Richard Bernstein M.D. F.C.C.P.
Internal Medicine,Nutritional Counseling, Asthma and Allergies, Cosmetic Skincare Procedures
133 Defense Highway Suite 109
Annapolis, Maryland 21401
410-224-5558
Board Certifications:
Internal Medicine
Pulmonary Diseases
Named one of America's Top Physicians
Consumer Research Council of America
Fellow American College of Chest Physicians
Member American College of Physicians
Member American Academy of Otolaryngology Allergy
Member American Academy of Laser Medicine and Surgery
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About Our Practice
While no one likes going to the doctor, we are dedicated to providing the best clinical experience a medical practice can offer. Our core practice is Internal Medicine.
We are all going to age, thus our philosophy is to provide services that help prevent disease as well as treat them. We want our patients to live long healthy lives, feel good about themselves and enjoy life. By incorporating lifestyle management strategies such as nutritional counseling we can help our patients achieve these goals.
We provide cosmetic skincare for patients who desire these services. We believe all of our patients are beautiful just the way they are, but if you would like to enhance your appearance we provide a full range of cosmetic skincare products and procedures. Procedures include Botox, Juvederm, Radiesse, IPL, Laser, and light chemical peels. All of our injectable procedures are performed by Dr. Bernstein. We are committed to obtaining optimal results in a cost effective manner.
Dr. Bernstein has an extensive background in pulmonary diseases where his major area of interest was asthma and exercise physiology. Twenty-five percent of the population suffer from allergies. In addition to allergy testing and in office consultation we provide allergy seminars and workshops for our patients as we believe patient education is the key to optimal success. We are uniquely qualified to provide asthma and allergy services to our patients because of Dr. Bernstein's pulmonary background.
Most importantly we want to provide an environment that makes our patients feel comfortable. We view our patients as an extension of our family. That is why there will always be someone to answer the phone, fit in emergency visits for same day appointments and we still make house calls.
Our staff is here to serve you. We encourage feedback both positive and negative so we can provide you the best quality care.
Richard A. Bernstein M.D. F.C.C.P
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Internal Medicine: Zetia and Vytorin
By now I am sure you have all heard the news that the drug Zetia, while lowering cholesterol does not decrease one's risk of having a heart attack. Why might this be the case and what does it mean. Since 1980, the incidence of fatal heart attack in this country has dropped 50%.This is primarily due to the use of statin drugs and improvements in interventional cardiology. I would like to think healthy lifestyle changes may be playing a role but during this time period the American public became more obese not less obese. The authors of this study estimated that this increase in obesity increased the incidence of heart attacks during this time period by 10%.
Studies have suggested that The lower the LDL cholesterol when treated with statin drugs,the lower the risk of heart attack in people with known coronary disease. In people with elevated cholesterol there are studies suggesting that by using the generic drug pravastatin (pravachol),the incidence of a heart attack can be reduced at 30%.
Several years ago,the drug company Merck was losing its patent on Zocor. The drug would be going generic. At that time they came out with a new drug called Zetia. This drug also lowered cholesterol, but worked by a different mechanism. Using the two drugs together would lower cholesterol more than using either drug alone. By putting these two drugs together the new drug Vytorin was created which allowed Merck to maintain its patent on a highly popular cholesterol drug. Unfortunately there had never been any studies linking lower cholesterol from Zetia with prevention of heart attacks. It was just assumed that the cholesterol was lower, the risk would be decreased. However this is not the case.Why might this be? This is because the statins work by different mechanisms than simply lowering cholesterol. They stabilize soft plaque. It is the rupture of soft plaque that actually causes heart attacks. There is no such evidence that Zetia causes stabilization of plaque. To my knowledge there are only two other drugs that stabilize plaque. These are ACE inhibitors such as lisinopril and fish oils. So for practical reasons it makes much more sense if one needs to be on a drug to lower cholesterol to use only a statin drug. Since there are a lot of generic statin drugs currently available it makes sense to start with one of these.
On the other hand, we know that by switching to a Mediterranean diet as demonstrated in the HALE study we can reduce the risk of having a heart attack by approximately 81%. This is better than statins alone. This does not mean that one should not be on statin drugs. These drugs have been demonstrated to be life-saving and are an important part of our drug armamentarium. It is my view tht these drugs should primarily be used in people with multiple risk factors for coronary disease or people with known atherosclerosis. However there is no substitute for making healthy lifestyle changes,to improve longevity, and reduce our likelihood of having heart attacks. Likewise you should not be lulled into a a false sense of security if you are on a statin. Lifestyle changes matter and are an important part of any health treatment plan. If you are currently taking Zetia or Vytorin please call to make an appointment so we can discuss treatment options.
RAB
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| Asthma and Allergy: The Smoking Ban on second hand smoke; Its about time
It may be hard to believe that studies demonstrating the health hazards of tobacco smoke have been around since the 1930's. Children who grow up in Households where adults smoke, have a significant increase in upper respiratory diseases and asthma.In addition,People who smoke have much more problems with Allergies. It is often much more difficult to treat allergies in patients who smoke. There is also evidence that secondhand smoke actually causes damage to our mitochondria which are the energy power houses of the cell. With the new year upon us now is a good time to make a new years resolution to stop smoking. We have found the new drug Chantix most helpful in helping our patients quit smoking. If you would like more information on smoking cessation or strategies or to help a loved one stop smoking please contact our office.
