Welcome to Monthly Medical -News with Josh. Every month I am
going to share with you some of the most talked about Medical stories
and how they can affect you. For February some of the topics I will
touch upon are- New Hope for Hepatitis C, Morning Sickness, Treatment
for Cold Sores, and Hormone Vaccine against Breast Cancer. Enjoy Monthly
Medical -News with Josh and don't forget the Doctor is always in!
1. Hormone Vaccine against Breast Cancer?
Researchers are pursuing a vaccine that could trick your body into
thinking it's pregnant. It is well known that short-term exposure in
early adulthood to the hormones of late pregnancy and to the hormones of
lactation offers a life long risk reduction against breast cancer.
Early in the 1700's, Dr. Bernardo Ramazzini described breast cancer as
an "occupational disease of nuns". Even if we got rid of the "risk
factors" for breast cancer, such as obesity, excess alcohol and hormone
therapy, we would drop the incidence of breast cancer from 180,000 cases
a year to 140,000. That's not much! What about genetics? In a study
published in The New England Journal of Medicine, in a study that looked
at "SNP's", which are changes in genes that can cause disease, these
changes only elevated the risk by 1.5 fold, which is truly not much, as
compared to those without single gene mutations. What is it about
pregnancy that decreases risk? No one really knows, but the bet is
against it being estrogen and progesterone's.
2. Wounds that Won't Heal: WARNING
Poorly healing wounds are a major problem, and it's often seen in
diabetics and people with poor circulation. Negative Pressure devices
have been used to aid in the healing of these chronic wounds. Now, the
FDA has issued a warning AGAINST these devices. Deaths have been
reported, and have been associated with bleeding, infection and other
problems. Negative pressure is appropriate for the right type of wound,
however. Some of the problems may have arisen because most wound
dressings are changed every day, but negative pressure bandages are not.
These are the wounds in which Negative Pressure Devices are NOT
appropriate:
1. Exposed nerves, or exposed vessels
2. Untreated infections of the bone [osteomyelitis]
3. Dead tissue present
4. Fistulas
5. Wound Infections
3. Morning Sickness Alert:
Don't take Nzu, also sold under the names of Calabash clay, Calabar
stone, Mabele, Argile, and La Craie. These are sold in health food
stores for morning sickness, and have been found to contain high levels
of Arsenic and Lead. My Advice: Acupuncture and Ginger.
The Long QT syndrome:
This is a genetic disease that seems to occur more commonly, maybe
due to better patient education about it. The story is "a young athlete
that died while training." The family is devastated and lives are
ruined. The truth is that we can screen for this. This disease affects
the potassium or sodium channels in the heart. These patients may
develop symptoms of fainting, tachycardia and eventually sudden death.
In general, in addition to the EKG on the patient, we believe it is
important to screen the first degree relatives as well, as this is a
genetic disease. A "QTc" longer than 450 msec in men and 470 msec in
women is considered worthy of more investigation. It is caused by 12
separate genes. WE call these "LQT 1-12". The "causative mutation" can
be seen in 70% of high-probability cases...not "100%"...so a negative
gene test at this point in time does not rule out Long QT syndrome. The
arrhythmia, or abnormal heart beat, is typically brought out by
swimming, exercise and emotions. Those with a mutation of LQT1 are the
highest risk for exercise or emotion-induced rhythm problems, and a
group of medications called Beta Blockers are used to treat it. Those
with mutations in LQT3 are at a higher risk of getting an arrhythmia
when they are at rest or sleeping. In addition to drug therapy, certain
drugs must be avoided and these can be see.
4.New Hope for Hepatitis C?
No vaccine. Not yet. But at least there is some drug therapy.
Telaprevir [VX 950: Johnson and Johnson] is a protease inhibitor,
something that emerged as a result of HIV research. When it is added to
the standard drug therapy for Hepatitis C, it leads to a sustained
Virological response [less virus] in those who previously failed drug
therapy. This study looked at those with HCV 1 and was called the
"PROVE3" study. Another weapon in the war against Hep C has been added!
Acne: Which is Better?
Adapalene 0.1% gel or BenzaClin? In a recent study, BenzaClin won.
43% vs. a 20% response. Wow....we have been using this for years
already. Keep in mind that Adapalene is a retinoid and may prevent you
from having other aesthetic procedures performed!
5.New Treatment for Cold Sores?
Combining a 5% acyclovir cream, with a steroid cream can prevent
recurrent herpes ulcers. This product was recently approved, but not yet
named. This product, however, seems to prevent cold sore development
and would be the first topical to do so.
Be in touch next month for some more medical news you and your family can use!
Dr. Fink has over 20 years of experience and he is a Fellow of
the American Society for Lasers in Medicine and Surgery as well as a
Fellow of the American College of Chest Physicians, and is Board
Certified in Internal Medicine and Pulmonary Disease.
He maintains
an active clinical practice in multiple areas of specialization,
including Internal Medicine and Pulmonary Diseases as well as Wound Care
in both Westchester and Manhattan. He is published in peer-reviewed
medical journals and he is Chief Clinical Instructor in programs that
teach the proper use of Dermal Fillers, Botox and Aesthetic Lasers
throughout the US, Asia, and Australia and he was recently awarded the
Prestigious Clinical Instructor award that recognizes his excellence in
teaching Botox, Restylane and laser technology throughout the world.
Dr.
Fink is also a recognized expert in the cosmetic use of lasers and
laser technology. Dr. Fink has been extensively involved in aesthetic
research, acting as the Principal Investigator for numerous laser and
cosmetic trials over the past several years. Dr. Fink's Westchester's
practice is conveniently located in Mt. Kisco, NY with availability in
his NYC office as well.
