IS THE SUPER BOWL HARMFUL TO YOUR HEART?

Studies suggest stress from big games may trigger heart attacks

Hot wings, nachos, sliders on one!

With Super Bowl XLVIII just days away, the hype is reaching fever pitch.  This annual NFL championship football game will be seen by millions around the world.

Fatty, salty foods, and beer on two!

Broncos, Seahawks, office pools.  Omaha!  Studies suggest that big games, like the Super Bowl, may trigger heart attacks in fans due to stress.

Beaumont cardiologist, Steven Almany, M.D. weighs in, “There have been a number of studies linking big games in World Cup soccer and the Super Bowl with fan heart attacks and other cardiovascular episodes.”

Researchers also noted that along with stress, food and drink consumed on Super Bowl Sunday may also be responsible.  Is the Super Bowl and the over-consumption of party foods the perfect health storm for some fans?

“There’s no doubt that stress, acts as an emotional trigger, setting off physical changes to the body.  When heart rates rise, so too, does blood pressure, increasing the heart’s oxygen demand.  While this is happening, the size of coronary arteries can decrease.  The decrease in oxygen delivery is not good, especially for those men and women with known heart disease.”

“The overeating, combined with alcohol doesn't bode well either.”

So, is there a connection to the Super Bowl and heart attacks?

Adds Dr. Almany, “Maybe, for some, but more research needs to be done.  Above all, fans need to remember it’s just a game, and that includes Lion fans who’ve experience long-term heartbreak.  Take your medications as prescribed.  Eat and drink in moderation.  Enjoy.”

POSTED ON:  http://beaumonthealthsystem.wordpress.com/2014/01/30/is-the-super-bowl-harmful-to-your-heart/

HEART HEALTHY RECIPE- BEEF AND VEGETABLE KABOBS

You can include red meat occasionally as part of a heart healthy diet by choosing lean cuts and limiting portions to 3 ounces.  Lean cuts, which are less tender than well-marbled ones, can be tenderized by marinating the meat in an acidic liquid such as lemon juice, vinegar or wine.

Beef and Vegetable Kabobs

                                                                     ½ c.  nonfat Italian dressing

2 T. red wine vinegar

2 tsp. minced garlic

¼  tsp. cumin

1 T. dried hot red pepper flakes

Freshly ground black pepper to taste

1 lb. ½ in. thick top round beef, trimmed, cut into 1 in.  pieces

16 large cherry tomatoes, washed, stems removed

16 large mushrooms, cleaned

1 green pepper, washed, seeded, cubed into 16 pieces

1 onion, peeled, cubed into 16 chunks

To prepare the marinade, combine the dressing, vinegar, garlic, cumin, red pepper flakes and black pepper in a shallow dish or pie plate.  Set aside a few tablespoons for basting.  Place the beef in the marinade, turning to coat thoroughly.  Marinate, covered, in the refrigerator for at least 4 hours or overnight.

Preheat the grill.  Drain the beef and discard the marinade.  Thread the beef and vegetables, alternating them, onto eight 10- inch skewers.  Brush the kabobs with the reserved marinade and grill them on a rack set 5 to 6 inches over glowing coals.  Baste them for the first 5 minutes with reserved marinade and turn for 10-15 minutes, or until beef is cooked through but still juicy.  Discard the remaining marinade.

Nutrition Information:  2 kabobs

Calories 176, Total fat 4 g,  Saturated  fat 1.5 g, Cholesterol 54 g, Sodium 95 mg, Carbohydrate 12 g, Fiber 2.5 g, Sugar 5 g, Protein 22 g

WHAT IS WHITE COAT SYNDROME?

Every time I go to the doctor my blood pressure is high, around 138/83.  Yet when I take it at home it’s usually under 130/80.  Which one should I go with?

Blood Pressure can vary with time of day and stress and psychological state.  Some people claim their BP is always higher in the doctor’s office due to some degree of anxiety.  If you are sure you are doing it right then go by the one taken when you are relaxed.  Just be sure you are doing it right.

