Psoriatic Arthritis

Posted on February 12, 2019 by Joann Ariola

According to the American College of Rheumatology, psoriatic arthritis is a type of inflammatory arthritis that occurs in some patients with psoriasis (is a chronic skin condition caused by an overactive immune system) and can affect the joints in the body.

It is a chronic disease that may present as mild with occasional flair ups or, in more severe cases, can cause joint damage in fingers and toes, as well as larger joints in the lower extremities, such as knees, back and sacroiliac joints in the pelvis.

The Mayo Clinic describes the symptoms of psoriatic arthritis as:

Swollen fingers and toes – Psoriatic arthritis can cause a painful, sausage-like swelling of your fingers and toes. You may also develop swelling and deformities in your hands and feet before having significant joint symptoms.
Foot pain -Psoriatic arthritis can also cause pain at the points where tendons and ligaments attach to your bones — especially at the back of your heel (Achilles tendinitis) or in the sole of your foot (plantar fasciitis).
Lower back pain -Some people develop a condition called spondylitis as a result of psoriatic arthritis. Spondylitis mainly causes inflammation of the joints between the vertebrae of your spine and in the joints between your spine and pelvis (sacroiliitis).

Psoriatic arthritis can go into remission. When in remission, the symptoms may alternate causing them to subside for a time and then reappearing in the form of painful, swollen joints.

Many people with psoriatic arthritis may first think they have rheumatoid arthritis since both diseases have similar symptoms. The only difference is that psoriatic arthritis is prevalent in patients who have psoriasis of the skin as well.

When seeing your doctor to determine whether or not you may have psoriatic arthritis your doctor may examine your joints for swelling or tenderness, check your fingernails, hands, feet and toes for pitting, flaking or other abnormalities.

Psoriatic arthritis is diagnosed by X-rays, Magnetic Resonance Imaging (MRI), testing the rheumatoid factor (RF) antibody in your blood or a joint fluid test to see if you have uric acid crystals in your joint fluid.

Since there isn’t a cure for psoriatic arthritis, healthcare professionals are focused on controlling the symptoms and thwarting permanent damage to the joints.

Some medications prescribed to treat psoriatic arthritis include:

NSAIDs – Non-steroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, and others) and naproxen sodium (Aleve).
Disease-modifying ant rheumatic drugs (DMARDs) -These drugs can slow the progression of psoriatic arthritis and save the joints and other tissues from permanent damage.
Immunosuppressants -These medications act to tame your immune system, which is out of control in psoriatic arthritis.
TNF-alpha inhibitors – Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory substance produced by your body. TNF-alpha inhibitors can help reduce pain, morning stiffness, and tender or swollen joints.

Other procedures that have been effective are steroid injections or joint replacement surgery. Steroid injections reduce inflammation rapidly and joint replacement surgery replaces the severely damaged joint with an artificial prosthesis made of metal and/or plastic.

If you are experiencing any of the symptoms of psoriatic arthritis and would like to speak with a doctor at Jamaica Hospital, call 718-206-7001 to schedule an appointment with a Rheumatology specialist.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Adenovirus Infections

Posted on January 29, 2019 by Xavia Malcolm

Adenoviruses are a group of viruses that can infect the lining of the eyes, respiratory tract, intestines, urinary tract and nervous system. Infections often result in common illnesses such as bronchitis, pink eye, diarrhea, sore throat, bladder infections or pneumonia.

Adenoviruses are highly contagious and can be spread when someone who is infected sneezes or coughs. According to the Centers for Disease Control and Prevention (CDC), adenoviruses can also spread through close personal contact (touching or shaking hands) or by “touching surfaces with the adenoviruses on it, then touching your mouth, nose, or eyes before washing your hands.” There have been cases in which adenoviruses have spread through stool or through water (for example swimming pools) but occurrences are uncommon.

The places in which adenoviruses are commonly found are daycare centers, summer camps, schools or other areas where large groups of children gather.

Anyone is at risk for contracting adenoviruses, but young children and individuals with compromised immune systems are more susceptible to infection than others. Symptoms of infection depend on the type of illness a person develops. They may include:

Fever
Coughing
Loose stools
Pain
Chills
Burning during urination

It is highly advised that medical attention is sought if symptoms persist for an extended period of time, and immediately received if they are accompanied by trouble breathing, signs of dehydration or swelling around the eyes.

There is no specific treatment for adenovirus infections; however, the risk of transmission can be reduced by taking preventative measures such as hand washing, avoiding contact with your eyes, nose and mouth with unwashed hands, staying home when sick, covering your nose and mouth when sneezing or coughing and avoiding personal contact. The CDC also advises, that you “keep adequate levels of chlorine in swimming pools to prevent outbreaks of conjunctivitis caused by adenoviruses.”

