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In the summer of 2020 the USA suffered more than 100,000 deaths due to Covid-19. Seniors were affected the most. Doctors, nurses and frontliners were risking their lives trying to save lives. In the memory of the lost Americans and as a tribute to all doctors, nurses and other front-liners, Dr.Bilani decided to build a memorial garden on part of the Florian Dental parking lot. The project started by breaking the concrete, changing the topsoil, and planting trees, roses and mulching on between. A marble stone was erected on the Memorial Day of 2020 and the Mural was finished on July 14, 2020.

To hear the story of the project click here:    IMG_3942

And here:      IMG_2986

 

 

 

 

 

We are pleased to inform you that Florian Dental resumed regular office hours on February 22, 2021. The doctor and staff were vaccinated against Corona virus with the two required doses. New protocol  applied for each appointment with no exception in order to assure the safety of the staff and our guest patients.

 

-A new extraoral vacuum machine had been installed in the treatment room to absorb all aerosols during the treatment, send them to a UV disinfecting container and return to the room disinfected.

 

-A new air purifier with UV light has been installed in each room to clean up the air from any bacterial or viral organism.

 

-Complete disinfection of waiting and operating rooms and sterilization area using ultraviolet lights is  provided after each patient and by the end of the day preparing for next day appointments.

-UV desinfecting light had been installed into the heating and cooling system.

-Only one patient at a time will be allowed to the office by appointment only and exactly at the appointment time. No waiting in a waiting room. Please, do not have friends or relatives accompanying you to the appointment since we will be asking them to wait outside. And please, be on time. If somebody comes to his or her appointment late, we will be forced to reschedule because any late show up will take up time from crucial cleaning and disinfection of the room which might jeopardize our and your safety.

 

-Patients will be asked to leave their personal belongings in their cars.

 

-Newspapers and magazines had been removed from a waiting room.

 

-Patients will be provided with shoe covers once inside the office until they leave the office.

 

-Body temperature will be taken once inside the office. Any reading above normal will lead to rescheduling.

 

-Patients without face masks will not be allowed inside the office.

 

-Patients will be provided with hand sanitizers before entering the treatment rooms.

 

-Patients will be asked to rinse with mouth wash with disinfecting agents once seated in the dental chair.

 

-Staff will be using disposable gowns, face shields, N 95 masks in addition to the regular disposable gloves.

 

-Patients will be given questionnaire to access their health status and recent travel history. Patients can look at the questions at home, and, if answers are YES, we will ask them to reschedule appointments.

 

-90 minutes will be given for every appointment to allow 30 minutes of cleaning and disinfection after each patient.

– Please, keep in mind that doors of the office are going to be locked. When you arrive on your scheduled appointment, please, ring the door bell. We will attend to you immediately.  We apologize for not accepting any walk-ins.

James A. Robb is an American pathologist and molecular virologist. He has a BA in theoretical physics from the University of Colorado. In 1965 he entered the University of Colorado Medical School where he received his MD degree. He took a residency in pathology, as well as training in molecular biology, at Yale University, then went to work at the National Institutes of Health. He has been a professor at the University of California, San Diego, a consulting pathologist at the National Cancer Institute, and director of anatomic and molecular pathology at Cedars Medical Center in Miami, Florida. He is board certified in anatomic pathology, clinical pathology, cytopathology, and dermatopathology.

During the 1970s while he was at UC-San Diego, Robb published some of the earliest descriptions of coronaviruses.

In February 2020 he wrote a “Dear colleagues” letter detailing his advice on how to avoid contracting COVID-19 and similar diseases.

Dear Colleagues, as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.
The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.

Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves:

1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.

2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.

3) Open doors with your closed fist or hip – do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.

4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.

5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.

6) Keep a bottle of sanitizer available at each of your home’s entrances and in your car for use after getting gas or touching other contaminated objects when you can’t immediately wash your hands.

7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!

What I have stocked in preparation for the pandemic spread to the US:

1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.

Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average – everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you – it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth – it is only to keep you from touching your nose or mouth.