POSTED BY:  Steven Ajluni, MD

HEART HEALTHY RECIPE- ITALIAN STYLE ZUCCHINI

Italian-Style Zucchini

                                                                  

Vegetable oil spray
6 medium zucchini, thinly sliced

2 T. olive oil

3/4  c. sliced onion

1 tsp. salt-free all-purpose seasoning

4 Italian plum tomatoes, sliced

1 ¼   tsps. dried basil

¾   tsp. oregano

¼  lb. shredded part-skim mozzarella cheese

1/3  c. freshly grated parmesan cheese

2 T. minced fresh parsley

Preheat oven to 375.  Lightly spray a casserole with vegetable oil.  Place zucchini in a saucepan with enough water to cover, and cook over medium-high heat until tender.  Drain and set aside.  Place olive oil in a small skillet over medium-high heat.  Add onions and saute’ until tender.  Add seasoning, toss lightly and remove from heat. 

In a bowl, combine zucchini, onions, tomatoes, basil, and oregano.  Toss lightly to mix well.  Place half of zucchini mixture in prepared casserole.  Sprinkle with mozzarella.  Add remaining vegetable mixture and sprinkle parmesan on top.  Bake uncovered, 25-30 minutes.  Sprinkle with parsley and serve hot. 

Nutrition Information:  1/6 recipe

Calories 206, Total fat 11 g, Saturated Fat 4 g, Cholesterol 15 mg, Sodium 226 mg, Carbohydrate 19 g, Protein 12 g

2014 BEAUMONT MICHIGAN HEART GROUP HOLIDAY SCHEDULE

Beaumont Michigan Heart Group closes in observance of all the major holiday's.  The 2014 days are listed below.  We ask, in order to ensure your prescriptions are refilled in time, please call at least one week prior to the holiday.  Calls taken after 10:00 am, the day before closing, are not guaranteed to be called in.

Monday	May 26, 2014	Memorial Day
Friday	July 4, 2014	Independence Day
Monday	September 1, 2014	Labor Day
Thursday	November 27, 2014	Thanksgiving
Friday	November 28, 2014	Day after Thanksgiving
Wednesday	December 24, 2014	Christmas Eve
Thursday	December 25, 2014	Christmas Day
Wednesday	December 31, 2014	New Year’s Eve (1/2 day)
Thursday	January 1, 2015	New Year’s Day

Thank you:
The Beaumont Michigan Heart Group Staff

NEW GUIDELINES MAY LEAD TO HIGHER STATIN USE

New guidelines that could lead to higher statin use among US adults were discussed on all three of last night’s national news broadcasts, where they received a total of eight minutes of coverage. The guidelines also garnered extensive coverage in print, with stories featured on the front pages of at least four major US papers, and online. Many sources portray the guidelines as a major shift in the treatment of high cholesterol. Some of the sources also characterize the guidelines as controversial.

        

NBC Nightly News reported that “the first new guidelines in a decade about how” statins “should be prescribed” have been released, and they “could result in many more Americans taking these” medications.

        

On ABC World News, ABC’s Dr. Richard Besser said that the “new guidelines...dramatically expand” the use of statins “to one third of adults.”

        

The CBS Evening News called the new guidelines “controversial,” and reported that they “put less emphasis on cholesterol numbers and more on other risk factors in determining who should take medication.”

        

In a second segment on NBC Nightly News, Dr. Tanya Benninson, Chief Medical Officer at NBC Universal, discussed the guidelines.

        

In a front-page story, the New York Times (11/13, A1, Kolata, Subscription Publication, 9.61M) reports, “The new guidelines, formulated by the American Heart Association and the American College of Cardiology and based on a four-year review of the evidence, simplify the current complex, five-step process for evaluating who needs to take” the drugs. The Times also points out that “in a significant departure, the new method also counts strokes as well as heart attacks in its risk calculations, a step that will probably make some additional people candidates for the” medications.

