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August 31, 2010

WP: Physicians Use Photos From Patients' Cell Phones to Guide Healthcare

The Washington Post on Aug 31, 2010, published an interesting story where emergency physicians at George Washington Medical Center enabled patients to take a picture of their wound on their cell phone and transmit it to the ER where a physician will take a look and come up with diagnosis and appropriately triage the patient. In this study, they found that 90% of diagnosis made by this method came out accurate! What many people may not realize is that some form of "online" consu…
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August 30, 2010

Nasal Surgery Helps With Snoring

Researchers have found that surgery to improve nasal breathing in setting of nasal obstruction, congestion, and/or resistance can also help with snoring . Depending on the study, surgical relief of nasal obstruction improves snoring in a range from 35% to as high as 86%. Unfortunately, complete CURE (ie, no snoring whatsoever) is less likely occurring in <15% of patients. What are the possible nasal surgeries one can undergo to relieve nasal obstruction and potentially achieve snorin…
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August 26, 2010

12 Year Old Child Dies After Tonsillectomy

There was a recent report of a 12 year old child who died after a routine tonsillectomy in Florida on Aug 15, 2010. Details on the exact circumstances of what caused her death has not been released and autopsy is pending. However, this story does illustrate that even though tonsillectomy is one of the most common surgery performed in the United States and is considered routine, NO surgery is without risk. Medical literature places the mortality rate from tonsillectomy between one in 15…
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Book Chapters Authored By Dr. Chang Published On Open Access

Dr. Chris Chang has co-authored two book chapters in a hardcover textbook entitled " Laryngeal Diseases: Symptoms, Diagnosis and Treatments ". The book chapters Dr. Chang has co-authored are NOW available for download via Open Access. Melissa Mainville, a voice therapist at Fauquier Hospital , also co-authored one of the book chapters (Chapter 1). CHAPTER 1: Psychogenic Voice Disorders by Grace W. Johnson, Carmen T. Gonzalez, Christopher Y. Chang , Sarah L. Maines, Melissa M. Mai…
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Allergies Associated with Heart Disease!

First weight gain and now heart disease. Allergies is certainly getting bad rap (though it has been associated with decreased risk of cancer ). Researchers in Philadelphia have found an association between allergies and heart disease when analyzing data from more than 8,600 adults aged 20 or older who participated in the National Health and Nutrition Examination Survey conducted between 1988 and 1994. After adjusting for other related factors, such as age and asthma, there was a 2.6-fold…
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August 25, 2010

Antihistamines Associated With Weight Gain!

Yale researchers have found an association between obesity and antihistamine use based on data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES). In the study , adults taking prescription H1 antihistamines were matched by age and gender with controls and compared on the basis of body measurements, plasma glucose, insulin concentrations, and lipid levels. What does tbis mean? It means that there is an association and not necessarily a cause-and-effect between we…
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Having Allergies Reduce Risk of Cancer!

Well maybe... According to a May 2010 study where questionnaire-based interviews were performed and encompassed self-reported history of prior medical diagnosis of asthma and eczema, medication use, and several covariates among 3,300 cancer cases and 512 population controls, a history of asthma was negatively associated with all cancer types combined (OR, 0.72; 95% CI, 0.5-1.1) and similarly for a history of eczema (OR, 0.66; 95% CI, 0.4-1.1). Why would this happen? Well, allergies is due t…
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August 22, 2010

Got Allergies? Maybe It's Actually Non-Allergic Rhinitis

USA Today published a story on Aug 22, 2010 describing a condition called "Non-Allergic Rhinitis" or "Vasomotor Rhinitis" which essentially is having pretty much all the symptoms of classic nasal allergies, but caused NOT by allergies! Such symptoms include: - Runny nose - Nasal congestion - Post-nasal drainage - Nasal obstruction - Sinus pressure - Sneezing etc These individuals also report that their nasal symptoms are triggered not only by pollen and dust,…
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Practice Website Search Engine Optimized (We Have 900+ Webpages in our Website Now!!!)

It is hard to believe, but our practice now maintains close to 900+ webpages and organizing such a voluminous amount of information is not easily accomplished if weren't for Google. We have optimized our  Google site search engine to allow patients as well as ordinary surfers to efficiently and accurately look for information throughout our website. On most webpages, there will be a search box link like this on the top left hand corner: Search Site Click here to check it out!
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August 21, 2010

Text Messaging to Find Out Wait Times for Medical Services?

I came across this interesting service offered by a Massachusetts hospital whereby patients can text message the hospital and get an immediate text message back with what the current wait times are in the Emergency Room. (Here's a news article describing the service.) Which got me thinking... how can text messaging (in general) be used to allow communication between a patient and medical services overall. This would save time and money (frees up a secretary who would otherwise be fiel…
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August 20, 2010

Should Boys Also Get Vaccinated for HPV?

