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FROM THE DOC
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Good-bye Personalized Medicine, Hello Precision Medicine
"Doctors have always recognized that every patient is unique, and doctors have always tried to tailor their treatments as best they can to the individuals. You can match a blood transfusion to a blood type-that was an important discovery. What if matching a cancer cure to our genetic code was just as easy, just as standard?"
I think this quote captures the simple goal of what was formerly termed Personalized Medicine, but has now been transformed to Precision Medicine. With the commitment of the NIH this year to the Precision Medicine Initiative, the goal is to engage one million patients into a broad study of human health, employing the latest genetic techniques applied to each individual, combined with the power of super-computer data-crunching, to derive new insights into diseases, and to define new methods of treatment that are tailored to the individual. The emerging power of genetics now allow us to sequence large portions of genetic code in the abnormal cells of an average individual with disease; what cost $10,000,000 to analyze one person's genome 20 years ago, now costs only $2,000 today. Combining that genetic data with the power of 'big data analysis', using the enormous advances in computer technology that are readily available, it is speculated that we can find insights into diseases that escaped detection and understanding, and that this will allow medical science to focus treatment specifically for the variations in a particular case.
As we have no doubt seen in our own lives, friends and acquaintances have had the same health condition, but their clinical courses differed. Why and how that happens is a fundamental question that can be answered when we can determine what makes those differences on a molecular basis. Identifying these differences occur, and developing specific treatments is the goal of this initial project. Read more about PMI now. You will be hearing much more about this type of approach as science and technology move forward in the next decade, and if you want, you can become part of this large-scale study.
- Yours in good health, Dr. Lakin
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| VOL 12 / Issue: #2 | Spring/ 2016 |
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Spring Is a Miraculous Experience.. . . . . . . .
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 The whole world comes alive after the winter in which it seemed that everything was dead. The world comes filled with color and the scent of delicious greenery. The world that seemed so dull and cold has come alive once again. Little did we know that beneath the cold hard ground the plants and trees were preparing for rebirth. Spring gives us hope for rejuvenation in our own lives as well. Spring is a time to renew the excitement and zest for life that lives inside.
- Family Friend Poems
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Shingles Isn't Just a Nasty & Extremely Painful Experience. . . . . .
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 Researchers found elderly people who suffered a bout of the excruciating blisters were more than twice as likely to have a stroke in the first week after an attack started, and nearly twice as likely to have a heart attack. Shingles, also called herpes zoster, is a souvenir of childhood chicken pox infection. Both are caused by the same virus, although it's called varicella when it causes chicken pox. Like all herpes viruses, it stays in the body forever, moving along the nerves. Usually the immune system can control it after the first outbreak of chicken pox, but as people get older, or if they get cancer or another condition that depresses the immune system, it can erupt in a band of blisters.
About a million Americans suffer a shingles outbreak every year. Unlike itchy chicken pox, however, shingles can hurt. And it can cause months of pain after the blisters heal.
Some studies had suggested that an outbreak of shingles might cause heart attacks, so Caroline Minassian and colleagues from the London School of Hygiene and Tropical Medicine looked at the medical records of more than 67,000 U.S. Medicare patients who had shingles and suffered either a stroke or heart attack within a year afterwards.
"We observed a marked increase in the rate of acute cardiovascular events in the first week after zoster diagnosis: a 2.4-fold increased ischemic stroke rate and a 1.7-fold increased MI (heart attack) rate," they wrote in the Public Library of Science journal PLoS Medicine.
"The most marked increase was observed during the first week following zoster diagnosis."
There are two possible causes, they said. The virus may be replicating inside the walls of the arteries, causing fatty buildups to break off and cause a stroke or heart attack. Or it might be the pain causing stress that sends the blood pressure up, they said.
- by Maggie Fox, NBC News Back To Top |
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Art Makes Us Healthier!
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 Art is good for the soul...and your health. This quiz in the NY Times is for anyone who likes art or who just thinks they have 'good taste'. Enjoy the beauty of these modern masterpieces and have a bit of fun at the same time.