        

USA Today (11/13, Szabo, 5.82M) reports, “The guidelines identify four high-risk groups who could benefit from statins: people with pre-existing heart disease, such as those who have had a heart attack; people ages 40 to 75 who have diabetes; patients ages 40 to 75 with at least a 7.5% risk of developing cardiovascular disease over the next decade, according to a formula described in the guidelines; and patients with the sort of super-high cholesterol that sometimes runs in families, as evidenced by an LDL of 190 milligrams per deciliter or higher.”

        

The Washington Post (11/13, A1, Dennis, Bernstein, 4.28M) reports on its front page that Kim Williams, vice president of the American College of Cardiology said, “Lower [LDL] is better, and no one’s arguing that, but once you have a reason to treat someone, they should be treated fully.” Williams added, “That’s really one of the bottom lines of this.”

        

In a nearly 1,200-word article on its front page, the Los Angeles Times (11/13, Healy, 3.07M) reports that the new “guidelines will align physician practices with a welter of new research showing what works – and what doesn’t – in preventing heart attacks and strokes, said Dr. Steven Nissen, an influential Cleveland Clinic cardiologist who was not involved in drafting the new” guidelines.

       

Bloomberg News (11/13, Cortez, 1.91M) reports that the aim “is to identify people most likely to benefit from treatment and stop trying to hit arbitrary targets that haven’t been proven to improve health, said Neil Stone...chairman of the panel that wrote the cholesterol guidelines.” However, it could “be difficult for some doctors and patients to adjust.”

        

In fact, the Wall Street Journal (11/13, A2, Winslow, Subscription Publication, 5.91M) points out that both those in favor of and against the new guidelines are concerned that they will lead to confusion among physicians and patients.

        

Additionally, the Boston Globe (11/13, A1, Kotz, 1.75M) reports on its front page that some physicians are concerned that nearly “one-third of American adults could now qualify for lifelong statin use, even if they do not have high cholesterol levels or any signs of heart disease.”

        

The AP (11/13, Marchione) points out that the “National Heart, Lung and Blood Institute appointed expert panels to write the new guidelines in 2008, but in June said it would leave drafting them to the” AHA and ACC. In addition to the statin guidelines, “new guidelines on lifestyle and obesity” were released yesterday, “and ones on blood pressure are coming soon.”

        

The New York Daily News (11/13, Miller, 3.94M) points out that “the new guidelines were published online” yesterday “and will appear in upcoming issues of the Journal of the American College of Cardiology and the AHA journal Circulation.”

        

The Los Angeles Times (11/13, Healy, 3.07M) “Science Now” blog reports that this “new game plan for statins represents a stark shift from approaches embraced by cardiologists and primary care physicians for most of the past decade.”

        

Similarly, CNN (11/13, Sloane, 14.53M) reports on its website that the new guidelines are “being called a tectonic shift in the way doctors will treat high cholesterol.”

        

CardioSource (11/13, 2K) reports on all of the new prevention guidelines. According to CardioSource, “Each provides important updated guidance for primary care providers, nurses, pharmacists and specialty medicine providers on how best to manage care of individuals at risk for cardiovascular-related diseases based on the latest scientific evidence.” Medscape (11/13, Wood, 164K) and MedPage Today (11/13, Neale, 122K) also report on all of the newly released CVD guidelines. Also covering the story are Reuters (11/13, Berkrot), the CBS News (11/13, Jaslow, 3.87M) website, the NPR (11/13, Knox, 465K) “Shots” blog, AFP (11/13), The Oregonian (11/13, Muldoon, 751K), the Time (11/13, Park, 13.4M) website, Forbes (11/13, Herper, 6.03M), HealthDay (11/13, 5K), Medscape (11/13, O'Riordan, 164K), and the Baltimore Sun (11/13, Cohn, 812K) “Picture of Health” blog. To view the full JACC article

POSTED BY: Steven Almany M.D.

HEART HEALTHY RECIPE- MUSHROOM SPINACH PASTA

This tasty recipe is low in both fat and sodium because of the low-fat and salt-reduced ingredients. 

