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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
    Click to Tweet

     

    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • July 31, 2019

    By MedStar Health

    Congratulations to all MedStar researchers who had articles published in July 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. Fresh and Savory: Integrating Teaching Kitchens with Shared Medical Appointments
      The Journal of Alternative and Complementary Medicine, 2019. DOI: 10.1089/acm.2019.0091
      Kakareka R, Stone TA, Plsek P, Imamura A, Hwang E.
    1. The Effects of Medicaid Expansion on Triage and Regional Transfer After Upper-Extremity Trauma
      The Journal of Hand Surgery, 2019. DOI: 1016/j.jhsa.2019.05.020
      Daly CA, Cho BH, Desale S, Aliu O, Mete M, Giladi AM.

    2. Clinical, Pathological and Molecular Profiling of Radioactive Iodine Refractory Differentiated Thyroid Cancer
      Thyroid, 2019. DOI: 10.1089/thy.2019.0075
      Shobab L, Gomes-Lima CJ, Zeymo A, Feldman R, Jonklaas J, Wartofsky L, Burman KD.
    1. Intravascular Ultrasound-Guided Drug-Eluting Stent Implantation
      Minerva Cardioangiologica, 2019. DOI: 10.23736/S0026-4725.19.04895-3
      Shlofmitz E, Kuku KO, Waksman R, Garcia-Garcia HM.
    1. Improved Survival After Multimodal Approach with 131I Treatment in Patients with Bone Metastases Secondary to Differentiated Thyroid Cancer
      Thyroid, 2019. DOI: 10.1089/thy.2018.0582
      Wu D, Gomes Lima CJ, Moreau SL, Kulkarni K, Zeymo A, Burman KD, Wartofsky L, Van Nostrand D.
  • July 31, 2019

    By MedStar Health

    We are pleased to announce the release of a new tool to broaden public awareness of open clinical trials happening across MedStar Health and MedStar Health Research Institute.

    We have launched the Study Information Portal on the MedStar Health Research Institute website, on the webpage that currently displays our open clinical trials. The Study Information Portal references real-time data from enrolling studies in OnCore to help patients and providers identify active clinical trials that meet their needs and interests. Users can browse our active clinical trials by site or by principal investigator, or they may search for a study by key words, such as a disease or diagnosis.

    Informational WebEx sessions will be available August 5th, 6th, and 7th at both 8:30am and 12:30pm daily to showcase the Study Information Portal and address any questions. Subsequent announcements will be made via Twitter, the MedConnect Minute, and MedStar Patient Portal to further share the tool with the MedStar Health community.

    The Study Information Portal is publicly accessible on the MedStar Health Research Institute website here.

    If you have any questions, please contact Allie Moses at Allison.E.Moses@MedStar.net.

  • July 31, 2019

    By MedStar Health

    Recent research from MedStar Health investigators and educators sought to understand the impact and perception of a newly implemented training statement for cardiovascular education. The research was the first to collect data from program directors in cardiology fellowships on how they understand and implement the new training guidelines.

    The research as published in Journal of the American College of Cardiology. The research team was led by Gaby Weissman, MD, and included Alex J. Auseon, DO; James A. Arrighi, MD; Lisa A. Mendes, MD; Paul Theriot, BSBA; Marty C. Tam, MD; and Julie B. Damp, MD.

    American College of Cardiology wanted to address the rapid advancement of knowledge for treating cardiovascular disease. Initially developed in 1995, the Core Cardiovascular Training Statement (COCATS), provided a uniform set of curricular recommendations for training in cardiovascular disease. The most recent iteration, COCATS4, differs from previous versions in that it added elements of competency-based medical education as well as adding new domains of knowledge such as critical care cardiology and it changed the duration of training that needed to be devoted to gaining clinical skills and knowledge. 

    Of the 229 cardiovascular disease training programs based in the United States, 130 (57%) responded to the survey over a month-long period. Each program self-reported their size based on fellows (small to large, one through 18+) and program type (university hospital-based, community hospital/university-affiliated, community-based, or military hospital).

    Half of the program directors found the guidelines to be helpful in assessing competency, with an additional 30% finding it somewhat useful. Many program directors (57%) found the COCATS4 guidelines to be extremely useful, with an additional 35% finding it somewhat useful. The majority of program directors (69%) found that the COCATS4 guidelines are better aligned with the needs of today’s job market.

