“As part of brain injury research effort, the NFL announced in 2013 its plan to invest $60 million to improve mTBI diagnosis.36 To make the game of football safer, it is important that the NFL continue to strive for concussion management, including prevention and treatment strategies.”


Part I “Total Brain Injury (TBI) in regards to Fall and Winter Sports”.

BRAIN INJURY IMAGE   brain Lobe Regions

concussion 3a concussion 2



We are days away from the fall and a few months away from the winter.  Football with Hockey and boxing already started and yet they maybe to many exciting but still can be severely dangerous.  One of the reasons when a football player catches the kickoff and not running it out starts no longer at the 20 but the 25 yard line, more safety even though some of us football fanatics think how wimpy.

The NFL now even takes action.  Through Fall and Winter Sports TBI Awareness Month, The Johnny OTM Foundation (Johnny O) is hoping to raise awareness regarding the health risks athletes face when they participate in winter sports, specifically traumatic brain injuries and concussions. September is a great time to put a spotlight on fall/winter sports safety and preventive measures athlete can take to avoid TBIs and concussions.

The mission of Johnny O “is to educate the American public to the growing seriousness of Alzheimer’s, Dementia and Traumatic Brain Injuries in the American population by raising the necessary donations through strategic research initiatives and heightened public awareness to accomplish our objectives.”1 Fall and Winter Sports TBI Awareness Month is one of many initiatives Johnny O is undertaking to not only raise public awareness, but also improve safety and reduce TBIs in Americans of all ages.

 A concussion is a traumatic brain injury that alters the way your brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination.

Although concussions usually are caused by a blow to the head, they can also occur when the head and upper body are violently shaken. These injuries can cause a loss of consciousness, but most concussions do not. Because of this, some people have concussions and don’t realize it.

Concussions are common, particularly if you play a contact sport, such as football. But every concussion injures your brain to some extent. This injury needs time and rest to heal properly. Most concussive traumatic brain injuries are mild, and people usually recover fully.

Remember the key to a brain concussion fully recovering is not to have impact to the head happening over and over again.  Based on the same concept if you get hit in the same spot over and over again anywhere in the body bruising to actual injury will happen whether it be muscle or bone.  Well get hit in the head over and over again like in sports especially boxing but now the big conversation with football even with a helmet on you will cause a permanent damage to the brain.   A perfect example of this is a boxer that gets hit over an over again to the head in a boxing ring.   The head is just another area of the body and no different than other areas of our body.

What actually happens is the concussion is most often caused by a sudden direct blow or bump to the head.  The brain is made of soft tissue. It’s cushioned by spinal fluid and encased in the protective shell of the skull. When you sustain a concussion, the impact can jolt your brain. Sometimes, it literally causes it to move around in your head. Traumatic brain injuries can cause bruising, damage to the blood vessels, and injury to the nerves.

concussion 5concussion 4

The result? Your brain doesn’t function normally. If you’ve suffered a concussion, vision may be disturbed, you may lose equilibrium, or you may fall unconscious. In short, the brain is confused. That’s why Bugs Bunny often saw stars after getting whacked in the head in his cartoon by some other character.

The new uptake with football is being concerned with players getting concussions from getting hit by their opponent players whether it be defense or offense while playing the game. Concussions have become big business in the football world. With 1,700 players in the NFL, 66,000 in the college game, 1.1 million in high school and 250,000 more in Pop Warner, athletes and families across the country are eager to find ways to cut the risks of brain injury, whose terrifying consequences regularly tear across the sports pages. And a wave of companies offering diagnostic tools and concussion treatments are just as eager to sell them peace of mind.