Is Taking Zinc Beneficial for Treating a Cold ?

Posted on January 16, 2019 by Andrew Rubin

Using zinc is one of the many home remedies people take when they feel like they have a common cold. Those who use it believe that it helps to shorten the duration of the cold and even lessen its symptoms.

The common cold is caused by the rhinovirus. This virus enters the body through the nasal passageway and the throat and multiplies rapidly once it is there.
The theory behind taking zinc is that it helps to prevent the virus from multiplying once it is in the body, thereby potentially shortening the duration of the cold. It also plays an important role in the body’s ability to resist infection and to help tissue repair.

The best way to take zinc is in lozenge form. It is recommended that the lozenge contain 13 to 23 milligrams of zinc and no more than four be taken per day, and not for more than four or five days. Taking too much zinc can actually suppress the immune system and can cause an upset stomach and give you a metallic taste in your mouth. While zinc is also available as a throat spray, it has side effects such as loss of the ability to smell.

Increasing the daily intake of zinc may help to prevent a cold. Some foods where zinc is found include:
• Shellfish
• Beans
• Dairy products
• Red meat
• Nuts

It is important to note that drinking coffee, tea or taking certain medications can inhibit the absorption of zinc by the intestines.

It is a good idea to speak with your physician before taking it to make sure that is safe for you. If you would like to be seen by a doctor at Jamaica Hospital Medical Center you may call 718-206-7001 to schedule an appointment.

Is The “Stress Hormone” Cortisol Causing You To Gain Weight?

Posted on January 9, 2019 by Joann Ariola

Obesity is one of the biggest health problems in the world. It can be a contributing factor in other diseases, such as diabetes, cardiovascular disease, cancer, stroke, and dementia. Overeating is often cited as the only reason people are obese. In discussions about weight gain and obesity, many people seem to think that it is purely a function of willpower.

Since what we weigh is, normally, attributed to what we eat we must ask the question:

Is over-eating the only reason a person becomes overweight?

Human behavior is driven by various biological factors like genetics, hormones, stress and neural circuits. Eating behavior, just like sleeping behavior, is driven by biological processes. Therefore, saying that behavior is a function of willpower is way too simplistic.

Studies have shown that when we are stressed or during tension filled times our body increases its production of the “stress hormone” Cortisol. The increase in Cortisol may be the culprit causing you to overeat.

According to increased levels of the stress hormone cortisol causes higher insulin levels which then cause your blood sugar to drop making you crave sugary, fatty foods. The end result of these actions can be an increase in appetite.

Here are some additional factors thought to be the leading causes of weight gain, obesity and metabolic disease that have nothing to do with willpower:

Genetics – Obesity has a strong genetic component. Offspring’s of obese parents are much more likely to become obese than offspring’s of lean parents.
Insulin – Insulin is a very important hormone that regulates energy storage, among other things. One of the functions of insulin is to tell fat cells to store fat and to hold on to the fat they already carry. When insulin levels elevate, energy is selectively stored in fat cells instead of being available for use.
Medications – Certain medications can cause weight gain as a side effect. Some examples include diabetes medication, antidepressants and antipsychotics. These medications don’t cause a “willpower deficiency,” they alter the function of the body and brain, making it selectively store fat instead of burning it.

Leptin –This hormone is produced by the fat cells and is supposed to send signals to the hypothalamus (the part of our brain that controls food intake) that we are full and need to stop eating. The problem for some is their leptin isn’t working as it should because the brain becomes resistant to it. This is called leptin resistance and is believed to be a leading factor in the pathogenesis of obesity.
Thyroid Disease – Thyroid hormone regulates our metabolism. Too little hormone slows the metabolism and often causes weight gain.
Cushing syndrome – Occurs when your body is exposed to high levels of the hormone cortisol for a long time. Cushing syndrome, sometimes called hypercortisolism, may be caused by the use of oral corticosteroid medication. The condition can also occur when your body makes too much cortisol on its own.

A doctor can determine if any of these conditions or treatments is responsible for your obesity. If you would like to see a physician, please contact the Jamaica Hospital Medical Center’s Ambulatory Care Center to schedule an appointment. 718-206-7001.

Is Having An Annual Physical Exam Important ?