Mushroom-Spinach Pasta

                        

                                               16 oz.  carton 1% low-fat cottage cheese                                   
                                                6 oz.  low-fat cream cheese, softened

                                                Vegetable oil cooking spray

                                                ½  c.  finely chopped onion

                                                ½ lb.  fresh mushrooms, sliced

                                               1/3 c.  dry white wine

                                                ¼  tsp. dried thyme, crushed

                                                Dash of pepper

                                                6 ½ oz.  evaporated skim milk

                                                10 oz.  pkg. frozen chopped spinach, defrosted and well drained

                                                16 oz.  spaghetti, cooked without salt

                                                1/3 c.  freshly grated Parmesan cheese

In a food processor or blender, combine the cottage cheese and cream cheese until smooth; set aside.  Spray a medium-sized saucepan with the cooking spray.  Add the onion and mushrooms and cook until tender.  Add the white wine, thyme and pepper.  Stir in the cheese mixture, evaporated skim milk and spinach; heat thoroughly, stirring occasionally.  Place the hot spaghetti on a large platter; top with sauce and toss gently.  Sprinkle with Parmesan cheese.

Note:  For a zestier version, increase the thyme to ½ tsp. and add ½ tsp. garlic powder and a dash of nutmeg.

Nutrition Information:  1/8 recipe

Calories 247, Total fat 8 g, Saturated  fat 4.5 g, Cholesterol 23 mg, Sodium 454 mg, Carbohydrate 26 g, Fiber 2 g, Sugar 3 g, Protein 18 g

WHAT ARE THE WARNING SIGNS OF A HEART ATTACK?

Sudden chest pain-often described as discomfort (tightness or pressure like) in upper chest associated with radiation to jaw or arm, with sweating, shortness of breath, and/or lightheadedness.  Any or all of these features can indicate a heart attack.  This classic presentation however is only described in a third of cases.  Atypical chest pain or no symptoms occur in 2/3 of patients.

POSTED BY:  Steven Ajluni, MD

HEART HEALTHY RECIPE- HEART SMART PASTA SALAD

This salad is a good choice for an outdoor buffet because it will not spoil easily.

Heart Smart Pasta Salad

                                                                        1 pkg. rotini pasta

                                                                        1 pkg. (8 oz.) fresh mushrooms

1 c.  broccoli florets

 3 c.  ice water for cooling broccoli
1 sweet green pepper, seeded, diced

1 sweet red bell pepper, seeded, diced

¼ c.  finely chopped onion

¼ c.  olive oil

¼ c.  red wine vinegar

¾  tsp. salt

¼  tsp. pepper

¼  c.  chopped fresh parsley

1 tsp. dried tarragon or oregano

                                                                         16 cherry or grape tomatoes, halved

Cook the pasta al dente according to package directions, omitting salt.  While the pasta is cooking, clean and slice the mushrooms.  Place in a nonstick skillet over medium heat and sauté until mushrooms are tender. Drain well and set aside.

Place the broccoli in microwave-safe dish and cook on full power, covered with plastic wrap, for 3 minutes.  Remove and plunge into ice water to stop cooking.  Drain the broccoli and set aside. 

Drain the pasta and rinse with cold water.  Mix the pasta, mushrooms, broccoli, peppers, and onion in large serving bowl. 

In a covered jar, combine the oil, vinegar, salt, pepper, parsley, tarragon or oregano, and shake well.  Pour the dressing over the pasta-vegetable mixture and toss well.  Chill at least 3 hours.  Just before serving, add the tomatoes.

Nutrition Information:  per 1/12 recipe

Calories 198, Total fat 5 g, Saturated  fat  0.5 g, Cholesterol  0 g, Sodium 143 g, Carbohydrate 32 g, Fiber 1 g, Sugar 2 g, Protein 6 g

ARE YOU VACCINATED? WHOOPING COUGH (PERTUSSIS) HAS BEEN A COMMON DIAGNOSIS THIS WINTER.