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Dress Like a Pro. . . . .
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 Wound dressings are important for getting the skin to heal properly, and there are a bunch of tricks to making this happen.
Among the most important tricks is getting the proper materials. Below is a list of various materials that will make you a virtual wound professional, and a resource for family and friends.
Products to get for the pro:
HYPAFIX:
This tape sticks nicely to the skin but is easy to remove and doesn't bother hairy skin that much. Best to find at Amazon or medical supply stores.
COBAN:
This is a self-adhering elastic that is great for wrapping around an arm or leg area that needs to be covered. It is easily removed, does not stick to the skin, and is available at your local pharmacy.
ADAPTIC:
This is a mesh that has a little vaseline ointment on it to prevent sticking. Perfect for any skin tear or open area that rebleeds when you take the dressing off due to sticking...THIS WON"T STICK!
GAUZE:
Always important to have around for absorbing fluids that leak from an open wound, but make sure it's not a problem that it sticks to the skins surfaces. Sometimes you want things to stick, like when you have a wound that needs material removed from it. Other times, it only causes bleeding and bother.
SILVER GEL OR SILVADENE CREAM:
Silver Gel is over the counter...while the cream is a prescription. Both are good anti-infectives as they work using silver ions where are a natural antibacterial substance. Gel or cream is important when you need to get a wound area to dry out. Ointments, which are what Neosporin and Bacitracin area.....keep tissues moist and often that is not the ideal topical as we want things to dry out just a bit.
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NEW BOOK: Taking Control, By Linda Stehling MD & Douglas M. Lakin MD
| "Advance care Planning Guide for When You Become Seriously Ill"
Get your copy at the office or read online
HERE!
Watch for our next Powerful Conversations for discussions!
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Work-life Balance Is Stressing Us Out -- At Home!
| People are more stressed out at home than they are at work, new research shows, but that may be because they are trying to juggle so many responsibilities at the same time.
"It seems like a lot of the stress at home comes from combining work and home responsibilities," said Sarah Damaske, assistant professor of labor, employment relations and sociology at The Pennsylvania State University.
Penn State asked 122 working adults to both self-report their stress levels at various intervals throughout the day, and to take a swab measuring their levels of cortisol, a major marker of stress.
They found that for the majority of participants, cortisol levels were higher at home than at work.
The participants' self-reported stress readings didn't necessarily match with their actual stress levels, however, said Damaske, one of the report's authors.
She said the findings don't necessarily suggest that people should work more, or that they aren't happy at home. Instead, she thinks it implies that the stress of trying to get everything done at home and at work tends to come out once people are home.
Still, she said the findings do also reinforce other research showing that people who work are healthier. Other research has found that works both ways - healthier people are more likely to be employed, and employment also appears to have additional health benefits in and of itself.
"What we're finding suggests that work is good for you - that there actually are benefits to working," she said. The Penn State findings were consistent for men and women, and similar for parents and non-parents.
The one exception was higher-income workers, who Damaske said had equal levels of stress at work and home. She said that makes sense given previous research showing that higher status jobs are more stressful.
There's plenty of research showing that parents in particular are stressed out by juggling work and family responsibilities. A Pew Research Center report released last year found that more than half of moms and dads found it difficult to balance the two. A separate study, released by Insights In Marketing earlier this year, also showed that many moms and dads were struggling to balance " having it all." - By Allison Linn, TODAY Back To Top
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Pat's Book Review. . . .
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"When Breath Becomes Air" by Paul Kalanithi ----------a profoundly moving, exquisitely observed memoir, written by 36 year old Paul Kalanithi, brain neurosurgeon, husband and father who was faced with his own mortality after a diagnosis of stage four brain cancer. At that moment he went from being a practicing brain surgeon to being a dying patient...a fatal transformation.
A writer, any writer who can teach about life, death and dying and still maintain a sense of participation and a sense of humanity has my attention from the start.
