Richard Bernstein M.D. F.C.C.P.
We Just Don't Treat Disease:
We Prevent it
Internal Medicine,
Asthma and Allergies,
Preventive Medicine, Aesthetic 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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What's New in Our Practice
We have had outstanding attendance and feedback from our Healthy Aging Seminar and our Asthma and Allergy Workshop. As a result we will be adding a new patient education component to our practice. Our spring seminar on Healthy Aging will continue each spring. We will be adding the following workshops and programs to our practice.
Principles of how to lose weight and maintain weight loss will be discussed. The program will include a patient support group, regular weigh ins, and coordination through our support staff.
- Allergy and Asthma Workshop
Allergies are the 5th most costly health condition in our country and affect 25% of the population. Each year 250,00 people die from asthma. The NIH guidelines recommend patient education as a key component of asthma management. This workshop focuses on what's new in allergy and asthma discussing skin, food and inhalant allergies.
This workshop is designed to teach patients principles of prevention of skin aging and keep them up to date with what's new in Aesthetics. Our 1st seminar will be entitled
Facial Contouring: Beyond filling lines and Reducing wrinkles
Tuesday July 28
5:00 p.m.
Special promotions offered to attendee's only
The above program will occur on Tuesday at 5 p.m. in our office. Call our office for additional information. Times and dates of other programs TBA.
A comprehensive program designed to prevent disease, provide healthy aging, improve longevity, and enhance our lives. This program is in development, details to follow.
For information of the above, please contact our office.
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Richard A. Bernstein M.D. F.C.C.P
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Internal Medicine:Back Pain
Recent Studies in the British Journal Lancet suggest that imaging studies such as MRI and X-Rays have no impact on outcomes or treatment decision making by physicians. Most back pain will get better on its own. If not, medication and physical therapy can help. Under certain circumstances such as a foot drop or weakness in an extremity an imaging study may be warranted if surgery is considered. For most back pain there is no evidence that surgery is more effective than conservative treatment
Women's Health:
Many women are considering hormone replacement for peri-menopause and menopause. In the recent lay press and on TV there has been much discussion between bio-identical and non bio-identical hormones. Bio-identical simply means the hormone has the same chemical structure as occurs in nature. There are commercially available bio-identical hormones.
The more pertinent question is how the hormone is taken. Oral estrogen increases the risk of blood clots and heart attack. Recent studies also demonstrate that oral estrogen increases blood pressure significantly compared to transdermal estrogen. The best form of estrogen to take is transdermal. This raises questions about birth control pills. Perhaps, we should be looking at a Trans-dermal delivery system for them as well.
Tick Bites
This has been a bad year of tick bites so here are a few tips.
- To remove ticks smother the tick in alcohol using a cotton ball doused in rubbing alcohol. This will cause the tick to withdraw its head so it can be removed.
- If the tick has been embedded less than 24 hours the likelihood of developing Lyme disease is low.
- If 200 mg of oral doxycycline is given within 72 hours of the tick being embedded in the skin the risk of Lyme disease goes down to zero.
RAB
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Preventive Medicine: Keys to preventing Memory Loss
At our healthy aging seminar we discussed the benefits of calorie restriction. In societies where people live to be 100 the average calorie consumption is 1800 calories. In this country it is 3000.Calorie restriction seems to work by up regulating the sirtuin enzyme which helps reduce insulin resistance. Calorie restriction has been associated with increased longevity in all species including Man. A recent study done in Germany looked at Women with a mean age of 60. When calories were reduced 30% their memory scores were significantly improved. This suggests that not only can a relatively low calorie Mediterranean diet improve longevity,but it may be our best defense for preventing Alzheimer disease.
Resveratrol
Resveratrol is a component of Red Wine. It seems Resveratrol up regulates the Sirtuin enzyme much like low calorie diets. Thus far animal studies have suggested Resveratrol may reduce insulin resistance and possibly prevent Cancer. Should we take Resveratrol? I don't know. There does not seem to be any harm from this supplement and there is potential for benefit. Resveratrol is relatively expensive and you need to make sure the manufacturer is reliable as supplements have little regulation. Remember Resveratrol is a supplement not a substitute. There is no substitute for a healthy diet.
RAB
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Asthma & Allergies:
Atopic Dermatitis
Eczema is a form of atopic or allergic dermatitis. It is often the first manifestation of allergy in children. Classically this has been treated with topical steroids and antihistamines. Recent evidence suggests that patients with atopic dermatitis also have defects in their skin barrier. This provides an explanation why treatments that improve skin barrier protection, such as the Trixera skincare products we use in the office seem to be effective in the treatment of allergic skincare conditions.
Why Allergy Test?
Allergy testing is a tool that allows us to answer several basic questions about allergy.
- Is Allergy the Correct Diagnosis?-- Many diseases can present with similar symptoms. Testing allows us to make the proper diagnosis.
- What items should the patient avoid?-- Testing allows us to accurately identify what patients are allergic to. Environmental controls are first line therapy in the treatment of allergic rhinitis and asthma. Patients incorrectly identify what they are allergic to 30-40% of the time.
- Should we consider desensitization?-- If desensitization is considered, specific identification is critical for good results.
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Aesthetics and Skincare: Skin Cancer Prevention
With Summer just around the corner its time to think about skin cancer prevention. Over 1 million new cases 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. Recent studies suggest that age spots or solar lentigenes actually have cancer markers in them suggesting they may be precursors to skin cancer. If you are interested in knowing how much UV light damage you have please schedule a complimentary 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: Skin Contouring
We are now in the next generation of antiaging skin correction. The first generation focused on the use of Botox in the upper face and dermal fillers such as Restylane and Juvederm to fill lines such as the nasolabial folds and marionette lines. We now know that by using principles of vector correction, we can use some fillers to actually recontour the face to provide lift volume and tightness. During the aging process gravity, sun damage, smoking and natural aging cause droopiness of the skin in certain predictable areas. A vector is a combination of direction and volume. Understanding the natural progression of these vectors can be corrected with certain fillers such as Radiesse. This can be used alone or in combination with Botox to provide a look that our patients have only described as "Wow". If you are looking for that "Wow" look it might be time to schedule that skincare consultation today.
RAB
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Preventive Medicine Tips:
- Make Vegetables and fruit the mainstay of your diet. This will keep your calories down and you healthy. In cultures where people live to be 100 they average 1800 calories per day. In the USA we average 3000.
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Richard A. Bernstein M.D. |
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