Whooping cough- known medically as pertussis- is a highly contagious respiratory tract infection.  Although it initially resembles an ordinary cold, whooping cough may eventually turn more serious, particularly in infants.  The best way to prevent it is through vaccinations.  The childhood vaccine is called DTaP.  The whooping cough booster vaccine for adolescents and adults is called Tdap.  Both DTaP and Tdap protect against whooping cough, tetanus and diphtheria.  Recommended vaccine ages are listed below:

Age/Status	Recommendations
Birth through 6 years	DTaP is routinely recommended at 2, 4, and 6 months, at 15 through 18 months, and at 4 through 6 years.
7 through 10 years	Tdap is recommended for children ages 7 through 10 years who are not fully vaccinated (see not 1) against pertussis: ·         Single dose of Tdap for those not fully vaccinated or ·         If additional doses of tetanus and diphtheria toxoid-containing vaccines are needed, then children aged 7 through 10 years should be vaccinated according to the catch-up schedule, with Tdap preferred as the first dose.
11 through 18 years	Tdap is routinely recommend as a single dose for those 11 through 18 years of age with preferred administration at 11 through 12.  If adolescents (13-18 miss getting Tdap at 11-12 yrs. then administer at the next patient encounter or sooner if that adolescent has close contact with infants.
19 years and older	Andy adult 19 yrs. of age or older who has not received a dose of Tdap should get one as soon as feasible- to protect themselves and infants.  This Tdap booster dose can replace one of the 10-year Td booster doses.  Tdap can be administered regardless of interval since the previous Td dose.  Shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity but may be appropriate if your patient is at high risk for contracting pertussis, such as during an outbreak, or has close contact with infants.
Pregnant women	Pregnant women should get a dose of Tdap during each pregnancy, preferable at 27 through 36 weeks gestation.  By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines.  Tdap will also help protect the mother at time of deliver, making her less likely to transmit pertussis to her infant.  It is important that all family members and caregivers of the infant are up-to0date with their pertussis vaccines (DTaP or Tdap, depending on age) before coming into close contact with the infant.
Health Care Personnel	A single dose of Tdap is recommended for health care personnel who have not previously received Tdap as an adult and have direct patient contact.  Tdap vaccination can protect health care personnel against pertussis and help prevent them from spreading it to their patients.  Priority should be given to vaccinating those who have direct contact with babies younger than 12 months. Tdap can be administered regardless of interval since the previous Td dose.  However, shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity.

Taken from the CDD at http://www.cdc.gov/Vaccines/vpd-vac/pertussis/default.htm

POSTED BY: Ilana Kutinsky, DO 

ENERGY DRINKS MAY CAUSE SERIOUS INCREASES IN HEART CONTRACTION RATES

On its website, CBS News (12/3, 3.87M) reports that research presented at the Radiological Society of North America annual meeting suggests that “energy drinks may cause serious increases in heart contraction rates within an hour of” consuming them.

        

The Huffington Post (12/3, 11.54M) reports that investigators “recruited 18 healthy people – 15 men and three women – with an average age of 27.5 to undergo cardiac magnetic resonance imaging before drinking an energy drink containing 32 milligrams/100 milliliters of caffeine and 400 milligrams/100 milliliters of taurine.” One “hour after consuming the drinks, all the participants underwent cardiac MRI to see if energy drink consumption had any effect on heart function.” The investigators “found that the participants’ hearts had increased contraction rates – indicated by increased peak systolic strain in the heart’s left ventricle – after drinking the energy drinks.”

        

The Los Angeles Times (12/3, Kaplan, 3.07M) “Science Now” blog reports that the investigators “also looked for changes in heart rate and blood pressure before and after volunteers consumed the energy drink, but the readings in both cases were essentially the same.”

        

On its website, FOX News (12/3, 6.72M) reports that researcher Dr. Jonas Dörner, said, “There are concerns about the products’ potential adverse side effects on heart function, especially in adolescents and young adults, but there is little or no regulation of energy drink sales.”