That’s actually a slogan for one company.   ImPACT, the maker of the world’s most popular concussion evaluation system, offers a 20-minute computerized test that players can take via software or online to measure verbal and visual memory, processing speed, reaction time and impulse control.  The idea behind ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) and similar batteries is that doctors or athletic trainers can give a baseline test to a healthy athlete, conduct follow-up tests after an injury and then compare the results to help figure out when it’s OK to return the athlete to play. Selling itself as “Valid. Reliable. Safe,” ImPACT dominates the testing market and has spread throughout the sports world: Most NFL clubs use the test, as do all MLB, MLS and NHL clubs, the national associations for boxing, hockey and soccer in the U.S., and nine auto racing circuits.

A total of 87 out of 91 former NFL players have tested positive for the brain disease at the center of the debate over concussions in football, according to new figures from the nation’s largest brain bank focused on the study of traumatic head injury.

Researchers with the Department of Veterans Affairs and Boston University have now identified the degenerative disease known as chronic traumatic encephalopathy, or CTE, in 96 percent of NFL players that they’ve examined and in 79 percent of all football players. The disease is widely believed to stem from repetitive trauma to the head, and can lead to conditions such as memory loss, depression and dementia.

In total, the lab has found CTE in the brain tissue in 131 out of 165 individuals who, before their deaths, played football either professionally, semi-professionally, in college or in high school.

Forty percent of those who tested positive were the offensive and defensive linemen who come into contact with one another on every play of a game, according to numbers shared by the brain bank with FRONTLINE. That finding supports past research suggesting that it’s the repeat, more minor head trauma that occurs regularly in football that may pose the greatest risk to players, as opposed to just the sometimes violent collisions that cause concussions.

But the figures come with several important caveats, as testing for the disease can be an imperfect process. Brain scans have been used to identify signs of CTE in living players, but the disease can only be definitively identified posthumously. As such, many of the players who have donated their brains for testing suspected that they had the disease while still alive, leaving researchers with a skewed population to work with.

 Even with those caveats, the latest numbers are “remarkably consistent” with past research from the center suggesting a link between football and long-term brain disease, said Dr. Ann McKee, the facility’s director and chief of neuropathology at the VA Boston Healthcare System.

“People think that we’re blowing this out of proportion, that this is a very rare disease and that we’re sensationalizing it,” said McKee, who runs the lab as part of a collaboration between the VA and BU. “My response is that where I sit, this is a very real disease. We have had no problem identifying it in hundreds of players.”

In a statement, a spokesman for the NFL said, “We are dedicated to making football safer and continue to take steps to protect players, including rule changes, advanced sideline technology, and expanded medical resources. We continue to make significant investments in independent research through our gifts to Boston University, the [National Institutes of Health] and other efforts to accelerate the science and understanding of these issues.”

The latest update from the brain bank, which in 2010 received a $1 million research grant from the NFL, comes at a time when the league is able to boast measurable progress in reducing head injuries. In its 2015 Health & Safety Report, the NFL said that concussions in regular season games fell 35 percent over the past two seasons, from 173 in 2012 to 112 last season. A separate analysis by FRONTLINE that factors in concussions reported by teams during the preseason and the playoffs shows a smaller decrease of 28 percent.





“A blood and bone marrow transplant is currently the only cure for sickle cell disease, and only a small number of people who have sickle disease are able to have the transplant. There are effective treatments that can reduce symptoms and prolong life. Early diagnosis and regular medical care to prevent complications also contribute to improved well-being. Sickle cell disease is a life-long illness. The severity of the disease varies widely from person to person.”

National Heart,Lung and Blood Institute

Sickle Cell Disease.

tsickle cell disease 2                 sickle cell disease 3

September is National Sickle Cell Disease (SCD) Awareness Month, and Mount Sinai Health System is reminding the community of the importance of newborn screening performed soon after birth with a blood test, education for families with this inherited condition and comprehensive care for children and adults including regular visits with a specialist can reduce complications of this illness.

SCD is the most commonly inherited blood disorder in the United States, affecting 100,000 people, and millions more worldwide. The disease primarily affects people of African, Hispanic, Mediterranean, Middle Eastern and South Asian ancestry.

