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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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  • August 29, 2019

    By MedStar Health

    The Health Data Leadership Institute is designed to meet the needs of transforming health care delivery. The Institute provides a unique opportunity for attendees to gain critical insights, from leaders in the field, into emerging data management practices that support quality improvement, research, innovation in care delivery, value-based care transformation, social determinants of health, patient engagement, population health, and more.

    The Institute ensures opportunities for dialogue and small group discussion with practitioners in the field and peers who are experiencing similar challenges and opportunities. Attendees learn from health policy experts, government program leaders, data users, entrepreneurs who have deep knowledge in data use, and data experts from technology and health care applications fields – through interactive panels and discussions within an intimate setting.

    September 25-26, 2019
    Register Here
    View Agenda

    LOCATION
    AcademyHealth Office
    1666 K St NW #1100
    Washington, D.C., 20006

  • August 29, 2019

    By MedStar Health

    The Office of Research Integrity continues to work on improving the human subject protection research program and is preparing for enhancements to be made to the Huron Electronic IRB system (eIRB) this fall. We think you’ll be pleased!

    These updates (8 and 9) will bring our system up to date with the latest version of the application and will provide several small enhancements and bug fixes.  Most of these changes are on the back end and will not modify the investigator team user experience with some exceptions listed below:  

    • Redesigned SmartForm for Submission of External IRB review
      • Improved user experience for External IRB studies
    • Redesigned SmartForm
      • A left navigator replaces the Jump-To menu and provides helpful status icons, the integrated Compare feature replaces View Differences, and slide-in views replace pop-ups, to improve the user experience.
    • Review Tracker
      • A new mode for reviewing projects features a single-page view of the entire SmartForm, ability to mark sections as reviewed, inline comparison with previous versions, and change indicators to narrow the scope of follow-up reviews.
    • Print Packets
      • All project types now support print packets that are available from within the SmartForm. Print packets provide new options for printer-friendly versions of projects including adding table of contents and related projects.  

    The upgrade is anticipated to take place in the last week of September 2019.   The upgrade will take just a few hours and will be scheduled overnight so that system downtime will be limited.  You will be notified when the date has been finalized.  In addition, stay tuned for more details including webinar dates where the upgrade will be discussed, training provided and you will have a chance to ask any questions. 

  • August 29, 2019

    By MedStar Health

    Recently published research from the team at the Curtis Hand Center explored whether the 2014 expansion of Medicaid in Maryland under the Affordable Care Act decreased the number of uninsured upper-extremity trauma patients and the volume of unnecessary emergency trauma visits at the hand center.

    “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma” was published in the Journal of Hand Surgery. The research team was led by Charles A. Daly, MD and included Brian H. Cho, MD; Sameer Desale, MS; Oluseyi Aliu, MD, MS; Mihriye Mete, PhD; and Aviram M. Giladi, MD, MS.

    In the United States, 17% of total trauma-related costs are associated with hand and wrist injuries. In addition, care for hand trauma is often complex and time sensitive which creates a burden for patients sometimes being transferred long distances for treatment. The Affordable Care Act was passed in March 2010 with an intent of expanding health insurance coverage and health care access nationwide. Currently, only 32 states and the District of Columbia have elected to expand coverage.

    The availability of trauma centers that specialize in upper-extremity care is critical to treating patients. However, there’s an overuse of referrals and transfers which creates additional financial burden for these centers. The study team hypothesized that by decreasing the number of uninsured trauma patients, Medicaid expansion would decrease unwarranted transfers because the patients may be able to find care closer to home.

    This retrospective study looked at patients with isolated hand and upper-extremity trauma between 2010 and 2017 at the Curtis Hand Center. Demographic data was collected and the intensity of each patient’s injury was classified using the Hand Trauma Severity Matrix. The Severity Matrix assists with indicating the need for acute specialized hand trauma management. Patients were classified as appropriate/inappropriate, transfer/non-transfer, and pre-expansion or post Medicaid expansion in Maryland.

    The research team studied 12,009 acute upper-extremity trauma patients. In total, 20% had Medicaid and 27% had no insurance. Thirty percent of patients traveled over 25 miles to obtain treatment and 25% of all patients were transferred to the hand center from other health care facilities. After Medicaid expansion, the percentage of trauma patients with Medicaid coverage increased from 15% to 24%, with a decrease in uninsured from 31% to 24%. After Medicaid expansion, non-transfer patient appropriateness decreased and appropriateness of transfers remained steady. Transfer patients were required to travel significantly farther for care than were non-transfer patients but the distance all groups traveled on average did not change significantly from before to after expansion.

    The results show that Medicaid expansion significantly decreased the proportion of uninsured upper-extremity trauma patients. However, the study team did not find a significant change in the appropriateness of transferred patients after expansion, whereas appropriateness of non-transferred patients declined after Medicaid expansion. There is still a high percentage of uninsured patients that remain in the hand trauma population, which continues to place a financial burden on regional referral centers. Future research should focus on how to lessen the burden of unnecessary urgent referrals and improving resource use.

    Dr. Avi Giladi recently had an interview with Dr. Brent Graham, Hand surgeon, Editor-in-Chief of the Journal of Hand Surgery (JHS) regarding “The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma” on the JHS monthly podcast. You may listen to Episode 42 here.  

