Blog Posts

United Against HIV and AIDS

November 30th, 2020

World AIDS Day, which is observed on December 1st, was created to unite people worldwide in the battle against HIV and AIDS. It’s also a time to show support for people who have the virus and commemorate those who have died from it. World AIDS Day serves as a perfect opportunity to review what we know about HIV and AIDS.

HIV, which stands for human immunodeficiency virus, is a virus that attacks your body’s immune system, specifically its infection-fighting CD4 cells. If your CD4 cells are depleted, you become more susceptible to other infections and diseases. Your body cannot eliminate HIV and there is no cure for its infection, so once you get the virus, you have it for life.

HIV is spread through contact with the body fluids of someone who is infected with HIV. These body fluids include blood, semen, pre-seminal fluid, vaginal fluids, rectal fluids and breast milk. In the US, HIV is spread mainly by having anal or vaginal sex without a condom, or sharing needles or other equipment to inject drugs with someone who has HIV.

Some people develop flu-like symptoms within two to four weeks after HIV infection, which is considered stage 1, or the acute infection stage. The common symptoms during this stage, which include fever, chills, skin rashes, night sweats, muscle aches, sore throat, nausea, vomiting, diarrhea, swollen lymph nodes and mouth sores, may last a few days or several weeks.

If you experience any of these symptoms and suspect that you’ve been exposed to HIV, see your health care provider and get an HIV test to determine for sure if you’ve been infected.

If you have HIV and don’t begin treatment right away, your condition can progress into stage 2: the chronic, or clinical latency, stage. During this stage, your HIV is still active, but is reproducing at a slower rate, so you may not experience any symptoms. Without treatment, this stage can last for a decade or longer. But in some people, it progresses more rapidly.

The third and most serious stage of HIV is acquired immunodeficiency syndrome, or AIDS. You are considered to have AIDS when your number of CD4 cells falls below 200 cells per cubic millimeter of blood  (a healthy count is between 500 and 1,500 cells/mm3) or when you develop one or more severe illnesses called opportunistic infections even if your CD4 count is above 200.

These opportunist infections, which include recurrent pneumonia, tuberculosis, brain and spinal cord disease, various lung infections, chronic intestinal infection, cytomegalovirus, salmonella and toxoplasmosis, remain a major cause of death in people with AIDS.

Without treatment, people with AIDS typically survive about three years. But if they contract a dangerous opportunistic infection, their life expectancy without treatment drops to about one year. Treatment with HIV medication at this point can still help and may even be life-saving, but beginning treatment as soon as you learn you have HIV gives you the best possible outcome.

There’s only one way to know for sure if you have HIV and that’s to get tested. There are several  types of tests, such as tests that look for antibodies and antigens in your blood, that you can get through your health care provider. Tests are also available at most medical clinics, community health centers and hospitals. Further, home testing kits are available at your pharmacy or online.

Home HIV testing is an especially valuable tool today, as many people are unable to visit their providers or an outpatient clinic due to the COVID-19 pandemic.

Treatment for HIV is a combination of medications called antiretroviral therapy, or ART. People on ART follow a regimen of certain medications every day. ART works by preventing HIV from multiplying, which reduces the amount of the virus in your body, which is called a virus load. A lowered virus load protects your immune system and prevents the progression of HIV into AIDS.

A main goal of ART is to reduce your viral load to an undetectable level, meaning the amount of HIV in your blood is too low to be detected on a viral load test. If you maintain an undetectable virus load, you will have virtually no risk of transmitting HIV to an uninfected partner.

The US Centers for Disease Control and Prevention estimated that there were 1.2 million people in the United States with HIV in 2018, the most recent year with available statistics. Of those people, the CDC estimated that about 14 percent, or 1 in 7, did not know they had the infection. Fortunately, the outlook for people with HIV has continued to improve over the decades.

In the 1990s, a 20-year-old individual with HIV had a life expectancy of 19 years. By 2011, it had improved to 53 years. Today, life expectancy is near normal if ART is started soon after contracting HIV.

If you don’t have HIV, there are a few things you can do to protect yourself against it. Practice safe sex. Use a condom each time you have anal, vaginal or oral sex. Don’t share needles or other equipment to inject drugs. If you think you’re at risk for HIV, consider pre-exposure prophylaxis, or PrEP. That involves taking certain HIV medications every day.

If you’re HIV-negative and are exposed to HIV, post-exposure prophylaxis, or PEP, is an emergency medication you take after exposure that can stop HIV before it infects your body. PEP consists of three antiretroviral medications given for 28 days. It should be started as soon as possible after exposure, but before 36 to 72 hours have passed.

 

Diabetes and Your Eyes

November 14th, 2020

Diabetes increases the risk for multiple health problems, from cardiovascular disease to kidney damage to skin conditions. Another common – and often preventable – problem linked to diabetes is vision loss. November is Diabetes Eye Disease Month, a time to spotlight the most common eye disorders associated with diabetes and focus on ways to decrease your risk.

According to the Centers for Disease Control and Prevention’s “National Diabetes Statistics Report 2020,” which analyzed health data through 2018, 34.2 million Americans – just over 1 in 10 – have diabetes. In addition, 88 million American adults – approximately 1 in 3 – have prediabetes. Further, 7.3 million adults over 18 were unaware or did not report having diabetes.

Over time, diabetes can damage your eyes and cause poor vision, even blindness. It can lead to
diabetic eye disease, a group of eye problems that includes diabetic retinopathy, diabetic macular edema, cataracts and glaucoma.

