Hey you teens and twenty somethings! This is test....of the emergency Ladydid system...run, do not walk to your nearest....doctor's office? Ok ok. HPV: human papillomavirus. I'm sure everyone's seen about a bajillion of those Gardasil commercials by now with the little girls jumping rope, right? Well, I've decided that this blog might be a good way for me to do some much needed research. I myself, despite being a female in the appropriate age bracket for this vaccine, don't actually know much about it. Currently, I am not vaccinated. And, as I'm soon going to find out, this may need to be remedied. Onward, research, tally ho!
So, for starters, let's begin with the virus itself, before discussing the vaccine. There are over 100 different strains of HPV, affecting between 20 and 24 million people in the US alone. Estimates say about 5.5 million people contract the virus each year; about half of all women by age 50 have been infected at least once. Now please, don't scream yet. Most strains of HPV aren't too problematic. It's still a sexually transmitted disease, so in general, it's not pleasant. Warts are the most common symptom of HPV strains, and can occur on various parts of the body, including: the genitals, tongue, larynx, soft palate, tonsils, face, neck, elbows, wrists, knees, and hands. There are different types of warts; for a better idea of the type of warts, visit here. HPV strains 6 and 11 often produce external genital warts, while strains 16 and 18 do not cause visible warts. In the latter two strains, the warts are internal, occuring on the cervix or anus, and are only visible with a colposcope. Strains clear up on their own 90% of the time before two years. If the individual has a compromised immune system, treatment may be required to clear up the infection. For external warts, cryotherapy (freezing), laser removal, or surgery may be required. Scars might form. Various chemicals may also be used (requiring frequent application), but are generally less effective, and take longer. These include: trichloroacetic acid, imiquimod, and podophyllin toxin. I am not saying these methods are ineffective-they just aren't as consistent. Individuals with compromised immune systems may continue to have outbreaks of genital warts from the virus.
Now, for the vaccine. Gardasil is produced by Merck, and is touted to prevent infection from strains 6, 11, 16 and 18. The first two strains cause almost 90% of genital wart outbreaks, while strains 16 and 18 are responsible for about 70% of cervical cancer cases. Gardasil is approved for women between the ages of 9 and 26, according to Merck's website. They are not encouraging young girls to have sex-they are simply providing possible immunity to the more common strains of HPV. The vaccine works best on young women, although it's not currently clear if there's a resistance to HPV built up as women age. Females who haven't yet had sex are the best candidates, since they are more likely to receive full immunity from those four types of HPV. If the individual has already been in contact with a particular strain, the vaccine cannot help. Currently, no tests have been performed to determine if the vaccine would be beneficial for males as well. People can be born with HPV. There is currently no way of determining which strains have been contracted if the infection (warts or other signs) has already cleared up. Latex condoms may help prevent some strains of HPV from being contracted, but it's not a guarantee. HPV is contracted through skin to skin contact (be it oral, anal, or vaginal sex). The vaccine does not prevent all forms of cervical cancer, and is not a treatment for HPV-it's merely a prevention for four strains.
So, should you get it? Should I get it? Really it comes down to personal choice. There hasn't been any major long term study performed, since the drug is brand spankin' new. Pregnant females should NOT receive the vaccine. I can't tell you to have your child vaccinated. I would suggest you talk to your daughter, and get her to talk to you about it. Sex should not be a taboo topic. Talk to your doctor. Weigh your options. Would you rather take the chance of contracting one of the two potentially cancer causing forms of HPV the vaccine can protect you from (if you haven't already had it), or would you rather risk some possible unknown side effect sometime down the line? Would you rather talk to your daughter about sex now, when it's embarrassing and she might be "too young", or would you rather take the chance that she'll have sex and contract a nasty strain that could have been prevented? Oh, and if you have a yeast allergy, do NOT get the vaccine. That would be bad.
On an aside, I was unable to find any data discussing the number of HPV strain 16 and 18 outbreaks that did not result in cervical cancer during life. I'm curious just how many people have these strains and don't develop cervical cancer from them. It'd be cool if someday we can determine which strains people have contracted, and compare that to the number of cancer cases caused by the strains.
Showing posts with label disease. Show all posts
Showing posts with label disease. Show all posts
Thursday, June 25, 2009
Wednesday, June 10, 2009
Clinical Diagnosis of the month: sarcoidosis!
I just realized I'm falling a bit behind on these suckers. It seems to be more of an "every other month" deal. Ah well.
