Patient Education

NCMA Shares Symposium Wrap-up Video

Northern California Medical Associates (NCMA) wrapped up the Physician Regional Spring Symposium and will begin offering a full library of new healthcare lectures for viewing on YouTube beginning this month.

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.

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 youtube.com/NCMAhealth. This educational program is provided by Northern California Medical Associates and St. Joseph Health –Santa Rosa Memorial.

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 youtube.com/NCMAhealth. 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.

Waist and hip size associated with heart attack risk in women

NCMA Cardiovascular Services offers patients a comprehensive range of cardiac services, interventional procedures and comprehensive care to meet the needs of our patient

Higher waist and hip size are more strongly associated with heart attack risk than overall obesity, especially among women, according to research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

In a study of nearly 500,000 adults (aged 40-69) from the United Kingdom, researchers found that while general obesity and obesity specifically around the abdomen each have profound harmful effects on heart attack risk in both sexes, women were more negatively impacted by higher waist circumference and waist-to-hip ratio than men.

This study suggests that the differences in the quantity and distribution of fat tissue not only results in differences in body shape between women and men, but may also have differential implications for the risk of heart attack in later life, researchers noted.

“Our findings support the notion that having proportionally more fat around the abdomen (a characteristic of the apple shape) appears to be more hazardous than more visceral fat which is generally stored around the hips (i.e., the pear shape),” said lead author Sanne Peters, Ph.D., Research Fellow in Epidemiology at the George Institute for Global Health at the University of Oxford in the United Kingdom.

Additional research on sex differences in obesity may yield insights into the biological mechanisms and could inform sex-specific interventions to treat and halt the obesity epidemic.

According to statistics in the AHA’s 2018 Statistical Update, 40 percent of American women age 20 and older and 35 percent of men were considered obese in 2013-14 national surveys. Being obese puts you at a higher risk for health problems such as heart disease, stroke, high blood pressure, diabetes and certain cancers.


Story Source: Read this article on Science Daily: American Heart Association. “Higher waist and hip measures may add up to greater risk for heart attack among women.” ScienceDaily. ScienceDaily, 28 February 2018. www.sciencedaily.com/releases/2018/02/180228085425.htm.


NCMA 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.  We provide cardiac care in three counties, with 11 offices, located in Santa Rosa, Petaluma, Sonoma, Fort Bragg, Mendocino, Ukiah, and Lakeport.

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 GoRedForWomen.org 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 ncmahealth.com 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. <www.sciencedaily.com/releases/2017/05/170522081109.htm>.

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

NCMA’s Diabetes Center Receives Prestigious AADE Accreditation

Northern California Medical Associates announces that the NCMA diabetes center under the leadership of Chief Endocrinologist Dr. Yuichiro D. Nakai, M.D. has achieved AADE accreditation through the American Association of Diabetes Educators education program.

Education, an important element of staying healthy with diabetes

Northern California Medical Associates announces that the NCMA diabetes center under the leadership of Chief Endocrinologist Dr. Yuichiro D. Nakai, M.D. has achieved AADE accreditation through the American Association of Diabetes Educators education program. Patients who have diabetes know how challenging it can be to manage the disease. In addition to constantly monitoring the condition and taking medication, reducing the risk for complications is part of the daily routine. Healthy eating, physical activity and managing symptoms while focusing on prevention may seem overwhelming for patients newly diagnosed with diabetes, this is where diabetes education steps in and helps to keep a patient on track.

As a member of the healthcare team, a diabetes educator focuses on making living with diabetes easier. They work with each patient individually to develop a personalized plan to stay healthy, while providing the tools and ongoing support to put that plan into action and make it a routine part of life.

“Most patients will never be “cured” of diabetes,” explains Dr. Nakai, NCMA endocrinologist Diabetes Center Medical Director. “Over their lifetime, most will have and live with multiple diabetes complications (medical, psychological, social, financial, etc.). As a chronic disease requiring both lifestyle and medication therapy, at some point, most will “burn out” on dealing with diabetes daily for at least some period of time.