The retina is the inner lining of the back of the eye. It senses light entering the eye and turns it into signals that your brain translates into images. Consistently high blood glucose levels associated with diabetes damages the small blood vessels in the eye, which can harm the retina and cause a disease called diabetic retinopathy.

In the early stage of diabetic retinopathy, called nonproliferative diabetic retinopathy, damaged blood vessels can weaken, swell, or leak into the retina. In the more serious stage, called proliferative diabetic retinopathy, some blood vessels close off and new blood vessels grow on the surface of the retina. These blood vessels are abnormal and can cause serious vision problems.

Diabetic macular edema involves fluid build-up on the center part of the retina, called the macula, which is responsible for the detailed, straight-ahead vision necessary for reading, driving and seeing faces. The built-up fluid makes the macula swell, blurring vision and destroying this sharp vision. Diabetic macular edema, which can cause permanent vision loss, typically develops in people who already have other signs of diabetic retinopathy.

The eye’s lens is a clear structure that sits behind the iris (the colored part of the eye) and helps focus light onto the retina. Natural lenses tend to become cloudy from protein deposits as people age. Cloudy lenses are called cataracts. People with diabetes are twice as likely to develop cataracts at a younger age than people without diabetes. That’s because, it is believed, high glucose levels cause protein deposits to build up on the lens.

Glaucoma is a group of diseases that cause damage to your eye’s optic nerve, which can lead to permanent vision loss. Glaucoma occurs when pressure builds up in your eyes. This pressure pinches the blood vessels that carry blood to the retina and optic nerve, causing gradual vision loss. Having diabetes doubles your chances of getting glaucoma.

With open-angle glaucoma, the most common type, pressure builds up inside your eye when fluid can’t drain effectively through the normal drainage channel, called the trabecular meshwork. This type of glaucoma can be treated with medication and eye drops that lower eye pressure, speed up drainage, and reduce the amount of fluid your eyes make

People with diabetes are at risk for a condition called neovascular glaucoma, in which new blood vessels form on the eye’s iris. These blood vessels block the normal flow of fluid and raise eye pressure. Treatment for neovascular glaucoma may include use of a laser to reduce the number of blood vessels or anti-neovascular endothelial growth factor (anti-VEGF) injections to halt the growth of new blood vessels.

There are other eye conditions associated with diabetes including branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). Arteries and veins are blood vessels that carry blood throughout the body. There is one main artery and one main vein supplying the retina.

When this vein becomes blocked, blood and fluid spills out into the retina and the macula can swell, which affects your sharp central vision. Over time, if blood circulation remains cut off, nerve cells in your eye can die and more vision can be lost.

When branches of the retinal vein become blocked, the resulting condition is called branch retinal vein occlusion (BRVO). When the main retinal vein becomes blocked, it is called a central retinal vein occlusion (CRVO).

Here’s the good news: You can help prevent all of these diabetes-related eye disorders by taking steps to manage your diabetes. To do that, you must control your blood glucose, blood pressure and cholesterol levels. Take good care of yourself through healthy eating, exercising regularly and taking medications as prescribed.

In addition, if you smoke, quit. There are many resources online and in the community to help you quit smoking. And don’t forget to get a complete, dilated eye exam once a year, so your eye care professional can detect early signs of diabetic eye disease. Be eye smart: Take steps to protect your vision.

Increase Your Lung Cancer IQ

November 9th, 2020

Your lungs are a pair of spongy, pyramid-shaped organs in your chest that bring fresh oxygen into your body when you inhale. The lungs also send out carbon dioxide, a waste product of cellular function, when you exhale. The lungs, along with a network of air passages, are part of your body’s respiratory system.

Lung cancer is a type of cancer that starts in the lungs. Cancer is a disease that occurs when cells grow and divide uncontrollably and destroy body tissue. Lung cancers can begin in any part of the lungs, but 90 to 95 percent of cancers of the lung arise from the epithelial cells. Those are the cells that line the larger and smaller air passages, called bronchi and bronchioles.

Lung cancer is the number one cause of cancer deaths in both men and women in the United States and worldwide. It’s estimated that in 2020, 228,820 adults in the US will be diagnosed with lung cancer, and 135,720 Americans are expected to die from it. But there is some good news. Death rates have declined by 51 percent since 1990 in men and 26 percent in women since 2002.

Research suggests that these declines are the result of more people not smoking and more people quitting smoking, as well as to advances in lung cancer diagnosis and treatment.

Lung cancers are generally grouped into two main categories: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). These cancers are distinguished by the way their cells look under a microscope, particularly the size of their cells. SCLC and NSCLC grow and spread differently and are often treated differently.

NSCLC is the most common type of lung cancer, accounting for 84 percent of all lung cancer diagnoses. NSCLC is an umbrella term for several subtypes of lung cancer: Adenocarcinomas start in the mucus-secreting cells of the lungs, squamous cell carcinomas generally arise in the central chest area in the bronchi, and large cell carcinomas, the least common, start in the lungs’ outer edges.

SCLC, which accounts for 10 percent to 15 percent of all lung cancer cases, is the most aggressive lung cancer. It spreads rapidly to other areas of the body and is most often discovered after it has spread extensively. In fact, about 70 percent of people with SCLC will have disease that has already spread at the time they are diagnosed.

Other cancers can occur in the lungs as well. Bronchial carcinoids, which account for up to 5 percent of lung cancers, are typically small when diagnosed and most often occur in people under 40 years old. Other types of lung cancer, including adenoid cystic carcinomas, lymphomas and sarcomas, as well as benign lung tumors such as hamartomas, are rare.