    Despite the new guidelines, almost one-half (45%) of programs had made no significant changes since the release of COCATS4, however 22% of programs increased the number of clinical months, 8% decreased the number of clinical months, and 11% increased the number of required echocardiography months. 57% of responding programs indicated that resource limitations impacted the lack of direct clinical experience. This included lack of subspecialty programs within their institutions. Another important finding was that over half of programs reported that they lacked the ability to deliver direct clinical experience in at least one domain of cardiovascular care. 

    This research helped to identify gaps in training programs based on the guidelines, finding that programs may need to utilize alternative educational experiences to ensure that their fellows are meeting the guidelines. This data can be used as a comparison for future research, as it can create a benchmark of training programs. Importantly, it should serve as a call for national organizations to help fill in the educational gaps that cardiology training programs may have.

    Journal of the American College of Cardiology, 2019. DOI: 10.1016/j.jacc.2019.03.488

  • July 31, 2019

    By MedStar Health

    Researchers from MedStar Heart & Vascular Institute, MedStar Washington Hospital Center, MedStar Georgetown University Hospital and National Institute of Health have recently sought to identify pre-transplantation cardiac testing practices and to report post-transplant cardiac outcomes in patients receiving renal allografts.

    “Pre-Operative Cardiovascular Testing and Post-Renal Transplant Clinical Outcomes” was published in Cardiovascular Revascularization Medicine. Chronic kidney disease and end-stage renal disease are closely linked to coronary artery disease. This retrospective analysis examined demographics and medical data for patients undergoing first renal transportation. Pre-transplant workup included echocardiograms, cardiac stress testing, coronary computed tomography, left heart catherization and any revascularization.

    The research included 235 patients and the mean length of follow-up was 1.63 years. Patients were reviewed for use of antiplatelet, HMG-CoA reductase inhibitors (statins), insulin, beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, mineralocorticoid receptor antagonists, and diuretics over a 6-month period before transplant. 219 (93%) patients had non-invasive functional testing before transplant. The most common co-morbidity was hypertension (88.1%), and the most common pre-transplant medication class was beta blockers (59.6%). The most common cause of chronic kidney disease/end-stage renal disease was hypertension (36.7%) and diabetes mellitus (26.2%). There were 3 deaths, 2 that were cardiac-specific. Of those patients with a 30-day post-operative troponin, 30 (13%) patients had an elevation due to a type II NSTEMI or myocardial injury.

    The results of the study show that cardiovascular testing remains an ever-present practice in pre-transplant evaluation, with an ongoing low rate of adverse cardiac outcomes for those patients who are ultimately deemed suitable for kidney transplant. In conclusion, this study demonstrates low mortality despite the relative frequency of post-operative troponin elevation. “There is no clear pattern of pre-cardiac testing results or revascularization inpatients who develop post-transplant major adverse cardiac outcomes.”

    The research team included Michael Yang, Patrick Miller, PT, DPT; Brian C. Case, MD; Alexander J. Gilbert, MD; Jared K. Widell, MD; Toby Rogers, MD; Lowell F. Satler, MD; Ron Waksman, MD; and Itsik Ben-Dor, MD.

    Cardiovascular Revascularization Medicine, 2019. DOI: 10.1016/j.carrev.2019.04.017

  • July 30, 2019

    By Kenneth L. Fan, MD

    When someone has plastic surgery, whether it’s a cosmetic surgery, breast reconstruction after breast cancer surgery, or a hernia repair, one of their first concerns typically is how much pain they will experience after surgery.

    This is something we take seriously at MedStar Washington Hospital Center. In fact, we follow the Enhanced Recovery After Surgery (ERAS) protocol, which is when our medical team works together with patients prior to surgery to learn about their pain tolerance and medical history to create care plans that result in:

    • Minimized pain after surgery
    • Quicker recoveries
    • Reduced narcotic usage

    We saw one patient who previously had more than six hernia surgeries, and her most recent one required a two-week hospital stay, some of which was in the intensive care unit (ICU). When she saw us for another surgery to treat her hernia, as a plastic surgeon, I spoke with her to learn how she tolerated her previous surgeries and worked with anesthesiologists and general surgeons to devise a care plan that minimized the invasiveness of her surgery and decreased the amount of pain she experienced afterward. She ended up walking the day after surgery and said that it was the best she’d ever felt compared to her previous surgeries.

