Friday, April 27, 2012
According to WebMD, herpes simplex viruses -- more commonly known as herpes -- are categorized into two types: herpes type 1 (HSV-1, or oral herpes) and herpes type 2 (HSV-2, or genital herpes). Most commonly, herpes type 1 causes sores around the mouth and lips (sometimes called fever blisters or cold sores). HSV-1 can cause genital herpes, but most cases of genital herpes are caused by herpes type 2. In HSV-2, the infected person may have sores around the genitals or rectum. Although HSV-2 sores may occur in other locations, these sores usually are found below the waist.
Although genital herpes used to almost always be caused by HSV-2 infection, HSV-1 is accounting for an increasing number of cases of genital herpes in developed countries, according to Avert.org. Only around 10-25 percent of people infected with HSV-2 are aware they have genital herpes. This is because genital herpes will often produce mild symptoms or no symptoms at all (asymptomatic infection). As a result, many cases of genital herpes go undiagnosed and frequently people unknowingly pass the virus on to their sexual partners. Genital herpes is passed on through skin contact with a person infected with the virus, most frequently during sexual intercourse. The virus affects the areas where it enters the body. This can occur during:
• vaginal sex
• anal sex
• oral sex (HSV-1 or HSV-2)
• kissing (HSV-1 only)
Herpes is most infectious during the period when itchy sores start to appear on the skin during an outbreak. But even if an outbreak causes no visible symptoms or breaks in the skin, there is still a risk of the virus being passed on to another person through skin contact. If symptoms do occur, they will usually appear 2 to 7 days after exposure and last 2 to 4 weeks. Both men and women may have one or more symptoms, including:
• Itching or tingling sensations in the genital or anal area;
• small fluid-filled blisters that burst leaving small painful sores;
• pain when passing urine over the open sores (especially in women);
• flu-like symptoms, including swollen glands or fever.
Subsequent outbreaks are usually milder and last for a shorter period of time, usually 3 to 5 days. The sores are fewer, smaller, less painful and heal more quickly, and there are no flu-like symptoms. Subsequent outbreaks, or primary outbreaks in people who have had the virus for some time but have previously been asymptomatic, usually occur during periods of stress or illness when the immune system is functioning less efficiently than normal, according to Avert.
Genital herpes, according to the Centers for Disease Control (CDC), is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). Most genital herpes is caused by HSV-2. Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.
Results of a nationally representative study show that genital herpes infection is common in the United States. Nationwide, 16.2%, or about one out of six, people 14 to 49 years of age have genital HSV-2 infection. Over the past decade, the percentage of Americans with genital herpes infection in the U.S. has remained stable. Genital HSV-2 infection is more common in women (approximately one out of five women 14 to 49 years of age) than in men (about one out of nine men 14 to 49 years of age). Transmission from an infected male to his female partner is more likely than from an infected female to her male partner. A significant amount of information about this topic can be found at this site: http://www.cdc.gov/std/herpes/stdfact-herpes.htm
Herpes infections, no matter where they occur first, have a tendency to recur in more or less the same place. Such recurrences may happen often (for example, several times per year) or only occasionally (for example, once or twice a year), according to MedicineNet.com. After infection, the virus enters the nerve cells and travels up the nerve until it comes to a place called a ganglion. There, it lays quietly in a stage that is referred to as "dormant" or "latent." At times, the virus can become active and start replicating again and travel down the nerve to the skin, causing sores and blisters. The exact mechanism behind this is not clear, but it is known that some conditions seem to be associated with recurrences, including
• a fever, a cold, or the flu;
• ultraviolet radiation (exposure to the sun);
• changes in the immune system;
• trauma to the involved area;
• sometimes there is no apparent cause of the recurrence.