3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.

4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY “cold-like” symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.

I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.

I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share this email. Good luck to all of us!

James Robb, MD

 

Did a Noted Pathologist Write This Viral Coronavirus Advice Letter?

Happy 4th of JULY….Florian Dental will be closed Fri the 3rd (inc) – Mon the 6th (exc)

As we become older, our arteries lose some elasticity and stiffen. This can lead to a progressive condition referred to as arteriosclerosis (hardening of the arteries). These stiffened arteries become clogged with fatty plaque. In arteriosclerosis deposits are composed largely of calcium. In atherosclerosis deposits consist of fatty substances, and artery walls lose their elasticity and harden.

Both conditions have about the same effect on circulation, causing high blood pressure and leading to angina, heart attack, stroke, or even sudden cardiac death.

Although arteriosclerosis causes high blood pressure, high blood pressure can also cause arteriosclerosis. Calcium based and fatty deposits basically form in areas of the arteries weakened by high blood pressure and strain. The narrowing of the arteries makes blood pressure go even higher. As the arteries become less pliable and less permeable, cells may experience ischemia (oxygen starvation) due to the insufficient circulation. The fatty plaques can be either stable or unstable. Unstable plaque allows particles to break away and cause further blockage downstream, in the smaller vessels, so it’s of more immediate clinical importance.

If one of the coronary arteries becomes obstructed by accumulated deposits or by a blood clot that has either formed or snagged on the deposits, the heart muscle will be starved for oxygen, and individual will suffer a heart attack (myocardial infarction MI or coronary occlusion). When arteriosclerosis occludes the arterial supply of blood to the brain, a cerebrovascular accident, or stroke occurs.

Older people are at a greater risk of arteriosclerosis. 20 percent of American population over sixty five affected by arterial disease.

Major risk factors for arteriosclerosis: smoking, family history, hypertension, diabetes, or abnormal cholesterol level.

Peripheral atherosclerosis is a type of peripheral vascular disease in which the lower limbs are affected. In the early stage the major arteries carrying blood to the legs and the feet become narrowed by fatty deposits. Atherosclerosis of the leg or the food can limit a person’s mobility, but also can lead to a loss of a limb. People who have diseased arteries in the leg or the foot are likely to have them elsewhere, mainly in the heart or brain.

Pain in the legs (most often in the calf, but sometimes in the foot, thigh, hip, or buttocks) brought on by walking and quickly removed by rest is called intermittent claudication, and it is the first sigh of developing peripheral atherosclerosis. Additional symptoms include numbness, weakness, and a heavy feeling in the legs. These symptoms occur because the amount of oxygenated blood passing through the plaque-clogged arteries is insufficient to meet the needs of the exercising leg muscle.

Peripheral Artery Function Self Test

A simple test can determine how well your blood flows through the arteries of your legs. There are three areas on the lower leg where a pulsating artery can be felt by lightly touching the skin covering the artery. One spot is the top of the foot, the second spot is the inner aspect of the ancle, and the third spot is behind the knee.

Apply pressure lightly to the skin on these spots. If you cannot find a pulse, this is an indication that the artery supplying the leg may be narrowed. You have to consult your health care provider.

 

According to Prescription for Nutritional Healing, Nutrients essential for people suffering from arteriosclerosis and atherosclerosis:

• Calcium and magnesium needed to maintain proper muscle tone in the blood vessels;
• Coenzyme Q10 improves tissue oxidation;
• Essential fatty acids reduce blood pressure, lower cholesterol level, help maintaining good elasticity of the blood vessels;
• Multivitamin and mineral complex is needed for protection;
• Vitamin C acts as a free radical scavenger.

These herbs are helpful with the arteriosclerosis: cayenne, chickweed, and hawthorn berries. Ginkgo biloba can improve circulation increasing the oxygen flow to the arms, legs, heart, and brain.  Green tea lowers cholesterol level. Japanese researchers recommend also black tea to lower a rate of lipoprotein oxidation, a chemical reaction that makes fats in the blood more likely to be deposited in the arteries. Garlic has a lipid regulating effect. Grape seed extract is probably the best natural free radical scavenger.

