Breast-Feeding May Limit Obesity Risk – NYTimes.com

Posted on March 17, 2011 by drlesliegreenberg

Want to decrease your kids’ chance of being overweight?  Great new study confirming the importance of breastfeeding (hooray!) AND waiting to start solids until baby is at least 4 months old.  Here is the link. . .

Breast-Feeding May Limit Obesity Risk – NYTimes.com.

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Press Announcements > FDA and Public Health Experts Warn About Electronic Cigarettes

Posted on March 16, 2011 by drlesliegreenberg

I have been told a few times this week by “former smokers” that they have stopped smoking, but are using “e cigarettes” instead.    I am overcome with genuine concern.  This FDA warning discusses the risks well.   There are great options to stop smoking that do not involve carcinogenic compounds. . . I can help.

Press Announcements > FDA and Public Health Experts Warn About Electronic Cigarettes.

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Endometriosis?

Posted on March 14, 2011 by drlesliegreenberg

Do you have frequent pelvic pain? pain worse with your period? pain with intercourse?  Endometriosis is a common gynecologic condition affecting women of childbearing age.

My job is to the find the cause of that pain.  Physical exam, blood work and vaginal cultures may all be normal . . .and yet the pain continues.  Pain control and oral contraceptives are the mainstay to help with symptoms.  If that fails, or the patient is unsuccessfully trying to conceive, a surgery by an ob/gyn surgeon is suggested.   Endometriosis is a condition where endometrial (uterine lining tissue) is found OUTSIDE the uterus, in the abdominal cavity.

There are other hormonal treatments that may help decrease pain, but may cause hot flashes and thin bones.

Our goal is to control pain and symptoms and increase quality of life all-the-while preserving future fertility.

Hope this helps.

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Sam’s Club offering health care?

Posted on March 10, 2011 by drlesliegreenberg

Now Sam’s Club is offering full service!  Tire rotation AND health care (do you hear my sarcasm?).  For $99/year Sam’s Club offers a health care plan that includes “at-home screening tests” (I am unsure what these tests might be . . . do you draw your own blood?), “hotline to nurses, health alerts and reminders and sends a summary of the plan to each patient’s physician.”

This is reportedly intended to add to a patient’s care. . . it seems disjointed and takes patients  further away from a “medical home.”  (That’s me. . . my patient’s medical home is me–not Sam’s).

Concerning. . . hmmmmmm.

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Does attending daycare make kids sicker? have more GI infections?

Posted on March 8, 2011 by drlesliegreenberg

All working parents who have sent their child to daycare wonder about the infections that seem to swarm around the daycare center.  There is a new study out, published by Archives of Pediatric and Adolescent Medicine that dispels many myths.

Snot.  Drool.  Lots of dirty diapers.  These negative visions (and smells) come to mind when thinking about large daycare centers.   But this recent study shows that children who attended a large day-care program before age 2 1/2 had higher rates of respiratory and ear infections around enrollment time compared to small daycare programs.   Day care was not associated with gastrointestinal infections at any developmental period.

These children who attended large daycare centers had fewer respiratory and ear infections once in elementary schools.   From birth to age 8, there was no difference in overall number of infections between children who attended home care and those who attended day care of any size before elementary school.

It seems like (from an infectious standpoint) home-cared versus large daycare center is “a wash.”

Hope this helps.

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What are the benefits to younger women getting mammograms?

Posted on March 6, 2011 by drlesliegreenberg

Annual mammograms decreased the risk of mastectomy in women aged 40-50 by half!  1138 women participated in a study and those who had a mammogram yearly were more likely to have a smaller, singular breast cancer.  These women were able to undergo breast-saving, tumor-excising surgery, instead of a mastectomy.  It is thought  that younger women frequently have more aggressive breast cancers, so women in the 40-to 50-year-old age range may have the most to gain from early detection.

Ladies, let’s get those mammograms scheduled.

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Study: Half of Men Had Genital HPV Infection : Family Practice News

Posted on March 3, 2011 by drlesliegreenberg

Few men have penile warts or are aware that 50% of them (regardless of age) have Human Papillomavirus (HPV).   Let’s talk up abstinence, safe sex, HPV vaccine, condoms . . . and pap testing for women.

Study: Half of Men Had Genital HPV Infection : Family Practice News.