What is sickle cell disease actually?

The term sickle cell disease (SCD) describes a group of inherited red blood cell disorders. People with SCD have abnormal hemoglobin, called hemoglobin S or sickle hemoglobin, in their red blood cells.

Hemoglobin is a protein in red blood cells that carries oxygen throughout the body.

“Inherited” means that the disease is passed by genes from parents to their children. SCD is not contagious. A person cannot catch it, like a cold or infection, from someone else.

People who have SCD inherit two abnormal hemoglobin genes, one from each parent. In all forms of SCD, at least one of the two abnormal genes causes a person’s body to make hemoglobin S. When a person has two hemoglobin S genes, Hemoglobin SS, the disease is called sickle cell anemia. This is the most common and often most severe kind of SCD.

Hemoglobin SC disease and hemoglobin Sβ thalassemia (thal-uh-SEE-me-uh) are two other common forms of SCD.

Cells in tissues need a steady supply of oxygen to work well. Normally, hemoglobin in red blood cells takes up oxygen in the lungs and carries it to all the tissues of the body.

Red blood cells that contain normal hemoglobin are disc shaped (like a doughnut without a hole). This shape allows the cells to be flexible so that they can move through large and small blood vessels to deliver oxygen.

Sickle hemoglobin is not like normal hemoglobin. It can form stiff rods within the red cell, changing it into a crescent, or sickle shape.

Sickle-shaped cells are not flexible and can stick to vessel walls, causing a blockage that slows or stops the flow of blood. When this happens, oxygen can’t reach nearby tissues.

The lack of tissue oxygen can cause attacks of sudden, severe pain, called pain crisis. These pain attacks can occur without warning, and a person often needs to go to the hospital for effective treatment.

Most children with SCD are pain free between painful crises, but adolescents and adults may also suffer with chronic ongoing pain.

The red cell sickling and poor oxygen delivery can also cause organ damage. Over a lifetime, SCD can harm a person’s spleen, brain, eyes, lungs, liver, heart, kidneys, penis, joints, bones, or skin.

Sickle cells can’t change shape easily, so they tend to burst apart or hemolyze. Normal red blood cells live about 90 to 120 days, but sickle cells last only 10 to 20 days.

The body is always making new red blood cells to replace the old cells; however, in SCD the body may have trouble keeping up with how fast the cells are being destroyed. Because of this, the number of red blood cells is usually lower than normal. This condition, called anemia, can make a person have less energy.  Anemia ending line is lack of oxygen to the tissue body parts all over.

“Sickle cell disease is devastating for patients and their families,” said Jeffrey Glassberg, MD, MA, Assistant Professor of Emergency Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai. “It’s a chronic disorder causing pain in the extremities and back, infections, organ failure and other tissue damage, skin infections, loss of eyesight, severe blood clots and strokes. Patients learn to function in a constant state of pain and when that pain becomes debilitating, they often end up in the emergency room,” said Dr. Glassberg, also Associate Director of the Comprehensive Sickle Cell Program at The Mount Sinai Hospital.

“Patients with SCD are more likely to live full lives if they undergo regular checkups, prevent infections and develop healthy habits,” said Jena Simon, MS, FNP-BC, RN, also of the Comprehensive Sickle Cell Program.

Tips to Staying Healthy

  • Get regular checkups. Regular health checkups can help prevent some serious problems.
  • Prevent infections. Common illnesses, like influenza quickly can become dangerous for both children and adults with SCD. The best defense is to get a flu shot every fall and to stay up-to-date on other immunizations.
  • People with SCD should drink 8 to 10 glasses of water every day and eat healthy food. They also should try not to get too hot, too cold, or too tired.
  • Look for clinical studies. New clinical research studies are beginning all the time at Mount Sinai and elsewhere, with the goal of finding better treatments for SCD. Study participants gain early access to experimental medicines and treatments.
  • Get support. People with SCD should find a patient support group or other organization in the community that can provide information, assistance, and support.

