Some Good News Regarding Breast Cancer
Amongst all the tragic stories dealing with breast cancer, one published last month provided some clarity and perhaps some hope. The Susan G. Komen for the Cure, a foundation dedicated to research and education related to breast cancer, commissioned the study asking what environmental factors affect breast cancer. Here are some of the facts regarding what is known and what is yet to be determined.
Members of the study commission concluded that the following are not responsible for causing breast cancer: hair dyes, microwave ovens, and cell phones. That information may provide some measure of peace of mind for some women.
Then there is another group of environmental exposures, such as pesticides and industrial chemicals, about which too little is currently known to say whether or not they are a risk for breast cancer. Further research is clearly needed.
Then there are the causes about which there is general agreement that they do increase the risk for breast cancer. Postmenopausal hormones containing both estrogen and progestin are a risk. Once this association was recognized a decade ago, the use of these hormones decreased sharply in the U.S. and the incidence of breast cancer began to decline.
A second recognized risk factor for developing breast cancer is “gaining excess weight after menopause.” The report doesn’t specify exactly how much is too much.
A third risk about which there is general agreement is ionizing radiation resulting from overuse of CT (computed tomography) scans. One scientist quoted in the Jan. 4, 2012 issue of JAMA noted that “the amount of ionizing radiation from 3 abdominal CT scans is equivalent to levels that Japanese women were exposed to in the World War II atomic bomb explosions in Hiroshima and Nagasaki.”
The next time your physician or emergency department doctor tells you that you need a CT scan, be sure to question why and ask whether watchful waiting is an option.
Brad Gascoigne, M.D.
Smart Readers Health Column
Passport Health Northern Ohio, Local News
Tuesday, February 7, 2012
Tuesday, January 17, 2012
Machu Pichu, Peru
Christine writes "Great trip - can't recommend it enough! We crossed Salkantay Pass at 15,000+ feet, an alt. record for our hiking. Thanks to Eileen (Passport Health Northern Ohio) for "hooking us up with the good stuff" before we left! One less thing to worry about!"
Friday, January 13, 2012
Travel to India, China, Indonesia in your future? Think Japanese Encephalitis Vaccine!
From the Center for Disease Control recently....
Japanese encephalitis vaccine is recommended for travelers to Asia who:
plan to spend at least a month in areas where JE occurs
are traveling to these areas for less than a month but plan to visit rural areas or engage in outdoor activities.
go to areas where there is a JE outbreak or are not sure of their travel plans.
Laboratory workers at risk for exposure to JE virus should also get JE vaccine.
JE vaccine is approved only for people 17 years of age and older. Younger people needing protection from Japanese encaphalitis should talk with their doctor.
The vaccine is given as a 2-dose series, with the doses spaced 28 days apart. The second dose should be given at least 1 week before travel.
A booster dose of JE vaccine may be given to anyone who was vaccinated more than one year ago and is still at risk of exposure, or might be re-exposed. Your doctor can give more information.
See; CDC / Japanese encephalitis vaccine
Japanese encephalitis vaccine is recommended for travelers to Asia who:
plan to spend at least a month in areas where JE occurs
are traveling to these areas for less than a month but plan to visit rural areas or engage in outdoor activities.
go to areas where there is a JE outbreak or are not sure of their travel plans.
Laboratory workers at risk for exposure to JE virus should also get JE vaccine.
JE vaccine is approved only for people 17 years of age and older. Younger people needing protection from Japanese encaphalitis should talk with their doctor.
The vaccine is given as a 2-dose series, with the doses spaced 28 days apart. The second dose should be given at least 1 week before travel.
A booster dose of JE vaccine may be given to anyone who was vaccinated more than one year ago and is still at risk of exposure, or might be re-exposed. Your doctor can give more information.
See; CDC / Japanese encephalitis vaccine
Tuesday, January 10, 2012
Why Hepatitis B vaccine highly recommended for those with diabetes
Hepatitis B Vaccine Recommended for Diabetics
As you’re probably aware, more and more Americans are being diagnosed with diabetes. The reasons include more obesity, less physical exercise, and genetics.
You’re probably also aware of hepatitis B, a potentially serious and sometimes fatal infection of the liver caused by hepatitis B virus. We don’t usually think of diabetes and hepatitis as being related, but there is an increased risk of becoming infected with hepatitis B if you’re a diabetic. The risk is present whether one has type 1 or type 2 diabetes.
