Regina Yavel, M.D.

Happy Groundhog Day!

Living in the Northeast, I welcome February 2nd as the halfway point in the slushy slog to spring. Rather than pine for a fast-forward button to April, I've come to appreciate winter for its unique characteristics, even though I acknowledge the momentary misery it sometimes brings (soaking wet socks and shoes from icy slush puddles come to mind). Winter may seem bleak, gray, and dormant, but the natural world is full of surprises and wonder. I took this photo of a Fragrant Wintersweet tree (below) on January 31st at a local botanical garden. These honey-scented flowers, which bloom in the depths of winter, are surprisingly fragrant and detectable even to the scarf clad nose in the bitter cold. The natural world's sense of humor does not hibernate either, as evidenced by every plucky groundhog that has tried to bite the hand of a publicity-hungry politician on February 2nd. I can recommend raptor gloves to these novice handlers, but better advice would be to stay away from marmots! On a more practical note, as there are still six weeks left of winter, it's worth reposting these tips on preventing dry winter skin.
https://www.mydoqter.com/blog/what-to-do-to-care-for-your-dry-winter-skin/

Happy Groundhog Day!

Check for Ticks!

After spending time outside doing a yard cleanup, relaxing at the beach, hiking in the woods and grass, or visiting the dog park with your best friend, don’t forget to check for ticks! Tick bites can transmit Lyme disease, the most commonly reported tick-borne disease in the United States, and other dangerous diseases. In addition to Lyme disease, the top five tick-borne diseases reported in the United States include:
Rocky Mountain Spotted Disease, considered to be the most deadly of the tick-borne diseases;
Anaplasmosis; Ehrlichiosis. and Babesiosis.

Even if you live or visit in an area where deer are not plentiful, ticks are still a concern. Mice, gray squirrels, chipmunks, other rodents, rabbits, and even bird species can host infected tick larvae and nymphs. Our dog pets can inadvertently become tick hosts if they wander in the woods, tall grass, or visit an infested dog park.

So, after you arrive inside your home, first check your clothing for ticks. Remove any ticks you find, and machine wash your clothing in hot water, followed by tumbling dry on high heat. The CDC also recommends showering within 2 hours of arriving inside, as showering may wash any unattached ticks off your body and provides an opportunity to check your body for ticks. Don’t forget to check your pet too!

You can find some helpful pointers on tick bite prevention, tick removal, and checking yourself and your pet for ticks at:

https://www.cdc.gov/ticks/avoid/on_people.html and

https://www.cdc.gov/healthypets/pdfs/publications/check-pets-for-ticks-508.pdf

(Image below used under license from shutterstock)

The term 'nonmelanoma skin cancer' is often used to refer to basal cell carcinomas and squamous cell carcinomas. However, other less common forms of nonmelanoma skin cancers include:
• 'Adnexal' carcinomas, which arise from sweat glands, sebaceous glands (oil glands), and hair follicles
• Merkel cell cancer
• Sarcomas of the skin

'Keratinocyte' carcinoma refers specifically to skin cancers that arise from skin cells (keratinocytes) in the epidermis. Basal cell carcinomas comprise approximately 80% of keratinocyte carcinomas, and squamous cell carcinomas comprise approximately 20%.

The Skin Cancer Foundation recommends that you see a dermatologist once a year for a full-body skin cancer screening. Individuals at higher risk for skin cancer may be screened more frequently. The Skin Cancer Foundation also recommends that you perform a monthly self-skin exam at home in a well-lit room.

You can find some helpful pointers on performing self-skin exams at:
https://www.skincancer.org/early-detection/self-exams/
and
https://www.aad.org/public/diseases/skin-cancer/find/check-skin

Detect skin cancer: How to perform a skin self-exam

Follow these tips from board-certified dermatologists to increase your chances of spotting skin cancer early, when it’s most treatable.

https://www.aad.org/public/diseases/skin-cancer/find/check-skin

A recent interview with Dr. Atul Gawande, Biden advisor on Covid.
https://www.fastcompany.com/90590937/atul-gawande-interview-haven-healthcare

Atul Gawande: To fix our broken healthcare system, start with primary care / Fast Company

The ex-CEO of Haven—Amazon, Berkshire Hathaway, and JP Morgan’s just-ended health venture—on what he’s learned as a surgeon, researcher, and entrepreneur.

https://www.fastcompany.com/90590937/atul-gawande-interview-haven-healthcare

Recently, psoriasis has been linked to a higher risk of heart disease. Imaging studies have confirmed the presence of increased plaque formation in the coronary arteries in patients with psoriasis. In particular, psoriasis patients have an increased risk of developing unstable types of coronary artery plaques. These plaques may rupture, leading to heart attack and stroke.

But there is good news!

There is evidence that biologic treatments for psoriasis are associated with a significant reduction in high-risk plaques in the arteries of the heart. Biologic medications (innovative medications given as injections or infusions) have been shown to suppress the inflammation that drives both psoriasis and the development of plaque formation in the arteries. Imaging tests have demonstrated a significant reduction in high-risk plaques in arteries in psoriasis patients one year after starting biologic treatment.

Platelet-rich plasma (PRP) therapy is a form of hair loss treatment that can harness and amplify the body’s unique natural growth factors to support hair growth.

The growth factors restore favorable conditions by:
1. Stimulating the proliferation of hair stem cells
2. Improving circulation to the hair follicles by stimulating the formation of new blood vessels around the hair follicles
3. Extending the growth phase cycle of the hair

Medical studies demonstrate PRP treatment:
• Increases hair count
• Increases hair density
• Increases individual hair shaft thickness
• Slows further hair thinning

Ask your dermatologist today if PRP is right for you!

Now more than ever, it's crucial to get your sleep!
Sleep deprivation at the time of vaccination has been found to attenuate antibody response to immunizations.

In one study, a group of healthy volunteers was vaccinated against influenza A on the morning following four nights of restricted sleep (1-5 AM sleep time). This group received two additional nights of sleep restriction following the vaccination. A control group of healthy volunteers whose sleep was not restricted also received the vaccine. Ten days post-vaccination, the mean antibody titers in the subjects who were immunized in a state of sleep deprivation were less than half those measured in the subjects with regular sleep times.

With a period of sleep recovery, the good news is that differences in antibody titers between the group that had been sleep-deprived and the control group was no longer significant three to four weeks post-vaccination. Nevertheless, this study points to sleep behaviors one might adhere to in the immediate period before and the first few weeks after vaccination to maximize vaccine benefits.

Spiegel K, Sheridan, JF, Van Cauter E. Effect of sleep deprivation on response to immunization. JAMA 2002;288(12);1471-1472.

As winter returns and the weather turns colder and drier, here are some tips to prevent dry winter skin, as well as why it's important to protect your nose too!
https://mydoqter.com/blog/what-to-do-to-care-for-your-dry-winter-skin/