Archive for the ‘Blog’ Category

In rough US flu season for kids, vaccine working OK so far

Monday, February 24, 2020 // Flu

NEW YORK (AP) — It may end up being a bad flu season for kids, but early signs suggest the vaccine is working OK.

The vaccine has been more than 50% effective in preventing flu illness severe enough to send a child to the doctor’s office, the U.S. Centers for Disease Control and Prevention said Thursday. Health experts consider that pretty good.

The vaccines are made each year to protect against three or four different kinds of flu virus. The ingredients are based on predictions of what strains will make people sick the following winter. It doesn’t always work out.

This flu season has featured two waves, each dominated by a different virus. Both of those flu bugs are considered dangerous to children, but tend not to be as dangerous to the elderly.

Health officials grew worried when it became clear that the vaccine didn’t match the Type B flu strain that ended up causing most early season illnesses. But the CDC estimates that the vaccine has been about 50% effective against that strain in children.

And the vaccine has been about 55% effective among kids against the Type A strain that has caused a second wave of flu illnesses.

“These estimates are reassuring,” said the CDC’s Brendan Flannery, who oversees the agency’s system for evaluating the vaccine.

Vaccines against many infectious diseases aren’t considered successful unless they work at least 90% of the time. But flu is particularly challenging, partly because the virus can so quickly change. Overall, flu vaccine averages around 40%.

This season, the vaccine has been 45% effective against both types of flu across all ages.

That can change as the flu season progresses. Updated vaccine numbers are expected later this year.

One troubling finding: This season’s vaccine has been virtually ineffective vs. the Type A virus in younger adults. The reason is a mystery, but may change as more data comes in, Flannery said.

U.S. health officials have counted 92 child flu deaths this year, up from the same time last year but fewer than were counted by this point in 2018. In all, the CDC estimates at least 14,000 Americans have died of the flu this season.

___

Read the article here: https://apnews.com/4f2d5db7835df43b22af8d40e238ee7a

0 Comments Read more
 

Just How Much of a Benefit Do We Get from a Healthful Lifestyle?

Monday, February 17, 2020 // Prevention

Anthony L. Komaroff, MD reviewing 

A long-term analysis suggests that adopting such a lifestyle at midlife might add as long as 10 years of disease-free life.

Virtually everyone knows that a healthful lifestyle — never smoking, normal body-mass index (BMI), moderate-to-vigorous physical activity, moderate alcohol intake, and a higher-quality diet — is good for their health. What very few people know is just how much benefit they get from achieving all these lifestyle goals.

A Harvard team examined data from about 111,000 people at age 50 and followed them prospectively for as long as 34 years. Healthful lifestyle factors were measured repeatedly and systematically, and development of various diseases and death were recorded. The primary endpoint was life expectancy free from diabetes, cardiovascular diseases, and cancer. Women who met all the healthful lifestyle measures had an additional 10.7 years of disease-free life compared with women who met no healthful lifestyle measures. For men, the number was 7.6 additional disease-free years.

COMMENT

Most of my patients know that a healthful lifestyle is good for them, but very few appreciate just how good — which negatively affects their desire to adopt one. This report might be helpful in that regard. You can say to your 50-year-old patient: “Adopting a healthful lifestyle (compared with not doing so) might allow you to live an additional 7 to 10 disease-free years.” For many, that would be an attractive and meaningful goal.

EDITOR DISCLOSURES AT TIME OF PUBLICATION

Disclosures for Anthony L. Komaroff, MD at time of publication

Consultant/Advisory Board: SerImmune Inc.; Ono Pharma

Grant/Research Support: NIH (1U54NS105542-01)

Editorial Boards: Harvard Medical School: Harvard Health Publications; Harvard Health Letter
CITATION(S):

Li Y et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: Prospective cohort study. BMJ 2020 Jan 8; 368:l6669. (https://doi.org/10.1136/bmj.l6669)

0 Comments Read more
 

High Blood Pressure

Monday, October 22, 2018 // Blood Pressure

New Multisociety Hypertension Guideline Is Released

Allan S. Brett, MD and Karol E. Watson, MD, PhD, FACC reviewing Whelton PK et al. J Am Coll Cardiol 2017 Nov 13.

The guideline lowers thresholds for categorizing people as having hypertension and for prescribing drug therapy.