There are certain factors that put you at higher risk for developing lung cancer. The number one risk factor for lung cancer is smoking. Lung cancer is strongly associated with cigarette smoking, with about 90 percent of lung cancers arising because of tobacco use. Exposure to secondhand smoke also increases your risk for developing lung cancer.

Another lung cancer risk factor is exposure to radon, a naturally occurring gas that results from the breakdown of uranium in soil and rocks that can accumulate in your home. Other risk factors include exposure to asbestos, diesel exhaust and other cancer-causing agents in the workplace; air pollution; previous radiation therapy and a personal or family history of lung cancer.

In many cases, there are no symptoms in the early stages of lung cancer. It is often discovered on a routine imaging exam for another condition. But in some cases, symptoms are present. If you notice any signs and symptoms of lung cancer, visit your doctor right away. Your doctor may be able to diagnose lung cancer at an early stage, when treatment is more likely to be effective.

Signs and symptoms of lung cancer include: a cough that doesn’t go away or gets worse; coughing up blood or rust-colored sputum; chest pain that’s worse with deep breathing, coughing or laughing, shortness of breath; hoarseness; loss of appetite, unexplained weight loss; fatigue; a respiratory infection that won’t go away; and new onset of wheezing.

Diagnosing lung cancer begins with a thorough medical history and physical exam followed by a combination of diagnostic tests and procedures. Tests used may include x-ray, CT, MRI; PET, bone scan, blood tests and sputum cytology. Your doctor may also perform a bronchoscopy, thoracentesis and/or needle biopsy to obtain tissue samples for examination under a microscope to look for cancer cells.

The treatment you receive will depend on several factors, including the type of lung cancer you have, how far it has spread, called the stage, and your overall health. You may get more than one type of treatment.

Treatments for SCLC include surgery, chemotherapy, radiation therapy, immunotherapy and laser therapy, which uses a laser to kill cancer cells. Treatments for NSCLC include surgery, radiation therapy, chemotherapy, immunotherapy, laser therapy and targeted therapy, which uses specific medications to target and kill cancer cells while avoiding harming healthy cells.

There’s no sure way to prevent lung cancer, but there are steps you can take to reduce your risk for developing it. Don’t smoke, but if you do, quit, and avoid secondhand smoke; test your home for radon and make any necessary upgrades; avoid asbestos, diesel exhaust and other cancer-causing agents at work; and maintain a healthy lifestyle. Eat a diet rich in fruits and vegetables and exercise regularly.

 

Bolstering Bladder Health

November 9th, 2020

November is Bladder Health Awareness Month. Your bladder is a hollow, muscular sac located in your lower abdomen. It temporarily stores the urine made by your kidneys until it is released into a tube called the urethra, which transports the urine out of your body. When empty, the bladder is about the size and shape of a pear.

The muscles of the bladder enable it to stretch to hold urine. A healthy bladder can hold one and a half to two cups of urine during the day and about four cups at night. When urinating, the muscles of the bladder contract, and two valves, called sphincters, open. This allows the urine to flow into the urethra and ultimately out of your body.

There are a number of conditions than can affect your bladder. Among the most common are urinary incontinence, overactive bladder (OAB), cystitis and bladder cancer. We’re going to take a brief look at these four disorders in this blog.

According to the American Urological Society, an estimated one quarter to one-third of adults in the US, both men and women, have urinary incontinence, which is a loss of bladder control. There are several types of urinary incontinence including stress incontinence, urge incontinence, overflow incontinence and mixed incontinence.

With stress incontinence, activities such as coughing, sneezing, heavy lifting, straining when using the bathroom and even laughing put pressure on the bladder and causes it to leak. Urge incontinence occurs when you feel the need to use the bathroom right away, but some urine leaks out before you can get there.

Overflow incontinence occurs when you don’t empty your bladder completely initially, so it overflows with new urine and leaks. Some people have more than one type of incontinence. They may leak urine when coughing or sneezing and leak when they have a strong urge to use the bathroom. In these cases, the condition is called mixed incontinence.

Overactive bladder, or OAB, is a combination of symptoms that may include the need to urinate more frequently, increased urgency and incontinence. You may also feel the need to urinate often at night. An estimated 33 million adults in the US suffer with OAB. About 17 percent of women over 18 years of age have OAB.

Weak pelvic muscles are a common cause of OAB, but it can also be caused by damage to the nerves that send signals from the brain to the bladder telling it to empty at the wrong time. Certain medications, infection, excess weight and an estrogen deficiency, such as what occurs after menopause, are other potential causes.

You can lessen your OAB symptoms by decreasing or eliminating foods and beverages known to worsen symptoms such as tea, coffee, alcohol, chocolate and caffeinated soft drinks. In addition, maintaining bowel regularity, maintaining a healthy weight and stopping smoking can help. There are also techniques for retraining your bladder so it holds and releases urine more efficiently.

Cystitis is inflammation of the bladder, most often due to a bacterial infection. It is considered a type of urinary tract infection, or UTI. UTIs are one of the most common reasons patients visit their physicians. Estimates based on physician office and emergency department statistics suggest there are about 7 million episodes of acute cystitis each year.

Common symptoms of cystitis include a strong, persistent urge to urinate, a burning sensation when urinating, urinating frequently but only small amounts, blood in the urine, cloudy or strong-smelling urine, pelvic discomfort, a feeling of pressure in the lower abdomen and a low-grade fever. See your doctor immediately if you experience back or side pain, fever and chills, or nausea and vomiting.