Sickle Cell Disease Facts & Figures:

  • SCD is an inherited blood disorder that can cause severe pain and permanent damage to the brain, heart, lungs, kidneys, liver, bones and spleen.
  • SCD is most common in Africans and African-Americans. It is also found in other ethnic and racial groups, including people from South and Central America, the Caribbean, Mediterranean countries, and India.
  • More than 2 million people carry the sickle cell gene that allows them potentially to pass the disease on to their children. People of African, Hispanic, Mediterranean, Middle Eastern, and Indian descent may want to be tested for the gene before having children. You can carry the gene and not have any signs or symptoms of SCD. Both parents have to have the gene to have a child with SCD.

SCD Awareness Events, The Mount Sinai Hospital campus, 1468 Madison Avenue (at 100th St.):

  • Lecture: Guided Imagery for Sickle Cell Pain Management – Friday, September 11, 11 am to Noon, Stern Auditorium.
  • Sickle Cell Community Engagement Day – Saturday, September 12, Noon to 4 pm, Hatch Auditorium and Guggenheim Pavilion Lobby. Education, free Bone Marrow Drive, IMPACT Repertory Theatre performance.
  • NYC Annual Sickle Cell A Walk in Central Park – Saturday, September 19, 11 am, Central Park (near Naumberg Bandshell)

About the Mount Sinai Health System?

The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services–.from community-based facilities to tertiary and quaternary care.


“Affects approximately 30,000 children in the U.S. if all forms are considered. This is comparable to the number of people affected with cystic fibrosis in the U.S. According to the Pediatric Cardiomyopathy Registry, one in every 100,000 children are diagnosed with symptoms each year. This number is conservative though, and for every diagnosed child there is another undiagnosed child unknowingly at risk of premature death.”

Children’s Cardiomyopathy Foundation (http://childrenscardiomyopathy.org/)

Cardiomyopathy in Children



Heart Enlarged


Cardiomyopathy is cardiomyopathy, meaning rather in adult or child the same problems in each age group occur but degree of the disease varies for all, it is case by case.  What is cardiomyopathy?

Cardiomyopathy is a disease of the heart muscle characterized by an abnormally large, thick or stiff heart muscle. It may affect only the heart’s lower chambers (ventricles) or both the lower and upper chambers (atria).  For an adult there just more wear and tear on the organ due to age and severity of the disease.

Cardiomyopathy causes damage to tissue around the heart, as well as heart muscle cells. In severe cases, the heart becomes so weak that it can’t pump blood properly. This can lead to heart failure or irregular heartbeats (arrhythmias). In some cases, cardiomyopathy also involves a buildup of scar tissue or fat within the heart muscle. In rare cases, the heart muscle can’t relax and blood can’t fill the heart properly.

Remember the natural pacemaker in humans is located in the upper right chamber (Rt. atrium) in the upper right region called the sinus node.  The sinus node initiates our impulses from that right atrium across to the Lt. atrium and works the impulse sensation down thru the A-V node-atrioventricular node (site between upper and lower chambers in the heart located at the inferior end of the interatrial septum ending at the top of the ventricles in the heart)).   From the A-V node the impulse sensation continues on from A-V node to the end of the lower right and left lower chambers (called the ventricles) of the heart that continues up the ventricles and passing through the bundle of His to the bundle branches/Purkinje fibers (The bundle of His is an important part of the electrical conduction system of the heart, as it transmits impulses from the A-V node, located at the inferior end of the interatrial septum, to the ventricles of the heart).   Than the impulse sensation goes located in the inner ventricular walls of the heart radiating over the outside of the ventricles = Purkinje Fibers. This whole process allows the heart beat to occur sounding “LubDub”.

