Category Archives: Internal Medicine

Internal Medicine

The COVID ’emergency’ is over. Should I relax precautions or still … – NPR

A poster in Kolkata, India, from peak pandemic days sends a message to mask up. Now that the official COVID-19 global emergency is no longer in effect, some folks are thrilled to stop masking but others wonder if it's a good idea to keep up certain precautions. NurPhoto via Getty Images hide caption

Last Friday, the World Health Organization ended the Public Health Emergency of International Concern that it announced three years ago when the virus that causes COVID-19 became a global threat. And the Centers for Disease Control and Prevention ended its public health emergency, effective May 11.

The FAQ series published in the Goats and Soda blog was a cornerstone of NPR pandemic coverage, touching on everything from transmission via pets (possible but unlikely) to whether a glass of wine after a vaccine is advisable (seems ok). As the world enters a new phase of the pandemic, we talked to public health gurus about how to move forward since the disease appears to be here to stay even as the emergency is lifted. Dear readers, if you have questions about this new phase of the pandemic, write us at goatsandsoda@npr.org and put "FAQ" in the subject line. Please include your name and location. We'll be answering a sampling of questions in a follow-up FAQ.

So remind me, what was the purpose of the emergency state?

Thomas Bollyky, senior fellow for global health, economics and development at the Council on Foreign Relations, says that a public health emergency is "really designed to spur international cooperation around a public health event that is serious, sudden, unexpected and requires immediate attention."

And what makes this an appropriate time to end the emergency state?

Last week when the World Health Organization ended its 3-plus year Public Health Emergency of International Concern, the emergency committee advising the WHO's Director General said it was time to do so because of "the decreasing trend in COVID-19 deaths, the decline in COVID-19 related hospitalizations and intensive care unit admissions, and the high levels of population immunity to SARS-CoV-2 [the virus that causes COVID-19]."

In the U.S., the Centers for Disease Control and Prevention said the U.S. Public Health Emergency was ending because "as a nation, we now find ourselves at a different point in the pandemic with more tools and resources than ever before to better protect ourselves and our communities."

Did those agencies do a good job explaining themselves?

Well, the quotes from the CDC and WHO are clear.

But Bollyky says articulating the targets and goals for the ending the pandemic all along such as how low the case and death counts would need to be to lift mask mandates or school closures would have helped the public understand why the agencies felt that May 2023 was the right time to conclude the public health emergency. "If the public can't see progress, it will be harder to convince them next time that these emergency measures are necessary," says Bollyky.

And how big of a threat is COVID now?

The announcement that the emergency is over doesn't mean the virus been vanquished, says Dr. Wafa El-Sadr, director of the Global Health Initiative at the Mailman School of Public Health at Columbia University. It's still infecting thousands and killing thousands each week.

Then again, so are diseases like malaria and cholera.

And just as we take those diseases seriously, we should take COVID-19 seriously, say the experts.

"HIV doesn't have a public health emergency declaration, tetanus doesn't have a public health emergency declaration, and yet people stay up to date with vaccinations and treatments," says Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, "People don't need a public health emergency to take something seriously."

Nonetheless, the reassuring message from CDC and WHO is that you're less likely to catch COVID-19 because case counts have dropped due to vigilance and treatments.

"WHO now sees COVID-19 as a threat in our regular repertoire of things-trying-to-kill-us," says epidemiologist Katelyn Jetelina. a health policy epidemiologist with the Meadows Mental Health Policy Institute in Dallas, who writes the blog Your Local Epidemiologist. And the truth is that the world now has better tools and treatments for COVID than for some age-old diseases: from the readily available self-tests to vaccines and boosters to the paxlovid pill to lessen severity for higher-risk patients.

So is it ok to just blithely dismiss a case of COVID?

Even if you're an individual with no health risks and you catch the virus, there are things to worry about: just plain feeling awful is possible even if you're not high-risk. You might have to miss work. You run a risk of long COVID. And then there's the possibility you could transmit the virus to others at risk of severe COVID and death from the virus.

And what if you test positive and have risks: say, you're older, immunocompromised or have underlying health conditions such as obesity, heart disease, a compromised immune system or diabetes. Don't just figure you can beat it on your own. Reach out to your doctor right away, says Dr. Aaron Glatt, chair of medicine at Mount Sinai South Nassau in Oceanside, N.Y. "There are effective treatments available for high-risk infected individuals that are underutilized. You may be a candidate, which could reduce your possibility of progressing to severe disease."

For example, there's the COVID antiviral drug paxlovid which has been proven to help. A review of federal data in JAMA Internal Medicine found that the risk of long-term health problems, hospitalization and death after a COVID-19 infection diminishes among those who take the medication within five days after testing positive. That's according to an analysis of federal health data by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system.

So then ... is it wise to keep maybe some precautions?

Many physicians interviewed for this story tell us they still take precautions they think warranted. "Professionally, I still wear a mask for most patient care in the clinic and the hospital," says Dr. Luis Ostrosky-Zeichner, chief epidemiology officer at the Memorial Hermann Healthcare System in Dallas.

"In my personal life," he adds, "I still have A Purell dispenser in my car and carry a small bottle when I travel. I wear a mask in the airport and until the plane takes off since I'm less exposed in my own seat and [because of] the plane's ventilation system and then put it on again and wear it until I get to my hotel room. And yes, I still have tests at home and travel with a pair of them."

And while many many people are glad to doff masks forever and plunge back into the madding crowds in transportation hubs, concert arena and sports venues, others are understandably ... nervous.

If you don't have underlying conditions that put you at risk and feel uncertain about how to proceed, have an honest converation with your doctor or health-care provider, suggests Dr. Preeti Malani, a professor of medicine in the Divisions of Infectious Diseases and Geriatric Medicine at the University of Michigan. Ask how to gauge your personal risk.

Malani does believe that too much worry is not good for you: Fear of COVID or severe anxiety out of proportion to risk can lead to depression and other mental health concerns, says Malani.

