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IN THIS ISSUE Treatment can help congestive heart failure page 10 Be smart in protecting kids from sunburn page 2 HEALTHWATCH THWA North Georgia’s Health & Prevention Magazine Autoimmune disorders responsible for more than 100 diseases page 17 FEATURING Pages 12-13

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HealthWatch April 2012

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  • IN THIS ISSUETreatment can help congestive heart failurepage 10

    Be smart in protecting kids from sunburnpage 2

    HEALTHWATCHHEALTHWA

    North Georgias Health & Prevention Magazine

    Autoimmune disorders responsible for more than 100 diseasespage 17

    FEATURING

    Pages 12-13

  • Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    By Savannah [email protected]

    Long summer days give kids more time for outdoor fun and more time for sun exposure.

    Without proper protection, ex-posing the skin to sunlight can cause damage and increase the risk of developing skin cancer.

    But navigating the sunscreen aisle can be a little tricky. There are sunscreens with an SPF of 15, 30, 100, broad spectrum, and the list goes on and on.

    Its very confusing for peo-ple. They think if they buy the highest one theyre getting the best protection, Haley Wil-son, a physician assistant at The Longstreet Clinic pediat-rics said. You want a broad spectrum because it protects against UVA and UVB rays.

    Wilson advises parents do a patch test on the inside of their childs arm before using a new sunscreen. Many kids have sen-sitive skin which could cause them to have an allergic reac-tion to some sunscreens.

    She said children under 6 months should only have sun-screen applied to small areas of their bodies and special pre-cautions should be taken to as-sure they dont get a sunburn.

    They shouldnt be out on the beach or at ball games without being completely covered, Wilson said.

    One of the most common mis-takes parents make when ap-plying sunscreen is forgetting about the scalp.

    Wilson recommends wearing a hat, sunglasses, shirt and sun-screen when outside for a pro-longed period.

    A typical sunburn doesnt blis-ter but leaves the skin hot and red. Wilson said the best course of action for a typical sunburn is to keep the burned skin cool and take an over-the-counter pain reliever.

    There are a number of topi-cal sprays that can help cool and numb the area so the burn isnt as uncomfortable.

    Wilson warns that these

    sprays can cause a burning sen-sation on some children so its a good idea to do a patch test on a small area and wait half an hour.

    If it doesnt cause discomfort then go ahead and apply to the entire area, Wilson said.

    Sometimes a sunburn will blister. When this happens it means the burn is a second-ary burn and a doctor can help

    prevent scarring from the blis-ters.

    Its concerning. But its not life threatening, Wilson said.

    Wilson said people should re-member that its important to be outdoors. Outdoor play is a great way to keep children ac-tive and healthy.

    Dont stay inside out of the sun, just use good safety pre-cautions, Wilson said.

    Besmartinprotectingkidsfromsunburn

    Montyce Scott puts sunscreen on her daughter Cara as they prepare for a day on the lake in this Times file photo.

  • Sunday, April 29, 2012 gainesvilletimes comThe Times, Gainesville, Georgia |

    By Savannah [email protected]

    Sometimes blurry vision can in-dicate nothing more serious than eye strain or dryness, but if youre seeing flashes of light or spots the problem may be more severe.

    While eye drops should take care of most cases of dryness, other symptoms like flashes of light or floaters could signal a more press-ing situation.

    We see a lot of spots and float-ers. That could be anything as sim-ple as a vitreous floater to a retinal tear, which could lead to a retinal detachment, said Dr. Jack Chap-man, an opthalmologist at Gaines-ville Eye Associates.

    The eye is filled with a clear gel called the vitreous humor. As people age, floaters form in the

    eye and cast shadows on the retina that cause spots in vision. The vit-reous can also start to liquefy as it ages, which can tug at the retina and cause a flash of light and could result in a tear of the retina.

    A torn retina can cause perma-nent blindness so its important to see a doctor if you notice a flash of light in vision.

    Chapman said losing vision can be a scary situation but doctors can correct a number of problems as long as they are caught in time.

    Eye strain is a common com-plaint, especially among those who work in front of a computer screen.

    Most of the time, when people describe strain its usually dry-ness. When they look at computer screens they tend not to blink as much and their eyes dry out, said

    Dr. Chirag Parikh, director of glau-coma at North Georgia Eye Clinic and Laser Center.

    Parikh suggested taking the time to rest the eyes and using over-the-counter artificial tears to help re-lieve dryness.

    If you take care of it yourself and you use artificial tears three to four times a day then youre prob-ably good to go, Parikh said.

    But if youre experiencing changes in vision or pain, its time to see a doctor.

    If you read a certain book and you know youve been able to read it but now you cant. Thats a bad sign, Parikh said.

    Many times the problem is as simple as needing a pair of pre-scription glasses. But Parikh said there is no way to know for sure whats going on without an eye

    exam.Experts recommend young peo-

    ple get their eyes checked about once every two to three years, older people more often depend-ing on their medical history.

    Eye doctors have been known to diagnose diseases through an eye exam.

    They say its the windows to a soul but it tells you the health of a persons body, Parikh said.

    Parikh said hes diagnosed pa-tients with lupus, brain tumors, multiple sclerosis and diabetes.

    Diabetes poses a certain risk to vision because the disease can cause blood vessels in the eye to bleed and cause blindness. Be-cause of the increased risks, the American Diabetic Association re-quires diabetics to have their eyes checked yearly

    Blurryvisioncouldsignalproblems

  • By Eryn BrownLos Angeles Times

    Researchers have found a way to classify breast cancer tumors into 10 distinct categories rang-ing from very treatable to ex-tremely aggressive, a major step on the way to the long-sought goal of precisely targeting therapies for patients.

    The new categories, described in a study released Wednesday, should help scientists devise fresh approaches to treat some of the cancers and could spare many women the risks and pain of un-necessarily toxic treatments, on-cologists said.

    If you belong to one group youll need one therapy, and if youre in another youll need an-other, said Dr. Carlos Caldas, a breast cancer geneticist at the University of Cambridge who helped oversee the research. For some women, he added, tu-mor typing might indicate that traditional chemotherapy isnt warranted at all.

    A lot of women are being over-treated, he said. Can we spare them that?

    The study, published by the journal Nature, is the first of many expected in the coming months that will use genetic clues in breast cancer tumors to help refine categories of the disease, which strikes one in eight women in the U.S.

    Doctors like to say that breast cancer is not a single disease, but a range of them. But because they dont completely under-stand which therapies will work for a given tumor and why, they tend to err on the side of caution administering treatments in cases in which they may provide

    little added benefit.This type of research could be-

    gin to change that, experts said.This is going to have a huge im-

    pact on the way we think about breast cancer, said Raju Kuch-erlapati, a genetics professor at the Harvard Medical School who was not involved in the study. Together with other data com-ing out in the next few months, I think the whole landscape of re-search, discovery and treatment is going to change.

