Research reveals new ways to preserve hearing loss after traumatic noise damage

It’s well known that exposure to extremely loud noises — whether it’s an explosion, a firecracker or even a concert — can lead to permanent hearing loss. But knowing how to treat noise-induced hearing loss, which affects about 15 percent of Americans, has largely remained a mystery. That may eventually change, thanks to new research from the Keck School of Medicine of USC, which sheds light on how noise-induced hearing loss happens and shows how a simple injection of a salt- or sugar-based solution into the middle ear may preserve hearing.

To develop a treatment for noise-induced hearing loss, the researchers first had to understand its mechanisms. They built a tool using novel miniature optics to image inside the cochlea, the hearing portion of the inner ear, and exposed mice to a loud noise similar to that of a roadside bomb.

They discovered that two things happen after exposure to a loud noise: sensory hair cells, which are the cells that detect sound and convert it to neural signals, die, and the inner ear fills with excess fluid, leading to the death of neurons.

“That buildup of fluid pressure in the inner ear is something you might notice if you go to a loud concert,” says the study’s corresponding author John Oghalai, MD, chair and professor of the USC Tina and Rick Caruso Department of Otolaryngology — Head and Neck Surgery and holder of the Leon J. Tiber and David S. Alpert Chair in Medicine. “When you leave the concert, your ears might feel full and you might have ringing in your ears. We were able to see that this buildup of fluid correlates with neuron loss.”

Both neurons and sensory hair cells play critical roles in hearing.

“The death of sensory hair cells leads to hearing loss. But even if some sensory hair cells remain and still work, if they’re not connected to a neuron, then the brain won’t hear the sound,” Oghalai says.

The researchers found that sensory hair cell death occurred immediately after exposure to loud noise and was irreversible. Neuron damage, however, had a delayed onset, opening a window of opportunity for treatment.

A simple solution

The buildup of fluid in the inner ear occurred over a period of a few hours after loud noise exposure and contained high concentrations of potassium. To reverse the effects of the potassium and reduce the fluid buildup, salt- and sugar-based solutions were injected into the middle ear, just through the eardrum, three hours after noise exposure. The researchers found that treatment with these solutions prevented 45-64 percent of neuron loss, suggesting that the treatment may offer a way to preserve hearing function.

The treatment could have several potential applications, Oghalai explains.

“I can envision soldiers carrying a small bottle of this solution with them and using it to prevent hearing damage after exposure to blast pressure from a roadside bomb,” he says. “It might also have potential as a treatment for other diseases of the inner ear that are associated with fluid buildup, such as Meniere’s disease.”

Oghalai and his team plan to conduct further research on the exact sequence of steps between fluid buildup in the inner ear and neuron death, followed by clinical trials of their potential treatment for noise-induced hearing loss.

Story Source: Materials provided by University of Southern California – Health Sciences. Note: Content may be edited for style and length. Read this article on Science Daily: University of Southern California – Health Sciences. “Simple treatment may minimize hearing loss triggered by loud noises.” ScienceDaily. ScienceDaily, 7 May 2018.


The ability to perceive sound enables one of life’s richest and most meaningful sensory experiences. Approximately 36 million people in the United States suffer from some degree of hearing loss. People of all ages experience symptoms of hearing loss, and these symptoms can lead to serious social problems and depression.

The Hearing Center at SRHN’s team of board ­certified otolaryngologists and experienced audiologists is devoted to finding the best, personalized hearing solutions and providing comprehensive care for all hearing and balance needs.

1701 4th Street, Suite 120
Santa Rosa, CA 95404

Call (707) 523-7025 — for Appointments and Referrals Today!

– Learn more here –

NCMA dermatologist Dr. Jeffrey Sugarman reveals the true risks of melanoma

Pediatric melanoma has increased on average 2% per year since 1973, although its incidence seems to have decreased over the last few years. The biggest increase in recent decades has been in girls ages 15-19, possibly because girls are more likely than boys to sunbathe and use tanning beds.

Dr. Jeffrey Sugarman of Northern California Medical Associates (NCMA) and Redwood Family Dermatology discusses the myths associated with sunscreens and tanning in a newly released video presentation.