So she's a champion of being realistic rather than fatalistic.

"We have the tools to mitigate and manage risk so that we can do all the things that are important to us," says Malani. She notes that people should keep in mind that masks work well especially when they are worn, if needed, and you are fully vaccinated. And it may be reassuring to have a plan for testing and treatment if needed.

So the idea is, to mask or not to mask ... it's up to me?

You are the keeper of your own health and the best authority on your own risk factor.

It is worth noting that even though masks were often deemed ineffective in the U.S. in the early days of the pandemic, global evidence shows that N-95s and KN-95s worn properly do reduce your risk of contracting COVID (not to mention the flu and other respiratory ailments). And the U.S. did eventually embrace masks.

You may still need to mask up in certain places, like health-care faciliites although rules are changing, with many hospitals and doctors offices ending the requirement for staff and patients. But that doesn't mean you have to take yours off. And if you're concerned you can ask maskless staff that interact with you to put one on. (And if you see a carelessly worn mask, you can muster up your best public-health voice and remark a mask should go above the nose.)

And ... keep getting those boosters, right? Or maybe not so necessary if it's not an emergency?

The rapid development of effective COVID vaccines around the world has been a medical marvel. There will be periodic new boosters available. But don't necessarily expect to be prodded on your cellphone one NPR reporter just got a message that his vaccine reminders will cease.

So with the emergency state over, you may have to pay attention to your own vaccine schedule rather than hearing calls from the government to go get your booster.

And public health specialists note that you shouldn't just focus on COVID when it comes to vaccines. "Learn about and stay up to date on all vaccines," says Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases. The first-ever vaccine for adults to prevent respiratory syncytial virus (RSV) is expected to be available by September in the U.S.. Then there are easonal flu shots and likely a new COVID booster. "Adults will want to talk to their doctors this fall about all the vaccines they need," he says.

Are there any surprising lessons from this emergency?

Loneliness sucks more than you can imagine. Yeah, well maybe that's not a big surprise but the pandemic reinforced the toll that a lack of social contacts can take on mental health.

Dr. Malani is the lead researcher on a January 2023 survey of more than 2,500 people ages 50 to 80 conducted by the University of Michigan Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine. The survey found that one in three people between the ages of 50 and 80 say they sometimes or often experience loneliness.

That's down from about half of older adults in June 2020, when remaining at home was advocated in order to help prevent contracting COVID-19. But it's still noteworthy, says Malani: "If anything, the pandemic has shown us just how important social interaction is for overall mental and physical health and how much more attention we need to pay to this from a clinical, policy and personal perspective."

She says that even for people at risk of severe disease from COVID-19 there are precautions to take to help avoid isolation including online conversations, meeting outdoors where risk of transmission is lower, continued masking and especially talking to your doctor to get a clear sense of your risk of severe disease.

"Some people who were treated for cancer years ago continue to worry that they are at high risk," says Malani. "A talk with your doctor can help you determine risk and precautions to help you engage with people and activities you enjoy." On a personal note, she says she masks when caring for patients but otherwise generally does not mask in meetings or even while traveling these days. "I pay attention to how I feel and am careful about not exposing anyone if I have any symptoms at all, even if mild," she says.

And when should I test for COVID in this post-emergency era?

Consider testing if you have been exposed to someone with the virus or have symptoms that could be COVID-19, especially if you fall into a high risk group, say the doctors we interviewed. And hang onto those masks. You'll want one if someone in your home tests positive so you can protect yourself and protect others if you test positive.

So can you sum it all up for me?

The end of the national emergency around COVID-19 means that there will be certain bureaucratic changes in the way COVID is handled, says Dr. Leana Wen, an emergency physician and professor of health policy and management at George Washington University. For example, she says, there will be less collection and posting of COVID data and fewer requirements for local public health departments to check in with the CDC.

But we're going to be living with COVID-19 for ... a while. Wen, who gave birth to her second child during the pandemic, says "it has become clear that this coronavirus will be with us for the foreseeable future and is an infectious disease that must be prevented, treated, and managed, like other serious conditions. The focus should shift from population-wide measures to safeguarding the most vulnerable and investing in better vaccines and treatments to help those at highest risk from severe outcomes due to COVID-19."

Editor's note: To all the medical professionals who have kindly shared their time and insights to answer questions for the coronavirus FAQ series even as many of them put themselves at risk of infection while caring for patients we offer our heartfelt gratitude.

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The COVID 'emergency' is over. Should I relax precautions or still ... - NPR

Internal Medicine

Liu Wins ASCI Emerging-Generation Award < Internal Medicine – Yale School of Medicine

Elise Liu, MD, PhD, associate research scientist in medicine (immunology) and instructor in medicine (rheumatology), was selected for an American Society for Clinical Investigation (ASCI) 2023 Emerging-Generation Award. One of 25 recipients to receive the honor, Liu was recognized at the AAP/ASCI/APSA Joint Meeting on April 22.

The award offers post-MD, pre-faculty appointment physician-scientists access to the Joint Meeting and two years of programming, with the intent of providing peer support and inspiration to help recipients stay on the path to becoming physician-scientist faculty.

It's wonderful to be recognized at this early stage in my career, Liu said. And its wonderful to have the opportunity to connect with a cohort of awardees who are in the same boatwere all trying to obtain funding and advance our careers.

Lius research focuses on the mechanisms of food allergy. She became interested in the subject when her first child, age one at the time, broke out with hives and vomited after eating peanuts. Liu was a student at Yale School of Medicine (YSM) at the time. It was scary for a parent, as you can imagine, she said.

Its wonderful to have the opportunity to connect with a cohort of awardees who are in the same boatwere all trying to obtain funding and advance our careers.

The incident led Liu to meet with allergists and learn all she could. I was surprisedand maybe disappointedto find out that we dont know much about why allergies develop and that there are limited options for treatment, she said.

