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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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  • November 03, 2017

    By MedStar Health

    Meet Kevin Handy, MD

    With the alarming rise in the abuse of prescription and non-prescription opioids dominating the headlines, many medical professionals may be at a loss to understand the full scope of the crisis, and what they can do about it.

    Kevin Handy, MD, hopes to help provide some of those answers. An attending physician in both Critical Care Medicine and Anesthesiology at MedStar Washington Hospital Center, Dr. Handy has developed a lecture series, highlighting the opioid epidemic and alternative pain control regimens for critical care. Decreasing usage of opioids in general, specifically among the critical care population, would go a long way toward reducing opioid prescriptions upon discharge. He is also working on opioid reduction protocols specifically for the cardiac surgical patient population

    Dr. Handy saw the extent of the epidemic firsthand in Boston, while performing his anesthesiology residency at Brigham and Women’s Hospital, and his critical care fellowship at Massachusetts General Hospital.

    “It was truly surprising to find the problem isn’t limited to rural areas, but is widespread in cities as well,” he says. “The ICU is a gateway for addiction, so we have a big responsibility, when it comes to pain control drugs and sedatives.”

    The Opioid Epidemic and ICU Cultural Shift 

    As revising these practices may involve a major cultural shift in critical care for many longtime practitioners, Dr. Handy hopes to start delivering his lectures next spring, to interns at Georgetown University’s School of Medicine, where he received his own medical training.

    “Teaching interns about opioids before they hit the floor, will help them build good habits at the outset of their careers,” he says.

    It was during his own medical school rotations that Dr. Handy chose what some might consider as diametrically opposite specialties. But he’s found that anesthesia and critical care actually balance each other quite well.

    In administering anesthesia, for example, “the 16-minute period before a procedure is very important, because the family is usually there, and you’re trying to gain their trust,” Dr. Handy explains. He adds that if a problem arises during surgery, it happens fast.

    “You’re usually working by yourself, so addressing any problem is all up to you,” he says.

    Critical care, on the other hand, involves more teamwork, with nurses, residents, technicians and others working together for each patient. As an attending physician, he must be able to delegate responsibilities, and trust that other members of the team understand what needs to be done.

    “I also enjoy teaching,” Dr. Handy adds, “and there’s no better place to do that than the ICU.”

    Outside the Hospital

    Dr. Handy’s family life is likewise a study in balance. His wife, Natasja, is taking time off from her career as an attorney, to perform in stage shows around the area. The couple also has a 15-month-old son, Ben.

    “We’re both from this area, so it’s great that we can see family regularly,” Dr. Handy says. Along with meeting up with his Dad for a round of golf, Dr. Handy also enjoys reading. And as one might expect, his choices alternate between fiction and non-fiction, “and always something non-medical,” he says with a laugh.

  • November 02, 2017

    By Pavle Doroslovacki, MD

    An old saying goes, "The eyes are the window to the soul." Though my work as an oculoplastic surgeon (a doctor who specializes in surgery on structures around the eyes) doesn't qualify me to make that call, the eyes can tell us a lot about a person's overall health.

    Many conditions that affect the entire body can be detected during an eye exam. Let’s discuss some of these conditions, as well as symptoms to be mindful of when it comes to your eye health.

    Eye conditions we look for

    Regular eye examinations are an important part of preventive health and wellness for your vision, just like regular physical exams support overall health. Especially for people with glasses or contact lenses, regular eye exams give us frequent updates on whether vision has changed and, if so, how much it’s changed and why.

    But these eye exams aren’t just valuable for people who need vision correction. An eye exam can provide early warning about conditions that can lead to loss of vision. The earlier we spot these conditions, the better chance we have to save your eyesight. Some of the many conditions we look for include:

    • Cataracts, cloudy areas in the eyes’ lenses
    • Glaucoma, a buildup of fluid in the eye that damages the optic nerve
    • Macular degeneration, a deterioration in a part of the eye called the macula, which is important for sharp central vision
    • Retinal tear or detachment, injuries to the retina, which senses light and transmits images to the optic nerve
    An #eyeexam can provide early warning about conditions that can lead to loss of #vision. via @MedStarWHC

    Click to Tweet


    Some of these conditions may require care from an oculoplastic surgeon like me.

