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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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  • August 05, 2020

    By Glenn W. Wortmann, MD

    While we continue to learn more about COVID-19, there’s still a lot we don’t know. But it’s important to stay up-to-date on basic information related to COVID-19 symptoms so that you know if and when you need to seek medical care. 


    Is sore throat a common COVID-19 symptom?

    A sore throat can be a sign of COVID-19, but it’s not common. A study in China reported that only l4 percent of 55,000 patients with confirmed cases of COVID-19 experienced a sore throat. Everyone’s body reacts differently to the virus, so while it’s possible to have a sore throat as a symptom of COVID-19, it’s more likely that you’ll have other symptoms.

     
    While sore throat can be a symptom of #COVID19, it’s uncommon. Infectious disease specialist Dr. Wortmann shares what you need to know about COVID-19 and sore throat: https://bit.ly/3d0jSPv.
    Click to Tweet

     

    What are common COVID-19 symptoms?

    COVID-19 is a respiratory illness so it commonly results in symptoms similar to that of the common cold, such as:


    • Fever
    • Cough
    • Fatigue

    Unlike the flu, COVID-19 symptoms appear gradually, according to the World Health Organization (WHO). Many people who become infected have mild to moderate symptoms that last around a week. And, some people with COVID-19 don’t experience any symptoms at all. 


    Aging adults or those with underlying health conditions are at a greater risk of experiencing more severe COVID-19 symptoms, but anyone can become seriously ill—even younger people. Severe COVID-19 symptoms include:


    • Shortness of breath
    • Difficulty breathing
    • Loss of smell or taste

    As we continue to learn more about COVID-19 and it’s symptoms, we may discover new information about what symptoms develop and when. 


    Related article: Learn how COVID-19 compares to the flu.

    When do COVID-19 symptoms appear?

    COVID-19 symptoms typically appear two to 14 days after you are exposed to the virus. Because it can take up to two weeks for symptoms to appear, many people may not realize they have it. And, some people don’t experience any symptoms from COVID-19. That’s why it’s so important to self-quarantine if you think you may have been exposed, even if you don’t feel sick. The Centers for Disease Control and Prevention (CDC) recommends staying home for 14 days to minimize the risk of spreading the virus to others.   


    How do I know if my sore throat is related to COVID-19?

    It can be hard to determine what is causing a sore throat. A sore throat could be a symptom of lots of other illnesses, including allergies, strep throat, or other infections. The best way to know if your sore throat is related to COVID-19 is to be on the lookout for more common symptoms of COVID-19, such as a fever, cough, or shortness of breath.


    How can I treat a sore throat at home?

    Whether or not your sore throat is a symptom of COVID-19, there are a few things you can do at home to ease your pain. To relieve irritation due to a sore throat, you can try:


    • Gargling warm salt water
    • Drinking warm tea
    • Sucking on throat lozenges
    • Using a humidifier 
    • Taking over-the-counter medicines (e.g. Tylenol)

    When should I seek medical care for a sore throat?

    In some cases, you may need to seek medical attention for a sore throat. If you have a severe sore throat that worsens or makes it challenging to swallow, consider using MedStar eVisit to talk to a doctor virtually. During a virtual visit, a doctor will ask you questions about your sore throat to determine when and where you should seek in-person medical care.


    What should I do if I suspect I have COVID-19?

    According to the WHO, most people can recover from COVID-19 at home. In fact, 80% of people who become infected with the virus recover without needing medical care in a hospital. 


    If you have mild symptoms, such as a light cough, you can probably ride out the virus at home. Be sure to quarantine, taking precautions to limit exposure to family members in the same household. Even if you don’t have symptoms, if you think you have COVID-19 or were exposed to the virus, the Center for Disease Control and Prevention (CDC) recommends:

    • Staying home
    • Avoiding any public area or transportation
    • Drinking water to stay hydrated
    • Resting and taking over-the-counter medication, such as Tylenol, to reduce discomfort
    • Separating yourself from family members by staying in a separate room
    • Wearing a facemask over your nose and mouth if you are around anyone in your home
    • Washing your hands often
    • Cleaning high-touch surfaces every day
    • Monitoring your symptoms
    If you have shortness of breath or difficulty breathing, you should seek medical attention immediately.