        

HealthDay (12/3, Thompson, 5K) reports that this “study raises concerns that energy drinks might be bad for the heart, particularly for people who already have heart disease, said Dr. Kim Williams, vice president of the American College of Cardiology.” According to Dr. Williams, “We know there are drugs that can improve the function of the heart, but in the long term they have a detrimental effect on the heart.” Also covering the story are Forbes (12/2, 6.03M), MedPage Today (12/3, Fiore, 122K), AFP-Relaxnews (12/3), BBC News (12/2, 1.62M), and the Daily Mail (UK) (12/3, 2.92M).

POSTED BY: Steven Almany M.D.

HEART HEALTHY RECIPE- LEMON POPPY SEED CAKE

Lemon Poppy Seed Cake

                                                            

  

Floured baking spray
1 2/3 c. all-purpose flour

¾ c. sugar

1 T. poppy seeds

1 tsp. baking soda

¾ c. skim milk

3 T. fresh lemon juice

3 T. vegetable oil

1 tsp. grated lemon rind

 2 egg whites, beaten

Preheat oven to 375.  Spray an 8-by-8 inch square baking dish with floured baking spray.  In a large bowl, combine the flour, sugar, poppy seeds and baking soda.  Stir well, and make a well in the center. 

In a medium bowl, combine the skim milk, lemon juice, oil, lemon rind and egg whites.  Add this mixture to the well in the flour mixture.  Stir just until the dry ingredients are moistened.

Spoon the batter into the prepared baking dish.  Bake for 28 minutes, or until a wooden pick inserted into the center comes out clean.  Remove from the oven and cool 10 minutes in the pan on a wire rack.

Nutrition Information:  per 1/9 recipe

Calories 202, Total fat 5 g, Cholesterol trace mg, Sodium 116 mg, Carbohydrate 35 g, Fiber 0.5 g, Sugar 17 g, Protein 4 g

COSTCHONDRITIS WHAT SYMPTOMS CAN I EXPECT?

Costochondritis is an inflammation of the cartridge-bone junction in the rib cage.  It leads to palpable point tenderness that might be aggravated by chest wall manipulation or deep breaths (when the chest cavity expands).  It is an inflammatory process that responds to anti-inflammatory medicines and reassurance.  It should be distinguished from such things as pulmonary embolism (which is very dangerous) by a physician.

POSTED BY:  Steven Ajluni, MD

HEART HEALTHY RECIPE- CAJUN STYLE ORANGE ROUGHY

Cajun-Style Orange Roughy

                                                                     1 can (10 oz.)  stewed tomatoes

                                                                     1 celery stalk, chopped

1 small onion, chopped

¼ clove garlic, peeled, ends removed, minced

¼ medium green pepper, cored, seeded, chopped

½ bay leaf

¼ tsp. ground thyme

½ tsp. ground black pepper

½ tsp. hot sauce, or to taste

Vegetable oil cooking spray

6 orange roughy fillets (6 oz. each), washed, patted dry

2 T. corn oil

2 oz. fresh parsley, washed, dried, chopped

In a heavy-bottomed saucepan over medium heat, combine the tomatoes, celery, onion, garlic, green pepper, bay leaf, thyme, black pepper and hot sauce.  Bring to a boil, then reduce heat and simmer.  Simmer the sauce until the vegetables are cooked and the sauce reduces, about 20 minutes.

Meanwhile, preheat the oven to 400 degrees.  Spray a shallow 11x15 inch baking pan with the cooking spray.  Place the orange roughy in the baking pan and brush lightly with corn oil.  Bake for 8 to 12 minutes, or until the fish is firm and flaky.  Remove the bay leaf and spoon the sauce over the cooked fish fillets.  Sprinkle with parsley for garnish.

