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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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  • July 31, 2018

    By MedStar Health

    Jessica E. Galarraga, MD, MPH, has been awarded an Early Career Research Development Grant from the Emergency Medicine Foundation (EMF) to continue her research evaluating the health care delivery effects of a population-based global budget revenue model. The grant will fund a two-year research project “Impact of Global Budgeting & Pay-for-Performance Incentives on Emergency Care Delivery.”

    In 2014, the state of Maryland implemented the global budget revenue (GBR) program to align with the following aims as defined by the Centers for Medicare and Medicaid Services: (1) reduce per capita costs, (2) enhance quality, and (3) improve population health. “Historically, MD has been the testing ground for new payment models in the United States. Maryland’s GBR program is among the most far-reaching alternative payment models using hospital settings as leaders for health care system improvement,” said Dr. Galarraga.

    This grant will continue Dr. Galarraga’s research into the effects of GBR on emergency care delivery, utilization, and outcomes. This research will serve to fill a gap in knowledge on the impact of GBR, as CMS has recently approved the renewal of Maryland’s GBR program effective 2019 and started to implement similar programs in other states beginning in 2017.

    This research with look specifically at the effects of GBR on the utilization and quality of hospital-based emergency care. It will also address issues related to transitions of care in emergency departments.

     “The findings from this research will generate implications for health care practice leaders and policymakers on the effects of population-based health care payment reform on emergency care delivery. This will hopefully provide guidance on the continual evolution and advancement of payment reform efforts with global budgeting,” said Dr. Galarraga.

    The EMF has awarded more than $16 million in research grants since its founding in 1972 by visionary leaders of the American College of Emergency Physicians. The mission of the EMF is to promote education and research that improve patient care, provide the basis for effective health policy, and develop career emergency medicine researchers.

    Dr. Galarraga is a physician Investigator at the MedStar Health Research Institute, an attending physician with MedStar Emergency Physicians, and Instructor of Emergency Medicine at the Georgetown University. She was also the recipient of a grant from the EMF in 2016, along with funding from the MedStar Health New Investigators Grant fund in 2016 and 2017.

  • July 31, 2018

    By MedStar Health

    Congratulations to all MedStar researchers who had articles published in July 2018. 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. Redesigning Hospital Diabetes Education: A Qualitative Evaluation With Nursing Teams.
      Journal of Nursing Care Quality. DOI: 1097/NCQ.0000000000000349
      Smith KM, Baker KM, Bardsley JK, McCartney P, Magee M
    2. A Hospital-Based Initiative to Reduce Postdischarge Sudden Unexpected Infant Deaths.
      Hospital Pediatrics. DOI: 1542/hpeds.2017-0211
      Krugman SD, Cumpsty-Fowler CJ
    3. Baricitinib, a Janus kinase inhibitor, in the treatment of rheumatoid arthritis: a systematic literature review and meta-analysis of randomized controlled trials.
      Clinical Rheumatology. DOI: 1007/s10067-018-4199-7
      Kunwar S, Collins CE, Constantinescu F
    4. A usability and safety analysis of electronic health records: a multi-center study.
      Journal of the American Medical Informatics Association. DOI: 1093/jamia/ocy088
      Ratwani RM, Savage E, Will A, Arnold R, Khairat S, Miller K, Fairbanks RJ, Hodgkins M, Hettinger AZ
    5. Medication Allergy and Adverse Drug Reaction Documentation Discrepancies in an Urban, Academic Emergency Department.
      Journal of Medical Toxicology. DOI: 10.1007/s13181-018-0671-7
      Kiechle ES, McKenna CM, Carter H, Zeymo A, Gelfand BW, DeGeorge LM, Sauter DA, Mazer-Amirshahi M
  • July 31, 2018

    By MedStar Health

    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. As you probably know, MedStar Health Research Institute is required to manage conflicts of interests as a condition of receiving federal funding for research.

    If you have completed the questionnaire as a researcher during the fiscal year 2018, a link to the conflict of interest disclosure was sent to you in July. If you held a research role at MedStar in FY18, you may have already entered data into the COISmart system during the fiscal year. Please follow the instructions in the email you received to certify your previous disclosure. You are required to certify your previously completed disclosure to ensure that it accurately reflects a full fiscal year of reporting (July 1, 2017, through June 30, 2018). Please make sure you confirm the information in the FY 2018 Questionnaire is accurate and resubmit it. As a researcher, the FY 2019 questionnaire is also open for your use between July 1, 2017, and June 30, 2018.

    You can access the system at https://medstar.coi-smart.com/.

    If you have any questions about the conflict of interest policy or accessing the COISmart system to make disclosures, contact the Research Compliance Program at researchcompliance@medstar.net.

  • July 31, 2018

    By MedStar Health

    Mark your calendars now to connect with other MHRI and MedStar associates by participating in one of these upcoming events to support the health of our communities.