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  • August 05, 2020

    By The MWHC Blog Team

    More than two decades ago, Ariam Yitbarek came onboard at MedStar Washington Hospital Center as a nurse in the Cardiac Surgery Step-Down Unit and loved that patient population. She had ambition to move up, however, and was always ready to take advantage of educational opportunities. 

    “I loved how supported I was and appreciated that MedStar Health offers a lot of development opportunities,” said Ariam. 

    After a year and a half in her first position, she became a clinical manager in the same department. Five years later, Ariam moved up to the position of nursing director on the heart failure unit. She says she kept an eye out for how she could be of service, helping to provide interim coverage on other units in cardiac services. This was around the time she completed her master’s degree in Health Care Administration from George Mason University.

    In 2009, Ariam began serving as interim senior nursing director of surgical and oncology services, which became permanent nine months later. “I took on roles where I was learning a lot about service lines I had no clinical experience with,” said Ariam. “I also looked to leaders and peers whom I learned from and who have guided me throughout my career. And I took full advantage of tuition reimbursement.”

    Excelling in that position, Ariam then transitioned into a position created for her: senior nursing director for ambulatory services and women’s and infants’ services. From 2013 to 2017, Ariam covered other service lines as well, and added emergency services to her portfolio. In mid-2019, Ariam was promoted to her current position, vice president of nursing operations. She says she appreciates the encouragement she has received from Chief Nursing Officer Tonya Washington, who is a mentor and a trusted friend. This gives Ariam the motivation to mentor others. She sees her role as having an impact and leaving a legacy wherein those she leaves behind have the tools to seamlessly succeed her. She says it is important for leaders to provide tools, knowledge, and resources, and to let people learn from their decisions.

    Finally, Ariam believes the key to success is looking at each of our roles as being a part of One Team.

    Regardless of your role in this hospital, we all impact patient care,” said Ariam. “At any level throughout the organization, we can tarnish the reputation of the hospital or we can look at ourselves as representatives of the hospital and say ‘My success is its success’ and be mindful of how we’re adding to that. I am truly proud to be part of this amazing organization. One Team!”


    Looking for a new career opportunity?

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    Visit our Jobs Portal

  • August 04, 2020

    By Ron Waksman, MD

    The thin, delicate tissues of the valves in the human heart may be small—but they have a big job to do. They keep the blood flowing forward in your body. If they malfunction, they need to be repaired or replaced

    At MedStar Heart & Vascular Institute, we are well equipped to restore optimal quality of life to patients requiring valve repairs or replacements. The good news for patients is that many of these procedures are minimally invasive, which means the patient can go home the following day.

    The good news for patients is that many heart valve procedures are minimally invasive. https://bit.ly/2D2Zqia via @MedStarWHC #ValveDiseaseAwareness
    Click to Tweet

    One Heart, Four Valves

    The human heart has four valves: the aortic, pulmonary, tricuspid, and mitral valve. Each can have its own problems, and each issue can manifest at a different age in patients. Some people are born with abnormal valves. Some develop malfunctioning valves through infection or as a result of aging.

    How Does a Valve Malfunction?

    Patients might experience two main issues with their valve, both involving the valve’s leaflets—thin flaps of tissue that open and close to allow blood flow.

    • First, the valve can become leaky, which means that the leaflets are not closing and operating well and there is a leakage of blood. Instead of just flowing forward, the blood also moves backward
    • Another problem is that the valves may develop stenosis, which is when the opening of the valve becomes narrowed and the leaflets don’t open enough. The result is that the ventricles, or lower chambers of the heart, don’t pump out enough blood

    Symptoms Can Be Silent, Sudden, or Gradual 

    Symptoms of valve disease depend on the degree of the disease. Some people—those with a mitral valve prolapse, for example—might have no symptoms, or the symptoms may go away.

    When something goes wrong with any of the valves, patients usually experience shortness of breath as well as weakness. The symptoms can be new to the patient—in other words, not previously experienced.

    Because the onset of symptoms can be gradual rather than abrupt, the patient may not necessarily notice their symptoms. The intensity of symptoms depends on the cause and degree of the valve malfunction.