Nutrition Information:  per 1/6 recipe

Calories 209, Total fat 6 g, Saturated fat 1 g, Cholesterol 74 mg, Sodium 224 mg, Carbohydrate 7 g, Fiber 1.5 g, Sugar 2 g, Protein 31 g  

ARE YOU VACCINATED? WHOOPING COUGH (PERTUSSIS) HAS BEEN A COMMON DIAGNOSIS THIS WINTER.

Whooping cough- known medically as pertussis- is a highly contagious respiratory tract infection.  Although it initially resembles an ordinary cold, whooping cough may eventually turn more serious, particularly in infants.  The best way to prevent it is through vaccinations.  The childhood vaccine is called DTaP.  The whooping cough booster vaccine for adolescents and adults is called Tdap.  Both DTaP and Tdap protect against whooping cough, tetanus and diphtheria.  Recommended vaccine ages are listed below:

Age/Status	Recommendations
Birth through 6 years	DTaP is routinely recommended at 2, 4, and 6 months, at 15 through 18 months, and at 4 through 6 years.
7 through 10 years	Tdap is recommended for children ages 7 through 10 years who are not fully vaccinated (see not 1) against pertussis: ·         Single dose of Tdap for those not fully vaccinated or ·         If additional doses of tetanus and diphtheria toxoid-containing vaccines are needed, then children aged 7 through 10 years should be vaccinated according to the catch-up schedule, with Tdap preferred as the first dose.
11 through 18 years	Tdap is routinely recommend as a single dose for those 11 through 18 years of age with preferred administration at 11 through 12.  If adolescents (13-18 miss getting Tdap at 11-12 yrs. then administer at the next patient encounter or sooner if that adolescent has close contact with infants.
19 years and older	Andy adult 19 yrs. of age or older who has not received a dose of Tdap should get one as soon as feasible- to protect themselves and infants.  This Tdap booster dose can replace one of the 10-year Td booster doses.  Tdap can be administered regardless of interval since the previous Td dose.  Shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity but may be appropriate if your patient is at high risk for contracting pertussis, such as during an outbreak, or has close contact with infants.
Pregnant women	Pregnant women should get a dose of Tdap during each pregnancy, preferable at 27 through 36 weeks gestation.  By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines.  Tdap will also help protect the mother at time of deliver, making her less likely to transmit pertussis to her infant.  It is important that all family members and caregivers of the infant are up-to0date with their pertussis vaccines (DTaP or Tdap, depending on age) before coming into close contact with the infant.
Health Care Personnel	A single dose of Tdap is recommended for health care personnel who have not previously received Tdap as an adult and have direct patient contact.  Tdap vaccination can protect health care personnel against pertussis and help prevent them from spreading it to their patients.  Priority should be given to vaccinating those who have direct contact with babies younger than 12 months. Tdap can be administered regardless of interval since the previous Td dose.  However, shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity.

Taken from the CDD at http://www.cdc.gov/Vaccines/vpd-vac/pertussis/default.htm

POSTED BY: Ilana Kutinsky, DO 

MEET THE MHG PHYSICIAN EXTENDERS, AN EXTENSION OF YOUR HEART CARE TEAM!

Beaumont Michigan Heart Group would like to introduce you to our physician extenders.  They are a critical part of the Cardiology team at Michigan Heart Group.  The Physician Extenders work hand and hand with the physicians, making decisions on the best treatment options for each patient on a case by case basis.  All of our extenders round on the weekends as well as work in the hospital during the week.  Most of our extenders also have have office hours and we encourage our patients to feel comfortable following up with them in the office.  Our medical decisions are often a team approach that each extender is a part of and they are often at the forefront of each decision that is made.

The practice is made up of Interventionist (plumbers) and Electrophysiologist (electricians).  The plumbers are located at 4600 Investment Drive, #200, while the Electricians are in the building next door at 4550 Investment Dr., #250.  In addition Michigan Heart Group has two satellite offices to accommodate our out of town patients.  One in Macomb at 15959 Hall Road, #304, Macomb and another in Novi at Ten Mile and Haggerty, 39500 Ten Mile, #103, Novi. Each extender is trained and familiar with both specialties however all but one currently they only see patients at our 2 main locations.