    Race to Beat Cancer

    Race start with blue archway for Race to Beat Cancer

    Saturday, September 15

    Four Seasons Hotel Washington, D.C., is proud to host the 38th annual Four Seasons Hotel Washington, D.C., Race to Beat Cancer 5K. This charitable event is one of the premier 5K races in Washington, D.C., The proceeds from this event are donated to the Washington Cancer Institute at MedStar Washington Hospital Center. In 2017, the event raised more than $300,000 for cancer research!

    Where: Four Seasons Hotel Washington, D.C.,
    Check-In: 7:00 am
    Starts: 8:00 am
    Length of Walk/Run: 5K
    To learn more and register, visit https://www.racetobeatcancer5k.com/home

     

    2018 Step Out: Washington, D.C.,

    Saturday, September 22

    Participating in the Step Out Walk is an experience you will never forget. You will be joining your community members along the beautiful route who share your passion to fight diabetes. You will be helping people in your own community who live with this disease every day. Bring your friends, family, and co-workers to walk with thousands of people from across the country and help us change the future of diabetes. This walk is hosted by the American Diabetes Association

    Where: Washington Monument Grounds, Washington, D.C.,
    Check-In: 8:00 am
    Event starts: 9:30 am
    Learn more about the walk here.

     

    Super H 5K Run, Walk & Wheel

    Sunday, September 23

    Help support the Adaptive Sports Programs at MedStar National Rehabilitation Network and participate in the Super H 5K Run, Walk & Wheel in Tysons Corner, VA. This race is open to all able-bodied and disabled athletes who can run, walk or roll through the course. All proceeds benefit Adaptive Sports Programs at MedStar National Rehabilitation Network, which helps children and adults with physical disabilities to pursue healthy, active lifestyles through recreational and competitive sports.

    Where: Sport & Health Club, Tysons Corner, VA
    Check-In: 7:00 am
    Event starts: 9:00 am
    Length of Walk: 5K
    Learn more and register at SuperH5K.com.

     

    2018 Step Out: Baltimore, MD

    Sunday, October 7

    The Step Out Walk to Stop Diabetes gives everyone in our community a chance to gather together to raise funds for diabetes research, advocacy, and education. Dollars raised through Step Out help to support those affected by diabetes in Maryland, and beyond. When you register for the Step Out Walk to Stop Diabetes, you become a part of the American Diabetes Association’s team. Joining you will be thousands of participants from around the country who come together and directly impact the lives of people facing the daily challenges of diabetes. This walk is hosted by the American Diabetes Association

    Where: Canton Waterfront, Baltimore, MD
    Event starts: 9:00 am
    Length of Walk 3.15 mile walk
    Learn more here.

     

    2018 Greater Washington Heart Walk

    Saturday, November 3

    Team MCRN at the 2017 Greater Washington Heart Walk
    Team MCRN in 2017.

    Hosted by the American Heart Association and the American Stroke Association, this event includes 1- and 3-mile routes. Join walkers from across our community as they step out to have fun, get inspired and support a meaningful cause.

    Where: The National Mall, Washington, D.C.,
    Check-In: 8:30 am
    Event starts: 10:00 am
    Length of Walk: 1-mile or 3-mile walk

    Learn more on the website.

  • July 31, 2018

    By John F. Lazar, MD

    Hernias are common, and you likely know someone who has had one at some point in their life. So, perhaps it’s no surprise that the most common esophageal condition I treat is paraesophageal hernia, which is when the stomach bulges into the chest through diaphragm—the primary muscle located along the lower ribs that is used in the process of breathing. Hernia occurs when the small opening connecting the esophagus and the stomach in the diaphragm weakens over time, allowing the stomach to move up into their chest.

    Anyone can develop a paraesophageal hernia. People who are overweight are at greater risk because they have increased abdominal pressure. Women who have had multiple babies sometimes have diaphragm weakening over time, which can result in a hernia, and genetic factors can contribute as well.

    Symptoms range from none to severely limiting one’s ability to eat, sleep, or do daily activities. Symptoms can include:

    • Acid reflux
    • Bloating and early fullness after eating
    • Cough
    • Dysphagia, or difficulty swallowing
    • Shortness of breath from the stomach pushing on the diaphragm or compressing the lungs
    • Retching up undigested food
    • Weight loss
    • Fear of food due to severe symptoms

    Some patients rely on over-the-counter antacids to try to manage their symptoms. But if left untreated, in extreme cases, a paraesophageal hernia can cause the stomach to twist along the esophagus and cut off the blood supply. Thankfully, paraesophageal hernias can be treated with medication from a doctor or even cured through advanced, minimally invasive robotic surgery.

    LISTEN: Dr. John Lazar discusses paraesophageal hernia treatment in the Medical Intel podcast.

    Diagnosis and treatment of paraesophageal hernia

    The only way to know for sure whether you have a paraesophageal hernia is to see a doctor and undergo:

    • A CT scan of the chest
    • Esophagogram, which is an X-ray to determine if liquids go down the esophagus properly
    • Esophageal manometry, which tests how well the esophagus squeezes food down the length of the esophagus
    • Esophagogastroduodenoscopy (EGD), which is a fiberoptic scope like a colonoscope that can be inserted into the esophagus and stomach to see any abnormalities

    Based on the findings of your tests, the doctor can recommend a variety of treatment options.

