Emollient use reduced infant eczema.

Posted on July 31, 2012 by drlesliegreenberg

.flickr.com/ photos/ etien1 3_73/956335796

Once-daily application of an emollient from birth until age 6 months shows promise to significantly decrease eczema.  This was considered to be a treatment when it was found that “skin barrier dysfunction” presents before eczema starts.

Risk factors for eczema are one or more first-degree relatives with a history of

  • asthma,
  • hay fever, or
  • atopic dermatitis (eczema).

Emolient reduced eczema by 67% in infants!  Lube them up, parents.

(The researchers used Cetaphil with 96% patient satisfaction).  The next study looking at the relative effectiveness of different emollients is the next study… I’ll stay tuned in.

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Are you taking too much thyroid medicine? This can be harmful.

Posted on July 24, 2012 by drlesliegreenberg

Lots of people are on levothyroxine (name brand Synthroid) to replace a sluggish thyroid.  Many like taking too much thyroid—as it may help you lose weight, feel more energetic, need less sleep.  But, there is a downside.  You may feel anxious, have insomnia, and have an irregular or fast heart rate.

TSH is a lab test that should be repeated once a year.  This yearly blood work will confirm if your current dose is the right dose.  If the TSH is low, this shows the strength of your pill is too high.  Getting too much thyroid replacement has been shown to increase risk of coronary heart disease deaths and atrial fibrillation (an irregularity in heart beat).  Too much thyroid was not shown to increase cancer or stroke mortality.

My advice:  Get yearly TSH lab work.  Take the correct dose of thyroid replacement.  It’ll do your heart good and you may live longer.

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Irritable bowel syndrome. Innovative treatment…

Posted on July 21, 2012 by drlesliegreenberg

Research about irritable bowel syndrome is turning us away from an “old friend” and instead to two different types of medicine.  A compilation of 56 randomized controlled trials (read this:  really good research studies) showed that there is better treatment for intermittent bouts of abdominal pain, constipation, gas and boating than fiber.

Antispasmodic medicines AND a special type of antidepressant help with abdominal pain.  Fiber has been found to help lower cholesterol, but antispasmodics and antidepressants may help IBS symptoms.

So, if you suffer from IBS… talk to your doctor now!

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Is your thyroid sluggish? That could harm your heart.

Posted on July 18, 2012 by drlesliegreenberg

flickr.com/photos/ alfromelkhorn /5069935943

I have many patients who are tired/fatigued. One condition for me to rule out is hypothyroidism. This is when the thyroid gland—the gland in front of your neck—isn’t working as well as it should. There is an inexpensive blood test which can show how the thyroid is working.

A low functioning/sluggish makes the thyroid work extra hard to get the normal amount of circulating thyroid hormone in the blood stream. This condition is called “subclinical hypothyroidism.” A new study of nearly 5000 patients showed that levothyroxine (generic thyroid replacement medicine) reduced all-cause mortality and the number of heart disease events in adults under age 70–those over 70 were not found to benefit. The number of ischemic heart disease (the heart not getting enough blood) was lowered by 39% in those whose subclinical hypothyroidism was treated with levothyroxine, compared to those who were left untreated. All-cause mortality was lowered by 64% in the treated patients in the younger age group.

… something to think about…

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Screening colonoscopies are receiving high marks!

Posted on July 15, 2012 by drlesliegreenberg

Screening colonoscopy cut the incidence of colorectal cancers by 51% compared with patients without colonoscopy!  Wow!

Here are the nuts and bolts:

  • This was in a study of 170,000 people followed up to 24 years.
  • The benefit from a single colonoscopy screen extended beyond 7 years.
  • When patients had two, three, or more screening colonoscopies over time, their risk of  colorectal cancer fell further than after a single screening.

Good news!

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Cervical cancer. How to make this an extinct problem.

Posted on June 27, 2012 by drlesliegreenberg

Many cancers are difficult to prevent, detect or cure… none of these are true of cervical cancer.  Women need to have regular medical testing and vaccination (if age-appropriate).

What is cervical cancer?  The cervix is the lower part of the uterus—the part that connects with the vagina.  The cervix can be affected by sexually transmitted infections, including the human papillomavirus (HPV), which is thought to be a precursor to cervical cancer.  Cervical cancer can occur in women of any age.

The “Pap” test was introduced in the 1950s.  During this test, cells from the end of the cervix are brushed and put into a specimen container.  The Pap does not detect cancer of the uterus, ovaries, or any other part of the body.

We now know that abnormal cervical cells are usually caused by HPV.  In some cases, the body fights off the HPV and clears it.  In others, the HPV causes genital warts and changes of cervical cells.

