Posted in coronavirus, disease, Health, news

Deadly Coronavirus Strain From China Here in US

Image above from shutterstock

A strain of virus from the family Cornavirinae, which has killed 106 and sickened over 4500 people in China, has been detected in a patient here in the US.

The virus, named 2019-nCoV, has been detected in a 30 year-old male who lives in Snohomish County, WA.  He had recently travelled from Wuhan, the perceived hub of the outbreak.  Health officials believe he had exposure to 16 people before being diagnosed.

Since then three other cases have been reported, two in California and one in Illinois.

All of the US cases were in those who traveled from China.

The majority of cases appear to be in China, but South Korea, Singapore, Saudi Arabia, Japan, Thailand and Australia have reported cases as well.

What is coronavirus?

HERO_coronavirus

Coronaviruses come in multiple types and can cause an array of illnesses from the common cold to SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome). The latter two causing severe illness, as SARS killed over 700 people and sickened over 8000 in the 2002-2003 outbreak.

Hence a coronavirus can be unpredictable, mutate to more virulent forms, or cause mild upper respiratory illness.

How is Coronavirus spread?

The virus can be spread from human contact with animals, and human to human contact. Scientists believe the strain of 2019-nCoV may be transmitted by saliva and respiratory secretions but are still investigating its ability to be spread by this “droplet transmission.”

What are the symptoms of the Coronavirus strain 2019-nCoV?

As with most viruses, this strain can cause any of the following symptoms:

  • Fever
  • Cough – dry early on and then in later stages may be productive
  • Runny nose
  • Headache
  • Fatigue/malaise
  • Sore throat
  • Wheezing
  • Difficulty breathing
  • Nausea
  • Vomiting
  • Diarrhea
  • Lack of appetite

How long after exposure can one become sick?

The incubation period can range anywhere from 2-14 days.

How does one die from Coronavirus?

If the illness persists or becomes severe, one could potentially suffer from pneumonia, respiratory difficulty and even secondary infections.

How does one tell if they have a mild Coronavirus strain or a deadly one?

The early onset of disease could mimic a cold or flu, hence it may be difficult to tell. However, severe or persistent symptoms could suggest a more aggressive strain of the virus and will warrant immediate evaluation.  Medical providers have been urged to ask patients about their travel habits and exposure to others who may have been exposed and to notify local health departments to facilitate testing of those who demonstrate symptoms of the 2019-nCoV strain.

Is there a vaccine for 2019-nCoV?

No, however, we have heard a vaccine for 2019-nCoV is being researched and may be in its early development.

What is the treatment for this strain of Coronavirus?

At this time there is no specific treatment for this strain. However, supportive measures can be instilled such as rest, fluids and maintaining oxygenation in severe cases.

How can we prevent a 2019-nCoV infection?

Experts urge avoiding sick contacts and washing hands thoroughly. Cover your nose and mouth when sneezing and coughing to avoid spreading illness if you are sick.  And if you do have a family member with 2019-nCoV, the CDC suggests the following:

Prevention Steps for People Confirmed to Have, or Being Evaluated for 2019-nCoV Infection Who Receive Care at Home
Your doctors and public health staff will evaluate whether you can be cared for at home. If it is determined that you can be isolated at home, you will be monitored by staff from your local or state health department. You should follow the prevention steps below until a healthcare provider or local or state health department says you can return to your normal activities.
Stay home except to get medical care
You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas, and do not use public transportation or taxis.
Separate yourself from other people in your home
As much as possible, you should stay in a different room from other people in your home. Also, you should use a separate bathroom, if available.

Call ahead before visiting your doctor

Before your medical appointment, call the healthcare provider and tell them that you have, or are being evaluated for, 2019-nCoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected.

Wear a facemask

You should wear a facemask when you are in the same room with other people and when you visit a healthcare provider. If you cannot wear a facemask, the people who live with you should wear one while they are in the same room with you.

Cover your coughs and sneezes

Cover your mouth and nose with a tissue when you cough or sneeze, or you can cough or sneeze into your sleeve. Throw used tissues in a lined trash can, and immediately wash your hands with soap and water for at least 20 seconds.

Wash your hands

Wash your hands often and thoroughly with soap and water for at least 20 seconds. You can use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid sharing household items

You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with other people in your home. After using these items, you should wash them thoroughly with soap and water.