Infections caused by HSV are contagious. The virus is spread from person to person by kissing, by close contact with herpetic lesions, or even from contact with apparently normal skin that is shedding the virus. Infected saliva is a common means of virus transmission. People are most contagious when they have active blister-like sores. Once the blisters have dried and crusted over (within a few days), the risk of contagion is significantly lessened. However, a person infected with HSV can pass it on to another person regardless of the presence or absence of symptoms and visible sores or blisters. This is because the virus is sometimes shed in saliva even when sores are not present. Despite popular myth, it is almost impossible to catch herpes (cold sores) from surfaces, towels, or washcloths. Much more detailed info can be found at this site: http://www.medicinenet.com/herpes_simplex_infections_non-genital/article.htm .
There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy for symptomatic herpes can reduce transmission to partners, according to the CDC. The surest way to avoid transmission of sexually transmitted diseases, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Genital ulcer diseases, as per the CDC, can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes. Persons with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV. A positive HSV-2 blood test most likely indicates a genital herpes infection.
According to Merck, during recurrences, antiviral drugs, such as acyclovir, valacyclovir, or famciclovir, may relieve discomfort slightly and help symptoms resolve a day or two sooner. Treatment is most effective if started early, usually within a few hours after symptoms start—preferably at the first sign of tingling or discomfort, before blisters appear. For people who have frequent, painful attacks, the number of outbreaks can be reduced by continuous therapy (suppression) with antiviral drugs. Antiviral drugs are available by prescription only.
Penciclovir cream, applied every 2 hours during waking hours, can shorten the healing time and duration of symptoms of a cold sore by about a day. Nonprescription creams containing docosanol (applied 5 times a day) may provide some relief. Acyclovir, valacyclovir, or famciclovir taken by mouth for a few days may be the most effective treatment. Severe HSV infections, including herpes encephalitis and infections in newborns, are treated with acyclovir given intravenously. If the virus becomes resistant to acyclovir, foscarnet can be given. People with herpes simplex keratitis are usually given trifluridine eye drops. An ophthalmologist should supervise treatment.
For people who have minimal discomfort, the only treatment needed for recurring herpes of the lips or genitals is to keep the infected area clean by gentle washing with soap and water. Applying ice may be soothing and reduce swelling. Applying prescription or nonprescription topical anesthetics, such as tetracaine cream or benzocaine ointment, may help relieve pain. If the mouth contains many sores, the mouth can be rinsed with lidocaine, which should not be swallowed. Topical anesthetics should be used only about once every few hours. If used more often, these drugs can have harmful side effects. Pain relievers may be taken for pain, according to Merck.
Herpes is a medical condition that can be painful and embarrassing. Learning to understand it, treat it, and live with it is something everyone can do who suffers from this health care issue. If you feel that you have symptoms, see your primary care physician for diagnosis. The common sense rules of personal interaction with someone who may have herpes should apply. Be careful, and be smart.
Until next time.
Monday, April 23, 2012
According to SkinCarePhysicians.com, Psoriasis (sore-EYE-ah-sis) is a medical condition that occurs when skin cells grow too quickly. Faulty signals in the immune system cause new skin cells to form in days rather than weeks. The body does not shed these excess skin cells, so the cells pile up on the surface of the skin and lesions form.
The lesions vary in appearance with the type of psoriasis. There are five types of psoriasis: Plaque, guttate, pustular, inverse, and erythrodermic. About 80% of people living with psoriasis have plaque (plak) psoriasis, also called “psoriasis vulgaris.” Plaque psoriasis causes patches of thick, scaly skin that may be white, silvery, or red. Called plaques (plax), these patches can develop anywhere on the skin. The most common areas to find plaques are the elbows, knees, lower back, and scalp.
Psoriasis also can affect the nails. About 50% of people who develop psoriasis see changes in their fingernails and/or toenails. If the nails begin to pull away from the nail bed or develop pitting, ridges, or a yellowish-orange color, this could be a sign of psoriatic arthritis. Without treatment, psoriatic arthritis can progress and become debilitating. It is important to see a dermatologist if nail changes begin or joint pain develops. Early treatment can prevent joint deterioration.