This entire impulse conduction process allows the heart to fill up the chambers with blood first in upper chambers to lower ones to releasing the blood in the ventricles (the Rt Ventricle pumps blood to the heart to get more oxygen from lungs that sends this fresh oxygenated blood to the left side of the heart.  The left ventricle pumps the filling of its blood into our blood stream called Cardiac Output in creating the heart to beat.  Stroke Volume x Heart Rate=our Cardiac Output (SVxHR=CO).  Stroke volume is the amount of blood circulated by the heart with each beat  x HR = beat in 60 secs.

Cardiomyopathy is very often a “time-will-tell” disease. Symptoms can vary and the progression of the disease can be unpredictable.  There are many forms of cardiomyopathy; just like in the adult.

What are the types of cardiomyopathy?

The main types include:

Dilated cardiomyopathy (DCM)

DCM is the most common type and occurs when the main pumping chamber of the heart muscle is too stretched out (dilated). Dilated cardiomyopathy makes the heart unable to pump blood effectively.

Hypertrophic cardiomyopathy (HCM)

HCM makes the heart muscle too thick. Usually, the thickening occurs in the muscle of the left ventricle in the heart, often involving the wall between the heart’s two ventricles.

Restrictive cardiomyopathy

Restrictive cardiomyopathy is a rare type of cardiomyopathy that causes the heart muscle to become very rigid or stiff. This makes it difficult for the ventricles of the heart to properly fill with blood.

Arrhythmogenic right ventricular cardiomyopathy (ARVC)

ARVC is a rare form of cardiomyopathy that affects only one in 5,000 people. It occurs when the muscle of the heart’s right ventricle is replaced by thick or fatty scar tissue. The scarring “scrambles” electrical signals within the heart and can make it difficult for the heart to pump blood.

Remember the sinus node (natural pacemaker) of the heart.

How Cardiomyopathy is diagnosed:

Because the symptoms of cardiomyopathy can be diverse, it is often misdiagnosed as asthma, an infection or a gastrointestinal problem but the tests similar to adults tests being ruled out for this disease.  Remember its the same problem at a different age.

In children who have no symptoms, cardiomyopathy is sometimes diagnosed when the child has a chest x-ray that shows an enlarged heart or an echocardiogram for another reason.

If your child’s doctor suspects cardiomyopathy, he or she may order one or more of the following tests, from least invasive to most invasive tests:

  • blood tests
  • chest x-rays
  • electrocardiogram  (EKG or ECG)
  • echocardiogram (cardiac ultrasound)
  • cardiac magnetic resonance imaging (MRI)
  • stress echocardiography, which uses ultrasound and heart-rate monitoring to assess your child’s heart function just before and just after exercise
  • stress test, or exercise test
  • cardiac catheterization
  • coronary angiography

What are the treatment (Rx) options for cardiomyopathy, again similar to adults Rx.?

Your child’s treatment options will be determined by the type of cardiomyopathy he or she has, as well as the specific symptoms. A child with no symptoms might not need medication or other treatment right away. Instead, the cardiologist will monitor your child to gauge the progression of the disease.

A child with more serious symptoms may need additional tests to give the treatment team more detailed information about how the cardiomyopathy is affecting the heart and the rest of the body. .

Many children with cardiomyopathy do well with medication alone. Others need surgery to improve the function of valves, and in the most severe cases, some children need a heart transplant.

Medication for cardiomyopathy

There are several different types of medications for cardiomyopathy, depending on which type your child has and the symptoms.

  • Angiotestin converting enzyme (ACE) inhibitors are drugs that dilate blood vessels in the body, fighting the constricting effect caused by heart failure.
  • Antiarrhythmic medications combat the abnormal heart rhythms caused by irregular electrical activity within the heart.
  • Beta blockers block certain chemicals from binding to nerve receptors in the heart, slowing the heart rate and lowering blood pressure.
  • Blood thinners or anticoagulants help prevent the formation of blood clots, especially in children with the dilated form of cardiomyopathy.
  • Diuretics prevent the buildup of fluid in the body and can help breathing by reducing fluid in the lungs. These drugs may also be helpful in treating scar tissue on the heart.