Since the early 1990s newborns and infants in the United States have routinely been vaccinated against hepatitis B, so most children and teenagers in the U.S. are now protected against this infection. Most adults are not.
This past fall the influential ACIP (Advisory Committee on Immunization Practices) recommended that all previously unvaccinated adult diabetics from 19 through 59 years of age be vaccinated with the hepatitis B vaccine “as soon as possible after a diagnosis of diabetes is made.” The recommendation was given an “A” category rating, its highest endorsement, based on the strength of the data. In late December 2011 the CDC (Centers for Disease Control and Prevention) published this recommendation in its weekly report.
For those who like figures, here are the benefits according to the CDC if 10% of unvaccinated adult diabetics in the U.S. got vaccinated against hepatitis B: 4271 fewer hepatitis B infections, 467 fewer hospitalizations, 33 cases of liver cancer prevented, 13 liver transplants avoided, and 130 fewer deaths. And that’s if only 10% of those eligible got vaccinated.
For diabetics 60 and older, the evidence supporting vaccination isn’t as strong. Part of the reason has to do with immune response in seniors. The younger one is when vaccinated, the better the vaccine works. (I wouldn’t be surprised if that recommendation were to change to a full endorsement of hepatitis B vaccination for seniors with diabetes in the not-too-distant future.)
For now, the vaccine is strongly “recommended” for adult diabetics 19-59 which means that your health insurance will likely cover its cost for you if you’re in this category. Millions of American adults are.
Brad Gascoigne, M.D.
Smart Readers Health Column
As you’re probably aware, more and more Americans are being diagnosed with diabetes. The reasons include more obesity, less physical exercise, and genetics.
You’re probably also aware of hepatitis B, a potentially serious and sometimes fatal infection of the liver caused by hepatitis B virus. We don’t usually think of diabetes and hepatitis as being related, but there is an increased risk of becoming infected with hepatitis B if you’re a diabetic. The risk is present whether one has type 1 or type 2 diabetes.
Since the early 1990s newborns and infants in the United States have routinely been vaccinated against hepatitis B, so most children and teenagers in the U.S. are now protected against this infection. Most adults are not.
This past fall the influential ACIP (Advisory Committee on Immunization Practices) recommended that all previously unvaccinated adult diabetics from 19 through 59 years of age be vaccinated with the hepatitis B vaccine “as soon as possible after a diagnosis of diabetes is made.” The recommendation was given an “A” category rating, its highest endorsement, based on the strength of the data. In late December 2011 the CDC (Centers for Disease Control and Prevention) published this recommendation in its weekly report.
For those who like figures, here are the benefits according to the CDC if 10% of unvaccinated adult diabetics in the U.S. got vaccinated against hepatitis B: 4271 fewer hepatitis B infections, 467 fewer hospitalizations, 33 cases of liver cancer prevented, 13 liver transplants avoided, and 130 fewer deaths. And that’s if only 10% of those eligible got vaccinated.
For diabetics 60 and older, the evidence supporting vaccination isn’t as strong. Part of the reason has to do with immune response in seniors. The younger one is when vaccinated, the better the vaccine works. (I wouldn’t be surprised if that recommendation were to change to a full endorsement of hepatitis B vaccination for seniors with diabetes in the not-too-distant future.)
For now, the vaccine is strongly “recommended” for adult diabetics 19-59 which means that your health insurance will likely cover its cost for you if you’re in this category. Millions of American adults are.
Brad Gascoigne, M.D.
Smart Readers Health Column
Tuesday, December 20, 2011
Yellow Fever spreads in Brazil...get your vaccine before travel.
CDC / Yellow Fever in Brazil
Center for Disease Control and Prevention: update December 19, 2011
Current Situation
Yellow fever is a risk for travelers to most areas of Brazil, except coastal regions. During 2009, an outbreak of yellow fever, including a number of deaths, occurred in parts of southeastern Brazil that had not been affected by yellow fever for many years.
In response, the Brazil Ministry of Health has gradually expanded the list of municipalities for which yellow fever vaccination is recommended in the four southeastern states of São Paulo, Paraná, Santa Catarina, and Rio Grande do Sul
.
Globally, yellow fever occurs in sub-Saharan Africa and tropical South America and is spread to people through the bite of infected mosquitoes. Symptoms can include sudden onset of fever, chills, headache, backache, nausea, and vomiting.