After earning her MD, Liu joined the lab of Stephanie Eisenbarth, MD, PhD, associate professor adjunct, to study immunology research in food allergy, as part of the Investigative Medicine Program, which provides individualized research training for physicians that leads to a PhD degree. Under the mentorship of Eisenbarth, Liu examined the role of the antibody immunoglobulin A (IgA) in food allergy, collaborating with researchers across the country to gather patient samples.

While Liu found that IgA does not play a protective role against food allergy, she continues to examine the antibodys role in oral immunotherapy, in which small amounts of an allergen are fed to patients to build their tolerance of the food. Ultimately, Liu hopes to start her own research program.

The ASCI Emerging-Generation Award definitely motivates me to go after the goal of becoming an independent physician-scientist, she said.

The Section of Rheumatology, Allergy and Immunology is dedicated to providing care for patients with rheumatic, allergic, and immunologic disorders; educating future generations of thought leaders in the field; and conducting research into fundamental questions of autoimmunity and immunology. To learn more about their work, visit Rheumatology, Allergy & Immunology.

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Liu Wins ASCI Emerging-Generation Award < Internal Medicine - Yale School of Medicine

Internal Medicine

QC Kinetix (Summerville) Offers a Variety of Regenerative Medicine Therapies in Summerville, SC – Yahoo Finance

Summerville, SC - (NewMediaWire) - May 12, 2023 - QC Kinetix (Summerville) offers treatment interventions for chronic pain, hair loss, and musculoskeletal conditions. The biologic therapies log into the body's self-healing mechanisms to hasten recovery. When patients first arrive for a zero-obligation consultation, they are ushered into a modern treatment facility to discuss their condition and the ways regenerative treatment can help them. The medical providers at the QC Kinetix (Summerville) pain control clinic have extensive experience working with patients taken aback by shoulder pain, hip pain, wrist pain, joint pain, lower back pain, and pain due to arthritis, among other conditions.

The well-researched and clinically tested treatments administered at QC Kinetix (Summerville) are a product of medical providers who understand pain in all its facets. Their hair restoration treatment is designed to help with hair growth and is only available in a few clinics. The providers at the clinic are conversant with the top-level- care concept when providing regenerative medicine therapies. Once the patient's condition is examined and determined, the medical providers will develop a customized treatment plan that meets the patient's medical needs. The selected therapies aim to achieve the set treatment goals, which include easing pain once and for all.

The team of providers at QC Kinetix (Summerville) includes Michael Garzone, FACP, FHM, DO; Alexandra White, PA-C; and Marc Difronzo, PA-C, MMS. Garzone studied Internal Medicine at Lake Erie College of Osteopathic Medicine and has extensive experience in palliative care, hospitalist medicine, critical care medicine, and geriatrics. Long Island native Marc Difronzo holds a B.S. in Exercise Science and has served in the military as a Special Operations for 16 years. He has also had six deployments with South Carolina Army National Guard. Board-certified physician White has interests in movement and exercise and regenerative medicine.

The QC Kinetix (Summerville) pain control clinic has become a center of interest for patients seeking natural hair regrowth treatments. The hair loss treatment Summerville is ideal for clients frustrated with hair loss. During the consultation, the team will explain to the patient the different treatments and explore the most plausible strategies to regain hair follicles. The clinic's tailored hair loss treatment Summerville regimen is multifaceted and several before and after images of patients undergoing treatments have been published on the website to give patients a sneak peek of the protocol's restorative ability. The results of the treatment intervention will vary from one patient to the other depending on the underlying condition.

A tear or strain in the ankle can cause stinging pain in the area where the subtalar, talocrural, and inferior tibiofibular join together to facilitate motion. Before treatment, QC Kinetix (Summerville) doctors will look out for symptoms like bruising, swelling, and skin discoloration and perform physical examinations. Once the diagnosis is issued, the medical providers will administer regenerative therapies to neutralize pain and inflammation. A patient who has been reeling from ankle pain said, "I've been with these great people for about 2 years now and when I started I was having pain from my ankles to my hips and when I say it helps it really does it's so amazing how these injections gave me so much relief."

QC Kinetix (Summerville) medical providers have put their in-depth experience to practice by providing cost-effective regenerative therapies. The team can be contacted at (843) 303-9825. They operate from an advanced treatment facility located at 1565 Rose Dr Unit B, Summerville, SC, 29483. Additional resources are provided for medics and investors looking to invest in the QC Kinetic franchise.

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Company Name: QC Kinetix (Summerville)

Contact Person: Marc Difronzo

Phone: (843) 303-9825

Address: 1565 Rose Dr Unit B

City: Summerville

State: SC

Postal Code: 29483

Country: USA

Website: https://qckinetix.com/charleston/summerville-sc/

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Internal Medicine

Heavy drinking poses even greater risk for one in three Americans – Keck Medicine of USC

LOS ANGELES Two people regularly have a few alcoholic drinks daily. One develops liver disease. The other doesnt.

What explains the different outcomes?

The answer may lie in a condition known as metabolic syndrome, a cluster of conditions that together raise the risk of coronary heart disease, diabetes, stroke and other serious health problems. This syndrome, characterized by symptoms such as abdominal fat, high blood pressure, high cholesterol and high blood sugar, affects more than one in three Americans.

A new study from Keck Medicine of USC published in the Annals of Internal Medicine shows that heavy alcohol use may be dramatically more damaging to the liver for people with metabolic syndrome.

Our research suggests that metabolic syndrome and alcohol interact in such a way that they multiply the effect of alcohol on the liver, more than doubling the risk of advanced liver disease among heavy drinkers, said Brian P. Lee, MD, MAS, a hepatologist and liver transplant specialist with Keck Medicine who is the lead author on the study. Drinking is harmful to the liver, but especially so for this segment of the population.

In the study, heavy alcohol use was defined as two drinks (a total of 12 fluid ounces) a day for women and three drinks (a total of 18 fluid ounces) per day for men.