According to the latest statistics more than 178,000 Americans are expected to be diagnosed with melanoma this year. A new video featuring Northern California Medical Associates (NCMA) dermatologist Dr. Jeffrey Sugarman sheds light on melanoma, sunscreen and tanning beds. For this presentation, Dr. Sugarman of Redwood Family Dermatology discusses how indoor tanning is a major contributor to the rising number of melanoma cases among young women.

Tragically, melanoma is the leading cause of cancer deaths in young women ages 25-30 and the second leading cause of cancer death in women ages 30-35. Some people have been led to believe that it is safer to get a tan using a commercial tanning bed. Dr. Sugarman says this is clearly not the case. “Indoor tanning beds are definitely not safer than tanning outdoors. Tanning beds emit UVA which is linked to melanoma. This is a huge risk factor for women under the age of 25 who are frequent tanning bed users.” Research suggests that exposure to tanning beds prior to the age of 30 can increase a person’s risk of developing melanoma by as much as 75 percent. “People who use tanning beds have a significantly higher risk of developing melanoma.”

Understanding Sunscreens

“While using sunscreen is important, sunscreens themselves can give people a false sense of security against melanoma,” explains Dr. Sugarman. “Many products that claim an SPF protection on the package do not always reflect the actual degree of sunscreen a person can expect to achieve.”

There are two basic types of sunscreen on the market today. Some contain chemicals to absorb ultraviolet radiation while others rely on particles of titanium dioxide or zinc oxide to block or scatter sunlight. Both products in fact contain inert chemicals. The SPF rating of sunscreens measures the ability of a product to reduce the amount of UVB radiation penetrating the skin. A sun protection factor of 10 reduces UVB penetration by 90 percent, SPF 20 by 95 percent, and SPF 30 by 97 percent.

“The truth about the SPF rating is that it is determined in a laboratory setting where sunscreen is applied in a precise and controlled manner and thickness. People normally only apply about one quarter to one half the recommended amount,” he says. “This significantly reduces the protection of sunscreen products.” Dr. Sugarman recommends that sunscreen be applied as directed 10-20 minutes prior to sun exposure, and it must be reapplied every 3-4 hours to maintain a protective quality.

“The best prevention against melanoma is to be smart about how much time you spend in the sun. For prolonged periods of sun activities covering exposed skin with clothing and wearing a hat is by far the best form of prevention.”

Dr. Sugarman’s presentation is available for viewing online at the Northern California Medical Associates’ YouTube Channel. It can be accessed by following this link:

About Dr. Sugarman

Dr. Sugarman is Assistant Clinical Professor in the Departments of Dermatology and Family and Community Medicine at U.C. San Francisco. Board certified in both pediatrics and dermatology, Dr. Sugarman has published many articles on topics ranging from cancer research to childhood eczema. His practice is evenly divided between pediatric dermatology and adult dermatology. To learn more visit the Redwood Family Dermatology website or call 707-545-4537 to schedule an appointment.

NCMA Wraps up 2018 Physician Regional Symposium – Videos Available Online

2018 physician regional spring symposium wrap-up

Northern California Medical Associates (NCMA) has wrapped up the Physician Regional Spring Symposium and is offering a full library of healthcare lectures for viewing on YouTube beginning April.

Northern California Medical Associates (NCMA) along with St. Joseph Health held the much anticipated annual Regional Primary Care Spring Symposium on March 24, 2018 in Santa Rosa. This well-attended conference plays a vital role in the local medical community, offering physicians and healthcare providers an opportunity to learn about cutting edge treatments, to collaborate, share research and gain fresh perspectives.

At this year’s event, physicians from a variety of backgrounds and fields of practice gave hot-topic educational lectures to an audience of healthcare providers that included; internal medicine and primary care physicians, emergency physicians, physician assistants, nurse practitioners, staff RNs, and medical assistants – all from the northern California region. This event gives doctors the opportunity to also earn Continuing Medical Education credits (CMEs) for their attendance.

Programs highlighted during the symposium gave in-depth overviews of the current state of healthcare, and included advanced treatments and new technologies from the experts as they continue to improve patient outcomes and provide exceptional patient experience in the process.