Monitor your symptoms

Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before going to your medical appointment, call the healthcare provider and tell them that you have, or are being evaluated for, 2019-nCoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask your healthcare provider to call the local or state health department.

Prevention Steps for Caregivers and Household Members
If you live with, or provide care at home for, a person confirmed to have, or being evaluated for, 2019-nCoV infection, you should:
  • Make sure that you understand and can help the person follow the healthcare provider’s instructions for medication and care. You should help the person with basic needs in the home and provide support for getting groceries, prescriptions, and other personal needs.
  • Have only people in the home who are essential for providing care for the person.
    • Other household members should stay in another home or place of residence. If this is not possible, they should stay in another room, or be separated from the person as much as possible. Use a separate bathroom, if available.
    • Restrict visitors who do not have an essential need to be in the home.
    • Keep elderly people and those who have compromised immune systems or chronic health conditions away from the person. This includes people with chronic heart, lung or kidney conditions, and diabetes.
  • Make sure that shared spaces in the home have good air flow, such as by an air conditioner or an opened window, weather permitting.
  • Wash your hands often and thoroughly with soap and water for at least 20 seconds. You can use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Wear a disposable facemask, gown, and gloves when you touch or have contact with the person’s blood, body fluids and/or secretions, such as sweat, saliva, sputum, nasal mucus, vomit, urine, or diarrhea.
    • Throw out disposable facemasks, gowns, and gloves after using them. Do not reuse.
    • Wash your hands immediately after removing your facemask, gown, and gloves.
  • Avoid sharing household items. You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with a person who is confirmed to have, or being evaluated for, 2019-nCoV infection. After the person uses these items, you should wash them thoroughly (see below “Wash laundry thoroughly”).
  • Clean all “high-touch” surfaces, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables, every day. Also, clean any surfaces that may have blood, body fluids and/or secretions or excretions on them.
    • Read label of cleaning products and follow recommendations provided on product labels. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves or aprons and making sure you have good ventilation during use of the product.
    • Use a diluted bleach solution or a household disinfectant with a label that says “EPA-approved.” To make a bleach solution at home, add 1 tablespoon of bleach to 1 quart (4 cups) of water. For a larger supply, add ¼ cup of bleach to 1 gallon (16 cups) of water.
  • Wash laundry thoroughly.
    • Immediately remove and wash clothes or bedding that have blood, body fluids and/or secretions or excretions on them.
    • Wear disposable gloves while handling soiled items. Wash your hands immediately after removing your gloves.
    • Read and follow directions on labels of laundry or clothing items and detergent. In general, wash and dry with the warmest temperatures recommended on the clothing label.
  • Place all used disposable gloves, gowns, facemasks, and other contaminated items in a lined container before disposing them with other household waste. Wash your hands immediately after handling these items.
  • Monitor the person’s symptoms. If they are getting sicker, call his or her medical provider and tell them that the person has, or is being evaluated for, 2019-nCoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask the healthcare provider to call the local or state health department.
  • Caregivers and household members who do not follow precautions when in close contact with a person who is confirmed to have, or being evaluated for, 2019-nCoV infection, are considered “close contacts” and should monitor their health. Follow the prevention steps for close contacts below.
  • Discuss any additional questions with you state or local health department
Prevention Steps for Close Contacts
If you have had close contact with someone who is confirmed to have, or being evaluated for, 2019-nCoV infection, you should:
  • Monitor your health starting from the day you first had close contact with the person and continue for 14 days after you last had close contact with the person. Watch for these signs and symptoms:
    • Fever. Take your temperature twice a day.
    • Coughing.
    • Shortness of breath or difficulty breathing.
    • Other early symptoms to watch for are chills, body aches, sore throat, headache, diarrhea, nausea/vomiting, and runny nose.
  • If you develop fever or any of these symptoms, call your healthcare provider right away.
  • Before going to your medical appointment, be sure to tell your healthcare provider about your close contact with someone who is confirmed to have, or being evaluated for, 2019-nCoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask your healthcare provider to call the local or state health department.
  • If you do not have any symptoms, you can continue with your daily activities, such as going to work, school, or other public areas.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is Board Certified Family Physician

Posted in cancer, disease, Health, medications, news

California to Decide if Acetaminophen Products Need “Cancer Risk” Label

In compliance with Proposition 65, the Safe Drinking Water and Toxic Enforcement Act of 1986, California may have to enforce retailers to label acetaminophen-containing products as having potential “cancer risk.”