    Clinicians already divide tu-

    mors into a few different types, and targeted treatments are available for some types of the disease. For instance, women with tumors that test positive for a cancer-promoting protein called HER2 often respond well to the drug Herceptin, which isnt effective against other types of tumors.

    But in a frustratingly high number of cases, scientists cant explain why one woman will re-spond to a given treatment and another woman wont even

    though they both might have tu-mors that are estrogen-receptor-positive, for example.

    Its not a very precise art, Caldas said.

    Hoping to hone the process, Cal-das and colleagues from Britain and Canada analyzed the genetic signatures of samples from 997 tumors, examining how aber-rations in DNA turned various genes on and off. They analyzed 2 million spots on the genome, fo-

    Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    Please see Breast cancer page 5

    Breastcancerclassifyingpromisesbettertherapies

  • Sunday, April 29, 2012 gainesvilletimes comThe Times, Gainesville, Georgia |

    cusing on differences in the num-ber of times a string of DNA is repeated and on small gene varia-tions known as single nucleotide polymorphisms, or SNPs. They also looked at RNA, which helps translate DNA instructions into proteins, to gauge gene activity.

    Then they correlated that data with long-term health outcomes of the women from whom the tumors were removed, establish-ing a link between the genetic patterns and how tumors pro-gressed. The analysis involved complicated number-crunching and took more than five years to complete.

    In the end, the research team identified 10 distinct subtypes of breast cancer. They reinforced previously known groups and were able to make further dis-tinctions within them.

    For example, they found that tu-mors in two of the categories had very few DNA aberrations com-pared with those in other groups. Tumors in one of these categories were particularly vulnerable to immune system cells, and they had one of the best profiles for prognosis.

    These tumors do have some-thing different about them, Cal-das said. And by studying them further, he suggested, research-ers may discover that they re-spond well to novel treatments.

    The team confirmed the valid-ity of their categories by testing them in a separate group of 995 tumors.

    Experts said the scale of the

    work was remarkable, as Kuch-erlapati put it.

    The fact that they have 997 samples for discovery and 995 for validation makes it very special, he said.

    Dr. John Glaspy, an oncologist at the University of California, Los Angeles Jonsson Comprehensive Cancer Center, added that the ge-netic analysis also sheds light on a fundamental question: How do cancers emerge?

    Its an insight into how this whole thing works, he said. In-sight is the beginning of new treat-ment.

    But Glaspy and others also cau-tioned that the discovery would not revolutionize the practice of medicine right away.

    I want to make sure people wont see this and say, Game over! said Stephen Friend, co-founder of Sage Bionetworks in Seattle, a nonprofit organiza-

    tion that promotes collaborative medical research. In truth, he said, the ability to match genetic signatures to long-term cancer outcomes is a sign that the game starts.

    University of British Columbia breast cancer researcher Samuel Aparicio, another leader of the study, said scientists would need to conduct clinical trials to deter-mine whether the gene aberra-tions the team identified could be effectively targeted with existing drugs. The findings should also help pharmaceutical companies create new drugs to fight breast cancer, he added.

    This should be a good stimu-lus for industry, he said.

    Complementary research is expected shortly from the Na-tional Cancer Institutes Cancer Genome Atlas and the Wellcome Trust Sanger Institute in Hinxton, England.

    BreastCancerContinued from page 4

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  • Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    Advertorial provided byGainesville Eye Associates

    A mild winter and early spring have sent pollen counts off the charts this year.

    A typical spring allergy sea-son spans from March to May, when the trees begin to polli-nate. This year pollen counts began spiking in early Febru-ary, leading to an especially long spring allergy season and a high number of irritants floating around in the air.

    As a result, reports of eye al-lergies (allergic conjunctivi-tis) are at an all-time high this year.

    Anything more than 90 parti-cles of pollen per cubic foot is considered a high pollen count, and counts more than 1,500 are considered extremely high. This spring in the South, we have had consistent pollen counts of more than 4,000, and on March 21, we hit an all-time high of 8,164, five times what is normally extremely high.

    Anyone who works or spends a lot of time outside can at-test. The early spring brought golfers to area courses, and many of those golfers have complained of eye allergies even more this year than in the past.

    What is an eye allergy?

    If your eyes are itchy, red, tearing or burning, dont ig-nore them. You may have eye allergies, a condition that af-fects millions of Americans.

    Eye allergies can occur alone, but often accompany nasal al-lergy symptoms, such as sneez-ing, sniffling and a stuffy nose. And, while most people treat their nasal allergy symptoms, they often ignore their itchy, red, watery eyes.

    What actually causes the allergy?

    An allergy occurs when your immune system reacts to allergens. When an allergen comes into contact with the eye, some eye cells release histamine and other chemi-cals to fight the allergen. This reaction causes redness of the eyes, which leads to itching and watery eyes.

    Most eye allergies are the bodys response to allergens in the air such as pollen, dust, an-imal dander, mold or smoke. In North Georgia, pine trees are the biggest culprit.

    But it is not just pollen that causes eye allergies. Aller-gic reactions to perfumes, cosmetics or medications can also cause conjunctivitis. Sometimes the eyes can react to allergens that are not nec-essarily in direct contact with the eye, such as those found in some foods, or those related to insect bites.

    Mold, house dust and ani-mals can also be a source of this pesky condition through-out the year. Eye allergies also can be inherited from parents, and are more likely to develop if both parents have suffered

    from them.

    What is the right treatment?

    First, your ophthalmologist must distinguish whether the symptoms are related to an eye infection or an allergic reaction. The ophthalmologist examines the eyes with a slit lamp microscope to check for signs of eye allergies such as enlargement of blood vessels on the surface of the eye.

    If there is a serious allergic reaction, your ophthalmolo-gist can prescribe a test for a specific type of white blood cells (eosinophils) that appear in the eye when there is an al-lergic reaction.

    Coping with allergens

    Avoidance is still the best advice. If pollen is the cause, avoid the outdoors during the time of the day when pollen counts are at their highest usually mid-morning to early afternoon. Also, take partic-ular caution on windy days when pollen is easily spread.

    Keep windows to your home and car closed to keep the al-lergens out. Use air condition-ers, and avoid window fans. Change the filter in your air conditioning system regularly to prevent recirculation of the same allergens.

    We know it is tough, but dont rub your eyes. Rubbing only irritates them more.

    Over-the-counter eye drops and oral medications are com-

    monly used for short-term re-lief of some eye allergy symp-toms. However, they may not relieve all symptoms.

    Decongestants reduce the redness of the eyes caused by allergies, and oral antihista-mines may be of some use to relieve itchy eyes. However, those same antihistamines can cause dry eyes, and thus worsen the symptoms of some eye allergies.