Surgical treatments for cardiomyopathy

There are several options for treating cardiomyopathy using surgery or minimally-invasive procedures.


For some children with cardiomyopathy — particularly HCM — an implantable cardioverter-defibrillator (ICD) can be a life-saving option. This tiny instrument, about the size of a deck of cards, is placed in the chest to monitor the child’s heartbeat. If the child has an arrhythmia, the defibrillator will administer a precise electrical pulse to restore normal heart rhythm.


Pacemaker implantation is minimally invasive option for some children with cardiomyopathy. The pacemaker — a small electronic device — is inserted directly under the skin, where it sends electric signals to the child’s heart, controlling and monitoring the heart rate. The procedure can be performed under local anesthesia in a matter of hours.

Radiofrequency ablation

Radiofrequency ablation is another type of minimally invasive treatment that can be very effective for some children with cardiomyopathy due to arrhythmia. A small, needle-like probe is inserted into the scarred tissue of the heart muscle, sending out radiofrequency waves that burns away the scar tissue and the arrhythmia.

Surgical removal of some heart muscle

In serious cases of hypertrophic cardiomyopathy, the treatment team may perform a surgery called a septal myectomy or septal myomectomy. This procedure involves the removal of a portion of the thickened muscle in the heart, widening the channel in the heart’s ventricle that leads to the aortic valve. The procedure has a very good success rate, and most children have improved blood flow throughout the heart and body.

Ventricular assist device

In certain types of cardiomyopathy, a ventricular-assist device (VAD) can be used to help recover the heart and normalize the heart’s function. After the heart’s function has returned to normal, the VAD will be removed and the child will be monitored for any further heart problems. This approach using the VAD is called a “bridge to recovery.”

Heart transplant

Children with the most severe cases of cardiomyopathy may need a heart transplant if other methods don’t manage symptoms. While your child is waiting for an available heart, a VAD may be used to support the heart. In many cases, children can return to school and other activities while waiting for a transplant.

So similar to how adults are treated also with cardiomyopathy.  The age is the pretty much the difference.



“If you have a bad case of acne, you may feel like you are the only one. But many people have acne. It is the most common skin problem in the United States. About 40 to 50 million Americans have acne at any one time.”

The American Academy of Dermatology AAD






Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. Acne usually appears on your face, neck, chest, back and shoulders. Effective treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.

Acne is most common among teenagers, with a reported prevalence of 70 to 87 percent. Increasingly, younger children are getting acne as well.

Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of lasting physical and emotional damage.

Acne signs and symptoms vary depending on the severity of your condition:

  • Whiteheads (closed plugged pores)
  • Blackheads (open plugged pores — the oil turns brown when it is exposed to air)
  • Small red, tender bumps (papules)
  • Pimples (pustules), which are papules with pus at their tips
  • Large, solid, painful lumps beneath the surface of the skin (nodules)
  • Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)

When to see a doctor

If home care remedies don’t work to clear up your acne, see your primary care doctor. He or she can prescribe stronger medications. If acne persists or is severe, you may want to seek medical treatment from a doctor who specializes in the skin (dermatologist).

The Food and Drug Administration warns that some popular nonprescription acne lotions, cleansers and other skin products can cause a serious reaction. This type of reaction is quite rare, so don’t confuse it with the redness, irritation or itchiness where you’ve applied medications or products.

Seek emergency medical help if after using a nonprescription skin product you experience:

  • Faintness
  • Difficulty breathing
  • Swelling of the eyes, face, lips or tongue
  • Tightness of the throat

Four main factors cause acne:

  • Oil production
  • Dead skin cells
  • Clogged pores
  • Bacteria

Acne typically appears on your face, neck, chest, back and shoulders. These areas of skin have the most oil (sebaceous) glands. Acne occurs when hair follicles become plugged with oil and dead skin cells.