Michael Johnson, D.P.M. of St. Joseph Health Medical Groups served as MC and NCMA’s Dr. Thomas Dunlap M.D. was co-course director along with Tucker Bierbaum, M.D. of St. Joseph Health for this year’s Symposium. NCMA physicians who spoke at the event included; Henry Huang, M.D. on Cardiovascular Updates, Yuichio Nakai, M.D. on Diabetic Updates/Medication Panel, Patrick Colman M.D. and Keith Korver, M.D. were included in a panel Update on TAVR, and Skin Lesions was presented by Jeffrey Sugarman, M.D.

Additional topics of presentations include;

  • Jack Boyd, M.D. – Current State of Robotics in Healthcare
  • Avinash Ramchandani, F.A.A.M.R., MD – The Opioid Conundrum – Angst, Anxiety and Answers
  • Elizabeth Tito, M.D. – How should you screen for breast cancer?
  • Ramzi Deelk, M.D., Sanjay Dhar, M.D., & Atoosa Molanazadeh, PA – Update on TAVR
  • Gerrard Ferrer, D.O. and Christopher Walker, D.O. – Concussions and Sports Medicine
  • Ian Anderson, M.D. – Lung Cancer Update – Screening

Complete episodes of these timely lectures are available online beginning in April via NCMA’s YouTube Channel where viewings are free and completely open to the public. The NCMA’s YouTube channel can be found at This educational program is provided by Northern California Medical Associates and St. Joseph Health –Santa Rosa Memorial.

About NCMA Healthcare

At Northern California Medical Associates (NCMA), innovative medicine and patient care is more than just a profession; it’s a calling. As one of the leading medical associations in the North Bay, NCMA takes pride in offering a highly diversified, professional staff and comprehensive health services to patients. No matter the level of medical expertise a patient may require, the professionals at NCMA will deliver expert care with respect and compassion. For more information visit the NCMA website.

Quality of life can be improved for people with chronic heart failure

Patients with chronic heart failure face related problems, such as depression and fatigue, that could be relieved by an expanded model of care, according to a recently published study.

Patients with chronic heart failure face related problems, such as depression and fatigue, that could be relieved by an expanded model of care, according to a recently published study led by a researcher from the University of Colorado School of Medicine.

The study, “Effect of a Collaborative Care Intervention vs Usual Care on Health Status of Patients With Chronic Heart Failure: The CASA Randomized Clinical Trial,” published in the current issue of the journal JAMA Internal Medicine, found benefit to some aspects of patients’ quality of life when conventional cardiac therapy is supplemented with a nurse and a social worker who collaborate with a team to address patients’ symptom and psychosocial needs.

“Many of the 5.8 million Americans with heart failure live with bothersome symptoms, reduced function and poor quality of life” said David B. Bekelman, MD, MPH, the study primary author. “Improving their care is important because many people with heart failure live with these challenges for years.”

Bekelman, an associate professor of medicine who practices at the Eastern Colorado Health Care System for the U.S. Department of Veterans Affairs, and his colleagues evaluated 314 patients, with half of them enrolled in a program that addressed those quality of life concerns.

The Collaborative Care to Alleviate Symptoms and Adjust to Illness intervention, also called CASA, offered 157 patients a nurse and social worker who collaborated with a primary care provider, cardiologist, and palliative care physician to address the patients’ needs. The CASA trial is the first clinical trial of such a collaborative intervention in heart failure and it included patients receiving care from VA, academic and safety-net health systems in Colorado between August 2012 and April 2016. Patients enrolled in the study were evaluated for a one-year period. The typical CASA intervention was three to four months.

The CASA intervention significantly improved patients’ depression and fatigue but did not result in significant changes in heart failure-specific health status, pain, shortness of breath, or number of hospitalizations. The number who died during the study was similar — 10 of the patients in the CASA intervention died, while 13 of those receiving the typical standard of care died.

The improvements in depression and fatigue are important results because they are both common, burdensome, and difficult to treat in heart failure, Bekelman said. Very few other studies have found treatments for these symptoms in patients with heart failure. Furthermore, the improvement in depression lasted the whole duration of the patient’s 12-month study period, months after the CASA intervention ended.

Bekelman discussed several next steps in the research, including studying the intervention in a higher-risk or more ill population, and using health technology, such as videoconference, to extend the reach of the CASA intervention.

Story Source: Read this article on Science Daily: University of Colorado Anschutz Medical Campus. “Improving quality of life for people with chronic heart failure.” ScienceDaily. ScienceDaily, 26 February 2018. <>.

