Posted in Health, news

Textured Breast Implants Again Linked to Aggressive Cancer

Image above from NYTimes

 

A new study out of Pennsylvania State University College of Medicine links textured breast implants to BIA-ALCL, anaplastic large cell lymphoma.

Although a rare cancer. researchers believe the lifetime risk is 1 out of every 30,000 women with breast implants and if the numbers are underreported, could be as common as 1 out of every 4000 women with implants.

Although the implants are used to augment breast tissue, the malignancy is not a breast cancer but rather a lymphoma.

Lymphomas make up the most common of the blood cancers.  The cancer begins in the lymphocytes, cells crucial for maintaining one’s immune system. Two main types of lymphoma are Hodgkin’s and Non Hodgkins.  Non Hodgkins is more common, and anaplastic large cell lymphoma is a subset if it.

 

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ANAPLASTIC LARGE CELL LYMPHOMA/PATHPEDIA.COM

In this study, researchers reviewed 115 scientific articles from 1997 – January 2017.  Unlike the report released earlier this year by the FDA, the researchers did not find a link between BIA-ALCL and smooth breast implants.  Of the articles reviewed, 93 cases were cited and the cancer appeared 10 years after the textured implants were placed.

According to the American Society of Plastic Surgeons, there are currently 160 cases in the US and a total of 391 worldwide as of September 2017.

Last March the FDA reported 9 women had died from anaplastic large cell lymphoma (BIA-ALCL) possibly associated with their breast implant use.  The FDA received 359 reports of BIA-ALCL,  a rare type of non-Hodgkins lymphoma, 9 of whom died as of February 1, 2017.

This is not the first time a link has been suggested.  6 years ago the World Health Organization suggested a link.  Then in 2011, the FDA identified a possible association between the two.  In 2016, the  Australian Therapeutic Goods Administration reported 46 confirmed cases with 3 deaths relating to breast implants.

The report last spring suggested that BIA-ALCL affected both smooth and textured implants. According to the FDA report, 231 of the 359 cancer cases provided information on implant type.   203 were reported to be textured implants and 28 reported to be smooth implants. When it came to silicone vs. saline implants, the FDA said 312 of the 359 reports provided these specifics and of those 186 reported implants filled with silicone gel and 126 reported implants filled with saline.

TEXTURED.jpg

So neither implant type appeared immune to the risk of BIA-ALCL but it appears the silicone, textured implants carried the most risk.

Now the cancer occurred within the breast and the FDA advises physicians to consider the possibility of BIA-ALCL if there appears to be a seroma (fluid filled cavity around the implant) or a contracture (pulling of the skin and tissue) near the implant.

In most cases the cancer is treatable, with removal of the implant and the surrounding tissue curative.  In some cases however, radiation of the area or chemotherapy is required.

Although 50,000 cases of non-Hodgkins lymphoma occurs annually in the US, it is unknown how many cases of BIA-ALCL occur each year.  Moreover, many countries may not have avid reporting systems of breast implant related cancers as we do.  According to the American College of Plastic Surgeons, close to 300,000 women receive breast implants each year, some of which for breast reconstruction after mastectomy for breast cancer.

The FDA reminds us that BIA-ALCL is rare and prophylactic breast implant removal is NOT recommended. However we need to be aware and evaluate if one develops swelling, pain, new lumps or asymmetry in the breasts….just as we do for those without implants.

For more on the study, visit here.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

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Posted in Health, news

Frequent Hair Dying Linked to Breast Cancer

Women who frequently dye their hair could be increasing their risk of breast cancer.

A study out of London found a 14% increase in breast cancer in women who color their hair multiple times a year.

Professor Kefah Mokbel conducted the study. He’s a breast cancer surgeon at Princess Grace Hospital in London.

He reviewed studies looking at links between hair dyes and cancer and reported the following, “Although further work is required to confirm our results, our findings suggest that exposure to hair dyes may contribute to breast cancer risk.”