Hair follicles are connected to oil glands. These glands secrete an oily substance (sebum) to lubricate your hair and skin. Sebum normally travels along the hair shafts and through the openings of the hair follicles onto the surface of your skin.

When your body produces an excess amount of sebum and dead skin cells, the two can build up in the hair follicles. They form a soft plug, creating an environment where bacteria can thrive. If the clogged pore becomes infected with bacteria, inflammation results.

The plugged pore may cause the follicle wall to bulge and produce a whitehead. Or the plug may be open to the surface and may darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it’s exposed to the air.

Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected. Blockages and inflammation that develop deep inside hair follicles produce cyst-like lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren’t usually involved in acne.

Factors that may worsen acne

These factors can trigger or aggravate an existing case of acne:

  • Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. And low amounts of androgens circulate in the blood of women and can worsen acne.
  • Certain medications. Drugs containing corticosteroids, androgens or lithium can worsen acne.
  • Studies indicate that certain dietary factors, including dairy products and carbohydrate-rich foods — such as bread, bagels and chips — may trigger acne. Chocolate has long been suspected of making acne worse. A recent study of 14 men with acne showed that eating chocolate was related to an increase in acne. Further study is needed to examine why this happens or whether acne patients need to follow specific dietary restrictions.
  • Stress can make acne worse.

Acne myths

These factors have little effect on acne:

  • Greasy foods. Eating greasy food has little to no effect on acne. Though working in a greasy area, such as a kitchen with fry vats, does because the oil can stick to the skin and block the hair follicles. This further irritates the skin or promotes acne.
  • Dirty skin. Acne isn’t caused by dirt. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse. Though it does help to gently remove oil, dead skin and other substances.
  • Cosmetics don’t necessarily worsen acne, especially if you use oil-free makeup that doesn’t clog pores (noncomedogenics) and remove makeup regularly. Nonoily cosmetics don’t interfere with the effectiveness of acne drugs.

Risk factors for acne include:

  • Hormonal changes. Such changes are common in teenagers, women and girls, and people using certain medications, including those containing corticosteroids, androgens or lithium.
  • Family history. Genetics plays a role in acne. If both parents had acne, you’re likely to develop it, too.
  • Greasy or oily substances. You may develop acne where your skin comes into contact with oily lotions and creams or with grease in a work area, such as a kitchen with fry vats.
  • Friction or pressure on your skin. This can be caused by items such as telephones, cellphones, helmets, tight collars and backpacks.
  • This doesn’t cause acne, but if you have acne already, stress may make it worse.




“In years past we used to call ovarian cancer the silent killer but it’s really not completely silent, at least in some patients.”

Dr. Edward Tanner (an assistant professor of gynecology and obstetrics at the Johns Hopkins University School of Medicine in Baltimore, Maryland).

Ovarian Cancer Awareness Month

ovariancancer ovariancancerII

Most people are aware that October is Breast Cancer Awareness Month, but how many of you are also aware that September is Ovarian Cancer Awareness Month? This cancer is the more silent sister to breast cancer which takes over the month of October with a worldwide pink party and numerous product promotions, some tasteful and some less so. Maybe people and product promoters are just drawn to pink versus the more reserved teal blue color for ovarian cancer. More likely it’s because breasts are visual and ovaries are invisible to the eye. But ovarian cancer is very visible to those diagnosed and to their loved ones.

We need to make more noise about ovarian cancer awareness. But first you have to listen… to your body. Ovarian cancer can be sneaky. Symptoms, such as indigestion, bloating, painful intercourse, menstrual irregularities and back pain, can point to other less invasive conditions. While breast cancer has screening protocols like mammograms and breast self-examination, there is no reliable screening for ovarian cancer. Unfortunately for many women the disease is often detected at an advanced stage. Both breast and ovarian cancer are diagnosed in women of all ages and ethnic backgrounds.

Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone.

Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat and is frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully.

