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
September 21st, 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.

 

 

 

 

 

 

 

 

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!

 

Halloween Safety from American Academy of Pediatrics

 

Halloween is an e ...See More


Halloween Safety from American Academy of Pediatrics

 

ALL DRESSED UP:

  1. Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
  2. Consider adding reflective tape or striping to costumes and trick-or-treat bags for greater visibility.
  3. Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives. Hats should fit properly to prevent them from sliding over eyes. Makeup should be tested ahead of time on a small patch of skin to ensure there are no unpleasant surprises on the big day.
  4. When shopping for costumes, wigs and accessories look for and purchase those with a label clearly indicating they are flame resistant.
  5. If a sword, cane, or stick is a part of your child's costume, make sure it is not sharp or long. A child may be easily hurt by these accessories if he stumbles or trips.
  6. Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional. While the packaging on decorative lenses will often make claims such as "one size fits all," or "no need to see an eye specialist," obtaining decorative contact lenses without a prescription is both dangerous and illegal. This can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss.
  7. Review with children how to call 9-1-1 (or their local emergency number) if they ever have an emergency or become lost.

CARVING A NICHE: 

  1. Small children should never carve pumpkins. Children can draw a face with markers. Then parents can do the cutting.
  2. Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest. 
  3. Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and not on a porch or any path where visitors may pass close by. They should never be left unattended.

HOME SAFE HOME:

  1. To keep homes safe for visiting trick-or-treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations. 
  2. Parents should check outdoor lights and replace burned-out bulbs. 
  3. Wet leaves or snow should be swept from sidewalks and steps. 
  4. Restrain pets so they do not inadvertently jump on or bite a trick-or-treater. 

ON THE TRICK-OR-TREAT TRAIL:

  1. A parent or responsible adult should always accompany young children on their neighborhood rounds. 
  2. Obtain flashlights with fresh batteries for all children and their escorts.
  3. If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.
  4. Only go to homes with a porch light on and never enter a home or car for a treat.
  5. Because pedestrian injuries are the most common injuries to children on Halloween, remind Trick-or-Treaters:
  6. Stay in a group and communicate where they will be going. 
  7. Remember reflective tape for costumes and trick-or-treat bags.
  8. Carry a cell phone for quick communication. 
  9. Remain on well-lit streets and always use the sidewalk. 
  10. If no sidewalk is available, walk at the far edge of the roadway facing traffic. 
  11. Never cut across yards or use alleys. 
  12. Only cross the street as a group in established crosswalks (as recognized by local custom). Never cross between parked cars or out driveways.
  13. Don't assume the right of way. Motorists may have trouble seeing Trick-or-Treaters. Just because one car stops, doesn't mean others will! 
  14. Law enforcement authorities should be notified immediately of any suspicious or unlawful activity.

HEALTHY HALLOWEEN:

  1. A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats. 
  2. Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
  3. Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items. 
  4. Try to ration treats for the days and weeks following Halloween. 

©2017 American Academy of Pediatrics

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