    Patients with valve disease may also experience palpitations, a kind of fluttering of the heart. Some palpitations, especially involving the mitral valve, could spur atrial fibrillation, an irregularity of the heart rate. Occasionally, palpitations may also cause some chest discomfort or chest pain (this is most likely with mitral valve prolapse).

    A Simple Test to Diagnose Valve Disease

    It is very easy to diagnose problems of the heart valves or heart muscle with an echocardiogram—basically, an ultrasound of the heart. The ultrasound is a very simple procedure, not that costly, and is free of any risks or side effects. The results will give you an accurate answer to whether or not you have valve disease, and you can be diagnosed after one visit.

    It’s important not to delay diagnosing valve disease. When the heart valves are not functioning properly, you may feel weak or have shortness of breath. The abnormal flow of blood may cause the heart muscle to start to behave differently.

    Home of Pioneering Medical Advances

    The team at MedStar Heart & Vascular Institute treats valve disease with an array of innovative, minimally invasive techniques, meaning we no longer have to perform traditional, open-heart surgery. Today, many patients can go home the next day with a repaired valve.

    Some technologies were implemented at MedStar Heart & Vascular Institute before they were well known within the United States. For example, we were first in the country to use heart valves in patients diagnosed with severe aortic stenosis but who had a low risk of death.

    We are now among the first to treat a mitral valve regurgitation with innovative technology started by some of our investigators, who also work at the National Institutes of Health. MedStar Heart & Vascular Institute can now offer this pioneering approach to its heart health patients.

    Repair or Replacement?

    Other than maintaining good dental health and living a clean lifestyle, there’s not much we can do to prevent heart valve disease. And once it occurs, it cannot be reversed. So, if a degenerative problem in the valve is diagnosed, it should be addressed, because it will not improve on its own.

    If the existing valve can be repaired, we do so. Some cases are beyond repair—for example, when there is a severe narrowing of the valve. In a case like this, we have to replace them with a new valve.

    A patient may be able to compensate for symptoms by using medication for some amount of time; however, this plan of care calls for the supervision of a cardiologist, as well as repeat ultrasounds of the heart to ensure no further deterioration of the valve conditions or the muscles.

    Do Right by Your Valves

    MedStar Heart & Vascular Institute, we’d like to underscore the critical importance of healthy heart valves.

    Patients should be aware that valve disease can be easy to understand and easy to diagnose. And, in most cases, it’s not difficult to treat. Early diagnosis can help. A recommendation: at age 50, arrange to have an ultrasound of your heart—even if you don’t have obvious issues or symptoms.

    If you do have to come see us, MedStar Heart & Vascular Institute is well equipped to help restore your valves. We have the capacity. We have the technology. We have the skills. We’ll do our best to bring you back to good health.


    Keep heart valves healthy.

    Connect with a heart valve specialist.

    Call 202-644-9526 or  Request an Appointment

  • August 01, 2020

    By MedStar Team

    Congratulations to all MedStar researchers who had articles published in July 2020. 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! We look forward to seeing your future research.

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

    Selected research:

    1. Functional mitral regurgitation
      Current Opinion in Cardiology, 2020DOI: 10.1097/HCO.0000000000000770
      Asch FM, Medvedofsky D.

       

    2. Infections in Burn Patients: Innovations in Infection Prevention and Treatment
      Surgical Infections, 2020. DOI: 1089/sur.2020.202
      Tejiram S, Shupp JW.

       

    3. Lymphoma survivors have an increased long-term risk of chronic kidney disease
      Leukemia & Lymphoma, 2020. DOI: 10.1080/10428194.2020.1786555
      Desai SH, Al-Shbool G, Desale S, Veis J, Malkovska V.

       

    4. Head Repositioning during Neurointerventional Procedures to Optimize Biplanar Imaging
      Journal of Neuroimaging, 2020. DOI: 1111/jon.12750
      Dowlati E, Zhou T, Stewart J, Felbaum DR, Liu AH, Mai JC, Armonda RA.

       

    5. Food Insecurity and Insulin Use in Hyperglycemic Patients Presenting to the Emergency Department
      Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 2020. DOI: 10.5811/westjem.2020.4.45918
      Nhoung HK, Goyal M, Cacciapuoti M, Day H, Hashemzadeh T, Magee M, Jarris YS.
  • August 01, 2020

    By MedStar Team

    A collaborative team of researchers from across MedStar Health published a case report which examined the need for improved situation awareness of all telehealth operations to effectively monitor and proactively manage patient experience, healthcare provider experience, and platform performance.  The team included investigators from MedStar Health National Center for Human Factors in Healthcare, MedStar Health Research Institute, MedStar Simulation Training and Education Lab, MedStar Telehealth Innovation Center, and Georgetown University School of Medicine.