RAB
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| Longevity and Preventive Medicine: Sirtuin (Can this enzyme be the key to Longevity)
Sirtuin is an enzyme found in the human body. It is also found in yeast, worms, fruit flies, mice and other mammals. Stimulating this enzyme has been found to extend life span and decrease the frequency of diseases of aging such as diabetes, heart disease,vascular disease, and cancer. When this enzyme is activated, oxidative stress is reduced.
Until now the only way to activate this enzyme has been through calorie restriction. As been clearly shown that societies that eat less calories tend to live longer. In fact the calorie consumption of the American public has increased 30% in the last 40 years. Societies that are the longest lived like those in Okinowa eat 40% less calories than we as Americans eat on a daily basis. A substance found in red wine and peanuts called resveratrol has also been shown to stimulate this enzyme.
Scientist have also found several other Sirtuins stimulating small molecules which cause the same positive changes. Currently resveratrol is being tested on human subjects and it is likely that in the future,there will be other similar compounds that are developed into drugs to help stimulate this enzyme and hopefully prevent aging and the diseases of aging. Unfortunately, often drugs have side effects that we don't anticipate. So for now the best advise is to adopt a healthy lifestyle which involves switching to a modified Mediterranean diet as we have suggested in our office and reducing your total calorie intake. Exercise is important, as is a positive state of mind. If you would like a copy of our dietary recommendations,please contact our office.
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Aesthetics: News from the International Masters Course on Aging Skin
Rae Garcia-Mooney our office manager and Aesthetics Coordinator recently returned from Paris, France after attending the International Masters course on Aging skin. Here is a summary of what's new.
Evolance a new collagen based filler was introduced. This has a cross linking matrix making it longer lasting than previous collagen fillers. This will probably be available in the U.S. in the next few years. The fact that it lasts a year will make it appealing. Currently there are primarily two types of fillers used in the U.S. Juvederm and Restylane (hylauronic acid) are probably the most popular but are limited by the fact that they only last 6 months. Radiesse (a filler that promotes collagen stimulation ) became F.D.A. approved last year and works more effectively for volume enhancement and deeper wrinkles. It last 1-2 years but is a little more difficult to work with. Currently all fillers should be given with a nerve block in my opinion to prevent pain. Both Juvederm and restyalne now include lidocaine as a topical anesthetic in Europe. They may soon be available in the U.S. in this form. The use of all dermal fillers has increased 35% worldwide
Botox use has increased 28% worldwide. Botox has primarily been used in the upper face to soften crows feet, reduce wrinkles in the glabellar area and the brow. It also creates a soft lift of the eye lids creating a refreshed look. I think in the future we will find an increase use of botox in the lower face in combination with fillers particularly to soften wrinkles around the lips.
The company that owns Restyane and Palomar (One of the worlds largest laser companies) Have merged. Expect the co-marketing of laser based technology and dermal fillers in the future.
Mexorl SX has been available in Europe for years. It is a long acting sunscreen that blocks both UVA and UVB rays. In particular it blocks the part of the UVA spectrum that causes wrinkling of skin. It is water resistant. It was recently FDA approved and is now available in the U.S. in the skinceuticals sunblock Active UV Defense.
The use of any aesthetic treatment should be done in the scope of an overall plan. The goal is to create an aged adjusted appearance that helps the patent look approximately 7 - 10 years younger than the norm for their age. Generally we want to create a V shaped appearance to the face. As we age the increased laxity of skin creates more of a square shaped appearance.
We provide complimentary aesthetic consultations for our patients. When you come in its helpful to bring a picture that was taken approximately 10 years ago. Incorporating a healthy lifestyle will enhance these goals. Here are a few tips:
Mental Health: Learn to nurture and appreciate the inner child within all of us. Realize that none of us are perfect. Write down 3 things you are grateful for once a week.
Diet: Try to eat 6 vegetables and 2 fruits per day. Avoid refined flour and Sugar.
Exercise: Take a walk 3 times per week and exercise 20- 30 minutes per day.
Avoidance of environmental toxins: Don't smoke. Don't microwave with plastic.
If you are interested in having a complimentary aesthetic consultation please contact our office for an appointment.
RAB.
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As Many of you know Trudy Trumpy has left our practice. She was a valued member of our team and will be missed. Unfortunately we will no longer be offering well women care in our office. If you would like to contact Trudy please contact our office and we will be happy to provide you with her forwarding address. If you were receiving well women care in our office and would like us to help facilitate you find a new provider for this service please contact our office.
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Asthma and Allergies: Workshop and Seminar
Jan 22 2008, May 20 2008, Sept. 23rd 2008
Location: Our Office
Time: 6-7 P.M.
Spring Seminar:
The Amazing Human Body
Four steps to Optimal Health and the Prevention of Aging
Thursday April 17th
7-9 pm
Sajak Pavillion
These events are complimentary but seating is limited. Please call 410-224-5558 to reserve a seat.
Thank you for taking the time to read our newsletter. We appreciate your referrals. If you think a friend or relative might benefit from our services or the information above, please forward this newsletter to them. Thank you.
Sincerely,
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Richard A. Bernstein M.D. |
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