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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
    Click to Tweet

     

    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • March 09, 2017

    By MedStar Health

    In January 2017, researchers reported that exercise is associated with a lower risk of death from metastatic colorectal cancer. Metastatic colorectal cancer is cancer of the colon or rectum that has spread to other areas of the body. This study found people who were physically active for four or more hours per week reduced their risk by 20 percent. People who exercised for at least five hours per week lowered their risk by 25 percent.  

    These results reinforce other data researchers have collected on how exercise affects the risk of colorectal cancer. Though we don’t fully understand why, exercise plays a role in the development of colorectal cancer—for people who may be at risk for the disease, people who already have it and people who have been treated for it.

    Who’s at risk for colorectal cancer?

    Several lifestyle factors can increase the risk for colorectal cancer, including:

    • Diets high in red meat, such as beef and pork
    • Diets high in processed meats, such as hot dogs and bologna
    • Heavy alcohol use
    • Obesity, particularly excess belly fat
    • Smoking

    Other factors can also increase the risk of developing colorectal cancer. These include:  

    • A history of inflammatory bowel disease, including Crohn’s disease and ulcerative colitis
    • Family history of colorectal cancer or colon polyps (growths in the colon)
    • Being African-American
    • Having type 2 diabetes

    Colorectal cancer tends to affect people in older age groups. That’s why we recommend people over 50 get a colonoscopy on a regular basis to lower their risk for colorectal cancer. Your doctor may recommend starting earlier if you have one or more of the above risk factors. For instance, we recommend African-Americans start getting regular colonoscopies at age 45. Though there are other tests available to screen for colorectal cancer, colonoscopy is still the best option for finding and treating the disease as early as possible. 

    Getting active to stay healthy

    As we age, we tend to be less active and at higher risk for conditions like heart disease and diabetes, which can further limit our activity levels. But even a little exercise every week can lower your risk of colorectal cancer. Studies cited by the National Cancer Institute have found adults who increase their physical activity can reduce their risk of developing colorectal cancer by 30 to 40 percent compared to people who don’t exercise. That’s on top of the benefit researchers have found exercise has in people whose cancer has spread.  

    Modest amounts of moderate exercise can help. I tell patients that if they’re breaking a sweat for about 20 minutes at a time two to three times a week, that seems to be enough. Walking is a great way to do this. Some other examples of moderate exercise, according to the Centers for Disease Control and Prevention (CDC), include:

    • Aerobics
    • Biking
    • Climbing stairs or using a stair climber
    • Dancing
    • Playing basketball
    • Swimming
    • Yoga 

    Research shows that people don’t have to do intense exercises to get these survival benefits. When it comes to lowering your risk of colorectal cancer, just getting up and doing something is important. If you can do more, that’s great! If you can’t, do what you can. Just make sure you’re doing something. And talk to your doctor about starting any new exercise plan, especially if you have conditions like heart disease, lung disease, diabetes or other serious conditions.

    Exercise even helps after a patient has had surgery to treat colorectal cancer. The American Cancer Society notes that people who exercise regularly after being treated for colorectal cancer have a lower chance of the disease coming back, as well as a lower chance of dying from the disease. In addition, exercise has been linked to an improved quality of life and less fatigue after colorectal surgery. If you’re starting or resuming an exercise routine after colorectal surgery, be sure to talk to your doctor beforehand about the types of exercise you can do safely. 

    Controlling your colon cancer risk

    I realize that getting active is easier for some people than others. By the time people are in their 60s and 70s, if they haven’t exercised regularly before, making that sort of lifestyle change can be tough. But I encourage my patients to do what they can to lower their risk for colorectal cancer. I let them know that even little changes in their activities or walking just a little bit can benefit them in the long term.  

    Older adults who have never exercised before may not know where to start. It can be intimidating to walk into the local gym and get started on a fitness plan. The National Institute on Aging has examples of sample exercises for older adults based on four key fitness areas: endurance, strength, balance and flexibility. Your doctor can also provide guidance on the types and amount of exercise you should do.  

    And exercise isn’t the only thing I advise people do to lower their risk. Other ways you may be able to reduce the risk of colorectal cancer include:

    Take the first step

    We need more research in this area of medicine to find out exactly why exercise lowers the risk of death from colorectal cancer and the risk of developing it in the first place. For now, though, the data show a clear link between the disease and activity levels.

     You don’t have to live at the gym or train for marathons to reduce your risk for colorectal cancer. Take a brisk walk around the block once a day, or watch your favorite TV show while you walk on the treadmill. Every step is one you’re taking to live a healthier, more active life—and one free from colorectal cancer. 

    Due for a colonoscopy? Or need a second opinion with a colorectal surgeon? Call 703-552-4036 or click below to make an appointment with our doctors.

    Request an Appointment

  • March 07, 2017

    By MedStar Health

    Since the 1970s, heart specialists have diagnosed and even treated certain conditions through cardiac catheterization—the process of threading a thin tube through an artery to reach the heart and its vessels. The technique gives cardiologists a close look at what’s going on inside, and even more importantly, the ability to intervene on the spot in cases of blocked, narrowed or weakened arteries.