Sponsoring Organizations: American College of Cardiology (ACC), American Heart Association (AHA), and nine other organizations

Target Audience: All clinicians

Background

In 2003, the National Institutes of Health (NIH) issued its last guideline on hypertension (Seventh Joint National Committee [JNC7]; NEJM JW Gen Med Jun 15 2003 and JAMA 2003; 289:2560). In 2014, the JNC8 guideline — written by an expert panel no longer affiliated with NIH — was published (NEJM JW Gen Med Jan 15 2014 and JAMA 2014; 311:507). Now, the ACC and AHA have issued a new guideline, intended to be the U.S. standard of care.

Key Recommendations

  • Newly defined categories are “elevated blood pressure (BP)” (systolic BP, 120–129 mm Hg and diastolic BP, <80 mm Hg); stage 1 hypertension (systolic BP, 130–139 mm Hg or diastolic BP, 80–89 mm Hg), and stage 2 hypertension (systolic BP, ≥140 mm Hg or diastolic BP, ≥90 mm Hg).
  • For people with elevated BP (but not hypertension), lifestyle modification is recommended.
  • For people with stage 1 hypertension who have known atherosclerotic cardiovascular disease (CVD) or 10-year cardiovascular risk ≥10% (according to the ACC/AHA calculator, which also is used for cholesterol management), both lifestyle modification and drug therapy are recommended. Stage 1 patients with <10% 10-year risk should pursue lifestyle modification only.
  • All people with stage 2 hypertension should receive medication (in addition to lifestyle modification).
  • The treatment goal for everyone is <130/80 mm Hg.

I’m not going to change my practice until I weigh responses to this guideline from a broad range of experts. In the end, initiating drug therapy in patients with BPs near treatment thresholds should reflect shared decision-making between clinicians and patients. One of the problems with these guidelines is that they don’t age into account.  Older, stiffer arteries may be less forgiving to attempts to lower blood pressure.  The risk’s of treatments have to be weighed against the risk of side effects.

0 Comments Read more
 

The Flu

Monday, October 22, 2018 // Flu

As most of you know the recent flu season was the worst flu season since 2009. It is now flu shot season.  When you see pumpkins, think flu shots. Patients with fall appointments will get the vaccination during their office visit.  We schedule brief appointments for individuals who want to get the vaccine to avoid waiting. We prefer not to do walk INS ins to minimize wait times. We will be giving the quadrivalent vaccine against 4 flu strains. For those over 65, a high dose vaccine is available which is a little more effective.  Let’s hope for a good match this year!

The flu takes a formidable toll each year. Researchers and health workers save lives by routinely rolling out seasonal vaccines and deploying drugs to fight the virus and its secondary infections. But in the U.S. alone the flu still kills tens of thousands of people and hospitalizes hundreds of thousands more.

A big part of the problem has been correctly predicting what strains of the influenza virus health officials should try to combat in a given season. A team of scientists from the U.S. and China now say they have designed a vaccine that could take the guesswork out of seasonal flu protection by boosting the immune system’s capacity to combat many viral strains.

The University of California, Los Angeles–led group reported in a recent Science that they may have created the “Goldilocks” of flu vaccines—one that manages to trigger a very strong immune response without making infected animals sick. And unlike current flu vaccines, the new version also fuels a strong reaction from disease-fighting white blood cells called T cells. That development is important because a T cell response will likely confer longer-term protection than current inoculations do and defend against a variety of flu strains (because T cells would be on the lookout for several different features of the flu virus whereas antibodies would be primarily focused on the shape of a specific strain). “This is really exciting,” says Kathleen Sullivan, chief of the Division of Allergy and Immunology at The Children’s Hospital of Philadelphia, who was not involved in the work.

FLU FACTS

The overall effectiveness of last season’s influenza vaccine has been estimated at 36%, according to an analysis in MMWR.

Researchers examined data on nearly 4600 patients who sought outpatient care for acute respiratory illness with cough within 7 days of symptom onset between November 2017 and February 2018. Some 38% tested positive for influenza on reverse-transcription polymerase chain reaction.

Roughly 43% of those with influenza had been vaccinated. Vaccine effectiveness was estimated for each virus type as follows:

  • Influenza A(H3N2): 25%
  • Influenza A(H1N1)pdm09: 67%
  • Influenza B: 42%

When examined by age group, statistically significant protection against influenza was observed only among children aged 6 months through 8 years (59% effective) and adults aged 18 through 49 (33% effective).