    Seeing overall health conditions in the eyes

    The information an eye doctor gathers during an eye exam isn’t limited to the state of your vision or even conditions that just affect your eyes. The eye and the eye socket are composed of many different types of tissues. Nerve tissue from the optic nerve sends information directly to the brain. The eye socket contains blood vessels and fatty tissue. The whites of the eyes and the tear ducts have mucous membranes that protect the eyes and keep them from becoming dehydrated.

    All these different tissues mean the eyes can play a role in many conditions that affect the head or the entire body. An eye exam is a way for doctors to examine blood vessels, nerves and connective tissues, which are difficult to see externally on the rest of the body.

    This means we can see indicators of diseases that are affecting specific tissues, sometimes even before a patient notices symptoms. For example, a bulging eye can be a sign of a thyroid disorder, or a drooping eyelid may be a sign of a condition called myasthenia gravis, an autoimmune disease that causes muscle weakness.

    Just a few of the conditions that may be reflected in the eyes include:

    Keeping an eye on eye health

    Regular eye exams are an important step in being proactive about eye diseases and other medical conditions. Most adults should have their eyes examined every year or two. A dilated eye exam, which uses special eye drops to enlarge the pupils, gives us a better view of the inside of the eyes.

    Some symptoms shouldn’t wait until your next regularly scheduled exam. If you notice any of these symptoms, call your eye doctor right away:

    • Double vision
    • Eye pain
    • Flashes of light
    • New floaters, or tiny specks in your vision, especially if you see many new floaters or much more than usual
    • Sudden loss of vision or vision that’s suddenly blurry
    • Swelling or redness of the eye or eyelid

    You can reduce your risk for certain eye conditions by following healthy habits you may be doing already. The Centers for Disease Control and Prevention’s Vision Health Initiative includes these tips to help keep your eyes healthy:

    • Eat plenty of fruits and vegetables, especially dark leafy greens
    • If you smoke or use tobacco, stop
    • Maintain a healthy weight
    • Tell your eye doctor about any eye conditions that have affected your family members
    • Wear sunglasses that block ultraviolet radiation, including UV-A and UV-B rays, when you’re outside in the sun

    Request an appointment with one of our ophthalmologists if you need an eye exam or if you notice any troubling eye symptoms.

    Request an Appointment

  • October 31, 2017

    By MedStar Health Research Institute

    Ultrasound’s long history as a medical tool dates back to the 1940s.  Today, diagnostic ultrasound’s ability to image in real-time, along with its excellent safety record and modern-day portability, has led to its prominence worldwide. 

    FDA physicist Greg Clement, PhD, presents research into therapeutic ultrasound’s bioeffects, many of which remain poorly understood.  In recent years there has been a marked increase in the use of high-intensity ultrasound as a minimally invasive therapeutic tool.  Marketed devices now permit the treatment of certain cancers, uterine fibroids, and essential tremor, while investigations into treating many other brain disorders and various cancers are ongoing.

    Presented by
    Greg Clement, PhD
    FDA’s Center for Devices and Radiological Health
    Ultrasonics Laboratory

    Thursday, November 9, 2017
    12:00 pm to 1:00 pm
    Register for the webcast here.

    The FDA Grand Rounds is webcast every other month to highlight cutting-edge research underway across the Agency and its impact on protecting and advancing public health. Each session features an FDA scientist presenting on a key public health challenge and how FDA is applying science to its regulatory activities. The 45-minute presentation is followed by questions from the audience.

  • October 31, 2017

    By MedStar Health Research Institute

    MHRI remains committed to improving our IT infrastructure with the ongoing work with OnCore, the clinical trials management system. OnCore provides the tools to manage the whole continuum of data during the clinical trial lifecycle. As of October 2017, OnCore has been implemented for 85% of the trials at MedStar. As a joint initiative with Georgetown University, there are also additional protocols in the system from Georgetown study teams.