Surgery and chemotherapy are generally used to treat ovarian cancer.

Early-stage ovarian cancer rarely causes any symptoms. Advanced-stage ovarian cancer may cause few and nonspecific symptoms that are often mistaken for more common benign conditions, such as constipation or irritable bowel.

Signs and symptoms of ovarian cancer may include and don’t ever ignore them:

  • Abdominal bloating or swelling
  • Quickly feeling full when eating
  • Weight loss
  • Discomfort in the pelvis area
  • Changes in bowel habits, such as constipation or diarrhea
  • A frequent need to urinate (urgency including difficulty to void)
  • Increased Abdominal Size
  • Painful Sex
  • Heavy menstrual bleeding
  • ***When to see a doctorIf you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. Your doctor may refer you to a genetic counselor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers. Only a small number of women are found to have genetic mutations that can lead to ovarian cancer.Certain factors may increase your risk of ovarian cancer.  Lets look at  Risk Factors:
  • Age. Ovarian cancer can occur at any age but is most common in women ages 50 to 60 years.
  • Inherited gene mutation. A small percentage of ovarian cancers are caused by an inherited gene mutation. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes were originally identified in families with multiple cases of breast cancer, which is how they got their names, but women with these mutations also have a significantly increased risk of ovarian cancer.
  • The gene mutations that cause Lynch syndrome, which is associated with colon cancer, also increase a woman’s risk of ovarian cancer.
  • Estrogen hormone replacement therapy, especially with long-term use and in large doses.
  • Age when menstruation started and ended. If you began menstruating before age 12 or underwent menopause after age 52, or both, your risk of ovarian cancer may be higher.
  • Never being pregnant.
  • Fertility treatment.
  • Smoking.
  • Use of an intrauterine device.
  • Polycystic ovary syndrome.

How is ovarian cancer diagnosed?

Ovarian cancer is difficult to diagnose. Screening tests, such as ultrasounds and computed tomography (CT) scans, show masses around the pelvis, which can suggest ovarian cancer. Removing part of the tumor for testing is the only way to officially diagnose ovarian cancer.

Finding ovarian cancer before it spreads is critical—when found early, about 94% of women live longer than 5 years after diagnosis. While there are currently no effective screening tests for ovarian cancer, there are scientific studies in progress to help determine ways to detect ovarian cancer.

What are the treatments?

1-Surgery is the first course of treatment for most women with ovarian cancer. Surgery to remove as much of the cancerous tissue as possible is called debulking. Its purpose is to remove all of the cancer that can be seen.

2-Chemotherapy is a drug that enters the bloodstream to kill cancer cells. This type of treatment works by killing cells in the body that divide frequently. The drawback of chemotherapy is that it also kills healthy cells, resulting in harsh side effects.

Chemotherapy can be injected into a vein, injected into the abdomen, or given by mouth. Ovarian cancer is usually treated with 2 or more types of drugs every 1 to 4 weeks.

The first group contains a platinum-based medicine and is thought to interfere with the DNA structure of the cancer cells, which stops them from making new cells, thus causing cancer cell death

Than a non platinum based medicine as another choice, collectively called taxanes. These disrupt cancer cell division.

3-Radiation therapy uses high-energy X-rays to kill cancer cells. This type of treatment can be useful in areas where the cancer has spread.  This treatment is not used as a primary treatment.

4-Targeted therapy uses a type of drug that can target cancer cells.

DNA damage that is not repaired can lead to cell death, which can be a good thing in cancer cells.  When someone with a BRCA mutation uses certain types of targeted therapy, DNA damage in cancer cells is less likely to be repaired, leading to cancer cell death.

5- Hormone therapy uses hormones or hormone-blocking drugs to attempt in killing cancer cells. It works by blocking hormones from working or lowering hormone levels to slow tumor growth.

6-There are also clinical trials provide the opportunity to study promising new treatments and procedures just like many other cancers.