NCMA’s Internal Medicine Physicians diagnose, treat, and manage a full spectrum of health conditions. In addition to general internal medicine services, we also have expertise, special interest, and experience in the following areas: gastroenterology, endocrinology, health screenings, diabetes management and care, immunizations, and women’s health. Visit the Internal Medicine section of our website to learn more.

Annual Physician Regional Spring Symposium Gets Underway in March

Santa Rosa Memorial Hospital and Northern California Medical Associates will be hosting the Annual Physician Regional Spring Symposium which will be held on Saturday, March 24, 2018, at the Hyatt Regency Sonoma Wine Country.

This year’s event will feature Key Note Speaker: Jack Boyd, M.D., Stanford, Thoracic and Cardiovascular Surgery – Current State of Robotics in Healthcare

Faculty Presenters include; Elizabeth Tito, M.D. – How Should You Screen For Breast Cancer?, Patrick S. Coleman, M.D., F.A.C.C. – Update on TAVR Christopher Walter, D.O., MMS – Sports Medicine, Gerrard Ferrer, D.O. – Concussions, Jeffrey Sugarman, M.D. – Skin Lesions, Ian, Anderson M.D. – Lung Cancer Update – Screening, Avinash Ramchandani M.D. – The Opioid Conundrum: Angst, Anxiety and Answers, Henry Huang, M.D. – Cardiovascular Update, and Yuichiro Nakai, M.D. – Diabetic Updates/Medication Panel.

RSVP by completing the online registration form. For more information call Debra Esposti at 707-569-7862.

2018 Symposium Agenda

NCMA Cardiovascular Services speaks out on American Heart Month

Northern California Medical Associates Cardiovascular Services explores national trends in cardiovascular disease and shares insight on staying heart healthy.

Northern California Medical Associates Cardiovascular Services explores national trends in cardiovascular disease and shares insight on staying heart healthy.

February is American Heart Month – a month-long event aimed at educating people all across the U.S. about heart disease and prevention. NCMA Cardiovascular Services is taking this opportunity to share some news about heart disease and offers some tips on how to have a healthy heart.

Heart Disease Statistics Never Get Better

Every year the American Heart Association updates the heart and stroke statistics and this year, the numbers are just as alarming as ever.

  • Coronary heart disease (CHD) (43.8%) is the leading cause of deaths attributable to cardiovascular disease (CVD) in the US, followed by stroke (16.8%), high blood pressure (9.4%), heart failure (HF) (9.0%), and other CVDs (17.9%).
  • Over the next two decades about 130 million adults in the US population (almost half) are projected to experience some form of cardiovascular disease, and total costs of CVD are expected to reach $1.1 trillion in 2035.
  • Stroke prevalence in adults is 2.7% in the US. The impact of hypertension management on stroke risk is evident with the greater risk reduction among those with more intense treatment.

Heart disease continues to be the leading cause of death for both of men and women, claiming more lives than all forms of cancer combined. Improving heart health is paramount to maintaining a healthy lifestyle. In this case, knowledge is power, and with just a little effort it is possible to protect against heart disease.

While education remains the best way to change a trend, getting people to take heart health seriously continues to be a challenge. “As long as a person is relatively healthy, making lifestyle changes aimed at improving cardiovascular function may not be at the forefront of most people’s minds,” says Dr. Henry W. Huang, M.D., of NCMA Cardiovascular Services. “But being proactive about heart health can have a significant impact on quality of life over a person’s lifetime.”

In addition to exercise, maintaining a healthy diet, controlling blood pressure, maintaining a healthy weight, making lifestyle choices to improve cardiovascular health will also improve quality of life, and lower the risk for heart disease. “You could say that these aspects make up the heart of heart health and represent a solid prevention strategy,” explains Dr. Huang “For people who have already had a heart attack and for those at high risk we also recommend taking a low-dose aspirin as part of their daily routine. This is a fairly simple measure anyone can take that has proven to inhibit clotting and lower the risk of future cardiovascular events.”

