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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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  • May 09, 2017

    By MedStar Health


    Heart disease is the leading cause of death for both men and women in the United States.

    While heart attacks and strokes get much of the attention when it comes to heart-related conditions, there is another common killer: congestive heart failure.

    In fact, recent statistics indicate that more than five million Americans are living with congestive heart failure (CHF), and nearly 550,000 new cases are diagnosed each year.

    Unfortunately, many people aren’t even aware that they are living with this very deadly disease.

    "The difficult thing about heart failure is that it doesn’t have just one way that it presents itself,” says Samer Najjar, MD, director of the Advanced Heart Failure Program at MedStar Heart & Vascular Institute at MedStar Washington Hospital Center. “With heart attacks and strokes, when you have symptoms, you have to go to the hospital very early because there are things that can be done. The longer you wait, the more injury can happen. Heart failure is different. There is a myriad of different types of symptoms people can have, which makes it harder to distinguish who has heart failure and who does not."

    Once a patient has been diagnosed with heart failure, Dr. Najjar explains it’s quite likely he or she will need to continue treatment for a lifetime. “This is not just a condition of something happened and you ended up in the hospital, we treat you and you go home and it’s over with. Not at all. Heart failure is something people live with for the rest of their lives.”

    LISTEN: Dr. Samer Najjar discusses heart failure in this podcast.

    Signs & Symptoms

    Common symptoms of CHF include swelling of the legs, shortness of breath, lethargy, loss of appetite and abdominal pain.

    Dr. Najjar explains there are two different types of heart failure. In one form, the heart is trying to pump but the muscle is too weak to do so efficiently. “If the muscle is weak, it’s having a hard time pumping the blood forward. Therefore, the blood will back up. It will back up into the lungs which is what causes shortness of breath and then it backs up into the rest of the body and that’s how patients start retaining fluid.”

    The other form of heart failure, known as preserved ejection fraction, can be deceiving, because despite the fact that the heart appears to be squeezing normally, it’s having difficulty getting blood to the rest of the body. “That’s something that we in the medical field have struggled with for some time, because it’s not immediately obvious to us,” says Dr. Najjar.

    Risk Factors

    Anything that can cause injury to the heart puts people at risk for having heart failure. For example, high blood pressure, high cholesterol, high blood sugar, previous heart attack(s), smoking–all of these can contribute.

    However, approximately 30 to 40 percent of those with heart failure have no discernible risk factors.

    Still, Dr. Najjar is quick to emphasize that while some cases seem to appear out of nowhere, “there are known risk factors, which is why these risk factors have to be addressed during one’s lifetime.”

    There are also lifestyle choices that are very important. “Exercise is a huge risk factor modifier and our population needs to do much more physical activity and exercise than what is common.”

    Treatment Options

    Advancements in medical science have provided a variety of treatment options, including oral medications.

    “There are a lot of medications that have been studied, and several have been shown without any doubt that they actually improve survival. People live longer and feel better,” says Dr. Najjar. With these medications, it’s important for patients to keep close contact with their doctors until the correct dosage has been determined.

    Other treatment options include devices such as pacemakers and defibrillators.

    And, there are steps patients need to take to ensure these treatments remain viable. For example, salt is a huge culprit in terms of fluid retention. Patients also need to monitor how much fluid they take in on a daily basis. Consistent weigh-ins can be helpful to monitor fluid retention and identify a problem prior to the appearance of any other symptoms.

    Life-Long Care

    Once a patient has heart failure, Dr. Najjar explains it’s quite likely he or she will need to continue treatment for a lifetime.

    The crucial thing to remember is that you cannot ignore risk factors. “You don’t want to wait until you have a problem, either a heart attack or heart failure,” says Dr. Najjar. “You have to be able to modify those risk factors in middle age, in young age, as soon as you find out that they happen, because when you’ve already developed the disease, you’ve already lost the opportunity to prevent them.”

  • May 08, 2017

    By MedStar Health

    It’s difficult to pin down the exact number of people who travel abroad to access medical services, but the Centers for Disease Control and Prevention (CDC) estimates that thousands of U.S. residents do so each year. And Patients Beyond Borders, a consumer source of information about medical tourism, says weight loss surgery is among the most-sought specialties, along with cosmetic surgery, dental work and cancer and heart treatments.

    There are a number of reasons people travel to get these procedures, but two of the most common are:

    • Lower costs: Surgical procedures in some countries can cost up to 80 percent less than in the U.S.
    • Broader eligibility criteria than in the United States: We follow National Institutes for Health guidelines to determine who is eligible for bariatric surgery. It’s not done purely for cosmetic reasons. This isn’t the case in some countries, so people who might not qualify in the U.S. may be eligible elsewhere.

    Not everyone who travels for medical care crosses the U.S. border. When a procedure or treatment isn’t available locally, some patients may need to go to a distant city or state to get it.

