Richard Bernstein M.D. F.C.C.P.
Internal Medicine,
Asthma and Allergies,
Preventive Medicine, 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
Member American Academy of Environmental Medicine
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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.
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.
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.
Richard A. Bernstein M.D. F.C.C.P
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Internal Medicine:New Drugs for Migraine Headaches
If you have ever had a migraine headache you know how devastating these can be. Often these can be triggered by certain foods. Common triggers include red wine, chocolate, nuts, hard cheeses and foods that contain nitrates. A complete list of these foods is available at our office. The most effective drugs to treat migraines are a class of drugs called triptans. Trade names of these drugs include Imitrex, Zomig, Maxalt, Amerge and Treximet. While effective these drugs have significant side effects which include chest discomfort, dizziness, and throat tightness. They are contraindicated in patients with underlying cardiovascular disease. Telecagepant is a new class of drug which does not have any of the vasoconstrictor side effects of triptans. In a study of 1380 patients in Europe this drug was found to be as effective as Zomig but without the side effects. While available in Europe this drug is currently being evaluated by the FDA for use in the U.S.A. If approved this drug shows promise as an effective alternative to triptans.
Peripheral Vascular Testing:
Peripheral Artery Vascular testing is a non invasive test which if abnormal is significantly associated with an increased incidence of heart disease and death from heart disease. In particular patients who have had a significant change from the previous year may be at significantly increased risk for a heart attack even if they are without symptoms. Current recommendations by the U.S. Preventative Service Task Force suggest this not be used as a broad screen. However in patients with increased risk factors for heart disease such as diabetes, smokers, and patients with hyperlipidemia this test may help identify patients who are at a significantly increased risk of having a heart attack. We provide this testing in our office.
RAB
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Spring Seminar: May You Live a Long and Healthy Life
This year's spring seminar is entitled May You live a Long and Healthy Life. We will discuss the keys to healthy aging and the prevention of disease. You will learn keys to addressing fatigue, preventing diseases such as diabetes, heart disease, cancer, and multiple sclerosis. It's updated from last year's seminar and we will have lot's of new information for you. It is based on the book I've written by the same title. The book is in its final stages of preparation and should be available at the time of the seminar. Following the seminar we will have a workshop on stress management and relaxation techniques with psychotherapist Susan Bernstein LCSW-C.
Fish Oils: A supplement worth considering?
Many supplements have been touted to have life enhancing benefits. For the most part these benefits have not been substantiated when subjected to significant scientific scrutiny. Fish oils are an exception. In an analysis of 12 studies that looked at 33,000 patients the following conclusions were drawn.
Fish oils lower risk of death from cardiac causes by 20% in all patients.
In patients with known cardiac disease, fish oils decreased the risk of sudden cardiac death by 20% and death from cardiac causes by 20%.
Among all patients fish oils did not lower overall risk for death.
While impressive keep in mind that this does not come close to the results of the HALE study which showed that overall mortality could be reduced 50% by switching to a Mediterranean diet. This once again reinforces the idea that supplements are only that. They supplement a diet they are not substitutes.
RAB
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Asthma and Allergies:Food Allergies
Allergy season is upon us and due to the warm February, I expect it to be a difficult season. Proper use of environmental controls can make treatment of Asthma and Allergic Rhinitis much easier to treat. Next time you are in the office ask for one of our environmental controls handout.
In this issue of our newsletter we will focus on food allergies. Food Allergies are a frustrating topic for many people. The symptoms can be varied and difficult to diagnose. Sometimes symptoms are due to intolerance rather than actual allergies. A complete discussion is beyond the scope of this article but I do want to focus on several types of reactions.
Oral Airway Syndrome: Patients present with symptoms of facial itching, swelling of the lips, and itching of the throat. This is due to a cross reactivity to a pollen allergy and often occurs after eating fruit. By cooking the fruit the protein causing the allergy is broken down and allergic reactions can be prevented.