The report’s authors write, “Even with current vaccine effectiveness estimates, vaccination will still prevent influenza illness, including thousands of hospitalizations and deaths. Persons aged ≥6 months who have not yet been vaccinated this season should be vaccinated.”

Dr. Anne Schuchat noted that three out of four children who’ve died from flu this season were not vaccinated.

0 Comments Read more

 

15th Anniversary

Monday, October 22, 2018 // News

Happy Fall! It is hard to believe it has been 15 years since the practice opened as the first concierge/personalized care physician practice in San Antonio. At the time a patient-centered practice was controversial. A practice that restricted its size so that there was more time to spend on preventive care and access was newsworthy then, but now is more in demand than ever. It’s been incredibly rewarding to practice medicine the way that I thought I would be able to in medical school. We’ve grown, Dr. Jennifer Wallace joined the practice and we continue to treat patients with the time and expertise an Internal Medicine specialty practice offers. We look forward to practicing this way for many years to come!

0 Comments Read more
 

New Employee

Monday, October 2, 2017 // Blog, News

We are pleased to have hired a new nurse Amber Allen. Amber was born in Oakland, California and raised in the Bay area. She moved to Texas in 1990.

Amber graduated from St. Philips Nursing School in 2010. Prior to joining us, she worked as a nurse at Haven for Hope.

She has a 9-year-old son named Caleb who plays baseball and football. Amber loves the water, floating the river and taking her son to concerts. They are also big football fans especially the Dallas Cowboys.

– – – – – –

Words written in italic are directly from Mark L. Thornton, M.D., F.A.C.P.

0 Comments Read more
 

Lifestyle Modification Reduces Heart Disease Risk

Monday, October 2, 2017 // Blog, Blood Pressure, News, Prevention

Nature versus Nurture: Even though people may have inherited genes that confer an increased risk of cardiovascular disease that doesn’t mean that there isn’t something that they can do about it. Not smoking, maintaining a normal weight, exercise and healthy eating will reduce that risk. Below is a summary of a study published in the New England of Journal Medicine in December.

Cardiovascular Disease: Genetics versus Lifestyle NEJM

December 15, 2016, Original Article:

Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease

Amit V. Khera, M.D., Connor A. Emdin, D.Phil., Isabel Drake, Ph.D., Pradeep Natarajan, M.D., Alexander G. Bick, M.D., Ph.D., Nancy R. Cook, Ph.D., Daniel I. Chasman, Ph.D., Usman Baber, M.D., Roxana Mehran, M.D., Daniel J. Rader, M.D., Valentin Fuster, M.D., Ph.D., Eric Boerwinkle, Ph.D., Olle Melander, M.D., Ph.D., Marju Orho-Melander, Ph.D., Paul M Ridker, M.D., and Sekar Kathiresan, M.D.

N Engl J Med 2016; 375:2349-2358December 15, 2016DOI: 10.1056/NEJMoa1605086

Background

Both genetic and lifestyle factors contribute to an individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown.

Methods

Using a polygenic score of DNA sequence polymorphisms, we quantified genetic risk for coronary artery disease in three prospective cohorts — 7814 participants in the Atherosclerosis Risk in Communities (ARIC) study, 21,222 in the Women’s Genome Health Study (WGHS), and 22,389 in the Malmö Diet and Cancer Study (MDCS) — and in 4260 participants in the cross-sectional BioImage Study for whom genotype and covariate data were available. We also determined adherence to a healthy lifestyle among the participants using a scoring system consisting of four factors: no current smoking, no obesity, regular physical activity, and a healthy diet.

Results

The relative risk of incident coronary events was 91% higher among participants at high genetic risk (top quintile of polygenic scores) than among those at low genetic risk (bottom quintile of polygenic scores) (hazard ratio, 1.91; 95% confidence interval [CI], 1.75 to 2.09). A favorable lifestyle (defined as at least three of the four healthy lifestyle factors) was associated with a substantially lower risk of coronary events than an unfavorable lifestyle (defined as no or only one healthy lifestyle factor), regardless of the genetic risk category. Among participants at high genetic risk, a favorable lifestyle was associated with a 46% lower relative risk of coronary events than an unfavorable lifestyle (hazard ratio, 0.54; 95% CI, 0.47 to 0.63). This finding corresponded to a reduction in the standardized 10-year incidence of coronary events from 10.7% for an unfavorable lifestyle to 5.1% for a favorable lifestyle in ARIC, from 4.6% to 2.0% in WGHS, and from 8.2% to 5.3% in MDCS. In the BioImage Study, a favorable lifestyle was associated with significantly less coronary-artery calcification within each genetic risk category.

