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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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  • June 01, 2017

    By MedStar Health

    Your plane tickets are purchased, accommodations are organized, and passport is squared away. You’re almost ready for a trip abroad. But depending on where you’re traveling, your health, and your planned activities, you may want to see a doctor before you take off.  

    Every destination has unique health risks and may be home to infections that your immune system hasn’t encountered before.  

    A 2016 review in the New England Journal of Medicine said depending on the destination, 22 percent to 64 percent of people report some illness during international travel. Most of these illnesses were mild, such as diarrhea, respiratory infections and skin disorders. But some returned with potentially life-threatening infections. 

    Depending on the destination, up to 64% of travelers return with some illness. https://bit.ly/2NtrxIb via @MedStarWHC

    Click to Tweet


    But you can prevent much of this discomfort with a pre-international travel consultation with a travel medicine specialist. The appointment usually takes 30 minutes, during which time we’ll:

    • Discuss where you’re going, the length of the trip and the activities in which you’ll participate  
    • Evaluate your health, including whether you’re up-to-date with all vaccinations
    • Provide education on topics such as insect, food and water safety.  

    Based on this information, we can advise you on how to prevent illnesses specific to your destination. This may include travel vaccinations or preventive antibiotics.  

    Who should get a pre-international travel consultation?

    Not everyone leaving the country needs a pre-international travel consultation with a travel medicine specialist. Many factors come into play, but in general, see your doctor if you are: 

    • Going to a developing country 
    • Taking part in high-risk or adventure activities 
    • Are pregnant or planning to become pregnant
    • Have pre-existing conditions or are immunocompromised
    • Traveling with children  

    If you grew up in an area, moved away, and return for a visit, be aware that your childhood immunity may not protect you anymore. For example, malaria immunity wanes after a few years after exposure, so when you go back, you may need a prescription for an anti-malaria drug. Researchers who authored an April 2017 study suspect a number of fatal bouts of malaria in the United States may be due to immigrants who returned to their home countries without taking proper precautions.  

    To learn about the specific health risks of your destination, go to the Centers for Disease Control and Prevention (CDC) and select the country you plan to visit.  

    See your doctor four to six weeks before your trip to ensure there is enough time to get any necessary vaccines or medications.

    Request an appointment for a pre-international travel consultation in our Travel Clinic or call 703-552-4036.

    Request an Appointment

    Illnesses we’re often concerned about during travel

    With preparation, medication, vaccinations and some common sense, you can prevent many illnesses present in different parts of the world. Examples available vaccines that can reduce your risk of infection include Hepatitis A, Hepatitis B, typhoid and the meningitis vaccine. Depending on where you’re traveling, some of these vaccines may be recommended for you.  

    Malaria

    Malaria is a mosquito-borne illness that causes flu-like symptoms and can be life-threatening if not treated. Malaria is found in parts of Africa, Asia and South and Central America. Depending on your destination and what you plan to do there, we can give you an antimalarial drug to prevent the illness.  

    If you become sick while away from home, medical facilities could be scarce depending on where you are. It’s better to prevent malaria before it strikes.

    Yellow fever

    Yellow fever also is a mosquito-borne virus. It’s found in tropical areas of South America and Africa and can range from a mild illness to causing severe liver disease.  

    You can get a vaccine to prevent yellow fever, and it may be required to enter certain countries. This vaccine is only available at designated vaccination centers, such as our Travel Clinic.  

    Other mosquito-borne illnesses

    Zika virus, while not a big threat to most people, can cause devastating birth defects in unborn children. It’s been spreading through South and Central America and turned up in mosquitoes in Texas and Florida in 2016. There is no cure for Zika virus, although researchers are working on a vaccine. In the meantime, women who plan to become pregnant should avoid visiting these areas.

    Check out the CDC map of areas with Zika risk.  

    Japanese encephalitis, a rare but serious condition found in agricultural areas in Asia and parts of the western Pacific, also is transmitted through mosquito bites. You can get a vaccine for this disease before your trip.  

