Tag Archives: awareness

On Mental Health

mental illness

More than one American in 20 has some form of major psychiatric illness, most often schizophrenia. Four times that number, one in five, has some sort of mental health issue. Despite the commonness of mental health problems, these problems continue to be stigmatized. This stigma is one of the most dangerous aspects of mental illness, and one of the largest obstacles to seeking treatment. Much of the difficulty mental illness causes the patient lies not in the illness itself but in lack of treatment and lack of support from friends, family, and co-workers, and an inability for patients to get the help they need, which in turn is due to the stigma preventing the patient from telling anyone or even, in many cases, getting a proper diagnosis.

In fact, only 40 percent of mentally ill people even start treatment, and many of them drop out. The stigma of mental illness is self-perpetuating. People with mental illness hide their conditions from those around them. The popular image of mental illness comes from fiction and from those who are too sick to hide it, and harmful, damaging, and pernicious stereotypes take root. People raised in the stereotypes, and surrounded by people who are raised in the stereotypes, are unable to tell people about their problems, or even recognize them as mental illness, and so it continues.

The stigma of mental illness also means sufferers face discrimination. It may be harder for people who are mentally ill to find jobs or housing, and in some cases they may even face physical violence. Women who are mentally ill are at heightened risk of sexual assault, in part because of the expectation that they will be dismissed as delusional if they report it, and all people with mental illnesses are under threat of violence from people who will be believed if they say it was defensive.

Fortunately, more and more people, including several celebrities, are coming forward about mental illness. By coming forward, they are changing the public face of psychiatric difficulty and helping break the stigma. There are some indicators that thee efforts are having the desired effect. Last year, a study conducted in England found attitudes toward the mentally ill improving, and greater sympathy and understanding of mental illness, with less fear and distrust.

Enterovirus Outbreak

enterovirus

Enterovirus 68 as been known for more than 50 years, but a recent outbreak that has hospitalized children across the United States has parents looking for answers. Enteroviruses are a common source of childhood illnesses, primarily causing respiratory or inflammatory disease. Most ordinary infectious diseases children get growing up result from enteroviruses. These diseases are generally fairly mild and quickly run their course, causing nothing worse than temporary discomfort. However, enterovirus 68 is on of the more severe types. Only six outbreaks were reported from 2005 to 2011, but since this past August, there have been nearly 700 cases throughout the country, resulting in five deaths.

The cold is a type of enterovirus and indeed most enteroviruses are spread like colds, through close contact. That means any sort of direct touching, or sharing eating utensils or drinking glasses, or toys. People can also pick up the virus by touching their faces after touching a surface that has the virus on it, such as a chair or table at which a sick person has recently been sitting. The spread can be prevented by washing hands and surfaces, and avoiding shaking hands with, kissing, or hugging people who might be infected. Most people with enterovirus 68 can treat it with the care given a cold—rest for a week, plenty of fluids. It is slightly more of a danger for children with asthma. It is unusual, though not unheard of, for enterovirus 68 to be deadly.

What is unusual about the August outbreak is its size. After fewer than 100 reported cases in the Unites States in half a century, the recent outbreak has seen 30 cases per day at just one hospital, with close to 700 overall over about two months. Some experts say it’s a statistical artifact, with previous cases going unrecognized, while better diagnostic techniques and greater attention by health agencies are making the virus more readily identified without actually being more common. This frequently happens with rare or recently discovered diseases. Some enterovirus 68 patients have had paralysis, but it’s not clear i or how this relates to the virus.

Give A Heart On Valentine’s Day

organdonorribbon

Today, 19 people will die who could have been saved. It isn’t yet known who they are, but they are among the more than 120,000 people awaiting organ transplants in the United States. Some of them are children. A small number are infants under one year old. One person will have die waiting for a transplant for every four patients who get transplants. These people will die because there are ten times as many people waiting for organs as there are willing donors, including living donors for some organs, and not all of those donors can donate to every, or even any, would-be recipient.

Organ transplants are necessary. In fact, because they are so difficult—they require not only an exact match, but anti-rejection drugs that suppress immune response to the transplanted organ isn’t rejected for the remainder of the recipients life—transplants are only performed when the recipient has a good chance with a transplant but essentially no chance without one. These people need donors who agree to allow their kidneys, pancreas, liver, lungs, heart, and intestines to be removed posthumously and given to someone who needs it, if it is useable, or for a part of any of these organs except the heart to be removed from a living donor and transplanted into a patient in need.