    LISTEN: Dr. Fan discusses reducing pain after plastic surgery in the Medical Intel podcast.

    How Does the ERAS Protocol Work?

    The benefit of doctors using the ERAS protocol, which was first introduced to MedStar Washington Hospital Center by Dr. Susan Dumsha Stasiewicz and later was incorporated into the care plans that other MedStar entities offer, is that it always results in faster recoveries—although recoveries still can vary depending on the type of procedure patients undergo. For example, some surgeries result in very little pain and allow individuals to go home the same day, while more invasive surgeries can require people to stay at the hospital overnight for one to four days because their pain is more severe.

    Recovery from #plasticsurgery almost always involves pain. But the enhanced recovery after surgery (ERAS) protocol consistently reduces patients’ pain and leads to quicker recoveries. Learn more. https://bit.ly/2KbZaNP via @MedStarWHC Click to Tweet

    Below is how we approach managing pain with the ERAS protocol before, during, and after surgery.

    Before Surgery

    The first and most important step of the ERAS protocol is to set the expectation of pain, which is important since not all patients perceive pain the same way. We set pain expectations through a preoperative assessment of patients in which we discuss how they:

    • Generally tolerate pain
    • Recovered from previous surgeries
    • See themselves recovering from this particular surgery

    Once we have pain expectations set, we provide patients with a cocktail of non-opioid medications that target the way their nerves fire. Make sure to speak to your doctor to learn about the different medication options and which might work best for you.

    During and After Surgery

    During plastic surgery, we provide patients medications that reduce nausea and vomiting, as well as a local anesthesia, or a technique used to eliminate pain from the area of the body in which you’re having surgery by numbing it and blocking the nerves associated with the area from activating.

    After surgery, we use medications similar to the ones patients received prior to surgery to reduce their pain by continuing to keep the nerves associated with the surgical site from firing as strongly. Because pain tolerance varies from person to person, consistent communication between a patient and their doctor is key to successfully managing the patient’s pain after surgery. This is done through both follow-up appointments and patients calling the doctor’s office when needed.

    How We Reduce the Use of Narcotics

    Opioid use has reached a tipping point in America, as it’s now considered a health emergency. Every day, more than 130 Americans die after overdosing on opioids. As a result, through the ERAS protocol, we avoid prescribing opioids to patients unless we feel it’s entirely necessary based on our initial conversations regarding their pain tolerance. We do this by managing pain in other ways, such as through local anesthesia and non-narcotic medication.

    If a patient and their doctor decide that taking opioids is necessary for pain tolerance after plastic surgery, it’s important to understand possible side effects and the correct dosage they should take. Speak to your doctor if you’re unclear about anything related to your prescribed medications.

    Although pain is a part of any plastic surgery, we have significantly reduced the amount of pain patients experience throughout the years with our ERAS protocol. Before your plastic surgery, make sure you and your doctor have a plan in place to help you effectively manage your pain after the procedure.

    Want to discuss your pain management plan for an upcoming plastic surgery? Call 202-877-3627 or click below to request an appointment with a plastic surgeon.

    Request an Appointment

  • July 26, 2019

    By MedStar Health

    Every day, I meet with patients who are considering bariatric surgery because the more standard and traditional ways of losing weight simply haven’t worked. Over the years, I’ve talked with plenty of patients who have never been able to lose weight on their own. And there are just as many people out there who have gotten on track, losing 50 or 60 or 70 pounds, only to put it all back on, maybe even more! Getting caught up in the vicious cycle of weight loss following by weight gain is not only easy; it’s also extremely common.

    6 Reasons People Consider Bariatric Surgery

    The reasons people consider bariatric surgery are all over the board:

    1. Some are simply tired of looking and feeling overweight.
    2. They are embarrassed about the way the look, or being overweight is holding them back from living life to its fullest.
    3. One recent patient told me her turning point was when her middle school-aged son came home in tears after a classmate spend the day making fun of him, because his mom was fat. She had anxiety, every day when the time came to send her son back to school alongside the bully.
    4. Another contacted my office after her family went to an amusement park, and she wasn’t able to fit into the seat on most of the rides. She was not only embarrassed, but also frustrated and sad.
    5. There was another patient who had to completely give up his love for the game of golf; because of his weight, he simply couldn’t get through a course. He felt completely defeated.
    6. Others come to see me because obesity is causing a number of life- impacting or even life threating health conditions – from blood pressure and cholesterol levels that are out of control to diabetes, sleep apnea, and even heart issues. It’s a proven fact that losing weight can help get these conditions under control, or even eliminate them, and this is why some people see bariatric surgery as a potentially life-saving solution.