About NCMA Cardio Services

NCMA Cardiovascular Services offers patients a comprehensive range of cardiac services, interventional procedures and comprehensive care to meet the needs of patients with 11 offices, located in Santa Rosa, Petaluma, Sonoma, Healdsburg, Fort Bragg, Mendocino, Gualala, Ukiah, and Lakeport. For more information, visit our website.


FountainGrove Cardiology Supports Go Red For Women

FountainGrove Cardiology Celebrated Go Red For Women

FountainGrove Cardiology Celebrates Go Red For Women










About Go Red For Women

In 2004, the American Heart Association (AHA) faced a challenge. Cardiovascular disease claimed the lives of nearly 500,000 American women each year, yet women were not paying attention. In fact, many even dismissed it as an older man’s disease. To dispel the myths and raise awareness of heart disease & stroke as the number one killer of women, the American Heart Association created Go Red For Women, a passionate, emotional, social initiative designed to empower women to take charge of their heart health.

What is the goal of Go Red For Women?

Go Red For Women encourages awareness of the issue of women and heart disease, and also action to save more lives. The movement harnesses the energy, passion and power women have to band together and collectively wipe out heart disease. It challenges them to know their risk for heart disease and take action to reduce their personal risk. It also gives them the tools they need to lead a heart healthy life.

In 2010, the AHA set a strategic goal of reducing death and disability from cardiovascular disease and strokes by 20 percent while improving the cardiovascular health of all Americans by 20 percent by the year 2020.

Learn more at Go Red For Women … 

Facts About Women and Cardiovascular Disease from AHA

Cardiovascular diseases, which includes stroke, claim the life of a woman about every 80 seconds. But about 80 percent of cardiovascular diseases may be prevented.
As the No. 1 killer of women — claiming the lives of one in three women — cardiovascular diseases force us to consider that a woman we know and love may be affected at any age. In fact, today heart disease claims more lives than all forms of cancer combined.
There is good news: heart disease and stroke may be prevented by understanding your family health history, knowing your numbers and making simple lifestyle changes.

Learn Your Family History.

You can control some risk factors such as blood pressure, smoking, cholesterol and lack of regular physical activity. You can’t control factors such as age, gender and family history.
Know Your Numbers and Act.

The five critical health numbers all women should know are:

1. Total cholesterol
2. HDL cholesterol
3. Blood pressure
4. Blood sugar
5. Body mass index (BMI)

Now is the time for women to take control of their health by Learning their Family History and Knowing their Numbers. Beating heart disease and stroke means more time for women to be change makers, business leaders and innovators, and more time to be moms, sisters, partners and friends. Beating cardiovascular diseases means more time to be here and be you.

When you support Go Red For Women by advocating, fundraising and sharing your story, more lives are saved. Every dollar raised helps fund lifesaving research and awareness that adds more time to women’s lives.

Facts about cardiovascular diseases

FACT 1: Cardiovascular diseases kill one woman about every 80 seconds and about 80 percent of cardiovascular diseases may be prevented.

  • Prevention starts with Knowing Your Numbers: Total Cholesterol, HDL Cholesterol, Blood Pressure, Blood Sugar and Body Mass Index (BMI).
  •  Less than 20 percent of women meet the Federal Physical Activity Guidelines.
  •  More than 66 percent of women age 20 and older are overweight or obese.
    About 63 percent are non-Hispanic whites.
  • About 82 percent are non-Hispanic blacks.
  • About 77 percent are Hispanics.
  • More than 50 percent of high blood pressure-related deaths were female.
  • About 42 percent of women in America age 20 or older have total cholesterol of 200 mg/dl or higher.

FACT 2: Cardiovascular diseases kill nearly one in three women each year.

• Heart disease is the No. 1 killer of women, taking more lives than all forms of cancer combined.
• More than one in three women is living with some form of cardiovascular disease.
• Women account for almost half of all cardiovascular deaths.
• Mortality from peripheral artery disease, or PAD, was nearly 11 percent higher in women than men. The prevalence of PAD for adults age 40 and older is greater than 6.8 million.

FACT 3: About 4.1 million stroke survivors alive today are women.

• Stroke is the No. 5 cause of death in the United States, killing nearly 130,000 people a year. That’s roughly one in every 20 deaths.
• Each year about 55,000 more females than males have a stroke.

FACT 4: Heart disease and stroke affect women of all ethnicities.

