Category: Disease

HPV Vaccination: It’s Not Just for Girls

While vaccines have been around for many years and are able to help prevent many diseases, there remains a lot of controversy over whether children should be vaccinated for many reasons, including the potential adverse side effects from the vaccine.  Parents have raised concerns about the HPV (Human Papilloma Virus) vaccine including: (1) the child is not sexually active, so there is not a need to vaccinated; (2) safety concerns related to side effects and (3) they claim that the vaccine is not needed or necessary.  In addition, many times this vaccine is not recommended by the child’s medical provider, so the parent does not know about the vaccine.

Regardless of the reason for not getting the vaccine, that decision has major ramifications. Currently, there are 30 types of HPV that are sexually transmitted and over 100 types that are t skin-to-skin.  Dr. Joan Cates, a Senior Lecturer at the University of North Carolina Chapel Hill in the School of Journalism and Mass Communication, has participated in several studies, some currently in the process, on the issue of HPV vaccination, specifically with young boys.  In 2011, the recommendation came out that young boys should receive the vaccination that historically had only been recommended for girls.  HPV can lead to a variety of cancers, not just cervical cancer in females. The “Protect Him” campaign focused on increasing the 13 year male vaccination rate.  In this campaign, two major factors appeared to be important in influencing parents.  First, parents reacted positively to information involving their son’s risk and the use of the word “protection” against disease.   The measures that were evaluated in this study included: immunization registry data, awareness, attitudes, beliefs, provider recommendation, vaccination intentions and initiation.  It was found from the study that those in the intervention group were 34% more likely to be vaccinated.  In Dr. Cates’ newest HPV awareness study, responses pre- and post-intervention were remarkably similar regarding awareness.  Dr. Cates is currently in the process of creating a video game study that would introduce adolescents to the HPV vaccine and provide them with important information. As someone with a chronic disease, Type 1 diabetes, it makes sense to be able to be protected from as many harmful diseases as possible.  Many of the diseases that we have vaccines for are potentially deadly, if contracted.  Who would not want to minimize his or her risk from these harmful and deadly diseases?

 

Photo Credit: Amanda Mezer

Let’s Be Precise: What is Precision Medicine?

If you watched the State of the Union a few weeks ago, you may have heard chatter about the new “Precision Medicine Initiative” introduced by President Obama. But what really is “precision medicine”?

A White House fact sheet uses words like “bold,” “revolutionize,” and “accelerate” to describe the proposed initiative, which would launch with a $215 million chunk of the 2016 Budget. This sum would be allocated to the National Institutes of Health (NIH) for a voluntary national research cohort, to the National Cancer Institute (NCI) to scale up efforts in genomics and cancer treatment, to the Food & Drug Administration (FDA) to employ additional expertise in the development of more efficient databases, and to the Office of the National Coordinator for Health Information Technology (ONC) to improve the privacy and security of databases and electronic health records.

While this initiative seems exciting and innovative, some say this concept isn’t new; in fact, it’s been used to treat cystic fibrosis and it is sometimes referred to as “personalized medicine” (others try to distinguish between “precision” and “personalized,” which may cause more confusion).

Any way you name it, there seem to be a few vague goals we’ve heard before (i.e. “cure cancer”) and unsurprisingly limited conversation about the insufficient funding focused on prevention and better understanding of growing health disparities. While there’s certainly no drawback to funding more NIH research, crowdsourcing disease cohorts, and supporting efforts to understand the basis of disease, one has to wonder if concentrating resources on treating rare diseases will help ease the growing costs of healthcare, or if there should be more endeavors to integrate healthy behaviors and smart lifestyle choices into American culture. When will public health and prevention get its time in the limelight?

 

Image credit: Alex Kamo via Flickr

Type 1 Tuesdays: Gastroparesis – A New Year’s Resolution or Result of Health Problems?

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Many of you may have set New Year’s Resolutions, such as “losing weight” or “eating healthier,” however, my New Year’s Resolution was forced upon me a few days after the New Year and after several weeks of illness.  As alluded to in one of my previous posts, I was diagnosed with gastroparesis, or delayed gastric emptying, this January, which is a condition wherein your stomach does not efficiently digest food.  This condition is a common complication of type 1 diabetes.

The primary treatment for this disorder is a diet of easy to digest foods and frequent small meals.  As my doctor advised, liquids are better than solids.  As you may already be thinking, many healthy foods we should eat everyday are hard to digest, such as fruits and vegetables.  So, this “diet” restricts consumption of those healthy foods and requires more low fat, high carbohydrate foods, such as potatoes and smoothies.  The “diet” also requires small meals throughout the day, instead of the normal three larger meals.  This “diet,” as with most things, has some positives and negatives.

Some of the positives are that you can save money on food.  One “normal” meal, whether home-cooked or from a restaurant, can now last 4-5 days.   Additionally, it can help with weight loss, which I have experienced first hand this past month.

Some negatives are that the “diet” is inconsistent with our American culture and with recommendations for a healthy diet as recommended by the United States Department of Agriculture (USDA).  Americans typically eat 3 large meals each day that include high fat foods and the USDA recommends a diet high in salads, fruits and vegetables.  I had heard in the past that small, more frequent meals are better for you, particularly for those with type 1 diabetes.  However, when I tried to impose this on myself, when it was not medically necessary, it was hard to abide by and stick to.  When eating a small portion, it takes much less time than other people at a meal and meals have become social events as well as a time for nourishment.  The foods required for this diet are the opposite of normal nutritional recommendations for any person, and particularly for “diabetic friendly” diets.