Originally, page upon page was written by this reviewer, extolling Dr. Kalanithi's virtues, talents, humanity, sense of family and appreciation for life - none as effectively presented as they were in his own words. It is in this light, this reflection upon his words, his adequacies in defining his appreciation for life, his family, his friends, his profession and his fellowships and ,of course, his invaluable sense of life in the presence of death, the reading of this book, his book, in his own words is how this book should be read, digested and reflected upon.
May we all be so fortunate to have such perceptions of life and death so productive and effectively presented as well as being grateful for the time given to us. In so doing, not only is Dr. Kalanithi's life cherished, respected and embraced but it becomes HIS gift to us.
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Be Sure You Have Our Correct Address!
| Paradise Valley Medical Clinic
Ninety Mountain View 9977 N. 90th Street, Suite 180
Scottsdale, AZ 85258
480.614.5800480.614.5800 (Phone)
480.614.6322 (Fax)
**Additional Top Floor Ramp Parking:
The 2nd floor ramp parking is very close to our door, but the entrance is at the VERY NORTH END of the parking area of the two buildings. You drive all the way North...enter at the NORTH END, then drive down to the SOUTH END of the 2nd FLoor Parking to get a space very near the entrance.
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Insights By Steve: Check it Out!
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|  | Insight By Steve (Author)
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New Study Indicates That Higher Glycemic Fools Have A Much Greater Risk Of Causing Lung Cancer:
How about a 49% higher chance! Researchers at the University of Texas MD Anderson Cancer Center, lead by author Xiefeug Wu MD, PhD, found that persons who ate food with a higher glycemic index, such as white bread, pretzels, bagels, baguettes, white rice, corn flakes, and white potatoes, were at far greater risk for lung cancer, even if they had never smoked.
Lower glycemic foods, those that raise the blood sugar levels more slowly after a meal, include whole wheat and pumpernickel bread, rolled oatmeal, and pasta. Dr. Sandeep Chunduri, a hematologist oncologist at Advocate Good Shepherd Hospital in Barrington, Illinois, points out that, in addition, diets rich in antioxidants, like fruit and vegetables, may actually reduce the risk of lung cancer while saturated fats, full0fat- dairy, and red meats may increase the risk.
The American Cancer Society reports that more people in the U.S. die of lung cancer, about 158,000 each year, than any other type of cancer (about one in four).
Dr. Chunduri states, "It is not the quantity of carbohydrates but rather the quality which determines the increase risk." Early education on diet and smoking cessation are also vital in reducing the incidence of lung cancer.
For more interest articles, Insights By Steve, see our website Favorite Link page or
**There is a new newsletter every month with more interesting and up to date health information! Check it out!
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Question On Your Lab Results? Check out: DoctorDoug's Academy
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Dr. Lakin's guide videos on how to better understand your lab work results.....
Check the first edition here: | | DoctorDoug's Academy: Lesson #1 CBC |
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Clean Home, Clean Conscience? Spotlessness May Lead To Ethical Behavior!
| Scrubbing your bathroom and vacuuming the carpet could mean more than a spotless home - it could lead to a cleaner conscience.
General cleanliness lends itself to ethical behavior, according to a new study, while feelings of disgust and uncleanliness were more likely to lead to immoral behavior like lying and cheating. Researchers conducted experiments with 600 male and female participants and found that after participants were deemed to be effectively "disgusted" by gross images, products or memories, their responses were significantly more selfish and deceptive. The antidote? Thinking about cleaning put them back on the straight-and-narrow.
"As an emotion, disgust is designed as a protection," Vikas Mittal, professor of marketing at Rice University's Jones Graduate School of Business and one of the study's three co-authors, said in a statement. "When people feel disgusted, they tend to remove themselves from a situation."
The experiments included evaluating particularly unpleasant consumer products like antidiarrheal medicine, diapers and adult incontinence products; writing essays about their most disgusting memory; and watching a nauseating toilet scene from the movie "Trainspotting." In a separate set of experiments, after being thoroughly grossed out, people were asked to evaluate cleaning products like disinfectants, household cleaners and body washes. Participants' behaviors were radically different. Responses to questions about cheating or lying for financial gain were deemed significantly more "deceptive" in a state of disgust than in a neutral or pleasant state of mind. Mittal said these responses have to do with a person's instinct to protect themselves against extreme unpleasant feelings, therefore prompting immoral and otherwise hostile behavior.