Lee and his colleagues were motivated to research a connection between advanced liver disease, alcohol use and metabolic syndrome after noticing that between 2009-2018, deaths from alcohol-associated liver disease surged in the United States by more than 30% while alcohol use, including heavy drinking, remained stable or declined.

During the last 20 years, the number of Americans with metabolic syndrome increased significantly. Previous research has shown that metabolic syndrome can cause liver abnormalities.

We therefore hypothesized that metabolic syndrome could be an important contributor to this unexplained surge in advanced liver disease, said Lee.

For the study, Lee and his fellow researchers used data from the National Health and Nutrition Examination Survey, which assesses the health and nutritional status of adults and children in the United States, pulling together samples representing the U.S. population 20 years or older between 1999 and 2018.

While the data revealed a slight increase in advanced liver disease with heavy alcohol use without metabolic syndrome, the greatest increase in advanced liver disease was found in those with combined heavy alcohol use and metabolic syndrome.

Lee believes that the increased risk of liver damage from drinking is a result of an increase in the amount of fat in the liver. A healthy liver contains less than five percent fat; any more than that can lead to inflammation and cirrhosis (scarring) of the liver, liver cancer and liver failure.

Both metabolic syndrome and drinking increase liver fat, and we think that the combination of the two accelerates the accumulation of fat in the liver and fuels inflammation, resulting in a greater chance of liver disease, said Lee.

He hopes the study will encourage physicians who screen and diagnose patients with metabolic syndrome to also ask about alcohol use and look for liver disease.

Our study indicates that these conditions may often coexist, and it is in patients best interest to address both issues, he said. Its also important for people with metabolic syndrome to realize they may be at an increased likelihood of advanced liver disease, and to monitor their drinking accordingly, he added.

The other authors of the study are Jennifer Dodge, MPH, assistant professor of research medicine and population and public health sciences with the Keck School of Medicine of USC; Wendy Mack, PhD, professor of population and public health sciences with the Keck School of Medicine; Adam Leventhal, PhD, professor of population and public health sciences with the Keck School of Medicine and director of the USC Institute for Addiction Science and Norah Terrault, MD, MPH, a Keck Medicine gastroenterologist and division chief of gastroenterology and liver diseases with the Keck School of Medicine.

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Heavy drinking poses even greater risk for one in three Americans - Keck Medicine of USC

Internal Medicine

M. Beverly Hosten Dorsey, M.D. Obituary – Press & Sun-Bulletin – Pressconnects

M. Beverly Hosten Dorsey, retired physician, passed away on May 9, 2023 due to gastrointestinal problems. Born April 5, 1925 in Manhattan, NY to the late Edward Rawle Hosten and Frederica Blanche Gittens Hosten. Beverly had three younger brothers who are deceased Edward Bernar Hosten, Gittens Burleigh Hosten, and Edison Rawle Borah Hosten. She spent her childhood in Bedford Stuyvesant, Brooklyn. Their father helped build the Panama Canal as a timekeeper, sold typewriters and zealously invested in the New York Stock Exchange, their mother was a seamstress.

Beverly graduated from Hunter College (Class of 44) where she received her B.A. in chemistry and the sciences. She taught grade school for a few years before entering Howard University Medical School. In the spring of 1950 when she visited Howard for her acceptance interview, Beverly Roscoe Dorsey bounded up and proclaimed, You have my name. Would you like to have lunch with me? Beverly Hosten surveyed the room filled with mostly male prospective classmates and replied, No I am going back to Brooklyn on the train. They started school in the fall, and Beverly did not give back chemistry notes she borrowed for a long time. When Beverly retrieved his notes Beverly reconsidered his lunch invitation, and they became best friends for life. The Bevs were married in 1953 and did their internship at Queens General Hospital. Beverly arrived in Binghamton as a young bride and started her residency along with her husband at Wilson Hospital in 1954.

Beverly was generous giving unconditional love and specific advice to family, patients and community. A high energy person with fierce determination to restore smiles and relief in the many venues she operated in, Beverly was a gifted healer and advocate. She was proud of her West Indian heritage and loved to reminisce about trips to Grenada, Barbados and Jamaica as well as her love of swimming in the ocean. She also traveled to China and France.

Dr. Hosten enjoyed exercising, football, track and other sports in which her husband, brothers, daughters and grandsons have been involved. Years ago, she participated in skating, skiing, and horseback riding.

Her cultural and scientific interests include current events, music, opera, theatre, and visual arts.

She retired in 1997 as a medical doctor and enjoyed her lifestyle living at St. Louis Manor. Beverly used Zoom and YouTube to maintain a very active presence at Trinity Memorial Episcopal Church and worked as a Eucharistic Minister helping the ill and homebound.

Her professional career included working as a Physician for Planned Parenthood, Laboratory Technician in Goldwater Hospital in NYC, Primary Grade School Teacher in Flushing, NY, Medical Advisor for the Broome County Home Care Committee, Medical Staff at Endicott Johnson Corporation and Private Medical Practice Internal Medicine With Dr. Beverly R. Dorsey (husband)

A dedicated community volunteer she formerly served in the following positions: United Health Service Hospitals (Board of Directors), Broome County Medical Society (Board of Directors), Council of Binghamton University (Advisor to President Louis De Fleur), Council of Binghamton University School of Education and Human Development, United Fund (forerunner of United Way), NYC Commission on Human Rights, Physicians for Planned Parenthood, Medical Advisor for Broome County Home Care Commission, the Vestry of Trinity Memorial Episcopal Church and as a Trustee for Childrens Home of Wyoming Conference (Methodist).

