• Recipe: Homemade

    Pumpkin Spice Latte

    Fall is finally here and we are officially excited about EVERYTHING pumpkin! Instead of buying the famous coffeehouse drink, skip out on the saturated fat, carbohydrates, and sugars by crafting your own version of the pumpkin spice latte in the kitchen. You may be used to waiting in a long line for this tasty treat, so you’ll be pleasantly surprised to find you can whip up this recipe in half the time. Better yet, this version uses real pumpkin, not syrup! Pumpkin is low in fat and calories, and also packs a healthy dose of antioxidants, vitamin A and vitamin C, as well as iron. Pumpkin is also a great dietary source of fiber.

    So, save yourself some calories, money, and time spent in line by adopting this version of a fall favorite!

    Pumpkin Spiced Latte

    Ingredients

    2 cups skim milk

    2 tablespoons canned pumpkin

    2 tablespoons Stevia

    2 tablespoons vanilla extract

    1/2 teaspoon pumpkin pie spice

    1/2 cup hot brewed coffee

    Whipped cream, pumpkin pie spice and ground nutmeg, optional

    Directions

    Combine milk, sugar, and pumpkin in a small pan over medium heat until steaming.

    Remove heat, stir in pumpkin pie spice and vanilla

    Transfer the mixture to a blender. Process for 15 seconds or until foamy

    Pour into two mugs, add ¼ cup coffee

    Top with whipped cream and a pinch of pumpkin spice

    Nutritional Facts

    1-1/4 cups (calculated without whipped cream) equals 307 calories, 0 g fat (5 g saturated fat), 33 mg cholesterol, 346 mg sodium, 39 g carbohydrate, 1 g fiber, 22 g protein

    Do you have any favorite healthy fall recipes you enjoy with seasonal fruits and vegetables? Share them with us in the comments!

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  • Infographic:

    Colors of the Eye

    From the famous lines of beloved songs to the stories of ancient legends, eye color has captivated audiences throughout time. The origins and genetic makeup associated with eye color makes the color of one’s eye more complex than a simple collection of aesthetic traits, however. Genes and pigment concentrations are two important factors in determining eye color. Some eye colors are more rare than others and can be linked to genetics or family origins and heritage.

    Hannah Scanga, MS, a genetic counselor at the UPMC Eye Center, explains, “The two primary genes that influence the color of the eye, primarily brown and blue eyes, are OCA2 and HERC2. Additional genes influence other eye colors and specific variations, including green or hazel eyes and gold rings.” The scale of eye color from most to least common is brown, blue, hazel, green, and silver.

    According to Ellen Mitchell, MD, “Concentrations of the pigment melanin in the iris of the eye is the primary determinant of eye color. Higher amounts of melanin lead to darker colors while lower amounts result in lighter eye colors.” Dr. Mitchell continues, “The pigment lipochrome also plays a role in determining eye color, specifically green eyes.”

    Eye color can also change due to factors like pupil size, emotions, and age. However, if these changes are drastic or only occur in one eye this may indicate a medical condition and you should discuss symptoms with a doctor.Eye Color Infographic

    Are you still curious about some of the fascinating facts behind blue (green, or brown) eyes? Visit the UPMC Eye Center website to learn more about the latest breakthroughs in the field of optometry and the different eye conditions we treat. Call 1-800-446-3797 to schedule an appointment today.

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  • 5 Ramen Noodle

    “Health Hacks”

    It’s that time of year again. The time when college students flock back to campus, ready to ace their tests, reunite with friends, and feast on the infamously unhealthy Ramen Noodles. Unfortunately, the beloved college-food was the subject of a recent health study, which linked it to series health issues. Even more disheartening? These issues were gender specific. Women who ate the noodles at least twice per week saw a 68 percent increase in their risk of cardiometabolic syndrome, while men saw no notable difference in their risk. But with all-nighters and deadlines looming, it’s not easy to toss the prepackaged delicacy into the trash for good. So what’s a busy college kid to do?