Yellow Fever Risk Areas in Brazil
Currently, Brazil and CDC recommend yellow fever vaccination for travelers to the following states:
All areas of Acre, Amapá, Amazonas, Distrito Federal (including the capital city of Brasília), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia, Roraima, and Tocantins.
Other designated areas of the following states: Bahia, Paraná, Piauí, Rio Grande do Sul, Santa Catarina, and São Paulo. Vaccination is also recommended for travelers visiting Iguassu Falls.
Source: CDC / Yellow Fever in Brazil, update
Center for Disease Control and Prevention: update December 19, 2011
Current Situation
Yellow fever is a risk for travelers to most areas of Brazil, except coastal regions. During 2009, an outbreak of yellow fever, including a number of deaths, occurred in parts of southeastern Brazil that had not been affected by yellow fever for many years.
In response, the Brazil Ministry of Health has gradually expanded the list of municipalities for which yellow fever vaccination is recommended in the four southeastern states of São Paulo, Paraná, Santa Catarina, and Rio Grande do Sul
.
Globally, yellow fever occurs in sub-Saharan Africa and tropical South America and is spread to people through the bite of infected mosquitoes. Symptoms can include sudden onset of fever, chills, headache, backache, nausea, and vomiting.
Yellow Fever Risk Areas in Brazil
Currently, Brazil and CDC recommend yellow fever vaccination for travelers to the following states:
All areas of Acre, Amapá, Amazonas, Distrito Federal (including the capital city of Brasília), Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Rondônia, Roraima, and Tocantins.
Other designated areas of the following states: Bahia, Paraná, Piauí, Rio Grande do Sul, Santa Catarina, and São Paulo. Vaccination is also recommended for travelers visiting Iguassu Falls.
Source: CDC / Yellow Fever in Brazil, update
Tuesday, December 6, 2011
A Doctor's Vaccine Christmas Wish List
Christmas Wish List
Wouldn’t it be wonderful if we had a vaccine to prevent tooth cavities? That possibility isn’t as far-fetched as you might think. For cavities to occur, they need sugar, plaque and bacteria, and the bacteria responsible for cavities in humans are lactobacillus and a type of streptococcus. I checked this week with three of my favorite dentists to confirm that there has been a lot of effort expended towards developing a vaccine that would protect us from ever getting cavities.
How about a vaccine against acne? The germ responsible for pimples and scars is propionibacterium acnes. It’s a bacteria against which we have antibiotics such as tetracycline and erythromycin. A vaccine which prevented acne would be welcome news for the complexions of millions of teenagers and young adults.
Here are a few others on my wish list. We currently have great vaccines against hepatitis A and hepatitis B. Whoever invents a vaccine against hepatitis C will be a rich man or woman.
Some day we’ll likely have a herpes vaccine. It’s a bit complicated, however, because there’s genital herpes and oral herpes and a few other cousins. A herpes vaccine might not help the more than 80 million Americans already infected with this virus, but it would be a boon for those in the future.
In many parts of the world, malaria is an everyday threat. An effective malaria vaccine could prevent an estimated 300-500 million infections per year.
It’s been more than twenty years since AIDS was first recognized as a new disease and HIV was identified as the virus responsible. Many thought that we would have a vaccine against HIV by the mid-1990s. Unfortunately, this virus has proven to be exceedingly resistant thus far to researchers’ efforts to come up with a safe and effective vaccine.
Lastly, MRSA (methicillin-resistant staphylococcus aureus) is a miserable bacteria that’s responsible for pneumonia and bloodstream infections, both in hospitals and in our communities. My Dad died as a result of an overwhelming staph infection, so I’ve always had a healthy respect for this particular bacteria. Selfishly, a vaccine against staph is at the top of my list.
Brad Gascoigne, M.D.
Smart Readers Health Column
Wouldn’t it be wonderful if we had a vaccine to prevent tooth cavities? That possibility isn’t as far-fetched as you might think. For cavities to occur, they need sugar, plaque and bacteria, and the bacteria responsible for cavities in humans are lactobacillus and a type of streptococcus. I checked this week with three of my favorite dentists to confirm that there has been a lot of effort expended towards developing a vaccine that would protect us from ever getting cavities.
How about a vaccine against acne? The germ responsible for pimples and scars is propionibacterium acnes. It’s a bacteria against which we have antibiotics such as tetracycline and erythromycin. A vaccine which prevented acne would be welcome news for the complexions of millions of teenagers and young adults.
Here are a few others on my wish list. We currently have great vaccines against hepatitis A and hepatitis B. Whoever invents a vaccine against hepatitis C will be a rich man or woman.