NPR on Aug 20, 2010 aired a story whether boys should also get vaccinated for HPV. It is well established that vaccines like Gardasil (FDA approved for boys in 2009) and Cervarix protect against two of the HPV types (HPV-16 and HPV-18) that can cause cervical cancer and some other genital cancers including anal, vulvar, vaginal, and penile cancers. However, it may potentially prevent other types of HPV related disorders (NOT mentioned in the NPR story) involving the head & neck in both …
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August 19, 2010

ABC: Boy With Ondine's Curse Must Think to Breathe

ABC news carried a story about a young boy named Liam Derbyshire who has an extremely rare sleeping disorder called Ondine's Curse . The medical name is Central Hypoventilation Syndrome (CCHS). As those familiar with folklore know, Ondine's curse is after a mortal who fell in love with a German nymph. He swears that his daily breath is a testimony to her love. But when the man is unfaithful, the king punishes him by making him remember all his bodily functions INCLUDING breathing. …
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Allergy to Cats, Dogs, or Dust Make Allergy to All Else More Severe

New research published in this month's Annals of Allergy, Asthma & Immunology reported that patients with allergy to cat, dog, and/or dust mite resulted in increased allergy symptom severity to other allergies like ragweed. In other words, if you have a cat allergy and also allergic to ragweed, the cat will actually make your allergy to ragweed even worse than if you did not have a cat (or have a cat allergy). These year-round allergies appear to “pre-prime” the immune system s…
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August 18, 2010

Wierdest Nose in the World!

A reader informed me of this interesting video by National Geographics on an animal called the "Star-Nosed Mole". There are 22 tentacles that make up the nose and it "smells" as well as "sees" by touch (pretty important given the mole is blind). The nose provides information about its surroundings in 25 milliseconds and it moves at lightspeed! Check out the video ! Pretty amazing!
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Fauquier Hyperbaric Oxygen Chamber

On June 9, 2009, Fauquier Hospital opened a wound center that included two hyperbaric oxygen chambers . Hyperbaric oxygen, also known as HBO, has a long and close-knit history with ENT. What hyperbaric oxygen treatment does, in a nutshell, is provide higher concentrations of oxygen to the bloodstream which allows for faster healing of chronic wounds as well as treatment of carbon monoxide poisoning and "the bends" when SCUBA diving. The higher concentrations of oxygen is achieved…
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August 17, 2010

Fauquier Hospital VIPeds Medical Camp Program on Channel 9 News

It was quite cool to see Fauquier Hospital's innovative VIPeds Medical Camp program featured on Channel 9 news. This unique hands-on program is for teenagers to learn more about the health profession and opportunities found inside a hospital. Local teens learn to apply a cast, to harvest a cornea (I personally have no idea how to do that!), to suturing a wound closed. No ENT related procedures however... Check out the video segment here .
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Dr. Chang Invited to Be a Judge for the 2010 Web Health Awards

Dr. Chang has been invited to be a judge for the Summer 2010 Web Health Awards . Now in its 12th year, the goal of the Web Health Awards is to recognize high-quality electronic health information. The awards program is organized by the Health Information Resource Center (HIRC), a national clearinghouse for professionals who work in consumer health fields. Read more about the Web Health Awards here .
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Vitamin D May Treat Or Prevent Allergies!

Vitamin D is being blamed for a great many deal of human illnesses including rickets, depression, chronic fatigue, chronic pain, autoimmune disease, certain cancers, osteoporosis, heart disease, etc. We might as well add allergies  to the list... Researchers have found that vitamin D may be an effective therapeutic agent to treat or prevent allergies! Low vitamin D levels was found to heighten Th2 reactivity which drives allergy response. The evidence is compelling enough that it would …
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Hearing Loss on the Rise in US Teenagers

JAMA published research showing a rise in hearing loss among US teenagers from 15% between 1988-1994 (2928 teens) to 20% from 2005-2006 (1771 teens). The study was a cross-sectional analyses of US representative demographic and audiometric data. No one quite knows exactly why this has happened... but my guess is the increasing prevalence of portable music players where loud music can cause hearing damage. Read a story on this in Reuters here . Reference: Change in Prevalence of Hearing…
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Cell Phones Causes Brain Tumor (Acoustic Neuroma)

In 2004, there was a Swedish study published in the International Journal of Epidemiology where researchers found that the risk of developing a benign brain tumor called an acoustic neuroma was almost double for those who started to use phones before their diagnosis. In addition, the tumor risk was almost four times higher on the side of the head where the phone was held. An acoustic neuroma is a benign tumor that causes symptoms or ringing of the ears ( tinnitus ) as well as hearing loss.…
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SFChronicle: Say goodnight to snoring with simple surgeries (or not?)