    Leslie Bonci, director of sports nutrition at UPMC Center for Sports Medicine, commented on the story and assured students that it doesn’t take much effort to make Ramen healthier. So next time late-night hunger strikes, try these simple steps to save your wallet and your health:

    Ramen Graphic

    1. Ditch the Seasoning

    The sky-high sodium content is the biggest health issue, so try adding flavor another way! Use water or broth and flavor it with garlic, ginger, herbs, chili, or sesame oil.

    2. Add Veggies

    If you live on campus, grab some vegetables from the salad bar to use in your Ramen. Otherwise, break out the frozen veggies to give your noodles an extra kick of nutrients!

    3. Pack in the Protein

    Chicken, shrimp, tuna, tofu, grilled salmon, eggs…the list goes on! Any protein you choose will make your Ramen healthier and keep you feeling full longer than Ramen alone.

    4. Use your Leftovers

    Have extra food from last night’s dinner? Combine it with ramen noodles (sans seasoning) for a delicious reworking that makes you forget you’re eating leftovers.

    5. Go Dry

    Cook the noodles, drain, and lightly toss in your favorite dressing or sauce! Think low-sodium soy sauce, Italian dressing, vinaigrette, or teriyaki sauce.

    6. Get Creative

    There are dozens (if not hundreds) of Ramen recipes for you to try. There are even Ramen Noodle cookbooks! So don’t settle for boring noodles, spice it up with a creative recipe.

    Eating habits tend to change when entering college mode, as campus life warrants an active and hectic lifestyle. Quick, convenient and unhealthy meals often take center stage, landing healthy eating and cooking in the bleachers. When you’re looking to get creative with regular old Ramen, check out some of our health hacks. Think of it as teaching an old dog new tricks, but this time you’re the dog and the tricks are disguised as noodles. Bring your dorm room dining to a new level while also becoming more conscious of the ingredients your putting in your body!

    How do you make your Ramen healthier? Share your ideas below!

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  • 7 Health Benefits of

    Lemon Juice

    There’s more to lemons than meets the eye. This fruit may pair well with some of your favorite dishes, but it also offers incredible health benefits. Lemons are packed with nutrients, promote weight loss, and have even been linked to kidney stone prevention and cancer treatment! This tangy fruit has also been known to possibly help halt bad breath and get rid of dandruff when applied to the scalp. In addition to its properties as a beauty treatment and health aid, there are a number of uses for lemons. Whether you enjoy the fruit alone or with your morning tea, here are just a few reasons to embrace lemons and their juice:

    1. Relieves a sore throat: Warm water mixed with honey and lemon can soothe a sore throat during cold season.
    2. Cancer-fighting benefits: Studies have shown lemons may have anticancer benefits.
    3. Prevents kidney stones: Lemon juice is shown to help prevent kidney stones by raising the urine’s citrate levels.
    4. Aid in digestion: Lemon promotes the production of digestive enzymes in the liver, which help eliminate waste from your body.
    5. High in essential nutrients: Lemons are high in many vitamins like Vitamin C (promotes immunity and battles infection), calcium (important for muscle function, intracellular signaling, and hormonal secretion), potassium (helps muscles and nerves work properly), and folate (Fights against spinal birth defects and helps red blood cell formation).
    6. Promotes weight loss: The pectin in lemons and their juice helps you feel fuller for longer, which will make your weight loss much more manageable.
    7. Helps clear skin: Lemons have natural antibacterial qualities and alpha hydroxyl acids, like many over-the-counter acne medications. It brightens, exfoliates, and helps remove blackheads!

    So how will you incorporate lemons and lemon juice into your life? Have you already seen the benefits of lemon in your daily diet or personal care regimen? Tell us in the comments below!