    I’ve never had a patient ask me for advice before going abroad for bariatric surgery, but I have seen patients over the years seeking follow-up care or treatment for complications. Before you travel to get a procedure, such as gastric bypass or sleeve gastrectomy take these precautions.

    1. Thoroughly research the doctor and facility

    Each country has its own standards that healthcare providers and facilities must meet, and these can be very different from the United States. Check the qualifications of your doctor and facility and learn how they compare to those in the U.S.

    You also can check with international accrediting organizations, which require facilities to meet a list of standards to be certified. The CDC recommends ensuring your facility is accredited by the Joint Commission International,  DNV GL - International Healthcare Accreditation or the International Society for Quality in Health Care.

    Ask about your doctor’s experience. How many surgeries have they performed and what are their success rates?

    Get in writing the specific treatment, supplies and care covered in the costs. You don’t want to be surprised when you arrive or get the bill.

    2. Arrange for before- and after-care close to home

    Bariatric surgery doesn’t start and end in the operating room. It’s not just an anatomical change; it changes how you’ll live the rest of your life. This type of change requires support–before and after surgery.

    Procedures, such as gastric bypass, change how your body processes and absorbs food. They require major lifestyle and dietary changes. If you don’t understand what you can eat, when you can eat it, and how much of it you can eat, you can suffer from digestive problems or vitamin deficiencies.

    Pre-surgery education and long-term follow-up care are essential components to a successful bariatric surgery outcome. Weight loss surgery patients in the United States go through, on average, six months of preparation and education by dietitians and other healthcare providers. After surgery, we recommend ongoing dietary supervision and regular appointments the first year and then yearly afterward, to monitor for nutritional deficiencies and other complications.

    If you travel for surgery, it’s likely not feasible—or even an option—to spend months before and after surgery in that destination for education and follow-up care.

    Form a relationship with a local bariatric surgery program to receive pre- and post-surgery education and care. Remember to check with your insurance company. If you’re having surgery outside the country, this care may not be covered by your plan. But as I said, this support is crucial to achieving your goal of long-term weight loss.

    "If you must travel to get bariatric surgery, establish a plan for before- and after-care close to home." via @MedStarWHC

    3. Plan for language barriers and potential complications

    If you receive care in a country where you do not speak the language fluently, determine how you will communicate with your doctor and care team. While foreign language interpreters may be commonplace in U.S. healthcare facilities, don’t expect every place to have them. It’s vital that you are able to effectively communicate with your team, so there are no misunderstandings about your care.

    Complications can arise, and you must be prepared for them. For instance, you may need to stay longer than anticipated to recover. If the problem is severe, you may need to return to the U.S. for more advanced care.

    If you or a loved one has to be transferred from one hospital to another, you know how involved that move can be–even within the same city. Now think about the difficulty involved in transferring a patient to another country.

    Keep in mind that flying after surgery has its own risks, including deep venous thrombosis (blood clots) and pulmonary embolism (blockage of an artery in the lung). To help prevent these complications during your flight:

    • Get up and walk around every two hours
    • Move your legs while sitting
    • Stay hydrated
    • Wear compression stockings

    Bariatric surgery can be a lifesaver for people who struggle with severe obesity and the complications that can accompany it, such as diabetes and hypertension. But it’s more than surgery; it’s a set of lifestyle changes that requires education and continuous support. When possible, it’s best to get this care close to home. But if you must travel, whether to the next town or overseas, make the preparations necessary to optimize for a successful outcome.

     

    Schedule an appointment to talk with our bariatric surgery team about pre- or post-surgery support.

  • May 08, 2017

    By MedStar Health

    In fall 2016, MedStar Health took a significant step toward supporting healthy eating for our patients and associates with the launch of WellRooted, a unique food delivery and nutrition education service (see my blog post on the topic here). WellRooted grew out of the innovative Health for America at MedStar Health fellowship in partnership with MedStar Diabetes Institute (MDI) and has continued to grow and evolve. Now, MedStar is strengthening its connection to healthy food in exciting new ways.

     Today, we refine and transform WellRooted to launch a new program: MedStar Healthy. Among other offerings, MedStar Healthy will become a “nutritional filter” on the new website of our ready-to-eat meal partner, Territory (formerly known as Power Supply). This filter will help our patients and associates identify the healthy options we recommend much more seamlessly while ordering meals through the Territory website.

    What is a MedStar Healthy Meal?

     Our criteria are similar to those created for WellRooted, under the guidance of MDI and inspired by American Diabetes Association and American Heart Association guidelines:

    • 350 - 600 calories
    • 30 - 60 g carbohydrates
    • Less than 750 mg sodium
    • Maximum of 7 g saturated fat

    However, we are not limiting ourselves to “diabetes-friendly” language in this next chapter because we believe these healthy meals should be enjoyed by a wide range of people, including those with diabetes and prediabetes.

