Twin Cities Pride Festival

The Twin Cities Pride Festival is a CELEBRATION of the LGBTQ+ Community.

Location: Loring Park

Time:  10:00 AM to 6:00 PM

  • 1382 Willow Street , Minneapolis, Minnesota 55403

We welcome exhibitors who support our community to participate in this event. We plan to have 400 exhibitor booths, 40 food vendors, and 4 free stages with music and other performances! All LGBTQ+ people and allies are welcome!

Click here for more information: https://tcpride.org/general-information/

Sunscreens & Chemical Levels in Blood — Dr. Crutchfield’s Position

In a preliminary study, evaluating 4 commercially available sunscreens, plasma/blood levels of the sunscreens were found to be higher than predicted. As a result, the study only supports the assertion that:1. More research needs to be done to determine if this study has any significant health ramifications and2. To actually establish fundamental safety levels for plasma levels of sunscreens.The results should not be misconstrued to suggest that these, or any other sunscreens should not be used. Until additional research is done, I am not changing my recommendations on sun protection measures and sunscreen use in my patients.Article Link: https://www.newbeauty.com/blog/dailybeauty/12743-chemical-sunscreen-bloodstream-fda-study/

Famous Coconut Cookie Recipe

Ingredients:

  • 1/2 teaspoon baking soda
  • 1 1/4 cups all-purpose flour
  • 1/4 teaspoon salt
  • 1/2 cup butter
  • 1/2 cup packed brown sugar
  • 1/2 cup white sugar
  • 1 egg
  • 1/2 teaspoon vanilla extract
  • 1/2 coconut extract  
  • 1 ½ cups flaked coconut

Directions:

  1. Preheat oven to 350 Degrees Fahrenheit.
  2. In a medium bowl, cream the butter, brown sugar, and white sugar until smooth.
  3. Beat in the egg and vanilla until light and fluffy. Gradually blend in the flour, baking soda, and salt.
  4. Mix in the coconut flakes.
  5. Drop dough in balls by 2 onto an ungreased cookie sheet.
  6. Bake for 8 to 10 minutes in the preheated oven, or until lightly toasted. Cool on tinfoil.

Esketamine: a promising new treatment for depression

Depression is a mental illness. It is estimated that depression will affect 15 percent of all people at some point in their lifetime. The condition is caused by imbalances in certain brain chemicals called neurotransmitters. These neurotransmitters play an important role in controlling your mood. In addition to directly affecting depression, neurotransmitters have other bodily functions.

Continue reading Esketamine: a promising new treatment for depression

Combating the opioid crisis

This alarming epidemic requires everyone’s help to counteract

The opioid crisis has been national news for the past several years, affecting thousands of people throughout the country, with seemingly no end in sight. It involves an increase in opioid addiction and overdose caused by misuse of opioids, such as prescription pain relievers, heroin, and synthetic opioids like fentanyl. 

Opioids trigger the release of endorphins, the “feel good” neurotransmitter, which numb your perception of pain and boost feelings of pleasure. When the drug wears off, you can have a desire to experience those good feelings again. Continuous use of this drug can lead to dependency and, eventually, addiction.

While the epidemic has peaked within the past five years, it has been gaining momentum since the late 1990s. This was a time when prominent pharmaceutical companies reassured members of the medical community that patients wouldn’t become addicted to prescription opioid pain relievers, resulting in widespread misuse of these medications by physicians before it became clear they were highly addictive. 

The statistics showing the prominence of opioid misuse and overdose warrant immediate attention from consumers and legislators. According to the Centers for Disease Control and Prevention (CDC), more than 130 people in the U.S. die every day after overdosing on opioids.

From 1999-2017, more than 700,000 people died from drug overdoses. That is more than 10 times the number of people who died in the Vietnam War.

Opioids are often prescribed for chronic pain; however, roughly 25 percent of patients prescribed opioids for chronic pain misuse them. Approximately five percent of people who abuse prescription opioids will transition to heroin.

The most common states of the country experiencing this opioid crisis are in the Midwest—including Ohio, Wisconsin, and Minnesota.

The CDC says the economic burden of this crisis is $78.5 billion a year, including costs of healthcare, loss in productivity, addiction treatment, and criminal justice involvement.

The significant magnitude of this national crisis is quite apparent. Here, we will identify and examine current approaches to correct the opioid crisis and what you can do in your community to combat the opioid crisis.