People who volunteer to donate organs are given the same treatment as other patients when they themselves are hospitalized. There’s no rush to declare them dead to use their organs. In fact, their organs require more extensive testing, to determine what is useable and how it can best be used. This testing is paid for by the recipients insurance, or by charitable organizations. These are also the sources of funding for living tissue donors; no expenses are born by the donors or their families. Modern donated organ and tissue recovery techniques mean it’s even possible for someone to have an open-casket funeral after donated tissue is removed. No one is too old or too sick to donate tissue; even people with illnesses affecting some organs are generally able to donate the rest. In most states, enlisting as a donor is done though the department of motor vehicles. but any health care facility should have information on how to volunteer.

Congenital Heart Defects

The heart is an intricate organ made up of many parts, making open heart surgery a common option when something goes wrong.

Congenital heart defects are the most common kind of birth defect among children born in the United States, affecting nearly one percent of all newborns in the country. There are multiple kinds of heart defect, classified according to the location of the problem within the heart as well as what, specifically, is wrong. The types of heart defect include:

Complete atrioventricular canal defect, a failure of the walls separating the chambers to meet and fully close. This means blood entering the lungs mixes with blood that s to circulate to the rest of the body, causing improper oxygen distribution.

Truncus arteriosus, in which the blood vessels leading in from the lungs and out to the body are fused together, when they are supposed to be separate. This condition also interferes with proper circulation of the blood through the body.

Ebstein’s anomaly, in which the heart valve on the left side cannot fully close.

Tetralogy of Fallot, the co-occurrence of four different malformations. These are a hole between the heart’s lower chambers, the aorta right above this hole and connected to both chambers rather than only the left, a blockage in the link between the heart and the lungs, and a thickening of the wall of the right chamber.

Pulmonary valve stenosis, in which the heart valve doesn’t open all the way and blood sometimes flows back out.

Atrial septal defect, a hole in the wall separating the heart’s upper chambers.

Coarctation of the aorta, a narrowing of the artery that carries blood out of the heart. This can can lead to high blood pressure, which is dangerous in infants.

It is often important that heart defects in newborns and infants be treated, usually with surgery. Because these defects are typically diagnosed so young—symptoms are frequently apparent early on, such as the tetralogy of Fallot, which can result in blue skin—and because infants born with heart defects may have other illnesses as well, there might be limits on the types of surgery that can be performed. In some cases, however, it is possible to leave the defect as is, at least temporarily, and it is sometimes possible for children born with heart defects to grow up quite healthy regardless.

Go Red For Women

Have you considered how exam room layout can affect patient care?

Heart disease kills more women than breast cancer. In fact, it kills more women than every form of cancer combined—one in four American women can expect to die of heart disease, making it the number one cause of death for women in the United States. Not only do more women die of heart disease than die of cancer, more women die of heart disease than men do, in part because people, doctors and patients alike, don’t realize that women don’t show heart disease the way men do. An estimated 42 million women have undiagnosed heart disease, and one reason it is undiagnosed is that health care professionals are looking for male symptoms women don’t have.

On top of that, the symptoms of heart disease in women are more subtle than in men, making them harder to spot as well as harder to recognize. When a woman has heart disease, it affects the main arteries, but is more likely to be in the smaller blood vessels in the chest as well than when a man does. She may experience neck or shoulder ache, abdominal pain, shortness of breath, throat pain, nausea, lightheadedness, dizziness and fatigue, or sweating.

The the symptoms are different, the risk factors for heart disease are largely the same in men and women, though not always to the same degree. Diabetes and stress, for example, are more strongly linked to heart disease in women. Smoking is one of the biggest controllable risk factors for heart disease in anyone, because it narrows the blood vessels, but this is particularly the case with the smaller ones that are more affected in women. The danger of smoking is also exacerbated by hormonal birth control; the hormones make the effects of smoking worse. On top of that, hormonal birth control is itself a risk factor, as are the hormonal changes wrought by menopause, both concerns unique to women.

To raise awareness of the special concerns women have for heart health, today is the American Heart Association’s Go Red For Women Day. Today is the day to start to take steps to lower your risk of heart disease death. That means quitting smoking. It means making the effort to get enough exercise, about 30 to 60 minutes most days. It means a heart-healthy diet with lots of fruits and vegetables and low in saturated fats. It means maintaining a healthy weight. It means talking to your doctor about an aspirin regimen that can help prevent arterial plaque from building up. It’s never too early, and you’re never too young, to start protecting your heart.