"Small cheating starts to occur. If I'm disgusted and more focused on myself and I need to lie a little bit to gain a small advantage, I'll do that. That's the underlying mechanism," said Mittal. The deeper meaning of the findings, he said, is to assert that strong emotions can be triggered by normal daily rituals, like reading the newspaper and listening to the radio. It suggests that a clean workplace could even affect an employee's willingness to cooperate with coworkers and produce more positive results.
"At the basic level, if you have environments that are cleaner, if you have workplaces that are cleaner, people should be less likely to feel disgusted," said Mittal. The study, released Tuesday by Mittal and colleagues at Penn State and Arizona State, is set to be published in the journal Organizational Behavior and Human Decision Processes.
Erik Helzer, Ph.D., assistant professor at Johns Hopkins Carey Business School in Baltimore, studies moral character, ethical behavior, and self-and-social assessment. He said through this study and similar laboratory studies conducted to measure the effects of cleanliness on a person's morals and ethics, research has generally found that cleanliness does affect behavior.
"When we're feeling disgusted or feeling pure, there's a tendency to think differently about the world around us than we might feel in the absence of those feelings," said Helzer, whose past research includes the influence of physical cleanliness on moral and political attitudes.
"It's also important to recognize that the effects of purity may not be inherently moral," he said. In his own research, Helzer studied the connection between political values, cleanliness, and perceived morality, which is subjective and depends on the participants' political beliefs.
- By Rebecca Ungarino, TODAY
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We Need Your Help!
| Keeping you on your correct medication is as important to us as it is to you. With your help, we can be more efficient and be sure you are getting your refill requests on time and to your correct pharmacy.
Tips: 1. If you need a refill, be sure to call your pharmacy FIRST, not our office. They will know if you have more refills, and if not, they will call/fax/electronically message us with your request. Then we will contact you if there is a question or concern.
2. Remember to call your pharmacy in plenty of time so you do not run out of your medications. Sometimes we need up to 48 hours to complete a request and we do not want this to be a hardship for you.
3. Register and use our SECURE PATIENT PORTAL for refill requests. We monitor this continually and again will contact you if there is a problem.
4. Remember we do not refill pain or routine medications on Fridays or weekends and all pain medications must be picked up at our office. We cannot mail or any medications outside our office. Please plan ahead and make arrangements!
We are always here to help you and appreciate the opportunity to care for your healthcare needs!
Yours in good health, Dr. Lakin & Staff
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Have You Scheduled Your Spring Physical Yet?
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As you all know, Dr Lakin is a strong supporter of annual physicals, and Spring is a time we can visit and explore any unresolved medical problems and any new health issues that need to be addressed. Annual physicals are one of the best ways to safeguard your health.
The American Medical Association recommends that if you are between the ages of 40 - 49 years, physicals should be done every two years. If you are 50 years plus, it is recommend you have yearly exams, especially if you have any chronic medical conditions that need to be monitored. Call to schedule your well care visit today!
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Are You Registered For Dr. Lakin's Secure Patient Portal?
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Now is the time! For help on how to register and FAQ, check our these videos: It's as easy as that!
**Please note that our Patient Portal is not 100% optimized for
Internet Explorer 11. Some of the functions will not work as intended. The software development team is working on it. Until then, please use Internet Explorer 8, 9, 10, or Mozilla Firefox, a free browser.
Please contact Nan at nan@doctordoug.com if you have further questions or concerns.
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AT THE MOVIES WITH BARB A.
| GREAT + + + + ENTERTAINING + + + RENT THE MOVIE + + FORGET IT! + **EMAIL ME! ???