What government is doing

With all of these startling statistics, what is being done about it? Several government agencies are brainstorming new ideas and programs to counteract this growing crisis. For instance, the U.S. Department of Health and Human Services (HHS) has several approaches including:

  • Developing treatment programs that optimize the use of opioid treatment medications such as Buprenorphine, Naltrexone, Clonidine and Methadone.
  • Continuing to research the use of cannabis as a new tool in the treatment of opioid addiction. Cannabis and opioid systems in humans interact very closely. Perhaps this will open a door for the development and utilization of cannabis-related medicines to treat opiate addiction. Although promising, much more research needs to be done. Cannabis will not be the solution, but it may be a significant component in the war against the Opioid Crisis.
  • Improving access to treatment and recovery services.
  • Promoting the use and widespread availability of overdose-reversing drugs such as naltrexone (Narcan).
  • Strengthening understanding of the epidemic through more public health surveillance data.
  • Providing up-to-date research on pain and addiction.
  • Advancing better practices for pain management by healthcare professionals.

The National Institute of Health (NIH), a research branch of HHS, echoes these initiatives by conducting research for new non-addictive strategies to manage chronic pain, as well as meeting with pharmaceutical companies and healthcare professionals to prevent the snowball effect of opioid misuse.

The CDC plans to take it one step further by partnering with public safety, such as law enforcement, to address the growing illicit opioid problem. Officials are also considering attacking the source to reduce opioid availability. This includes targeting the opioid manufacturers who produce much more medication than is actually needed.

Purdue Pharma, the manufacturer of Oxycontin, is currently involved with lawsuits from over 30 different state attorneys general (including Minnesota’s) and over 1,500 personal liability suits. We are just at the beginning of these legal challenges.

Also, legal minds have discussed the possibility of prosecuting the large pharmaceutical distribution companies that make sure that the supply is plentiful across the country by delivering opioids to every drug store in the country at quantities that appear to be ridiculously high.

What local communities must do

An important question to ask is what you can do at a community level. You must realize that anyone who takes opioids is at risk of developing an addiction. The public must be made aware of this. An individual’s personal history and the length of time opioids are used both play a role, but it is impossible to predict who’s vulnerable to eventual dependence and abuse of these drugs.

Another thing you can do for your family and community is become aware of the signs of addiction, which include but not limited to:

  • Irresistible craving for a drug
  • Compulsive use of the drug
  • Continued use of the drug despite repeated harmful consequences

If you are prescribed an opioid by your physician to manage acute pain, such as after a surgery, opioids are safest when used for three or fewer days. Try to avoid using opioids unless you absolutely have to for recurrent chronic pain.

If you do need opioids, ask your doctor for the lowest possible dose for the shortest time required, and use it exactly as prescribed. The key is to have a discussion with your doctor on the proper pain management specific for you.

You can help prevent addiction in your family and community by disposing of unused opioids properly, specifically by contacting local law enforcement or using the Drug Enforcement Administration (DEA) medication discarding and take-back programs. If there are none in your area, contact your pharmacist on how to properly discard the medication.

It is critical to realize that anybody who uses opioids, either prescribed or illegal, are at risk of developing dependence and possible addiction. Therefore, we must educate ourselves and our community of this matter to combat this evolving crisis one neighborhood at a time.

Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He received his M.D. and Master’s Degree in Molecular Biology and Genomics from the Mayo Clinic. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine. Dr. Crutchfield was recognized by Minnesota Medicine as one of the 100 Most Influential Healthcare Leaders in Minnesota. He is the team dermatologist for the Minnesota Twins, Vikings, Timberwolves, Wild and Lynx. Dr. Crutchfield is an active member of both the American and National Medical Associations, and president of the Minnesota Association of Black Physicians.

 Alexis E. Carrington is a senior medical student at St. George’s University School of Medicine and a graduate of Pepperdine University. She is currently applying for a dermatology residency and research fellowship.

Hidradenitis suppurativa: hard to pronounce, live with, and treat

Dr. Crutchfield, my cousin had a skin problem where she developed pimples in sensitive areas that would get bigger, become painful, turn into boils and break. The areas would smell bad. She saw a dermatologist and was diagnosed with a condition called “hidradenitis suppurativa.” What is hidradenitis suppurativa?

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that may be caused by an inappropriate response of the body’s immune system.

No one knows for sure what exactly causes HS. One theory is that HS is the result of an abnormality in hair follicles. HS tends to occur when hair follicles become blocked, leading to a clogged hair follicle. When the follicle is blocked, pressure builds up in the follicle, causing a rupture and leakage to the sides of the follicle, deep into the skin. The leakage produces a response by the immune system to the material in the skin. The immune response is in the form of inflammation.

This cycle can repeat itself over and over and in many areas, producing a chronic medical condition. The lesions of HS appear as boils in the skin. The medical term for a boil is an abscess. The abscesses of HS can be mild, moderate, or severe.

