ASHLEY MALTZ, MD
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Study: Airport Scans Pose Minimal Health Risk

3/29/2011

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Here's an interesting study that just came out regarding the radiation recieved from airport scanners. Per Physician's Watch (online physician newsletter):

"The backscatter x-ray scanners that were recently installed at U.S. airports pose 'no significant threat of radiation,' authors conclude in a special article in the Archives of Internal Medicine.

While the full-body scanners do emit ionizing radiation, the authors note that it would take 50 scans to get the same amount of radiation as one dental x-ray, and 1000 scans for the same amount of radiation as a chest x-ray.

For 1 million frequent flyers who make 10 trips weekly for a year, the backscatter scans could contribute four additional cancers. Meanwhile, radiation from cosmic rays received while flying would contribute 600 cancers.

The authors conclude: 'Based on what is known about the scanners, passengers should not fear going through the scans for health reasons, as the risks are truly trivial.'"

Archives of Internal Medicine
article
 (Free PDF)

What's the bottom line? The jury is still out on whether on not these scanners are harmful. Keep in mind that this study used ESTIMATED data collected from the government, not independent measured data (ie, a non-governemental agency goes out and actually measures the exact radiation levels in and around the machines), as pointed out to me by a friend in Science Policy (Thanks Jeremy!). It will be interesting to see the long term (ie, after years and years) studies on these devices. Another friend from med school pointed out that the radiation estimates are actually calculated per unit area of skin (epidermis) but not for the entire body, meaning that if the skin is the only body part exposed to the radiation, skin cancers are a possibility.

So, flyer beware. I'm going for the pat-down.

All the best,
Dr. M
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Alcohol decreases Alzheimer's risk???

3/22/2011

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Here's a study many of you will love to hear about! Researchers in Germany recently published a study in the March 2nd issue of Age and Aging suggesting that a daily drink or two may help protect our brains from Alzheimer's disease and/or other forms of dementia! In the study, the drinking habits of more than 3,300 older patients of German primary care doctors were analyzed over 3 years and those that drank a light to moderate amount of alcohol were less likely to develop dementia and Alzheimers! This is very interesting news for our rapidly aging population. As many of you know, the Baby Boomer generation is coming of age and a dramatic age shift is occurring in the U.S.

Now don't all rush out to the bars and start pounding away at drinks. (Although if I was a bar owner, I may use this study to entice people to come in on a regular basis). The authors emphasized "light to moderate" consumption of alcohol. This generally means no more than 1 drink for women per day and no more than 2 drinks for men per day. This emphasis is likely due to the increased risk of cancer (mostly breast) and weight gain caused by higher rates of alcohol consumption. There are many other health problems with drinking heavily, as you all are aware of.

Now I know that many of you are thinking, "Hmm, does it matter what TYPE of alcohol I drink?". According to a study I recently read, it does NOT! Red wine is ideal as it has extra antioxidants from its rich tannins, however, white wine and other distilled alcohols provide the same health effects as the red stuff (assuming they're being drunk at light to moderate levels).

So, in honor of a delayed St. Patrick's Day greeting...Slainte!
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March Awareness Madness!

3/21/2011

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Hey everyone,

In my busy-ness I have failed to inform you of some key awareness months this month. For one, March is National Nutrition Month - so eat your fruits and veggies (at least 5 a day)!! March is also National Colorectal Cancer Month. This is basically to bring awareness to colorectal cancer PREVENTION methods (ie, colonoscopies starting at the age of 50)...so PLEASE GO GET YOUR COLONOSCOPY if you are 50 years old and haven't done so already!!! It could save your life!
 
Colonoscopies are a PROVEN method of finding colorectal cancers early, and therefore dramatically decrease your risk of dying from this type of cancer. The actual procedure is generally safe and comes with minimal discomfort (although you will be given sedatives so you won't even be aware of what's going on). The preparation for the test is actually the worst part, so you will be tied to your bathroom overnight. But, that's it! And...now colonoscopies are 100% covered by all national health insurance companies and Medicare! So...NO DEDUCTIBLE IS NECESSARY! Amazing!

March is also Brain Injury (BI) Awareness Month, a super important event! In the U.S. it is calculated that a brain injury occurs every 15 seconds. Brian injuries are not really on the radar for most people in the world, however, these frequent events are often extremely devastating and debilitating (physically, emotionally and financially) . In the best of forms (a concussion), brain injuries take minutes to hours to recover. But in the worst of forms, brain injuries can be fatal. Most often, a BI takes months of rehab to recover from and often leaves residual effects, like difficulty walking, talking, driving, reading, etc. They also are extremely expensive to treat!!