Recommendations for people suffering from arteriosclerosis and atherosclerosis :

• Eat high-fiber foods that are low in fats and cholesterol. Fruits, vegetables and grains are your best choice.
• Eat plenty of food containing vitamin E to improve circulation: green leafy vegetables, legumes, nuts, seeds, soybean, wheat germ, whole grains.
• Eat plenty of food containing omega-3 fatty acids: cold water fish, fish oil, canola oil, flaxseed oil, walnut oil.
• Use only pure cold-press olive oil or unrefined canola oil. Do not heat them.
• Avoid eating any candies, cookies, chips, fried food, gravis, junk food, high-cholesterol food, ice cream, processed food, red meat, saturated fat.
• Maintain a healthy weight.
• Get regular moderate exercise. A daily walk is good.
• Monitor your blood pressure.
• Do not smoke and avoid exposure to secondhand smoke. Cigarette smoke contains large amounts of free radicals, many of which are known to oxidize low-density lipoproteins, making them more likely to deposited on the walls of the blood vessels.

Coronary artery disease is a general name for the diseases connected to the arteries supplying the heart with oxygen and nutrients. It may include angina, heart attack, stroke and other disorders. Coronary arteries that supply blood to the heart might get narrow limiting the amount of oxygen and nutrients the heart gets. This oxygen and nutrient deprivation causes pain in the chest called angina pectoris. When the heart cannot get oxygen and nutrients because of the obstruction in the coronary arteries, the part of a heart muscle can die, and it’s called the heart attack.

The coronary artery disease is the most common cause of death in the United States of America. More that 1 million Americans die annually because of this disease. Approximately 59.7 million Americans have it, many of them may not even know about it: coronary artery disease may not have symptoms until it’s well developed.

 

Symptoms of the heart attack:

• Felling of burning, squeezing pain or intense pressure on the chest. This pain may last for several minutes, and extend to the shoulders, arm, neck or jaw. The pain may come together with the feelings of anxiety;
• Sweating, nausea, vomiting, shortness of breath, dizziness, fainting;,
• Difficulty swallowing, sudden ringing in the ears;
• Loss of speech.

What to do in the case of the heart attack:

• If you have a chest pain for more than 20 min and it doesn’t go away after resting, call 911. It’s very important to get medical help immediately if you have a heart attack.  The heart muscle is not dead during first 3 hours yet, so there is a great chance to bring it back to normal if the obstruction to its blood supply is removed on time.
• After calling the emergency number chew or swallow an aspirin tablet, drink a glass of water, and wait for the medical team.

The most common form of coronary artery disease is the atherosclerosis which is the buildup of fatty deposits on the inside of the arteries. These fatty deposits narrow the vessels and slow down the blood flow causing the heart to get insufficient amount of oxygen and nutrients. While healthy arteries are like clean pipes with smooth lining, the arteries damaged by atherosclerosis have fatty streaks called plaque in the walls. The damage begins with little cracks on the walls caused by high blood pressure, elevated level of cholesterol and triglycerides, smoke, diabetes, drugs, infections of the inner walls of the arteries. Very soon these little cracks joined by mixture of fats, calcium deposits and cell debris causing the inflammation in the wall of the artery. The body’s immune system starts fighting the inflammation sending the white blood cells to the injured area and then fibrous cap is formed over the fatty deposit. If deposit is growing it can block the vessel causing chest pain. If the fibrous cap is ruptured the heart attack may occur.