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  • Understanding

    Depression

    When you think of depression, you might think of being sad, or just down in the dumps. But in fact, it’s much more than that. It’s a clinical condition that can take control of your life and cause serious complications. According to the National Institute of Mental Health about 16 million people had at least one episode in the past year. To put that into perspective, that’s one out of every 10 people.

    depression graphic

    Symptoms of Depression and Treatment Options

    Depression symptoms may be different for everyone. One person may experience symptoms that seem to last for years, while others will only have moderate bouts and return to their normal life relatively quickly. However, depression can be treated, often with medication, psychological counseling or both. Other non-conventional treatments also may help. But before any type of treatment is initiated, the symptoms must be recognized. When people experience episodes of depression, they may suffer through:

    • Sadness, unhappiness, or an emptiness feeling
    • Sleep disturbances
    • Severe lack of energy where even the smallest tasks require extra effort
    • Loss of interest in hobbies or normal daily activities
    • Changes in appetite (some people may eat less and lose weight while some may overeat and gain weight)
    • Anxiety or restlessness
    • Fogginess, confusion, and slowed speaking or body movements
    • Feelings of worthlessness or guilt, frequent thoughts of death, suicidal thoughts, suicide attempts, or suicide

    Causes of Depression

    Because depression is such a complex disease, the causes of it can greatly vary. One theory suggests that it may be caused from having too much or too little of brain chemicals called neurotransmitters. These chemicals communicate information throughout our brain and body. When the nerves that release these chemicals malfunction, too little or too much of these neurotransmitters may be released, which has been linked as a known cause of depression. Certain antidepressant medications work to control the release of these neurotransmitters.

    Yet, this information is not conclusive. Many researchers don’t agree that a simple increase or decrease of brain chemicals is the lone factor when determining that causes of depression. Rather, it’s a combination of factors, which may include:

    • Genetic vulnerability (depression may be more common in people whose relatives also suffer, or have suffered from depression)
    • Faulty mood regulation by the brain
    • Stressful life events (loss of a loved one, high stress, childhood trauma or recent trauma)
    • Medications or medical problems

    Depression Is Not Mental Weakness

    Often, people associate being depressed as a sign of weakness. In a recent study conducted by the National Mental Health Association, out of 1,022 adults interviewed by telephone, 43 percent said they believed depression is a personal weakness. However, this is far from the truth. Depression does not discriminate. It can affect anyone of any ethnicity. Whether, you’re rich or poor, or old or young, depression can affect you.

    If you or someone you know is suffering from depression, seek help. It’s never too late talk to someone about getting better. There are an array of hot lines and helpful information where you can seek the help of professionals 24 hours a day. There is also helpful information on suicide awareness and prevention.

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Pulmonary Hypertension Q&A

by Pulmonary Hypertension

Ask the Expert: M. Patricia George, MD

Question: What are the different types of lung disease?

Answer: Lung disease is a huge category that includes many diseases. One simplified way to think about the different types of diseases is by where in the lung they target. For example, there are diseases that attack the airways (the tubes in the lungs) such as COPD, asthma and bronchiectasis.

Then there are diseases that affect the lung tissue such as pulmonary fibrosis, coal miner’s lung. There are also diseases that affect the blood vessels such as pulmonary hypertension or pulmonary embolism (blood clot in the lungs).

And then there are diseases that can affect multiple parts of the lung, such as sarcoidosis which can affect the tissue or the airways or blood vessels. And lung cancers can come from different areas of the lung depending on the type of cancer.

Question: What do healthy lungs do that those with lung disease don’t?

Answer: Healthy lungs are responsible for respiration – the process of getting oxygen into our bodies and also getting rid of carbon dioxide. Our bodies need oxygen for cells to be happy and function properly.

We breathe nearly 25,000 times per day, and normally this all happens in a very efficient manner – so efficient and automatic that we are not usually aware of it. That is until we have lung disease. Lungs can become diseases in different ways that affect how this process happens, but in general when lungs become impaired in their function, this process requires more energy and effort.