    Other illnesses that can be passed on by mosquitoes include dengue and chikungunya. Travelers should take steps to prevent mosquito bites, including:

    • Using insect repellents that contain DEET.  
    • Wearing long-sleeved shirts and long pants in the evening.
    • Sleeping under a mosquito bed net if window screens aren’t available.  

    Altitude sickness

    Altitude sickness symptoms can start at 8,000 feet. That’s the elevation of the north rim of the Grand Canyon.  

    Altitude sickness is a result of exposure to low levels of oxygen and can cause symptoms such as headaches, loss of appetite, fatigue and poor sleep. Severe altitude sickness can be dangerous, affecting your lungs and brain.

    If you plan to go above a certain altitude, we can give you medications to help prevent altitude sickness. It would be awful to spend a lot of money to travel somewhere and then spend most of the time with a headache.  

    You also can prevent or limit altitude sickness by drinking plenty of water, avoiding alcohol, resting often, and gaining elevation slowly to better adjust to the altitude.  

    How to avoid food-borne illnesses while traveling

    Traveler’s diarrhea is a common gastrointestinal infection known by many names around the world, including Montezuma’s revenge and Delhi belly. Along with diarrhea, it can cause fever, abdominal cramps and bloating. Traveler’s diarrhea causes up to 40 percent of travelers to change their plans during a trip.  

    During your pre-international travel consultation, we’ll talk about how to avoid food-borne illnesses and maybe prescribe a short course of antibiotics to take in case you get sick. These medications usually can knock the illness out in about 12 hours. 

    Up to 40 percent of travelers change plans during a trip due to traveler’s diarrhea. https://bit.ly/2NtrxIb via @MedStarWHC

    Click to Tweet


    I know part of the allure of traveling is trying local cuisine, and in general, this is fine. But there are a few things to think about regarding food, especially when visiting developing countries.  

    Food to avoid: 

    • Raw fruits and vegetables, such as salad. They may have been washed with unsafe water. If you can peel it yourself, it’s safe. This includes bananas and oranges.
    • Raw or undercooked meat, seafood and eggs.
    • Unpasteurized milk and cheeses.
    • Food from street vendors.  

    Tips to ensure you drink safe water:  

    In developing countries, water may be contaminated by bacteria, parasites or viruses:  

    • Don’t drink tap water. Stick to bottled water.
      • Ice often is made with tap water, so don’t use it in your drinks.
      • Use bottled water when you brush your teeth.  
    • If bottled water is not available, boil your water for up to three minutes or use commercial iodine or chlorine tablets before drinking.

    Contrary to popular belief, alcohol does not kill bacteria, so avoid alcoholic drinks with ice in them or throwing a splash of gin in your water to kill the germs.  

    People often have changes in bowel habits when they travel due to unfamiliar food and spices. However, we do want to avoid dysentery, which is characterized by bloody stool. If you have a fever, severe cramping and bloody stool, see a medical professional.  

    What to be aware of when you return from your trip

    Just because you return home healthy doesn’t mean you can let your guard down. Symptoms for some illnesses, such as malaria and tuberculosis, can take several weeks to months to occur after returning from travel.    

    If you experience fever, weight loss or other abnormal symptoms, tell your doctor about your travel history. If symptoms persist, you may want to consider seeing an infectious disease doctor.

    One last topic I like to discuss during pre-international travel consultations is behavioral risks. Vacation makes you feel uninhibited and relaxed, as it should. But some travelers may not take certain precautions that they normally would at home. They feel like they’re in a bubble and invincible.  

    It’s not uncommon to see people return from a trip with a sexually transmitted infection. Be careful and use condoms during sexual activity. Safety and health rules still apply no matter where your travels take you.

    We want you to have the trip of a lifetime, and staying healthy is important. Before you get on the plane, check “pre-international travel consultation” off your to-do list. 

  • May 31, 2017

    By MedStar Health Research Institute

    Register now for the inaugural National Center for Advancing Translational Sciences Advocacy Day: Partnering with Patients for Smarter Science. The purpose of the event is to inform patients and their advocates about NCATS and its programs, identify patient needs, and collectively discuss ways for improved patient inclusion in NCATS’ translational science activities. Admission is complimentary, but space is limited so be sure to register early.

