Thursday, 21 September 2017 17:08

One-third of Americans Have “Bad Teeth”

A study out of the University of Michigan finds 1 in 3 middle-aged Americans suffer poor dental health.

The Institute for Healthcare Policy and Innovation at the University of Michigan, with support from AARP and Michigan Medicine, conducted the University of Michigan National Poll on Healthy Aging poll and found the following:

 

  • 33% of Americans aged 50-64 are embarrassed by the condition of their teeth

  • Close to 40% suffer pain, difficulty eating and missing work due to their teeth

  • 40% do not get regular cleanings or preventative care for their dental health

  • 28% lack dental insurance

  • 51% are concerned they won’t have dental coverage once they turn 65

  • Many of the study participants only went to the dentist once the dental issue was serious

  • 13% are hoping that Medicare or Medicaid will provide their dental coverage, but traditional Medicare doesn’t cover routine dental care and Medicaid dental benefits are rare.

 

The majority of the respondents understand the importance of routine preventative dental care and would seek evaluation earlier if they could.

 

Study author Dr. Preeti Malani, stated, “Even those who were diligent about seeing the dentist and had dental insurance throughout adulthood may find it harder to afford dental care as they get older and coverage options may be more limited.”

 

Other issues that affect one seeking dental care include fear of having a dental procedure and lack of local dental specialists in their city or town.

 

Emphasis needs to be put on ensuring dental care is apart of Medicare or any new healthcare system, and should include children and adults of all ages.

 

Tooth decay and gum disease can be linked to a variety of health issues including cardiovascular risk.

The American Dental Association recommends the following:

 

  • Brushing your teeth with fluoride toothpaste twice a day.

  • Flossing once a day

  • Drinking plenty of water and keeping a healthy diet

  • Replace your toothbrush every 3 months or sooner if frayed or damaged

  • Dental check ups once or twice a year, or more often if needed.

 

 

young-woman-brushing-teeth

 

 

 

The moral, don’t wait till the last minute.  Regular checkups prevent worsening issues, and a dental issue caught early is easier, and less expensive, to treat.

 

For more on this study, see here.

 

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Daliah Wachs is a guest contributor to GCN news.  Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

Published in News & Information
Tuesday, 19 September 2017 17:09

Study: Bald Men ARE Sexy

A recent study reports bald men are found to be more attractive, confident and dominant.

 

For years I’ve been urging listeners and patients to embrace their receding their hairline and shave their heads rather than struggling to maintain their precious locks.  So many men who’ve donned the clean-shaven look have overshadowed their hairy competitors. Just look at Bruce Willis (image above).

 

Now a study out of the University of Pennsylvania confirms that people find bald men more attractive.

 

Researchers asked male and female college students to rate attractiveness, confidence and dominance after viewing pictures of men with hair and then their hair digitally removed.  Although shaving one’s head made the subject appear 4 years older, they were found to be at an advantage in all categories.

 

Maybe it’s because we grew up seeing Mr. Clean with his bald head and ripping muscles make our mom’s giggle when she cleaned the house.  Maybe its because of the myth that balding could signify high testosterone.

What causes baldness?

 

Hair is made in follicles within the skin and grows for about three years until it sheds and new hair grows.  Hair loss (alopecia) occurs when hair follicles shrink and smaller, thinner hairs grow, lasting shorter and shorter times.

 

Genetics play a huge factor, with the most influential genes coming from mother’s X chromosome, which came from her father.  So maternal and paternal genes can both be responsible for baldness.

 

Sex hormones, androgens, can cause male pattern baldness.  Medications (such as anabolic steroids), illness such as low thyroid and diabetes, and cancer can cause hair loss as well.   A recent study found Prostaglandin D2 protein may block hair growth in those who suffer male pattern baldness. It’s believed 80% of men under 70 will have some receding hairline.

 

Although hair offers many protective elements, especially from the sun, male pattern hair loss is not considered dangerous.  And study authors suggest rather than spending time, money and energy on hair loss treatment, embrace the scalp.  It's sexy….

 

Yul-Brynner

 

Yul Brynner, The King and I



 

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Daliah Wachs is a guest contributor to GCN news.  Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information

Media giant, Larry King, reveals he underwent surgery this summer to treat lung cancer.

The 83-year-old veteran broadcaster and TV host said, in an interview with US Weekly, that a routine check up revealed an abnormal chest x-ray that was followed up with a CT scan and later PET scan.  The result was early stage lung cancer.