Proposition 65 requires the state to maintain a list of chemicals that can cause cancer, birth defects or reproductive harm. Businesses must also provide warnings if their products sold contain compounds included on the list.  If they don’t, they can be subject to a $2500 fine per violation per day.

There are over 900 chemicals currently on the list of toxic substances, and state regulators reviewed 133 studies to see if acetaminophen needs to be included.

Although acetaminophen use has been linked to liver disease (see below), and pediatric asthma, autism and ADHD if exposed perinatally, cancer studies have been far and few between.

However, in 2011, a study published in the Journal of Clinical Oncology, found “high use of acetaminophen was associated with an almost two-fold increased risk of incident hematological malignancies” such as myeloid neoplasms, non-Hodgkin lymphoma and plasma cell disorders.  By “high use” they described taking acetaminophen more than 4 times a week for over 4 years.  The cancer risk was still deemed as rare, but statistically significant.

A designation of being included in the Proposition 65 “list” is controversial as its hopes of educating the public could cause fear in the use of a medication has has been deemed relatively safe as opposed to other products used for similar illnesses (i.e. using acetaminophen for pain relief instead of an opioid), while at the same time open companies up to lawsuits if one alleges their medical condition came from an acetaminophen-containing product.

TYLENOL® poisoning, more common than we think

Acetaminophen (paracetamol in Europe) has long been known to cause liver failure. But now researchers reveal why its the number one cause of acute liver failure.  And even more troubling, many people don’t realize they are overdosing on this common medication.

What does the liver do?

The liver filters and detoxifies blood.  Additionally it breaks down and stores cholesterol and lipids and produces proteins. The liver also produces bile that gets stored in the gall bladder to help digest food after eating.  It is one of the few organs in the body that can regenerate itself when tissue is damaged.  So its troubled scientists how drug toxicity could irreversibly damage the liver to the same degree hepatitis, cirrhosis and cancer do.   Researchers from the University of Edinburgh studied human and mouse liver cells and now know why.

What is liver failure?

In order for the liver cell to work, it needs to work in concert with the cells surrounding it but work in separate groupings, each with a different function.  Excessive acetaminophen (the main ingredient in Tylenol) disrupts these cell connections, called “tight junctions”, hence the cells don’t function properly.  “Failure” of an organ, such as “liver failure”, “heart failure”, and “renal failure” occur when the cells of the organ aren’t healthy enough to allow the organ to function.

Signs and symptoms of liver failure include:  jaundice (yellow color to skin and eyes), fatigue, weakness, easy bleeding, nausea, diarrhea, confusion to name a few.

Knowing the mechanism of injury to the hepatocytes, liver cells, may allow scientists to create a means to repair liver cells that can’t be repaired themselves.  Or design a pain reliever that doesn’t damage the liver.

How much acetaminophen is toxic?

Taking more than 4 grams a day could be considered and “overdose” and toxic.  Frighteningly, this level is commonly consumed on a daily basis.  Over the counter an “extra strength” dose contains 500 mg of acetaminophen.  So if a person takes 1-2 pills every 4-6 hours, they can easily take 4 grams a day. Add a pain medication such as Vicodin or Percocet which contain acetaminophen, or a cough and cold remedy, or even an over the counter sleeping aid which may contain it as well, and its no surprise so many end up in the emergency room.

The following is a list of over the counter medications that may contain acetaminophen (provided by knowyourdose.org)

Some Common Over-the-Counter Brand Name Drugs That Contain Acetaminophen

Actifed®
Alka-Seltzer Plus®
Anacin®
Cepacol®
Contac®
Coricidin®
Dayquil®
Dimetapp®
Dristan®
Excedrin®
Feverall®
Formula 44®
Goody’s® Powders
Liquiprin®
Midol®
Mucinex®
Nyquil®
Panadol®
Robitussin®
Saint Joseph® Aspirin-Free
Singlet®
Sinutab®
Sudafed®
Theraflu®
Triaminic®
TYLENOL® Brand Products
Vanquish®
Vicks®
*And store brands

Some Common Prescription Drugs That Contain Acetaminophen (or APAP)

Butalbital®
Endocet®
Fioricet®
Hycotab®
Hydrocet®
Hydrocodone Bitartrate®
Lortab®
MIDRIN®
NORCO®
Oxycodone®
Percocet®
Phenaphen®
ROXICET ™
Sedapap®
Tapanol®
Tramadol
TYLENOL® with Codeine
Tylox®
Ultracet®
Vicodin®
Zydone®
*And generic drugs

 

We recommend discussing all your medication, especially over the counter, with your medical provider, and to not assume just because its available without a prescription, its safe in any dose.