  • Mild: This means a single abscess or a few abscesses that don’t connect or drain. They can be very painful.
  • Moderate: Commonly, several abscesses are widely separated. These are painful. They may connect and drain with pus and blood.
  • Severe: Multiple abscesses that are close together and cover large areas. These are painful and drain profusely. The common areas are the scalp, on the neck, around the ears, under the arms, under the breasts, in the groin, and on the backside. These areas coincide closely with hair-bearing areas.

HS starts as pimples in sensitive hair-bearing areas that enlarge and turn into large abscesses that can be extremely painful, connect and rupture, and smell foul. The connection between abscesses is called a sinus tract.

HS is an inflammatory skin disease. It is a chronic medical condition, meaning it lasts for a long time, maybe even a lifetime. Some people mistakenly think that HS is an infection. It is not an infection, but is actually a malfunction of one’s immune system.

There are a lot of misconceptions about HS. Here are some other things you should know:

  • HS is not the fault of the person who has it.
  • HS is not transmitted sexually.
  • HS is not caused by poor personal hygiene.
  • HS is not contagious.

What are the symptoms of HS?

The lesions of HS are boils or abscesses. They form under the skin in areas where hair grows and the skin may rub together. They are painful and fill with pus and blood. When they get big, the lesions can rupture and release a very foul-smelling fluid. The amount of fluid produced can be quite significant, and in severe cases they can drain all day long, causing the person to have to wear absorbent pads in the areas that need to be changed often.

Larger regions can connect by tunnels in the skin known as fistulas or sinus tracts. Over time some areas can form scars, and new areas can form. The constant drainage of bad-smelling drainage can lead to a foul odor that travels with the affected person.

As one could imagine, the condition is terribly embarrassing and can interfere or prevent normal personal social interactions, leading to an inferior quality of life. As a result, many dermatologists believe that HS is one of the very worst skin diseases to have.

In some cases, HS may temporarily subside, but it often comes back. It may start out as mild but rapidly progress to severe. Being overweight and smoking are two factors that can be managed and have an impact on the severity and progression of the disease.

Treatment

Physicians will recommend smoking cessation and weight reduction. In addition, these treatments are available:

  • Antibiotics (as anti-inflammatories, not to treat infection)
  • Steroids
  • Surgery
  • Hormone therapy
  • Immunosuppressant medications
  • Biologic medications

HS can be devastating for self-esteem and lead to profound depression. If HS is impacting social relationships, self-esteem, and/or depression, it is important to talk to experts in the fields of mental and sexual health. It also may be helpful to join a support group so you can share feelings and information with other people who have HS. 

For stubborn or severe cases, you should visit a dermatologist who specializes in HS. These dermatologists are medical doctors who have experience in diagnosing and treating inflammatory conditions of the skin. They understand what you’re going through and can recommend treatment options that are appropriate for you.

There are good treatments for HS, and no one should have to suffer from this terrible condition. Fortunately, there is an FDA-approved biologic treatment (named ‘adalimumab’) for HS.

To find a dermatologist who specializes in the treatment of HS and for a list of national support groups to join, visit www.noBSaboutHS.com.

That dry, itchy scalp might not be dry at all

Dr. Crutchfield, I seem to be having a problem with dandruff and a dry, itchy scalp, especially this winter. Can you help me?

Your concern over a dry, itchy scalp is a very common one. In fact, I see several patients every day with the same complaint.

I tell patients that when it comes to treating dry, itchy scalps, I have good news and I have bad news. The bad news is that there is no cure for the condition, but the good news is that it can be managed and controlled to the point where it seems like it does not exist.

The surprising fact is that the condition that everyone seems to think of as dry, itchy scalp is not dry at all. It is a unique type of eczema (also known as dermatitis) that makes the scalp seem like it is dry because it produces lots of flakes.

 The flakes are not a result of the skin being dry; rather, the skin grows too fast as a response to inflammation in the scalp. Sheets of skin pile up because they can’t be shed quickly enough. The inflammation is driven in part by the oil production or sebum in the scalp.

This massive amount of skin flakes tricks us into thinking it is dry skin when it really is not. It is a very common skin condition called “seborrheic dermatitis.” The condition is so common that it probably affects 25 percent of all people to some degree. It can occur on the scalp, face (especially sides of the nose), eyebrows, ears, chest, belly button, groin, armpits, and even the backside’s “gluteal cleft.” 

For now, I will only talk about seborrheic dermatitis when it occurs on the scalp. The familiar, non-medical name of seborrheic dermatitis when it happens on the scalp is dandruff. It is a common skin disease that causes the skin to be red, itchy and flakey.