Her organization affiliations were: National Medical Association (Black Medical Society), American Medical Association, Medical Society of the State of New York, Broome County Medical Society, Interracial Association (forerunner of the Urban League), Broome County Urban League, NAACP of Broome County, Broome County Martin Luther King, Jr. Commission, Delta Sigma Theta Sorority, Inc. (Apalachin Alumnae Chapter), Charter Life member of Howard University Medical Alumni Association, Inc. (HUMAA)

Her service to the community was recognized with many honors, including Broome County Status of Women Council (Honoree from Delta Sigma Theta Sorority, Inc. (1984), Achievers Award from Utica Consistory of Prince Hall Masonic Affiliation (1998), Paul Harris Fellowship Distinguished Citizen Award (From Rotary in November 1999), Woman of Distinction 2000 Honoree (From Indian Hill Girl Scouts), Chairmans Recognition Award (In appreciation of service to Department of Internal Medicine at United Health Services Hospital in October 2000) and Broome County Council of Churches Honoree (2000).

Beverly is survived by her daughters, Adrienne Celeste Wheeler and Jeannine Michelle Thomas and three grandsons: Zachary Paul Thomas, William Dorsey Wheeler, and Seth Emanual Thomas, sister-in-law, Ann Denise Burt Hosten, nephews, Michael Orlando Hosten, Gregory Rawle Hosten, Terence Borah Hosten, Paul Trestand Hosten, and Joseph Santiago Hosten and a circle of devoted friends.

She will be remembered for her compassionate and caring nature, her intelligence and quick wit, her honesty and integrity, her humor and her knowing smile.

A memorial service will be held at a date to be announced at the Trinity Memorial Episcopal Church, 44 Main St. Binghamton. Those wishing to honor her memory may do so by making a gift in her name to the Howard University Medical School, 520 W Street, NW, Washington, DC 20059. The Hopler & Eschbach Funeral Home is assisting the family. Please sign her guestbook at http://www.HEFUNERALHOME.com

Posted online on May 12, 2023

Published in Press & Sun-Bulletin

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M. Beverly Hosten Dorsey, M.D. Obituary - Press & Sun-Bulletin - Pressconnects

Internal Medicine

Life in our Foothills May 2023 – Clover Acupuncture and Wellness … – Tryon Daily Bulletin

Published 2:01 pm Thursday, May 11, 2023

The history of acupuncture goes back over 3,000 years. In recent decades, its popularity has grown worldwide. The first documentation of acupuncture that described it as an organized system of diagnosis and treatment is recorded in The Yellow Emperors Classic of Internal Medicine, from 100 BC.

Clover Acupuncture and Wellness, located at 31 S. Trade St. in Tryon, stands as more proof of the growing popularity of this specific therapeutic technique of Chinese medicine. Licensed Acupuncturist Candice Behan, the owner and operator of Clover Acupuncture and Wellness, describes acupuncture as being the last resort with the best results for anyone dealing with chronic pain, migraines, and other common disorders.

Owner Candice Behan (left) and Office Manager Kelly Thompson (right).

In addition to acupuncture, the recently renovated facility offers massage, facials, and herbs used for general wellness.

Candice came to Tryon from South Florida by way of Ireland, where she lived for several years with her husband, Simon. Shes been an acupuncturist for 12 years, and is also a licensed herbalist. Candice had originally looked into opening a shop in Asheville. Her parents live in the area, and Behan began working temporarily in Tryon while getting settled. She really liked it and didnt relish commuting to Asheville daily, so in 2018 she set up shop on N. Trade St. in Tryon. Recently, she moved from one end of Trade St. to the other after purchasing and refurbishing the new location.

The building, owned by Candice Behan, was completely renovated.

I was going to an acupuncturist myself and asking a lot of questions, Behan says when asked how she got into the field. My acupuncturist suggested, I attend the local college where he was the head of the department.

Part of the ancient practice of traditional Chinese medicine, acupuncture is the practice of penetrating the skin with thin, solid, metallic needles, which are then activated through gentle and specific movements of the practitioners hands or with electrical stimulation. Practitioners use numerous acupuncture points connected by pathways or meridians. These pathways create an energy flow, qi (pronounced chee). Applying acupuncture to specific points helps to improve the flow of qi.

Clover offers many other services besides acupuncture.

A first-time visit always begins with a consultation to understand a patients specific problems or goals. At the detailed sit-down, Behan will discuss whether acupuncture is a good fit for someone who is interested in the services.

The one thing I wish more people knew about acupuncture is how much it can treat. Its a versatile medicine, says Behan. Its designed to treat many things and treat them successfully. We practice a holistic approach here. The word holistic means dealing with the whole. From this definition, we understand holistic medicine involves the wellness of the whole person.

Even Hippocrates, the father of modern medicine, took a holistic approach to treat disease, encouraged self-healing of the body. The holistic approach of Clover is highlighted by their team, that also features Licensed Esthetician Kellie Byron, Licensed Massage & Body Work Therapist Kim Engle, and Office Manager Kelly Thompson, who is likely to be the first voice many customers will hear when they call to make an appointment.

Byron provides services focused on skin care, including skin treatments, facials, makeup application and hair removal. She individually tailors to each clients needs and goals.

Engle provides massage therapy that can address various health conditions, such as high blood pressure, insomnia or heart disease, depending on the type of massage. Massage therapists typically focus on the muscles, whereas a bodyworkers primary goal is to improve the bodys skeletal structure, alignment and energy flow.

I love the experience of working with the clients and being able to come to work in such a calm relaxing environment with a wonderful boss like Candice, says Thompson.

Clover Acupuncture and Wellness also offers essential oils, Chinese herbal medicine, and CBD products.

Holistic medicine is about treating the whole body. Chinese medicine wants to know why those specific areas give a patient problems by looking at the body as a whole, adds Behan. There is almost nothing Chinese medicine cant address. If you are dealing with some kind of discomfort, you should consider trying acupuncture. We are usually the last resort when someone is dealing with chronic pain, but we have some of the best results. Chinese medicine asks questions to help solve the problem, where, what, how, and why. Acupuncture works well when no one can figure out the problem. It gives a different perspective.

Clovers recently refurbished facility offers a calm and beautiful environment, with renovations done by Greg Junge Construction. They kept the classic ceiling in the building while adding multiple examination rooms and creating a stunning decor, filled with aloe plants and natural light.