                                                                                                         

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is Board Certified Family Physician

Posted in disease, Entertainment, Health, news, Parkinson's

Ozzy Osbourne Reveals He Has Parkinson’s Disease

In an interview on Good Morning America, Ozzy Osbourne, 71, revealed that he was recently diagnosed with Parkinson’s.

He describes he recently had a cervical spine surgery and then was diagnosed with the neurodegenerative disorder:

“I got a numbness down this arm for the surgery, my legs keep going cold,” he said. “I don’t know if that’s the Parkinson’s or what, you know, but that’s — see, that’s the problem. Because they cut nerves when they did the surgery. I’d never heard of nerve pain, and it’s a weird feeling.”

He continues:

“Coming from a working class background, I hate to let people down. I hate to not do my job,” said Osbourne. “And so when I see my wife goin’ to work, my kids goin’ to work, everybody’s doing — tryin’ to be helpful to me, that gets me down because I can’t contribute to my family, you know.”
“But you know, put it this way — I’m a lot better now than I was last February. I was in a shocking state.”

 

What is Parkinson’s Disease?

Parkinson’s disease is the second most common neurodegenerative disorder, next to Alzheimer’s, and the most common movement disorder that affects 1% of the world’s population over 60 years old. In the US, 60,000 new cases are diagnosed each year.  It affects several areas of the brain, primarily the substantia nigra, altering balance and movement by affecting dopamine producing cells.

 

substantia nigra

IMAGE FROM THE SCIENCE OF PARKINSON’S DISEASE

 

It was first described in 1817 by James Parkinson as a “shaking palsy.”

What are the Symptoms of Parkinson’s?

Common symptoms of Parkinson’s include:

  • Stiffness and rigidity
  • Poor balance
  • Tremor at rest, especially a pill-rolling tremor
  • Slow movement
  • Inability to move
  • Shuffling steps, gait

and patients may later develop…

  • Depression
  • Anxiety
  • Memory loss
  • Constipation
  • Decrease ability to smell
  • Difficulty swallowing
  • Erectile dysfunction
  • Pneumonia
  • Fractures from falling
  • Hallucinations
  • Delusions
  • Dementia

Who is at Risk for Parkinson’s?

Most cases are idiopathic, meaning the disease arises with no specific cause.  However some cases are genetic and multiple genes have been identified that are associated with the disease.

The average age of onset is 60, but some cases may occur as “early onset”, before the age of 50, and if before the age of 20, it is known as juvenile-onset Parkinson’s.

Men appear to be more affected than women at twice the rate.

Risk may be enhanced with a history of head trauma.

Exposure to herbicides and pesticides has been linked to an increase risk of Parkinson’s as well.

 

How Quickly do Parkinson’s Symptoms Progress?

Average progression rates can last years to decades, however, earlier onset disease may manifest much quicker.

The stages of Parkinson’s are illustrated below:

What-Are-the-Stages-of-Parkinson_s-Disease

How is Parkinson’s treated?

Although there is no cure for Parkinson’s, symptoms can be treated by a variety of measures.

  • Levadopa – converts to dopamine in the brain, helping replace the deficient hormone.
  • Carbidopa (Sinemet) – if given with levadopa prevents the latter from being broken down before it reaches the brain.
  • Dopamine agonists – mimic dopamine
  • MAO-B inhibitors – helps block the enzyme MAO-B, which breaks down natural dopamine
  • Other medications including COMT inhibitors, amantadine and anticholinergics
  • Medications to treat anxiety and depression
  • Deep brain stimulation – a surgeon implants electrodes into the brain, allowing stimulation of parts that help regulate movement.
  • Stem cell therapy – being investigated as a means to create dopamine-producing cells
  • Physical and occupational therapy

 

Famous People Diagnosed with Parkinson’s

  • Michael J. Fox
  • Janet Reno
  • Robin Williams
  • Muhammad Ali
  • Casey Kasem
  • Johnny Cash
  • Linda Ronstadt
  • Pope John Paul II
  • Peanut’s creator Charles Schulz
  • Rev. Jesse Jackson
  • Neil Diamond

It’s been postulated Adolf Hitler suffered from Parkinson’s as well.