Psoriasis is very common. Anyone can get it, but it most commonly begins between ages 15 and 35, according to the National Institutes for Health (NIH). The following may trigger an attack of psoriasis or make the condition more difficult to treat:
• Bacteria or viral infections, including strep throat and upper respiratory infections
• Dry air or dry skin
• Injury to the skin, including cuts, burns, and insect bites
• Some medicines, including antimalaria drugs, beta-blockers, and lithium
• Too little sunlight
• Too much sunlight (sunburn)
• Too much alcohol
Psoriasis can appear suddenly or slowly. Many times, it goes away and then comes back again and again. Symptoms include:
• Irritated, red, flaky patches of skin
• Most often seen on the elbows, knees, and middle of the body
• Red patches may appear anywhere on the body, including the scalp
The skin may be:
• Dry and covered with silver, flaky skin (scales)
• Pink-red in color (like the color of salmon)
• Raised and thick
Other symptoms may include:
• Genital lesions in males
• Joint pain or aching
• Nail changes, including thick nails, yellow-brown nails, dents in the nail, and nail lifts off from the skin underneath
• Severe dandruff on the scalp
Much more detail can be found at this site: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001470/ .
Treating your psoriasis is critical to good disease management and overall health, according to the National Psoriasis Foundation. Work with your doctor to find a treatment—or treatments—that reduce or eliminate your symptoms. What works for one person with psoriasis might not work for another. So it's important to know the different treatment options and keep trying until you find the right regimen for you. People with psoriasis on less than three percent of their body are considered to have a mild case. Those with three to 10 percent of the body affected by psoriasis are considered a moderate case. More than 10 percent is considered severe. (The surface area of the hand equals about one percent of the skin.) Significant details about this dermatologic condition and treatment can be found at this site: http://www.psoriasis.org/i-have-psoriasis .
In the United States, nearly 7.5 million people have psoriasis and about 150,000 new cases are diagnosed each year, according to SkinCarePhysicians.com. Studies indicate that psoriasis develops about equally in males and females. Research also shows that Caucasians develop psoriasis more frequently than other races. A study conducted in the United States found the prevalence was 2.5% in Caucasians and 1.3% in African Americans. A family history of psoriasis seems to increase the risk of developing psoriasis. It is important to know that a family history of psoriasis does not guarantee that someone will develop psoriasis.
For some people, psoriasis is a nuisance. Others find that psoriasis affects every aspect of their daily life. The unpredictable nature of psoriasis may be the reason. Psoriasis is a chronic (lifelong) medical condition. Some people have frequent flare-ups that occur weekly or monthly. Others have occasional flare-ups. When psoriasis flares, it can cause severe itching and pain. Sometimes the skin cracks and bleeds. When trying to sleep, cracking and bleeding skin can wake a person frequently and cause sleep deprivation. A lack of sleep can make it difficult to focus at school or work. Sometimes a flare-up requires a visit to a dermatologist for additional treatment. Time must be taken from school or work to visit the doctor and get treatment.
These cycles of flare-ups and remissions often lead to feelings of sadness, despair, guilt and anger as well as low self-esteem. Depression is higher in people who have psoriasis than in the general population. Feelings of embarrassment also are common. As psoriasis is a life-long condition, it is important to take an active role in managing it. Learning more about psoriasis, seeing a dermatologist to discuss treatment options, and developing a healthy lifestyle can help people live life to the fullest.
Thanks to ongoing research, there are many treatments for psoriasis. It is important to work with a dermatologist to find treatment that works for you and fits your lifestyle. Every treatment has benefits, drawbacks, and possible side effects, according to the American Academy of Dermatology (AAD). Before you see a dermatologist for treatment, it helps to know about the treatment options. This knowledge will help you work with your dermatologist to create a treatment plan that is right for you.
For helpful tips on managing psoriasis, visit this site: http://www.aad.org/skin-conditions/dermatology-a-to-z/psoriasis/tips/psoriasis-tips-for-managing .
Until next time.
Thursday, April 19, 2012
A health risk assessment (HRA) is a health questionnaire, used to provide individuals with an evaluation of their health risks and quality of life. Commonly a HRA incorporates three key elements – an extended questionnaire, a risk calculation or score, and some form of feedback i.e. face-to-face with a health advisor or an automatic online report. The Centers for Disease Control and Prevention define a HRA as: “a systematic approach to collecting information from individuals that identifies risk factors, provides individualised feedback, and links the person with at least one intervention to promote health, sustain function and/or prevent disease.” There are a range of different HRAs available, however most capture information relating to:
--Demographic characteristics – age, sex.