 

In July, King had a stage I cancerous mass removed at Cedars-Sinai Medical Center in Los Angeles and was back to work within a week.

 

King suffered a heart attack in 1987 and hadn’t smoked since.  Prior to quitting he had been smoking three packs a day.  Since then, he’s been diligent with his annual check-ups stating, “I’ve gone through a lot in life – I’ve had a heart attack and heart surgery. Part of my checkup is the chest X-ray, and that is the protocol.”  King referred to his bypass surgery after his heart attack, managing diabetes, and undergoing radiation treatment for prostate cancer over the years.

 

King suggests the cancer was not a metastasis to the lung but rather a primary lung cancer.  In the US interview, he stated, “the doctor said that tobacco from 30 years ago is still related to this lung cancer.”

 

It’s true. Although lung cancer risk drops dramatically the longer one avoids tobacco products, the resulting tissue damage, injury to one’s immune response, and genetic mutations may persist.  Moreover, lung cancer can occur even in non-smokers.

 

Early lung cancer can be silent.  As it progresses, however, symptoms such as chronic cough, wheeze, blood in sputum, lethargy and weight loss can ensue.

 

But Larry King won’t let this hold him back. He’s currently working on the sixth season of Larry King Now.

 

larry king and I.jpg

Larry King and Dr. Daliah Talkers Los Angeles 2011


 

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LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs is a guest contributor to GCN news.  Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information
Tuesday, 29 August 2017 18:23

Hurricane Harvey: How You Can Help

The Category 4 hurricane that hit southeast Texas Friday evening is expected to cause “widespread devastation” to the area.

 

Torrential downpours are expected to continue as power outages, floods, raging waters, and the potential for tornadoes threaten coastal and inland residents.

 

Hurricane Harvey, although weakening, is expected to hover over the next few days bringing more deadly conditions.

 

After the initial flooding and torrential downpour subside, Hurricane Harvey will put thousands of residents at risk for major health issues.

 

In addition to drowning, falls and other deadly injuries, victims of Harvey may endure the following:

Malnourishment

 

Many of those who did prepare for the storm may not have stored plenty of food, especially healthy fresh food. Those trapped in their homes may find the food they did store contaminated by flood water.

 

Infectious disease

 

The World Health Organization states that floods bring water borne diseases such as cholera, typhoid fever, leptospirosis and Hepatitis A. Vector borne diseases include Zika, malaria, dengue hemorrhagic fever, yellow fever, and West Nile.

 

Mosquitos initially get washed away during the storm, but the resulting puddles of water take weeks to dry and make ideal breeding grounds for insects.

 

The water gets dirty pretty quickly. People touching the flood water need to wash their hands thoroughly before eating or preparing food.

 

Moreover due to the moisture that seeped into walls and floors of houses, mold can grow and cause a variety of respiratory issues among other physical ailments. Massive disinfecting needs to take place before coming home to flood water contaminated residencies.

 

Chemical exposure

 

Chemicals from garages and fuel seeping into flood water expose victims to many compounds such as benzene, toluene and xylene that can cause a multitude of health effects including those that affect breathing, skin, the gut, balance, thought, and memory.

Psychological

 

When one loses their home, neighborhood, income, treasured belongings and more, it’s devastating. Post traumatic stress disorder may ensue.

 

To combat these risks, medical personnel and the CDC are preparing. Among food, shelter and clothes, paper products, sanitizer, cleaning supplies, tetanus vaccinations and counselors will be needed in mass quantities.

How can we help?

 

Blood supplies will be needed as residents who routinely donate have evacuated the area. Donating blood at your local blood bank may be shipped to the area in need.

 

United Blood Services have locations throughout the country that can accept your blood Donation. Contact UBS here.

 

The American Red Cross is accepting donations. On their website, they ask to visit redcross.org, call 1-800-RED CROSS or text the word REDCROSS to 90999 to make a $10 donation.

 

The Salvation Army is also accepting donations online and by calling 1-800-SAL-ARMY (725-2769).

 

The Red Cross and Salvation Army may also need local volunteers to help set up shelters.  Contact the above numbers.

 

Local volunteers are asked to donate supplies to nearby recreation centers housing evacuees.

 

Supply drives in out-of-state locations may not be accepted directly but could help local charities who need to ship supplies to the affected area.