So, be safe on the roads, always wear a helmet when riding bicycles and motorcycles and truly be aware that we are all susceptible to these types of injuries. Our brains are one of our most precious resources! Protect it!!

March also happens to be Poison Prevention Month; another key awareness event. Posionings occur every day, whether it be from drinking too much alcohol (alcohol posioning), overdosing on acetaminophen, ie, Tylenol (VERY COMMON AND CAN BE FATAL!) or an accidental posioning by a child (the worst kind). These types of injuries can be prevented quite easily by limiting alcohol and drug ingestion (including both prescription and over-the-counter drugs -Tylenol, cough mediciation, etc) and by storing household cleaning & maintenance supplies as well asmedicines out of the reach of children.

And finally, March is Save Your Vision Month and Workplace Eye Wellness Month, something we tend to take for granted. Make sure your work place is ergonimically designed for optimal eye health. Wear glasses (if needed) to prevent eye strain and take frequent breaks from staring at the computer/TV screen. Also, pay a visit to your local optometrist/opthalmologist (if needed) about once a year (or more frequently if you have certain eye conditions, such as glaucoma, and diabetic retinopathy) to update your prescriptions.

I hope this short summary gives you an update on the awareness events going on this month. April is sure to be filled with even more events/activities. As is often said, "an ounce of prevention beats a pound of cure".

Till next time, stay safe!!!

Dr. M
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Factors during adolescence may contribute to breast cancer risk later on...

3/8/2011

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Hot off the presses of the American Institute for Cancer Research (and excerpted from ScienceNow), it looks like researchers are uncovering some of the mysteries behind environmental influences on breast cancer risk in women. Read on for further details.

'Evidence pointing to adolescence as a vulnerable period for life-long breast health stems from both animal and human observational studies. During puberty, the structure of the breast changes as a network of branching ducts develops. Cells are dividing at a quicker pace and any carcinogen that cells are exposed to puts them at greater risk of essentially making a mistake copying the DNA from parent to daughter cell.

"Some of these changes occur and are latent for several decades, waiting for a second hit, for something else to go wrong that triggers breast cancer," says Lindsay Frazier, MD, a pediatric oncologist at Dana-Farber Cancer Institute who is currently conducting an AICR-supported study related to adolescents' diets and risk of breast cancer. "It’s possible [during this time] there are ways nutrition protects the cell from acquiring a genetic mistake, or likewise it could be more vulnerable to potential carcinogens in the diet."

Diet and Drinking
In studies on adolescent diet and later breast cancer, alcohol is one factor that has consistently linked to increased risk. Studies have produced conflicting findings for many other exposures, including vitamin D, milk, types of fat and vitamin E.

The challenge in replicating study findings may have a lot to do with human fallibility. The majority of studies investigating adolescent lifestyle habits ask women to recall their weight, physical activity and diet from decades earlier, a challenge to remember correctly. Unknowingly, recall bias may also play a factor. In several studies, when women diagnosed with breast cancer recalled their diet, the findings differed from women who were cancer-free. It’s possible that the cancer survivors were falsely recalling factors they thought might explain their disease.

In her research, Frazier is removing these possible measurement errors by using data from the Growing Up Today Study (GUTS), a group of approximately 9,000 girls who were ages 9-14 when the study began 13 years ago. (GUTS participants are the children of Nurses Health Study II participants.) The AICR-funded study is focusing on fiber and vitamin D; examining their link to types of benign breast disease (BBD) linked to increased risk of breast cancer.

Soy at Early Ages

Some of the earliest evidence suggesting a young girl’s diet may play a role in future breast cancer risk relates to soy. Researchers have long observed that Asian women, who eat soy as part of their standard diet, have a significantly lower breast cancer risk than Caucasian women. Yet when Asian women move to the West, their daughters’ risk becomes similar to that of Caucasian women.

After numerous laboratory studies and her recent review of the literature, Leena A. Hilakivi-Clarke, PhD, says the evidence shows that soy protects against breast cancer, but only when women were exposed to soy at young ages. A Professor of Oncology at Georgetown University Medical Center, Hilakivi-Clarke’s animal studies have found that soy’s genistein leads to several long-lasting changes, including activating a tumor suppressor gene and decreasing the estrogen receptor’s response to estrogen.

