Dr. Paul Diamond

01/26/2025

Good news for those looking to complete immigration medical examinations [I-693] - you now do not have to show proof of COVID vaccine(s), which had been a stickler for many examinees in the past.

09/15/2024

Here is an article about new national guidelines concerning mammogram reports. However, the breast ultrasounds may not be covered by a health insurance plan - in our experience it almost always is, and we can do them in-house. The breast MRI would be another story with regard to coverage; however those with the original Medicare plan should have it covered.

Breast Density and Your Mammogram Report
Regular mammograms are the best way to find breast cancer early. But if your mammogram report says you have dense breast tissue, you might be wondering what that means for you.

What is dense breast tissue?
Breast density is a measure of how much fibrous and glandular tissue (also known as fibroglandular tissue) there is in your breast, as compared to fat tissue. It isn’t related to breast size or firmness.

Breasts are made up of lobules, ducts, and fatty and fibrous connective tissue.

Lobules are the small glands that produce milk, while ducts are the tiny tubes that carry the milk from the lobules to the ni**le. Together, the lobules and ducts are referred to as glandular tissue.
Fibrous tissue and fat give breasts their size and shape and hold the other structures in place.
color illustration showing the structure of the breast (including location of ar**la, ni**le, collecting ducts, ducts, lobules, fatty connective tissue, duct cells and lobular cells)
Fibrous and glandular tissue are harder to see through on a mammogram, so your breast tissue may be called ‘dense’ if you have a lot of these tissues (and not as much fat).

Having dense breast tissue is common. Some women have more dense breast tissue than others. For most women, breasts become less dense with age. But in some women, there’s little change.

How do I know if I have dense breasts?
Radiologists are doctors who “read” mammograms (and other types of imaging tests). They check your mammogram for abnormal areas, and they also look at breast density.

There are 4 categories of breast density. They go from almost all fatty tissue to extremely dense tissue with very little fat. The radiologist looks at your mammograms to determine which of the 4 categories best describes how dense your breasts are:

Category A: Breasts are almost all fatty tissue.

Category B: There are scattered areas of dense glandular and fibrous tissue (seen as white areas on the mammogram).

Category C: More of the breast is made of dense glandular and fibrous tissue (described as heterogeneously dense). This can make it hard to see small masses in or around the dense tissue, which also appear as white areas.

Category D: Breasts are extremely dense, which makes it harder to see masses or other findings that may appear as white areas on the mammogram.

In general, patients whose breast density falls into categories C (heterogeneously dense) or D (extremely dense) are considered to have dense breast tissue. This includes about half of all women in the US who have mammograms to look for breast cancer.

Mammogram reports sent to health care providers typically include a description of breast density, so your health care provider can tell you if your mammogram shows that you have dense breasts. Mammogram reports sent directly to patients often mention breast density as well, although the wording used in these reports is often different. In Florida it is state law for the imaging facility to send a letter concerning mammogram results to the patient, which is why we do not notify of normal mammograms in our office.

Do mammogram reports have to include breast density?
As of September 10, 2024, the Food and Drug Administration (FDA) requires that all mammogram reports sent to patients must include breast density, which should be described as either “not dense” or “dense.”

If your breast tissue is not dense, the report will say, “Breast tissue can be either dense or not dense. Dense tissue makes it harder to find breast cancer on a mammogram and also raises the risk of developing breast cancer. Your breast tissue is not dense. Talk to your healthcare provider about breast density, risks for breast cancer, and your individual situation.”

If your breast tissue is dense, the report will say, “Breast tissue can be either dense or not dense. Dense tissue makes it harder to find breast cancer on a mammogram and also raises the risk of developing breast cancer. Your breast tissue is dense. In some people with dense tissue, other imaging tests in addition to a mammogram may help find cancers. Talk to your healthcare provider about breast density, risks for breast cancer, and your individual situation.”

In addition, mammogram reports sent to healthcare providers must include an overall assessment of breast density using the 4 categories described above.

Why is breast density important?
Breast density is important for two main reasons:

Women who have dense breast tissue have a higher risk of breast cancer compared to women with less dense breast tissue. It’s unclear at this time why dense breast tissue is linked to breast cancer risk. It may be that dense breast tissue has more cells that can develop into abnormal cells.
Dense breast tissue also makes it harder for radiologists to see cancer on mammograms. Dense (fibrous and glandular) breast tissue looks white on a mammogram. Breast masses and cancers can also look white, so the dense tissue can make it harder to see them. In contrast, fatty tissue looks almost black on a mammogram, so it’s easier to see a tumor that looks white if most of the breast is fat tissue.