Stay safe!

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Wound Care May Matter More Than Antibiotics – NYTimes.com

Posted on February 27, 2011 by drlesliegreenberg

Want to ward off MRSA? Wash. Wash. Wash.

Wound Care May Matter More Than Antibiotics – NYTimes.com.

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Do your bones deserve a density screening?

Posted on February 24, 2011 by drlesliegreenberg

New update!  Federal recommendations provide more detail on when to screen women UNDER age 65 for osteoporosis.   

Osteoporosis is when bones are less dense and therefore, are more likely to break, or fracture. White people are at higher risk of osteoporosis than other ethnic groups, but it occurs in all groups.  Almost half of all postmenopausal women and 1 out of every 5 men older than 65 years will have osteoporosis-related fracture. Fractures can lead to pain, surgery, loss of independence/mobility, and death.

To prevent osteoporosis take adequate calcium (500 mg 3x/day) and vitamin D (1000 IU a day), exercise, and avoiding tobacco and alcohol. Drugs can prevent osteoporosis, but they are not recommended for general prevention because of their side effects and expense. Instead, the U.S. Preventive Services Task Force (USPSTF)  recommends screening for osteoporosis and prescribing drugs only to people who have documented thin bones. Screening involves measuring bone density using dual-energy x-ray absorptiometry (DEXA).

For women OLDER than 65 years the USPSTF recommends osteoporosis screening. (Medicare will currently pay for a DEXA every 2 years).  Approximately 9 out of every 100 white women who are 65 years of age with no risk factors for osteoporosis will have an osteoporotic fracture within 10 years.

Women YOUNGER than 65 years who have a risk for osteoporosis similar to that of a 65-year-old white woman should also be screened. Risk factors for osteoporosis include

  • advanced age,
  • low body weight,
  • and tobacco and alcohol use,
  • as well as having a parent with an osteoporotic fracture.

femur (thigh bone) fracture

There is a great tool to show your 10-year fracture risk.  Input your personal risk factors and the FRAX (Fracture Risk Assessment) tool helps estimate your risk for osteoporosis. The FRAX tool is available at www.shef.ac.uk/FRAX.

Lastly, about men. . . the advisory panel concluded that there is not enough information to recommend either for or against osteoporosis screening in men.

Hope this helps.

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Do you need the chicken pox vaccine?

Posted on February 22, 2011 by drlesliegreenberg

Chicken pox is a hot topic.  What once was a rite of passage has become a much maligned and feared rash.  Should you be vaccinated?  Are you already immune?  Here’s more info. . .

Varicella zoster (the chicken pox virus) is one of 8 herpesviruses, yes, “those” herpes viruses.  Usually a chicken pox infection causes fever, fatigue and up to 300 pox-like lesions.  It is self-limited and resolves spontaneously without treatment.  Significant complications like pneumonia, hepatitis and encephalitis (brain inflammation) are more common in adults, pregnant women and those who are immune suppressed. 

The varicella vaccine (the chicken pox shot) was introduced in the US in 1995.  This is a live, but altered, virus vaccine.   CDC guidelines are to give, starting at 12 months of age, two vaccines.  Most common schedule is at 12 months and then at the “kindergarten physical” at age 4-6.  Adolescents by the age of 13 should have received 2 doses of the vaccine.  Adults with ongoing risk of exposure (child or health care workers), women of childbearing age, and those with immunosuppressed houseguests should also receive 2 doses of the vaccine if not already immune (see below). 

Pregnant women should not receive the live vaccine until the infant delivers.  Interestingly, the immunosuppressed houseguests have not been found to get chicken pox from the newly immunized, unless pox lesions result.

How do you know if you are immune?

  • Documentation of two doses of varicella vaccine at least four weeks apart.  Keep those pink vaccine records into adulthood!
  • History of chicken pox or shingles infection.
  • Birth in USA before 1980 (because the infection was so commonplace and contagious).
  • Lab confirmation that the immune system has responded to a varicella “sighting.”

In high-risk groups (like health care workers or pregnant women) age alone isn’t enough, blood testing may be needed to show immunity.  The risk is that we will become a vector and pass on the infection (to our patients or unborn baby)  as contagiousness occurs 48 hours BEFORE the rash develops until all lesions are crusted over.

Be wise.  Immunize!

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