Author Archives: Trudy

Maybe Not So Safe: New Evidence On E-Cigarettes

When e-cigarettes were introduced in the U.S. in 2006, they were promoted as a safer alternative to smoking. Users inhale nicotine-infused vapor, without the mix of carcinogenic chemicals found in regular cigarettes.

E-cigarettes and vaporizers (which produce large, fluffy clouds of vapor) have gained popularity among current and former smokers, as well as those who have never smoked, including teenagers. The idea that e-cigarettes are safe is so widespread that some smokers are switching from cigarettes to e-cigarettes.

Since e-cigarettes are relatively new, there isn’t much research linking them to specific diseases. However, most doctors would probably agree that sucking clouds of nicotine-laden vapor (propylene glycol or vegetable glycerin) into your lungs is probably not a good idea.

But now, two recent studies suggest e-cigarette users risk harming their airways, suffering bacterial infections, and compromising their immune system.

Airway inflammation: In experiments with mice, researchers at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System found that mice exposed to e-cigarette vapors were more likely to suffer inflammation of their airways. They also observed that e-cigarette vapor appeared to make bacteria – including the antibiotic-resistant MRSA “superbug” ─ more dangerous. Twenty-five percent of mice infected with MRSA died after exposure to e-cigarette vapor, compared to zero mice that weren’t exposed. In fact, the vapor seemed to make bacteria thrive.

The study did not link e-cigarette vapor to specific diseases. However, scientists noted that some of the physiological changes observed in the mice are also found in the airways and blood of cigarette smokers, while other changes are found in people with cancer or inflammatory lung diseases.

Bacterial infection: In a second study, researchers at Johns Hopkins Bloomberg School of Public Health exposed mice to e-cigarette vapor and then subjected them to Streptococcus pneumoniae, bacteria responsible for pneumonia and sinusitis, or the virus for Influenza A.  Mice exposed to e-cigarette vapor were significantly more likely to develop compromised immune responses to both the virus and the bacteria, which in some cases killed the mice.

Since e-cigarettes have not been fully studied, it isn’t known what their long-term effects may be, but public officials aren’t waiting to find out. At least 38 states place restrictions on the sale of e-cigarettes to minors, and more than 100 cities have prohibited the use of e-cigarettes in public places. Also, the FDA Center for Drug Evaluation and Research has proposed regulating them as tobacco products.

More research is needed, but the two studies cited in this article do suggest that e-cigarettes are not the safe alternative to smoking people once thought they were.

Patricia Jett, M.D.Dr. Patricia Jett is a Maryland Primary Care Physicians, LLC partner and practices in MPCP’s Annapolis office. She is certified by the American Board of Family Medicine. She received her medical degree from the University of Maryland School of Medicine and completed her residency program in Family Practice at Franklin Square Hospital Center.

A New Prescription: Treating Disease with Exercise

The next time your doctor reaches for his prescription pad, don’t be surprised if he recommends exercise instead of medication.  A growing number of healthcare providers are encouraging patients to think of physical activity as their new medication.

A study published in the British Medical Journal found that exercise affects outcomes for some serious medical conditions about equally as well as prescription drugs.  For example, exercise provided better outcomes in patients rehabilitating after a stroke, and for people with coronary heart disease and pre-diabetes, exercise and drugs had about equal outcomes.

This is not to say that patients should throw their prescriptions away. Medication is necessary for the successful treatment of many conditions. However, the study supports the idea that many patients would benefit from their doctors prescribing exercise.

In general, people who are physically active tend to live longer and are at lower risk of heart disease, stroke, Type 2 diabetes, depression and some cancers, according to the Centers for Disease Control and Prevention.  And since obesity is linked to serious health problems, exercise leading to weight loss can also help reduce the risk for conditions such high blood pressure, heart disease and stroke.

This isn’t surprising.  Our bodies are meant to move, so incorporating exercise into our day allows them to work optimally. That includes our brains: physical activity improves sleep, mood, cognition and the ability to concentrate.

Exercise isn’t the answer to every health problem, but it can play an important role in the treatment and prevention of disease. Talk to your doctor about how a “prescription” for exercise can help you.

Exercise Rx for Better Health

The CDC recommends weekly exercise and strengthening activities for adults. This can include physical activities such as labor, yardwork and housework.  Also, you don’t have to do all of your exercise at once; you can spread your activity out during the week. You can even break it up into smaller chunks of time during the day, as long as you do at least 10 minutes at a time.

The following options will give you the activity levels you need for better health.

Option 1

150 minutes of moderate-intensity aerobic activity (such as brisk walking) every week

AND

Weight training/muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

Option 2

75 minutes (1 hour and 15 minutes) of vigorous-intensity aerobic activity, such as jogging or running every week

AND

Weight training/muscle-strengthening on 2 or more days a week.

WPNeverdon_HHarriett Neverdon, Family Nurse Practitioner-Certified, sees patients in MPCP’s Columbia office. She received her Bachelor of Science in Nursing degree from Towson University and her Master of Science in Nursing degree from University of Maryland School of Nursing. She is board certified by the American Association of Nurse Practitioners in Family Practice.

Zika Virus Awareness

The Maryland Departments of Health & Mental Hygiene, Agriculture, and Natural Resources have worked together to create informative Public Service announcements regarding Zika Prevention. Click on a YouTube video to watch….

Zika Skeeter Song

Zika & Your Gutters

Zika & Tarps in Your Yard

Zika & Your Yard

Zika & Your Swimming Pool

Zika & Children’s Toys

Zika & Your Drain Pipes

Important Facts About That Cough You Have

Cough is a frequent symptom seen in medical offices at this time of year. It can be a source of aggravation, frustration and anxiety for many patients. A cough falls into one of the following categories based on its duration: it can be acute, lasting less than 3 weeks; subacute, lasting from 3 to 8 weeks; or chronic, which lasts over 8 weeks.

The acute cough is mostly a result of upper respiratory tract infections and acute bronchitis. Most of the time, these are due to viruses and do not require the use of antibiotics. Fever may or may not be present and phlegm can be discolored. Pertussis, or whooping cough, is on the rise in the United States and may manifest by violent coughing and should be treated with an antibiotic. Approximately 15% of users of commonly prescribed blood pressure medications, lisinopril or zestril, may develop a cough, which usually begins within a week of beginning the medication. Treatment is stopping the offending medication and waiting 1-4 weeks for resolution, which you’ll want to coordinate with your primary care provider so you can get on an appropriate replacement medication. Lastly, pneumonia may also cause you to develop a cough. Depending on what incites coughing, therapy is supportive with cough medication, antihistamines, decongestants, antibiotics (if needed), and possible inhalers if asthma-like signs are present.

A subacute cough is most commonly a result of a prior upper respiratory infection. It can also be caused by asthma, postnasal drip, gastric acid reflux (even if heartburn is not present) or a primary lung disease. At this time, a chest X-ray should be obtained, especially for smokers or former smokers. Specific therapy is suggested depending on the cause.

Finally, chronic cough should be evaluated by requesting appropriate tests which may include sinus imaging, CAT scans, cardiac or gastroenterologic evaluations. A referral to a specialist may be needed.

If you or a loved one is suffering with a cough, particularly one that has lasted for more than 3 weeks, see your primary care provider, who can then determine an appropriate course of treatment.

 

Janice Rutkowski, M.D.Janice Rutkowski, M.D. is an MPCP partner and is certified by the American Board of Internal Medicine. She sees patients at the Arundel Mills office.