 

spanish book

Learning Medical Spanish is Easy!!!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in children, Entertainment, Health, news, smart devices, Social Media, video games

Most Parents Are Concerned With Their Child’s Gaming Habits

A poll from C.S. Mott Children’s Hospital found 86% of parents feel kids spend too much time gaming.

They report the following:

Among parents who say their teen plays video games every day, 54% reported extended gaming of 3 or more hours each day, compared to only 13% of teens that do not play every day; 13% of these parents believe their teen spends more time gaming than other teens, while 78% believe their teen’s gaming is less than or about the same as other teens. One in five parents (21%) say their teen does not play video games at all.
Most parents agree or strongly agree (86%) that teens spend too much time playing video games. Parents try a variety of strategies to limit the amount of time their teen spends gaming including sometimes or frequently encouraging other activities (75%), setting time limits (54%), providing incentives to limit gaming (23%) and hiding gaming equipment (14%).
Overall, parents say gaming sometimes or frequently gets in the way of other aspects of their teen’s life such as family activities/interactions (46%), sleep (44%), homework (34%), friendship with non-gaming peers (33%) and extracurricular activities (31%). Parents whose teen plays every day are more likely to report that gaming has a negative effect on their teen’s mood compared to those who play less frequently (42% vs. 23%).
Although many parents (71%) believe video games can be good for teens, some (44%) try to restrict the type/content of the games they play. Parents of teens 13-15 years, compared to teens 16-18 years, are more likely to use rating systems to make sure games are appropriate (43% vs. 18%), encourage their teen to play with friends in person and not online (25% vs. 18%) and not allow gaming in their teen’s bedroom (28% vs. 14%).

The Helicopter Theory

Many parents may have inadvertently fueled their child’s gaming habits as if their child is in their home playing a video game, they are not away and getting into mischief….a “helicoptering” if you will…..

Parents fear drug use, unsafe sex practices, DUIs, abductions with their teens and so gaming at home while socializing online seems safer and may not be discouraged in a household.

But it’s not “safe” as predators lurk online and hours of gaming can lead to obesity, blood clots, sleep disorders, and depression.

 

Gaming Disorder Now Considered “Mental Illness”

Those who find themselves playing video games for hours on end may end up with a mental health diagnosis.  The World Health Organization suggested adding “gaming disorder” to its list of disease classifications.

But do those World of Warcraft, Call of Duty, Fortnite, and Candy Crush fans need to seek professional help immediately?  Well to qualify as having a “gaming disorder”, the WHO suggests the following guidelines:

  • The compulsive pattern of behavior has to exist for at least 12 months.
  • The behavior affects one’s personal life, occupation or health negatively.
  • Once the behavior negatively affects one’s life, the behavior continues or escalates.

They write: impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.

They continue:  The inclusion of gaming disorder in ICD-11 follows the development of treatment programs for people with health conditions identical to those characteristic of gaming disorder in many parts of the world, and will result in the increased attention of health professionals to the risks of development of this disorder and, accordingly, to relevant prevention and treatment measures.

Why are we getting addicted?

Video games act on the pleasure centers of the brain, just as alcohol, opiates and chocolate do.  We get “rewarded” by certain behaviors, giving us confidence and ego boots that we don’t get in the real world.  We begin to prefer to be alone with our controller than outside being written up by a supervisor, or turned down by a potential date.  Colors, sounds, awards, level advancement is psychologically addicting.

How to treat a gaming disorder

Many times gaming disorders are accompanied by other internet addictions such as porn and online shopping.  The following are treatment options used to curb one’s compulsive gaming behavior:

  • Limit screen time to one hour a day
  • Screen time holidays, or only use screen time for academic, work purposes
  • Play old school games with the kids such as Chess, Monopoly, or Dungeons and Dragons
  • Encourage family and friend outings such as camping, hiking, and cool projects
  • Visits to the library to use encyclopedias rather than going to Google (avoiding online ads that could tempt one to continue playing/shopping)
  • Cognitive/behavioral therapy
  • Medications, such as Zoloft, that treat OCD.
  • Treatment of the underlying disorder…depression, anxiety, loneliness, etc.