In the Sunday Times, Mokbel recommends women color their hair no more than 5 times a year.  He also encourages using products with natural ingredients such as beetroot, rose hip and henna.

For years, women have been concerned if their cosmetics were putting them at risk for breast cancer.  Parabens and phthalates are currently being studied to determine their impact if any.

Parabens are used in a variety of cosmetics including moisturizers, foundations, makeup, body washes, deodorants, and fragrance products, including hair spray.  They are antimicrobial, so used to help ward off pathogens, which is why women don’t appear to get skin infections from makeup that sits on their counters open to the air.  Parabens, however, may mimic the hormone estrogen.  This however, may only be a weak imitator, and its role in inducing estrogen-sensitive breast cancer has not been confirmed.

Phthalates are also used in a variety of cosmetics as well as plastic products. There has been evidence that phthalates, such as diethyl phthalate, act as endocrine disruptors and can mimic estrogen as well.

 

This article originally appeared in the New York Post.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

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How common is breast cancer?

1 in 8 women will develop invasive breast cancer of the course of their lifetime. According to BreastCancer.org, an estimated 252,710 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,410 cases of non-invasive breast cancer.

40,610 of these women are expected to die this year of breast cancer.

How is breast cancer staged?

Breast cancer is staged based on size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body.  Prognosis varies greatly on the stage.

Screen-Shot-2012-09-27-at-9.59.51-AM.png

IMAGE ABOVE FROM JOHNSTON HEALTH

 

Is family history a huge factor?

85% of breast cancer cases occur in women with NO family history.

Screening of breast cancer

Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74.  However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.

FullSizeRender (1)

3-D MAMMOGRAM IMAGE

What are the risk factors for breast cancer?

Risk factors for breast cancer include:

Age greater than 50

Family History

BRAC1 and BRAC2 genetic mutations

Alcohol use

Never been pregnant or becoming pregnant for the first time over 35 years old

Early menarche at age 11 or younger

Obesity, especially after menopause

Dense breasts

Lack of physical activity

Use of oral contraceptives

Previous “precancerous” tumors such as atypical hyperplasia

DES exposure

Previous radiation therapy

 

Posted in Health, news, Sports

Clavicle, Collarbone Fractures – Your Questions Answered

On Sunday, Green Bay Packers Quarterback Aaron Rodgers suffered a collarbone fracture and may be out for the season.  Here are your questions answered.

What exactly is a collarbone?

The collarbone is another name for the clavicle.  It’s the bone that connects the scapula (shoulder-blade) to the sternum (breastbone).  We have one on each side and it runs horizontally providing shoulder girdle support.  Not only does it provide upper skeletal strength and support but it also protects many major vessels that run underneath it.

 

clavicle

Image from AAOS

What’s a collarbone fracture?

The clavicle (collarbone) is one of the most common types of bones to fracture during sports injuries.  There are three major Groups or Types of clavicle fractures.

Type I – is the most common and occurs in the middle third of the clavicle

Type II – is the second most common and occurs distally, or closer to the shoulder.

Type III – is the most rare and occurs the most medially, or closer to the rib cage/sternum.

clavicle fractures

 

What are the signs/symptoms of a clavicle fracture?

Before bruising and swelling ensue, one will have sharp pain in the area of the collarbone and have difficulty moving his shoulder.

So signs of a clavicle fracture include:

Pain

Loss of range of motion of the shoulder

A bulge at the fracture site

Swelling

Bruising

Tenderness at the fracture area

In young children, not wanting to move the arm on the affected side

 

How are collarbone fractures treated?

If the bone has not shifted too significantly, clavicle fractures can be treated non- surgically.  Arm slings will be given to decrease the movement of the shoulder girdle.  Pain medication and antiinflammatories may be prescribed, and physical therapy will be instituted immediately to improve range of motion and strength.

If the clavicle is displaced significantly from the injury then surgery will be needed to reunite the ends using plates, rods and screws.

 

How long does it take collarbone fractures to heal?