    The full day event will feature presentations, interactive activities and a poster session. Designed for patients, families, caregivers and patient advocacy groups, the event will foster an open dialogue among patients and their advocates to discuss common translational science roadblocks, brainstorm ideas for improvement, and apply that knowledge to strengthen patient and community engagement at NCATS.

    Join in the conversation on June 30, 2017, via #NCATSAdvocacyDay on Twitter.

    Website Agenda Register

    NCATS is one of 27 Institutes and Centers at the National Institutes of Health, and was established to transform the translational process so that new treatments and cures for disease can be delivered to patients faster.

    June 30, 2017
    9:00 a.m. – 4:15 p.m.
    John Edward Porter Neuroscience Research Center
    National Institutes of Health
    35 Convent Drive
    Bethesda, Maryland 20892

  • May 31, 2017

    By MedStar Health Research Institute

    Did you know that all MedStar associates are required to complete three compliance-related training modules in SITEL by June 30th? The three modules are Corporate Compliance and HIPAA, the MedStar Compliance Structure, and the MedStar Code of Conduct. Please ensure that you have completed this training by the deadline of June 30, 2017.

    Our compliance with this requirement as an entity will be reported to senior leadership. The expectation is that MHRI will have 100% of the associates complete these requirements in a timely manner. This includes all as-needed associates and volunteers.

    If you do not complete them by June 30, 2017, the modules will close and you will not have the opportunity to complete them after that date. If you have questions about how to access these required training modules or about whether you or your associates have already completed the training, please contact the Research Compliance Program at researchcompliance@medstar.net.

    To access your mandatory courses:

    1. Log into SiTEL at sitelms.org
    2. Navigate to the left panel
    3. Click on “My Curriculum” under the Learning Center
    4. Launch and complete each course listed.

    To ensure you are fully compliant, please complete the training by June 30. If you experience any difficulty in accessing the training, contact the SiTEL Help Desk at 1-877-748-3567 or Susanne Selzer at Susanne.e.selzer@medstar.net.

  • May 31, 2017

    By MedStar Health

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

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

     Selected research:

    1. DA-EPOCH-R for Post-Transplant Lymphoproliferative Disorders (PTLD).
      European Journal of Haematology, DOI: 10.1111/ejh.12904
      DeStefano CB, Malkovska V, Rafei H, Shenoy A, Fitzpatrick K, Aggarwal A, Catlett JP.
    2. Are You Paying Attention? Related Guidance on How Concepts of Attention May Inform Effective Time Sharing of Tasks in Emergency Medicine
      Annals of Emergency Medicine, 2017. DOI:1016/j.annemergmed.2017.01.027
      Benda NC, Fairbanks RJ
    3. Comparison of Propensity Score-Matched Analysis of Acute Kidney Injury After Percutaneous Coronary Intervention With Transradial Versus Transfemoral Approaches.
      American Journal of Cardiology, 2017. DOI: 1016/j.amjcard.2017.02.032
      Steinvil A, Garcia-Garcia HM, Rogers T, Koifman E, Buchanan K, Alraies MC, Torguson R, Pichard AD, Satler LF, Ben-Dor I, Waksman R
    4. Intraoperative Adverse Events in Abdominal Surgery: What Happens in the Operating Room Does Not Stay in the Operating Room
      Annals of Surgery, DOI: 10.1097/SLA.0000000000001906
      Bohnen JD, Mavros MN, Ramly EP, Chang Y, Yeh DD, Lee J, de Moya M, King DR, Fagenholz PJ, Butler K, Velmahos GC, Kaafarani HMA
    5. Efficacy and safety of once-weekly semaglutide versus once-daily insulin glargine as add-on to metformin (with or without sulfonylureas) in insulin-naive patients with type 2 diabetes (SUSTAIN 4): a randomised, open-label, parallel-group, multicentre, multinational, phase 3a trial
      The Lancet Diabetes & Endocrinology, 2017. DOI:10.1016/S2213-8587(17)30085-2
      Aroda VR, Bain SC, Cariou B, Piletič M, Rose L, Axelsen M, Rowe E, DeVries JH
  • May 31, 2017

    By MedStar Health

    Research led by Andrew Shorr, MD, MPH, in the Department of Pulmonary and Critical Care Medicine Service at MedStar Washington Hospital Center has identified some causes of hospital-acquired infections for patients not on ventilators.

