Protecting Your Health in Erie, PA | Erie County Medical Society

 

The Erie County Medical Society is a voluntary, non-profit professional organization of physicians, both MD and DO, in Erie, PA, founded in 1828. Our mission is to advance the standards of medical care, to uphold the ethics of the medical profession, and to serve the public with important and reliable health information.



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10:19 AM
November 12th, 2019

Vaping and Lung Damage

 

Vaping and Lung Damage

 

On September 6, 2019, the Centers for Disease Control (CDC) and Food and Drug Administration (FDA) issued a clear warning about lung toxicity related to e cigarette use. They along with state and local health departments are investigating the cause or causes of this potentially life-threatening disease. The investigation stems from a study of 53 patients from the states of Illinois and Wisconsin who presented to the hospital with lung and gastrointestinal symptoms. A third of those patients required mechanical ventilation and one death were reported in this study. The median age was 19 years.

 

E-cigarette, or more colloquially vaping, usage especially among adolescents has increased exponentially. Recent studies from Monitoring the Future, a 44 year old study, show that the increased prevalence of vaping represents the largest increase in risky behaviors since the initiation of monitoring.  Although used as a means to transition from cigarettes, use of the nicotine still carries with it the risk of addiction.

 

Investigations into the cause of lung toxicity are ongoing, but there are several clues at this juncture. The presence of tetrahydrocannabinol (THC) usage by users and use of black market devices and flavorants appear to be the focus of current investigations. More information will be forthcoming. For now, despite the use as a means of tobacco cessation, it is wise to avoid vaping until investigators have clarified more clearly the cause or causes of lung toxicity. At the same time it is important to continue to remain tobacco-free given the heart, lung and stroke risks which are clearly present.

 

Jeff McGovern, MD

Jeffrey McGovern, MD, FCCP, FAASM

Vaping and Lung Damage

Centers for Disease Control (CDC) and Food and Drug Administration (FDA) have warned  ...See More


Vaping and Lung Damage

 

Vaping and Lung Damage

 

On September 6, 2019, the Centers for Disease Control (CDC) and Food and Drug Administration (FDA) issued a clear warning about lung toxicity related to e cigarette use. They along with state and local health departments are investigating the cause or causes of this potentially life-threatening disease. The investigation stems from a study of 53 patients from the states of Illinois and Wisconsin who presented to the hospital with lung and gastrointestinal symptoms. A third of those patients required mechanical ventilation and one death were reported in this study. The median age was 19 years.

 

E-cigarette, or more colloquially vaping, usage especially among adolescents has increased exponentially. Recent studies from Monitoring the Future, a 44 year old study, show that the increased prevalence of vaping represents the largest increase in risky behaviors since the initiation of monitoring.  Although used as a means to transition from cigarettes, use of the nicotine still carries with it the risk of addiction.

 

Investigations into the cause of lung toxicity are ongoing, but there are several clues at this juncture. The presence of tetrahydrocannabinol (THC) usage by users and use of black market devices and flavorants appear to be the focus of current investigations. More information will be forthcoming. For now, despite the use as a means of tobacco cessation, it is wise to avoid vaping until investigators have clarified more clearly the cause or causes of lung toxicity. At the same time it is important to continue to remain tobacco-free given the heart, lung and stroke risks which are clearly present.

 

Jeff McGovern, MD

Jeffrey McGovern, MD, FCCP, FAASM

Restless Legs

Restless legs syndrome (RLS) is an almost irresistible urge to move the legs; it is distinctly bothersome and sometim ...See More


Restless Legs

 

Restless Legs and You

 

Definition

Restless legs syndrome (RLS) is an almost irresistible urge to move the legs. It is not described as painful but can be distinctly bothersome or even excruciating. The symptoms occur when the subject is resting or otherwise inactive, such as in an airplane or movie theater. Restless legs are relieved partially and only evanescently by walking or stretching.