Seborrheic dermatitis can wax and wane and appear and disappear at any time. Sometimes the condition will resolve without treatment, but more often than not it may require medical treatment.

Seborrheic dermatitis can occur in all people. In babies, it is commonly called “cradle cap.” It can also occur in a baby’s diaper area. It tends to occur most often in infancy and adulthood and in men more than women. It is more common among family members, in people with oily skin, and for some odd reason in people with Parkinson’s disease and HIV.

The condition is harmless and not contagious, although it certainly is a nuisance. The constant itching and abundant skin flakes can be extremely problematic and embarrassing. 

Interestingly, the exact cause of seborrheic dermatitis is still not completely understood. Perhaps the excess oil in our skin serves as a food source for yeast that commonly live on everyone’s skin. The yeast grow, and for some unknown reason some people have a brisk reaction to the larger population of yeast on the surface of the skin. This response comes in the form of inflammation (redness, flaking and itching).

The yeast component is only a part of the problem. The other part is purely genetic, and the common areas are prone to inflammation with or without yeast. The diagnosis can be made easily by an examination by a doctor, especially a dermatologist.

As mentioned earlier, there is no cure for seborrheic dermatitis. The goal is management and control of the condition until it is unnoticeable and no longer a nuisance.

For scalp seborrheic dermatitis, I have a two-part treatment plan. First, let me say that I am not a big fan of using a hair shampoo to treat a skin condition. I recommend a medicated oil applied once per week to reduce and maintain scalp inflammation. This part is the maintenance program.

Washing one’s hair weekly is also very important. I recognize that weekly hair washing may be a challenge for some, but it is essential to clean the scalp skin and wash away the dead skin and flakes that are continually building up.

Secondly, I have a very potent topical treatment to use for five days if the condition should flare up and break through the maintenance program. Three two-treatment steps work exceptionally well.

If you or a loved one has dry, itchy scalp, talk to your doctor to see if it really is the medical condition called seborrheic dermatitis. If it is, rest assured there are excellent treatment programs to make the embarrassing and troubling situation much better to the point of seeming not to be there at all.

Six tips for staying healthy in a world of germs

Dr. Crutchfield, it seems like everyone at work is sick. What can I do to protect myself from getting sick at work?

Here are some tips on protecting your health in the workplace in spite of all the germs that may be lurking there.
 


Tip 1: Wash your hands.
As you entered your office, you probably touched one of many common surfaces just teeming with germs. These common surfaces include elevator buttons, escalator railings, and door handles. Whenever possible after such contact, wash your hands for 15 seconds with warm, very soapy water.
I was at a professional sporting event this weekend and the men’s bathroom was extremely full. I counted 30+ people. I paid very close attention, and half the people did not wash their hands.

The ones who did attempt to wash their hands did so in such a poor manner that they really only wasted their time. Many just splashed or rapidly rinsed their hands under the water for less than five seconds. No soap. It was almost like a theatrical performance or a gesture of washing hands so as not to look bad in front of the other bathroom patrons. They did not engage in a significant, worthwhile, useful hand-washing event. 

Remember, you should engage in at least 13-30 seconds of hand washing with warm, soapy water. True story: When I did wash my hands, I did it properly, and the man behind me commented, “Dude, you’re washing your hands like you’re a doctor!” Wow, did that bring a smile to my face.
Also, be sure to keep a bottle of hand sanitizer handy. Make sure it contains at least 60 percent alcohol. It can be almost as effective as washing your hands with warm, soapy water.

When it comes to your desk, the area is mainly contaminated with your own germs, so they are unlikely to make you sick unless you brought germs in with you (as from doorknobs, elevator buttons) and did not clean your hands.

Also if you have other people who may work in your personal work area, like an IT person working on your computer, then you should clean your area. This is best done with commercially available disinfectant wipes. Keep these handy and use daily or whenever someone else works in your space or uses your computer.
 
Tip 2: Try not to touch your face.
This is much easier said than done, but with practice and concentration, you can minimize or decrease how much you touch your face. Studies have shown that most people touch their face 60-100 times per day, and some people even much more.
Your hands carry germs, and they can enter your body through your mouth, eyes and nose. Minimizing the number of times you touch your face will minimize how often you get sick.
 
Tip 3: Keep your distance.
Maintain a safe distance from your co-workers. You can’t control if your co-workers arrive sick, but you can control the distance between you. Most germs, including the flu virus, are unlikely to spread beyond three feet.
For good health, be sure to stay three feet away from co-workers, especially anyone who is sick. Wearing a mask may seem safe, but in most work environments it is not practical.
 