Bacterial cystitis is the most common type of cystitis, but there are other types as well. These include interstitial cystitis, drug-induced cystitis, radiation cystitis, foreign-body cystitis, chemical cystitis and cystitis caused by other conditions such as diabetes, kidney stones, an enlarged prostate or spinal cord injury.

Bladder cancer is the fourth most common cancer. The American Cancer Society estimates there will be about 82.400 new cases of bladder cancer in the United States in 2020. That includes 62,100 cases in men and 19,300 in women. And according to the ACS, there will be about 17,980 deaths from bladder cancer in 2020, 13,050 in men and 4,930 in women.

There are three types of bladder cancer that begin in the cells that line your bladder. They are transitional cell carcinomas, which start in the innermost tissue layer of the bladder; squamous cell carcinomas, which start in the thin, flat squamous cells lining the inside of the bladder; and adenocarcinomas, which begin in the glandular cells found in the lining of the bladder.

Blood in the urine is often the first sign of bladder cancer. Other signs and symptoms of bladder cancer include: the need to urinate more often than usual, pain or burning while urinating, an urgent need to urinate even when your bladder isn’t full, trouble urinating or having a weak urine stream and frequent nighttime urination.

Treatment for bladder cancer depends on its stage, which is the extent to which the cancer has grown and spread. Five types of standard treatment are traditionally used for bladder cancer: surgery, radiation therapy, chemotherapy, immunotherapy and targeted therapy. In addition, new therapies are currently being evaluated in clinical trials.

You may not be able to prevent bladder cancer, but there are steps you can take to reduce your risk and improve the overall health of your bladder. Some things you can do to keep your bladder healthy include: drinking an appropriate amount of water, avoiding constipation, maintaining a healthy weight, exercising regularly, eating a healthy diet and quitting smoking.

Defend Yourself Against Diabetes

November 9th, 2020

In its “National Diabetes Statistics Report 2020,” the US Centers for Disease Control and Prevention’s Division of Diabetes Translation details the most updated “state of the disease” in America. The CDC aims to use the report’s information to improve diabetes prevention and management strategies available in this country.

According to the report, which analyzed health data through 2018, 34.2 million Americans, or just over one in 10 individuals, have diabetes. Further, 88 million American adults, approximately one in three, have prediabetes. Unfortunately, most people with prediabetes are unaware they have it.

Diabetes is a chronic, or long-lasting, disease that affects how your body turns the food you eat into fuel your body can use for energy. When you eat food, most of it is broken down into a sugar called glucose that is then released into your bloodstream.

When you eat, your glucose level increases, and that signals your pancreas to release a hormone called insulin. Insulin serves as the “key” to unlock your body’s cells and allow glucose to enter. The cells can then use the sugar for energy. Diabetes occurs when there isn’t enough insulin or your body doesn’t use it efficiently, and the glucose in your blood becomes too high.

There are two main types of diabetes: type 1 and type 2.

Approximately 5 to 10 percent of people with diabetes have type 1 diabetes, which is typically diagnosed in children and teens. With type 1 diabetes, your own immune system attacks the specialized insulin-creating cells in the pancreas called islet cells. Normally, islet cells produce the exact amount of insulin necessary to normalize the glucose level in your blood.

With type 2 diabetes, the more common type, you still produce insulin but it’s inadequate for your body’s needs. Generally, the release of insulin from your pancreas is defective and, as a result, the amount is insufficient. Type 2 diabetes occurs most often in people over 30 years old, and its incidence increases with age. It is sometimes referred to as adult-onset diabetes.

Prediabetes is when your blood sugar is higher than it should be but not high enough for your doctor to diagnose diabetes. Almost all people with type 2 diabetes had prediabetes first.

Symptoms of diabetes include: increased thirst, frequent urination, extreme hunger, unexplained weight loss, fatigue, irritability, blurred vision, slow-healing sores and frequent infections,. Abdominal pain, itchy skin and tingling or numbness in the feet or toes may also occur. Symptoms vary depending on the level of glucose in your blood.

The onset of type 2 diabetes is typically slower than that of type 1 diabetes, and the symptoms may be less noticeable. Or you may overlook the symptoms or attribute them to another condition or to simply getting older. But if you notice symptoms, see your health care provider to be tested for prediabetes or diabetes.

Type 1 diabetes is treated using injections of insulin or wearing an insulin pump. The injected insulin performs the same function as the insulin normally made by the islet cells of your pancreas. It serves as the key to allow glucose to enter your cells for use as energy.

Treatment for type 2 diabetes generally begins with lifestyle modification, such as altering your diet, increasing your exercise and losing weight. If your glucose level remains high, you may be instructed to use medications that help your body use insulin more efficiently. It may be necessary to use insulin injections to manage your blood glucose.

If you cannot adequately control the glucose level in your blood, you may develop chronic complications of diabetes. These arise due to blood vessel damage caused by consistently high blood glucose and can affect your eyes, kidneys, nerves and heart. These complications include diabetic retinopathy, diabetic neuropathy, erectile dysfunction and coronary artery disease.

Currently, there is no cure for diabetes, so the aim of treatment is to manage the disease and prevent complications. Management involves controlling your blood glucose, and that requires consistent monitoring. You must test your blood glucose level throughout the day to be sure it is not too high or too low. Both extremes can have serious consequences.