    Lifestyle Changes Are a Must

    Here’s the thing. Bariatric surgery alone doesn’t provide the easy way out, or a be-all, end-all solution, for ANY patient. Instead, bariatric surgery is a tool that can lead to great success, for people who are willing to make all of the lifestyle changes that must go along with the actual procedure. It’s about making better, smarter, reasonable choices at meal time, and picking healthy snacks rather than filling up on junk food. Its about understanding what a sensible portion is, and building meals that account for the amount of food you should be consuming to fuel your body, rather than eating so much that you feel stuffed and even sick to your stomach. Does this mean you can never have pizza again, or enjoy a night out for ice cream with your kids? Absolutely not. Here are some changes to incorporate into your lifestyle:

    • You can have a slice of pizza; you just can’t have six.
    • You can have the occasional ice cream; just choose the smaller portion, and consider topping it with fresh fruit rather than crushed candy and chocolate sauce.
    • It’s also about finding some time, every day, to be active. This doesn’t mean that you need to go train for a marathon or bike 30 miles per day. For some people, it’s as simple as adding a power walk to the morning routine, taking Zumba classes a few times a week with a group or friends, or joining a yoga studio and committing to getting there each day after work.

    How You Can Make It Happen

    Change is not easy. But we are here to give you the resources, guidance, and support you need, to make it happen. This is why so many patients who have turned to the Bariatric Surgery Center at MedStar Franklin Square Medical Center have such great, inspiring stories to tell. Not one of them will tell you that they had the surgery, and pounds began magically melting away. Instead, they will tell you about the lifestyle adjustments they committed to, with our support, and that lots of little changes really can and do add up to significant results.

    A lot of people ask me why they should choose the Bariatric Surgery Center at MedStar Franklin Square, opposed to some of the other programs that are available. It’s no secret that there are many hospitals in the Baltimore area. You do have choices. A few things come to mind, that I think really set the MedStar Franklin Square program apart. First, the comprehensive nature our services, starting months before your surgery date and extending long after your surgery is over and your goal is reached, are absolutely top notch. When we say a patient of ours is a patient for life, we really mean it. You will not find a team more committed to your success than what you will find at MedStar Franklin Square. Second, we are recognized as a leader, at both the local and national level, in robotic surgical techniques. We perform 100 percent of our bariatric cases using the da Vinci® Robotic Surgical System, and have even trained other surgeons from across the country on use of this equipment, based on our superior skills and experience. Robotic technology has changed the definition of surgery in so many ways, and offers patients tremendous benefits. Think smaller scars, less blood loss during the surgery, shorter hospital stay, and shorter overall recovery time. Need I say more?

    The First Step in Your Weight Loss Journey

    The decision to undergo surgery is a big one, not to be taken lightly. We know and understand that people who are beginning to consider bariatric surgery, and therefore beginning to do some research into their options, have a lot of questions and concerns. This is why we ask that as a first step, prospective patients attend one of our bariatric information seminars, either in person or online. The session is designed to help you understand who is eligible for bariatric surgery, the procedures we offer, the benefits and risk factors associated with each, and the lifestyle changes you must be willing to make, for this to work and ultimately give you the results you are after. You will also have the opportunity to hear testimonies from patients who have already undergone the procedure, and are who are living their best lives, today, as a result. If you are wondering if bariatric surgery is right for you, I highly recommend that you register for a seminar to learn more. By registering, you aren’t making a commitment to having surgery; instead you are simply opening a door for yourself to learn more as you continue to contemplate your weight loss options.

    Information seminars at the Bariatric Surgery Center are available, at both our MedStar Franklin Square office as well as at MedStar Health Bel Air Medical Campus.

    Ready to take the next step in your weight loss journey? Click below to view upcoming seminar dates and times.

    Register Now


    If you prefer to enroll in a web-based seminar, click here to activate the 30-minute program.