 

Prevalence

RLS affects 5-15% of the US population. Overall, it is about twice as common in women as in men. Restless legs can occur at any age but is more frequent and often becomes more severe after the age of 45.

 

Cause

The cause of most RLS is unknown but there are some associations. Heredity predisposes toward RLS, which is familial in 25-75% of cases; nevertheless, there is no genetic test. Pregnancy also predisposes, and RLS may affect 20-45% of pregnant women.

 

RLS is also associated with folate or magnesium deficiency, diabetes, Lyme disease, and B12 deficiency.

 

Finally, restless legs is associated with kidney disease and iron deficiency. RLS may subside after kidney transplant in patients with kidney failure. Treatment with iron may improve patients whose RLS results from iron deficiency.

 

Course

RLS for which no cause has been identified can usually be treated only symptomatically, not definitively. Although there are remissions lasting days, weeks, months, or even years, such RLS may gradually worsen with age, becoming more frequent and more severe, occasionally involving the upper extremities.

 

Treatment

The most frequent drugs used to treat RLS are the anti-seizure drugs gabapentin and pregabalin or the anti-Parkinson drugs ropinirole, pramipexole, and rotigotine.

 

Non-drug therapies also contribute to the therapy of RLS. Avoiding alcohol, caffeine, and tobacco is suggested, along with the establishment of regular sleep patterns. Moderate exercise, but not just before bed, is also thought to be helpful. Additionally, a warm bath at bedtime as well as leg massage may help.

 

Of course, if symptoms are mild or infrequent, treatment may not be needed.

 

 

Thomas Falasca, DO

 

Further Information

Further information is available at

 

BRAIN

P.O. Box 5801

Bethesda, MD 20824

800-352-9424

www.ninds.nih.gov

 

National Sleep Foundation

1010 N. Glebe Road, Suite 310

Arlington, VA 22201

703-243-1697

www.sleepfoundation.org

 

Restless Legs Syndrome Foundation

3006 Bee Caves Road, Suite D206

Austin, Texas 78746

512-366-9109

www.rls.orgrls.org

 

References

Bozorg, A., & Benbadis, S. (2019, June 25). Restless Legs Syndrome. Retrieved from https://emedicine.medscape.com/article/1188327-overview

 

Restless legs syndrome fact sheet (2001). Bethesda, MD: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health.

 

 

 

 

 

 

 

 

Holiday Food Health and Hygiene Tips

No one wants a holiday dinner spoiled by a trip to the emergency room for a burn or food poisoning.  That is why ...See More


Holiday Food Health and Hygiene Tips

No one wants a holiday dinner spoiled by a trip to the emergency room for a burn or food poisoning.  That is why the Erie County Medical Society is eager to offer the following holiday food health tips in the hope that they help you enjoy your holidays to the fullest.

 

Safe Thawing

Holiday turkeys present an unusual hazard because their great size vastly increases the length of time needed for thawing.  The bacteria within the fowl were safely arrested in their multiplication while the turkey was frozen.  But the bacteria begin to multiply when any part of the bird reaches 40 degrees Fahrenheit.  The longer it takes the rest of the turkey to thaw, the more time these bacteria have to multiply to dangerous levels.  Dangerous bacterial multiplication occurs when the turkey thaws on the counter or in warm water.  The bacteria continue to multiply until the turkey reaches 140 degrees Fahrenheit in the oven.

 

So, for safe thawing begin four or five days early and thaw the turkey in the refrigerator so that it thaws without any part of the turkey reaching 40 degrees Fahrenheit.  The other choices are thawing the turkey in COLD water or in the microwave, provided that microwave oven size and absence of metal allow.

 

Safe Preparation 

Bacteria on and in the turkey cease multiplying and die when the turkey reaches 140 degrees Fahrenheit in the oven, but not the bacteria transferred from the turkey to the chef’s hands, the work surface, or to the kitchen utensils.  These continue to multiply and are transferred to subsequent foods, some of which may not require cooking.