___________________________________

Some play but some blay….

Blaying is when one continues to play a level of a game despite being bored and disliking it.

Researchers estimate over 420 million people are addicted to the internet.  Smartphone addiction is rising exponentially as well.  These addictions many times involve gaming.  Hours are spent playing online games and levels within these games many times require multiple attempts.  If the level is not mastered, one is “stuck” on the level, but continues to play it in hopes the next level will be “better”.  This is all too time consuming.

Those of you who play Candy Crush know exactly what “blaying is”.  For example, you get stuck on level 2124 and can’t advance until you master that level.  But you hate it.  You keep losing and are really bored with the level.  But everyday you return to blayin the hopes that your luck will change and you can advance to a new level.  Eventually that level gets tiresome and you must blay your way through that one.

maxresdefault.jpg

Another example:  Advancing to a new World of Warcraft level can be so tempting that one blays for weeks until they finally complete all the quests necessary to advance.

Remember “Around the World” in basketball.  One shoots from  different markers on the court and can’t advance until they make a basket.  But some of us get stuck forever on level 3, and cringe everytime we miss.  But we continue to blay until someone wins or has the chutzpah to say “This is boring!”.

But the psychology behind it is fascinating in that rather than having a quitting mentality, the gamer drudges on.  But why go through such boredom and anguish?  If we can get to the psychological root of blaying, maybe we could be a step closer to fighting internet addiction.

______________________________________

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is a Board Certified Family Physician

Posted in Beauty, dating, disease, fashion, Health, news, sex

Women Are Digging the Beard….But Only If It’s Clean

Beards are in and ladies will like…..unless they think its dirty and full of “lice.”

A study from the University of Queensland and University of Sterling interviewed 919 heterosexual women and found that they preferred the more masculine looking face (narrow eyes, prominent brow, cut jawline) including a beard, unless they had a personal eversion to ectoparasites such as lice and fleas.  This eversion to critters made them less attracted to a beard.

However those who were less concerned with critters but more concerned with bacteria and viruses, preferred the beard.  Ironic, but in nature hair, such as those in one’s nose, protects one against infectious disease, so instinct may be kicking in.

A Man’s Beard Found to Be Dirtier Than Dog Fur

For those of us who find beards sexy, this study might sway us a tad.

A recent study published in European Radiology found human hair to be dirtier than a dog’s.

Study authors looked at 18 men and 30 dogs and compared the bacterial load in CFUs (colony forming units) from both beards and dog fur.  Then they examined MRI scanners used for both dogs and humans and compared the bacterial load to those only used for humans.

The results were:

OUR STUDY SHOWS A SIGNIFICANTLY HIGHER BACTERIAL LOAD IN SPECIMENS TAKEN FROM MEN’S BEARDS COMPARED WITH DOGS’ FUR (P = 0.036). ALL OF THE MEN (18/18) SHOWED HIGH MICROBIAL COUNTS, WHEREAS ONLY 23/30 DOGS HAD HIGH MICROBIAL COUNTS AND 7 DOGS MODERATE MICROBIAL COUNTS. FURTHERMORE, HUMAN-PATHOGENIC MICROORGANISMS WERE MORE FREQUENTLY FOUND IN HUMAN BEARDS (7/18) THAN IN DOG FUR (4/30), ALTHOUGH THIS DIFFERENCE DID NOT REACH STATISTICAL SIGNIFICANCE (P = 0.074). MORE MICROBES WERE FOUND IN HUMAN ORAL CAVITIES THAN IN DOG ORAL CAVITIES (P < 0.001). AFTER MRI OF DOGS, ROUTINE SCANNER DISINFECTION WAS UNDERTAKEN AND THE CFU FOUND IN SPECIMENS ISOLATED FROM THE MRI SCANNING TABLE AND RECEIVER COILS SHOWED SIGNIFICANTLY LOWER BACTERIA COUNT COMPARED WITH “HUMAN” MRI SCANNERS (P < 0.05).
Hence bearded men harbor “significantly higher burden of microbes and more human-pathogenic strains than dogs.”

Last year, researchers out of Manchester University found 47% of beards tested contained fecal matter that contained deadly pathogens.