If you happen to be a big House MD fan, sarcoidosis is not a new term to you. In most episodes, it is either mentioned or a possible evaluation, although I can't recall if any patient has ever actually HAD sarcoidosis. Sarcoidosis is an inflammatory disease that can affect just about anything in your body. In short, your body's immune system goes into overdrive, eventually damaging the tissues where the inflammation occurs. The most notable symptoms are granulomas-small red spots, similar to a rash. These can be found on the organs themselves, or in some cases, on the skin-legs especially. If the granulomas congregate too frequently on an organ, they can inhibit its function. Many cases of sarcoidosis involve lymph nodes and lung tissues, but can also include eyes, skin, liver, kidneys, heart, muscles, and brain (if it's a part of your body, it can be affected).
The cause is unknown, although some scientists believe there are genetic risk factors. General symptoms include: fever, fatigue, weight loss, malaise, and night sweats. If the lungs are the affected tissue, a cough often develops, without dissipating. Shortness of breath and chest pain may also be felt. The lungs are involved in about 90% of cases. If the lymph nodes are affected, swelling is seen. Anybody noticing a lousy trend here?
Sarcoidosis sounds a lot like most diseases. The symptoms are nonspecific, and sound a lot like many common ailments. Diagnosis is extremely difficult. Various tests can be used, but it often takes a while for the proper diagnosis. Physical exams, blood tests, chest x-rays, pulmonary function tests, fiberoptic bronchoscopy, CT scans, MRI's, and PET's are some of the more common methods employed to elucidate a diagnosis.
In some cases, no treatment is offered-it's expected that the disease with wax and wan over time. If the symptoms are bad enough, corticosteroids (prednisone, cortisone, prednisolone), anti-malaria meds (hydroxychloroquine), or immunosuppressants (methotrexate, cyclophosphamide, mycophenolate mofetil, azathioprine) may be administered.
For more information, check out Stop Sarcoidosis, or the National Heart Lung and Blood Institute.
If you happen to be a big House MD fan, sarcoidosis is not a new term to you. In most episodes, it is either mentioned or a possible evaluation, although I can't recall if any patient has ever actually HAD sarcoidosis. Sarcoidosis is an inflammatory disease that can affect just about anything in your body. In short, your body's immune system goes into overdrive, eventually damaging the tissues where the inflammation occurs. The most notable symptoms are granulomas-small red spots, similar to a rash. These can be found on the organs themselves, or in some cases, on the skin-legs especially. If the granulomas congregate too frequently on an organ, they can inhibit its function. Many cases of sarcoidosis involve lymph nodes and lung tissues, but can also include eyes, skin, liver, kidneys, heart, muscles, and brain (if it's a part of your body, it can be affected).
The cause is unknown, although some scientists believe there are genetic risk factors. General symptoms include: fever, fatigue, weight loss, malaise, and night sweats. If the lungs are the affected tissue, a cough often develops, without dissipating. Shortness of breath and chest pain may also be felt. The lungs are involved in about 90% of cases. If the lymph nodes are affected, swelling is seen. Anybody noticing a lousy trend here?
Sarcoidosis sounds a lot like most diseases. The symptoms are nonspecific, and sound a lot like many common ailments. Diagnosis is extremely difficult. Various tests can be used, but it often takes a while for the proper diagnosis. Physical exams, blood tests, chest x-rays, pulmonary function tests, fiberoptic bronchoscopy, CT scans, MRI's, and PET's are some of the more common methods employed to elucidate a diagnosis.
In some cases, no treatment is offered-it's expected that the disease with wax and wan over time. If the symptoms are bad enough, corticosteroids (prednisone, cortisone, prednisolone), anti-malaria meds (hydroxychloroquine), or immunosuppressants (methotrexate, cyclophosphamide, mycophenolate mofetil, azathioprine) may be administered.
For more information, check out Stop Sarcoidosis, or the National Heart Lung and Blood Institute.
Wednesday, April 15, 2009
Clinical Diagnosis of the Month: treatment of kidney stones
The photo to the left shows a potential kidney stone as it might travel through the body.
While visiting your doctor/hospital, urine and blood tests will be run as well, to get a better idea of why your body formed the stones. However, these tests are rarely conclusive.
If the stone is too large to pass, extracorporeal shock wave lithotripsy may be used; this process uses shock waves to pulverize the tiny, dense stone. The fragments are then relatively easily passed through the body. Percutaneous necrolithotomy is another method that can be used; a small incision is made in the back, tunnelling straight to the kidney housing the stone. A necroscope is then used to extract the stone. If the stone is huge, ultrasonic or hydraulic energy may be used to fragment the stone first, before extraction. If the stone becomes lodged in the ureter and not the kidney, another method may be used: uteroscopic stone removal. This final method uses a fiberoptic uteroscope to locate the stone (think catheter shoved past the bladder into the ureter), then implements a cage-like device to remove it. Again, sonication may be used to break the stone.