Heart Health

heart-attack-check-up

The heart is the body’s motor, and when it stalls out, it can cause problems. The heart doesn’t deteriorate as its person gets older, but when heart disease strikes, it can interfere with the functioning. Heart disease is deadly, and it gets more likely with age. However, just because it is more likely doesn’t mean it’s inevitable. It is estimated that 80 percent of cardiac-related deaths could have been prevented. That would mean saving close to 650,000 people. It’s easy to keep the heart healthy with a few simple lifestyle changes.

Avoiding stress is one of the most important things a person can do to prevent heart disease, and it has a fairly large return on investment, yielding a lot of improvement for simple actions. Destressing can mean slowing down, getting enough sleep, organizing one’s life—through straightening up the home, the office, and the e-mail inbox as well as staying on top of scheduling by making to-do lists and maintaining a calendar. Taking a relaxed attitude and keeping life in perspective also helps. And some destress techniques are also good for the heart in and of themselves, such as quitting smoking, eating a healthy diet, and staying active.

In fact, even simply walking can help the heart—as little as parking at the far end of the lot, or getting off the bus of subway one stop earlier than usual, will make a difference. Just 30 minutes of walking a day provides benefits. More intense workouts are even better for people who can do them. Twenty-five minutes of intense aerobic exercise a day, three days a week is a great way to build a healthy heart.

A heart-healthy diet is also important, but it doesn’t have to be bland or boring. Good menu options for heart health include oatmeal which can be dressed with fruit such as bananas; avocados, including in guacamole; soy; olive oil; and berries. These foods help lower cholesterol, cut fat, and provide protein. Potatoes, tomatoes, red wine, and green tea are all good for the heart, containing substances that actually fight heart disease , such as lycopene in tomatoes and flavonols in red wine. Flavonols are also found in dark chocolate, another indulgence that helps the heart.

Cervical Cancer And HPV

New findings show that one dose of the HPV vaccine may do the trick.

Nearly every person who develops cervical cancer did so as a result of contracting one of around 15 types of human papillomavirus, or HPV, a sexually transmitted disease. There are actually more than 150 types of HPV, though most of them are not associated with cancer; a substantial portion of sexually active people have one form or another of the infection, but because most strains cause no symptoms, the exact percentage is hard to determine.

Both HPV and cervical cancer in its early stages are generally asymptomatic—the strains of HPV that cause genital warts are different from those that cause cancer. That is why it is important to be screened for HPV for someone who is sexually active regularly. A test called a Pap smear, after a shortening of the name of the doctor who developed it, Georgios Papanikolaou, is used to look for signs of cancer in the cervical canal, the exit and entrance of the uterus.

Cervical cancer strikes more than 10,000 women each year. It is very rare for someone to get it except as a result of HPV infection. While a high partner count makes transmission of the virus more likely, anyone who is sexually active can acquire HPV. Not every HPV infection, even with the high-risk strains, leads to cancer. Things like smoking and smoking, stress, poor overall health, and other sexually transmitted infections such as chlamydia can make it more likely that cancer will develop.

Nonetheless, HPV prevention, quixotic a task as that is, can help reduce the incidence of cervical cancer. Many of the risk factors for HPV appear to be behaviors that are related to having more than one sexual partner—either resulting from decision, facilitating it, or simply the behaviors of someone likely to make it—and it is more likely that their contribution of these factors to getting HPV is mediated by that. Regardless, condom use provides a degree of protection, but it is imperfect because the virus can be transmitted by contact between areas of skin not covered.

The HPV vaccine is becoming more popular. It is available for children and teenagers—since HPV can be transmitted during a person’s first sexual encounter, it is recommended that people be vaccinated before they become sexually active, but the vaccine is effective through age 26 in women and 21 in men. The vaccine provides protection against the three HPV strains that cause more than three quarters of all cervical cancers, and experts say vaccination programs could cut cervical cancer deaths by as much as two-thirds.

January Is Radon Month

radiohazard

The second leading cause of lung cancer in the United States—after tobacco smoke—is invisible and odorless radon gas, which is blamed for 20,000 lung cancer deaths . Unlike smoking, it’s not something people expose themselves to intentionally. The radioactive element uranium is ubiquitous, albeit in small amounts, in soil, an is gradually decomposes into radon, which naturally occurs in gaseous form. In 1985, scientists realized that this gas comes into homes through the foundation, which is generally slightly porous. In some cases, the building materials can emit radon—this is seldom enough to cause problems, but it can add to the radon from the soil. Whatever the source, it gets trapped by the walls and roof. It can’t be seen or smelled, but it can be spotted with radon testing kits.