• Among women age 20 and older:
• About one third of non-Hispanic whites have CVD.
• Nearly half of non-Hispanic blacks have CVD.
• About one third of Hispanics have CVD.
• Only 17 percent of women consider heart disease or stroke to be the greatest health problem facing Americans today.
• African-American women are the least likely among all women to consider heart disease or stroke to be the greatest health problem facing Americans today – only 13 percent consider it the greatest health problem.
• 15 percent of Hispanic women and 15 percent of Asian women consider heart disease or stroke to be the greatest health problem facing Americans today.
• 18 percent of Caucasian women consider heart disease or stroke to be the greatest health problem facing Americans today.

*Facts from Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

About Go Red For Women

In the United States, cardiovascular diseases kill approximately 1 in 3 women each year. Go Red For Women is the American Heart Association’s national movement to end heart disease and stroke in women. Cardiovascular diseases in the U.S. kill approximately one woman every 80 seconds. The good news is that 80 percent of cardiac events may be prevented with education and lifestyle changes. Go Red For Women advocates for more research and swifter action for women’s heart health. The American Heart Association’s Go Red For Women movement is nationally sponsored by Macy’s and CVS Health, with additional support from our cause supporters. For more information, please visit or call 1-888-MY-HEART (1-888-694-3278).

About FountainGrove Cardiology

At NCMA Cardiovascular Services, our goal has been to create one of the most comprehensive and cost-effective health care groups in the nation.

From cardiac catheterization to open-heart surgery, from electrophysiology to rehabilitation and prevention, the Northern California Medical Associates (NCMA) Cardiovascular Services team is dedicated to delivering the highest quality care and the best patient results.  Our professional staff not only maintains its commitment to our patients’ health and well-being but to maintaining a tradition of excellence and expertise in our practice of the most current, innovative treatments in cardiovascular medicine.

The Cardiovascular Services team is comprised of highly skilled physicians, specialists, nurses, and other healthcare professionals dedicated to our patients’ health care needs. Since 1975, the group has focused on sub specialization within cardiovascular health to provide services by the most highly trained and experienced physicians and staff.

FountainGrove Cardiology
3536 Mendocino Ave. Suite 200
Santa Rosa, CA 95403

(707) 573-6166 Main Number
(707) 573-6199 Scheduling
Fax: (707) 573-6165

NCMA Pulmonologist shares insights on new study associated with living with asthma

Northern California Medical Associations’ (NCMA) Dr. James M. Steele M.D. talks about the latest study on asthma and the necessity of managing symptoms to help keep down costs.

Northern California Medical Associations’ (NCMA) Dr. James M. Steele M.D. talks about the latest study on asthma and the necessity of managing symptoms to help keep down costs.

Researchers from the Centers for Disease Control and Prevention recently analyzed data from the Medical Expenditure Panel Survey to discover the financial toll asthma has on sufferers and their families. More than 213,000 respondents participated over a six-year period with 10,237 people identified with treated asthma. According to the results of the survey about 15.4 million people in the U.S. undergo treatment for asthma each year with annual costs in the $82 billion range. Those who suffer from asthma spend about $3,266 every year on medical care. Around 3,168 deaths are attributed annually to asthma.

“This survey clearly shows the impact asthma has on patients and society as well,” says Dr. James Marco Steele, NCMA Pulmonologist. “The best way to keep medical expenses down for asthma patients is to have an active treatment plan in place and to avoid triggers. Taking asthma medication as prescribed and using the quick-acting meds when needed will help to keep attacks in check for most patients.”

Understanding Asthma

Asthma is a disease that affects the lungs causing recurring episodes of wheezing, breathlessness and chest tightness. Asthma patients also frequently experience nighttime and early morning coughing episodes. During an asthma attack the airways in the lungs swell and shrink. This means that less air can get in and out of the lungs. The situation becomes all the worse when mucous clogs up the airways, restricting the ability to breathe even more. An asthma attack can be scary and stressful for the person having an attack. Asthma triggers can include:

  • pollen, mold, dust mites, cockroaches, pet dander
  • smoke, air pollution, chemicals and strong odors
  • aspirin, acetaminophen and other medications
  • weather conditions
  • exercise, physical activity
  • emotional stress

Chronic health problems can also exacerbate the symptoms of asthma such as obesity, obstructive sleep apnea, acid reflux, stress and depression. Colds and sinus infections can also worsen asthma symptoms.