For more information on Clover Acupuncture and Wellness, visit cloveracupuncture.com. For an appointment, call (828) 817-9883. Its operating hours are 11 a.m. to 6 p.m. on Monday, 9:30 a.m. to 6 p.m. on Tuesday and Thursday and 9 a.m. to 5 p.m. on Friday.

The exterior of 31 Trade St., home of Clover Acupuncture & Wellness.

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Internal Medicine

Is It Safe to Take Allergy Medications Every Day? – Verywell Health

Key Takeaways

Warming temperatures have increased pollen concentration and prolonged allergy seasons. If you have hay fever or eye allergies from pollen exposure, you might be taking daily over-the-counter antihistamines for symptom relief.

But is it safe to be taking allergy medications every day? We asked allergy experts for their advice.

For people with year-round symptoms, taking allergy medications every day may be necessary and it's safe, according to Yul D. Ejnes, MD, MACP, a board-certified internal medicine specialist and chair of the American Board of Internal Medicine.

However, Ejnes warns against the long-term use of antihistamines with decongestantswhich are usually labeled with a D" after the brand namesuch as Benadryl-D or Claritin-D. The decongestants might not be suitable for people with high blood pressure, overactive thyroid, and heart problems in the long run.

Purvi Parikh, MD, a board-certified allergist and clinical assistant professor at NYU Grossman School of Medicine, said that medications with decongestants can actually make allergies worse over time. This is a condition known as rebound congestion, where nasal congestion becomes more severe once the medication wears off. People can also develop an addiction to decongestants, she added.

The main safety concern with antihistamines is drowsiness or sedation, as it might disrupt daily tasks such as driving, cooking, or anything that requires focus and sharp attention.

Enjes said newer antihistamines such as Claritin (loratadine), Zyrtec (cetirizine), and Allegra (fexofenadine) aren't sedative and shouldn't pose any problems.

Some studies published in 2015 linked long-term antihistamine use to an increased risk of dementia, but this isn't really a concern with the newer class of drugs, according to Anil Nanda, MD, a board-certified allergist-immunologist.

The first-generation antihistamines were anticholinergics, which can block the action of a neurotransmitterthat's responsible for involuntary muscle movements, digestion, and urination. Nanda said the 2015 studies examined the impact of these older antihistamines and the participants were mostly older patients who might have been already at risk of dementia.

However, many anticholinergics, including Benadryl, have sedative properties that can cause confusion and increase the risk of falls in older adults.

For those exposed to allergens every day, like pets or pollen, Nandas said its best to start with changes to your environment. For example, you could keep your windows closed during pollen seasons. Or, if you have a pet allergy, you can avoid sleeping with your pets or try to bathe them more often.

However, as a previous pet owner himself, Nandas said he understands how some of these changes may not be possible. Treatments like immunotherapyan "allergy shot"or allergen desensitization can help reduce or eliminate allergy symptoms over time by building tolerance in your immune system.

Nasal steroid sprays are also recommended by many allergy experts. Steroids often get a bad rap, but the steroids in nasal sprays are anti-inflammatory and they're much safer than steroid injections or pills, Nandas explained.

Allergy medicines are not a one size fits all, Nandas said. When trying to find the right treatment for your symptoms, visit an allergist or immunologist for the best recommendation tailored to your lifestyle and needs.

It's generally safe to take the newer generation of antihistamines daily if you have year-round allergy symptoms. But make sure to avoid anything that has a "D" in its brand name, which stands for decongestants. Long-term use of decongestants will worsen your allergy symptoms.

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Is It Safe to Take Allergy Medications Every Day? - Verywell Health

Internal Medicine

People on the Move: May 12 – Delaware Business Times

People on the Move is a rundown of recent hirings, promotions, appointments and other notable movements by professionals in the state. If youre interested in submitting an entry, please contact news@delawarebusinesstimes.com.

U.S. Senator Tom Carper (D-Del.) was named to the National Advisory Board for President Joe Bidens re-election campaign. The National Advisory Board is a select group of national Democratic leaders who will serve as the primary surrogates for the Democratic National Committee and Biden-Harris campaign in 2023 and 2024.

U.S. Senator Tom Carper (D-Delaware)

Im excited to join President Bidens national advisory board to stand beside my good friend Joe throughout his re-election campaign. Since they took office, President Biden and Vice President Harris have been fighting for everyday Americans and to protect our freedoms,Senator Tom Carper said in a statement. President Biden ran for the presidency in 2020 because he believed that we were in a battle for the soul of this nation and we still are. I encourage all Delawareans to join me in supporting the Biden-Harris campaign so we can all come together to help Joe and Kamala finish the job.

The stakes of this election couldnt be higher, President Joe Biden said. Our freedom and democracy are on the line. Im grateful to this group of diverse and dynamic leaders who will help us win the battle for the soul of America and finish the job for the American people.

Gawthrop Greenwood partner Carl W. Heckert has been elected secretary of the Delaware State Bar Associations Family Law Section during the esteemed organizations 100th anniversary year.

Heckert, who has more than 25 years of experiencepracticing family law in Delaware, has been a member of the Delaware State Bar Association since 1992 and will serve for the 2023-2024 section year.

Carl Heckert | PHOTO COURTESY OF GAWTHROP

Heckert is a member of theFamily Law Departmentin Gawthrop Greenwood, PCs Greater Wilmington office in Greenville, litigating and mediating divorce. In 2019, he became a Certified Family Law Mediator in Delaware following the states inaugural certification program by the Family Court of the State of Delaware as well as the Delaware State Bar Association. A certified Delaware family law mediator is a neutral third party who is charged with preserving confidentiality while helping couples resolve issues more creatively and amicably than they can in court, including custody, visitation, child support, property division and alimony.