This study was also coauthored by Fragrance Direct, and found despite cleaning habits of study participants, enterococcus was found on 47% of beards swabbed and cultured.

Enterococcus is a bacteria commonly found in the colon and feces and has over 17 types, the most common being E. faecalis and E. faecium. These may cause infections in the urinary tract, abdomen, pelvis, wound and even blood (sepsis).

 

enterococcus-faecalis-bacteria-br-image-credit-janice-haney-carr-cdc-pete-wardell-br.png

This study followed one done in 2015 by Quest Diagnostics in New Mexico, in which a microbiologist swabbed beards and grew out cultures finding bacteria that commonly colonize our colon.

Bacteria like to hide on the skin but need cover, and beard hair offers a nice warm, moist shelter.  Oral sex increases one’s chance of being “contaminated” with pelvic and rectal bacteria.

A spokesman for Fragrance Direct states, “Caring for your beard is essential for its health, helping it stay fresh to keep the bacteria at bay.  Everyone knows to shampoo their hair, but beards need some attention too. Men should use beard shampoo when they shower, along with conditioner afterwards.”

So the next time you run your fingers through a man’s beard, sanitize them afterwards….

 

IMG_1781

The Baby Boomer’s Guide to Online Dating

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Beauty, Health, medications, news, sex

Testosterone Therapy: New Guidelines Released

Millions of men take testosterone supplements each year in the U.S.  Low testosterone, or “Low T”, can manifest in a variety of symptoms including:

  • fatigue
  • erectile dysfunction
  • depression
  • lack of sex drive
  • muscle loss
  • loss of strength
  • decrease muscle strength
  • loss of fertility
  • osteoporosis (decrease bone mass)
  • and may contribute to many other issues.

 

testosterone

The most popular forms of testosterone are injections and gels. Pill forms are available but are not as effective.

Testosterone slowly decreases with age at a rate of 1.6 % per year beginning in one’s 30’s. A man with significant testosterone loss, however could  signify a more serious health issue such as diabetes.  So many physicians don’t hesitate when it comes to supplementing this vital hormone.

However, its not without its risks.   Risks of testosterone therapy include:

  • Increasing risk of prostate size
  • risk of prostate cancer
  • polycythemia (increase red blood cell levels)
  • mood issues
  • sleep apnea
  • acne
  • and multiple studies have found it increases risk of heart attacks and stroke.

 

This week the American College of Physicians released new guidelines on testosterone replacement.

They suggest to only use testosterone therapy when treating sexual dysfunction but not for the other aforementioned conditions as the evidence is not supportive.

Recommendation 1a:

ACP suggests that clinicians discuss whether to initiate testosterone treatment in men with age-related low testosterone with sexual dysfunction who want to improve sexual function (conditional recommendation; low-certainty evidence). The discussion should include the potential benefits, harms, costs, and patient’s preferences.

Recommendation 1b:

ACP suggests that clinicians should reevaluate symptoms within 12 months and periodically thereafter. Clinicians should discontinue testosterone treatment in men with age-related low testosterone with sexual dysfunction in whom there is no improvement in sexual function (conditional recommendation; low-certainty evidence).

Recommendation 1c:

ACP suggests that clinicians consider intramuscular rather than transdermal formulations when initiating testosterone treatment to improve sexual function in men with age-related low testosterone, as costs are considerably lower for the intramuscular formulation and clinical effectiveness and harms are similar.

Recommendation 2:

ACP suggests that clinicians not initiate testosterone treatment in men with age-related low testosterone to improve energy, vitality, physical function, or cognition (conditional recommendation; low-certainty evidence).

They also prefer intramuscular forms over transdermal preparations due to cost.

Testosterone therapy linked to blood clots

In 2016 researchers found a 63% increase risk of blood clots within the first 6 months of testosterone therapy.  These are deadly as they increase risk of heart disease, stroke, pulmonary embolism and organ damage.  They form in veins, deep veins, and thus have an obstructed path to reach vital organs and prevent blood flow.  This is not the first time venous thromboembolism (VTE) has been linked to testosterone therapy. Back in 2014 the FDA recommended warning labels on testosterone products.