+ + + +
45 YEARS...
VERY BRITISH AND CERTAINLY NOT A TEA AND TOAST EPIC. IT IS A TRUE DOMESTIC DRAMA. CHARLOTTE RAMPLING AND TOM COUIRTENAY PLAY A HUSBAND WIFE. KATE AND GEOFF ARE PLANNING A 45TH WEDDING ANNIVERSARY PARTY. THE MOVIE TAKES PLACE OVER A 7 DAY PERIOD. A LETTER ARRIVES TELLING GEOFF THAT HIS FIRST LOVE, KATYA, IS NOW DECEASED AND HAS BEEN FOUND IN A GLACIER. HIS WIFE KATE KNOWS NOTHING ABOUT HER. HOW THIS MARRIED COUPLE DEAL WITH THIS NEWS IS FASCINATING TO WATCH. AWESOME FILM.
+ + + +
HELLO, MY NAME IS DORIS...
THIS IS A DELIGHTFUL MUST-SEE MOVIE, AND IT IS A SHOWCASE FOR SALLY FIELD. IT TAKES PLACE IN NEW YORK CITY. DORIS BECOMES SMITTEN WITH A MUCH YOUNGER MAN AT HER OFFICE. THERE ARE MANY LAUGH OUT LOUD MOMENTS AS WELL AS MOMENTS WHICH TUG AT YOUR HEART. HER BEST FRIEND PLAYED BY TYNE DALY IS HILARIOUS. YOU NEED TO SEE THIS AND THE SOONER THE BETTER.
+ + + + +
I SAW THE LIGHT....
TO ANYONE ELSE THIS WOULD PROBABLY BE A **
BUT I HAPPEN TO BE A COUNTRY MOVIE FAN. HANK WILLIAMS IS MY ALL TIME FAVORITE. THIS FILM WAS A DELIGHT FOR ME TO SIT FOR TWO HOUSE AND LISTEN TO HIS MUSIC. IT WAS REALLY MORE LIKE A DOCUMENTARY THAN A MOVIE. I LOVED IT.
That's it for now... See you at an ASU Baseball game or the movies! |
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| For this seasonal (and vegetarian) twist on carbonara, stir the yolk into your portion while the pasta is still steaming hot.
Ingredients - 3 tablespoons olive oil, divided
- 1 bunch asparagus, trimmed, cut into 2" pieces
- Kosher salt and freshly ground black pepper
- 2 tablespoons unsalted butter
- 8 oz. shiitake mushrooms, stems removed, caps sliced
- 1 small shallot, finely chopped
- 1 teaspoon chopped fresh oregano
- 1 teaspoon chopped fresh thyme
- 12 oz. dried or 1 lb. fresh fettuccine
- 3 oz. Parmesan, grated (about ¾ cup), plus more for serving
- 4 large egg yolks*
- *Raw egg is not recommended for infants, the elderly, pregnant women, people with weakened immune systems...or people who don't like raw eggs.
Preparation
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Heat 2 Tbsp. oil in a large skillet over medium-high heat. Add asparagus, season with salt and pepper, and cook, stirring occasionally, until just tender, about 4 minutes. Transfer to a plate.
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Heat butter and remaining 1 Tbsp. oil in same skillet over medium-high heat. Add mushrooms, season with salt and pepper, and cook, tossing often, until tender, about 5 minutes. Add shallot and cook, tossing occasionally, until softened, about 2 minutes. Toss in oregano, thyme, and asparagus.
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Meanwhile, cook pasta in a large pot of boiling salted water, stirring occasionally, until al dente. Drain, reserving 1 cup pasta cooking liquid.
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Add pasta, ½ cup pasta cooking liquid, and 3 oz. Parmesan to skillet. Cook, tossing and adding more pasta cooking liquid as needed, until sauce coats pasta, about 2 minutes; season with salt and pepper.
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Divide pasta among plates and top each with yolks and more Parmesan.
Nutrition
- Calories (kcal) 670
- Fat (g) 28
- Saturated Fat (g) 11
- Cholesterol (mg) 240
- Carbohydrates (g) 78
- Dietary Fiber (g) 5
- Total Sugars (g) 8
- Protein (g) 26
- Sodium (mg) 500
- By Chris Fischer
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Have a safe and healthy Spring!
Dr. Douglas Lakin & Staff
Paradise Valley Medical Clinic PC
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