Some day we’ll likely have a herpes vaccine. It’s a bit complicated, however, because there’s genital herpes and oral herpes and a few other cousins. A herpes vaccine might not help the more than 80 million Americans already infected with this virus, but it would be a boon for those in the future.
In many parts of the world, malaria is an everyday threat. An effective malaria vaccine could prevent an estimated 300-500 million infections per year.
It’s been more than twenty years since AIDS was first recognized as a new disease and HIV was identified as the virus responsible. Many thought that we would have a vaccine against HIV by the mid-1990s. Unfortunately, this virus has proven to be exceedingly resistant thus far to researchers’ efforts to come up with a safe and effective vaccine.
Lastly, MRSA (methicillin-resistant staphylococcus aureus) is a miserable bacteria that’s responsible for pneumonia and bloodstream infections, both in hospitals and in our communities. My Dad died as a result of an overwhelming staph infection, so I’ve always had a healthy respect for this particular bacteria. Selfishly, a vaccine against staph is at the top of my list.
Brad Gascoigne, M.D.
Smart Readers Health Column
Saturday, November 19, 2011
Better Hearing and Speech Month
May is “Better Hearing and Speech Month,” and in the fall we have “National Protect Your Hearing Month.” Both of these designations help remind us that good hearing is
not something we should take for granted.
The American Audiology Association (www.audiology.com) provides a helpful chart of levels of noise. Faint noises, like leaves rustling, are in the 20 decibel (dB) range. At the other end of the spectrum are “Painful & Dangerous” noises, e.g. fireworks and jackhammers, in the 130-140 dB range. Here’s a more complete listing:
20 dB leaves rustling
30 dB whispers
40 dB quiet library
50 dB moderate rainfall
60 dB normal conversation
70 dB traffic, vacuums
80 dB alarm clocks
90 dB lawnmowers, power tools, hair dryers
100 dB snowmobiles, MP3 players at full volume
110 dB concerts, car horns, sporting events
120 dB jet planes during take off
130 dB jackhammers, ambulances
140 dB fireworks, gun shots, custom car stereos at full volume
A large study released last summer reported that the prevalence of hearing loss in adolescents in the U.S. has increased in recent years. However, as the list above suggests, it’s not just teenagers who are being exposed to a myriad of loud noises.
Exposure to any noise over 85 decibels for a period of 30 minutes or longer is considered dangerous and can result in permanent hearing loss. Noise at 120 dB and above can damage one’s hearing in 30 seconds or less.
I recently asked Dr. Gail Murray, Director of Audiology Services at University Hospitals Case Medical Center in Cleveland, for her advice. She said that she had ear plugs form- fitted for her ears and that she carries them with her to use when she finds herself exposed to unavoidable loud noise.
What have you done lately to protect your hearing?
Brad Gascoigne, M.D.
Smart Readers Health Column
not something we should take for granted.
The American Audiology Association (www.audiology.com) provides a helpful chart of levels of noise. Faint noises, like leaves rustling, are in the 20 decibel (dB) range. At the other end of the spectrum are “Painful & Dangerous” noises, e.g. fireworks and jackhammers, in the 130-140 dB range. Here’s a more complete listing:
20 dB leaves rustling
30 dB whispers
40 dB quiet library
50 dB moderate rainfall
60 dB normal conversation
70 dB traffic, vacuums
80 dB alarm clocks
90 dB lawnmowers, power tools, hair dryers
100 dB snowmobiles, MP3 players at full volume
110 dB concerts, car horns, sporting events
120 dB jet planes during take off
130 dB jackhammers, ambulances
140 dB fireworks, gun shots, custom car stereos at full volume
A large study released last summer reported that the prevalence of hearing loss in adolescents in the U.S. has increased in recent years. However, as the list above suggests, it’s not just teenagers who are being exposed to a myriad of loud noises.
Exposure to any noise over 85 decibels for a period of 30 minutes or longer is considered dangerous and can result in permanent hearing loss. Noise at 120 dB and above can damage one’s hearing in 30 seconds or less.
I recently asked Dr. Gail Murray, Director of Audiology Services at University Hospitals Case Medical Center in Cleveland, for her advice. She said that she had ear plugs form- fitted for her ears and that she carries them with her to use when she finds herself exposed to unavoidable loud noise.
What have you done lately to protect your hearing?
Brad Gascoigne, M.D.
Smart Readers Health Column
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