    In some cases, prescription eye drops and oral medica-tions also are used to treat eye allergies. Prescription eye drops provide both short-term and long-term targeted relief of eye allergy symptoms, and they can be used to manage eye allergy symptoms in con-junction with an oral antihis-tamine that might be taken to manage nasal allergy symp-toms.

    Gainesville Eye Associates has offices in Gainesville, Bra-selton, Cornelia, Blairsville, Clayton, Hayesville, and Hia-wassee, with a consultation office Franklin, N.C. To find out more about Gainesville Eye Associates, or to sched-ule an appointment, contact their office today at 770-532-4444. You can also learn more about the services offered by Gainesville Eye Associ-ates by visiting their website at www.gainesvilleeye.com and following them on Face-book (www.facebook.com/gainesvilleeye) and Twitter (@GainesvilleEye).

    Recordpollencountdrivesincreaseineyeallergies

  • Sunday, April 29, 2012 gainesvilletimes comThe Times, Gainesville, Georgia |

  • Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    Polypsareverycommon,oftenbenignBy Savannah King

    [email protected]

    One of the easiest and most ef-fective ways to prevent cancer is to get a colonoscopy.

    A colonoscopy allows the doc-tor to visually inspect the inside of the colon and check for abnor-mal growths, or polyps. If any are found, they can be removed be-fore they become cancerous.

    We dont mean to scare people, but its one of those things that I want people to know that 1 in 4 people will have polyps. Not all of those polyps are going to become cancer, obviously, but I cant tell you which are and which will not, said Dr. Chad Copper, a gen-eral surgeon with The Longstreet Clinic.

    The American Cancer Society recommends people older than 50 get a colonoscopy every 10 years. If the patient has a family history of colon cancer, the soci-ety recommends they be tested 10 years earlier than the age of their relative when diagnosed.

    As we age, were more likely to develop polyps. If you have a fam-ily history, youre more likely to develop polyps, said Dr. Namita Pareek, gastroenterologist with Gastroenterology Associates of Gainesville.

    According to the Centers for Disease Control, as many as 60 percent of colorectal cancer deaths could be avoided by proper screening.

    New guidelines for screening could help prevent even more deaths in the future.

    The other thing that were try-ing to stress is that the new guide-lines say that African-Americans

    should be screened at age 45 be-cause they have an increased risk of developing colon cancer, Cop-per said.

    Men have a slightly higher rate of occurrence, but Pareek said gender isnt of much significance when it comes to colon cancer.

    Many people dont get a colo-noscopy until they notice symp-toms. Some symptoms that could signal a problem include rectal bleeding, changes in bowel hab-its, abdominal pain, weight loss or blood in the stool.

    The majority of polyps do not cause symptoms. Some that are really big can cause bleeding, pain or diarrhea, Pareek said.

    People often ask doctors how to prevent colon polyps. Based on studies, doctors say that healthy habits like exercise and eating di-ets high in fiber and low in animal fat can help reduce the risk of de-veloping colon cancer.

    Healthy habits that are good for you in other ways, your heart and your lungs, are good for your colon, too, Pareek said.

    The American Cancer Society estimates that 141,210 people

    were diagnosed with colon cancer in 2011, and nearly one-third of them will die from the disease.

    Colon cancer is the third most commonly diagnosed cancer, ac-cording to the American Cancer

    Society. Each case is unique, but in gen-

    eral, if the cancer hasnt spread to the lymph nodes, our cure rates for surgery alone are very high, Copper said.

    Polyp is a general term for any raised mass of tissue growing on the inside wall of the large intestine.They occur in many shapes and sizes.

    Polyps of the large intestine

    Magnified view ( right ) through a colonoscope; physician removes any polyps found with electric sparks or a wire snare

    Cancer concern: Some polyps may developinto tumors; larger polyps pose a higher risk

    Source: Merck Manual, Human Anatomyand Physiology, KRT News In Motion

    Smallintestine

    Large intestine (colon) About 5 ft. (150 cm) long Absorbs water and dissolved chemicals Most people have a few tiny polyps that cause no symptoms

  • Sunday, April 29, 2012 gainesvilletimes comThe Times, Gainesville, Georgia |

    1240 Jesse Jewell Pkwy., Ste. 500 Gainesville, Ga. www.ngdc.com 770-536-9864

    If you are having trouble: getting to sleep, staying asleep, or if you feel excessively

    tired during the day, the Northeast Georgia Diagnostic Clinic Department of Sleep Medicine can help.

    Under the direction of Wesley Head, MD, Board Certified in Sleep Medicine, the NortheastGeorgia Diagnostic Clinic Sleep Center ensures its patients thehighest level of care for their sleep disorders.

    From the initial diagnosis, through the initiation of CPAPtherapy, education, compliance, patient support and follow-up,we do more than just test and prescribe equipment. We makesure it works for you.

    Our CPAP Clinic is staffed by registered respiratory therapists who are availableat our Sleep Center to see all patients with sleep disorders utilizing CPAP therapy,not just those we diagnose or treat. Our program is accredited by the AmericanAcademy of Sleep Medicine.

    For more information call the Northeast Georgia Diagnostic Clinic Sleep Center: 678-450-3625.

    May is Better SleepMonth

    May is Better SleepMonth

    Shannan [email protected]

    If you thought the bumps and blisters that came with that case of the chickenpox you had were bad, then you certainly dont want to experience shingles.

    Unfortunately, if you were ex-posed to or have ever contracted the chickenpox virus, the culprit that causes shingles is already in your body. The varicella virus is responsible for giving 98 percent of American adults chickenpox at some point in their lives, and it remains in the body with the ever-present chance of reappearing as the painful shingles virus.

    Shingles is reactivation of the chickenpox virus, which you typi-cally have as a child. It presents itself as a painful rash on one side

    of the body, explained Dr. Marti Gibbs, a family medicine physi-cian with The Longstreet Clinic. Most people know someone who has had shingles, and its a very painful rash. Ive had some pa-tients end up in the hospital just from the pain that is associated with shingles.

    This rash produces blisters that can be found in clusters on the body or sporadically on the skin, but they always appear where nerve endings reach the bodys surface. However, the symptoms of shingles are not felt exclusively through a blistering rash on the skin. Headaches, chills and flu-like symptoms could also accom-pany the virus in the early stages.

    Fatigue and weakness is pretty profound for patients, and they just feel sick, said Gibbs.

    Fortunately, there are options for the many who are at risk or al-ready have shingles. Many phar-macies and doctors offices offer a vaccine for shingles.

    Whos most at risk? The older you get, the more likely you are to develop shingles. Health care pro-fessionals recommend that if you are age 60 or older, you should be vaccinated.

    According to Gibbs, If youre 60 or up, theres no reason for you not to have the shot. If your phy-sician hasnt recommended it, I would say to initiate that conver-sation with them. Thats a natural question for us to ask them.