--Lifestyle – exercise, smoking, alcohol intake, diet.
--Personal and family medical history (in the US, due to the current interpretation of the Genetic Information Non-discrimination Act, questions regarding family medical history are not permitted if there is any incentive attached to taking a HRA).
--Physiological data – weight, height, blood pressure, cholesterol.
--Attitudes and willingness to change behavior in order to improve health.
The main objectives of a HRA are to:
--Assess health status.
--Estimate the level of health risk.
--Inform and provide feedback to participants to motivate behavior change to reduce health risks.
Once an individual completes a HRA, they usually receive a report, detailing their health rating or score, often broken down into specific sub scores and areas such as stress, nutrition and fitness. The report can also provide recommendations on how individuals can reduce their health risks by changing their lifestye, according to the American Journal of Public Health. In addition to individual feedback, HRAs are also used to provide aggregated data reporting for employers and organizations. These reports include demographic data of participants, highlight health risk areas and often include cost projections and savings in terms of increased healthcare, absence and productivity. Organization-level reports can then be used to provide a first step by which organizations can target and monitor appropriate health interventions within their workforce
According to the Mayo Clinic, motivating and sustaining health behavior change is the key to improving population health and productivity and controlling health care costs. A health risk appraisal can lead to health risk reduction. Health behavior research has shown that helping people identify threats to their health facilitates the process of healthy change.
Extensive research, according to the Journal of Occupational and Environmental Medicine, has shown that HRAs can be used effectively to:
--Identify health risk factors.
--Predict health-related costs.
--Measure absenteeism and presenteeism.
--Evaluate the efficacy and return on investment of health promotion strategies.
There is also recent evidence to suggest that taking a HRA alone can have a positive effect on health behavior change and health status. However, it is generally accepted that HRAs are most effective at promoting behavior change when they form part of an integrated, multi-component health promotion program. Applied in this way, the HRA is used primarily as a tool to identify health risks within a population and then target health interventions and behavior change programs to address these areas.
Often, an HRA will show certain health care issues that require more attention by your primary care physician. After completing a health risk assessment, the report that is generated usually makes certain recommendations. Among them, elevated markers indicating more follow up are encouraged with your doctor. The limitations of a HRA are largely related to its usage and it is important to recognize that a HRA highlights health risks but does not diagnose disease and should not replace consultation with a medical or health practitioner.When consulting with your physician or health care provider, be sure to:
• Listen carefully to what your health professional says. Make sure you understand what you are told about any diagnosis or treatment.
• Ask questions. If you don't understand something your health professional says, ask for it to be repeated in a different way.
• Be honest. If your values, beliefs, fears, or concerns may interfere with a treatment that is suggested, talk with your health professional about it. Other treatment options may be available.
• Take an advocate. Have a family member or friend with you during your appointment, if possible. That person can take notes, ask questions to clarify information, and help you remember what your health professional says.
• Ask for instructions. Before leaving your health professional's office, make sure you know what you are supposed to do to care for yourself. Ask for written information or instructions.
Health Risk Assessments are designed to show you where you are, and they can identify particular medical, and behavioral problems, that need more attention to help improve your health and lifestyle. The Wellness Councils of America (WELCOA) outlines 10 key benefits of conducting personal health risk assessments. Health risk assessments:
--Provide employees with a snapshot of their current health status.
--Enable individuals to monitor their health status over time.
--Provide employees with concrete information thus preparing them for lifestyle change.
--Help individuals get involved with health coaching.
--Provide important information concerning employees' readiness to change.
--Help employers measure and monitor population health status.
--Provide employers with important information that can help them build results-oriented health promotion programs.
--Can provide employers with important information on productivity.
--Allow employers to evaluate changes in health behavior and health risks over time.
