Dr. Breite and Dr. Rein are both in the office during their normal hours

Wednesday, February 28, 2007

Hepatitis A Can Strike in the Nicest Places

Hepatitis A is a food born virus that is spread via the fecal-oral route. Although we usually immunize people when they travel to developing nations, the disease can strike anywhere. This was proven when, recently, an employee of the famous caterer Wolfgang Puck was found to have have the disease. Although no one has gotten sick yet, up to 3500 people were potentially exposed. The original article is here.

For patients who travel or eat out a lot, it may make sense to talk to one of us about vaccination against hepatitis A. The two shots you need may save a lot of hassles down the road.

Monday, February 26, 2007

Woman's Heart Disease Risk Score (The Reynolds Index)

A woman's signs and symptoms for heart disease are different than a man's. Women are less likely to have classic signs of heart disease such as chest pain and more likely to have non-specific symptoms such as generalized fatigue. Although standard procedures such as a stress test or an angiogram work to asess risk in the symptomatic patient, better methods of stratifying which women are at higher risk for developing heart disease in the future are needed.
One promising new development is the Reynold's Risk Score, which allows a clinician to plug in certain numbers, such as age, cholesterol, smoking status and a special blood test called the c-reactive peptide. By entering these numbers into the website, a woman can assess your risk of heart disease over the next 10 years.

We are happy to help you calculate your Reynold's Risk Score. Please realize that many insurance companies do not pay for the c-reactive peptide, and this may be an out of pocket expense (themoney goes to a lab, not to us)

Sunday, February 25, 2007

Whats The Evidence (or Why Are You Giving Me That Drug??)

Decisions about what to do given a set of symptoms and signs is one of the most important functions that a physician performs. In recent years, more attention has been given in the medical literature to ways to synthesize the available scientific data and make medical decisions. The formal study of how to determine which decision is right based on the available literature is called Evidence Based Medicine, or EBM. EBM has been used to evaluate many controversial, and formerly controversial issues, including hormone replacement, the use of certain medications in heart disease and diabetes, and cancer prevention. EBM holds out the promise that it will cut the number of unnecessary tests and increase adherence to practices that will actually promote health.

Having said that, EBM can be a double edged sword. As well described in an article in this week's Time Magazine, EBM is often perceived of taking the "art" out of medicine and also making it less humanistic and more mechanistic and impersonal. Also, for ethical or practical reasons, EBM can't answer all the questions doctors would like to answer.

As a physician, it is important to keep up with EBM, and using proprietary software, at Westside Medical we do. Having said that, many of the questions that face the primary care physician, particularly in the area of acute care, are not fully answered and need the art of medicine as well as the science.

Saturday, February 24, 2007

Coffee: It Has Fiber, Too

Many people who enjoy a cup of coffee in the morning notice that it has a cathartic effect on the bowels as well. Although this is likely due to its stimulating the colon, a recent study from Spain has shown that coffee contains anywhere from 1.1 grams of soluble fiber (filter) to 1.8 grams (instant). Soluble fiber is helpful in producing non-gassy stool and may have cholesterol decreasing benefits as well. Go Coffee!

Friday, February 23, 2007

Should You Learn the Heimlich Manuever?

I have to admit I was a bit suprised when I read this. But according to Lenore Skenazy in the New York Sun, the American Heart Association is now recommending three ways to help a choking victim. These are (in the order you should try them)
  1. A hard back slap right between the shoulder blades. If that doesn't work...
  2. The Heimlich Manuever (now just called abdominal thrusts). And if that fails...
  3. Chest compressions (as you would do for CPR)

Don't worry if you do Heimlich first (I will still give the man the credit her deserves). The most important thing in the case of choking is to act quickly.

PS: I tried to go to the AHA website to find this new guideline. Its not officially posted, but you can buy it!

Tuesday, February 20, 2007

Join the Gym! Know the Price!

We encourage a regular exercise program for almost everyone at Westside Med. But joining a gym is confusing: there's always a "special" and you always think you are getting ripped off compared to the next person. The NY Post has an excellent article today showing how prices can literally change day by day. The article also points out that January and May offer the best deals. We encourage joining any gym as long as you go three days a week!

Monday, February 19, 2007

Salmonella Outbreak

There is a sizable Salmonella outbreak throughout the United States, and many cases have been reported in New York State. The source is peanut butter: Peter Pan and Great Value which have a product code located on the lid of the jar that begins with the number "2111." If you find yourself with a diarrheal illness and have had this, please be sure to bring the peanut butter and yourself to the office.

Fake Drugs?

The New York Times published an article describing a study on the growing problem of counterfeit drugs. Although a problem mainly in Asia and Africa, there have been reports of fake drugs for sale in the United States. Most of these were "recreational" drugs such as oxycontin or Viagra, but Tamiflu, used to treat influenza, has also been counterfeited. The level of sophistication of the counterfeiters was scary: drugs were packaged correctly and even had the hologram "seal of authenticity" of the real deal.

Bottom line: Although not a problem in the United States at the moment, care should be taken when getting drugs from certain foreign countries.