Posted on January 3, 2019 by Andrew Rubin

It’s the beginning of a new year which is a perfect time to make a promise to take bettercare of yourself. What better way to do this than by scheduling an appointment for a regular medical check-up. Even if you feel fine, it is a good idea to see your medical doctor to ensure that you don’t have any underlying health issues. The American Medical Association is now recommending that physical exams be performed once every five years for people between 18 and 40 years of age and every three years after the age of 40, as long as there are no chronic illnesses that require more frequent check-ups. After the age of 55, an annual exam is probably a good idea.

There are many reasons that having a physical exam is something that everyone should make time to do. These include:

• Prevention of illnesses
• Monitoring the risk of chronic disease
• Identify illnesses that don’t have symptoms
• Monitoring your weight, blood pressure, heart rate, and basic body chemistry
• Adjusting your lifestyle to best suit your rage
• Keeping an ongoing relationship with your physician

If you would like to schedule an appointment with a physician at Jamaica Hospital Medical Center, please call 718-206-7001.

What is Ulcerative Colitis?

Posted on December 28, 2018 by Michael Hinck

Ulcerative colitis (UC) is a chronic bowel disease that affects the large intestine, or colon. People with UC experience inflammation of the colon, which is typically marked by swelling and irritation that eventually leads to the development of ulcers (open sores) that produce blood, pus, and mucus. There is currently no cure for UC so those with the disease usually have symptom flare-ups off and on for life.

Ulcerative colitis occurs when the immune mistakenly identifies food, good gut bacteria, and the cells that line your colon as intruders. When this happens, the white blood cells that usually protect us, attack the lining of our colon instead, which causes inflammation and ulcers.

While doctors don’t know definitively what causes UC, some believe that both genetics and environmental factors may play a role in the development of the disease for some. While other factors such as food and stress don’t cause UC, they can trigger a flare-up of symptoms.

The main symptom of u ulcerative colitis is bloody diarrhea. Other problems may include:

Crampy belly pain
Sudden urges to empty your colon right away
Lack of appetite
Weight loss
Feeling tired
Fever
Dehydration
Feeling like you haven’t completely emptied your colon after you use the bathroom
Not being able to hold your stools in

Your doctor will use different tests to determine if you have UC or another type of gut disease. Tests typically include stool and blood samples, x-rays, or a flexible sigmoidoscopy or colonoscopy where tubes containing cameras are used to view the inside of the colon and take a biopsy of its lining.

If UC is confirmed, your doctor will work with you to address your symptoms and prevent future flare-ups. This may include altering your diet and prescribing certain medications to reduce inflammation and stop your immune system from attacking your colon. In severe cases, a surgical procedure to remove your colon (colectomy) may be required.

If you are experiencing symptoms of colitis, you should schedule an appointment with your doctor. If you do not have one, Jamaica Hospital has qualified physicians that can diagnose and help you manage this condition. To make an appointment, please call 718-206-7001.

Gout

Posted on October 23, 2018 by Xavia Malcolm

Gout is a common form of arthritis that is characterized by attacks of pain, swelling, stiffness, redness or tenderness in the joints. These attacks or flares typically affect one joint at a time. They can occur suddenly and return over time.

Gout is caused by an accumulation of urate crystals in the joint. Urate crystals form when there are high levels of uric acid in your blood. Uric acid is produced when your body breaks down purines; substances that are found naturally in our bodies and in foods such as steak, seafood and organ meats. Alcoholic beverages and drinks sweetened with fructose (fruit sugar) are known to promote higher levels of uric acid in the body.

Some people are more likely to develop gout than others. Factors that increase your risk include:

Being obese; If you are overweight your body produces more uric acid and your kidneys may not be able to properly eliminate excessive amounts
Having a diet that is rich in purines, this includes seafood, red meat, organ meat, or beverages sweetened with fructose
Consuming excessive amounts of alcohol
Having certain health conditions such as hypertension, diabetes, heart and kidney disease
Using certain medications such as diuretics or low-dose aspirin

Men are more at risk of developing gout than women; this is because women tend to produce lower levels of uric acid. Men are also more likely to develop gout at an earlier age than women. In men, symptoms may occur as early as the age of 30, and in women after menopause.

There are a few things you can do to reduce your risk for gout or prevent future attacks, they include:

Drinking plenty of water
Limiting your intake of seafood and meat
Limiting or avoiding alcohol
Maintaining a healthy weight

If you are experiencing symptoms of gout, or believe that you may be at risk, make an appointment to see a physician. Your doctor may order a series of test or assess your current state of health to receive a diagnosis or to determine if you are at risk.

Stuttering

Posted on October 22, 2018 by Jamaica Hospital Medical Center

Stuttering, sometimes called stammering or dysfluency is a disruption in the normal patterns of speech. It can take many forms, such as:

• Repeating a sound or a syllable, especially at the beginning of the word, such as “li- li- like.”
• Prolongation of a sound such as “ssssss”
• Complete stoppage of speech or the omission of a sound.
• Repeated interruption of speech with sounds such as “uh” or “um.”