    What Else is MedStar Healthy?

    MedStarHealthy.org represents our ever-increasing commitment to the general health and wellness of those we serve. It provides a direct link to order the Territory MedStar Healthy ready-to-eat meals with an exclusive 5% discount for our patients and associates. You’ll also find easy recipes for healthy cook-at-home meals that meet the same criteria and links to free MedStar wellness classes.

    More to Come!

    Today, we join Territory in initially announcing this exciting news. Learn more via Territory’s press release.

    In the coming weeks, we’ll introduce MedStar Healthy more directly to our patients, associates, and community. Stay tuned to MedStar Health and Health for America social media channels for more information.


    Editor's Note (December 2018): Although Territory has since changed its menu filters and no longer specifically points to MedStar Healthy meals, the MedStar Healthy program still lives on at MedStarHealthy.org and includes a special discount to order Territory meals, in addition to MedStar-recommended recipes and wellness classes. Territory continues to clearly label the nutrition facts of its meals, making it possible for patients to watch for MedStar Healthy criteria or other nutritional recommendations discussed with their doctor.


  • May 05, 2017

    By MedStar Health Research Institute

    Research Grand Rounds are sponsored by MHRI and Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) and bring together the MedStar Health community for a learning experience focusing on a different topic each month.

    Research Grand Rounds are open to all members of the research team, from principal investigators to clinical and research coordinators and trainees. Topics covered in the Research Grand Rounds range from community-focused research to best practices and are intended to increase collaboration within the research community in and outside of MedStar Health.

    Genetics and Neurobiology of Pain in Sickle Cell Disease
    Presented by James Taylor, MD, Howard University

    June 2,2017                                                                                                                                      
    12 Noon to 1 PM – Presentation
    1 PM to 1:30 PM – Lunch
    MedStar Washington Hospital Center, 6th Floor, CTEC Theater
    110 Irving Street, NW, Washington, D.C., 20010

    View the listing of the FY17 Grand Rounds.

  • May 05, 2017

    By MedStar Health Research Institute

    Are you an affiliate of Georgetown University or MedStar Health who is committed to improving public health or medical product development through research and education?

    CERSI Scholars will raise awareness among their peers and throughout their careers about regulatory science and how its application can improve innovation in medical product development. This program will elevate training and mentorship opportunities for rising leaders in regulatory science, clinical and translational research and public health.

    CERSI Scholars is a collaborative effort between the Georgetown University Center of Excellence in Regulatory Science and Innovation (CERSI), Georgetown University Medical Center (GUMC), and MedStar Health Research Institute (MHRI). The program engages individuals who are deeply committed to public health and actively pursuing research, education, or training in regulatory science at Georgetown University or MedStar Health.

    Regulatory Science is an interdisciplinary area of scientific research that aims to enhance the development of safe and effective medical products. Regulatory science relies on a community of scientists from diverse fields to collaborate in new ways, to generate new knowledge that will inform the regulatory decision-making process.

    “Personally, as an early career researcher, the CERSI program gave me the recognition and motivation to move my research idea forward despite the busyness of my role supporting much larger grants,” said Erica Savage “The CERSI program is also useful in making connections across MedStar, Georgetown, and the FDA. I found the seminar speakers to be interesting and helpful in thinking about new ways to think about research at MedStar.” Ms. Savage is a project manager at MedStar’s National Center for Human Factors in Healthcare and MedStar Ambulatory Services Quality and Safety. In additional to health IT research, Ms. Savagefocuses primarily on human factors and safety consultations and is the project manager on several MedStar Health committees that aim to optimize processes and culture to improve safety and outcomes.

     

    Benefits

    CERSI Scholars are provided with research stipends of up to $5,000 for application towards related activities, such as support ongoing research, fees associated with peer-review publication, or travel costs to research conferences.

    CERSI Scholars will have access to structured mentoring from Georgetown and MedStar faculty whose work involves regulatory science as well as FDA staff and scientists.

     

    Duration and Program Activities

    This is a one-year program, which will allow Scholars to engage with their peers and thought leaders from industry, academia and the FDA to discuss important topics in regulatory science.

    Scholars will be required to attend all seminars and will be expected to give a presentation on their work.

     

    Application Criteria

    The full request for applications can be found here. The following materials will need to be submitted, in the order listed, as a single PDF:

    • Cover Letter
    • Curriculum vitae or Resume
    • Regulatory Science Research Proposal (1-2 pages)
    • One professional letter of reference from Georgetown or MedStar faculty or staff
    • Submit applications to Daphne Guinn, PhD via email (dag137@geogetown.edu) by June 15, 2017.

