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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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  • February 02, 2019

    By MedStar Health

    The Revised Common Rule went into effect on January 21, 2019. The Office of Research Integrity and MHRI leadership are working to ensure required changes to our policies and processes are made to comply with the new requirements. Here are some frequently asked questions about the common rule.

    What are the Key Changes and What Should I Expect?

    Exempt Research
    Some of the existing categories of exempt research have changed, while a few new ones have been added. For a few of the exempt categories, there will now be a limited Institutional Review Board (IRB) review required. Want more information about the new exemptions? A handout describing the changes is available here.

    Continuing Review
    Continuing review is no longer required for studies that meet the following conditions: (1) eligible for expedited review, (2) research that underwent “limited review”, and (3) research that has progressed and involves only data analysis and/or accessing follow up clinical data for standard of care procedures. Despite the elimination of the continuing review requirement, institutions have the flexibility to require an accounting of ongoing research.

    At MHRI, one final formal continuing review submission and approval will be required post 1/21/19 and after that, moving forward, the IRB will make a risk determination based on the nature of the protocol and history of review whether to require an additional check in for studies that fall into the above categories of review.

    Informed Consent
    Under the revised Common Rule, the informed consent document must provide information a reasonable person would want to have in order to make an informed decision. It must contain a concise and focused presentation of the key information that is most likely to assist a subject in understanding the reasons why one might or might not want to participate in the research. This portion of the informed consent document must be organized and presented in a way that facilitates comprehension. Certain specific statements must also be included in the Informed Consent Form (ICF) if you are working with identifiable private information or biospecimens.

    When submitting to the MHRI IRB, you should use the new informed consent templates available in the library section of the new eIRB system. Note, that in addition to the above common rule requirements, this new consent template also folds the HIPAA authorization into the consent form for a combined consent/HIPAA authorization. If you need access to a consent template and do not yet have a Huron login please contact ORI.

    Broad Consent
    The revised Common Rule provides a new voluntary option for consent for the storage/maintenance/future use of identifiable data and biospecimens. Currently, researchers have the options to obtain consent from subjects or ask the IRB for a consent waiver. Broad consent is now an additional consent option for these specific activities. Once implemented, the institution is required to keep track of any individual’s refusal to provide broad consent so that the IRB does not waive consent for that individual in the future.

    MHRI supports the concept behind the broad consent portions of the Common Rule revisions and will support a broad consent process once a technical infrastructure is implemented to track which individuals have been approached and whether they denied broad consent. Since the technical aspects of broad consent have not yet been addressed nationally or locally, MHRI has opted NOT to adopt the broad consent provisions. More information will follow once it is available.

    Single IRB Review
    The National Institutes of Health (NIH) is now requiring single IRB review for multi-site studies funded by the agency. The Common Rule revisions adopt a single IRB review requirement for multi-institutional research studies which mirrors the recent changes to the NIH policy. The Common Rule compliance date for single IRB review is January 2020. MHRI will be releasing information about single IRB review for multi-institutional studies funded by Common Rule agencies in the future.

    Any questions about the Common Rule changes? Contact MHRI-ORIHelpDesk@MedStar.net

  • February 02, 2019

    By MedStar Health

    Abstract submissions for the annual MedStar Health—Georgetown University Research Symposium are now being accepted!

    All abstracts must be submitted through the Symposium Abstract Submission Portal. All MedStar physicians, nurses, researchers, staff and residents/fellows are encouraged to submit abstracts. Submissions close at 11:59 pm on Thursday, February 28. Please read carefully the submission instructions and detailed guidelines on the Abstract Submission Portal prior to submitting your abstract.

    This year, the GUMC’s Center for Innovation and Leadership in Education (CENTILE) will be hosting the Sixth Annual Colloquium for Educators in the Health Professions together with the MedStar Health—Georgetown University Research Symposium. The Colloquium is an opportunity for those across the system focused on education to gather, share ideas, and learn together.