According to researchers at Icahn School of Medicine at Mount Sinai in New York City state the overall risk is still low, one case per 1000 men a year, but could be of huge concern for those at risk of blood clots.  Lead researcher, Dr.Carlos Martinez, states, “Risk peaks rapidly in the first six months of treatment and lasts for about nine months, and fades gradually thereafter.” So a promising finding is the risk falls as time passes since therapy.

  • Risk factors for VTE include:
  • genetic predisposition
  • prior blood clots
  • cancer
  • prolonged immobility (long flights, hospitalization stays)
  • pregnancy (women)
  • smoking
  • and of course risk increases with age.

Study author Dr. Mark Creager states, “My advice is to review the patient’s underlying risk factors for VTE, and weigh that risk against the potential benefit of testosterone therapy,” Creager said. “These individuals should at least be made aware of the fact that their risk would be even higher with testosterone.”

This study was published online 11/30/2016 in the BMJ (British Medical Journal)

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is a Board Certified Family Physician

Posted in Health, news

Cervical Cancer Awareness: The Simple Scoop on Pap Smears…..

Let’s face it… Pap Smears aren’t fun.  The only test to sample tissue for cervical cancer just happens to be one of the most embarrassing and awkward.  But it can be one of the most life saving and simple.  So what is it and how does it work?  Here’s your questions answered.

 

What is the cervix and what is cervical cancer?

The uterus looks similar to a light bulb.  The larger top portion being where the fetus develops, and the bottom, narrower area, the cervix.  The cervix thins and dilates during childbirth, as you’ve heard in the movies “she’s only 7 cm!” and then after childbirth becomes narrow again.  It affects nearly 13,000 and kills 4,100 women each year, rising each year.  It can affect women of any age but is more common between 20 and 50 years of age.

 

375x321_cervix

http://www.webmd.com/women

 

What causes cervical cancer?

The most common cause is HPV (Human Papillomavirus), especially HPV-16 and HPV-18.

cervical cancer.jpg

Image from WebMD

This is acquired through unprotected sex, so condom use is encouraged. Thus its one of the most preventable causes of cancer.  Additionally, there are 3 vaccines for HPV currently approved by the FDA, Gardasil, Gardasil 9, and Cervarix.

 

What are the symptoms of cervical cancer?

Early cervical cancer may not be symptomatic but as it develops it may cause any of the following:

  • vaginal odor
  • discharge
  • pain with urination
  • pain with sexual intercourse
  • generalized pelvic pain
  • bleeding. This bleeding may occur after sex, a pelvic exam, or intermittent bleeding not associated with a menstrual cycle.

 

Is cervical cancer treatable?

Yes.  Early detection is key and can be done by a Pap Smear, explained below.  Multiple treatments are available including surgery, chemotherapy,  radiation therapy, and targeted therapy such as Bevacizumab (Avastin®which prevents new blood vessel growth that can feed a tumor.

 

Who should get screened for Cervical Cancer?

The USPSTF (United States Preventive Services Task Force) recommends the following:

Screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years or, for women age 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years.

 

What is a Pap Smear?

It is the cytology (cell analysis) of the cervix.  Years ago, a cytobrush would collect the cells and the medical provider would “smear” it onto a slide, place fixative, and then send it to the laboratory for the pathologist to analyze it.  Now ThinPrep® Pap tests are used more commonly as the cells from the brush are placed into a container with fixative, and this vial is sent to the pathologist to spin down and analyze.

 

cervical-smear-test-equipment-97358274-575db1493df78c98dc633c53

TEK IMAGE/SPL / Getty Images

 

In order to obtain the cells from the cervix, the medical provider needs to use a speculum to open the vaginal canal and allow access to the uterus.  A woman may be in the lithotomy position…lying on one’s back on the exam table with her feet in stirrups and knees bent. During the speculum exam, the medical provider may take cultures to test for common vaginal infections such as yeast, bacteria vaginosis, or sexually transmitted illnesses such as gonorrhea and chlamydia.  After the speculum exam, the provider may perform a pelvic exam with her gloved hand to examine the uterus and ovaries, evaluating for tenderness, shape, size and masses.

How is an HPV test done?

An HPV test can be done with the cells obtained during the Pap Smear.  The laboratory evaluates the cells to see if the HPV virus that causes cervical cancer is present.

In summary the thousands of deaths that occur each year to cervical cancer can be prevented with simple testing, such as the Pap Smear.  Discuss with your medical provider when cervical cancer screening is best for you.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is Board Certified Family Physician