Conclusions

Across four studies involving 55,685 participants, genetic and lifestyle factors were independently associated with susceptibility to coronary artery disease. Among participants at high genetic risk, a favorable lifestyle was associated with a nearly 50% lower relative risk of coronary artery disease than was an unfavorable lifestyle. (Funded by the National Institutes of Health and others.

– – – – – –

Words written in italic are directly from Mark L. Thornton, M.D., F.A.C.P.

0 Comments Read more
 

Prostate Cancer Screening Revisited

Monday, October 2, 2017 // Blog, News, Prostate

Opinions in medicine change over time. “Every dogma shall have its day,” I tell my medical students. Two years ago the United services Preventive Task Force (USPSTF) recommended against screening for prostate cancer because the risk and expense of screening were felt to outweigh the benefits. Now they have revised that recommendation as follows:

The USPSTF recommends that clinicians inform men ages 55 to 69 years about the potential benefits and harms of prostate-specific antigen (PSA)–based screening for prostate cancer.

The decision about whether to be screened for prostate cancer should be an individual one. Screening offers a small potential benefit of reducing the chance of dying of prostate cancer. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and impotence. The USPSTF recommends individualized decision making about screening for prostate cancer after discussion with a clinician so that each man has an opportunity to understand the potential benefits and harms of screening and to incorporate his values and preferences into his decision.

We will ask men age 45-69 if they wish to be screened for prostate cancer. For those interested in additional information here is a related article for National Public Radio.

Federal Task Force Softens Opposition To Routine Prostate Cancer Screening

April 11, 2017 – Rob Stein

A common blood test checks for elevated levels of prostate-specific antigens (PSA) in a man’s blood, as an indicator that he may have prostate cancer.

An influential federal task force is relaxing its controversial opposition to routine screening for prostate cancer.

In the proposed revised guidelines released Tuesday, the U.S. Preventive Services Task Force says men ages 55 to 69 should decide individually with their doctors whether and when to undergo prostate-specific antigen (PSA) testing.

The task force would continue to recommend against PSA testing for men age 70 and older, saying the potential harms continue to outweigh benefits of routine screening in this age group.

The proposal, which isn’t yet final, pending input from the public, comes five years after the task force surprised many men and their doctors by recommending against the routine use of the commonly used blood test. That 2012 guidance prompted a significant drop in PSA testing.

Almost 180,000 American men are diagnosed with prostate cancer each year, and at least 26,000 die from the disease, making it one of the most common and deadly cancers among men.

The task force decided to adjust its screening recommendations based on new research.

“The new evidence allowed us to say that, on balance, we think now the benefits do outweigh the harms,” says Dr. Kirsten Bibbins-Domingo, a professor of medicine at the University of California, San Francisco, who chairs the task force. The latest research also suggests a small net benefit from screening, she says.

“Therefore,” Bibbins-Domingo says, “what we are recommending is that doctors and patients talk together about whether screening is right for them.”

While PSA tests can detect prostate tumors at their smallest, most treatable stage, the testing has some risks, she says.

The harms include stressful false alarms that often lead to painful and sometimes dangerous biopsies. And even if the test detects an actual malignancy, many prostate cancers grow so slowly that they never become life-threatening. Nonetheless, many men undergo surgery and radiation, which can leave them incontinent or impotent.

Why Prostate Cancer Screening Is So Tricky

“The PSA test is not a great test,” Bibbins-Domingo says. “It doesn’t help us distinguish the types of cancers that are going to kill you from those cancers that are going to not progress over time and will not cause a man health problems.”

So when the task force last issued guidelines in 2012, the panel decided the potential harms of screening outweighed the benefits.

But the results of research from the last five years have changed that equation, the task force says.

Specifically, the European Randomized Study of Screening for Prostate Cancer (ERSPC) found PSA testing cuts the chances of developing advanced prostate cancer by about 30 percent and the risk of dying from the disease by about 20 percent.

At the same time, an increasing number of men confronted with a diagnosis of prostate cancer are skipping treatment, according to recent research. Instead, they and their doctors are opting for “watchful waiting” or active surveillance of the malignancy. That less aggressive approach to treatment minimizes the harms of screening, the task force says.