Cervical cancer takes years to develop and has NO symptoms.  Women should have a Pap test taken beginning at age 21 and may need a follow-up test more of less often than each year.

A vaccine to prevent HPV infection has become available in recent years.  The vaccine protects against four types of HPV, but not all.   The Centers for Disease Control recommends that Gardasil be given to girls at age 11, or up to age 26 if not previously vaccinated.

Vaccinate.  Pap.  Be aware.

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Kansas car seat rules…4 Steps

Posted on June 18, 2012 by drlesliegreenberg
  1.  Infant. Birth-12 months.  Rear-facing car seat.  There are different types of rear-facing car seats.  Infant-only seats can only be used rear-facing.  Convertible (and 3-in-1) car seats have a higher height and weight limits for the rear-facing position.  The rules used to be rear-facing until one year.  We now know that it is safer for the toddler to be rear facing until nearer to age 2.
  2. Toddler.  Ages 1-3.  Face backwards until age 2, if their length permits.  Once your child outgrows the rear-facing car seat, they can use a forward-facing car seat with a harness.  This toddler seat should be used through age 3.
  3. Children 4-7 years.  All children ages 4, 5, 6, and 7 are required to ride in a car seat or booster seat unless the child weighs more than 80 pounds or the child is taller than 4 feet 9 inches or only a lap belt is available.  Still keep your child in the back seat.  (Did you know that booster seats  decrease injury by 59% compared to those only using seat belts?!)
  4. Children ages 8 and up.  Keep your child in a booster seat until the child is big enough to fit in a seat belt properly.  The lap belt must lie snugly across the upper thighs—not the belly.  The shoulder belt should be snug across the shoulder and chest—not across the neck or face.

And, stay in the back seat until age 13—as the air bag could deploy and harm your child.

Children imitate adults.  Buckle yourself and your child.

More information available at www.kansasboosterseat.org  Consider a child seat inspection station.  Find one nearby with www.kansascarseatcheck.org

flickr.com/ photos/tbeitz/ 1171635897

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Ever-present Tylenol. Overdoses are frequent AND dangerous.

Posted on June 15, 2012 by drlesliegreenberg

flickr.com/ photos/ kevinomara/ 4764991547

Did you know that Acetaminophen (Tylenol) is in more than 600 medicines?  Do you know which of your medicines it is in?

Acetaminophen is the most common drug in America.  It is in both prescription and over-the-counter medicines.

  • Pain relievers,
  • fever reducers,
  • sleep aids,
  • cough, cold and allergy medicines.
  1. Read and follow the medication labels.
  2. Know if your medicine contains acetaminophen.
  3. Never take two medicines that contain acetaminophen at the same time.

Why is acetaminophen dosing important?  An overdose or chronically taking too much can cause liver failure and/or death.

Want more information?  www.KnowYourDose.org sponsored by the Acetaminophen Awareness Coalition

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Drugs of abuse: On the grocery shelves?!

Posted on June 8, 2012 by drlesliegreenberg

flickr.com/ photos/ imakeguernsey/ 5359794790

Bath salts and synthetic cannabinoids are being sold in stores throughout the world.  Their labels may read “not to be taken internally” but are often snorted (by nasal insufflation) or injected.

They are highly addictive.  Repetitive dosing every 3 or four hours may be needed to maintain stimulant effect.  Mephadrone and Methylenedioxypyrovalerone (MDPV) are identified in the substances and may cause symptoms of fast heart rate, chest pain, elevated blood pressure, seizures, and hallucinatory delirium with paranoia and violent behavior.  Suicides and homicides have also been reported following the use of these drugs.

They may be marketed online as “synthetic marijuana” and are popular in dance clubs in urban areas.  These agents have a potency of 4 to 10 times that of marijuana.

Make yourself aware.

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Don’t brush teeth immediately after eating.

Posted on June 4, 2012 by drlesliegreenberg

flickr.com /photos /28408249@N07/ 3000025970

Am I serious?  Don’t brush after eating?  Yes, recent research shows that brushing too soon after meals (especially after eating acidic foods and drinks) can be harmful to the teeth.  Brushing after an acid reflux episode can also damage the teeth.

Acid attacks your teeth; it erodes enamel and the dentin.  Brushing can accelerate the process of erosion because brushing can push the acid deeper into the enamel and dentin layer.

What about diet soda?  An increase in dentin loss was noted by researchers when brushing took place within 20 minutes after drinking diet soda.  But there was less tooth wear when brushing took place 30-60 minutes later.

The conclusion is that to protect the dentin, people should wait at least 30 minutes to brush their teeth after drinking or eating acid.  To remove acid, it is better to rinse out the mouth with water or an acid-neutralizing mixture: one part baking soda to eight parts water.

Hope this helps.

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