Stuttering can begin at any age, but it’s most common among children who are learning to form words into sentences. Boys are more likely than girls to stutter.

Approximately one out of every 20 children will develop stuttering that lasts for more than six months, but this does not necessarily mean that stuttering is going to be a lifelong problem. Knowing what to look for and responding appropriately to your child’s stuttering will go a long way toward preventing it from becoming a more long-term or even permanent condition.

Why does stuttering begin? At one time many people thought that stuttering was the result of either physical or emotional trauma. While there are rare instances of stuttering following traumatic events, this is not the typical factor when determining why stuttering begins. Instead, experts point to other factors that contribute to stuttering:

• Family History – According to research, 60% of all stutterers have someone in the family who also stutters.
• Child Development. – Children who have other language and speech problems are more likely to stutter than children who don’t.
• Neurophysiology – Which part of the brain processes language can contribute in identifying why some children stutter
• Family Dynamics – Some children’s stuttering has been attributed to high family expectations and a fast-paced lifestyle.

Talk to your doctor if you are concerned about your child’s stuttering. Your doctor may refer you to a specialist known as a speech-language pathologist (SLP) who can evaluate your child and determine whether or not there is a risk of a long-term problem. In most cases, treatment primarily focuses on training and working with the parents to develop techniques to help the child cope with and get beyond his or her stuttering.

Parents of children who stutter can also help by creating a relaxing atmosphere at home that encourages speech, even if a stutter is present. Some tips include:

• Create opportunities for talking that are relaxed, fun, and enjoyable.
• When conversing with your child, try to create an environment with limiting distractions, such as the presence of television.
• Don’t be critical of your child’s speech or insist on precise or correct speech. Don’t correct his speech, or complete his sentences.
• Don’t put pressure on your child to verbally interact with others when stuttering becomes a problem.
• Listen attentively to what your child is saying, maintaining normal eye contact without displaying signs of impatience or frustration.
• Model a slow, relaxed way of speaking to help your child slow down his own speech.
• Don’t be afraid to talk with your child about stuttering and answer questions. Explain that disruptions in speech are common.

When is the Best Time to Get a Flu Vaccine ?

Posted on October 2, 2018 by Andrew Rubin

Flu season can start in September and run until May. Even before the summer is over, pharmacies start advertising that the flu vaccine is available. While many people believe that the best time to get a flu vaccine is as soon as possible, getting it in October probably is the best option. Some research has shown that the effects of the vaccine start to wear off after six months so we want to make sure we are well protected when the height of the flu season is upon us.

Every year the flu vaccine is different, manufactured with the hope that it will be effective against the prevalent strain expected for that year. It is estimated that it takes approximately two weeks for the vaccine to become fully effective, so being covered early is important. Everyone who is going to be vaccinated wants to be prepared before the peak of the flu season which runs from December to late March. If you would to schedule an appointment for a flu vaccine in the Ambulatory Care Center please call 718-206-7001.

Hemorrhoids

Posted on September 25, 2018 by Xavia Malcolm

Hemorrhoids often referred to as piles, are swollen veins located in the lower part of your rectum or around the anus. They are very common; in fact, nearly three out of four adults will get hemorrhoids in their lifetime.

The causes of hemorrhoids vary, they can result from increased pressure on the veins due to pregnancy, straining during bowel movements, sitting for long periods of time on the toilet or being overweight.

Hemorrhoids are sometimes symptomless, so it is common for people to have them and be unaware. If symptoms do present, they may include:

Itching, pain or discomfort around the anus
Swelling around the anus
Painless bleeding during a bowel movement
Lumps near the anus

The symptoms of hemorrhoids are rarely severe; there are several remedies or over-the-counter medications you can try to get some relief. Treatments you can try at home include:

Non-prescription creams or wipes
Ice packs
Sitz baths
Oral pain relievers
Sitting on cushions or other soft surfaces

If symptoms persist for more than one week or if you have bleeding of the rectum, make an appointment to see your doctor right away. Your doctor can diagnose hemorrhoids by assessing your family history and conducting a physical exam. If further medical treatment is required your doctor may recommend minimally invasive procedures such as rubber band ligation or sclerotherapy (injection) to shrink the hemorrhoids or coagulation to harden and shrivel the hemorrhoids. If these procedures are unsuccessful, surgical procedures such as a hemorrhoidectomy or hemorrhoid stapling may be necessary.