--Engage both employers and employees in the health management process.
One of the best companies in the HRA market is Trotter Wellness, based in Wisconsin, and the company provides services to companies of all sizes, governments, resellers and individuals throughout the world. Having served thousands of clients and hundreds of thousands of members they have developed systems achieving member participation and satisfaction as well as client renewal rates well into the 90th percentile. These results have been achieved through the Trotter Wellness® system having the highest quality and most cost effective programs and services that resulted from the careful integration and coordination of scientifically crafted or selected components that are delivered using proprietary platforms and protocols. These systems drive high participation and satisfaction with a measureable return on investment for the participant and the client buyer. Trotter Wellness has built a national reputation for having the highest level of client service and satisfaction through their exceptional logistics, communications, health risk assessments, web tools, coaching, results reporting and active one on one relationship management.
Health Risk Assessments complement an overall wellness plan; and for any organization or employer, and for individuals, an HRA is an essential tool to provide a path for improved health and lifestyle choices. If your company is considering implementing a wellness initiative, or as an individual you are concerned about your health risks, get a tool in place through an HRA that can give you the peace of mind about your current health. Take the time to find out where you are, so you can figure out where you need to be and get there.
Until next time.
Monday, April 16, 2012
The infection is spread by contact with droplets from the nose, mouth, or throat of an infected person. Sneezing and coughing can put contaminated droplets into the air. Those who have had an active measles infection or who have been vaccinated against the measles have immunity to the disease. Before widespread vaccination, measles was so common during childhood that most people became sick with the disease by age 20. The number of measles cases dropped over the last several decades to almost none in the U.S. and Canada, according to the US National Library of Medicine. However, rates have started to recently rise again.
Some parents do not let their children get vaccinated because of unfounded fears that the MMR vaccine, which protects against measles, mumps, and rubella, can cause autism. Large studies of thousands of children have found no connection between this vaccine and autism. Not vaccinating children can lead to outbreaks of a measles, mumps, and rubella -- all of which are potentially serious diseases of childhood.
According to KidsHealth.org, while measles is probably best known for its full-body rash, the first symptoms of the infection are usually a hacking cough, runny nose, high fever, and red eyes. A characteristic marker of measles are Koplik's spots, small red spots with blue-white centers that appear inside the mouth. The measles rash typically has a red or reddish brown blotchy appearance, and first usually shows up on the forehead, then spreads downward over the face, neck, and body, then down to the arms and feet.
Measles are highly contagious — 90% of people who haven't been vaccinated for measles will get it if they live in the same household as an infected person. Measles are spread when someone comes in direct contact with infected droplets or when someone with measles sneezes or coughs and spreads virus droplets through the air. A person with measles is contagious from 1 to 2 days before symptoms start until about 4 days after the rash appears.
There are two types of measles, each caused by a different virus, according to eMedicineHealth.com. Although both produce a rash and fever, they are really different diseases:
• The rubeola virus causes "red measles," also known as "hard measles" or just "measles." Although most people recover without problems, rubeola can lead to pneumonia or inflammation of the brain (encephalitis).
• The rubella virus causes "German measles," also known as "three-day measles." This is usually a milder disease than red measles. However, this virus can cause significant birth defects if an infected pregnant woman passes the virus to her unborn child.
If people are immune to the virus (either through vaccination or by having had measles in the past), they cannot get the disease caused by that virus. For example, someone who had rubeola as a child would not be able to get the disease again. Remember that rubella and rubeola are different viruses. An infection with one of these viruses does not protect against infection with the other. Both rubella and rubeola have become so uncommon that patients normally present to their physician for a diagnosis. In general, both children and adults who have fever and a rash should contact their physician. People who have come in contact with an infected person should also be evaluated to see if they need special measures to keep them from getting sick. Normally, measles is not a disease that requires emergency care. Although there is no cure for measles, there are steps that can make the disease more tolerable. These include the following:
• Get plenty of rest.
• Sponge baths with lukewarm water may reduce discomfort due to fever.
• Drink plenty of fluids to help avoid dehydration.