 

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information

22,186 cases of swine flu have been reported in India, with the death toll reaching 1094.  This is a four-fold rise in deaths from last year.

 

The hardest hit areas appear to be Maharashtra with 437 deaths followed by Gujarat with 297 casualties.

What is the Swine Flu?

 

Swine Flu is the H1N1 Influenza A virus.  It originated in pigs before infecting humans. Current swine flu is not contracted from swine but passed between humans.

How deadly is Swine Flu?

 

The 2009 Swine Flu pandemic killed over 12,000 people in the US, and 200,000 people worldwide.  Many who die, do so from viral or bacterial pneumonia, although dehydration can also play a role.

Is the current outbreak in India the same virus that caused the 2009 pandemic?

 

No.  In 2009 the predominant strain of H1N1 was the California strain. This was replaced last year with the Michigan strain.

Do we have a vaccine against the Swine Flu?

 

Yes.  In the US, the trivalent and quadrivalent flu vaccines have included H1N1 since 2010.  These vaccines would include the following strains (according to the CDC):

 

  • an A/California/7/2009 (H1N1)–like virus,

  • an A/Hong Kong/ 4801/2014 (H3N2)–like virus, and

  • a B/Brisbane/60/2008–like virus (Victoria lineage)

with an additional B virus called B/Phuket/3073/2013-like virus (B/Yamagata lineage) for the quadrivalent vaccine.

 

Currently the World Health Organization (WHO) recommends changing the Northern Hemisphere flu vaccine to:

 

  • For H1N1, an A/Michigan/45/2015-like virus

  • For H3N2, an A/Hong Hong/4801/2014-like virus

  • For B, Brisbane/60/2008-like virus (belonging to the Victoria lineage)

with an additional B virus called B/Phuket/3073/2013-like virus (B/Yamagata lineage) for the quadrivalent vaccine.

What are symptoms of the Swine Flu?

Symptoms can include:

 

  • Fever

  • Cough

  • Chills

  • Sore Throat

  • Headache

  • Body Aches

  • Diarrhea

  • Vomiting

 

Who is at risk for Swine Flu?

 

Any child or adult could be at risk for H1N1 infection. However, the 2009 outbreak appeared to predominantly affect younger adults. One theory proposed for why this occurred was older individuals might have been immune having been exposed to the H1N1 during the 1950’s and when it reemerged in the 1970s.  Moreover 40 million Americans were vaccinated against swine flu in the 1970’s.

 

Those, however, at high risk for a severe Swine Flu infection include those who are pregnant, children under 2, asthmatic or other lung conditions, diabetic, immunocompromised (HIV, transplant recipient), sickle-cell, elderly, those in a nursing home, and patients with heart, liver or kidney disease.

How is Swine Flu treated?

 

Many times the H1N1 flu symptoms will last a week and then subside on their own. Some patients will need antivirals such as Tamiflu or Relenza. Any worsening symptoms (persistent fever, vomiting, diarrhea, chest pain, dizziness, confusion, lethargy), should prompt immediate evaluation by one’s medical provider.

How can we avoid Swine Flu?  Do face masks work?

 

swine-story_650_022415095428.jpg

 

 

Prevention of swine flu is best accomplished through vaccination, avoidance of affected individuals and good hand washing. Face masks generally are not recommended, but the CDC provides some guidance with these tables:




            Setting

Persons not at increased risk of severe illness from influenza

(Non-high risk persons)

Persons at increased risk of severe illness from influenza (High-Risk Persons) 3

Community

No 2009 H1N1 in community

Facemask/respirator not recommended

Facemask/respirator not recommended

2009 H1N1 in community: not crowded setting

Facemask/respirator not recommended

Facemask/respirator not recommended

2009 H1N1 in community: crowded setting

Facemask/respirator not recommended

Avoid setting.