Heckert also draws on his more than 30 years of real estate experience to settle real estate disputes during divorce proceedings. In January, he presented a seminar on the topic for Delaware family law judges and practitioners of theMelson-Arsht Inns of Court. He has also led Continuing Legal Education courses in family law matters including custody, protection from abuse and representing an unwilling minor as a guardian-ad-litem. Heckert received his law degree fromWidener University School of Lawand holds a Bachelor of Science degree from theUniversity of Delaware.

Wilmington Trust announced the addition ofSuzanne Lane as the senior relationship executive.

Lane will focus on asset managers and financial institution relationships for the loan market solutions team, employing innovative solutions to help meet individual clients goals. Throughout her 25-year career in corporate trust and banking, she has taken numerous leadership positions on multiple finance and asset management teams.

Lane is a passionate advocate about empowering women in the financial services industry and has served as a mentor for many women as they start or build their careers. Prior to joining Wilmington Trust, Lane was a relationship lead for U.S. Banks Global Platinum Corporate Trust clientele.Previously, she was Chief of Staff for Relationship Management in the Shareowner Services division of BNY Mellon. She also has held roles at KPMG, AIB, and State Street Bank.

Lane has managed large client service teams both domestically and in Europe. She holds a bachelors degree in business administration from Northeastern University, and has earned the CPA, CFA and CAIA designations.

Allen Friedland, M.D., MACP, FAAP, has been recognized with the Dema C. Daley Founders Award for his national impact as an educator, innovator and leader in internal medicine.

Allen Friedland | PHOTO COURTESY OF CHRISTIANACARE

Given by the Alliance for Academic Internal Medicine, the award honors internal medicine doctors who have greatly influenced undergraduate and graduate medical education and the development of training programs in internal medicine.

Dr. Friedland has been a tireless advocate and innovator for internal medicine, medicine-pediatrics, and residency education over two decades, said Vinay Maheshwari, M.D., MHCDS, Hugh R. Sharp Jr., Chair of Medicine and physician executive of the Medical Group at ChristianaCare. He is a mentor to countless physicians across the country and beloved by those who have had the privilege of working alongside him. What is most evident about Dr. Friedland is how much he cares about those he has taught locally and nationally all of them will forever be a part of his family. This award is a testament to a lifetime career dedicated to graduate medical education.

Friedland is ChristianaCares section chief of Medicine-Pediatrics (Med-Peds) and has served as the director of ChristianaCares combined Internal Medicine-Pediatrics residency program for 25 years. He also teaches medical students at ChristianaCare, which is a branch campus of Sidney Kimmel Medical College at Thomas Jefferson University and Philadelphia College of Osteopathic Medicine.

His accomplishments include:

Amanda Hewes, MS, education program manager at ChristianaCares Gene Editing Institute, has been named one of the 2023 Outstanding Delaware Women in STEM by Million Women Mentors, an international movement dedicated to encouraging girls and women to pursue careers in science, technology, engineering and math (STEM).

Amanda Hewes | PHOTO COURTESY OF CHRISTIANACARE

Hewes selection spotlights her dedication to engaging young people in the science of gene editing by introducing the Gene Editing Institutes CRISPR in a BoxTM educational toolkit into classrooms across Delaware and her commitment to bridging disparities in STEM education.

Im overjoyed to be honored among so many amazing women in this state, Hewes said. Its humbling to be considered and to stand alongside them. All of these women foster and lead dynamic communities of young women that inspire me every day. I hope that I can do the same by making young women in this state feel empowered through the work that I do.

Hewes joined ChristianaCares Gene Editing Institute in 2017 with a focus on expanding its CRISPR gene editing system in a cell-free environment. She was first author in a publication in Nature that established the highly innovative gene editing on a chip protocol that allowed CRISPR to edit DNA outside of the cell for the first time. This methodology enables researchers to take fragments of DNA extracted from human cells, place them in a test tube and precisely engineer multiple changes to the genetic code.

This gene editing system eventually led to the creation of the CRISPR in a Box toolkit. This innovative educational resource provides a way for students to learn about this exciting frontier of science through a hands-on exercise in which they use CRISPR gene editing to disrupt a synthetic gene within a plasmid. The simplicity of this experiment allowed for the reaction to be developed into a remarkable teaching tool that can be brought into most school laboratories containing basic laboratory equipment.

Once CRISPR in a Box was developed, Hewes recognized the potential it could have for high school and college students. She took on a new role as education program manager and expanded the Gene Editing 360 platform, which is the Gene Editing Institutes suite of educational tools for engaging students and the public.

Hewes was honored alongside 10 other women by Gov. John Carney, Lt. Gov. Bethany Hall-Long and others at the Delaware State House with the signing of a proclamation to declare March 24, 2023, as Delaware Women and Girls in STEM Day.

After 35 years of wearing Service Unlimited, Inc. (SUI) green, Safety Coordinator David Parag announced his retirement closing out a remarkable career serving the company and the people of New Castle, Delaware, and the surrounding areas.

Originally hired in the mid-1970s as an HVAC mechanic, Parag has served our customers in many different roles over three different terms. In his second term with the SUI family, Parag served as an electrician for our sister company, Electric Unlimited, Inc. (EUI), and ultimately led the company. Parag again returned to SUI as the Director of Construction Quality. He eventually added safety responsibilities to that role. Parag most recently was Safety Coordinator because of his passion for doing things the safest way rather than the fastest or easiest way.

Parag holds a Master License in both HVAC and Electrical. He has conducted countless training sessions, delivered tons of how-to documents, and mentored dozens of team members including Vice President Brian Martinenza. Parag will always be known around SUI for his oversized brain and his oversized heart because he knows virtually everything, and cares deeply about the people in his life. He enjoys being a catalyst for personal development and professional growth.

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People on the Move: May 12 - Delaware Business Times

Internal Medicine

Burnett School of Medicine at TCU Graduates Ready To Break … – Fort Worth Magazine

Ive Avila is the product of immigrants from Mexico, raised with her three siblings in Chicago. Her mother was a janitor at a school and her father worked in construction.

She studied molecular biology simply typing that is a dizzying task from Loyola University Chicago, and an MBA from Southern New Hampshire University.