    Gibbs noted another group of ideal candidates for the shot would be those with a compromised im-mune system.

    While the vaccine isnt perfect,

    it does cut the chances of getting shingles in half. Additionally, if you do still get shingles after hav-ing received the shot, the disease may not last as long and the pain may not be as intense.

    Dr. Christina Rich of North-east Georgia Physicians Group described the treatment options that wont cure the disease but will help with the symptoms.

    There is medicine for shingles that will reduce the pain in the nerves and antibiotics to reduce symptoms. But once you have it, you have it.

    For those who have it, the rash and other symptoms could last anywhere from two to four weeks. In some cases, the pain from the rash can last several months, but the effects rarely last beyond that.

    Vaccinehelpsavoidriskofpainfulshingles

  • 10 Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    By Megan [email protected]

    Congestive heart failure is a disease people may not exactly understand. What is this dis-ease, and what does it actually mean for you if youre diag-nosed with it?

    Heart failure is when, for some reason, the heart cant do its job, said Dr. Brenda Hott, medical director of heart failure programs at Northeast Georgia Medical Center and cardiologist at Northeast Geor-gia Heart Center.

    This can be caused by either the pumping part of the heart not working properly, or the heart not being able to relax property to let blood back in. Sometimes its a combination of both.

    Congestive heart failure is when they have too much fluid, Hott said about patients with CHF. The heart cannot work properly, and there is an excess of fluid.

    Patients with CHF often get swelling in their stomach, lungs and legs from a build-up of fluid, she said. There are sev-eral other symptoms involved with the disease.

    They will often have a de-crease in exercise tolerance or what they can be able to do, she said. They might wake up in the middle of the night and cant breathe.

    Other symptoms include fatigue, shortness of breath, weight gain and wheezing.

    While all the symptoms sound frightening, there are a variety of treatment options for people

    with CHF. Medical therapy is the option most commonly used.

    We try to improve the qual-ity of life, Hott said. Some-times we can even get the heart back to normal with medical therapy.

    Medical therapy includes medicine and lifestyle changes such as restrictions of sodium and fluid and checking weight daily. Also, during the first few weeks following the start of treatment, there are check-ups roughly every two weeks.

    We see them quite often initially to see if we can fix the heart, Hott said. Its very frequent until we get them on a steady regimen, and then we back off from there. Once we maximize their medicines, we have to give them time to see if

    Treatmentcanhelpcongestiveheartfailure

    Please see Heart page 11

    SCOTT ROGERS | The TimesMedical poster in Dr. Brenda Hotts office shows normal and enlarged heart.

  • Sunday, April 29, 2012 11gainesvilletimes comThe Times, Gainesville, Georgia |

    the medicine is working.Several months after maximi-

    zation of the medicine, cardiol-ogists will check patients to see how effective the treatments were.

    In the most severe of cases, CHF patients may seek other options for treatment if they qualify for it. These options include mechanical devices placed to help the heart func-tion better, or sometimes heart transplants.

    Depending on how severe, their activities may be differ-

    ent, Hott said.There are ways people can

    prevent their risk of having CHF. Hott said 50 percent of CHF cases are caused by coro-nary diseases such as diabetes, hypertension and obesity. If you control the health risk fac-tors, you can help prevent your chances of getting the heart dis-ease.

    If youre diagnosed with CHF, the most important thing to re-member is that while it is a life-threatening disease, it is also one that can be treated.

    It is something we can treat and improve peoples quality and quantity of life, Hott said. Theres a lot we can do for them. We are getting new things every day.

    HeartContinued from page 10

    SCOTT ROGERS | The TimesAn ICD (Implantable cardioverter-defibrillator) which is implanted inside the body of patients who are at risk of sudden cardiac death due to ventricular fibrillation and ventricular tachycardia.

  • 12 Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com Sunday, April 29, 2012 13gainesvilletimes comThe Times, Gainesville, Georgia |

    7 0 5 Je s s e Je w e l l Pa r k w a y, S E , S u i t e 2 0 0 , G a i n e s v i l l e P h o n e 7 7 0 . 5 3 4 . 9 0 1 4 w w w. g h v g . n e t

    At Gainesville Heart & Vascular Group, we believe that the patient is the center of our practice. We are committed to providing the best possible care through diligent clinical evaluation and appropriate use of state-of-the-art technol-ogy. Guided by compassion for each individual, we strive to provide convenience and peace of mind to our patients by providing most services under one roof. Our ultimate goal help our patients achieve a better quality of life.

    GAINESVILLE HEART AND VASCULAR GROUP

    SERVICES OFFERED Adult Consultative Cardiology ECG, Holter and Event Monitoring Exercise Treadmill Testing Echocardiography Transesophageal Echocardiography Stress Echocardiography Myocardial Perfusion Imaging (Nuclear Scans) Peripheral Vascular (claudication) Testing Cardiac Catheterization (leg and wrist access) Coronary Angioplasty and Stenting Peripheral Vascular Angioplasty and Stenting Renal Angioplasty and Stenting Pacemaker Implants Loop Recorder Implants Pacemaker and ICD Management Anticoagulation Management Lipid Management Pulmonary Hypertension Testing

    GAINESVILLE HEART AND VASCULAR GROUPCardiovascular disease affects over 80 million people in the United States.

    2957

    08 0

    1-22

    em

    Coronary heart disease or disease in the blood vessels which supply oxygen to the heart affects 17,600,000.

    Myocardial infarction or a heart attack affects 8,500,000 people. There are 785,000 new heart attacks and 470,000 recurrent per year.

    Angina pectoris, chest pain or discomfort caused by reduced blood supply to the heart muscle, affects 10,200,000 people.

    Stroke or disturbance to brain function due to decrease to the brains blood supply affects 6,400,000.

    Peripheral vascular disease or disease affecting the blood vessels of the arms and legs affects 10,000,000.

    Heart failure, the hearts inability to meet the bodys demand, affects 5,800,000.

    Risk factors associated with cardiovascular disease include age, diabetes, high blood pressure, high cholesterol, tobacco use and family history of cardiovascular disease. Symptoms associated with cardiovascular disease include chest pain, shortness of breath, arm/leg pain, loss of consciousness and fatigue.

    We at the Gainesville Heart and Vascular Group specialize in prevention, diagnosis and treatment of cardiovascular disease. Established in 1994, the Gainesville Heart & Vascular Group, formerly known as the Gainesville Heart Group, is recognized as the first cardiology practice dedicated to the care of heart patients in Gainesville and surrounding areas.

    Its founder, Dr. David P. Johnson is a Gainesville native who had a dream of providing full-time and full-service cardiac care to the community. He and his partners played an integral part in bringing the Open Heart Surgery program to Gainesville in 2002.