    Medications

    Patients can use antacids such as Rolaids or Tums to neutralize minor stomach acid symptoms. Proton pump inhibitors (PPIs) like Prilosec, meanwhile, are stronger acid-blocking medications. There’s a growing debate regarding long-term injury from using PPIs. This had led many patients to ask whether surgery is right for them.

    Surgery

    We can cure paraesophageal hernias at MedStar Washington Hospital Center through minimally invasive robotic surgery. We use a robotic system that is completely controlled by the surgeon to help enhance the surgeon’s vision and ability to handle delicate tissues of the abdomen. The surgery entails releasing the hernia scar tissue, which allows the stomach to return to its proper place in the abdomen. Then, the opening in the diaphragm where the stomach herniated through is closed with sutures. Patients are usually back home two to three days after surgery.

    I urge you to see your doctor if you experience symptoms of a paraesophageal hernia. What might seem like acid reflux or difficulty swallowing could lead to serious health problems down the road.

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

    Request an Appointment

  • July 24, 2018

    By MedStar Health

    The number of first-time total knee replacements, also known as arthroplasties, is expected to grow by 673 percent, reaching 3.48 million procedures by 2030, according to a study published by the Journal of Bone and Joint Surgery. The primary reasons that we feel contribute to this huge increase are the growing rates of baby boomers living longer and desiring to maintain youthful active lifestyles.

    Historically, knee arthritis patients undergo full knee replacement to relieve arthritis pain, stay active, and maintain their quality of life. However, many patients could achieve these goals with partial knee replacements, which keep more of the original knee intact for a more natural-feeling joint. This procedure usually results in shorter recovery times and longer-lasting outcomes than traditional procedures.

    LISTEN: Orthopedic surgeon Evan Argintar discusses joint replacement bioplasty in the Medical Intel podcast.

    When should you choose partial knee replacement?

    This search for long-term relief leads many people with arthritis of the knee to opt for a full knee replacement. A full knee replacement replaces the inside portion, outside portion, and underneath the kneecap. This is great if all three parts of the knee are diseased or arthritic. The problem with a full knee replacement is that you must sacrifice the ligaments on the inside of the knee, often changing how the knee feels. This results in a knee that feels artificial and is limited in the activities it can perform.

    In addition, sometimes the inner or outer portion of the knee is worse than the rest of the joint. In this case, a full knee replacement might not be necessary, and a patient can opt for a partial knee replacement—allowing them to maintain their youth and activity, plus avoid some of the limitations inherent with a more major surgery.

    We incorporate technologies of partial knee replacements with some of the isolated treatments we have done in the sports world, such as cartilage restoration or ligament reconstruction. In years past, if you had medial isolated arthritis on the inside of your knee without an ACL (anterior cruciate ligament) injury, you had no option but to have a full knee replacement. Now, you can do a partial knee replacement with an ACL reconstruction. This is an exciting prospect for patients who want to get back to physical activity.

    Who is a candidate for partial knee replacement?

    Every person with arthritis likely has had a meniscal tear. These patients might be better off receiving a partial knee replacement in combination with some other cartilage-restorative procedure rather than arthroscopy alone. Arthroscopy will not predictably cure or relieve pain from arthritis.

    Other candidates include those with knee pain who have been diagnosed with a degenerative disease in only one or two parts of their knee. If arthritis is found only underneath the knee, then a partial replacement can be performed to preserve as much normal anatomy as possible. The more we can preserve the ligaments, cartilage, and meniscus, the better the knee will feel. The term we use for this is bioplasty, which combines arthroplasty with biology, or your normal body.

    Our patients benefit from a team approach. We have many experts who specialize in joint procedures, including:

    Get back to being you

    A partial knee replacement procedure is not only more comfortable and natural, but it also allows for a shorter recovery time compared to traditional surgery. With a full knee replacement, you would look at a minimum recovery time of six months. However, with new technological advances, a partial knee replacement requires only a four-month recovery period. This is huge for someone who is physically active. Moreover, there is less inflammation and pain, plus more mobility.

    This approach worked out great for a patient who was in her 40s and had undergone a full knee meniscectomy (removal of meniscus from the knee) a decade earlier. At the time, she was working and continually active with her young children, but she was experiencing knee pain due to arthritis. She wanted to combat the pain, but the last thing she wanted to do was sacrifice two-thirds of her knee and restrict her mobility. To treat her, we did an ACL reconstruction, which allowed us to perform a successful partial knee replacement. Today, she’s back at work, exercising, and able to chase her children around.

    If you’ve been experiencing knee pain from arthritis or a sports injury, don’t ignore it! You could be suffering from arthritis or a tear in one of your knee ligaments. Treating your condition early might mean you can spare more of your natural knee tissue, which can result in less pain and better function for years to come.

     

    Considering a partial knee replacement? Call 202-877-3627 or click below to make an appointment with an orthopedic surgeon.

    Request an Appointment