One way to test your glucose level at home is to use a fingerstick to obtain a drop of blood that you place on a meter that calculates your glucose level. There are also monitors that you wear on your body, called continuous glucose monitors (CGMs). CGMs use sensors to measure your glucose level. They provide continuous, dynamic glucose information every five minutes.

If you notice symptoms of diabetes, visit your doctor for testing. If you test positive for diabetes or if you’ve had diabetes for a while, follow your doctor’s recommendations for controlling your blood glucose and managing your condition. And most of all, monitor, monitor, monitor.

Brushing Up on Dental Hygiene

October 26th, 2020

The US Centers for Disease Control and Prevention (CDC) reports that 69 percent of Americans ages 35 to 44 have lost at least one of their permanent teeth. The CDC also notes that by age 50, Americans have typically lost an average of 12 teeth, including their wisdom teeth. Further, among adults ages 65 to 74, 26 percent have lost all their teeth.

You don’t have to be one of those statistics. You can keep your teeth – and your smile – throughout your lifetime by maintaining a healthy mouth and practicing good dental care. October is National Dental Hygiene Month, a time to spread the word that odorless breath, strong teeth, and clean gums are all part of good overall oral health.

This month also serves as a perfect opportunity to review a few key strategies for brushing up on your dental hygiene practices. Good oral hygiene is the best way to prevent cavities, gum disease, and other dental disorders. It also helps prevent bad breath. Oral hygiene consists of both personal and professional care.

On the personal side, everybody knows they’re supposed to brush their teeth twice a day with fluoride toothpaste. But do you know the proper brushing technique? To begin, hold your toothbrush at a 45-degree angle. Aim its bristles at the spot where your teeth meet your gums. Brush gently, using short, back-and-forth strokes across the sides and tops of your teeth. Brush for at least two minutes.

Be sure to use a soft-bristled toothbrush, and don’t brush too hard because it can harm your gums. Replace your toothbrush every three months, or sooner if the bristles become frayed or irregular. Don’t forget to clean between your teeth daily with floss or an interdental cleaning device such as a Waterpik. And use a mouthwash. It can go where brushing and flossing can’t.

Your lifestyle habits can have an impact on your oral health as well. To best maintain a healthy mouth and keep your teeth, adopt a diet that’s tooth-friendly. It should include plenty of nuts, fruits, cheese, chicken, and vegetables. Cheese causes your salivary glands to produce more saliva, which neutralizes the acid. Acid damages your teeth.

For overall better oral health, it’s also recommended that you stop smoking and limit your intake of soda and alcohol. Tobacco can cause periodontal complications including oral cancer, and soda and alcohol contain phosphorus, which on its own is important for health. But too much phosphorus depletes your body of calcium, and that can lead to tooth decay and gum disease.

Good dental hygiene also has a professional component, which includes seeing your dentist regularly. The standard recommendation is to visit your dentist twice a year for check-ups and cleanings. But your dentist may want to see you more or less often, so talk with your dentist about the frequency that’s best for you.

During a routine dental visit, your dentist or a hygienist will clean your teeth and check for cavities and gum disease. Your dentist will also evaluate your risk for other oral problems and check your mouth, face, and neck for signs of cancer. X-rays of your teeth are generally taken once a year, but your dentist may recommend other procedures to help diagnose a suspected dental condition.

Not only is good dental hygiene key to maintaining a healthy mouth and keeping your teeth for a lifetime, but it’s also important for your body’s overall health. Research study after research study has shown that people who have poor oral health have higher rates of cardiovascular problems such as heart attack or stroke than people with good oral health.

Several theories about how this happens have been proposed. One suggests that the bacteria that infect the gums and cause gum disease travel through the blood vessels to other areas of the body. There, they cause blood vessel inflammation and damage, and tiny blood clots, heart attacks, and strokes may follow.

Another theory suggests that it’s not the bacteria, but the body’s immune response to it that sets off the vascular damage. A third theory states that there may be no direct connection between gum disease and cardiovascular disease, but a third factor, such as smoking, is a risk factor for both conditions.

What’s more, gum disease associated with a particular bacterium called porphyromonas gingivalis has been linked to rheumatoid arthritis and pancreatic cancer.

However you look at it, brushing up on your dental hygiene is a good way to go. Make it the focus of this Dental Hygiene Month and always.

Down Syndrome Defined

October 22nd, 2020

Generally speaking, people have 23 pairs of chromosomes for a total of 46 chromosomes. Chromosomes are rod-like structures on DNA that store your genes, the material that carries the instructions for inherited traits such as hair color, skin color, and height. For each pair of chromosomes, you get one from your mother and one from your father.

A person with Down syndrome has a third copy of one chromosome, chromosome 21, instead of the usual pair. This extra copy of chromosome 21 disrupts the course of normal brain and body development. Those with Down syndrome typically have distinct physical features and often experience physical and mental delays and disabilities.

Down syndrome is the most common chromosomal condition identified in the United States. Each year, approximately 6,000 American babies are diagnosed with Down syndrome. It occurs in about one in every 700 babies. According to the National Down Syndrome Society, there are more than 350,000 people living with Down syndrome in the US.

Certain physical features are common in people with Down syndrome. These features include a slightly flattened face, particularly the bridge of the nose, almond-shaped eyes that slant upward, a short neck, small ears, bulging tongue, small hands and feet, short stature, and poor muscle tone. People with Down syndrome may have some or all of these features to varying degrees.