Tip 4: Sneeze into your elbow. 
In the old days, we were taught that when sneezing we should do so into our hands to prevent propelling germs into an aerosolized cloud that could contaminate those around us. Unfortunately, our hands subsequently touch many surfaces like telephones, coffee pot handles, refrigerator door handles, doorknobs, vending machine buttons, etc.
Sneezing or coughing into our hands just allowed germs to spread differently, not to mention transmission by shaking hands. Coughs and sneezes should be done into one’s elbow or a tissue.
 
Tip 5: Get vaccinated.
Vaccination is one of the best things that you can do for your good health. It protects you and also those around you, including people who can’t get vaccinated, like infants or those with weakened immune systems.
Sure, there are all kinds of cold medicines that can make you feel better if you are sick, but the best strategy is to prevent getting sick in the first place. Eat a healthy diet rich in fruits and vegetables that will help boost your immune system — and get vaccinated.
 
Tip 6: If you are sick, stay home.
You will recover faster at home and not spread your illness to your co-workers. The rule of thumb is that if you have a fever, do not go to work. If you are ill but not feverish and can work, this is the one time to wear a mask and keep your distance from coworkers.
 
Remember, you can’t completely eliminate getting sick at work, but you can do many things to minimize your risk of getting sick that will protect both you and your coworkers.

New technology could revolutionize food safety

Rarely does a month go by that there is not some national recall or warning about tainted foods. Food contamination is a worldwide problem. Recently, there was a nationwide ban on romaine lettuce in the U.S.

In 2008, for another example, 50,000 babies were hospitalized in China after eating infant formula contaminated with melamine, an organic chemical used in the manufacture of plastics. Melamine is toxic when present in high concentrations.

In April of last year, more than 90 people died and many others were blinded in Indonesia after drinking alcohol contaminated with methanol. Methanol is a toxic and cheap alcohol that is frequently used to dilute and extend liquor that is sold in black markets around the globe.

Here are some other facts bearing on the issue of food safety:

  • 48 million Americans get sick every year from the food they eat.
  • 128,000 Americans are hospitalized with illnesses that come from contaminated food.
  • Hundreds go blind from contaminants in bootleg alcohol.
  • 3,000 Americans die every year from contaminated foods.

If you have ever gotten sick from the food you have eaten or thought the food in the fridge smelled a bit off or wondered about the freshness or date printed on a food product you were about to consume, help may be on the way.

Researchers at the Massachusetts Institute of Technology (MIT) are using artificial intelligence to develop a wireless sticker system, called RFIQ (Radio Frequency IQ), that can check foods and drinks for a wide variety of illness-producing organisms and other tainted products. It would give consumers direct control over detecting contaminants in their food and drink.

They have developed a special, small, and very precise and accurate sensor that can attach to your smartphone and check for contaminants in food and beverages. The system should be able to:

  • Detect E. coli and other germs in produce and foods
  • Detect lead and mercury in water
  • Detect contaminants in alcohol and milk

MIT scientists are excited that they are developing a system that could revolutionize the field of food safety. Eventually, the device would be the size of a phone charger and plug directly into a smartphone. It would then interact with an app that directs the detection.

This technology has the potential to be a groundbreaking advance. There are thousands of people who have become critically ill from foodborne illness. As a result, many have a terrible relationship with food and live in constant fear, dreading every day doing something as essential to life as eating food.

The new system would enable people to test the food in grocery stores, farmer’s markets, restaurants and at home. For commercial foods and beverages, there could be a standardized, unique identifier code on the label that is scanned. If any contaminants are detected, not only would the device’s owner be alerted, but so would the product manufacturer, and even safety organizations like the Centers for Disease Control (CDC), for potential early and widespread warnings.

Ideally, the device will first serve individual consumers. Eventually, the MIT team’s goal is to scale-up the technology for commercial applications and then adopt it nationally, and even globally, so it becomes part of an invisible, seamless, food and beverage production infrastructure. Foods and drinks would then be scanned automatically before they ever hit the shelves or are sold in markets or served in restaurants.

Think about the profound effect this food safety technology can have; we could soon have the ability to check any food or liquid, before we eat it, making sure that they contain no contaminants.

The scientists are also developing additional technologies so the scanner can detect sugar, calories and other components. These additional capabilities would be extremely beneficial for people with diabetes, those watching their weight, or with food allergies.

Researchers say that the devices could be in consumer’s hands in as little as three to five years. The U.S. Food and Drug Administration has also expressed an interest in the project.

When it comes to food safety, the future looks bright.

For more information, read MIT’s RFIQ project report at bit.ly/2X2hXAC.