    The Colloquium and the Research Symposium are open to all members of the research and education community interested in learning more about scholarship at MedStar and Georgetown.

    Please contact research@medstar.net if you have any questions.

  • February 01, 2019

    While there’s no one magic food that can completely protect you against cancer, research suggests that there are certain foods that, when included in your diet, can lower your risk of developing cancer. What’s even more interesting is that evidence suggests that the synergy of vitamins, minerals, and phytochemicals in your overall diet offers the strongest cancer protection, according to the American Institute of Cancer Research.

    What does that mean? That eating a well-rounded healthy diet (that includes the foods in this article) on daily basis will give you the best protection. The other important factor in keeping cancer risk down is to decrease excess body fat. Too much adipose (fat) tissue can increase the risk of 11 different cancers! The foods below can also help with weight management, so read on to see what you should add to your grocery list.

    Cruciferous Vegetables

    Your mom told you to “eat your greens” for a very good reason. The cruciferous group includes two types of vegetables, green leafy varieties such as kale, spinach, collard greens, and flower-type plants, such as broccoli, cauliflower, Brussels sprouts, rapini or broccoli rabe, cabbage, and turnips.

    These special vegetables have been well studied, and research shows that individuals with diets high in these types of vegetables have lower rates of colorectal and certain oral cancers. Compounds called glucosinolates are found in all cruciferous vegetables, and are believed to play a role in reducing cancer risk.

    • Prep Tip: Steam, microwave, stir-fry, or sauté to retain the important phytochemicals and vitamins in these foods. Boiling greens in a pot of water can cut content of the beneficial substances in half.

    Flaxseed

    This tiny seed is packed with dietary fiber, omega-3s, and Vitamin E. At least partly due to its high fiber content, the evidence is convincing that flaxseed can lower the risk of colorectal cancer. One theory is the fiber is used by healthy bacteria in the colon to produce substances that may protect colon cells.

    Flaxseed also may contribute to lower overall cancer risk because the fiber creates a satiating effect, which in turn may help with weight control. To be sure to get all the health benefits from flaxseed, do not consume them whole. Instead, buy the whole seeds and grind every week in a coffee or spice grinder to make sure you are getting the freshest dose.

    • Prep Tip: Sprinkle ground flaxseed on salads or on top of cooked vegetables for a nutty flavor.

    Cranberries

    This bright fruit is a great source of vitamin C, dietary fiber, and is also high in antioxidants. One serving of cranberries provides at least 10 percent of the recommended daily amount of fiber. Research on this suggests that cranberries can play a role in decreasing the risk of colorectal cancer as well as decreasing the risk of lip, mouth, tongue, and other aerodigestive cancers (cancers involving the respiratory and digestive tracts).

    Part of what gives this food its cancer-fighting powers is flavonoids called anthocyanins, which give this tasty fruit its rich red color. Remember that cranberry juice and whole cranberries will not deliver the same benefits, cranberry juice contains little to no fiber and usually includes added sugar.

    • Prep Tip: Add one tablespoon of dried cranberries to cereal, oatmeal or plain yogurt.

    Garlic

    Garlic’s anti-cancer quality appears to stem from its allyl sulfur compounds and phytochemicals. Most of the research related to garlic and cancers have focused on colorectal and stomach. Yet emerging research suggests garlic may also play a role in the prevention of other cancers. Its cancer-fighting abilities are thought to work in multiple ways, such as inhibiting enzymes that activate cancer-causing agents, boosting enzymes that detoxify carcinogens slowing growth of cancer cells, and limiting cancer’s ability to spread by decreasing tumor’s ability to grow new blood vessels.

    In animal studies, garlic compounds stimulate breakdown of testosterone and slow development of prostate cancer. In some human studies, when researchers compared people who consumed high amounts of garlic to those that consumed little, they noticed a reduction in risk of cancers of the esophagus, pancreas, breast, endometrium, and prostate.