People with Down syndrome typically have some degree of developmental disability, but it’s generally mild to moderate. They may be slow to reach developmental milestones such as crawling, walking, and talking. Mental and social delays may result in impulsive behavior, poor judgment, short attention spans, and slow learning.

There are also certain medical problems that are common in people with Down syndrome. These conditions include congenital (meaning present at birth) heart defects; obstructive sleep apnea, a condition in which breathing temporarily stops while the person is sleeping; hearing loss; ear infections; eye disorders, and thyroid problems. People with Down syndrome must be routinely monitored for these conditions by a health care provider.

There are three types of Down syndrome: trisomy 21, translocation Down syndrome, and mosaic Down syndrome. Trisomy 21 is the most common, occurring in about 95 percent of Down syndrome cases. With trisomy 21, each cell in the body has three separate copies of chromosome 21.

Translocation Down syndrome occurs in about 3 percent of cases. With this type, an additional full or partial copy of chromosome 21 is present, but it attaches, or translocates, to another chromosome, usually chromosome 14, instead of existing on its own.

People with translocation Down syndrome can inherit the condition from an unaffected parent who is a carrier of the genetic rearrangement. In one-third of cases of Down syndrome resulting from translocation, there is a hereditary component, accounting for about 1 percent of all cases of Down syndrome.

Mosaic means mixture or combination, so people with mosaic Down syndrome have a mixture of cells with three copies of chromosome 21 and cells with the normal two copies. People with this type of Down syndrome, which occurs in about 2 percent of cases, may have milder symptoms and effects because they have fewer cells with an extra chromosome 21.

The cause of Down syndrome is unknown, but certain factors increase your risk of having a baby with the syndrome. One factor is the mother’s age. Your risk of having a baby with Down syndrome increases as you get older, especially if you are age 35 or older. Still, the majority of babies with Down syndrome are born to mothers younger than 35 because there are many more births in younger women.

In addition, if you or your partner are a carrier of the translocation Down syndrome gene, you can pass it on to your baby. And if you already have a baby with Down syndrome, your risk of having another baby with the same syndrome is increased.

If you want to know if your baby has Down syndrome before it is born, there are two types of tests that can be done: screening tests and diagnostic tests. Screening tests can reveal if your baby has a higher risk, but cannot determine if your baby definitely has Down syndrome. Screening tests typically include various blood tests and ultrasound.

Diagnostic tests can determine if your child has Down syndrome, but there’s a slightly higher risk for miscarriage associated with these tests. One diagnostic test is chorionic villus sampling, which analyzes a tissue sample removed from the placenta to look for genetic disorders.

Other diagnostic tests include amniocentesis, which examines some of the amniotic fluid surrounding your baby in the uterus, and percutaneous umbilical cord sampling, which involves taking a small amount of blood from the baby’s umbilical cord to check for chromosomal defects.

If you choose not to have these prenatal tests, Down syndrome will be diagnosed when your baby is born. If your doctor suspects Down syndrome, he or she will take a sample of your baby’s blood for karyotype testing. This test is done to identify and evaluate the size, shape, and number of chromosomes. It can detect three copies of chromosome 21.

Many problems associated with Down syndrome are lifelong, but early intervention, beginning in infancy, can help people overcome the challenges and live long lives. In 1960, babies born with Down syndrome often didn’t see their 10th birthday. Today, the average life expectancy of individuals with Down syndrome is 60 years, with many living into their 60s and 70s.

What’s more, many people with Down syndrome are able to work and fully participate in social activities. These people live full and meaningful lives.

The Bottom Line on Breast Cancer

October 12th, 2020

It’s October, and everybody knows October is National Breast Cancer Awareness Month. Look around. Pink ribbons are everywhere. The color pink is a reminder to get the facts about breast cancer and then get screened. And men, don’t think this doesn’t apply to you. Though it is much more common in women, men can get breast cancer, too.

Group of People and Breast Cancer Concept

Consider these facts. About one in eight American women will develop breast cancer over the course of her lifetime. Breast cancer is the second most common cancer in women after skin cancer and the second leading cause of cancer death in women. Only lung cancer kills more women each year.

The American Cancer Society estimates that 276,480 new cases of invasive breast cancer and 48,530 new cases of noninvasive breast cancer will be diagnosed in American women in 2020. Sadly, about 42,170 women are expected to die from it.

Further, the ACS estimates that about 2,620 new cases of invasive breast cancer will be diagnosed in men in 2020, and about 520 men will die of breast cancer. A man’s lifetime risk for developing breast cancer is about one in 883.

Breast cancer occurs when cells in the breast start growing uncontrollably. Most of the time, but not always, these extra cells collect and form tumors. These are the lumps that can often be detected in the breasts on your self-exams or mammograms.

A new lump in your breast or armpit is one symptom of breast cancer, but there are others as well. You might notice thickening or swelling of an area of your breast or irritation or dimpling of your breast skin. Look for red or flaky skin near the nipple, as well as secretions from the nipple other than breast milk. Changes in the size and shape of your breast and pain in any area of the breast are other breast cancer symptoms.

If you have any of these symptoms, visit your doctor for a proper diagnosis.

Breast cancer is the result of a mutation, or abnormal change, in the genes that regulate the growth and reproduction of breast cells. About 5 percent to 10 percent of breast cancers are inherited, or caused by mutations passed on from your parents. The rest are caused by abnormal changes that occur as a result of aging and life in general.