Examples would be an asthmatic who becomes short of breath and very uncomfortable from narrowed and inflamed airways, or a patient with a serious pneumonia who has an infection that is filling the air spaces and not allowing this process to happen efficiently.

Question: How can I decrease my chances of lung disease?

Answer: Don’t smoke, or if you smoke cigarettes, quit. This is the number one step to decreasing chances of lung disease – especially COPD and lung cancer. Avoid second hand smoke.

Test your home for radon (while cigarette smoking is by far the greatest risk factor for developing lung cancer, radon is the second leading cause of lung cancer in the United States). Avoid working with asbestos (and if your job requires it wear protective equipment) and protect yourself from dust and chemical fumes. Talk to your doctor about whether influenza and pneumococcal vaccinations are appropriate for you.

Question: If someone has pulmonary arterial hypertension (PAH) because of a Congenital Heart Defect and Bi-directional Shunting, is it possible they could also have PH because of Lung Agenesis/Hypoplasia or Restrictive Lung Disease?

Answer: Thank you for your question. Pulmonary hypertension can definitely be complicated, and can be due to a combination of causes.

And while congenital heart defect is likely the biggest contributor, there have been reports of pulmonary hypertension in approximately 19 percent of cases of unilateral agenesis of the lung (though it is more common in agenesis with someone who also has a left-to-right shunt) (Capuani et al. 1982). And yes, restrictive lung disease can contribute to PH as well.

Question: I am 72 years old, and I had Asthma as early as I can remember. In 2008, after frequent admission to the hospital without success of medications, I was then diagnosed with pulmonary hypertension. Do you think I had PH after all these years, or is it possible the Asthma turned into PH?

Answer: It is unlikely that asthma would “turn into” PH. What may be the case is that you have two lung conditions, or as you suggest, that your symptoms were in fact due to PH.

Without the details of your case I cannot comment specifically on whether either of these is true (or another explanation altogether). However I will say that it is not uncommon that PH goes undiagnosed for years before the correct diagnosis is made.

That is one reason we are working so hard to raise awareness about the disease – to physicians and non-physicians alike. The Pulmonary Hypertension Association has been leading this campaign called Sometimes It’s PH.

Question: The doctors told me I have PH about a month ago, and they said it was mild. I’m very scared and on no medication right now. I have another echo In June, and I currently feel okay and am still going about life. What is in my future with this?

Answer: Thank you for sharing your question and what you are feeling right now about having a new diagnosis – and undoubtedly a lot of questions that come with it – is completely understandable and overwhelming.

The good news is you “feel ok” and that they said it was mild, but the next steps I would recommend are discussing with your physician more about pulmonary hypertension. Ask them what the next steps are and whether you need more testing or to see a PH specialist (even if only for a second opinion). Also, there is a lot of good information (and not so good) info on the internet about PH (as well as other lung diseases).

I highly recommend going to the Pulmonary Hypertension Association website. This is a fantastic organization that can provide you resources both online as well as connect you with people who live with PH and can support you in this. You are not alone.

Question: I was diagnosed with IPAH last year and right heart failure which caused three heart attacks. I was really sick all winter but the summer before as I kept my normal walking and physical activities I didn’t have to be admitted. I did nothing in the winter but stay home doing nothing so I was hospitalized five times. I started my walking and am currently doing three miles a day without excretion keeping my Oximeter on and monitoring my HR. Will physical activities cause my PAH to get worse?

Thank you for your question and sharing your story. I’m sorry to hear you had a rough winter. It certainly was a rough (and long) one for all of us, especially those with respiratory conditions. In general, I am a big advocate of exercise when PAH is well-treated and the patient is seeing a PH specialist regularly.

Many PAH physicians agree that not only is exercise not harmful but that it may even be beneficial. That said, it is always important to talk to your PH specialist before starting an exercise program of any kind, and it is important to not exercise beyond the point where you have symptoms (light-headedness, chest pain, severe shortness of breath).