San Francisco Chronicle on Aug 16, 2010 published a story entitled " Say goodnight to snoring with simple surgeries ." Although the article is pretty balanced, especially when discussing how various factors lead to a person's snore , I do feel the success rates mentioned in the article of 80-95% may be overly optimistic when talking about all patients. Such success rates are certainly possible in a select patient population with the appropriate anatomy. Furthermore, the story…
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Cause of Nickle Allergy Determined

There are millions of people who are allergic to nickle which causes itching, burning, and redness upon contact with skin. It's the reason why people have skin reactions when wearing cheap jewelry as well as cell phones. The cause of such dermatitis was a mystery until recently when scientists in Germany have discovered the underlying mechanism of this reaction. Using mice, they figured out that nickel binds to a protein called toll-like receptor 4 or TLR4, which signals the immune syst…
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August 16, 2010

MRSA-Killing Paint Created

Scientists at Rensselaer Polytechnic Institute has developed a high tech paint that safely kills MRSA . This special paint was developed for use on surgical equipment, hospital walls, and other surfaces. When MRSA touches this special coating, it dies preventing the main way this germ travels from one person to another (which is by contact). 100 percent of MRSA in contact with this special paint were killed within 20 minutes. The paint contains a naturally occurring enzyme called lysostaph…
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Intra-Nasal Cooling System Effectively Chills Brain After Cardiac Arrest

In a study in this month's Circulation , a new nasopharyngeal device was used to initiate cerebral cooling during cardiac arrest. This device, called RhinoChill made by BeneChill cools the major vascular structures of the brain thereby improving neurological outcome. Use of this device was found to increase survival over CPR alone by 27% and a 26% increase in neurologically intact survival. Reference: Intra-Arrest Transnasal Evaporative Cooling. A Randomized, Prehospital, Multicente…
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August 15, 2010

Two Book Chapters By Dr. Chris Chang Soon To Be Published!

Dr. Chris Chang has co-authored two book chapters in a soon to be published hardcover textbook entitled " Laryngeal Diseases: Symptoms, Diagnosis and Treatments ". The book chapters Dr. Chang has co-authored are entitled: Psychogenic Voice Disorders by Grace W. Johnson, Carmen T. Gonzalez, Christopher Y. Chang, Sarah L. Maines, Melissa M. Mainville, Amy J. Asbury and Age as a Factor in Responses to Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients by Christoph…
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August 07, 2010

Dr. Oz Does Nosebleeds (With Some Errors)

A reader informed me that Dr. Oz did a TV show recently on nosebleeds ... I took a look at the video clip and it is my opinion that some information Dr. Oz conveyed is not entirely correct. Again, I should stress that this is just my opinion and I'm sure there will be many who may feel differently. Error #1: Contrary to what was said on the show, ice packs do NOT help with nosebleeds significantly. Though it makes sense that cold constricts the blood vessels... it does so only at th…
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Disfigured Teen on Cover of Time Magazine To Receive Reconstructive Surgery in US

As reported on MSNBC on August 6, 2010, the Afghan teen on the cover of Time Magazine (Aug 9, 2010) will receive reconstructive surgery to repair the disfigurement of her face. The surgery will be done by Dr. Peter Grossman , a plastic surgeon. For those who don't know, the teen's nose was cut off as punishment from running away from her abusive husband.
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August 06, 2010

Fauquier Hospital Medical Directory WebApp Created

A new mobile phone WebApp has been created specifically for cell phones called " Fauquier Med ". It provides a listing of all the physicians on staff at Fauquier Hospital broken down by last name, specialty, and practice group. Commonly used hospital numbers are also listed. The WebApp was created specifically for the iPhone, though other mobile smartphone users (Blackberry and Google Android) should also be able to use without difficulty. Directions to add to at least your iPhon…
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August 05, 2010

Our Practice Now Has a QuickMark Barcode!

Not sure what to do with it however at the moment, but given I am starting to see it plastered in more places, newspapers, magazines, etc, I thought I better jump on the bandwagon as well. For those not familiar with QuickMark, it is the new 2 dimensional barcodes in the shape of a square meant for mobile phone deciphering. iPhone has a couple apps to decipher using the camera. The barcode you see to the left is one for our practice... Try it out! There is a more sophisticated QuickMark …
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August 03, 2010

H. Pylori Infection Can Cause Urticaria and Angioedema!

Thanks to a recent blog post by medical blogger, Dr. Ves Dimov , I was made aware of how H. Pylori (Helicobacter pylori) infection of the stomach can cause chronic (idiopathic) urticaria as well as angioedema and that eradication of H. Pylori thru antibiotics and acid suppression can significantly improve the problem! For those who do not know what H. pylori is... It is a germ that is the most important cause of gastritis and peptic ulcer disease. It can be diagnosed by measurement of H. p…
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UK First Place in the World to Approve Botox for Migraine Headaches

Wall Street Journal reported on July 9, 2010 that the United Kingdom has become the first country in the world to approve botox injections for migraine headaches . The U.K. approval could shortly precede a decision on migraine treatment from the U.S. Food and Drug Administration. Botox treatment for migraines can be obtained currently in the US, but is rarely covered by insurance. Dr. Chang has been performing botox injections for migraines since 2006. Read the WSJ article here .
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FDA Potentially to Approve Botox for Migraines

As reported in MSNBC today, FDA regulators seem inclined to approve Allergan Inc's wrinkle drug Botox to prevent migraine headaches in millions of Americans, industry analysts said, based on information the drugmaker released on Monday. That would be great news for current patients of mine who receive botox for migraines. However, once FDA has approved botox for migraines, it may take awhile before it becomes an insurance "covered" procedure. Read the MSNBC article here .…
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