“As with most pulmonary issues, asthma can be a challenge for patients to deal with, but many people live completely normal lives with the condition, as long as it’s properly managed with the help of a healthcare provider,” explained Dr. Steele. “Our goal with asthma patients is to have a good treatment plan in place and to provide adequate education and support, so that the patient can resume a normal and active life.”

Treating Asthma

In addition to avoiding allergens that trigger asthma symptoms, drug therapies can also help. As mentioned previously, severe attacks are best deal with by having an emergency action plan in place. A healthcare provider may also recommend using a peak flow meter to monitor the asthma. A peak flow meter is a small handheld device that measures how much air the patient is able to push out through the lungs. By tracking airflow, changes can be made to the treatment plan that may include additional behavioral or environmental changes, or possibly an alternative asthma medication.

Untreated asthma can have adverse effects on a person’s life. In addition to wheezing and coughing, asthma symptoms can cause time lost from work or school, inability to participate in activities, and occasional visits to the hospital. The best way to manage attacks and get back to a more active life is to consult with a physician. “Asthma may not be curable, but with the help of a team of knowledgeable healthcare providers, symptoms can be managed, and flare-ups reduced,” said Dr. Steele.

About Dr. Steel

NCMA Pulmonologist James Marco Steele, MD, provides diagnostics, treatment, and management of the full spectrum of pulmonary diseases including asthma. Dr. Steele is Board Certified in Sleep Medicine, Pulmonary Medicine, Internal Medicine, and Critical Care by the American Board of Internal Medicine (ABIM). Dr. Steele offers his expertise in the following areas: sleep disorders, critical care medicine, pulmonary hypertension, adult cystic fibrosis, clinical research, and special procedures that encompass a wide range of diagnostic and interventional pulmonary medicine. For more information visit the website or call (707) 525-3786.  




Research highlights connection between sleep loss and weight gain

Sleep loss increases the risk of obesity through a combination of effects on energy metabolism. This research, presented at the European Congress of Endocrinology in Lisbon, will highlight how disrupted sleep patterns, a common feature of modern living, can predispose to weight gain, by affecting people’s appetite and responses to food and exercise.

In the 24/7 culture of the modern world, an increasing number of people report routine reduced quality of sleep and several studies have correlated sleep deprivation with weight gain. The underlying cause of increased obesity risk from sleep disruption is unclear but may relate to changes in appetite, metabolism, motivation, physical activity or a combination of factors.

Dr Christian Benedict from Uppsala University, Sweden and his group have conducted a number of human studies to investigate how sleep loss may affect energy metabolism. These human studies have measured and imaged behavioural, physiological and biochemical responses to food following acute sleep deprivation. The behavioural data reveal that metabolically healthy, sleep-deprived human subjects prefer larger food portions, seek more calories, exhibit signs of increased food-related impulsivity, experience more pleasure from food, and expend less energy.

The group’s physiological studies indicate that sleep loss shifts the hormonal balance from hormones that promote fullness (satiety), such as GLP-1, to those that promote hunger, such as ghrelin. Sleep restriction also increased levels of endocannabinoids, which is known to have appetite-promoting effects. Further work from Dr Benedict’s team shows that acute sleep loss alters the balance of gut bacteria, which has been widely implicated as key for maintaining a healthy metabolism. The same study also found reduced sensitivity to insulin after sleep loss.

Dr Christian Benedict remarks, “Since perturbed sleep is such a common feature of modern life, these studies show it is no surprise that metabolic disorders, such as obesity are also on the rise.”

Although Dr Benedict’s work has shed light on how short periods of sleep loss can affect energy metabolism, longer-term studies are needed to validate these findings. The group are now investigating longer-term effects and also whether extending sleep in habitual short sleepers can restore these alterations in appetite and energy metabolism.

Dr Christian Benedict says, “My studies suggest that sleep loss favours weight gain in humans. It may also be concluded that improving sleep could be a promising lifestyle intervention to reduce the risk of future weight gain.”