    • Prep Tip: Allow crushed or chopped garlic to stand for about 10 minutes before cooking. This allows time for the enzymes to produce the bioactive compound thought to hold the anti-cancer benefit.

    For delicious, healthy, and inventive recipes from the American Institute for Cancer Research, visit AICR.org/HealthyRecipes.

    Want to receive nutrition advice from one of our experts? Click below to learn more about our nutrition counseling services.

    Learn More

  • January 31, 2019

    By MedStar Health

    The Human Research Protection Programs (IRBs) at both Georgetown University (GU) and MedStar Health (MedStar) use an electronic system to manage their respective Human Research Protection Programs and the IRB review process. On November 29, 2018, the joint system went live for research at both institutions, replacing existing IRB systems.

    All new submissions for IRB review, including modifications and continuing review of active projects must be submitted through the new eIRB platform at gumedstarirb.georgetown.edu/IRB

    Logging In
    Individuals who do not have a MedStar ID or Huron login must request one to obtain access to the system. Not all study personnel who needed Huron IDs were automatically provided with a Huron Login, creating delays in submission and access. While approximately 1,000 MedStar individuals were automatically provisioned with access to the Huron system, it was not enough. The ORI and IS worked with HR and the GME Office to obtain coordinator and resident lists. Regulatory coordinators and residents were uploaded into the system by January 15, 2019.

    For those who are non MedStar employees and do not have a MedStar ID and are unable to access the Huron eiRB system, all studies will be assigned to a scientific center. The Scientific Center Administrator assigned to that center will be asked to assist the researcher who needs access. The SCA or designee will reach out to the study team and obtain the necessary information.

    All individuals to be listed on a study submission in Huron must have a valid Huron ID.

    Proxy Designation
    The PI Proxy can perform IRB submission responsibilities such as submitting studies, modifications, continuing reviews, and reportable new information. The principal investigator is responsible for ensuring these procedures are carried out, and that submissions are complete and accurate. The PI Proxy must be a study team member with engagement in the study conduct. A PI can designate a PI proxy at the time of study submission and must be assigned protocol by protocol. Designation of a PI Proxy does not defer PI responsibility in the conduct of research as defined in regulations, policies, and the Investigator Manual (HRP-103).

    The PI proxy must provide a substantial contribution to the conception or design of the work; the implementation of the work; provides regulatory support to the work; or the acquisition, analysis, or interpretation of data for the work.

    Data Migration
    Protocols not yet approved and or those with items actively being reviewed by the MHRI IRB will have those reviews completed in InfoEd and then migrated to the new system in February 2019.

    Investigative sites generally have a 12 month grace period to upload documents and update the record. Investigative sites should upload the most current version of the protocol, consent(s), and other study documents at the time of continuing review or modification to the study, whichever comes first.

    When submitting a continuing review for the first time in the new system if a modification was not previously submitted, the continuing review must be submitted as a combined continuing review/modification so that protocol documents are uploaded. Continuing reviews submitted without a modification will be returned to the investigative site as they do not allow for the upload of existing or new documents.

    If you’d like to stay informed and have access to detailed information on training schedules, access to the system, links to policies, forms and templates as well as quick reference guides, training materials, and frequently asked questions, please visit here.

  • January 29, 2019

    By Konstantinos Loupasakis, MD

    Rheumatoid arthritis is a chronic inflammatory condition that primarily affects peripheral joints (typically the hands, wrists, elbows, knees, feet, and ankles) of about 1.5 million Americans, due to the immune system becoming inappropriately activated. The disease also can affect organs such as the heart, lungs, eyes, and skin. The most common symptoms include:

    • Joint pain
    • Stiffness (particularly in the morning)
    • Swelling of the joints
    • Warmth and limited range of motion

    Most people get the disease around their 50s, although it can often happen earlier or later in life. The exact cause of rheumatoid arthritis is not known. Researchers have identified individual genes that associate with the development of the disease and also some environmental risk factors that include smoking and poor dental hygiene.