If unavoidable, consider facemask or respirator 45

Home

Caregiver to person with influenza-like illness

Facemask/respirator not recommended

Avoid being caregiver. If unavoidable, use facemask or respirator

Other household members in home

Facemask/respirator not recommended

Facemask/respirator not recommended

Occupational (non-health care)

No 2009 H1N1 in community

Facemask/respirator not recommended

Facemask/respirator not recommended

2009 H1N1 in community

Facemask/respirator not recommended but could be considered under certain circumstances

Facemask/respirator not recommended but could be considered under certain circumstances

Occupational (health care)6

Caring 7 for persons with known, probable or suspected 2009 H1N1 or influenza-like illness

Respirator

Consider temporary reassignment. Respirator





  1. The effectiveness of respirators and facemasks in preventing transmission of 2009 H1N1 (or seasonal influenza) in various settings is not known. Use of a facemask or respirator is likely to be of most benefit if used correctly and consistently when exposed to an ill person.  (Ref. a) MacIntyre CR, et al.  EID 2009;15:233-41. b) Cowling BJ, et al. Non-pharmaceutical interventions to prevent household transmission of influenza. The 8th Asia Pacific Congress of Medical Virology, Hong Kong, 26-28 February 2009.)

  2. For the purpose of this document, respirator refers to N95 or any other NIOSH-certified filtering facepiece respirator.

  3. Persons at increased risk of severe illness from influenza (i.e. high-risk persons) include those groups at higher risk for severe illness from seasonal influenza, including:  children younger than 5 years old;  persons aged 65 years or older;  children and adolescents (younger than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection;  pregnant women;  adults and children who have pulmonary, including asthma, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders, such as diabetes; adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV); and, residents of nursing homes and other chronic-care facilities.

  4. The optimal use of respirators requires fit testing, training and medical clearance. Proper use is recommended to maximize effectiveness. The use of facemasks may be considered as an alternative to respirators, although they are not as effective as respirators in preventing inhalation of small particles, which is one potential route of influenza transmission.  There is limited evidence available to suggest that use of a respirator without fit-testing may still provide better protection than a facemask against inhalation of small particles. Respirators are not recommended for children or persons who have facial hair (see FDA websiteExternal Web Site Icon).

  5. Use of N95 respirators or facemasks generally is not recommended for workers in non-healthcare occupational settings for general work activities.  For specific work activities that involve contact with people who have influenza-like illness (ILI) (fever plus at least either cough or sore throat and possibly other symptoms like runny nose, body aches, headaches, chills, fatigue, vomiting and diarrhea), such as escorting a person with ILI, interviewing a person with ILI, providing assistance to an individual with ILI, the following are recommended: a) workers should try to maintain a distance of 6 feet or more from the person with ILI; b) workers should keep their interactions with the ill person as brief as possible; c) the ill person should be asked to follow good cough etiquette and hand hygiene and to wear a facemask, if able, and one is available; d) workers at increased risk of severe illness from influenza infection (see footnote 3) should avoid people with ILI (possibly by temporary reassignment); and, e) where workers cannot avoid close contact with persons with ILI, some workers may choose to wear a facemask or N95 respirator on a voluntary basis  (See footnote 1). When respirators are used on a voluntary basis in an occupational work setting, requirements for voluntary use of respirators in work sites can be found on the OSHA websiteExternal Web Site Icon.

  6. See case definitions of confirmed, probable, and suspected 2009 influenza A (H1N1). Also see infection control in the health care setting. When respiratory protection is required in an occupational setting, respirators must be used in the context of a comprehensive respiratory protection program as required under OSHA’s Respiratory Protection standard (29 CFR 1910.134). This includes fit testing, medical evaluation and training of the worker.

  7. “Caring” includes all activities that bring a worker into proximity to a patient with known, probable, or suspected 2009 H1N1 or ILI, including both providing direct medical care and support activities like delivering a meal tray or cleaning a patient’s room.

 

Setting

Recommendation

Home (when sharing common spaces with other household members)

Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze

Health care settings (when outside of patient room)

Facemask, if tolerable

Non-health care setting

Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze

Breastfeeding

Facemask preferred, if available and tolerable, or tissue to cover cough/sneeze



LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information

The report released Monday revealed the 41 year old pro-golfer had the following in his system when he was found asleep in his car on the side of the road while the lights were on and turning signal was flashing:  Ambien, Xanax, Dilaudid, Vicodin and Delta-9 carboxy THC (tetrahydrocannabinol).

Woods had undergone spinal fusion surgery weeks prior.

Vicodin is a narcotic made of hydrocodone and acetaminophen.  It is used for pain and most commonly prescribed post-operatively.

Dilaudid is hydromorphone, a stronger narcotic.

Xanax is a benzodiazepine used for sedation, relaxation and to lower anxiety.

Ambien is a hypnotic type of sedative used for sleep and works within 15 minutes of ingestion.