North Coast Sleep Centers with Dr. James Marco Steele

NCMA Pulmonologist James Marco Steele, MD, provides diagnostics, treatment, and management of the full spectrum of pulmonary diseases. Dr. Steele is Board Certified in Sleep Medicine, Pulmonary Medicine, Internal Medicine, and Critical Care by the American Board of Internal Medicine (ABIM). Dr. Steele offers his expertise in the following areas: sleep disorders, critical care medicine, pulmonary hypertension, adult cystic fibrosis, clinical research, and special procedures that encompass a wide range of diagnostic and interventional pulmonary medicine.

Story Source:

Materials provided by European Society of EndocrinologyNote: Content may be edited for style and length.

Read this article on Sciencedaily: European Society of Endocrinology. “Sleep loss affects your waistline.” ScienceDaily. ScienceDaily, 22 May 2017. <>.

Who Needs a Cardiac Electrophysiologist?

A clinical cardiac electrophysiologist, or cardiac EP, specializes in treating rhythm problems of the heart. A cardiac EP is a cardiologist who completes 3 years of extra training beyond that required for board certification in cardiology to specialize in problems of the heart and blood vessels.

NCMA Bedi photo

Dr. Ashwani Bedi is board certified in cardiac electrophysiology, cardiovascular disease and internal medicine. He brings specialty expertise in all aspects of cardiac electrophysiology including SVT and VT ablations, atrial fibrillation ablations, pacing (including BiV pacing) and defibrillation as well as intracardiac echocardiography. Dr. Bedi was the recipient of the Health Care Hero Award and received multiple WOW designations at Deaconess Hospital in Evansville, Indiana. He has a professional interest in cardiac ablations, prevention and awareness of sudden cardiac death in communities and has been actively involved in cardiac screening for college athletes.

Common reasons to see an electrophysiologist

A cardiac EP can diagnose and treat conditions such as Atrial fibrillation (an irregular, fast heart rhythm in the upper chambers of the heart), Bradycardia (a heartbeat that is too slow), Tachycardia (a heartbeat that is too fast), Ventricular tachycardia ( a particularly dangerous type of very fast heartbeat), Supraventricular tachycardia (characterized by a sudden, very fast heartbeat), Ventricular fibrillation (dangerous fluttering of the heart muscle that doesn’t let it pump blood and can be fatal), sudden cardiac arrest (the heart suddenly stops beating), Long QT syndrome  (a disorder of the heart that can cause sudden arrhythmias) Wolff-Parkinson-White (WPW) syndrome (a condition that causes episodes of a fast heartbeat  caused by an extra electrical pathway in the heart), other arrhythmias (Arrhythmias can be caused by pregnancy, medicine interactions, or metabolic problems)

What is Arrhythmia

In a normal, healthy heart, the upper chambers (the atria) and lower chambers (the ventricles) work together, alternately contracting and relaxing to pump blood. Sometimes the rhythm changes, resulting in an irregular heartbeat — it may becomes too fast (more than 100 beats per minute) or too slow (fewer than 60 beats per minute). Sometimes arrhythmia is caused by an injury from a heart attack. It can also happen in patients who are recovering from heart surgery, have coronary artery disease or valve disorders.

Arrhythmia can also be caused by an imbalance of sodium or potassium, or be the result of  stress. An electrophysiologist can order special tests to confirm arrhythmia and to determine its cause. Once identified, arrhythmia can be treated in a number of way including;

  • lifestyle changes
  • medications
  • invasive therapies if necessary

If medications and lifestyle changes don’t correct the problem, an electrophysiologist may consider catheter ablation. With this procedure a thin tube is inserted into a blood vessel in the groin. A wire is put through this catheter and sent up to the heart. A small part of the heart that is causing arrhythmia is destroyed with radiofrequency energy, restoring normal heart function.

Electrophysiologists work to understand what is causing the disease and and using their vast knowledge and available resources, they work to develop new strategies for treating the condition. They help people with irregular heartbeats manage their condition, and work as a team with other physicians and healthcare providers so patients receive the best care possible.

For more information about the full range of services offered by Northern California Medical Associates, visit the NCMA Health website. To make an appointment with Dr. Bedi, call (707) 573-6199

FountainGrove Cardiology
3536 Mendocino Ave. Suite 200
Santa Rosa, CA 95403
(707) 573-6166 Main Number
(707) 573-6199 Scheduling
Fax: (707) 573-6165