In adults, healing could take anywhere from 6-12 weeks.  For children, clavicle fractures may heal sooner.

How does one prevent a collarbone fracture?

During sports, protective equipment is key to avoiding injuries from falls and tackles.  As in Aaron Rodger’s and Tony Romo’s cases, being sacked by another large player barreling towards them must be avoided at all costs.

 

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

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Posted in Employment, food, Health

Employers: How to Help Improve Your Employees’ Health

Image above from MedicalDaily.com

 

While the future of employer based health insurance remains uncertain, one certainty that remains is employers need healthy employees.

Your staff is the backbone of the organization, hence nurturing and facilitating good health practices not only ensures their stability and health but also that of your company/business.

Here are a few ways to accomplish this:

Offer the Flu Shot

According to the CDC, 20% of Americans get the flu each year, costing businesses $87 billion dollars a year.  The cost of supplying the flu shot pales in comparison to 1/5 of your workforce calling out sick during your busy season.  Supplying a one day flu shot clinic is not only economical but life saving as the flu can be deadly.

flu-vaccine

 

Provide Adequate Sick Leave

Sick leave varies per company and critics of extended sick leave are concerned with abuse of the paid days given.  Some employees may use up their sick leave for personal time and then when cough and cold season comes around, they are forced to go to work sick or face unpaid leave.  This exposes other workers to illness leaving more posts vacant when those employees need to take leave.  Understandably, it’s a controversial subject as a small employer would have to staff double to ensure adequate coverage of a position if one calls out sick. The more sick leave, the potentially higher the cost.

However a few modifications may help both employer and employee.

a.  Begin the Sick-Leave Cycle during Flu Season.  Rather than Leave Periods renewing every July 1, start the new Leave Cycle November 1.  This helps increase the chance that the employee would have their sick days untouched during a very common time of year when it needs to be used.

b.  Make sure adequate hours are offered for both sick leave and personal leave.  A cold, respiratory infection, stomach ailment, etc. can easily burn through 5 sick days.  An employee taking off one or two days could still be contagious days 3-5 or more.  Adequate sick leave prevents one from returning to work too soon.

c.  Offer a means to earn extra days of leave.  If an employee wants to re-earn sick leave/personal hours for later in the year, offer incentives or work projects that allow employees to gain extra days.

d.  Institute an “hours bank”.  If an employee has used all of his/her personal, vacation and sick leave, they can borrow from an “hours bank”.  The “hours bank” could include hours donated by other employees, hours won during office contests, or simply a bank that exists that will award an employee additional time with the understanding that they will have to replenish the hours in the bank at a later date.  This will allow an immediate need for sick time to be gratified but prevent abuse as it is understood to be a “loan” of hours.

Promote Prevention/Offer Screening Services

Encouraging employees to get preventative screens may help prevent serious illness. These screens can be done at their primary care provider’s office or the employer can bring the screening in-house.

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

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Encourage Getting Up and Moving Around

Before the end of each hour, a “stand up and move around” alarm should go off and allow 5-10 minutes of physical activity. Not only is this beneficial for health but helps prevent burnout in the work place.

Offer Heathy Snacks

Swap the sugary carbs in the snack machine with healthy juices, snacks, and bottled water.  Encourage potlucks or contests where employees bring in their most creative healthy snacks.

Healthy_Vending_Machine_Option.jpg

Image above from HealthyFamily

 

Have Plenty of Sinks and Hand Sanitizing Stations

An individual’s workplace can get very dirty as studies have shown computer keyboards to hold more pathogens than a toilet seat.  Offering cleansing wipes, wall sinks and sanitizing stations will improve employee hygiene.

sanitizer.jpg

Offer Workstation Modifications

Many employees may suffer from low back pain, arthritis, hemorrhoids, and a variety of conditions that may worsen when one sits all day at a computer.  Offering chair modifications, for example, could decrease their need to call out and help improve their comfort and therefore efficiency.

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A well implemented program for workplace and employee health is a necessity for all organizations, and as you will come to see, cost saving in the long run.