Delta-9 carboxy THC (tetrahydrocannabinol) is the psychoactive ingredient in marijuana.

None of these medications are to be used while driving. Additionally none should ever be used in combination. The respiratory depression of one narcotic combined with the sedative effect of the benzodiazepine or hypnotic could cause death.

Woods entered a plea of not guilty to DUI, as alcohol was not involved and a mixture of medications was to blame, but it's been reported a deal was made among prosecutors including a lesser charge of reckless driving and a stint in a “diversion program.”

Last month Woods stated he completed a private intensive program on his own. On Monday he stated, “Recently, I had been trying on my own to treat my back pain and a sleep disorder, including insomnia, but I realize now it was a mistake to do this without medical assistance.”

Polypharmacy, or taking multiple medications at the same time, can increase the risk of serious adverse events if the drugs act synergistically or mask side effects of one another.

Many overdoses occurring with pain pills may not always be a quantity issue with the narcotic but rather a mixture of the narcotic with another medication such as those taken by Tiger Woods.  He was lucky to still be alive when found as were those pedestrians or drivers on the street that evening.

LearnHealthSpanish.com / Medical Spanish made easy.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information

The CDC reports 3.4 million Americans suffer from epilepsy based on their 2015 data.  This number rose from 2.3 million in 2010.  470,000 of these cases are children.

 

According to their website, the CDC reports 1.2% of the population suffers from “active epilepsy.”  Active epilepsy is defined in adults as those having one or more seizures in the past year and requiring medication daily to control them. In children it means they currently have a seizure disorder.

 

The exact explanation for the rise in cases is unclear, however population growth and improved testing has been cited.

 

What is a seizure?

 

A seizure occurs when there is abnormal electrical activity in the brain. If the electricity doesn’t conduct properly, brain function gets disrupted. This could lead to convulsions  (involuntary jerking movements), loss of muscle tone, changes in senses such as vision, hearing and smell, loss of bladder control, loss of consciousness and sometimes stroke, brain damage and death.

 

HGT0066_neurons-seizure-brain_FS.jpg

 

 

Epilepsy and seizures can be caused by a multitude of factors including genetics, brain trauma, tumors, infection, damage during birth, and stroke.

Can cell phones cause seizures?

 

Data has been limited linking seizure activity to cell phone use. However, some studies have found a modest link.

 

In 2016, Kouchaki et al tested mobile phone radiation in mice and concluded “continued and prolonged contact with the mobile phone radiation might increase the risk of seizure attacks and should be limited.”

 

Also in 2016, a study published in Epilepsy and Behavior by Tatum et al found texting to induce a “new type of brain rhythm.”

 

In 2013, Cinar et al examined the effects of electromagnetic waves (EMWs) on humans and suggested the following, “acute exposure to EMW may facilitate epileptic seizures, which may be independent of EMW exposure time. This information might be important for patients with epilepsy. Further studies are needed.”

 

In 2006, Ferreri et al found mobile phone “emissions” to increase human brain excitability, implying this could affect those with epilepsy.

 

More research therefore needs to be done investigating why epilepsy cases are on the rise and if cell phone radiation plays any role.

 

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information
Tuesday, 08 August 2017 16:05

Tuberculosis: Your Questions Answered

Tuberculosis (TB), once called “Consumption”, has been one of the deadliest lung infections in history.  With recent advances death rates have drastically dropped, but currently 1/3 of the world’s population is infected with TB and worldwide it ranks in the top 3 causes of death.

What is Tuberculosis?

 

TB was first discovered in 1882 by Robert Koch. It  is caused by the bacteria, Mycobacterium tuberculosis.  It’s an acid-fast staining bacteria (significant for diagnosis purposes) and it needs oxygen to survive, hence the lungs offer the perfect environment for this pathogen to grow.

How is Tuberculosis passed?

 

TB is passed by aerosol/droplet transmission so when someone coughs, sneezes, or passes respiratory fluid they could transmit TB.  It may also grow on contaminated surfaces.

What are symptoms of Tuberculosis infection?

 

Symptoms may include the following:

  • Coughing > 3 weeks

  • Coughing up blood (hemoptysis)

  • Pain with coughing and/or breathing

  • Weight loss

  • Fatigue

  • Fever

  • Night sweats

  • Chills

  • Loss of appetite

How is Tuberculosis diagnosed?

