From the Doctor’s Desk

Dr. Obinna Nwobi                 

Vascular & Interventional Pavilion

April 2, 2015

Celebrate Foot Health Awareness Month with a Brisk Walk Suggests Dr. Nwobi

Tampa, Florida - A walk in the fresh April air is an ideal way to participate in the national American Podiatric Medical Association’s Foot Health Awareness Month. 

“Walking is great exercise for the feet,” said Obinna Nwobi, MD, of Vascular and Interventional Pavilion. Both podiatrists and vascular surgeons agree that good blood flow is essential for foot health. A brisk 30-minute walk every day is just what the doctor ordered.
Simple steps for daily foot care include:   

• Improve circulation by walking, bicycling, dancing, and swimming  
• Inspect feet for the cuts, sores, blisters, redness, warm spots, or swelling. Wash feet in warm water. Moisturize for soft skin. Cut toenails straight across  
• Wear socks and proper fitting shoes
• Protect feet from heat and cold
• Wiggle toes. Flex feet and ankles for five minutes two to three times each day to maintain blood flow 

“Feet are our foundation,” said Dr. Michael King, president of the American Podiatric Association. “Healthy feet are fundamental to the quality of our daily lives. We need to take care of them every day, and see a medical professional if they begin to hurt.” Vascular surgeons and podiatrists work closely to access and treat patients with severe foot problems. 

Symptoms that require care by a podiatrist:    

• Hair loss on toes may be a sign of poor circulation
• Blue thread veins and very white skin is common among lifelong smokers and may indicate vascular disease 
• A swollen foot may indicate a blocked lymph node or deep vein thrombosis, a dangerous blot clot in the legs  
• Corns and blisters are important to treat promptly in those with diabetes. Sufferers may not feel the pain in their feet due to numbness, and left untreated, these conditions may lead to serious illness. 
• Dry, cracked heels may indicate a thyroid problem 
• Swollen feet may indicate heart or kidney problems 
• Any changes in the color, thickness, or loosening of the toenails should be evaluated

Additional foot care information is available at www.todays,, and or call (813)-922-3177.

If you have any questions regarding anything vascular feel free to call our offices at 813-922-3177 or visit our website at, or

Dr. Obinna Nwobi                 

Vascular & Interventional Pavilion
March 20, 2015

It’s March Madness a.k.a. Couch Potato Time Advises Dr. Nwobi

Tampa, Florida - From March 15 (Selection Sunday) to April 6 (National Championship), March Madness consumes America. Arm chair hoopsters stare at their flat screens with tournament brackets in hand.  

“Instead of simply cheering, try some fancy footwork,” said Obinna Nwobi, M.D., a member of the Society for Vascular Surgery®. “Participate in March Madness by shooting a few hoops.” 

For a 150-lb. person, 30 minutes of basketball can burn off: 

• 153 calories shooting hoops solo
• 204 calories during an informal game 
• 272 calories during a five-on-five game of basketball*

“Your vascular system will have a great work out,” said Dr. Nwobi.  “Vigorous exercise such as basketball pumps your blood and lowers your blood pressure. This helps to keep your weight down. These are all positive health benefits.” 

For the slam-dunk of vascular health: 

• participate in 30 minutes of exercise daily. This may reduce the risk of stroke, the fourth leading cause of death in America according to the United States Center for Disease Control and Prevention’s 2010 National Vital Statistics Report. In 2010, 137,000 Americans died of stroke. 
• eat healthy,
• don’t smoke, 
• maintain a healthy body weight.

The lack of regular physical activity results in 250,000 deaths annually according to a 2003 report in the medical journal, Circulation.  Least physically fit persons have a mortality risk 4.5 times higher than physically fit persons.

Non-invasive vascular disease screening tests and medications are available. For vascular health information, visit:,, or 

If you have any questions regarding anything vascular feel free to call our offices at 813-922-3177 or visit our website at, or

Article Content Return To Library

Using Ultrasound to Prevent Strokes

By Neil Wagner

A new non-invasive approach to finding coronary plaques that are likely to cause a stroke.

Cholesterol plaques are fatty deposits that collect in arteries and can block blood flow. And when plaque ruptures, it can kill. Depending on where the broken piece lodges, it can cause a heart attack, stroke or even instant death.

Now Swedish researchers have found a way to use ultrasound to determine which plaques are likeliest to break off. Their initial results are 78% accurate.

We have known for a while that plaque most likely to rupture — also called unstable, vulnerable or soft plaque — had a different composition from more stable plaque. Stable plaque is largely composed of connective tissue (collagen) and smooth muscle cells.

Unstable plaque has a larger core and is rich in fat and macrophages, a type of white blood cell. It can also contain blood. But telling these two types of plaque apart while they were still in the body was difficult, if not impossible.

Six years ago, Swedish researchers began trying to find a way to determine which plaques were rupture-prone. Since unstable plaques have a different composition, they reasoned there should be some way to test for this. Currently, surgical removal of plaque is generally performed only when a substantial amount of plaque has collected.

Ultrasound, a safe and painless way of producing pictures of the inside of the body using sound waves, seemed a promising choice. The method uses ultrasound gel and a small probe and placed directly on the skin (see photo above) to produce a scan capable of showing the characteristics of internal organs, veins and arteries.

Tobias Erlöv, a researcher in Lund University's Department of Biomedical Engineering, found a way to interpret these differences that showed up in an ultrasound scans of the carotid artery. It involved a mathematical calculation based on a measurement of the reflected sound waves called a center frequency shift. “The more harmful substances, the greater the so-called centre frequency shift,” explained Erlöv in a statement.

To assess the method's reliability, Erlöv performed ultrasound scans on 157 different portions of 18 plaques that had been surgically removed and on 39 patients scheduled for surgical removal of plaque from their carotid artery. These plaques were stained for fat, blood, smooth muscle cell and collagen content and examined under the microscope.

Plaques deemed rupture-prone by ultrasound had larger cores, more macrophages and less collagen, in agreement with the standard definition of rupture-prone plaques. The scans detected these rupture-prone plaques with an accuracy of 78%.

Because ultrasound is both harmless and inexpensive, the method has the potential for widespread use. The researchers predict that in the future, ultrasound scans will lead to the ability to perform vascular surgery at an earlier stage for dangerous plaques and will eliminate the need for surgery in other cases when plaques are less dangerous.

More studies are needed to confirm their results and validate the method. One such study involving 1,500 patients is now underway by Summit, a pan-European research consortium.

The study appears in Atherosclerosis.

April 7, 2016



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