“One crucial concept in diabetes care is goal-setting and management which comes with the understanding that most patients will experience a greater, cumulative lifetime benefit from setting aggressive goals for their diabetes management early in their diagnosis, rather than waiting to make lifestyle changes until symptoms become a real problem. This means that patients need to be educated in goal setting and promoting safe, yet aggressive early therapies for the disease. This in turn will lead to a lifetime of not only managed diabetes, but a longer, healthier life overall.”

The Educational Guidelines

Diabetes education is now a recognized part of diabetes care and is covered by Medicare and most health insurance plans when it is offered through an accredited diabetes education program such as the newly AACE/ACE accredited NCMA Diabetes Center, which has met vigorous criteria set by the U.S. Department of Health & Human Services.

The AACE/ACE guidelines contain specific processes to assist in choosing therapy of which Dr. Naiki’s recommendations include:

  • Remember that lifestyle modifications first addressed back in 1916 still work and that aggressive lifestyle changes can outperform adding an individual diabetes drug without lifestyle change.
  • Discuss what are likely to be changing individualized diabetes goals over time and provide specific suggested changes to get to those goals. If unable to do so personally due to time or other constraints, refer patients for diabetes and nutritional education.
  • Recognize that most drugs will have benefits and side effects within days so in most circumstances adjustments can be made rapidly. The exceptions that take a little longer for full dose effect include TZDs, weekly incretins and new, longer-acting basal insulins.
  • Scheduled, short-interval, one- to three-month follow-up appointments to specifically address success and side effects of medications may help keep the focus on diabetes and help minimize therapeutic inertia.
  • Try to identify when patients are not ready or able to intensify glucose control early in visits, and then redirect time/effort to other long-term diabetes-related concerns such as foot exams, pushing patients to schedule eye exams, and addressing lipid or blood pressure goals.
  • Refer to an endocrinologist or diabetes specialist when a patient is not meeting individualized goals.

About NCMA Diabetes Center

The NCMA Diabetes Center is under the leadership of Chief Endocrinologist and Diabetes Center Medical Director, Yuichiro D. Nakai, M.D. and offers a multidisciplinary team approach to treatment with diabetic nurse specialist Naya Barretto, FNP-BC, MPH, RN and Jennifer Logan, R.D., C.D.E.

Recognizing that education is the key to prevention as well as proper management of diabetes, NCMA Diabetes Center offers workshops to cover all aspects of diabetes care including diabetic weight management, nutrition, safe exercise for diabetics, glucose meter use, insulin use, carbohydrate exchanges/ carbohydrate counting. One-on-one patient diabetes education and nutritional visits are also offered.

To learn more or to schedule an appointment call 707-578-7530.

High Blood Pressure Substantially Reduced with Low Salt Diet

Low-salt, heart-healthy dash diet as effective as drugs for some adults with high blood pressure
A study of more than 400 adults with prehypertension, or stage 1 high blood pressure, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowers systolic blood pressure — the top number in a blood pressure test — especially in people with higher baseline systolic readings.

A study of more than 400 adults with prehypertension, or stage 1 high blood pressure, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowers systolic blood pressure — the top number in a blood pressure test — especially in people with higher baseline systolic readings.

Results of the randomized clinical trial of the dietary combination, conducted by researchers at the Johns Hopkins University School of Medicine, were published in the Nov. 12 issue of Journal of the American College of Cardiology.

“Our results add to the evidence that dietary interventions are as effective as — or more effective than — antihypertensive drugs in those at highest risk for high blood pressure, and should be a routine first-line treatment option for such individuals,” says Stephen Juraschek, M.D., an adjunct assistant professor at Johns Hopkins and an instructor of medicine at Harvard Medical School.

The Dietary Approaches to Stop Hypertension (DASH) diet, long promoted by the National Heart, Lung, and Blood Institute and the American Heart Association, is rich in fruits, vegetables and whole grains, along with low-fat or fat-free dairy, fish, poultry, beans, seeds and nuts.

While both low-sodium and DASH diets have long been known to prevent or lower high blood pressure, Juraschek says the new study was designed to examine the effects of combining the two diets in adults with early or modest forms of high blood pressure — those considered to be at greatest risk for developing more severe forms of hypertension known to increase the likelihood of stroke, kidney disease, heart attacks and heart failure.