    Our staff has a reputation of applying a personal touch to our care and cherishing the relationship we have with our patients. Our staff, including physicians, enjoys residing and being an active part of the Hall County community.

    Our office has a wide variety of services, including general cardiology consultation, electrocardiography, echocardiography/ 2-D Doppler, stress echocardiography, nuclear stress testing and ankle brachial pressure index. Our physicians are staffed round the clock, 365 days a year, at the Northeast Georgia Medical Center.Cardiac catheterizations, including coronary and peripheral artery stenting, stress testing, transesophageal echocardiography and pacemaker devices are performed at the Northeast Georgia Medical Center.

    We would enjoy an opportunity to meet with you to prevent, diagnose and treat cardiovascular disease.

  • 12 Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com Sunday, April 29, 2012 13gainesvilletimes comThe Times, Gainesville, Georgia |

    7 0 5 Je s s e Je w e l l Pa r k w a y, S E , S u i t e 2 0 0 , G a i n e s v i l l e P h o n e 7 7 0 . 5 3 4 . 9 0 1 4 w w w. g h v g . n e t

    At Gainesville Heart & Vascular Group, we believe that the patient is the center of our practice. We are committed to providing the best possible care through diligent clinical evaluation and appropriate use of state-of-the-art technol-ogy. Guided by compassion for each individual, we strive to provide convenience and peace of mind to our patients by providing most services under one roof. Our ultimate goal help our patients achieve a better quality of life.

    GAINESVILLE HEART AND VASCULAR GROUP

    SERVICES OFFERED Adult Consultative Cardiology ECG, Holter and Event Monitoring Exercise Treadmill Testing Echocardiography Transesophageal Echocardiography Stress Echocardiography Myocardial Perfusion Imaging (Nuclear Scans) Peripheral Vascular (claudication) Testing Cardiac Catheterization (leg and wrist access) Coronary Angioplasty and Stenting Peripheral Vascular Angioplasty and Stenting Renal Angioplasty and Stenting Pacemaker Implants Loop Recorder Implants Pacemaker and ICD Management Anticoagulation Management Lipid Management Pulmonary Hypertension Testing

    GAINESVILLE HEART AND VASCULAR GROUPCardiovascular disease affects over 80 million people in the United States.

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    em

    Coronary heart disease or disease in the blood vessels which supply oxygen to the heart affects 17,600,000.

    Myocardial infarction or a heart attack affects 8,500,000 people. There are 785,000 new heart attacks and 470,000 recurrent per year.

    Angina pectoris, chest pain or discomfort caused by reduced blood supply to the heart muscle, affects 10,200,000 people.

    Stroke or disturbance to brain function due to decrease to the brains blood supply affects 6,400,000.

    Peripheral vascular disease or disease affecting the blood vessels of the arms and legs affects 10,000,000.

    Heart failure, the hearts inability to meet the bodys demand, affects 5,800,000.

    Risk factors associated with cardiovascular disease include age, diabetes, high blood pressure, high cholesterol, tobacco use and family history of cardiovascular disease. Symptoms associated with cardiovascular disease include chest pain, shortness of breath, arm/leg pain, loss of consciousness and fatigue.

    We at the Gainesville Heart and Vascular Group specialize in prevention, diagnosis and treatment of cardiovascular disease. Established in 1994, the Gainesville Heart & Vascular Group, formerly known as the Gainesville Heart Group, is recognized as the first cardiology practice dedicated to the care of heart patients in Gainesville and surrounding areas.

    Its founder, Dr. David P. Johnson is a Gainesville native who had a dream of providing full-time and full-service cardiac care to the community. He and his partners played an integral part in bringing the Open Heart Surgery program to Gainesville in 2002.

    Our staff has a reputation of applying a personal touch to our care and cherishing the relationship we have with our patients. Our staff, including physicians, enjoys residing and being an active part of the Hall County community.

    Our office has a wide variety of services, including general cardiology consultation, electrocardiography, echocardiography/ 2-D Doppler, stress echocardiography, nuclear stress testing and ankle brachial pressure index. Our physicians are staffed round the clock, 365 days a year, at the Northeast Georgia Medical Center.Cardiac catheterizations, including coronary and peripheral artery stenting, stress testing, transesophageal echocardiography and pacemaker devices are performed at the Northeast Georgia Medical Center.

    We would enjoy an opportunity to meet with you to prevent, diagnose and treat cardiovascular disease.

  • 14 Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    By Melissa HealyLos Angeles Times

    Even among psychiatric dis-orders, depression is a difficult disease to diagnose. Its causes remain a mystery, its symptoms cant be defined with precision, and treatments are spotty at best.

    But that may soon change. Sci-entists are looking for ways to identify patients with depression as reliably as they diagnose car-diovascular disease, diabetes and cancer. A new study takes a sig-nificant, though preliminary, step in that direction by demonstrating

    that a simple blood test can distin-guish between people who are de-pressed and those who are not.

    The test examined a panel of 28 biological markers that circulate in the bloodstream and found that 11 of them could predict the pres-ence of depression at accuracy levels that ranged from medium to large. And if that were not re-markable enough, researchers pulled off this feat in a group of teenagers, whose angst often de-fies all efforts at classification.

    The study, published this month in the journal Translational Psy-chiatry, offers hope that doctors

    can do a better job of helping ado-lescents whose mood difficulties go beyond those of typical teens, and whose lifelong prospects could be greatly improved by early treatment. Whats more, by using objective data to diagnose mental pain, researchers hope to remove the stigma that often pre-vents patients from reaching out to doctors.

    Once you have a measurable index of an illness, its very dif-ficult to say, Just pull yourself together, or Get over it, said study leader Eva Redei, a pro-fessor of psychiatry and behav-ioral sciences at Northwestern Universitys Feinberg School of Medicine in Chicago. A federal re-port released last year estimated that as many as two-thirds of the

    nations 2 million depressed teens are too embarrassed or ashamed to get help.

    The study drew responses of praise and caution from other re-searchers seeking better ways to diagnose and treat major depres-sive disorder.

    This is definitely an encour-aging study, said Dr. Andrew Leuchter, a University of Califor-nia, Los Angeles psychiatrist who is researching ways to improve treatment with genetic testing and was not involved in the new work. Finding a way to intervene with teens would be particularly valu-able because a bout of depression early in life makes repeat epi-sodes more likely, and therefore

    Blood test looks promising in diagnosing depression

    Please see Depression test page 15

  • Sunday, April 29, 2012 15gainesvilletimes comThe Times, Gainesville, Georgia |

    more urgent to treat, he said.The current study focused on

    teens and early onset depres-sion, but the researchers said they hoped to include adults in future testing.

    Redeis study takes a middle-of-the-road approach to the search for a biomarker of depression. Her team did not look for genetic variations that might predispose an individual to depression, nor did it use advanced MRI scans to home in on peculiarities in the way the depressed brain works. Instead, the team focused on the messenger molecules that carry out genetic instructions for pro-ducing or inhibiting proteins.