So, in its proposed revision, the task force drops its “D” recommendation against PSA testing for men ages 55 to 69 and replaces it with a “C” recommendation that each man in that age group make the decision about whether to get screened individually — in consultation with his doctor.

Bibbins-Domingo stresses that the task force has stopped short of urging screening for all young men.

“There are some men who might say, ‘You know, I really want to avoid dying of prostate cancer. That’s the most important thing to me. So even if there’s a small likelihood this will work I want to do it,’” Bibbins-Domingo says. Screening saves an estimated one or two lives out of every 1,000 men who get screened.

And with treatment’s risk of impotence or incontinence, it’s also a reasonable choice for some men to decide, “ ‘I’m not willing to risk the things that may happen along the way,’ “ Bibbins-Domingo notes.

Doctors who have long advocated aggressive PSA testing are praising the new guidelines.

“I’m very pleased. I view this as a victory for PSA screening for prostate cancer,” says Dr. William Catalona, a professor of urology at the Northwestern University Feinberg School of Medicine.

“PSA screening saves lives,” he says. “And having the U.S. Preventive Services Task Force discourage PSA screening has sort of created a whole generation of family practitioners and internists who feel that PSA screening is a bad thing to do for patients. If this were to continue, we would lose all these gains in reducing the prostate cancer death rate.” He says he wishes the group had gone further and recommended that doctors actively encourage PSA screening beginning at age 40 and continuing past age 70.

Dr. David Penson, a urologist at Vanderbilt-Ingram Cancer Center, agrees with the task force’s decision. “The idea of letting men make their own decision, I think, is a really terrific thing,” he says, noting that the new draft guidelines are in line with those of other medical groups.

But other doctors fear the task force’s recommendation will be oversimplified into a recommendation for screening.

Dr. Dan Merenstein, a family medicine physician at Georgetown University, doesn’t think the new evidence warrants a change. And he worries the new guidelines are confusing.

“What I’m afraid of is that rather than having this discussion — because it’s a difficult and long discussion — physicians will just order this test like they do… a cholesterol panel,” Merenstein says. “And that will cause much more harm than good.”

Meanwhile, Dr. Otis Brawley, the chief medical officer for the American Cancer Society, believes the guidelines strike the right balance.

“I really do think that there is a pendulum in a lot of things that we do in medicine,” Brawley says. “And the pendulum here may be getting to the right place where we realize there are harms and there are benefits and individuals need to weigh these harms and benefits and tailor a decision that’s right for them.”

And the latest word from The Annals of Internal Medicine:

More Support for Prostate Cancer Screening?

By Amy Orciari Herman

A reanalysis of U.S. and European data seems to offer more support for prostate-specific antigen (PSA)-based screening for prostate cancer. The findings appear in the Annals of Internal Medicine.

Researchers re-examined data from the European Randomized Study of Screening for Prostate Cancer, which originally showed a reduction in prostate cancer mortality with screening, and the U.S. Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which showed no reduction. In the new analysis, the researchers attempted to account for the high rate of PSA screening that contaminated the control group of the U.S. trial. Ultimately, they concluded that the results of both screening trials could be consistent with roughly a 25%–30% reduction in prostate cancer mortality over 11 years’ follow-up.

Dr. Allan S. Brett, editor-in-chief of NEJM Journal Watch General Medicine, weighed in: “I’d like to see a critical analysis of this report by other groups with sophisticated statistical expertise. But in the end, it doesn’t really matter whether the U.S. data legitimately can be interpreted as supporting the European data. We already know (from the European trial) that screening likely confers a small absolute reduction in prostate cancer mortality, but that many men must be treated (or subjected to repeated testing and biopsy) to benefit one person. So this latest analysis doesn’t change anything: We’re still left with the same debate about benefit vs. harm in PSA screening.”

We will screen men 45-69 years of age if they want. We won’t screen older men unless there extenuating circumstances.

– – – – – –

Words written in italic are directly from Mark L. Thornton, M.D., F.A.C.P.

0 Comments Read more
 

Flu Vaccine 2017

Sunday, October 1, 2017 // Blog, Flu, Prevention, Vaccines

Information for 2017-2018

Getting an annual flu vaccine is the first and best way to protect yourself and your family from the flu. Flu vaccination can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations. The more people who get vaccinated, the more people will be protected from flu, including older people, very young children, pregnant women and people with certain health conditions who are more vulnerable to serious flu complications. This page summarizes information for the 2017-2018 flu season.