 

Safe food preparation requires thorough washing of hands, work surfaces, and kitchen utensils immediately after working with raw poultry.

 

Safe Stuffing

Because of the large turkey size, the interior may have difficulty reaching a bacterial kill temperature of 165 degrees Fahrenheit.  Therefore, it is far better to cook stuffing outside the turkey.

 

If stuffing is cooked inside the turkey, it is imperative not to insert the stuffing until immediately before cooking and to use a properly calibrated food thermometer inserted to the center of the stuffing and consistently reading at least 165 degrees Fahrenheit. 

 

A food thermometer’s calibration can be readily checked by placing the end of the thermometer in the center of a pot of slowly and evenly boiling distilled water.  If the temperature reads between 210 and 214 degrees Fahrenheit, the thermometer is properly calibrated.  

 

Safe Cooking

The turkey should be completely thawed and then placed in an oven set to at least 325 degrees Fahrenheit.  The fowl should be breast-side up on a wire rack in a shallow roasting pan.  The inside temperature at the center of the stuffing (if present), breast, thigh, and wing should be at least 165 degrees Fahrenheit as determined by a food thermometer.  A food thermometer is essential as color and texture are not reliable indicators of thorough cooking.

 

Safe Serving  

A disposable aluminum baking pan is too weak to support a heavy holiday turkey.  It is prone to bend in the middle, spilling hot grease on the server.  Grease can attain high temperatures and cause severe burns.  A disposable aluminum baking pan is best supported by placing it in a conventional heavy gauge metal baking pan to prevent unfortunate bending and spillage.

 

The Erie County Medical Society encourages you to incorporate these tips into your holiday planning and sincerely wishes you happy holidays with safe and delicious holiday meals.

 

Thomas Falasca, DO

Enjoy this fun and informative food safety video from the Finnish Food Safety Authority!

Seasonal Flu

Influenza, or “flu,” is a highly contagious respiratory illness that occurs in seasonal epidemics.   ...See More


Seasonal Flu

What Is Flu?

Influenza, or “flu,” is a highly contagious respiratory illness that occurs in seasonal epidemics.  An episode of flu typically runs its course over several days.  Although usually just a severe nuisance, flu can sometimes result in respiratory failure and death.

 

Symptoms

An attack of influenza is usually accompanied by muscle aches, headache, fever, sore throat, red watery eyes, runny nose, and cough.  Only some of the symptoms may be present.

 

These symptoms sound like a cold, and like a cold, flu is a respiratory infection. However, influenza is caused by a different virus and is more severe.

 

Severity

Each year about 200,000 Americans are hospitalized because of flu complications. The number of deaths varies depending on the annual virus strain; but American deaths have recently ranged from 3,000 to 49,000 in a year.  While human lives are most important, it is noteworthy that even mild strains of the flu can impact the American economy by $10 billion annually in lost productivity.

 

Contagion

Influenza is typically spread by the aerosol droplets propelled in the course of a cough or sneeze.  Even people six feet from a sneeze are at increased risk of infection from these micro particles.  

 

Flu can also be spread from surfaces.  If a person coughs into their hand or sneezes into a handkerchief and then touches an object such as a doorknob or computer keyboard, that object becomes contaminated. A person who touches the object shortly afterward can be infected, usually when they transfer the virus from their hand to a mucous membrane such as the nose, mouth, or eye.

 

Because of the high level of contagion, it is important that flu patients remain home to avoid infecting co-workers.

 

Infectivity

Once a person becomes infected by the virus, it takes 1 to 4 days before they exhibit symptoms.  However, they may transmit the virus to others even before symptoms become evident. Thus it is not sufficient to avoid persons who appear to be sick.  It is important to make a habit of frequent hand washing as this can reduce both virus dissemination and acquisition.