Once that pesky stone has been handled (either naturally removed or doctor-removed), most treatments involve pain medication, antibiotics if there was an infection, and a possible change in diet. Individuals with oxalate-containing stones may want to decrease the amount of spinach, beets, chocolate, peanuts, and other oxalate-rich foods they ingest. Individuals with calcium-containing stones need not avoid milk, cheese and yogurt. Salt can leech calcium, so decreasing sodium and other salt intakes, while increasing water, are other beneficial ways to hopefully prevent future stones from forming. Unfortunately, it is unclear if changes in diets decrease kidney stone frequency or prevalance.
Just remember-this too shall pass. :)
Clinical Diagnosis of the Month
I know, I know, I've been neglecting my little blog project. So, to spruce things up, I've decided....to add....Cinical Diagnosis of the Month! ...::::(golf claps)::::.... Now, by no means am I a doctor (at least not yet, and not of the medical/human variety). So please, don't take everything I say as absolutely perfect. I do think I do a decent job of researching these things, but there's a lot of info, and it's not always easily understood or characterized. So, we'll start slightly simple.
KIDNEY STONES. Got a sharp, stabbing, radiating pain in your lower back, maybe towards one side or the other? Does it ebb and flow? Change in urination? Change in color (brown/red/pink instead of clear/yellow)? Fever, chills, vomiting, diarrhea, nausea, these are all possible symptoms of kidney stones. There are other symptoms, but for the most part, these are the most frequent ones felt by sufferers of this poorly understood phenomenon.
Frequency of kidney stones in the US has been increasing since the 1970's, from roughly 4% of the population suffering from these friendly little rocks, to now a bit over 5%. The stones are not ingested; the human body creates them. Individuals with a family history of stones (uric acid included) are at a higher risk, as are people who've had them before. If you've had a stone in the past, you're about 7 times more likely than the average bloke to get another one. Fun.
Most often, the stone will be passed on its own. Many stones are passed every year without anyone knowing. Small ones cause little to no problems. However, if you happen to have a pointy or large stone, problems are more likely. As the stone migrates from the kidney to the ureter, down to the bladder, and out through the urethra, the tissues of these various organs and vessels may become inflamed, many times leading to UTI's. Pain is most often felt as the stone leaves the kidney, resulting in low back pain, and possible bladder/groin pain as the stone leaves the bladder.
If you think you have a kidney stone, please contact your physician. If it's intense pain that isn't abating, or you can't wait for an appointment, go to the emergency room. Most likely a CT scan or x-ray will be taken to determine the size and location of the stone. If it is too large to be passed naturally, various techniques may be used to pulverize that stupid pain-inducing rock.
KIDNEY STONES. Got a sharp, stabbing, radiating pain in your lower back, maybe towards one side or the other? Does it ebb and flow? Change in urination? Change in color (brown/red/pink instead of clear/yellow)? Fever, chills, vomiting, diarrhea, nausea, these are all possible symptoms of kidney stones. There are other symptoms, but for the most part, these are the most frequent ones felt by sufferers of this poorly understood phenomenon.
Frequency of kidney stones in the US has been increasing since the 1970's, from roughly 4% of the population suffering from these friendly little rocks, to now a bit over 5%. The stones are not ingested; the human body creates them. Individuals with a family history of stones (uric acid included) are at a higher risk, as are people who've had them before. If you've had a stone in the past, you're about 7 times more likely than the average bloke to get another one. Fun.
Most often, the stone will be passed on its own. Many stones are passed every year without anyone knowing. Small ones cause little to no problems. However, if you happen to have a pointy or large stone, problems are more likely. As the stone migrates from the kidney to the ureter, down to the bladder, and out through the urethra, the tissues of these various organs and vessels may become inflamed, many times leading to UTI's. Pain is most often felt as the stone leaves the kidney, resulting in low back pain, and possible bladder/groin pain as the stone leaves the bladder.
If you think you have a kidney stone, please contact your physician. If it's intense pain that isn't abating, or you can't wait for an appointment, go to the emergency room. Most likely a CT scan or x-ray will be taken to determine the size and location of the stone. If it is too large to be passed naturally, various techniques may be used to pulverize that stupid pain-inducing rock.
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