Each month we will be focusing on one extenders achievements, this month we recognize Cheryl Vincent.

Cheryl Vincent, MSN, A.P.R.N:  She started in August 1993, just 2 years after the practice was opened.  Cheryl received her Bachelor of Science in Nursing from the University of Maryland and a Master of Science in Nursing from Wayne State.  She is licensed by the American Nurses Credentialing Center as a Nurse Practitioner. Cheryl's focus is on risk factor management and patient education.  She works at Michigan Heart Rhythm Group with office hours all day Thursday-Friday, however you may see her rounding at Troy Beaumont Hospital as she assist the physicians with this task both during the week and on weekends.  Cheryl is the veteran of the group, having been here the longest she is very familiar with almost all of our patients.  You may not know her; however she will almost always know you.

OUR EXTENDER TEAM AND WHERE YOU MAY SEE THEM:

Anita Juriga, MSN, A.P.R.N:  Sees patients at Michigan Heart Group all day Tuesday, Thursday and Friday.  Also, sees patients at William Beaumont Hospital- Troy, covers Beaumont RO when needed.

Howard Hollinger, P.A.-C.:  Sees patients at Michigan Heart Group all day Monday and Tuesday.  Also, sees patients at William Beaumont Hospital- Troy, covers Beaumont RO when needed.

Debby Goodall, A.P.R.N, A.N.P.-B.C.:  Sees patients at Michigan Heart Group on Monday afternoons and at Michigan Heart Rhythm Group on Friday afternoons.  Also, sees patients at William Beaumont Hospital- Troy, covers Beaumont RO when needed.

Michelle Forcina, P.A.-C.:  Sees patients at Michigan Heart Rhythm Group all day Mondays and Tuesdays and in the morning on Wednesdays.  Rounds at both William Beaumont Hospital- RO and Troy on the weekends.

Dawn Mitchell, A.C.N.P.:  Sees patients at Michigan Heart Group all day Wednesdays.  Also,  sees patients at William Beaumont Hospital- Royal Oak, covers Beaumont Troy when needed.

Lily Paciorkowski, R.N., MSN:   Sees patients at William Beaumont Hospital- Royal Oak, covers Beaumont Troy when needed.

Mariann Graham, R.N., BSN:  Sees patients at William Beaumont Hospital- Royal Oak, covers Beaumont Troy when needed.

We are very fortunate to have such a great, caring and educated team working with us.  They look forward to meeting you and we hope you look forward to meeting them.

Thank you!
The Beaumont Michigan Heart Group Physicians

HEART HEALTHY RECIPE- CABBAGE AND WHITE BEAN SOUP

Cabbage and White Bean Soup

                                                        

                                                                    1 T. olive oil

1 c. finely chopped onion
2 carrots, peeled and sliced

1 lg. celery stalk, sliced

1 tsp. caraway seeds

2 c. chopped green cabbage

3 c. chicken broth

1 T. light brown sugar

1 can (16 oz.) crushed tomatoes in juice

1 can (15 oz.) white beans, drained and rinsed

1 T. cider vinegar

¼ tsp. ground white pepper

¼ c. fresh parsley or chives, chopped

In medium soup pot, heat the olive oil and sauté the onion for 3 minutes.  Add the carrots and celery; sauté 3 minutes.  Add the caraway seeds; cook, stirring for 1 minute. 

Stir in the cabbage, chicken broth and brown sugar.  Simmer, covered, for 5 minutes.  Stir in the tomatoes with juice.  Simmer, covered, for 20 minutes.  Add the white beans, vinegar and white pepper.  Simmer, uncovered, for 5 minutes until heated through.  Stir in the parsley or chives, if desired.  Serves 4.

Nutrition Information:  per serving

Calories 173, Total fat 4 g, Saturated fat 0.5 g, Cholesterol 1 mg, Sodium 429  mg, Carbohydrate 27 g, Fiber 2.5 g, Sugar 8 g, Protein 10 g