If I have dense breasts, do I still need a mammogram?
Yes. Most breast cancers can be seen on a mammogram even in women who have dense breast tissue, so it’s still important to get regular mammograms. Mammograms can help save women’s lives.

Even if you have a normal mammogram report, you should know how your breasts normally look and feel. Anytime there’s a change, you should report it to a health care provider right away.

Should I have any other screening tests if I have dense breast tissue?
At this time, experts do not agree what other tests, if any, should be done in addition to mammograms in women with dense breasts.

Digital breast tomosynthesis (3D mammography) can find some cancers not seen on regular (2D) mammograms. Some studies have suggested 3D mammography might be particularly helpful in women with dense breasts. It can be used as a screening test along with or instead of standard mammography, although it isn’t yet available at all imaging centers. - All of our local imaging centers do tomosynthesis, and that is my standard mammography order.

Studies have shown that breast ultrasound and possibly magnetic resonance imaging (MRI) can also help find some breast cancers that can’t be seen on mammograms. But ultrasound and MRI can also show more findings that are not cancer. This can lead to more tests and unnecessary biopsies. And the cost of an ultrasound or MRI may not be covered by insurance.

Talk to your health care provider about whether you should consider any of these tests.

What should I do if I have dense breast tissue?
If your mammogram report says that you have dense breast tissue, talk with your health care provider about what this means for you. Be sure that your doctor or nurse knows if there’s anything in your medical history that increases your risk for breast cancer. To learn more about breast cancer risk factors, see Breast Cancer Risk and Prevention.

Any woman who’s already in a high-risk group (based on inherited gene mutations, a strong family history of breast cancer, or other factors) should have an MRI along with her yearly mammogram.
To learn more about if you’re in a higher-risk group for breast cancer, see American Cancer Society Recommendations for the Early Detection of Breast Cancer.

11/12/2022

Connecting unhealthy lifestyles to COVID-19 deaths
by Ochsner Health System

COVID-19 death rate in the United States reported to the CDC, by state/territory (deaths per 100,000). Source:1 Centers for Disease Control and Prevention (CDC): https://covid.cdc.gov/covid-data-tracker/ . AS = American Samoa; FSM = Federated States of Micronesia; GU = Guam; MP = Northern Mariana Islands; PW = Palau; RMI = Republic of Marshall Islands; VI = Virgin Islands. Credit: The American Journal of Medicine (2022). DOI: 10.1016/j.amjmed.2022.06.006
The American Journal of Medicine has published an article recognizing the link between unhealthy lifestyle behaviors and the one million COVID-19 deaths in the United States. Dr. Carl "Chip" Lavie, Medical Director Cardiac Rehabilitation and Prevention at the John Ochsner Heart and Vascular Institute was a senior author on this manuscript.

In 2022, the United States surpassed one million COVID-19 related deaths. The publication states there is a significant association between unhealthy behaviors and conditions such as low physical activity, obesity, diabetes and smoking, and poorer outcomes from COVID-19 infections.

"Clinicians have long been aware of the link between increased mortality rates and unhealthy lifestyles," said Dr. Lavie. "Individuals who live sedentary lives with poor eating habits and multiple chronic conditions are always more prone to negative health outcomes."

Dietary habits and body mass index status across the United States. Source:18 Althoff T, Nilforoshan H, Hua J Leskovec J. Large-scale diet tracking data reveal disparate associations between food environment and diet. Credit: The American Journal of Medicine (2022). DOI: 10.1016/j.amjmed.2022.06.006
The article explains that the current state of health outcomes has been building for decades and should be considered a syndemic, which is the simultaneous occurrence of two prevalent health conditions or endemics. In this article, the authors compare geographic maps of the Unites States outlining COVID-19 deaths, several lifestyle behaviors, obesity, and chronic conditions. With this, a pattern is evident and quite alarming for medical professionals.

"The reality of this comparison should be quite eye-opening for many," said Lavie. "The only way to combat the syndemic we are experiencing is to promote healthy lifestyles and address the health needs of all, especially those in underserved communities who have been disproportionately impacted by poor outcomes related to chronic conditions and COVID-19."

