention
1.   Mediterranean diet and glycaemic load in relation to incidence of type 2 diabetes: results from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)
   This big Greek study observed 22,000 people for 11 years and found that a Mediterranean diet (low starch and sugar and meat and dairy, high legumes, vegetables, olive oil, fish) reduced diabetes by a whopping 12%.
October 31, 2013

2.   Multivitamin and mineral use and breast cancer mortality in older women with invasive breast cancer in the women’s health initiative
   Women who took a multivitamin with mineral for about 7 years experienced a 24% reduction in their risk of death from breast cancer during that period, after controlling for confounding variables. This is the first study I have seen in along while attesting to the merits of multivitamin. Just because a multivitamin reduced deaths from breast cancer in 1 observational study, does not mean it will make you live longer.
October 8, 2013

Monday, March 17, 2014

Welcome Ashley!


We are pleased to announce that we are joined by a new colleague!  Ashley Kontra, PA-C, will assist in delivering our core mission of excellence in primary care. In addition, she has taken a leadership position with our Progressive Weight Loss Program.

Ashley Kontra is a graduate of Pennsylvania College of Technology’s Physician Assistant Program. During her studies she served as class historian and graduated cum laude. Before studying to become a physician assistant, Ashley attended Lock Haven University where she earned her undergraduate degree in Health Sciences. Her special interests within primary care include dermatology, weight loss, and helping those with special needs. Ashley is a current resident of Philadelphia, PA and grew up in Lancaster, PA. While not at the office, she enjoys exploring Philly, photography, and the arts. Her goal is to make every healthcare visit a positive and comfortable experience that motivates her patients to strive for wellness.

Saturday, March 15, 2014

Live Long and Prosper Newsletter #3

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

Nutrition
1.   Relationship between 25-hydroxyvitamin D and all-cause and cardiovascular disease mortality.
   Being deficient in vitamin D puts you in a category that has almost double the risk of death relative to normal levels. However, supplementation with vitamin D has not shown greater longevity. We know that low vitamin D levels come with the usual suspects (obesity, sedentary behavior).
August 12, 2013

2.   Towards measurement of the Healthy Ageing Phenotype in lifestyle-based intervention studies.
   Interesting discussion. E.g. If you have these conditions in mid-life: overweight, pre-diabetes, elevated blood pressure, then it puts you at greater risk for cognitive decline later in life. Waist line of 52 inches in men or 45 inches in women doubles your risk of mortality.
August 14, 2013


Exercise
1.   Cardiovascular fitness and mortality after contemporary cardiac rehabilitation.
   People who have coronary heart disease live longer if they get on a cardiac rehab exercise program. The greater the level of fitness they are able to achieve and the more they work out, the longer they live.
August 12, 2013

2.   Benefits and costs of intensive lifestyle modification programs for symptomatic coronary disease in Medicare beneficiaries.
   Dean Ornish style low lat diet plus lifestyle changes resulted in better outcomes and a little lower costs for patients with coronary heart disease.
August 12, 2013



Lifestyle
1.   Lifestyle interventions in patients with coronary heart disease: a systematic review.
   The aggregate research done to date suggests when doctors do "multifactorial lifestyle interventions" (i.e., trying to get patients to eat and exercise better), their patients' risk of dying from heart disease is reduced by 18%.
August 12, 2013

2.   Non-nutritive sweeteners: Review and update.
   There is insufficient evidence to conclude that artificial sweeteners are safe.
August 12, 2013

Prevention
1.   Comparison between the effects of continuous and intermittent aerobic exercise on weight loss and body fat percentage in overweight and obese women: a randomized controlled trial.
   2 interesting findings in this small study: (1) that exercise added weight loss to those eating a calorie-restricted diet, and (2) splitting up exercise into three daily ~13 minute bouts caused 3X the weight loss at 12 weeks, than doing 40 minutes of exercise all at once. This suggests that we might be best served to "exercise as you are, whenever you can" rather than the monolithic trip to the gym.
September 22, 2013

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