 

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in food, Health, news

Childhood Obesity is Exploding – Why and How to Stop It

Image above from the Huffington Post

 

The World Health Organization (WHO) finds the number of obese children in the world to be 10 times greater than what it was 4 decades ago.

They estimate currently 50 million girls and 74 million boys are obese worldwide.

Back in 1975 only 11 million children world-wide were obese. Now the number sits at 124 million.

True, population has grown since then, but the percentage of children obese is exploding.  19% of girls and 22.4% of boys in the US are considered obese.

Adult obesity is skyrocketing as well.  In 1975 there were 100 million obese adults worldwide. This jumped to 671 million in 2016 and doesn’t include the 1.3 billion “overweight” adults.

The Center for Disease Control and Prevention (CDC) states the following:

Obesity is defined as having excess body fat. Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors. Body mass index, or BMI, is a widely used screening tool for measuring both overweight and obesity. BMI percentile is preferred for measuring children and young adults (ages 2–20) because it takes into account that they are still growing, and growing at different rates depending on their age and sex. Health professionals use growth charts to see whether a child’s weight falls into a healthy range for the child’s height, age, and sex.

  • Children with a BMI at or above the 85th percentile and less than the 95th percentile are considered overweight.
  • Children at or above the 95th percentile have obesity.

 

Why such a rise in obesity?

 

  1.  We’re successfully fighting the war on tobacco.  Adults especially can’t turn to a stick of nicotine as easily as they once could to curb their appetite.  Teen smoking is down as well, so their appetites may be up.
  2. We like fast food.  Its cheap, yummy and convenient.  For 99 cents you can get a small burger that is served to you in a matter of minutes and can be eaten before your next meeting or class.  Fast food contains excess calories, fat and preservatives that our body doesn’t need.
  3. We eat too quickly.  The speed at which we eat may affect our metabolism.  Eating too quickly prevents a satiety signal from reaching the brain, hence we will gulp down more food than is needed.  For more on this read here.
  4. We don’t move around as much.  We can all agree that children and adults these days don’t play outside as much as we did in previous generations.  And even if we did get some exercise in each day during PE or at the gym, we lose much of the ground gained when we sit on our computers at night for hours on end.
  5. More hormones are in our food.  Hormones such as steroids and recombinant bovine growth hormone (rBGH) that enhance food production in our food-producing animals may affect our metabolism.
  6. Sugar isn’t a treat anymore, it’s considered a food group.  In the 70’s if you got dessert one night at dinner it would be a rare treat.  Today kids have dessert at lunch and even breakfast has sugar levels overflowething the cereal bowl.  Excess sugar leads to fat storage.
  7. Our portions have gotten bigger.  Remember when the Quarter Pounder came out in the early 70’s and we thought it was the biggest burger ever?  Now people will eat two in one sitting.

Below is a table showing the difference in portion sizes today vs. the 1950’s.

portion sizes.jpg
Image from Daily Mail

 

What can we do to combat the obesity epidemic?

 

  1.  Make exercise not a choice but a daily necessity.  Schools should have English class conducted on walks around the school rather than sitting in desks.  A 30 minute workout should be a given every morning without excuses.  We brush our teeth, we wash our hair, we gas up our truck, we exercise.
  2. Eat fresh, avoid fast food.  The more junk food the more junk in your trunk.  Avoid preservatives and processed foods. Your body was designed to eat the basics.  Give it what it needs.
  3. Eat slowly.  No need to chow down on the run.  If you’re in a hurry then eat half the sandwich as save the rest for later.  Which brings us to…
  4. Eat smaller portions. Get rid of the platters you call plates these days and eat your dinner off of a saucer dish.  You’ll still fill up your tummy.
  5. Swap vegetables for carbs.  Its healthier, filling, and helps you poop.
  6. Just say NO to sugar.  This will be a hard one for me but if you do it, I will.