That makes getting older a risk factor for breast cancer, one you can’t do anything about. Other risk factors for breast cancer you cannot control include getting your period before age 12 and menopause after 55, having dense breasts, having a personal or family history of breast cancer, and having been treated with radiation therapy.

There are also risk factors for breast cancer you can control, things like being physically inactive, being overweight, drinking a lot of alcohol, and taking hormones. In addition, having your first baby after age 30, not breastfeeding, and never having a full-term pregnancy can also increase your risk for breast cancer.

You can’t change your age or your genes, but there are steps you can take to reduce your risk for breast cancer. A few of these suggestions are no-brainers. We already know that we should maintain a healthy weight, exercise regularly, and limit our alcohol consumption to one drink a day.

These suggestions you may not have heard. For one, think hard and have a heart-to-heart discussion with your doctor about the risks of taking the Pill or hormone replacement therapy (HRT). They may not be right for you. If you have a baby, consider breastfeeding, if you’re able. If you have a family history or a genetic mutation, talk to your doctor about ways you can lessen your breast cancer risk.

With breast cancer, as with most cancers, early detection is critical to treatment success. It’s best to find it before the cancer cells have had a chance to invade the nearby lymph nodes and spread to other areas of the body. Maintaining a routine screening schedule can assist with early detection.

The first part of the screening process is regular breast self-exams. You know the look and feel of your breasts, so you’re likely to notice changes such as lumps, pain, or differences in size or shape. You should also get routine clinical breast exams by a doctor or nurse, who use their hands to feel for lumps in your breasts.

The next step is to get a mammogram. The American Cancer Society’s Breast Cancer Screening Guideline recommends that women begin yearly mammograms by age 45. They can switch to having mammograms every other year at age 55. If lumps are detected, your doctor may perform a biopsy to determine if their cells are cancerous.

If cancer is detected, there are many approaches to treating it. Doctors often use more than one approach for each patient.

Chemotherapy is a common approach. It uses drugs to kill cancer cells and shrink tumors. Surgery, called mastectomy, is often used to remove the breasts and the tumors. Radiation therapy uses high-energy rays directed at the spot of cancer to kill cancer cells. Unfortunately, chemotherapy and radiation therapy have uncomfortable side effects.

Doctors use additional treatment approaches including hormonal therapy, which doesn’t allow the cancer cells to get the hormones they need to survive. Another approach is biological therapy, which works with the immune system, your body’s natural defense against disease. Biological therapy helps the immune system to fight cancer. It also helps control the side effects of other cancer treatments.

Breast cancer is the subject of much research, and if you’re interested, you can participate in a clinical trial to test the safety and effectiveness of new drugs and treatments. To find a clinical trial near you, ask your doctor or go to clinicaltrials.gov.

Now, you’ve got the facts on breast cancer. Put on something pink and share what you’ve learned!

Highlighting Health Literacy

October 5th, 2020

One of the biggest problems that health care providers have to deal with pertains to health literacy, which is a person’s ability to understand health care information and navigate the health care system. Currently, health literacy in the United States is woefully deficient.

So what exactly is health literacy?

There are many definitions out there, but the concept behind them is essentially the same. An example comes from the American Medical Association Foundation, which defines health literacy as: “the ability to obtain, process and understand basic health information and services needed to make appropriate health decisions and follow instructions for treatment.

The Center for Health Care Strategies puts it more simply. In their definition, health literacy refers to “the skills necessary for an individual to participate in the health care system and maintain good health.” The skills they identify are reading and writing, calculating numbers, communicating with health care professionals, and using health technology such as electronic diabetes monitors.

The Network for the National Library of Medicine agrees that health literacy involves using a certain set of skills. The network suggests that “health literacy requires a complex group of reading, listening, analytical and decision-making skills, as well as the ability to apply these skills to health situations.”

According to the US Centers for Disease Control and Prevention (CDC), anyone who needs health information and services also needs health literacy skills. You can use those skills to find appropriate information and services, communicate your needs and preferences, and respond to the information and services.

Health literacy skills also enable you to understand the choices, consequences, and context of the information you receive. With such understanding, you can make decisions based on which information and services match your needs and preferences.

But there’s a big problem. An estimated 90 million Americans, nearly 36 percent, have low health literacy. And it affects certain populations more than others.

For example, Hispanic adults have lower health literacy skills overall than any other ethnic or racial group. Low health literacy is also more common in people who speak another language or speak English as a second language, as well as in older people, people with lower socioeconomic status or education, and people who are uninsured or on Medicare or Medicaid.

It’s imperative that we improve health literacy in this country because low health literacy is having a negative effect on how Americans use the health care system and on overall health outcomes. And as a result of increased use of services and poor outcomes, low health literacy is making an enormous impact on the nation’s health care costs.

The authors of a report titled “Low Health Literacy: Implications for National Health Policy” estimate the impact of low health literacy on the nation’s economy to be between $106 billion and $238 billion annually. That amount, the authors point out, represents between 7 percent and 17 percent of all personal health care expenditures.

To achieve optimal health, you must be an active participant in your health care. But people with low literacy often don’t have the skills necessary to clearly describe their symptoms to their health care provider, or fully understand their diagnosis and follow the instructions for their treatment. Many are simply unable to play an active role in their care.

And that affects the way they use the health care system. Many avoid going to the doctor, and when they have a health concern, they go to the emergency room for care instead. Studies show that people with low health literacy are 2.3 times more likely to visit the emergency room. And with that comes an associated increase in hospital admissions.