    The researchers started out with rats, breeding some for their vulnerability to depression and raising others to serve as healthy control subjects. In an effort to tease out the long-term molecular consequences of childhood stress, some rats from both groups spent hours restrained and alone in their cages. After several genera-tions, the researchers identified 11 distinct molecules that were of-ten found in the blood and brains of depressed rats but were largely absent in the healthy animals.

    The tests also turned up 15 mol-ecules that distinguished rats who suffered from a combination of depression and severe anxiety from those whose depression re-sulted in listless, helpless behav-ior.

    Then the researchers tested the predictive value of the same biomarkers in a group of 14 de-pressed teens between the ages of

    15 and 19 and a group of 14 healthy control subjects. Sure enough, the teens with depression had signifi-cantly higher concentrations of the 11 targeted molecules in their blood. In addition, there were 18 biomarkers that could distinguish between adolescents who suf-fered from depression alone and those who had depression and anxiety.

    Dr. Sidney Kennedy, a psychia-trist at the University of Toronto who is leading a project called the Canadian Depression Biomarker Network, said Redeis study was the first to use messenger mol-ecules as biological signposts for depression. As other efforts to find biomarkers mature including costly brain scans and genetic analyses those could refine and strengthen a blood test to screen large populations, he said.

    There is merit in this work, Kennedy added.

    In the meantime, he praised the study for making a first attempt at one of the fields most ambitious goals: to explain, describe and distinguish among depressions many and varied forms.

    Redei said her team hoped to perfect the blood panel by testing it in larger and more varied groups of subjects including those with other psychiatric illnesses, in-cluding bipolar disorder, that are sometimes mistakenly diagnosed as major depression.

    But before any such blood test could go into broad use, she cau-tioned, scientists would have to show that it could reliably detect the presence of illness without generating too many false posi-tives.

    The probability that we will be able to put together a panel thats usable is rather high, she said. This data at the moment truly proves that it can be done.

    DepressiontestContinued from page 14

  • 16 Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    By Nancy ChurninThe Dallas Morning News

    Kathy Krolikowski of Frisco, Texas, suspected something was wrong long before her doctors did.

    Every time she said her body ached, she was told she was working too hard or not exercising enough. It took three years before she heard, just as she had suspected, that she had the same autoimmune disorder that had afflicted her mother: rheu-matoid arthritis.

    Autoimmune disease, which dis-proportionately strikes women, is easy to miss, says Dr. Neelay Gandhi, a family practitioner on the medical staff at Baylor Regional Medical Center at Plano, Texas who took over Krolikowskis care six months ago.

    Thats because the general symp-toms of fatigue and achiness are common, and autoimmune disease can take many forms, including lu-pus, thyroid disorders and multiple sclerosis, he says.

    In autoimmune disorders, an im-mune system attacks the healthy tissues it was designed to protect. Getting an early diagnosis can be crucial because the damage the disease causes generally can be stopped or slowed, but not reversed. Krolikowski, 64, says thats why she advises women to be persistent when something feels wrong and to find a doctor who will be attentive to their concerns.

    Sometimes its hard to keep go-ing in when you think, They dont believe me. What am I going to do? she says.

    Dr. Noel Rose, director of the Johns Hopkins Center for Autoimmune Disease Research in Baltimore, has

    spent decades advocating for in-creased recognition of autoimmune diseases, which he says afflict an esti-mated 20 million Americans. Three-fourths of those cases are women; the Office of Research on Womens Health at the National Institutes of Health describes it as the underly-ing cause of more than 100 serious, chronic diseases, and it was cited in the American Journal of Public Health in 2000 as being one of the top 10 leading causes of death among women 65 and younger.

    The hope for cures lies in finding the common roots for the diseases that continue to be treated in a scat-tershot way by a variety of special-ists as separate conditions, says Rose, co-author of the Encyclopedia of Au-toimmune Diseases (Facts on File, $75). Rose would like to see autoim-mune disease recognized as an um-brella for these various conditions, just as cancer is used to describe a wide array of diseases with an under-lying cause.

    In fact, the more we understand about autoimmune disease, the bet-ter we will understand cancer be-cause theyre opposite ends of the same problem, he says. Cells are too quick to attack healthy tissue in au-toimmune disorders and too slow to fight in cancer, allowing harmful tis-sue to grow out of control.

    Autoimmune diseases are rela-tively common, and people should be aware that theyre as much a threat to their health as cancer and heart disease, Rose says.

    Dr. Benjamin Greenberg, a neu-rologist and assistant professor at UT Southwestern Medical Center at Dallas, sees great promise in the Bos-ton-based Accelerated Cure Project.

    While it focuses primarily on sup-porting the latest research on multi-ple sclerosis, the studies can provide insight into other autoimmune dis-orders, he says. He also encourages patients to check clinicaltrials.gov, where patients can learn about the latest drugs being studied for various conditions.

    Greenberg says research suggests that some important risk factors for autoimmune disorders are vitamin D deficiency, smoking, genetics, tox-ins in the environment and poor nu-trition. Current cures involve killing or suppressing the cells. One exciting

    idea on the horizon involves drugs that can retrain cells to not attack healthy tissue, he says.

    An intriguing area to explore is why women suffer disproportion-ately from autoimmune disorders. Experts speculate that because hor-mones tend to stimulate immune re-sponses, womens major hormonal swings may play a significant role in many, though not all forms, of the dis-ease (Type 1 diabetes actually occurs more often in males). Women seem to be at greatest risk during their

    Autoimmune disorders responsible for more than 100 diseases

    Please see Autoimmune page 17

  • Sunday, April 29, 2012 17gainesvilletimes comThe Times, Gainesville, Georgia |

    childbearing years.Good communication between

    doctor and patient can prove the key to navigating this disease, Green-berg says. In neuromyelitis optica, a rare autoimmune disorder that attacks the optic nerves and spinal cord, he learned, many patients re-ported incidents of vomiting or fre-quent hiccups before the symptoms manifested themselves. Now when he takes a patients history, he asks about hiccups and vomiting.

    If they have this condition and you catch it early, you can prevent them from losing their vision or becoming quadriplegic, he says.

    Elizabeth Brammer, 30, of Burle-son, Texas didnt have anyone around to ask her questions like that when she was 11 and began struggling off and on with her eyesight. Her symptoms were dismissed at first as a plea for attention and were later mistakenly diagnosed as multiple sclerosis.

    Due to the lack of proper treat-ment, she lost vision in one eye while in college. She finally got the correct diagnosis from a neurologist in New York four years ago. Since moving to Texas in 2010, she has been under the care of Greenberg, who prescribes regular, preventive immunosup-pressive medications that have pre-vented a flare-up, attack or relapse during her pregnancy with her twin boys. Gavin and Garrison turned 1 on March 24, and she continues to be in remission.