     

    For more information, you are invited to attend the CERSI Scholars Seminar, Reception and Information Session
    Wednesday, May 17
    Seminar: 3:00pm to 4:30pm
    Reception & Information Session: 4:30 pm to 6:00 pm
    2115 Wisconsin Ave NW, Room 106
    Please RSVP by May 15 to Daphne Guinn at dag137@georgetown.edu

    The full request for applications is available at https://regulatoryscience.georgetown.edu/CERSIscholars

  • May 05, 2017

    By MedStar Health Research Institute

    Approximately 800 people were in attendance on Monday, May 1 to see how research is advancing health at the 6th Annual MedStar Health Research Symposium. More than 300 abstract posters and case reports were presented by MedStar investigators on topics ranging from health services to critical care to orthopedics. This year also marked the first year that the Symposium brought together residents and fellows from across the system for the first system-wide MedStar Resident Research Day.

    The afternoon began with pre-conference educational workshops. Each workshop provided a ‘bootcamp’ on a select topic such as “Which biostatistical test should I run?” to “Research 101: How to Star Your Research Career at MedStar” to academic appointments at Georgetown University Medical Center.

    Following the pre-symposium workshops, the resident research day started with oral presentations from the top six residents/fellow research projects.  The state-of-the-art auditorium was packed with more viewers watching the live-stream in the main ballroom. For residents (PGY 1-3), Travis Thompson, MD was awarded first place for his presentation of “Increasing Ultrasound Evaluation in Renal Colic”. Maame Sampah, MD awarded 2nd place and Jasneet Riar, MD and Max Romano, MD tied for the third place award. For fellows (PGY-4 and above), Yasar Torres-Yaghi, MD, placed first with “Tyrosine kinase inhibition clears Tau and reserves neuropathology and motor symptoms in a novel model of progressive supranuclear palsy”. For research fellows, Jason Chen, MD placed first with “Racial Disparities in Mortality and Complications After Burn Injury”.

    Then the poster presentations began in the grand ballroom. Each poster presented was peer-reviewed before being selected for presentation at the Symposium. Advancing health through research at MedStar Health was truly on display, with a top score award presented to nurses Kathryn Curtin, RN, BSN, and Shannon Walters, RN, BSN, from MedStar Washington Hospital Center for their abstract “Follow the Blue Feet: Nurse Implemented Post-Operative MOBILITY Program”.

    Main stage remarks were shared by Stephen R.T. Evans, MD, Executive Vice President, Medical Affairs Chief Medical Officer, MedStar Health, William Oetgen, Jr., MD, MBA, vice chairman, MedStar Health Board of Directors, Edward B. Healton, MD, MPH, Executive Vice President for Health Sciences and Executive Dean of the School of Medicine, Georgetown University and Neil J. Weissman, MD, President, MedStar Health Research Institute and Professor of Medicine, Georgetown University. Jamie Padmore, DM, MSc, vice president of Academic Affairs at MedStar Health, introduced the keynote speaker, Darrell Kirch, MD, president and chief executive officer, Association of American Medical Colleges.

    Dr. Evans spoke of the event and highlighted that it shows “the future of healthcare,” and “This is what innovation, education, and research can do together.” Dr. Healton highlighted the level of collaboration of the research presented, saying that it offered a glimpse of "what the future holds for us as [MedStar and Georgetown] continue to work together." Mrs. Padmore addressed the residents and fellows in attendance: “You are the future of advancing health, not just for MedStar, but the entire community.”

    Dr. Kirch highlighted the benefits of being an integrated, academic health system. “I believe that the only active agents who exist in America, who can transform the healthcare system for better outcomes, better satisfaction for patients and clinicians, the people who can do that are highly innovative academic health systems,” he said. He highlighted that the Symposium brings together the next generation of clinicians, a group who understand the benefit of collaboration and interdisciplinary work in advancing the health the community. He reminded attendees of the power of education and power of research in caring for people.

    In addition to the speakers, the Symposium also included exhibits from MHRI and MedStar. The MedStar Institute for Innovation presented “Think Differently”, showcasing different innovative approaches that they have been working on and how they connect with research. The MedStar Philanthropy group highlighted gratitude as part of our research. From MHRI, the Office of Research Development, Office of Research Integrity, the Department of Biostatistics and Biomedical Informatics were among those exhibiting.

    The Symposium would not have been possible without the support of MHRI and Academic Affairs associates, who both planned, prepared and staffed the event. In addition, the event was supported by the 2017 Symposium Scientific Committee, chaired by Waddah Al-Refaei, MD and supported by Ana Barac, MD, PhD, vice chair and Dawn Fishbein, MD, past chair. Conference planning staff was Michele Lee Clements and Eva Hochberger of the Office of Research Development at MHRI.

    If you have any questions about research or would like to be connected to an investigator or other resources, please contact research@medstar.net.