    Over the past three months, there has been a marked increase in both user log-ins and study visits within OnCore. The implementation of OnCore helps both the study teams and the administrative teams. All study visits can be logged into the system, which helps to both track the patient’s study progress and ensures billing compliance.

    MHRI is also working to link OnCore to Cerner PowerTrials, a module within the MedStar electronic medical record. These two systems both serve a different purpose within a clinical trial but work with each other to serve study and subject information to the appropriate users. In addition to the advancements made in OnCore and PowerTrials, MHRI will also be implementing a unidirectional connection between OnCore and PeopleSoft in order to streamline the billing process. This custom integration will allow PeopleSoft to be the system of record for accounts receivable and cash management.

    MHRI is also in the process of implementing a research pharmacy IT system, Vestigo. The pharmacy at MedStar Georgetown University Hospital has been using this system for nearly two years. The system implementation is being completed in stages, which began with MedStar Washington Hospital Center in October.

    Thank you to all associates who have been part of working groups and training programs for your efforts in ensuring a smooth transition to these systems.

  • October 31, 2017

    By MedStar Health Research Institute

    Abstract submissions for the seventh annual MedStar Health Research Symposium will open on November 13, 2017. The MedStar Health Research Symposium brings together associates from across the system to feature research completed throughout the community. From health services research to clinical research to translational science, all MedStar Health providers, researchers, residents, and fellows are encouraged to submit abstracts for presentation. Submissions will be open until January 8, 2018.

    Only selected abstracts will be presented as posters at the Symposium. Poster selection will be determined by the Scientific Review Committee. The committee will seek to achieve a balanced distribution of submissions for presentation at the Symposium, based on scientific writing, research fields and participation from multiple MedStar Health sites/departments. You must be present at the Symposium in order to present.

    Learn more about the Symposium and view the full abstract submission guidelines at MedStarHealth.org/Symposium.

  • October 31, 2017

    By MedStar Health

    A MedStar study comparing the load-to-failure and stiffness associated with differing surgical techniques in the repair of elbow fractures was published in The Journal of Hand Surgery. In “Fixation of Regan-Morrey Type II Coronoid Fractures:  A Comparison of Screws and Suture Lasso Technique for Resistance to Displacement,” the authors compared the results between screw fixation and suture lasso fixation in cases of coronoid fractures.

    The research team at the Curtis National Hand Center at MedStar Union Memorial Hospital included Nicholas P. Iannuzzi, MD; Adrian G. Paez, BS; Brent G. Parks, MSc; and Michael S. Murphy, MD.

    Coronoid fractures most commonly occur in tandem with complex elbow dislocations. This type of fracture accounts for less than 2% of all elbow fractures but has been identified in 10% of elbow dislocations. In the Regan and Morrey classification system, based on the height of the coronoid fragment, Type II fractures are 50% or less.

    The study team performed a biomechanical study using 10 pairs of cadaveric elbows, which were randomized to receive either a screw fixation or suture lasso fixation. The load to failure and stiffness were then measured using a material testing machine.

    The authors found that screw fixation provided greater strength and stiffness than suture lasso fixation. They concluded that when feasible, screw fixation may provide greater resistance to displacement of the coronoid compared with the suture lasso technique.

    While this research was conducted with a small sample, it is clinically relevant, as other researchers have reported a higher rate of failure after screw fixation. For type II coronoid fractures, screw fixation may provide a stronger fixation construct for fractures of adequate size to support a screw. Future research may consider the use of multiple, smaller screws for fixation and the role that soft tissue structures, particularly the anterior capsule, have in imparting elbow stability after terrible triad injuries of the elbow. The authors wrote that “where feasible, the improved biomechanical stability imparted by screw fixation supports the use of screws in Regan-Morrey type II coronoid fractures in the setting of unstable fracture dislocations about the elbow.”  

    The Journal of Hand Surgery, 2017. DOI: 10.1016/j.jhsa.2016.11.003