    Symptoms often become recognizable once inflammation sets in. While we could only provide some limited pain relief years ago, we now have new treatments that can restore the functionality of affected joints and prevent permanent damage and progression to disability. These new treatments have revolutionized rheumatoid arthritis patient care.

    LISTEN: Dr. Loupasakis discusses rheumatoid arthritis in the Medical Intel podcast.

    How is rheumatoid arthritis diagnosed?

    Diagnosis begins with review of a patient’s history and symptoms combined with a thorough physical exam by a rheumatologist, and specific laboratory workup. Rheumatoid arthritis is a systemic disease, which means that it can affect the whole body, not just the joints. As a result, we will also look for symptoms such as generalized weakness, fatigue, malaise, unintentional weight loss, or even less common manifestations such as shortness of breath, cough, eye redness/pain, or skin nodules.

    The evaluation includes:

    • Blood and urine tests
    • Physical exams
    • X-rays of the affected joints
    • Ultrasound or MRI of affected joints

    How is rheumatoid arthritis treated?

    People with rheumatoid arthritis have a great chance at managing their symptoms, preventing further damage, and living relatively normal lives with current treatment options—especially if it’s treated early or before joints are heavily damaged.

    Years ago, corticosteroids (aka “cortisone” or “steroids”), which we still use for patients with bad flare-ups to provide fast relief, was the only medication patients could use. But patients now have new alternatives, including:

    • Oral tablets
    • Injectable medications that patients can self-administer at home
    • Intravenous (IV) infusions that is administered by a medical professional

    Previous medications addressed pain and symptoms but were inadequate for the treatment of inflammation, which is the source of pain and the cause of subsequent irreversible damage and disability. New medications, however, can target the inflammation and often restore a patient’s functionality, allowing them to get back to some of their normal activities, depending on how affected their joints are. It is important to note that full restoration of their functionality isn’t always possible once the arthritis has caused permanent damage. In some of these patients, joint replacement by an orthopedic surgeon can be an effective next step.

    Physical therapy is also a part of treatment, as it can strengthen muscles, providing better support to affected joints, and increase the joints’ range of motion. The combination of early, effective treatment with physical therapy can often lead to sustained remission and restoration of function, and allow patients to return to activities such as running, swimming, and playing sports. Others do so with modifications, such as restrictions on the amount of time spent on an activity or special shoe insoles or joint braces that minimize the impact on their joints.

    A success story

    I often recall the story of a woman in her 60s with severe rheumatoid arthritis who had unsuccessfully tried several medications, including high doses of steroids. Even though her symptoms were briefly relieved at times, she had never been able to get through a day pain-free, and she had developed joint deformities and motion limitation. As a result, she became increasingly depressed and hopeless, which further impacted her quality of life as she was no longer able to enjoy time with her children and grandchildren.

    Availability of newer medications has certainly provided more options, but I was also starting to feel discouraged after many options failed. Switching medications can take anywhere from a few weeks to several months to take effect, and the patient was understandably desperate. After multiple treatment changes and a lot of perseverance from the patient and our medical team, we identified an injectable medication that worked well for her. Over the following months, her joint swelling and pain improved remarkably, and she became more functional again. During her follow up visits, she explained how she had been convinced she would never find relief, and yet she was now able to enjoy life with her family and friends. It is hard to describe in words how thankful she was and how happy her outcome made me feel.

    Can symptoms come back, even during treatment?

    Even when a patient consistently takes their medication, their rheumatoid arthritis still can become active from time to time. While we don’t always know the reason, sometimes a viral infection such as the flu or a cold can trigger the immune response, resulting in the arthritis flaring; other times, flare-ups occur for no obvious reason.

    When that happens, patients usually experience increased pain in the affected joints that persists if it’s not treated. In this case, patients should speak to their rheumatologist about their symptoms so they can be tested and have their medication regimen modified, if necessary.