More information: Ross Arena et al, Mapping One Million COVID-19 Deaths and Unhealthy Lifestyle Behaviors in the United States: Recognizing the Syndemic Pattern and Taking Action, The American Journal of Medicine (2022). DOI: 10.1016/j.amjmed.2022.06.006
Journal information: American Journal of Medicine

12/06/2021

Another interesting article I came across:

Probiotics and Mental Health
Your second brain plays a major role in mood and mental function
BY LISA ROTH COLLINS December 5, 2021

You may wonder how beneficial bacteria could possibly have a positive impact on mental health. If you have heard of the brain-gut axis—the pathway that exists between the brain and the gut—then you might guess there is a definite link between these two areas of the body.

This relationship is important to understand so you can take advantage of using probiotics to assist with mental health issues. Let’s begin with a few basics.

How Can Probiotics Affect the Brain?
Probiotics, also known as beneficial or good bacteria, consist primarily of species in both the Lactobacillus (L.) and Bifidobacterium (B.) genera. These bacteria live in the intestinal tract and are charged with supporting nutrient absorption and keeping the body in balance. Probiotics are part of the body’s microbiome, which also consists of viruses, protozoa, and fungi (including yeasts).

So how do probiotics get from the intestinal tract to your brain? The gut-brain axis is a phenomenon that links the two regions of the body: the nervous system in the digestive tract (known as the enteric nervous system) and the brain (the central nervous system). The main pathway between the gut and brain is the vagus nerve, which is also the longest nerve in the human body.

Researchers have called the gut the “second brain” because it makes serotonin, dopamine, and gamma-aminobutyric acid, neurotransmitters also found in the “other” brain. All of these neurotransmitters have a major role in regulating mood, which translates into an impact on mental function.

Probiotics and Mental Health
Researchers have uncovered many instances in which good bacteria have had a beneficial effect on mental health. For example, in a 2016 systematic review that included 38 studies, investigators found that B. longum, B. breve, and B. infantis as well as L. helvetius and L. rhanosus helped improve memory (non-spatial and spatial) as well as some psychiatric disorders-related behaviors.

How are probiotics for managing stress? According to the findings of a 2019 double-blind study, stress was significantly reduced among those with moderate stress who took a probiotic supplement containing L. plantarum DR7. The authors concluded that this bacterial strain could be used “as a natural strategy to improve psychological functions, cognitive health, and memory in stressed adults.”

How to Choose Probiotic Supplements
If you’ve decided beneficial bacteria can be helpful for enhancing mental health for yourself and your family, you need to select the most effective and convenient supplements.

One of the most asked questions about probiotic supplements is whether they should be refrigerated. The answer is easy: Since heat is the enemy of beneficial bacteria, choose probiotics that are refrigerated and keep them stored in your fridge.

Now that you have a viable supplement, what’s the best form for it to be in? Since your supplement is transporting valuable cargo, you want a vehicle that is foolproof against dangers that will prevent the probiotics from working efficiently, such as gastric stomach acid. This substance is enemy No. 1 of probiotics since it can destroy the good bacteria before they even have a chance to reach their destination.

For that job, you need an enteric-coated probiotic supplement. The coating ensures the beneficial bacteria reach the intestinal tract, where they are set free.

Bottom Line
The use of probiotics is often overlooked when it comes to managing mental health issues. Considerable research shows that a number of species from both Lactobacillus and Bifidobacterium genera can be helpful in this area of health. Be sure to choose probiotic supplements that are enteric-coated and kept refrigerated.

11/29/2021

GOOD NEWS!!
Florida Reports Lowest Daily COVID-19 Cases per Capita in US
November 28, 2021

Florida is now tied for the lowest daily COVID-19 cases per capita in the United States.

A Nov. 26 update shows the Sunshine State reported a daily average of 1,393 cases as of Friday, or about six cases per 100,000 people. That represents a five percent decrease over the past two weeks, data from the state shows.

Hawaii also had a daily average of 81 COVID-19 cases, or about six per 100,000 people, according to the data. Puerto Rico, a U.S. territory, had 82 COVID-19 cases, representing about 2 cases per 100,000 people.

Michigan saw a daily average of 8,457 COVID-19 cases, or 85 cases per 100,000 people—the highest in the United States, according to the data. Those figures represent a 59 percent increase in cases over the past two weeks.

Next were New Hampshire, New Mexico, and Vermont, which had 73, 67, and 61 COVID-19 cases per 100,000 people, respectively, according to the data.