    In fact, cardiac catheterization is so common today that more than 1 million people in the United States undergo the procedure each year. And in nearly every case, cardiologists use the femoral artery, a large vessel deep in the groin, as the point of entry.

    But not always.

    The Current Landscape

    “There’s been a push over the last five years or so to approach cardiac catheterization through the wrist, using the much smaller radial artery,” says Robert Lager, MD, an interventional cardiologist at MedStar Heart & Vascular Institute at MedStar Washington Hospital Center, and president of MedStar Cardiology Associates. “It poses less of a risk of bleeding—the major complication of traditional cardiac catheterization techniques—and it’s more comfortable for patients.”

    That’s because recovery from the femoral approach requires patients to remain motionless on their back for four to eight hours to prevent significant post-procedure bleeding and other potential complications. For many, that inconvenience is a small price to pay for a potentially life-saving procedure. But for those with congestive heart failure, back or breathing problems, the protracted time lying flat can be miserable.

    By contrast, recovery from the transradial approach is fast and easy.

    “In theory, a patient could literally walk off the table after transradial catheterization,” says Dr. Lager, who uses the approach for approximately 80 percent of his cases. “In reality, we keep people in bed for an hour or so post-procedure to monitor for any problems from sedation. But they’re free to sit up, and even get a drink or eat soon afterward.” In addition, the time to discharge is shortened for those going home, and avoiding the groin allows patients to resume more strenuous activities like climbing stairs and aerobic activity earlier in their recovery, adds Dr. Lager.

    Transradial cardiac catheterization has been the norm in many parts of Asia and Europe for decades. In the U.S., it currently only accounts for about 30 percent of procedures, in part because of the steep learning curve. However, that ratio is quickly changing.

    “As more cardiology fellowship programs train new doctors to use the wrist instead of the groin for cardiac catheterization, we are getting closer to a tipping point of transradial becoming the default approach,” says Dr. Lager. “It’s already the preferred choice among younger cardiologists.”


    LISTEN: Dr. Lager discusses transradial cardiac catheterization in this Medical Intel podcast.

    Who Should Get Transradial Cardiac Catherization?

    Not everyone is a good candidate for the transradial catheterization, however. Patients on dialysis may not be eligible, for example. And patients who have had bypass surgery can also pose more technical challenges, although Dr. Lager still uses the wrist for the vast majority of his bypass patients. In fact, national statistics report a 90 percent success rate for the transradial approach overall.

    For those who are eligible, however, the advantages in comfort and convenience are compelling.

    “Patients are already seeking out physicians who will do the transradial procedure,” concludes Dr. Lager. “As more people learn about its benefits, the demand is only going to increase.”

  • March 03, 2017

    By MedStar Health

    We are pleased to announce the 2017-2018 cohorts of MedStar Teaching and Research Scholars.

    At the heart of the MedStar Teaching Scholars program is MedStar’s commitment to teaching clinician educators from across MedStar Health how to apply research principles to medical education; to become informed consumers of the medical education research literature; to be effective collaborators in medical education research; and to develop as leaders in academic medicine. This two-year longitudinal program leads to Medical Education Research Certification (MERC) and Leadership Education and Development (LEAD) certification. This program is a joint endeavor from MHRI and MedStar Health Academic Affairs, offered in conjunction with the Association of American Medical Colleges.

    The MedStar Research Scholars program supports the development of MedStar clinicians who seek careers with a focus on clinical and translational research, in large part by addressing the need for research mentorship and critical feedback in project design, analysis, and presentation. MedStar Health Research Institute, MedStar Health Academic Affairs, and the Georgetown-Howard Universities Center for Clinical and Translational Science offer this research career development program to clinical and junior research colleagues.

    More information on both programs can be found here. Congratulations to the new scholars!

     

    Teaching Scholars

    Anne Kelemen, LICSW
    Palliative Care
    MedStar Washington Hospital Center

    Leon Lai, MD
    Infectious Disease
    MedStar Washington Hospital Center

    Daniel Marchalik, MD, MA
    Urology
    MedStar Washington Hospital Center

    Laura Moreno, MD
    Family Medicine
    MedStar Franklin Square Medical Center

    Nargiz Mugalinskaya, MD
    Internal Medicine 
    MedStar Franklin Square Medical Center

    Sarah Thornton, MD
    Hospital Medicine
    MedStar Georgetown University Hospital

    Francis Tirol, MD
    Neurology
    MedStar Georgetown University Hospital

         
    Research Scholars


    Cynthia Deklotz, MD
    Dermatology
    MedStar Washington Hospital Center

    Carter Denny, MD, MPH
    Neurology
    MedStar Georgetown University Hospital

    Suhasini Kaushal, MD
    Neonatal Perinatal Medicine 
    MedStar Georgetown University Hospital

    Deliya Wesley, PhD, MPH
    Health Services Research
    MedStar Health Research Institute

  • March 03, 2017

    By MedStar Health

    Congratulations to all researchers who were published in February 2017. The selected articles and link to PubMed provided below represent the body of work completed by MedStar Health investigators, physicians, and associates and published in peer-reviewed journals last month. The list is compiled from PubMed for any author using ‘MedStar’ in the author affiliation. Congratulations to this month’s authors, and we look forward to seeing your future research.