Though heredity is linked to the developing of coronary artery disease, life style plays much more important role than genetics. The chances that a person will develop coronary artery disease are much more in the case of:

• Smoking. Smoking doubles your risk of developing CAD, and it makes your chances to have a heart attack even six times more likely. Quit smoking, and after 3 years you will be at the same risk as nonsmokers!
• Physical inactivity. People who exercise moderately two or three times a week for at least 30 min decrease their risk of heart disease.
• High cholesterol level. Cholesterol is the major component of atherosclerotic plaque.  Lower the cholesterol! For each percent you lower your cholesterol level you drop your chances of developing CAD for 2-3 percents.
• High blood pressure. Lowering your blood pressure protects you from heart disease and the stroke!
• Diabetes. People who have diabetes three to seven times likely to die of cardiovascular disease.
• Being overweight. Being at least 20% more than your ideal weight makes you more likely to have high blood pressure, diabetes.
• Excessive alcohol consumption. It’s generally believed that two drinks a day for men and one drink for women can decrease chances of developing heart disease, but anything more than this limit harms your systems.

Combination of factors increases the risk rapidly. Depression and suppressed anger are marked too as a risk factor.

 Preventing heart disease:

Make sure your diet is balanced and contains lots of fiber.  Breakfast cereal is very beneficial for the heart.

• Eat plenty of raw fruits and vegetables. An eight year study of almost 40,000 men found that men who ate at least five servings of fruits and vegetables a day had 39 percent lower chances of stroke.
• Drink raw juices. Pomegranate juice is believed to be very helpful in softening your arteries by reducing blood vessel damage as well as reverse the progress of atherosclerosis.
• Include onion and garlic in your diet. They help reduce serum cholesterol.
• Eat omega-3 fatty acids containing food such as raw nuts, olive oil, pink salmon, tuna, trout, mackerel, Atlantic herring. The omega-3 acids lower level of blood triglycerides and reduce the tendency to form blood clots.
• Limit total fat intake. Total fat intake for the atherosclerosis should be 20-30 % of calories with saturated fat not more than 10% of calories. Avoid trans fatty acids and hydrogenated fats.  For protein eat broiled fish, and low in fat skinless turkey and chicken. When choosing dairy products go for low-fat or skim options.
• Drink plenty of water. It’s recommended to consume at least 80 ounces of water a day.
• Reduce sodium in your diet. Recommended dose is 6 grams a day for a healthy person. If you already suffer high blood pressure try to stay away from salt and all sodium containing products. They can be hidden under names of “soda”, “sodium”, or symbol “Na” on the label.
• Keep your weight down.
• Avoid stress.

The best heart food:

Fresh fruits. They contain fiber, vitamins, minerals and antioxidants.

Beans and legumes. Fiber and plant proteins in beans and legumes help to lower LDL (bad) cholesterol.

Cold-water fish. Omega-3 fatty acids in fish help to lower cholesterol.

Dark leafy greens. Spinach, mesclun, swiss chard, argula, and other greens help to reduce levels of a blood enzyme implicated in heart disease.

Avocadoes. They are rich in monounsaturated fats which help to reduce LDL level, and potassium, which helps to regulate the heart rhythm, and blood pressure.

Whole grains. They are rich in fiber and B vitamins.

Nuts. Good source of mono – and polyunsaturated fats, and minerals.

Soy foods. They are rich in phytoestrogens helping keep correct level of blood fat. Including 25 g of soy protein in your diet lowers your cholesterol in people with elevated cholesterol level by about 9 percent.

Spices and herbs. They help digest fat.

Wheat germ and flax meal. They are rich in fiber, vitamin E, and omega-3 fatty acids.

Easy tips to cut saturated fat intake:

• Choose a leaner cuts of meat and remove fat whenever possible.
• Downsize meat portions.
• Cook with olive oil or vegetable oil instead of butter or margarine.
• Use tofu or nuts in stir-fries instead of meat.
• Try adding a slice of avocado instead of cheese to a sandwich.
• Enjoy a baked potato instead of fries, and use low-fat yogurt instead of sour cream.
• Switch to a lower-fat milk.
• Substitute buttermilk instead of mayonnaise in salad dressings, or instead of butter in mashed potato.
• Add more beans and vegetables to casseroles and chillies – use less meat or veggie ground round.
• Enjoy fruit served with frozen sherbet or low-fat frozen yogurt instead of ice cream for deserts.