For the study, investigators tested and followed 412 adults, including 234 women, ranging in age from 23 to 76 years and with a systolic blood pressure of 120-159 mm Hg and a diastolic blood pressure between 80-95 mm Hg (i.e., prehypertension or stage 1 hypertension). Fifty-seven percent of the participants were African-American.

At the start of the study, none of the participants was taking antihypertensive drugs or insulin, none had a prior diagnosis of or current heart disease, renal insufficiency, poorly controlled cholesterol levels or diabetes.

Investigators put all participants on the DASH diet or a control diet for 12 weeks. The control diet was similar to that of a normal American diet based on the average macronutrient and micronutrient profile of the U.S. population.

All participants were also fed 50 (low), 100 (medium) or 150 (high) mmol/day of sodium in random order over four-week periods. Fifty mmol/day is equivalent to 1,150 mg of sodium. A teaspoon of salt is equal to 2,400 mg of sodium. A diet that includes 100 mmol/day of salt is equivalent to 2,300 mg of sodium — or nearly a teaspoon of salt. This is the maximum level of sodium intake recommended by the U.S. Food and Drug Administration (FDA) and is thought to reduce the risk for heart disease and stroke.

At the time of the study, according to the National Health and Nutrition Examination Survey, Americans consumed about 150 mmol/day of sodium, which is considered by the FDA to be harmful and may increase a person’s risk for high blood pressure, heart disease and stroke.

Participants were sorted into four groups based on their baseline systolic blood pressure: 120-129, 130-139, 140-149 and 150 or greater baseline systolic blood pressure.

After four weeks, the investigators found that the group with 150 or greater baseline systolic blood pressure on just the DASH diet had an average of 11 mm Hg reduction in systolic blood pressure compared to a 4 mm Hg reduction in those solely on the DASH diet, but whose baseline systolic pressures were less than 130.

When the researchers combined the DASH diet with the low-sodium diet and compared participants’ blood pressures to those on the high-sodium control diet, they found that the group with less than 130 systolic blood pressure at baseline had a 5 mm Hg reduction in systolic blood pressure; the group with 130-139 mm Hg baseline systolic blood pressure had a 7 mm Hg reduction; and the group with baseline systolic blood pressure between 140-149 had a 10 mm Hg reduction.

Most surprisingly, say the researchers, a participant who had a baseline systolic blood pressure of 150 or greater and was consuming the combination low-sodium/DASH diet had an average reduction of 21 mm Hg in systolic blood pressure compared to the high-sodium control diet.

“This is outstanding, it’s huge,” says Juraschek, because it suggests that those at highest risk for serious hypertension achieve the greatest benefit from the combination diet.

To put the potential impact of the findings into context, Juraschek says, the FDA requires any new antihypertensive agent submitted for approval to lower systolic blood pressure by 3-4 mm Hg. Most established medications on the market, such as ACE inhibitors, beta-blockers, or calcium channel blockers, on average reduce systolic blood pressure by 10-15 mm Hg.

“What we’re observing from the combined dietary intervention is a reduction in systolic blood pressure as high as, if not greater than, that achieved with prescription drugs,” says senior study author Lawrence Appel, M.D., M.P.H., professor of medicine at the Johns Hopkins University School of Medicine. “It’s an important message to patients that they can get a lot of mileage out of adhering to a healthy and low-sodium diet.”

The researchers caution that the study did not address effects in people with systolic blood pressure of 160 or greater or in persons with prior cardiovascular disease or medication treated diabetes. Further studies with larger sample sizes are needed to investigate the impact of the low-sodium/DASH diet on these populations.


Journal Reference:

  1. Stephen P. Juraschek, Edgar R. Miller, Connie M. Weaver, Lawrence J. Appel. Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure. Journal of the American College of Cardiology, 2017; DOI: 10.1016/j.jacc.2017.10.011

Read this article on science daily: Johns Hopkins Medicine. “Low-salt, heart-healthy dash diet as effective as drugs for some adults with high blood pressure.” ScienceDaily. ScienceDaily, 22 November 2017. www.sciencedaily.com/releases/2017/11/171122131412.htm.


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