 

If a patient has any of the above symptoms the first test needed is a Chest X Ray.  The chest x ray may show an effusion (fluid), consolidation (area of the lung obscured with fluid/infection infiltrate), and lymphadenopathy (lymph node swelling). Ghon’s lesions (a necrotic, calcified focus of infection) and a Ghon’s complex (a Ghon’s lesion with lymph node involvement) may be seen as well.

Cultures of the sputum/mucous can be done but they take 4-6 weeks.  Acid-fast staining can be done on the sputum which will give a quicker diagnosis.

Can Tuberculosis spread?

 

Yes. 15-20% of the cases can be extrapulmonary. Meaning “beyond the lung”, one could have extrapulmonary TB, with infections affecting the gastrointestinal tract, genitourinary tract, lymph nodes and lining of the brain.

 

Sometimes TB may disseminate throughout the lungs and body, this is called Miliary TB.  Miliary TB can spread to the above areas as well as heart, brain, and bone.

TB may also become “latent” and reactivate at a later date.

How is Tuberculosis treated?

 

Active TB needs to be treated for 6-9 months. The following medications include:

 

  • Isoniazid (INH)

  • Rifampin (Rifadin, Rimactane) (RIF)

  • Ethambutol (Myambutol) (EMB)

  • Pyrazinamide (PZA)

  • Initially we prescribe a 2 month “intensive phase” treatment of the above four drugs.  Then its followed by a “continuation phase” of only INH and RIF.

  • For latent TB cases we prescribe a 9 month regimen of INH.

  • Health care providers watch for liver toxicity and, especially with INH, vitamin B6 deficiency.

 

Is there a vaccine for Tuberculosis?

 

Yes. The BCG Vaccine was created in the 1920’s and it is the most common vaccine given outside of the US. Due to cost and its lack of efficacy (only 50% effective) it's not given during routine vaccination here in the US. Moreover, it may interfere with PPD skin tests used for screening, as one vaccinated will show a positive result.

How do we screen for Tuberculosis?

 

The Mantoux, purified protein derivative (PPD) skin tests are given subcutaneously in the arm and read 48-72 hours later, looking for a red marking.

 

ppd

mar97table1.gif

 

Two steps are done a week apart to ensure against false negatives.

IGRA – Interferon Gamma Release Assay blood tests, such as QuantiFERON®, can be done and provides results within 24 hours.  It is beginning to replace the PPD test for screening in many healthcare settings.

Who is at risk for acquiring TB?

 

High risk populations include the following:

  • Healthcare workers

  • Prisoners

  • Homeless shelters

  • Nursing homes

  • Alcoholics

  • Chronically debilitated

  • Those with HIV

Where is TB the most common?

 

Countries with the highest TB rates include:

  • India

  • Indonesia

  • China

  • Nigeria

  • South Africa

  • Philippines

  • Pakistan

  • Bangladesh

 

50% of all cases in the US are immigrants coming from any of the above countries.

How does one prevent TB?

 

In addition to vaccination, and treating household/close contacts of those infected with TB, prevention includes the following:

  • Education

  • Homes with good ventilation

  • Avoidance of sick household contacts

  • Avoid close quarters with large amounts of people



LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

Published in News & Information

A study published this week in Lancet Global Health reveals, without increasing access to treatment, the number of cases of blindness will rise from 36 million cases reported in 2015 to 115 million by 2050.

The cause is the growing aging population, even though the actual percentage of the population with visual impairment is declining.

 

Factors leading to blindness may include diabetes, stroke, macular degeneration, retinal detachment, cataracts, glaucoma, and trauma.

 

In addition to these startling numbers of vision loss, moderate to severe visual impairment cases are set to surpass 550 million by 2050.

 

Study author, Rupert Bourne of Anglia Ruskin University, reviewed population based data from over 188 countries and found currently 200 million people suffer from moderate to severe visual impairment.

Bourne states, “Interventions provide some of the largest returns on investment. They are some of the most easily implemented interventions in developing regions.”

 

He continues, “They are cheap, require little infrastructure and countries recover their costs as people enter back into the workforce.”

 

Even minimal visual impairment can prevent those affected from obtaining a driver’s license or performing many activities, resulting in economic hardship.

 

The study authors hope this news could help shape future public health policies as well as encourage more investment into cataract surgeries and access to eyewear.

 

One is deemed “legally blind” when their central visual acuity falls under 20/200 (in the better eye under the best corrected circumstances) or their visual field is 20 degrees or less.