"There are so many different changes caused by soy and genistein; right now we don’t know which of these might be the critical ones. It’s likely multiple pathways."

The Puzzle of Body Fat Protection

Among adults, clear evidence shows that excess body fat increases the risk of post-menopausal breast cancer. Yet when it comes to body fatness of girls and adolescents, a growing body of evidence suggests the opposite.

In one of the larger studies, almost 200,000 participants who recalled their body fatness at young ages were tracked for 16 years. The study found that body fatness at young ages overall decreased later breast cancer risk; the greatest decrease in risk was observed for adolescent body fat. As body fatness increased, breast cancer risk declined. And the link was unaffected by adult weight.

Exactly how excess adolescent body fat may protect against breast cancer is not known. The next goal is to understand what is driving the association in order to focus on prevention, said Heather J. Baer, ScD, Instructor in Epidemiology at the Harvard School of Public Health and lead author of the study.

"This study is part of a bigger picture, looking at cancer risk over the life course…. Now we know there are a number of factors at different stages of life that could impact breast cancer risk many years later.'

Source - AICR Feb 23 newsletter. Original source excerpted from ScienceNow. 

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Serena Williams hospitalized for pulmonary embolism. Guess what...this may have been prevented!

3/3/2011

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Serena Williams was just hospitalized for a condition known as a pulmonary embolism (PE), a blood clot that likely formed in her leg and traveled to her lung. It appears that Serena will be fine, however, this headline affords the medical community some free face time with the topic of blood clots. Unfortunately, PE's are pretty common and can be deadly, however, you'll be happy to know that PE's can, for the most part, be prevented. Here's how:

For one...get active! A sedentary lifestyle can cause the build up of turbulence in the large veins in your legs, leading to thrombus (clot) formation. If you've recently had surgery, you should be prescribed blood thinning medications and/or compression stockings to prevent these clots during your recovery.

Two...lose weight! Obesity in and of itself is a risk factor for PE. This is thought to occur due to pro-inflammatory factors, including higher estrogen levels, produced by fat cells. 

Three...Move around and drink LOTS of fluids when traveling long distances!  We all know how cramped airplanes are these days. It seems like airlines are trying to pack more and more people into the same amount of space! However, moving around is essential the airplane cabin is essential to preventing PE's. If you are truly stuck in your seat and can't get up, do calf flexing muscles at various intervals at your seat. This gets the blood pumping in and back out of your legs, staving off accumulation and clot formation. Drinking lots of fluids also keeps your blood nice and flushed allowing it to stay less sludgy and relatively "thinned out". 

Four...NEVER SMOKE WHILE ON BIRTH CONTROL PILLS!!!!  This is an absolute!!!!!!!! It is a well known fact that the combination of smoking cigarettes and being on birth control pills dramatically increases your risk of forming blood clots...DON'T DO IT! In fact, why would you smoke anyway...it's NOT attractive! Contact your doctor or health professional about ways to quit smoking. Most insurance companies cover nicotine replacement patches, gums and some even cover oral medications such as Chantix and Zyban. Make this a priority!

Five...be aware that certain genetic disorders (Protein C or S deficiencies, prothrombin/thrombin gene mutations), auto-immune disorders (such as certain variants of Lupus), all types of cancer and even pregnancy, lead to an increased chance of clotting. Therefore, if you happen to present with a deep vein thrombosis (DVT) or PE at some point, you WILL be checked for these conditions. If you have one of these conditions, talk with your doctor or health professional about ways to minimize your risk.

Always remember, an ounce of prevention beats a pound of cure!



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    Dr. Maltz earned a Medical Degree and Master in Public Health from the University of Texas Medical Branch (UTMB) in Galveston, TX. She completed a combined Internal and Preventive Medicine Residency at UTMB in June, 2011. She then completed a 2-year Integrative Medicine Fellowship at Stamford Hospital in Stamford, CT, during which she simultaneously underwent an intensive 1000-hour curriculum created by The University of Arizona Integrative Medicine Program founded by Dr. Andrew Weil.  

    Dr. Maltz's specific interests include helping her patients and populations improve their health through lifestyle interventions including, but not limited to, natural pain relief, nutrition, mind-body techniques and decreasing environmental exposures. She spent the last year of her four-year medical residency participating in health policy, cancer prevention and environmental health rotations and enjoys guiding people through the overwhelming amount of health information available on the web.

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