Celiac Disease: This is a part of any food allergy workup. This is an autoimmune reaction that occurs in 1 out of every 250 individuals. Rather than due to an IGE mediated reaction like asthma or allergic rhinitis celiac disease is mediated by the antibody IGA. It is due to an allergy to gluten which is a component of wheat. Symptoms may include fatigue, weight loss, iron deficiency, irritability and depression. Diseases such as Thyroiditis and Diabetes are linked with celiac disease. The definitive diagnosis is made by small bowel biopsy but can also be checked by a simple blood test which checks for anti-transglutamase antibodies. The treatment is strict avoidance of gluten.
Histamine Intolerance: Histamine intolerance occurs in patients who due to genetics have a deficiency of the enzyme Diamine oxidase. When these patients consume foods that contain large amounts of histamine symptoms of excessive histamine levels can occur. These symptoms include headache, flushing, palpitations, nasal congestion, wheezing, and hives. Histamine sensitivity occurs in 1% of the population and usually is expressed in patients when they reach middle age. Foods high in histamine include citrus fruits, nuts, peanuts, tomatoes, spinach, chocolate, crustaceans and pork. Certain drugs such as beta blockers and Verapamil can stimulate histamine release. Diagnosis can be made with genetic testing for SNPS which we discussed in our previous newsletter (and is available in our office) and blood testing for histamine levels. Treatment involves using antihistamines, and avoidance of food and drugs that stimulate histamine.
Sulfite intolerance. This can cause symptoms similar to histamine intolerance but less severe. It is due to a genetic defect which prevents a liver detoxification mechanism called sulfation. Treatment involves avoidance of sulfite containing foods and supplementation with the vitamin molybdenum.
Niacin Flushing: Niacin is a vitamin which is used to treat the disease Pellagra as well as lower triglyceride levels. It is found in a number of nutritional supplements as well as energy drinks. Symptoms include flushing, redness, and abdominal pain. It can be confused with a food allergy. Symptoms can be decreased if taken with an Asprin.Taking high doses of Niacin ( greater than 500 mg per day) over long periods of time can exacerbate gout, cause liver toxicity, and abdominal pain, so monitoring with bloodwork is required. Patients with gout, liver disease or diabetes should use niacin with caution.
Food allergies are frustrating and the workup is usually more complex than people think. If you think food allergies could be a problem for you please schedule an appointment.
RAB
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Aesthetics and Skincare: Skin Cancer Prevention
With Daylight savings just around the corner its time to think about skin cancer prevention. Over 1 million new cases of of skin cancer are diagnosed each year and is the most common cancer found in humans. Ultraviolet light is the the main cause of skin cancer. The most common warning signs of skin cancer is a change in appearance or color of an existing skin lesion, a new growth or a lesion that will not heal. Unexplained changes in the appearance of the skin lasting more than two weeks require evaluation. The best way to lower risk is by regular surveillance (by both patients and physician) and avoidance of ultraviolet light exposure. I recommend a sunblock that has both UVA and UVB prevention. Reflective blocks that contain zinc oxide are best, but new sunblocks that contain Mexoryl(tm) are promising and more cosmetically elegant. Based on evidence that stabilized L- ascorbic acid can prevent skin cancer precursors we also recommend L-ascorbic acid serums for skin cancer prevention and prevention of skin aging. If you are interested in knowing how much UV light damage you have please schedule a complementary skin care consult with visia analysis. More information on skin cancer can be found from the Skin Cancer Foundation. You may contact them via telephone (212-725-5176) or their website (www.skincancer.org)
Dermal Fillers: Radiesse
If you received our recent email blast you know that we are offering a promotion on Radiesse. Radiesse is a wonderful filler that is easy to work with and provides excellent results for correction of nasal labial folds, marionette lines, and restoring volume from the loss of fat underneath the eyes and cheeks. This special promotion is being offered with support from the manufacturer so after the expiration date it will likely not be repeated. Radiesse is unique because it lasts 10-18 months. Most other fillers last 6 months or less. In the future we will offer demonstrations as well as skin care seminars for patients interested in aesthetics. If you have ever considered having correction with a dermal filler now would be a great time to schedule a complimentary skincare consultation.
RAB
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Spring Seminar 2009:
"May You Live a Long and Healthy Life"
Richard A. Bernstein M.D. F.C.C.P.
Stress Management and Relaxation Techniques with Susan Bernstein LCSW-C
Tuesday May 5, 2009
7:00 p.m.- 9:00 p.m.
This event is 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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