It is estimated that one in 15 American homes has what is considered to be a high level of radon, more than 4 picocuries per liter of air. Picocuries per liter is the measurement of the concentration of a radioactive substance, based on the radioactive decay of radium, which Marie and Pierre Curie studied. Excess radon gas can cause cancer. Radon is the most common cause of lung cancer among non-smokers—more than secondhand smoke—and one reason for this is that secondhand smoke can be seen and often avoided, while radon gas cannot be.

That is why home testing is so important. Winter, when the doors and windows are closed, is ordinarily the season of peak radon concentration, meaning if radon levels are not dangerously high in the winter they are unlikely to be dangerously hi in other parts of the year. Test kits are available, for short-term testing over a period of to days to three months, or long-term testing that can be longer than that. The reason even short-term testing can last so long is that the intention is to get an average radon level over time.

There’s no way to completely remove radon gas from the home; there’s always be some around. However sealing up cracks in and near the foundation can help prevent more from entering, and ventilation can help get out what is already there. Specialized radon reduction can can even be installed that is designed to get radon gas out of the home.

Folic Acid And Health

folic foods

Only 400 μg per day of vitamin B9, or folic acid, taken prenatally can help the fetus to develop normally, avoiding miscarriage and reducing the risk of birth defects by nearly three fourths. In particular, it helps prevent spina bifida, a condition in which some of the vertebrae that ordinarily cover the spinal cord don’t fully close, leading to physical problems and neurological and cognitive deficits.

However, there are other birth defects that folic acid, which is a part of the cell division process that underlies almost all tissue formation and growth, can help prevent. It helps prevent all neural tube defects, the type of birth defect of which spina bifida is among the most common, and also congenital heart defects, cleft lip, and other conditions.

To be most useful in fetal development, folic acid should be taken early in the pregnancy—the most effective time to up B9 intake is the first four weeks after conception. Most people don’t know they’re pregnant for much of that time, which is why women who might become pregnant are generally advised to get their extra 400 μg daily, in order to be sure they’re ready. However, getting a head start—being sure to get that amount even before conception—has been shown to have benefits for the future fetus.

Moreover, folic acid is beneficial in adults as well, even men. Folic acid can help prevent colorectal cancer as well as cervical cancer. It’s good for the heart, lowering the risk of heart attack and stroke. It’s also good for a large number of other things. People worried about the effects of growing older should know B9 helps slow or prevent Alzheimer’s disease and a kind of progressive vision loss called age-related macular degeneration, as well as other signs of aging. It’s good for depression and sleep problems, nerve and muscle pain, and even AIDS.

Fortunately, folic acid is easy to get. There are supplements, but most people don’t need them. Vitamin B9 is found in leafy green vegetables, asparagus, okra, bananas, beans, oranges, lemons, organ meats, mushrooms and even yeast. By law it’s added to flour as well in the United States. Inadvertently omitting folic acid from the diet would be next to impossible.

Flu Vaccine

New research may lead to better flu vaccinations.

Flu season means flu vaccine time. Th widely available influenza vaccine is one of the most effective ways to stop the spread of the contagious viral illness. The flu virus changes slightly from year to year, which is why a new vaccine is needed each season, but the vaccine provides long-term protection against each season’s specific strain of the disease.

The flu vaccine works in two primary ways. First, it prompts the immune system to produce antibodies that fight off a specific strain of influenza virus, making it easier for the body to rid itself of an infection before it can cause illness. Second, it reduces the level of flu virus in the population, so people fewer are exposed to the virus in the first place. This means the vaccine is effective even for the small number of people who do not produce sufficient antibodies in response to the vaccine, or for whom vaccination is unsafe.

In some cases people are reluctant to get vaccinated because of erroneous beliefs about the vaccine. While the vaccine does contain flu virus, it is in an inactive form, enough to trigger an immune response, but not enough to actually sicken most people. The vaccine can cause side effects in some patients, but many fears—of neurological problems, of heart disease, of Alzheimer’s—are exaggerated, or often the opposite of the case, in that flu vaccine reduces these risks. Conversely, people often liken "flu" to a bad cold, even though flu killed thousands of people per year.

There are people for whom flu vaccine is not recommended. People who have had severe allergic reactions in the past are poor candidates for vaccination. None of the types of vaccines are approved for children under six months. People who are not feeling well should get better before being vaccinated. Other people need to take precautions before vaccination. It may not be possible for people with egg allergies to receive the vaccine, and they should discuss the best course of action with their healthcare professionals. Similarly, people with Guillain-Barré syndrome are prone to complications and should talk to a doctor. Vaccination is recommended for everyone else, particularly people under four or over 50 and their caregivers, children or teenagers on aspirin therapy, people with suppressed immune systems, people with certain chronic conditions such as diabetes, health care workers, and anyone else at high risk of flu complications.