On Saturday, the 32-year-old will be part of the first graduating class of the Anne Burnett Marion School of Medicine at TCU, a groundbreaking moment for all involved, including the school perched on University Drive, celebrating 150 years in 2023.

We are immensely proud of these young doctors. They will forever be a part of TCUs 150th, said Chancellor Victor J. Boschini Jr. This is a day that has been years in the making, and it is only fitting that this special class would be a part of such a celebratory moment in the life of our university.

The 52 graduates, who all placed inresidency programs, will now go out into the world and begin molding the reputation that plays such a critical role ultimately in the formation of the medical school.

Avila is going to serve an OB/GYN four-year residency at Baylor Scott and White in Temple.

I think it's a huge responsibility, honestly, Avila says, Going on to the real world, going into our residency programs as MDs, I think that's an even bigger responsibility because now programs are seeing the product of the school essentially, and, hopefully, we can show them what we've learned throughout the four years, and how our LIC [Longitudinal Integrated Clerkship] program has, I think, prepared us more so than other traditional programs, at least when it comes to patient interaction and practice.

The graduates hooding ceremony will take place at 2 p.m. on Friday at the Van Cliburn Concert Hall. Commencement ceremonies for the med school are scheduled for 9 a.m. on Saturday at Schollmaier Arena.

Briana Collins is another soon-to-be graduate.

Collins grew up in Dallas and attended Ursuline Academy before ultimately earning an undergraduate degree in kinesiology at Louisiana State University.

She will be moving to Palo Alto, California, for a three-year residency in internal medicine at Stanford Health Care. Her plan is to follow that up with a fellowship to train specifically in cardiology for another three years.

Like Avila, Collins didnt hop from undergraduate school to med school. After graduating in 2015, she took the MCAT, the standardized test for prospective med school students, but didnt get the score that I wanted. Not deterred and seeking ways to improve her candidacy, she was accepted into The University of North Texas Health Science Centers masters course of study in medical science.

She worked as an EMT and as-needed emergency technician at UT Southwestern. After graduating with the masters, she dedicated three to four months preparing for the MCAT.

I finally got the score that I was comfortable applying with after my third attempt, Collins says.

Soon, Collins will start a residency in one of the most prestigious programs in the country. More than anything, these professional degrees require incredible work and study habits, and dogged persistence. The whole concept of quitting inspires loathing.

That brings me back to Avila, who had an active young child I could hear in the background as we spoke by phone.

Quin his full name is Quentin, like Quentin Tarantino is 16 months old.

Pregnancy during medical school is not standard operating procedure, but Avila and husband Sam found out they were expecting. Avila and Sam met in Austin on a blind date, though both were working at Lone Star Circle of Care. Avila was an enrollment counselor there, and Sam is still a physician recruiter with the company.

Avila says shes Type-A personality when it comes to scheduling, not spontaneous at all.

I like things to go the way that I plan them. And clearly that did not go that way, Avila says. I did not plan to be pregnant or have a child in medical school. But my husband and I became pregnant and we actually lost our first baby. Here I was freaking out about how [pregnancy] was gonna throw everything off and finally, you accept it, you fall in love, and then you lose your baby.

Now, she had to deal with heartbreak. The couple had made plans to welcome a baby, in their home and their hearts. The experience manifested itself in the couple actually deciding to try to have a baby.

Welcome to the world, Quin.

A tight schedule remained key to handling the newcomer and her studies, plus, she had support from her family, which, by this time,had moved from Chicago to Austin, where her father operates his 23-acre ranch, specializing in sheep and goats. (A little slow cooked, oven braised cabrito would hit the spot about right now.)

As soon as I had him, my mom [Rebeca] retired, and she was like, There's no way we worked so hard to get you here collectively as a family youre going to keep going. So, shemoved in with us. She was our full-time nanny/babysitter. There's no way I could have done it without her.

There's an apothegm or there should be if there's not out there: Its difficult to get through this journey of life without good friends and family, and a bottle of something.

Well, now I'm projecting.

To the inaugural graduating class of the Burnett School of Medicine, we wish you the best. It goes without saying that lots of people will be counting on you.

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Burnett School of Medicine at TCU Graduates Ready To Break ... - Fort Worth Magazine

Internal Medicine

Internal Medicine Case Challenge: Hallucinations, Moaning, and … – Medscape Reference

Editor's Note:The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

An 88-year-old woman who has had confusion and a decline in mental status over the past 2 weeks is brought to the emergency department by her daughter. The patient's daughter reports that her mother has also had occasional hallucinations for the past week, with associated intermittent moaning. She is unable to provide a history for herself, and all history is gathered from her daughter.

Her past medical history is significant for hypertension and skin and breast cancer; she had a partial mastectomy 10 years ago. The only medication she takes daily is metoprolol for hypertension.

Forty-five days ago, the patient underwent an open reduction and internal fixation of a left femur intertrochanteric fracture. The surgery was uncomplicated, and she was discharged from the hospital to a rehabilitation facility 35 days ago. Before the fracture, the patient was independent; she lived alone and went to a bar every night with her friends. According to her daughter, she does not use tobacco or illicit drugs.

Her daughter noticed that her symptoms of confusion started 2 weeks ago and have progressively worsened. She removed the patient from the rehabilitation facility 5 days ago owing to "improper care." Her daughter also reports that her mother's baseline status is alert and oriented to person, place, time, and event. Her decline in mental status has occurred over the past 2 weeks and has worsened during the past 3 days. The daughter reports that her mother has not had chest pain, shortness of breath, nausea, vomiting, or diarrhea; however, she has had multiple episodes of abdominal pain and deep bone pain over the past 2 weeks.

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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Danny Gersowsky.Internal Medicine Case Challenge: Hallucinations, Moaning, and Confusion in an 88-Year-Old-Medscape-May10,2023.

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Internal Medicine Case Challenge: Hallucinations, Moaning, and ... - Medscape Reference