    For Brammer, finding out she had neuromyelitis optica, or NMO, came as a shock, a relief and a vindication that she was right to push her doctors into investigating her case further for so many years.

    I was overwhelmed. I cried be-cause at least I had found a compass as opposed to rolling around in circles

    not knowing what to think or what in the world was going on. Its terrifying that I have NMO, but at least now I am under the proper care.

    COMMON AUTOIMMUNE DISEASES FOR WOMEN

    Lupus: The immune system creates an antibody that can damage any part of the body, but most commonly the joints, skin, kidneys, heart and lungs. Symptoms include fever, weight loss, hair loss, mouth sores, fatigue, rashes, painful or swollen joints and muscles, sensitivity to the sun, chest pain, head-ache, dizziness, seizure, memory problems and behavior changes.

    Rheumatoid arthritis: The immune system attacks the lining of the joints, resulting in fatigue, fever, weight loss, eye inflammation, lung disease, lumps of tissue under the elbows and anemia. Can lead to stiff, swollen, deformed joints and reduced move-ment.

    Multiple sclerosis: The immune system attacks the protective coat-ing around the nerves, damaging the brain and spinal cord and causing trouble with coordination, balance, speaking and walking. It can ulti-mately lead to numbness and tingling in arms, legs, hands and feet and to tremors and paralysis.

    Thyroid disease (two common forms):

    Hashimotos disease (underactive thyroid): The immune system dam-ages the thyroid gland, leading to decreased production of thyroid hor-mone, resulting in fatigue, weakness, weight gain, sensitivity to cold, muscle aches, stiff joints, facial swelling and constipation.

    Graves disease (overactive thy-roid): The immune system binds to receptors in the thyroid gland and activates the gland to make too much thyroid hormone, resulting in insom-nia, irritability, weight loss, heat sen-sitivity, sweating, brittle hair, muscle weakness, light menstrual periods, bulging eyes and shaky hands.

    AutoimmuneContinued from page 16

  • 18 Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    By Judy HevrdejsChicago Tribune

    Think of your stomach as one big test tube. Maybe you drop in a vitamin or herbal supple-ment each morning. Maybe a cholesterol-lowering statin or a blood-pressure drug. Per-haps an infection-fighting an-tibiotic or allergy-relieving antihistamine. And you wash it down with fruit juice or milk or coffee.

    That may not always be a good thing because some foods and beverages from choco-late and caffeine to dairy and alcohol as well as dietary supplements (vitamins, herb-als, etc.) and over-the-counter (OTC) drugs can interact with prescription drugs when they land in your gut. Those interac-tions may affect the ability of the drug to work as it should. Or that mix may cause unwanted side effects.

    With some tetracyclines, for example, you may need to avoid dairy products at the time you take the drug. If you take digoxin for your heart, you may need to steer clear of St. Johns wort and large amounts of black licorice (that contains glycyrrhizin). Take ACE Inhibitors to lower your blood pressure? Go easy on high potassium foods such as bananas, oranges and green leafy vegetables. And depend-ing on the statin youre taking there are many different types in this class you may need to avoid grapefruit.

    Such drug, food and supple-ment interactions become es-pecially important as the num-

    ber of drugs taken increases.Shiew Mei Huang, acting di-

    rector, office of clinical phar-macology at the Food and Drug Administrations Center for Drug Evaluation and Research, cites a survey published in the Journal of the American Medi-cal Association that found in the population 57 and older in the U.S., at least 80 percent use at least one prescription drug. Half of them use OTC drugs. And some use dietary supplements.

    Says Huang, What is impor-tant in that report is that almost 30 percent use more than five drugs. And among those who take a prescription drug, half of them take either OTC or di-etary supplements.

    It is the dietary supplements we have to be very careful (about), she adds, and doctors need to be told about them.

    Hartmut Derendorf, a pro-fessor who heads the pharma-ceutics department in the Uni-versity of Floridas College of Pharmacy, might agree about the role dietary supplements play.

    Sometimes they look alike and patients think they are medications like normal med-ications. But dietary supple-ments are not required to be investigated and tested with the same rigor, he says.

    Because your age, gender, medical history, etc. can affect how a drug interacts with other substances in your gut, there are no general rules, says Der-endorf. The key is for patients to be very open, to work with their pharmacist and physician and tell them about the use of

    supplements and also look for the specific food interactions that are known for the medica-tion that they are using.

    Thats crucial because guide-lines can change. The FDA reg-ularly releases food-and-drug interaction consumer updates that are prompted by a variety of factors, Huang explains, in-cluding the recent grapefruit juice-statin update issued last month. So what should you use to help the medicine go down? Stick to a plain glass of water, say experts.

    Points to remember:Keep a record of all drugs

    (prescription, over-the-coun-ter), vitamins and herbal sup-plements that you take. This FDA chart can help www.fda.

    gov/drugs/resourcesforyou (type my medicine record in the search field).

    Tell your doctor or pharma-cist about all drugs (prescrip-tion, OTC) and supplements you take.

    If a doctor prescribes a new drug, ask the doctor or phar-macist if there are food inter-actions.

    Read drug information from the pharmacist; dont discard.

    The following websites offer guidelines, but check with your doctor: www.fda.gov/drugs/resourcesforyou (type avoid food and drug interactions in the search field; nclnet.org/health/146-food-drug-interac-tions druginteractioncenter.org and webmd.com/drugs.

    Some foods dont mix with drugs, supplements

  • Sunday, April 29, 2012 19gainesvilletimes comThe Times, Gainesville, Georgia |

    770-536-8109 or Toll Free 1-877-683-9410

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    We only treat digestive issues/diseases.So, when it comes time for your colon screening,

    trust only a gastroenterologist.We ARE the experts.

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  • 20 Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    By Delthia RicksNewsday

    There is no compelling evi-dence that poor dental health leads to clogged arteries, heart attack or stroke, and treating dis-eased gums will not reduce the risk of cardiovascular disorders, a medical panel said earlier this month.

    The panels findings comprise the American Heart Associations new stance on the matter, alter-ing a position many experts had accepted as gospel.

    For decades, the provocative notion that gum problems peri-odontal disease are linked to clogged arteries has been at the very core of the so-called Germ Theory of cardiovascular disease. Bacteria and inflammation asso-ciated with gum problems lead to dangers elsewhere the theory posits.

    Aside from cardiovascular disorders, diseased gums have also been linked to miscarriages, Alzheimers and some forms of cancer.

    But a team of cardiologists, den-tists and infectious disease spe-cialists assembled by the heart as-sociation, reanalyzed more than 60 years of research 500-plus studies and found none pro-duced a causative link between periodontal and cardiovascular disorders.