It has been a struggle to change my eating habits regarding the timing of meals and the consumption of fruits and vegetables.  However, I am seeing that if people would eat smaller portions and watch fat intake, this could definitely be beneficial – even though this is contrary to the culture we are surrounded by.  Are we literally feeding the obesity epidemic by our cultural standards for food consumption?  How should we develop and implement the changes necessary to create a healthier culture?

 

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Is Excessive Salt Restriction Really Necessary?

Salt serves an important function in our food, and in our bodies. As a preservative, it helps to limit the spoilage of food by preventing microbial growth. It is also essential for the proper functioning of the human nervous system.

The American Heart Association currently recommends consuming less than 1,500 mg of sodium per day, considerably less than the 2,300 mg included in the latest rendition of the Dietary Guidelines for Americans. For the average person, this can be very difficult to achieve, with even ‘healthy’ foods like whole wheat bread containing upwards of 200 mg of sodium per serving, and average consumption in the range of 3,400 mg per day. Although more and more products are being offered in low- and no-salt added formulations, keeping total daily intakes under 1,500 mg basically requires preparing most food from scratch, emphasizing fresh fruits and vegetables that are naturally low in sodium and high in potassium. There is no question about the beneficial qualities of a whole-foods, plant-based diet, but are guidelines pushing for excessive sodium restriction really necessary?

A new study published in the Journal of the American Medical Association reported no significant differences in the risk for developing heart disease over 10 years between individuals who consumed 1,500 mg of sodium per day and those who consumed 2,300 mg per day. This adds to the growing body of literature suggesting that moderate salt consumption is appropriate for most people, with salt restriction necessary only for those with specific health conditions, such as kidney disease, that require lower intakes.

We should certainly continue to encourage people to reduce the amount of salt in their diet. However, many find a 1,500 mg sodium diet to be hard to swallow. If you are looking to make healthy changes to your diet, don’t feel like you need to sacrifice taste – you won’t likely stick to the changes for very long. Instead, balance moderate salt intake with more potassium, a prevalent mineral found in fresh fruits and vegetables. Aim for a 2:1 ratio, consuming twice as much potassium as sodium. People can enjoy the benefits of a healthy diet without giving up all of the foods they enjoy. You can have your salt, and eat it too.

 

Photo credit: http://www.gilchristdermatology.com/sodium-and-your-skin#.VMjZny6WnVI

 

iPhone: Is it also a Medical Alert Bracelet?

Did you get a new iPhone over the holidays, already have an iPhone or are considering getting one?  Whether you are a new or old Apple user, there is a great feature that could apply to you! Have you noticed the “emergency” button on the screen where you enter your 4 number passcode?  This is a cool feature, especially for those who have health problems, such as Type 1 diabetes.  In this area, you can enter your name, medical conditions, allergies, and an emergency contact information.

What does this mean to you?  If you are unconscious or having a medical emergency wherein you cannot communicate, your phone could literally save your life.

This feature is fairly easy to set up.  To set up your information, follow these easy steps:

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  • Step 1: Go to the “Health application” on your phone.

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  • Step 2: There should be a button on the bottom that says “Medical ID” and looks like a *. If you click on that logo, you come to a page where you can enter the information you wish to fill out.

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  • Step 3: Enter the information you want entered. Make sure the “Show When Locked” is selected!

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  • Step 4: Click “Done” when you are finished putting in your information.

Follow these easy steps to retrieve your “Medical ID” information:

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  • Step 1: Now, when you are on the locked screen, if you select “Emergency,” a logo on the bottom will appear that says “Medical ID” below the keypad.

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  • Step 2: If you click on “Medical ID,” the information you entered will be present on the screen.

In the past, people with medical conditions wore “medical alert” bracelets, which were institutional looking bracelets (sometimes made cuter with beads and other decor) or, more recently, they actually got medical alert tattoos (on one’s arm or wrist).  Are cell phones the future of medical identification?  Would you consider using this feature on an iPhone to allow people to have vital emergency information about you?

 

Photo Credit: Main Image by: Kimberly Hislop. All other photos by: Amanda Mezer

Got shots?

“I’m going to Disney World!”

Well, maybe not, since the California Department of Public Health confirmed 59 cases of measles in that state since the end of December 2014, of which 42 were linked to Anaheim’s Disneyland or Disney California Adventure Park.

The CDC's website presented this graph showing the recent dramatic spike in U.S. measles cases.

The CDC’s website presented this graph showing the recent dramatic spike in U.S. measles cases.

In 2000 measles was officially declared eliminated in the United States because of high levels of population immunity achieved by high levels of vaccination. However, it is a small world, after all; the Centers for Disease Control and Prevention linked nearly half of 2014’s unprecedented number of measles importations into the U.S. to travel to the Philippines during an outbreak in that country. The CDPH has confirmed the vaccination status of the sufferers in 34 of the 59 current cases; 28 were unvaccinated.

“Vaccination is the most important strategy to prevent measles,” the CDPH states. “Two doses of measles-containing vaccine… are more than 99 percent effective in preventing measles.”

Many Americans—indeed, many young doctors– have never seen a case of measles, so a description bears repeating: “Measles is a highly infections, airborne disease that typically begins with fever, cough, runny nose and red eyes,” the CDPH press release states. “Within a few days a red rash appears, usually first on the face and then spreading downward to the rest of the body.” Infected people are contagious from four days before their rash starts through four days afterwards, according to the CDC. Complications can include pneumonia, encephalitis and death.

The CDC’s Jan. 23 Health Advisory notes the current outbreak is limited to Western states (California, Utah, Washington, Oregon, Colorado, Nebraska and Arizona) as of that writing. The CDPH advises people who think they may have been exposed to contact their health provider by phone to avoid the spread of the disease in doctor’s offices.