    “Rapid Development of Visualization Dashboards to Enhance Situation Awareness of COVID-19 Telehealth Initiatives at a Multi-Hospital Healthcare System” was published in Journal of the American Medical Informatics Association.  The COVID-19 pandemic has required the need for prompt acceleration of telehealth programs to lessen community spread while providing safe patient care.  The researchers used a situation awareness model and five-step process to identify operational end-user needs, along with design and develop visualizations to meet those needs.  Three stakeholder groups (healthcare system executives, telehealth leaders, and telehealth managers) were identified and provided with visualization dashboards to seek their relative needs.

    The multidisciplinary visualization team used a five-step process to support the launch and ongoing development of the telehealth program. The five steps were:

    • Subject Matter Expert Interviews to Increase Domain Knowledge
    • User Needs Analysis and Feature Identification
    • Processing Telehealth Data Sources
    • Visualization Design, Development, and Testing
    • Dissemination and Iterative Refinement

    The results show that executive stakeholders needed weekly awareness of high-level metrics and trends to convey telehealth activity across the MedStar Health system. Telehealth leaders requested daily awareness of key operational indicators to monitor telehealth operations.  Telehealth managers and team members needed detailed information about their respective areas with the ability to diagnose where issues such as increased patient volumes, poor patient experiences, or dropped calls were occurring.

    User feedback suggests the visualizations improved situational awareness and may have provided valuable information to better inform operational decisions. In the future, the researchers plan to improve data accessibility and gather more feedback from end-users for dashboard optimization.

    The study team included Raj M. Ratwani, PhD; Ethan Booker, M.D; Ram A. Dixit, M.S; Stephen Hurst, Katharine T. Adams, Christian Boxley, Kristi Lysen-Hendershot, and Sonita S. Bennett, M.S.

    Journal of the American Medical Informatics Association, DOI: 10.1093/jamia/ocaa161/5866982

  • August 01, 2020

    By MedStar Team

    As of July 1, 2020, a single COI platform is available to all Researchers employed by MedStar Health (to include those located at MedStar Georgetown University Hospital (“MGUH”) or elsewhere on the Georgetown University campus). With the launch of a single COI platform for MedStar Health employed Researchers, the need for separate submissions through a MedStar Health platform and a Georgetown University platform will be eliminated. Both Georgetown University and MedStar Health have agreed to use the MedStar Health COI Platform for MedStar Health employed Researchers. The Questionnaire will be accessible to Researchers to submit disclosures throughout the entire fiscal year (July 1st – June 30th).

    The COI-Smart platform will meet both organizations’ research COI reporting requirements. This new process will eliminate the Georgetown University COI disclosure for those Researchers who formerly completed a MedStar Health COI questionnaire and a Georgetown University questionnaire. MedStar Health and Georgetown University COI reviewers will have access to the information reported, will review transactions and implement a consolidated research management plan.

    At the onset of a new study routing through MedStar Health/MedStar Health Research Institute or Georgetown University, in accordance with current practices, Researchers must update their COI questionnaire or verify that it is up-to-date. You will access the COI system in the same manner that you have in the past. If you held a research role at MedStar in fiscal year 2020 (FY20), you may have already entered data into the COISmart system during the fiscal year. If you have completed the questionnaire as a researcher during FY20, a link to the conflict of interest disclosure should have been sent to you.

    MedStar Health policies require that all individuals engaged in the conduct of research complete the annual conflict of interest disclosure. The annual research conflicts of interest disclosure process is designed to manage financial and nonfinancial research interests. 

    MGUH Researchers may contact Mary Schmiedel at mary.schmiedel@georgetown.edu to establish a COI-Smart COI account. If you have any questions on the COI-Smart application, please contact Carol Mason at Carolyn.m.mason@medstar.net or 410-772-6607 or Lauren Brummell at Lauren.e.brummell@medstar.net or 410-772-6578.