Health literacy affects overall health and mortality as well. Low health literacy has been linked to increased frequency of depression, physical limitations, and chronic diseases such as heart disease, stroke, diabetes, and asthma.

Making matters worse, people with low health literacy often have little understanding of their chronic disease. And because they are less engaged in their health care, they are less likely to use preventive services or follow instructions for managing their chronic disease. As a result, people with low health literacy have a much higher risk of complications and death.

Health care providers, health educators, and patients all have roles to play if we’re going to boost health literacy in America. Patients must be willing to engage with their providers and listen to what they say. Providers and educators can do their part by following these Four Simple Strategies for Improving Your Patients’ Health Literacy:

  • Use plain language in both verbal and written communication
  • Use visual aids
  • Recommend and use technology – Research shows that nearly 90 percent of Americans use the internet and 81 percent own a smartphone. Using these technologies can be a good way for providers to get their message to patients.
  • Use effective teaching methods – Some techniques include talking slowly, asking open-ended questions, and asking patients to repeat instructions given to them.

Why is health literacy important? It’s important because it allows you to make good decisions about your health. Health literacy also enables you to get appropriate medical care, take your medications correctly, and manage chronic diseases. And most importantly, it helps you lead a healthy lifestyle so you can live a full and healthy life.

AFib: Hurried Heartbeats

September 21st, 2020

Atrial fibrillation, or AFib, is the most common type of irregular heartbeat, or arrhythmia. With AFib, your heart beats much faster than the normal 60 to 100 beats per minute. To create a normal heart rhythm, or sinus rhythm, your heart’s upper and lower chambers must work in concert. But with AFib, the activity of those chambers is out of sync.

The heart pumps blood to the rest of the body, and the pumping is controlled by the heart’s own electrical system. Each heartbeat is essentially an electrical impulse that navigates through the heart. The impulse is generated by a small mass of specialized tissue in the right upper chamber, or atrium, of the heart called the SA node.

The SA node sends the electrical charge to the AV node, which is located in the wall of tissue that separates the right and left atria called the interatrial septum. The AV node conducts the impulse from the atria to the ventricles, the bottom chambers of the heart. Each impulse moves blood through the atria into the ventricles, from where it is pumped out to the rest of the body.

With AFib, the atria don’t move blood into the ventricles effectively, so the ventricles can’t pump blood to the body efficiently. This can cause your heart to beat irregularly, to be very rapid and feel like quivers or thumps in your chest. AFib can lead to serious heart-related complications including heart failure.

When blood is not pumped efficiently out of the ventricles, it is more likely to clot. If a blood clot leaves the ventricles and enters the bloodstream, it can lodge in an artery going to the brain and cause a stroke. People with atrial fibrillation are 5 to 7 times more likely to have a stroke than the general population. And about 15 to 20 percent of people who have strokes have this heart arrhythmia.

It is estimated that between 2.7 million and 6.1 million people in the United States have AFib. It is more common with age, so as our population gets older, this number will increase. Further, more than 454,000 hospitalizations in which AFib is the primary diagnosis occur each year, and AFib contributes to about 158,000 deaths annually. And that number is expected to rise.

A congenital heart disorder can cause AFib, and certain diseases and conditions that can damage your heart can result in arrhythmia. Possible causes of atrial fibrillation include high blood pressure, heart attack, coronary artery disease, heart valve disease, chronic lung disease, previous heart surgery, an overactive thyroid or metabolic disease, a viral infection, and exposure to stimulants such as caffeine, cocaine, tobacco or alcohol.

Some people have no symptoms and don’t know they have AFib. Their arrhythmia is typically detected during a physical exam when the doctor performs a test called an electrocardiogram, or ECG, which measures heart rhythm. Common symptoms of AFib include the following:

  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • General fatigue
  • Dizziness, faintness or confusion
  • Chest discomfort
  • Shortness of breath
  • Weakness
  • Sweating

In addition to an ECG, your doctor may use other tests to help diagnose AFib. These may include a Holter or portable event monitor, which records your heart’s electrical activity over a period of time. Transesophageal echocardiography, or TEE, uses sound waves to take pictures of your heart through your esophagus. Your doctor uses this test to look for blood clots.

Treating AFib generally includes making certain lifestyle changes, including quitting smoking and limiting your intake of alcohol and caffeine. Also, control your high blood pressure and blood sugar levels, exercise regularly and maintain a healthy weight, and eat a heart-healthy diet that is low in salt, saturated fat, trans fats and cholesterol.

Initially, medications are used to treat atrial fibrillation. These include medications that control heart rhythm, which help return the heart to normal sinus rhythm. Thera are also medications that control heart rate. These work by preventing the ventricles from beating too rapidly. Anticoagulant medications, or blood thinners, which reduce the risk of blood clots and stroke, are also typically prescribed to patients with AFib.

Among the nonsurgical procedures for atrial fibrillation are electrical cardioversion and radiofrequency ablation. With electrical cardioversion, an electrical shock is placed on the outside of the chest to “reset” the heart to normal sinus rhythm.

During radiofrequency ablation, a catheter is inserted through a blood vessel and gently guided into your heart. Your malfunctioning tissue is destroyed using radiofrequency energy delivered through the catheter, and the tissue can no longer send abnormal signals.

Implanted pacemakers are among the surgical procedures for atrial fibrillation. Another is the maze heart surgery. During this procedure, the surgeon cuts small slits in the upper part of your heart. The scar tissue that results interferes with the transmission of electrical impulses that cause AFib, and normal heart rhythm is restored.

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