11/29/2021

Here's an interesting hygienic article I came across tonight:

Things Happen When You Don’t Wash Your Sheets

BY LISA ROTH COLLINS November 28, 2021 Updated: November 28, 2021

How often do you wash your sheets and put fresh ones on your bed? That’s OK, you don’t need to let anyone else know; you can keep the answer to yourself. However, the best answer is no longer than two weeks, and less in some cases.

If you and your family are sleeping on sheets that have been on your bed longer than that, then there are some gross and unhealthy things that may be happening in your bedrooms. So be prepared: What follows may not be for the faint of heart.

What’s Happening to Your Sheets?

The human (and pet) body is constantly shedding skin cells. How many is a matter of some debate, but it is significant, like millions of cells a day. Since you spend about one-third of your life in bed, plenty of cells are accumulating in your sheets.

Skin cells aren’t the only things that are gathering in your bed. Some of those other “things” have legs. Moisture from sweating can accumulate during the night, making your sheets a breeding ground. Therefore, according to hygiene physician Dr. Lisa Ackerley, failing to wash your sheets often could be putting you and your family at risk for significant health problems. Let’s explore what those problems might be.

Health Hazards When You Don’t Wash Your Sheets
Here are a few of the health issues that can arise when you keep your sheets on the bed too long.

Mighty Mites: The dead skin cells that accumulate in your bed linens in between clean sheet replacements are dinner for dust mites that enjoy this delicacy. Mites and their droppings may trigger asthma and allergies and contribute to eczema.

Pet Issues: Cat and dog hair and dander are dinner for dust mites as well. In addition, if your canine friend sleeps in your bed and has mange, the mites can irritate your skin. Pet sleep buddies may also transmit ringworm. If you want to allow your pets to sleep with you, be sure to routinely check their health and change your sheets weekly.

Germ Garden: Dead skin cells, sweat, saliva, yeast, f***l matter, and other bodily deposits in your bed are a fertile garden for germs to thrive. Some tests, for example, have found that pillowcases unwashed for one week had 17,000 more bacterial colonies than a toilet seat.

One bacterium that can linger in your sheets is Staphylococcus aureus, which is found on both healthy skin and on cuts and other skin conditions. Yeast is another threat, as it can accumulate in folds of skin where there is moisture and result in skin infections.

Acne Problems: If you suffer from acne, you should be changing your pillowcase every two to three days. That’s because bacteria, dead skin cells, and dirt in the pillowcase can contribute to outbreaks and clog your pores.

Lingering Germs. Whenever you or family members are ill, bacteria and viruses can linger in your sheets for up to several hours, depending on the microorganism. Therefore, it’s a good idea to wash your linens more often to kill germs.

How to Wash Your Sheets:

According to a 2017 survey, only 44 percent of Americans wash their sheets once or twice a month. Eleven percent wash them once a season, and 5 percent do it only once or twice a year. However, the optimal sheet washing schedule is once every two weeks, but once a week if you sweat a lot or if you are allergic to dust mites. In the latter case, the water should be at least 130 degrees Fahrenheit so you will kill the mites.

If you or a family member is sick, then sheets and other bedding should be changed as soon as you or the family member feels better to reduce the risk of reinfection. Use hot water to kill the germs and a hot dry cycle.

Use an all-natural laundry detergent to keep your sheets and your skin free of exposure to potentially harmful chemicals. You can also help reduce waste by reducing laundry packaging waste and using detergent strips. These strips are plastic-free, dissolve in both hot and cold water, and are free of harmful chemicals.

Other Tips:

--Don’t make your bed right away in the morning. Allow any moisture that may have accumulated in your sheets to dry, this makes them less attractive to bacteria and mites.
--Use a mattress protector and pillow protectors, which are easy to wash.
--Shower or bathe before going to bed. This helps reduce dirt and other contaminants in your bed.
--Provide a separate blanket for your dog or cat to lie on in your bed and wash it once a week.

Bottom Line:

Do your part for yourself and your family. Wash your sheets more often and help protect your family’s health. If you do, you might really get the beauty rest you’ve been looking for.

09/17/2020

https://www.euronews.com/living/2020/09/15/live-lamb-used-in-provocative-new-vegan-commercial-in-israel?utm_source=Jewish+Insider+Contacts&utm_campaign=9c4d21f652-EMAIL_CAMPAIGN_2020_06_24_06_53_COPY_02&utm_medium=email&utm_term=0_008e75e2f9-9c4d21f652-92774253

The advert reached over a third of Israel's population - often dubbed the vegan capital of the world.