     Journal of Hand Surgery, 2019. DOI: 10.1016/j.jhsa.2019.05.020

  • August 29, 2019

    By MedStar Health

    Congratulations to all MedStar researchers who had articles published in August 2019. 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. Qualitative Findings From a Pilot Stage Implementation of a Novel Organizational Learning Tool Toward Operationalizing the Safety-II Paradigm in Health Care
      Applied Ergonomics, 2019. DOI: 10.1016/j.apergo.2019.102913
      Hegde S, Hettinger AZ, Fairbanks RJ, Wreathall J, Krevat SA, Jackson CD, Bisantz AM.
    1. Utilization of Left Ventricular Assist Devices in Vulnerable Adults Across Medicaid Expansion
      Journal of Surgical Research, 2019. DOI: 10.1016/j.jss.2019.05.015
      Ehsan A, Zeymo A, McDermott J, Shara NM, Sellke FW, Yousefzai R, Al-Refaie WB.
    1. Assessing the Impact of Serious Illness on Patient Intimacy and Sexuality in Palliative Care
      Journal of Pain and Symptom Management, 2019. DOI: 10.1016/j.jpainsymman.2019.04.015
      Kelemen A, Cagle J, Chung J, Groninger H.
    1. The Relationship Between Hemihamate Graft Size and Proximal Interphalangeal Joint Flexion for Reconstruction of Fracture-Dislocations: A Biomechanical Study
      Journal of Hand Surgery, 2019. DOI: 10.1016/j.jhsa.2018.09.017
      Elliott RM, Nayar SK, Giladi AM, Forthman CL, Parks BG, Means KR Jr.
    1. Respiratory and Hemodynamic Changes in Neonates with Hypoxic-Ischemic Encephalopathy during and after Whole-Body Hypothermia
      American Journal of Perinatology, 2019. DOI: 10.1055/s-0039-1694730
      Sheppard SR, Desale S, Abubakar K.
  • August 29, 2019

    By MedStar Health

    Congratulations to Raj Ratwani, PhD, director of the MedStar Health National Center for Human Factors in Healthcare and associate professor of the Georgetown University School of Medicine, for receiving the American Psychological Association’s (APA) Earl Alluisi Award for Early Career Achievement. The award is given annually to psychologists who, within 10 years of receiving their PhD, have made remarkable contributions to the field through research and publications, novel technology or techniques, theoretical advancements, and more. It is sponsored by APA’s Division 21, whose members work to advance the field of applied experimental and engineering psychology. The MedStar Health Human Factors Center is part of the MedStar Institute for Innovation and works in partnership with MedStar Health Research Institute and others throughout MedStar Health.

    In the seven years he has been with MedStar Health, Dr. Ratwani has been awarded more than 25 grants and contracts, published more than 30 articles, and delivered more than 27 invited international, national, and regional presentations—all in collaboration with his growing team. 

    The award, which emphasizes the translation of research into practice, recognizes Dr. Ratwani’s success in utilizing human factors science to impact healthcare operations and policy. His research on health information technology usability—and related work to advance patient safety and provider well-being—has been published in top-tier journals and was recently shared in a national campaign. Additionally, Dr. Ratwani’s research on interruptions and task resumption has informed innovative models that show the time cost of interruptions on physician workflow processes. These theoretical contributions lay the foundation for interventions that can prevent or mitigate interruption-related errors in health care.

    In addition to his research efforts, Dr. Ratwani spearheads the continued growth of the MedStar Health Human Factors Center and has served as its leader since 2018. Currently, the Center has four active Research Project Grant (R01) awards from the U.S. Department of Health and Human Services, provides usability consultation and safety advisement to clients in and beyond MedStar Health, and works to expand the footprint of human factors through diverse education and outreach initiatives. Learn more about the Center’s latest work here

  • August 29, 2019

    By MedStar Health

    MedStar Health Research Institute (MHRI) and the Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) host Research Grand Rounds on the first Friday of each month, from 12:00 to 1:00 p.m., followed by lunch at 1:00pm. These interdisciplinary grand rounds are appropriate not only for principal investigators, but also for clinical and research trainees and for all members of the research team. They are intended to introduce projects, approaches, research methods, populations and resources which are of interest throughout all disciplines, and could lead to new collaborations and research opportunities.

    “Big Data for Clinical and Translational Research: From Data to Doctor and Back”
    Nawar Shara, PhD
    Director, Dept. of Biostatistics and Biomedical Informatics
    Associate Professor of Medicine, Georgetown University
    Director BERD-CTSA (Georgetown-Howard)

    Friday, September 6, 2019
    12 Noon to 1 PM – Presentation
    1 PM to 1:30 PM – Lunch
    MedStar Washington Hospital Center, 6th Floor, CTEC Auditorium
    110 Irving Street, NW, Washington, D.C., 20010

    For those located at remote sites and unable to attend in-person, log on to https://georgetownu.adobeconnect.com/mhri/ on September 6, 2019, at 12:00 Noon to hear Dr. Shara’s presentation.

    For more information, please contact Research@medstar.net or visit https://www.georgetownhowardctsa.org/.