Childhood Vision Impairment

 

According to Prevent Blindness Northern California, 3% of children under 18 in the US are blind or visually impaired, despite maximum correction efforts.

 

In 2015, the American Community Survey (ACS) reported 455,000 children in the US with vision impairment.  Of these, 62,000 are legally blind, according to the 2015 Annual Report from the American Printing House for the Blind (APH).

 

Sadly, not all states have schools for the blind.

 

Leslie Jones, marketing and special events director of Nevada Blind Children’s Foundation (NBCF), tells us, “Nevada is one of a handful of states without a school for the blind, and what resources are available through the Clark County School District are severely limited (there are just 11 Teachers for the Visually Impaired {TVIs} for more than 500 visually-impaired students needing resources from the Vision Services department).”

 

Foundations such as the NBCF try to fill the gap with services these children need.

 

Jones states, “Nevada Blind Children’s Foundation (NBCF) works alongside CCSD to provide additional after-school educational and adapted recreational programs and services to ensure that these underserved children are given what they need to succeed in the classroom and in life.”

 

A child’s development and windows for learning necessitate early intervention.  Programs slow to enroll or lacking funding burdens blind children more as they fall behind in learning and development.  Building schools for the blind, such as in Nevada, will help thousands of children lessen their disability.

 

To help the Nevada Blind Children’s Foundation, please visit: here.

 

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Dr. Daliah Wachs with Children from NBCF – Lady Bug Ball 2017

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Published in News & Information
Wednesday, 02 August 2017 17:29

Eating too FAST makes you FAT

Fast food has become the staple of many American and European diets and we’ve seen obesity rise.  True more people take public or private transportation to work over walking, and many have given up smoking every time they had a hunger itch, but the most popular reason for our waistline increase is fast food. But is it the caloric content of the fast food that’s fueling the obesity epidemic, or the speed at which its ingested?

 

What is Fast Food?

 

According to the Merriam-Webster dictionary, Fast Food is “food that can be prepared and served quickly”.  A burger, shake and fries is considered fast food but so is a take away salad or sandwich.  It’s implied that fast food is a meal that is not made fresh but made previously and preserved such that it can taste fresh when needed to be served.

How Caloric is Fast Food?

 

According to CalorieKing, a McDonald’s Big Mac is 540 calories.  A large order of fries is 510 calories.  So a meal over 1000 calories is obviously not the healthiest choice.

 

But let’s return back to the sandwich alone. While a Big Mac is 540 calories, CalorieKing finds Chick-Fil-A’s Cobb Salad (without dressing) 500 calories.  Bob Evans Restaurant’s Cobb Salad is 516 calories.




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Now on the same site a Tuna Salad Sandwich (5 oz) w. mayo, 3 oz Bread is 679 calories.

So are we becoming obese eating cobb salads and tuna salad for lunch just as one would eat a Big Mac?  We don’t know since people don’t study cobb and tuna salad eating consumers. My guess is no.

 

Are we eating too fast?

 

Yes, and so fast that I believe it could be messing with our metabolism.

 

Think back to caveman days.  We had to chew.  And not on a soft sesame seed bun, but chew our meat.  Nuts and vegetables took a chewing as well.  Food was more scarce so it was savored and meals weren’t on the run while on a subway or at a stop light in one’s car.

 

Previous studies have shown that eating slowly and chewing it multiple times allow the body’s signals to trigger the satiety sensation sooner, hence one would eat less.

So gulping down a burger in 5 bites could be accomplished prior to the brain receiving the signal that it should be satisfied.

 

Now the metabolism issue.  Fast food could contain sugars, fats and preservatives that alter metabolism.  But eating on the run could cause metabolism issues in and of itself.

 

When a body senses that the food source is short-lived, unpredictable, and coming at a speed preventing proper absorption of nutrients, it may slow down metabolism to allow the body to make the most of what it has.  Eating a meal slow and methodical may be the most successful way to not only feel full but to eat less and lose weight.

 

I suggest a study be done looking at two groups of people eating the same food with the same caloric content but differing on the speed at which they eat it.

 

I suggest to you all to take an extra 15 minutes to complete your meal than what you’re accustomed to and determine if you see results after a few weeks.

 

Of course avoiding fast food would be the most beneficial for our weight but if you must eat fast food, eat it slowly.

 

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LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information
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