    People with rheumatoid #arthritis can experience flare-ups when they have the #flu or cold. Dr. Loupasakis says patients should speak to their rheumatologist if this happens so they can be tested and have medications modified if necessary. https://bit.ly/2D2gDF1 @MedStarWHC

    Click to Tweet

    How can I prevent rheumatoid arthritis?

    Smoking and poor oral hygiene are modifiable risk factors for rheumatoid arthritis, according to studies. Both smoking and the bacteria that arise in the mouth when people don’t take good care of their teeth can affect the tissues in the lungs and mouth in a way that may lead to stimulation of the immune system. As a result, inflammation can occur and may ultimately involve the joints leading to rheumatoid arthritis.

    We implement a team approach at MedStar Washington Hospital Center by working closely across specialties. For example, patients not only will consult with a rheumatologist but also physical therapists, orthopedic surgeons, pain specialists, and physiatrists. We also provide referrals to psychotherapists and psychiatrists as needed to support our patients during the stressful course of chronic disease. This helps patients get support for their rheumatoid arthritis as well as their mental health, since long-lasting symptoms can be emotionally difficult on patients.

    Rheumatoid arthritis treatment has come a long way over the years. With the ability to prevent further damage and often restore the functionality of affected joints, patients should speak to a doctor if they experience symptoms to find a solution that works best for them.

    Call 202-877-3627 or click below to make an appointment with a rheumatologist.

    Request an Appointment

  • January 23, 2019

    By MedStar Health

    Many parents are cautious to protect their children against seasonal illnesses, such as colds and the flu. However, a lesser-known viral infection called hand, foot, and mouth disease, is also prominent among little ones, and so far, it has affected thousands of children in the Northeast.

    Hand, foot, and mouth disease is a contagious virus that is characterized by blisters or sores in the mouth and rashes on the hands and skin. Symptoms can also include:

    • Fatigue
    • Fever
    • Loss of appetite
    • Sore throat

    The disease is spread through the air by sneezing and coughing, as well as through physical contact with people or contaminated objects, such as doorknobs. Kids are the most susceptible to hand, foot, and mouth disease because their immune systems haven’t yet developed an immune response to it like adults have.

    Thankfully, hand, foot, and mouth disease is usually easy to manage. Parents can take simple steps to ensure their children overcome it quickly.

    Hand, foot, and mouth disease is a common #Infection among children that can cause mouth blisters or a skin #Rash. Thankfully, treatment is usually easy to manage. Learn more via @MedStarHealth
    Click to Tweet

    How do I treat my child’s hand, foot, and mouth disease?

    Hand, foot, and mouth disease is a virus, so the body is able to naturally fight it off in about seven to 10 days without treatment. Don’t worry if your child has a low-grade fever during the first few days of the illness; fevers are the body’s friend, helping to fight off illnesses.

    However, one thing we must keep in mind while kids recover is their susceptibility to dehydration. Keeping kids hydrated can be difficult, as sores in their mouths can cause drooling and make it painful to swallow liquids. Consider giving your child a pain medicine, such as ibuprofen or Tylenol®. Keep an eye on their hydration levels by checking their urine color–the lighter the better.

    How can I keep my child from getting sick?

    To reduce the risk of your child developing hand, foot, and mouth disease, make sure they:

    • Avoid close contact, such as kissing, hugging, and sharing cups with infected kids
    • Don’t touch their nose, eyes, and mouth with unwashed hands (yes, it’s tough!)
    • Only touch physical objects, such as doorknobs and chairs, that have been disinfected
    • Wash their hands frequently with soap and water, for at least 20 seconds at a time

    Diagnosing hand, foot, and mouth disease can be simple to do, even at home, because it’s quite easy to identify the symptoms. Thankfully, it’s a mild illness that is usually easy to recover from, as long as your kids stay hydrated.

    Click below to learn more about our pediatric services.

    Learn More

    Want to learn how to protect your children against hand, foot, and mouth disease? Watch the video below.