 

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in food, Health, news

Acid-Reflux Drugs Found to Increase Liver Disease Risk

A study out of the University of San Diego, California found Proton Pump Inhibitors such as Prilosec, Prevacid and Nexium change the gut microbiome.  The overgrowth of the new bacteria can lead to liver inflammation.

As opposed to being forms of calcium carbonate, such as acid neutralizers such as Tums, or H2 (Histamine H2 Antagonist) blockers such as Pepcid and Zantac, the PPI’s reduce stomach acid production from the start.  They’re popularity has been skyrocketing over the last two decades and have become a mainstay treatment for multiple gastrointestinal issues including ulcers.

Stomach acid pH averages around 2-2.5.  Any minor change to this could allow downstream bacteria in the intestine to change its growth patterns.  If the liver is not accustomed to the new growth, it may “stress”.  Stress leads to inflammation and cell death.  Moreover, if the bacteria travel to the liver, it could cause inflammation as well.

In this study mouse models were used to see what would happen to their livers if they were given alcohol, a proton pump inhibitor, or genetically engineered to not produce enough stomach acid.  Researchers found Enterococcus faecalis bacteria to grow, exacerbating alcoholic liver disease.

When they colonized new mice subjects with E. faecalis, the rodents developed steatosis, or fat deposits within the liver consistent with liver disease.

They then reviewed medical records of 4,400 chronic alcohol drinkers and evaluated their liver disease risk based on their past PPI use. Those who used PPIs actively raised their risk of liver disease by 20%. Those who didn’t only raised their risk by 12.4%.

In 2015 McDonald et al found PPI use to increase risk of recurrent Clostridium difficile infection.

In 2011, Fohl et all found an increased risk of community acquired pneumonia in those taking PPIs.

PPI’s liked to stroke

In a Danish study, researchers reviewed the records of 245,000 patients who were suffering from abdominal pain and reflux, and found 9,500 to later suffer from stroke. After adjusting out for other causes of heart disease and stroke they concluded that the Proton Pump Inhibitors increased these patients’ risk of ischemic stroke by 21%.   It varied depending on the brand with Prevacid and Prilosec increasing stroke risk by 33%, Nexium by 50% and Protonix, 79%. They note that these were high doses of PPIs as low doses appeared NOT to increase risk of stroke.

 

Researchers do not know why this class of drugs increases stroke risk. They theorize it may have something to do with altering gut bacteria, or prevention of vital nutrients being broken down to become absorbed since stomach acid levels are decreased.

Foods that cause reflux

Gastroesophageal reflux disease can be caused by foods difficult to digest like processed foods, sugars, and those with refined carbohydrates.

acid-reflux-1-1100x700

 

Foods that help relieve acid reflux

They following may help relieve acid reflux symptoms:

Oatmeal

Banana

Salad

Aloe vera

Parsley

Celery

Couscous

Rice

Lean turkey and chicken

 

Here’s another chart that shows foods that may help or trigger reflux:

reflux foods

Elevating the bed 45 degrees at night helps reduce reflux symptoms.

Avoiding drinking lots of water before sleep helps as well.

Eating smaller meals and avoiding a large dinner at bedtime will decrease acid reflux.

So why take medication at all?

Those suffering from GERD can be prone to esophageal cancer if the stomach acid bombarding the lower esophagus fails to be subdued.  Acid reflux can also cause chronic sore throat and chronic cough.  For these reasons, PPIs will still be recommended for severe reflux cases, but maybe lower doses and combinations with other drugs and lifestyle changes should be started first.

 

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

Posted in Entertainment, Health

The New Star Wars Trailer is Out!

At halftime during the Chicago Bears, Minnesota Vikings game Monday night, fans came together to watch the first release of the Star Wars: The Last Jedi trailer.

Lei and Luke appear to have huge roles in the next saga and Kylo and Ren appear to join forces at the jawdropping end.  I love it…..and wish I could train to be a Jedi!

The Last Jedi (Official) Trailer

 

And here is the (Official) Teaser……

 

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

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