    View the full list of publications on PubMed.gov here.

     Selected research:

    1. Reading the Room: Lessons on Holding Space and Presence.
      Journal of Cancer Education. DOI: 1007/s13187-017-1189-4.
      Kelemen AM, Kearney G, Groninger H.
    2. The spoon test: a valid and reliable bedside test to assess sudomotor function.
      Clinical Autonomic Research. DOI: 1007/s10286-017-0401-2.
      Khurana RK, Russell C.
    3. Deconstructing Postmastectomy Syndrome: Implications for Physiatric Management.
      Physical Medicine and Rehabilitation Clinics of North America. DOI: 1016/j.pmr.2016.09.003.
      Wisotzky E, Hanrahan N, Lione TP, Maltser S.
    4. Acute coronary syndromes in 2016: Assessing strategies to improve patient management.
      Nature Reviews Cardiology. DOI: 1038/nrcardio.2016.210.
      Waksman R.
    5. Subspecialty Influence on Scientific Peer Review for an Obstetrics and Gynecology Journal With a High Impact Factor.
      Obstetrics & Gynecology. DOI: 1097/AOG.0000000000001852.
      Parikh LI, Benner RS, Riggs TW, Hazen N, Chescheir NC.
  • March 03, 2017

    By MedStar Health

    In response to limited data comparing different types of hysteropexy procedures, researchers at MedStar Washington Hospital Center and Georgetown University collaborated to publish “Vaginal and Laparoscopic Mesh Hysteropexy for Uterovaginal Prolapse: A Parallel Cohort Study.” Published in the American Journal of Obstetrics and Gynecology, this multicenter study compared the 1-year efficacy and safety of laparoscopic sacral hysteropexy versus vaginal hysteropexy.

    A hysteropexy is performed to correct prolapse of the uterus. Uterine prolapse occurs when the uterus sags or slips from its normal position due to weakened or ineffective muscles or ligaments. The majority of prolapse repairs are performed with a hysterectomy, even though the uterus is not the cause of the prolapse. Interest in uterine conservation has been increasing for a variety of reasons, including sexual function, sense of identity, fear of complications and preservation of future fertility. Hysteropexy procedures can be done with native tissue or synthetic mesh. In this study, two different minimally invasive surgical procedures were performed utilizing synthetic mesh to lift the uterus. Both  procedures were laproscopic (i.e., performed through keyhole surgery).

    The study included women, ages 35-80, who desired uterine conservation, were not planning to have children in the future and were undergoing one of the two procedures for stage 2-4 symptomatic anterior/apical uterovaginal prolapse. Of the patients, 74 received a laparoscopic sacral hysteropexy and 76 received vaginal mesh hysteropexy.

    No differences in blood loss, complications, or hospital stay were found for patients in either cohort. One-year outcomes showed consistent results between the cohorts, with 95% of patients in each group “very much better” or “much better.” Pelvic floor symptom and sexual function scores improved for both groups.

    “Laparoscopic sacral hysteropexy and vaginal mesh hysteropexy had similar 1-year cure rates and high satisfaction,” the authors said.

    This research was led by Robert E. Gutman, MD, and was presented as a late-breaking abstract awarded Best Surgical Paper at the 2015 annual meeting of the American Urogynecologic Society. It was also a featured article on the American Journal of Obstetrics and Gynecology website.

    Collaborators on this research were from the Alpert Medical School of Brown University/Women & Infants Hospital of Rhode Island, Stanford University School of Medicine, University of North Carolina, University of British Columbia, Christ Hospital/University of Cincinnati, Greater Baltimore Medical Center, and Cleveland Clinic.

    American Journal of Obstetrics and Gynecology, DOI: 10.1016/j.ajog.2016.08.035

  • March 03, 2017

    By MedStar Health

    For the fifth year, the MHRI Wellness Committee invited associates to wear red in support of the American Heart Association’s (AHA) fight against heart disease. Heart disease is the leading cause of death for men and women, according to the Centers for Disease Control and Prevention. At MedStar Health Research Institute, many of our research efforts are designed to improve quality of life for heart patients. Cardiovascular research provides patients with the opportunity to contribute to the advancement of knowledge and treatment for heart and vascular disease. Clinical research trials also may provide access to new drugs and interventions.

    Thank you to all who showed their support for this important cause! We are pleased to announce that the winner of this year’s competition is MCRN’s Invasive Imaging CoreLab! Second place goes to the MedStar Community Clinical Research Center at University Town Center. Honorable mention goes to the MHRI Corporate Office at University Town Center and the ECHO Core Lab.

    Check out all the photos that were submitted by MHRI associate teams. Thank you to all who took the time to participate.

    Thank you to our judges from the MedStar Health Corporate Offices:

    • Kathy Senger
    • Marianne  McGucken
    • Natasha Adams
    • Joan Goss
    • Hussein Tahan
    • Paula Winkis