    Published in Respiratory Medicine, the study, “Viruses are prevalent in non-ventilated hospital-acquired pneumonia”, looked at hospital-acquired pneumonia arising in non-ventilated patients (NVHAP) to identify the prevalence of viruses causing NVHAP and to identify any patient characteristics that could be identified as having a viral etiology.

    Nosocomial can be acquired by any patient in a hospital, whether or not they are on a ventilator. Most current research focuses on ventilated patients, as it is easier to identify an occurrence within an intensive care unit. “Traditionally, most cases of pneumonia in the hospital, whether they be community-acquired pneumonia, hospital-acquired pneumonia, or ventilator-associated pneumonia are thought to be caused by bacterial pathogens,” the authors said.

    This retrospective analysis identified the prevalence of a virus as the cause for NVHAP and identified patient characteristics for these infections in 174 cases. Bacterial pathogens were found in 23.6% of patients and viruses were identified in 22.4% of patients. Few differences were found between patients for whom cultures were negative for viruses and patients with either viral or bacterial etiologies.

    “Our findings are important in that they help to confirm that the etiologic agents of ventilated hospital-acquired pneumonia are generally similar to those in NVHAP,” said the authors. While this research does have limitations in scope, as both testing for viral infections and cultures are not conducted for all cases of NVHAP and there are cases of false-negatives for those cultures, it suggests that further research is necessary to verfiy the conclusions.

    Dr. Shorr is Associate Director of Pulmonary and Critical Care Medicine and Chief of the Pulmonary Clinic at MedStar Washington Hospital Center.

    Respiratory Medicine, 2017. DOI: 10.1016/j.rmed.2016.11.023

  • May 31, 2017

    By MedStar Health

    The administration of an institutional review board (IRB), or any regulatory committee for that matter, can feel like death by a thousand paper cuts. Each step in the process is like a tiny paper cut: one step individually can be annoying, but not enough to do you in. However, the culmination of these injuries can have a greater overall harm. Process improvement for an IRB office requires taking a meticulous look at each step and asking these questions:

    • Is the step required by regulations?

      • If no, is it a best practice or does it adhere to an industry standard?

        • If no, does it fulfill a business purpose?

          • If no, can the step be eliminated? And if so, what are the risks of eliminating the step?

    The goal behind this method is to ensure the Office of Research Integrity (ORI) is effective in our processes, eliminating unnecessary red tape so that the office and its committees can focus on the things that matter, protecting human subjects and conducting animal use procedures with the highest scientific, humane, and ethical principles.

    Of course, research and medical care are a heavily regulated industry. Eliminating steps or processes is not always possible. The next goal is to focus on efficiency. Can we meet these requirements in a less burdensome way?

    With this as the backdrop, ORI would like to announce the following changes that may affect investigators:

    1. Removing signatures and stamping of approval documents (except consent forms)
      Regulations do not require IRB approval letters to be signed. Stamping is not mentioned in the regulations. “Stamping” became a practice for consent forms because of OHRP commentary in warning letters published in the 1990s and early 2000s. Stamping was a viable solution in the 1990s and -2000s, when IRB processes were on paper. However, most abandoned the practice of “stamping” all approved documents when IRB processes moved into electronic systems. Printing, signing, stamping, scanning and inputting back into InfoEd causes delays in providing notifications back to study teams.
      Starting in June, ORI will no longer sign approval letters or stamp any approved documents except for consent forms. The IRB-approved letters will include the version and date to provide the necessary audit trail as to what documents were approved.
      Future enhancements will include evaluating InfoEd in the coming weeks to replace the physical stamp with an e-generated mark on the consent forms.
    2. Reducing review times for personnel changes
      Currently, personnel changes are reviewed by the ORI staff and a voting member of the IRB. OHRP guidance states that personnel changes (other than a change in PI) are not considered “modifications to the research” and do not require IRB member review. To reduce review times for personnel-only changes, member review will no longer be required for personnel-only changes.