 

Complications

Occasionally influenza does not run its normally uneventful course but instead results in complications.  Some of the most serious of these are viral pneumonia, bacterial pneumonia, respiratory failure, an inflammation of the heart (myocarditis), an inflammation of the membrane surrounding the heart (pericarditis), and multiorgan failure.

 

Vulnerability

Fatalities are most common in infants and the elderly. Thus it is important that senior citizens receive vaccination, the “flu shot.”  Vaccination is also important for pregnant women.  Pregnant females are not at risk from the flu shot and they need vaccination because they are at increased risk of complications from flu and they need to pass on their immunity to the newborn.

Others who are at increased vulnerability are those who are immunocompromised from disease or chemotherapy.

 

Pandemics

A pandemic is an epidemic that occurs over a broad area.  Four flu pandemics have occurred in the last century.  These epidemics occurred when a highly contagious and aggressive strain of the virus emerged.  

 

The infamous “Spanish flu” of 1918 killed nearly 675,000 people in the US and a possible 50 million people worldwide.  

 

The “Asian flu” of 1957 killed about 69,800 people in the US.  

 

The “Hong Kong flu” of 1968 took the lives of 33,800 people in the US.  The relatively modest number may have been largely due to the availability of antibiotics to treat secondary bacterial infections.  

 

The “swine flu” of 2009 caused between 9,000 and 18,000 deaths.  The reduced number of deaths in this epidemic may have been due to the fact that 80 million people were vaccinated.

 

Flu Vaccination Does Not Cause Flu

Vaccination against flu can be by injection or nasal spray.  The injection contains virus that is inactivated (“killed”). The nasal spray contains virus that is attenuated (“weakened”) and so altered that it can be active only at the cooler temperatures of the nose and not in the warmer temperatures of the lungs. The result is that flu vaccination does not cause the flu!

 

Vaccination Side Effects

Serious vaccination side effects are quite rare.  They are circumvented by avoiding certain flu vaccinations in specific groups of people.

 

Traditionally, flu vaccine was produced using chicken eggs and was contraindicated in persons with egg allergy.  Since 2012 a vaccine prepared in a different manner has been available for persons 18 years of age and older who are allergic to eggs.

 

An inactivated virus vaccination rather than an attenuated virus vaccination is generally appropriate for persons with weakened immune systems congenitally, from illness, or from chemotherapy.

 

In short, some type of flu vaccination should be appropriate for most individuals 6 months of age and older.

 

So If I Get Vaccinated, I Can’t Get the Flu, Right?

Not quite!  In the recent past flu vaccination has had 70% effectiveness against influenza B and 60% effectiveness against influenza A.  This is so because:

  • The US Center for Disease Control (CDC) must project in advance the virus strains of the upcoming flu season.
  • Different individuals have different capabilities of manufacturing antibodies in response to the stimulus of the vaccine.
  • It takes 1-4 days after infection for flu symptoms to emerge.  Persons can be infected before they receive the vaccination.
  • It requires 7-14 days for the body to build antibodies from the stimulus of the vaccination. Vaccinated people can be infected with flu during this time period.
  • Symptoms of flu can be simulated by other virus infections.  Flu vaccinated persons who seem to get the flu may have these other infections.

 

How Can I Prevent the Flu?

The best method of dealing with the flu is not to have it!  In order to greatly reduce chances of getting the flu, it is most important to take these precautions:

  • Practice frequent hand washing, especially after contact with objects touched by infected persons or the general public.
  • Avoid proximity to infected persons.
  • If infected, stay home and avoid contact with others. Bear in mind that you are infectious for 4-9 days after onset of symptoms.
  • Finally, present yourself for vaccination.  This is your surest way of protecting yourself from flu.  As an added benefit, remember that by getting vaccinated, you are also protecting newborns, elderly, chemotherapy patients, and others unable to fully benefit from their own vaccination.

 

Conclusion

So please stay well this season and protect yourself from flu.

 

Thomas Falasca, DO

View this fact-filled video on flu symptoms from the US Centers for Disease Control!

 

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