04/11/2020

Interesting statistics, health and healthy lifestyles - eating properly and daily exercise, are most important

A Flourish data visualisation by Robert Martin

03/26/2020

The scientist who helped successfully combat the HIV/AIDS epidemic explains the science behind the novel coronavirus and looks toward the future of the world affected by COVID-19.

03/22/2020

Corona - simple answers on a tough subject - go to:

The scientist who helped successfully combat the HIV/AIDS epidemic explains the science behind the novel coronavirus and looks toward the future of the world affected by COVID-19.

06/21/2019

Enclosed is an interesting article concerning cancer detection that is still in the infantile stage, with the investigator whom you would not suspect....
Cancer-sniffing dogs 97% accurate in identifying lung cancer



JAOA researchers say the dogs’ abilities may lead to the development of an effective, safe and inexpensive means for mass cancer screening.

Three beagles successfully showed they are capable of smelling lung cancer, a first step in identifying specific biomarkers for the disease. Researchers say the dogs’ abilities may lead to the development of an effective, safe and inexpensive means for mass cancer screening.

After eight weeks of training, the beagles—chosen for their superior olfactory receptor genes—were able to distinguish between blood serum samples taken from patients with malignant lung cancer and healthy controls with 97% accuracy. The double-blind study is published in the July edition of The Journal of the American Osteopathic Association.

“We’re using the dogs to sort through the layers of scent until we identify the telltale biomarkers,” says Thomas Quinn, DO, professor at Lake Erie College of Osteopathic Medicine and lead author on this study. “There is still a great deal of work ahead, but we’re making good progress.”

The dogs were led into a room with blood serum samples at nose level. Some samples came from patients with non-small cell lung cancer; others were drawn from healthy controls. After thoroughly sniffing a sample, the dogs sat down to indicate a positive finding for cancer or moved on if none was detected.

Dr. Quinn and his team are nearing completion of a second iteration of the study. This time the dogs are working to identify lung, breast and colorectal cancer using samples of patients’ breath, collected by the patient breathing into a face mask. Researchers say findings suggest the dogs can detect cancer just as effectively using this method.

The next step will be to further separate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified. The goal is to develop an over-the-counter screening product, similar to a pregnancy test in terms of cost, simplicity and availability. Dr. Quinn envisions a device that someone can breathe into and see a color change to indicate a positive or negative finding.

Early detection is key
According to the American Cancer Society, lung cancer is the leading cause of cancer death worldwide for both women and men, and more than 200,000 people in the U.S. annually receive a diagnosis of lung cancer. The five-year survival rate for stage IA non–small cell lung cancer (NSCLC) is 92%. That drops to 13% in stage IIIC NSCLC, and after metastasis, the five-year survival rates range from 10% to less than 1%, depending on the stage.

Additionally, screening and imaging for lung cancer is costly and not always reliable. Chest X-rays have a high false-negative rate, while CT scans with a computer-aided diagnosis have a high false-positive rate. Previous studies indicated that 90% of missed lung cancers occur when using chest X-rays, and CT scans have difficulty identifying small, central, juxtavascular lung cancers.

Dr. Quinn believes his research can lead to better screening and diagnosis solutions, potentially creating a change in cancer detection.
“Right now it appears dogs have a better natural ability to screen for cancer than our most advanced technology,” says Dr. Quinn. “Once we figure out what they know and how, we may be able to catch up.”

Article written by:
By JEFF BRENNAN, THE DO
Published, June 19, 2019

03/19/2019

Here's an article concerning heart risk and eggs and meats; note the third paragraph!!

Are Eggs Back on the Naughty List?

By Kelly Young

Frequent egg consumption or high cholesterol intake is associated with increased risk for incident cardiovascular disease and mortality, according to a JAMA study.

In six cohort studies, nearly 30,000 adults free of cardiovascular disease provided information on their dietary intake at baseline. During a median 18 years' follow-up, there were 5400 incident cardiovascular events and 6100 deaths.

Every 300-mg increase in daily dietary cholesterol intake, which included eggs and meats, was associated with 17% increased risk for incident CVD and 18% increased risk for mortality. Each additional half egg eaten every day was associated with 6% and 8% increased risks, respectively. These latter associations were all or largely explained by the eggs' cholesterol content. A large egg contains roughly 190 mg of cholesterol.

An editorialist concludes: "Considering the negative consequences of egg consumption and dietary cholesterol in the setting of heart-healthy dietary patterns, the importance of following evidence-based dietary recommendations, such as limiting intake of cholesterol-rich foods, should not be dismissed."