What viruses will the 2017-2018 flu vaccines protect against?

There are many flu viruses, and they are constantly changing. The composition of U.S. flu vaccines is reviewed annually and updated to match circulating flu viruses. Flu vaccines protect against the three or four viruses that research suggests will be most common. For 2017-2018, three-component vaccines are recommended to contain:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus
  • an A/Hong Kong/4801/2014 (H3N2)-like virus
  • a B/Brisbane/60/2008-like (B/Victoria lineage) virus

Four-component vaccines, which protect against a second lineage of B viruses, are recommended to be produced using the same viruses recommended for the trivalent vaccines, as well as a B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

We will be giving the Quadrivalent Flu Vaccine this fall.  A high dose vaccine will be available for those 65 and over.  It is marginally more effective and does not appear to have any greater risk of side effects.  If you have a scheduled appointment this fall, we will give it then.  Otherwise, you can call to schedule an appointment.  The optimal time is late October and early November.  Think pumpkins when thinking of the optimal time.  It is readily available, so if it is more convenient for you to get it at your pharmacy, work or school, it is fine to get it there.

– – – – – –

Words written in italic are directly from Mark L. Thornton, M.D., F.A.C.P.

0 Comments Read more
 

Preventing Falls Among Older Adults

Friday, August 5, 2016 // Prevention

preventing-falls

 

We all want to protect our older family members and help them stay safe, secure, and independent. Knowing how to reduce the risk of falling, a leading cause of injury, is a step toward this goal.

The Reality

Each year, one in every three adults ages 65 or older falls and 2 million are treated in emergency departments for fall-related injuries. And the risk of falling increases with each decade of life. The long-term consequences of fall injuries, such as hip fractures and traumatic brain injuries (TBI), can impact the health and independence of older adults. Thankfully, falls are not an inevitable part of aging. In fact, many falls can be prevented. Everyone can take actions to protect the older adults they care about.

Prevention Tips

You can play a role in preventing falls. Encourage the older adults in your life to:

  • Get some exercise. Lack of exercise can lead to weak legs and this increases the chances of falling. Exercise programs such as Tai Chi can increase strength and improve balance, making falls much less likely.
  • Be mindful of medications. Some medicines—or combinations of medicines—can have side effects such as dizziness or drowsiness. This can make falling more likely. Having a doctor or pharmacist review all medications can help reduce the chance of risky side effects and drug interactions.
  • vision
    Keep their vision sharp.
    Poor vision can make it harder to get around safely. Older adults should have their eyes checked every year and wear glasses or contact lenses with the right prescription strength to ensure they are seeing clearly.
  • Eliminate hazards at home. About half of all falls happen at home. A home safety check can help identify potential fall hazards that need to be removed or changed, such as tripping hazards, clutter, and poor lighting.

Steps for Home Safety

The following checklist can help older adults reduce their risk of falling at home:

  • Remove things you can trip over (such as papers, books, clothes, and shoes) from stairs and places where you walk.
  • Install handrails and lights on all staircases.
  • Remove small throw rugs or use double-sided tape to keep the rugs from slipping.
  • Keep items you use often in cabinets you can reach easily without using a step stool.
  • Put grab bars inside and next to the tub or shower and next to your toilet.
  • Use non-slip mats in the bathtub and on shower floors.
  • Improve the lighting in your home. As you get older, you need brighter lights to see well. Hang lightweight curtains or shades to reduce glare.
  • Wear shoes both inside and outside the house. Avoid going barefoot or wearing slippers.

More Information

CDC offers various materials and resources for all audiences about older adult falls and what can be done to prevent them. These resources are for the general public, public health officials, and anyone interested in programs that aim to prevent falls.

walking-family

25th Year of Precepting

This marks my 25th year of serving as a community preceptor for medical students at the University of Texas Health Science Center at San Antonio.  My thanks to those patients who have taken time to meet with students.  Here is a comment from one of them:

 

The past 4 weeks with Dr. Thornton was probably one of my favorite rotations of 3rd year. There is an ample amount of diversity in the types of medical problems seen from routine follow ups to vaccinations needed for world travel as well as more chronic conditions. Dr. Thornton’s attentiveness and laid back personality make him a great instructor. He often provided me with articles he found interesting and we had many conversations about medicine and life in general. He really made me feel like I was part of the treatment team. His staff is extremely nice and personable. I feel very fortunate to have had this rotation.

0 Comments Read more