    Much of the literature is con-flicting, said Dr. Peter Lockhart, the panels co-chair. If there was a strong causative link, we would likely know that by now.

    The message sent out by some

    in the health care professions that heart attack and stroke are di-rectly linked to gum disease can distort the facts, he said.

    Doctors have long known that smoking, elevated cholesterol, hypertension and obesity explain a vast number of heart attacks and strokes but not all. The periodontal link seems to fit, some experts say, because risk factors associated with gum disease are involved in heart disorders.

    Also, dental plaque, which must be scraped off teeth, contains a veritable rogues gallery of mi-crobes that colonize the teeth, invade beneath the gumline and are maintained in place by a tough biofilm.

    Some microbes associated with gum disease are also found in ar-terial plaque, but no one knows if theyre causative agents or merely innocent bystanders in heart attacks and strokes.

    Dental experts not associated with the heart association say more research needs to be con-ducted.

    What we have here is a very rigorous analysis, said Dr. Ron-ald Burakoff, chairman of dental medicine at Long Island Jewish Medical Center in New Hyde Park. But its possible that fur-ther research into periodontal and heart disease could explain

    the biological possibility of one causing the other.

    Dr. David Paquette, a profes-sor and associate dean at Stony Brook Universitys School of Den-tal Medicine, said the panel has taken a cautionary stand.

    Earlier research, Paquette noted, has also shown that C-reac-tive protein, a biological marker for inflammation, is high in the blood of people with gum disease

    and those with cardiovascular problems.

    More research could shed more light on the proteins role in both, he said.

    Meanwhile, the Stony Brook team is leading a nationwide analysis of 500 people that is ex-ploring whether periodontal dis-ease is linked to diabetes. That could confirm periodontal prob-lems play a role in heart disease because diabetics are at elevated risk for heart attacks and strokes, he said.

    Paquette acknowledged the panels analysis seems to prove there is no causal relationship. But, he added, I would say the discussion is not over yet.

    Study questions link between gum disease, cardiovascular problems

    Some microbes associated with gum disease are also found in arterial plaque.

  • Sunday, April 29, 2012 21gainesvilletimes comThe Times, Gainesville, Georgia |

    By Alison JohnsonDaily Press (Newport News, Va.)

    Turning good dental practices into habits very early can pre-vent cavities and many other problems down the road. Its all about making it a routine, which will last a lifetime, says Dr. Miles Hall, chief dental officer at Cigna. Some tips:

    Start early. As soon as a childs first tooth appears, begin clean-ing it with a brush and water no toothpaste yet and make a dental appointment.

    Introduce toothpaste slowly. Kids usually are ready for tooth-paste by age 2 or 3 years old. To keep them from swallowing large amounts, put a pea-sized bead of paste on the brush and squash it

    down into the bristles. Let kids pick out their tooth-

    brushes. Opting for a favorite color or cartoon character helps them feel in control.

    Make brushing fun. Put on some great music and do a little dancing as part of the nighttime brush-and-floss routine. Parents can brush at the same time so kids can imitate them.

    Help with flossing. Kids dont need to floss until gaps between their teeth have closed, but they likely wont be coordinated enough to try it on their own un-til ages 6 to 8. Before that, its a parents job.

    Expand the tooth fairys role. She doesnt just need to bring money for lost teeth. She also might leave encouraging notes

    and little rewards for good brush-ing and flossing.

    Limit sugary snacks. Empha-size regular meals and healthy snacks, but if kids do eat or drink something sugary, teach them to brush or rinse their mouths with

    water soon afterward.Talk up the dentist. Dont pass

    on your hatred of dental appoint-ments or details on your fillings and root canals. Keep it positive: the dentists office is a fun place that helps kids stay healthy.

    How to introduce oral hygiene to kids

  • 22 Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

    By Andrea K. WalkerThe Baltimore Sun

    Large doses of vitamin C may moderately reduce blood pressure, Johns Hopkins re-searchers have found.

    But the scientists dont rec-ommend people start taking large amounts of the vitamin.

    Researchers led by Dr. Ed-gar Pete R. Miller, an asso-ciate professor in the division of general internal medicine at Hopkins, reviewed and an-alyzed data from 29 previous clinical trials and found that taking 500 milligrams of Vita-min C daily, or five times the recommended amount, could lower blood pressure by 3.84 millimeters.

    Although our review found only a moderate impact on blood pressure, if the entire U.S. population lowered blood pressure by 3 milliliters of mercury, there would be a lot fewer strokes, Miller said in a statement.

    However, Miller warned that none of the studies showed that

    vitamin C directly prevents or reduces rates of cardiovascu-lar disease, including stroke.

    Scientists have focused on vitamin Cs potential role in blood pressure reduction be-cause of its biological and physiological effects. It may act as a diuretic, causing the kidneys to remove more so-dium and water from the body. This helps to relax the blood vessel walls and in turn lowers blood pressure.

    Large doses of vitamin C may lower blood pressure, research finds

  • Sunday, April 29, 2012 23gainesvilletimes comThe Times, Gainesville, Georgia |

    Life is not for spectators...Join in.

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    Gainesville, April 27, 2012 Since its formation in 1995, The Longstreet Clinic, P.C., (TLC) has been committed to innovation and driving improvement in health care. By embracing compassion-ate, evidence-based quality stan-dards of care, the Clinic recently received recognition from two national organizations that mea-sure and certify practices in key areas of performance, making it one of the first to achieve such designations.

    Longstreet Cancer Center is now one of only two practices in the state of Georgia and 116 in the United States to be certified

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    Medicine in Oakwood, which in-cludes Marti Gibbs, M.D., John N. Range, M.D., and Andrew B. Reis-man, M.D., had been certified as a Level 3 Patient-Centered Medi-cal Home Program, an innovative program for improving primary care. The Longstreet Clinic is the first practice in Northeast Geor-gia and only the 10th in the state to receive this level of PCMH rec-ognition.

    Obtaining this level of recogni-tion means a practice has demon-strat ed that it meets required standards including utilization of evidence-based criteria, patient-centered care and information technology in the delivery of care to patients.

    In addition to the PCMH, TLC holds certification by the NCQAs Diabetes Recognition Program and Heart/Stroke Recognition Program, making it the only practice in the state to carry three different sets of NCQA rec-ognitions.

    As the delivery of medical care continues to evolve, our commit-ment to providing the highest level of patient care hasnt wa-vered, said Mimi Collins, CEO of The Longstreet Clinic. We are pleased that we continue to be leaders when it comes to adopting the best practices in the industry that improve the quality of care, patient outcomes and pa-tient satisfaction.

    The Longstreet Clinic again the first in area to achieve quality care recognition

  • 24 Sunday, April 29, 2012 The Times, Gainesville, Georgia | gainesvilletimes com

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