• A humidifier or vaporizer may ease the cough.
• Pain relievers and fever reducers such as acetaminophen (Tylenol, Liquiprin Drops, and other brands) and ibuprofen (Advil, Motrin and other brands) can help with symptoms when used according to directions. Remember never to give aspirin to children or teenagers because it may cause a disease known as Reye syndrome.
Infants are generally protected from measles for 6 months after birth due to immunity passed on from their mothers. Older kids are usually immunized against measles according to state and school health regulations, according to KidsHealth.org. For most children, the measles vaccine is part of the measles-mumps-rubella immunization (MMR) or measles-mumps-rubella-varicella immunization (MMRV) given at 12 to 15 months of age and again at 4 to 6 years of age. Measles vaccine is not usually given to infants younger than 12 months old. But if there's a measles outbreak, the vaccine may be given when a child is 6-11 months old, followed by the usual MMR immunization at 12-15 months and 4-6 years. As with all immunization schedules, there are important exceptions and special circumstances. Your doctor will have the most current information regarding recommendations about the measles immunization. The measles vaccine should not be given to these at-risk groups:
• Pregnant women.
• Children with untreated tuberculosis, leukemia, or other cancers.
• People whose immune systems are suppressed for any reason.
• Kids who have a history of severe allergic reaction to gelatin or to the antibiotic neomycin, as they are at risk for serious reactions.
During a measles outbreak, an injection of measles antibodies called immune globulin can help protect people who have not been immunized (especially those at risk of serious infection, such as pregnant women, infants, or kids with weakened immune systems) if it's given within 6 days of exposure. These antibodies can either prevent measles or make symptoms less severe. For women who are not pregnant and people not in one of the other at-risk groups mentioned above, the measles vaccine may offer some protection if given within 72 hours of measles exposure.
Kids with measles should be closely watched. In some cases, measles can lead to other complications, such as otitis media, croup, diarrhea, pneumonia, and encephalitis (a serious brain infection), which may require antibiotics or hospitalization. In developing countries, vitamin A has been found to decrease complications and death associated with measles infections. In the U.S., vitamin A supplementation should be considered for children between 6 months and 2 years old who are hospitalized with measles and its complications. Also, all kids over 6 months old with certain risk factors — such as vitamin A deficiency, a weakened immune system, or malnutrition — might benefit from vitamin A supplementation. Call the doctor immediately if you suspect that your child has measles. Also, it's important to get medical care following measles exposure, especially if your child:
• is an infant.
• is taking medicines that suppress the immune system.
• has tuberculosis, cancer, or a disease that affects the immune system.
Remember that measles, a once common childhood disease, is preventable through routine childhood immunization.
Because of widespread vaccination of children, both kinds of measles occur much less often than in the past, according to eMedicineHealth.com. Children in the United States routinely receive the measles-mumps-rubella (MMR) vaccine according to a published immunization schedule. This vaccine protects against both red measles and German measles. Vaccination (or written refusal) is required for entry into school. Doctors usually give the first dose of the measles immunization at 12-15 months of age. Doctors give a second dose of the immunization when the child is 4 to 6 years old. Although most children tolerate the vaccine well, a few may develop fever and even a rash from five to 12 days after the immunization. Adult women who get the vaccine may notice short-term aching in their joints. The vaccine is about 95% effective in preventing measles of either type. That means that a small number of people who get the vaccine may still be able to get measles. The vaccine should not be used in people with egg allergies. Rarely, the measles vaccine can cause a measles-like illness. This is most common in people with weak immune systems, such as those with advanced HIV or those on chemotherapy. In such patients, the risk of vaccination should be balanced carefully against the risk of getting measles.
Women who may become pregnant should have a blood test to be sure they are immune to rubella ("German measles").
Measles can be easily prevented, and anyone exposed to the disease should have a follow up visit to their primary care physician if symptoms start to develop. Immunization is the best way to keep measles from being contracted, and stay away from anyone who has the disease. Although usually not fatal, measles can be very uncomfortable for the duration it lasts in your system. Be wise, and be careful.
Until next time.