In patients who are starting out, pulmonary rehabilitation programs can be helpful in teaching safe limits of exercise as well as well-rounded programs. Plus, when you can do it, exercise is a part of actively taking an element of quality of life back. Good luck!

Question: I have PH and was diagnosed month ago. I also have sleep apnea. My doctor said I have a mild case. What is this disease outlook?

Answer: Although I do not have the details of your case to be able to talk to you about overall outlook, I will make a general statement to say that if you have mild PH, talking to your doctor about possible treatments as well as current risk factors that can make it worse would be helpful.

One such risk factor is sleep apnea. If you have untreated sleep apnea, which has been associated with pulmonary hypertension, treating it may help your condition. I recommend talking to your primary doctor and sleep doctor about this. Good luck.

Question: For those that are newly diagnosed with PH, how does a physician know which drug will be the best fit fit their patient when they determine they are in fact dealing with PAH.

Answer: After making that first step of establishing the diagnosis, of course the next challenge is deciding which treatment options are best to start.

When a PH doctor makes a diagnosis of PAH – pulmonary arterial hypertension – which means high blood pressure in the lungs due to a disease of the arteries in the lungs, the doctor also assesses other aspects of the patient’s case.

How sick is the patient at this moment and how have they felt recently? Is there involvement of the right side of the heart in their disease? Do they have any underlying heart or lung disease or blood clots? Have they been on any therapies before?

These are some of the questions that a PH doctor will try to answer before initiating therapies, as different treatments help depending on the pateint’s whole condition.

Question: My doctor’s philosophy is to wait for transplant until the last possible minute. Other doctors I’ve seen think it’s time now. What markers should be used to decide when it’s time?

Answer: In general, when patients are getting worse despite medical therapy, and there seem to not be other options available, it is a reasonable time to at least consider lung transplant. As a transplant physician, I would rather evaluate someone too soon (and if the patient is too healthy for transplant, hold off on listing and just follow them over time in the event that they worsen) rather than too late in the disease (when it becomes more difficult to try to address any medical or other problems that increase a patient’s risk for transplant).

Earlier evaluation allows the patient and family to learn more about transplant from the center, and address any concerns that may arise in the evaluation process.

Question: Could scarring from pneumonia be a reason for interstitial lung disease?

Answer: There are many forms of interstitial lung disease (ILD) (diseases that affect the lung’s structural tissue as opposed to diseases of the airways like COPD or asthma). And there are many known causes of ILD.

While I would not necessarily attribute ILD to scarring from a focal bacterial pneumonia, it is believed that lingering active infections or chronic ongoing infections may contribute to developing ILD.

Question: What are the factors that prevent you from being listed for lung transplant?

Answer: As for factors that prevent one from getting a lung transplant, this is also a complicated question, and varies based on transplant centers. But active smoking or active substance abuse, not going to the doctor or taking medications as prescribed are major “red flags.”

There are other factors that – depending on severity – may prevent one from getting a lung transplant such as other serious medical conditions (severe irreparable heart disease, kidney or liver failure, sepsis), but it is best to talk to a transplant center about the individual patient to explore whether transplant is an option.

At our center we definitely evaluate patients on an individualized basis as everyone is unique. So while I cannot tell you current life expectancy after lung transplant, I can give you the median survival data from the latest data from the International Society for Heart and Lung Transplantation.

In patients transplanted from 2004-2011 is a median survival of 6.1years. This means that at 6.1 years after transplant, 50% of recipients are still alive. This is not life expectancy per se, as we don’t really have good mathematical models to predict life expectancy after transplant.

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About Pulmonary Hypertension

The UPMC Division of Pulmonary, Allergy, and Critical Care Medicine is among the nation’s leaders in treating chronic lung conditions. As part of the one of the world’s leading lung transplant centers – with more than 1,400 lung and combined heart-lung transplants performed – our pulmonologists offer expert transplant evaluation for patients with life-threatening lung conditions. Through our disorder-specific specialty clinics, our physicians see and treat patients with a wide variety of respiratory conditions.