Will At Home Testing Improve Screening and Lower Cancer Rates?

Mailing colorectal cancer screening tests to patients insured by Medicaid increased screening rates for this population, report researchers at the University of North Carolina Comprehensive Cancer Center.

In collaboration with the Mecklenburg County Health Department in Charlotte, researchers with UNC Lineberger’s Carolina Cancer Screening Initiative examined the impact of targeted outreach to more than 2,100 people insured by Medicaid who were not up-to-date with colorectal cancer screening. The project resulted in a nearly 9 percentage point percent increase in screening rates for patients who received a screening kit in the mail compared with patients who just received a reminder, and it demonstrated that their method could serve as a model to improve screening on a larger scale. The findings were published in the journal Cancer.

The American Cancer Society estimates that more than 97,000 people will be diagnosed with colorectal cancer in the United States this year, and it will result in approximately 50,600 deaths. It is third most common type of cancer in the United States, and the second leading cause of cancer death.  Cancer, overall, is the second killer in the US, behind heart disease.

While colorectal cancer screening has proven effective in reducing cancer deaths, researchers report too few people are getting screened. Current guidelines from ACS recommend regular screening with either a high-sensitivity stool-based test or a structural (visual) exam for average-risk people aged 45 years and older, and that all positive results should be followed with colonoscopy.

Despite these recommendation, studies have identified notable gaps in screening rates, including by race, geographic region and other socioeconomic factors. Among patients who are insured, people with Medicaid have the lowest rates of colorectal cancer testing.

“There has been a national push to increase colorectal cancer screening rates since colorectal cancer is a preventable disease, but screening rates are only about 63 percent, and low-income, and otherwise vulnerable populations, tend to be screened at even lower rates,” said the study’s first author UNC Lineberger’s Alison Brenner, Ph.D., MPH, research assistant professor in the UNC School of Medicine Department of Internal Medicine.

For the project, researchers either mailed reminders about colorectal cancer screening and instructions on how to arrange one with the health department, or reminders plus a fecal immunochemical test, or FIT kit, which can detect blood in the stool—a symptom of colon cancer. The patient completes the test at home and returns it to a provider for analysis. Patients who have a positive FIT kit result will be scheduled for a colonoscopy.

The UNC Lineberger researchers worked with the Mecklenburg County Health Department staff, who coordinated the reminders and mailings and ran the test analyses. They also partnered with Medicaid care coordinators to provide patient navigation support to patients who had abnormal test results and required a colonoscopy.

Twenty-one percent of patients who received FIT kits in the mail completed the screening test, compared with 12 percent of patients who just received a reminder. Eighteen people who completed FIT tests had abnormal results, and 15 of those people were eligible for a colonoscopy. Of the 10 who completed the colonoscopy, one patient had an abnormal result.

“Preventive care amongst vulnerable populations rarely rises to the top of the mental queue of things that need to get done,” Brenner said. “In North Carolina, many Medicaid recipients are on disability. Making something like colorectal cancer screening as simple and seamless as possible is really important. If it’s right in front of someone, it’s more likely to get done, even if there are simple barriers in place.”

Brenner said the study shows the potential to harness resources like the county health department for health prevention services.

“This collaborative and pragmatic quality improvement effort demonstrates the feasibility, acceptability, and efficiency of using existing health services resources and infrastructure, including Medicaid-based navigation to colonoscopy to deliver timely cancer screening services to low income populations,” said UNC Lineberger’s Stephanie Wheeler, Ph.D., MPH, associate professor in the UNC Gillings School of Global Public Health and the study’s senior author.

She said researchers plan to move forward to study whether they can implement their approach on a larger scale, and to understand all of the cost implications.

“This is looking at expanding the medical neighborhood—to harness community resources to target patients and in this case, insured patients, who are maybe not getting this from a primary health care organization, and how to increase screening rates in these types of vulnerable populations,” Brenner said.


If you are looking for a doctor to discuss the need for colon cancer screening or your results, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Source:  originally printed, “By sending tests in the mail, researchers boost colorectal cancer screening.”  July 14, 2018 , UNC Lineberger Comprehensive Cancer Center

More information: Alison T. Brenner et al, Comparative effectiveness of mailed reminders with and without fecal immunochemical tests for Medicaid beneficiaries at a large county health department: A randomized controlled trial, Cancer (2018).  DOI: 10.1002/cncr.31566

Provided by: UNC Lineberger Comprehensive Cancer Center

July is Sarcoma Awareness Month – Raise Awareness for this “Forgotten Cancer”

If you see yellow ribbons around your community during the month of July, it may mean something different than the usual “Support Our Troops” many think of when first sighted. Instead, they could be displayed in honor of Sarcoma Awareness Month, observed each July.

Sarcoma is a soft-tissue cancer that may occur in a variety of the body’s soft tissues, including the nerves, muscles, joints, blood vessels, fat and more. Sarcoma may also occur in the bones.  Although rare in adults, making up just ONE percent of adult cancers, sarcoma is relatively common in children, accounting for fifteen percent of childhood cancer cases.  Bone and joint cancer is most frequently diagnosed among teenagers, while soft tissue cancers typically affect those 55 years or older.

Sarcoma is most often found in the arms and legs, where the majority of connective tissues are located, but it can occur virtually anywhere. Because the disease often starts deep in the body, it may not be noticeable until a large lump or bump appears — and at this point the cancer may be difficult to treat.

The Sarcoma Foundation of America (SFA) estimates that about 20 percent of sarcoma cases are curable by surgery while another 30 percent may be effectively treated with surgery, chemotherapy and/or radiation. However, in about half of cases, the disease is resistant to all form of treatments, highlighting an urgent need for new therapies.

Soft tissue sarcomas form in cartilage, fat, muscle, blood vessels, tendons, nerves, and around joints. Osteosarcomas develop in bone; liposarcomas form in fat; rhabdomyosarcomas form in muscle; and Ewing sarcomas form in bone and soft tissue.

In 2018, over 13,000 cases of soft tissue sarcoma and 3,400 cases of bone sarcomas are expected to be diagnosed in the United States, according to data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER). Approximately 5,100 and 1,590 people are expected to die from soft tissue and bone sarcomas, respectively. The five-year survival rate for soft tissue sarcomas is 50 percent, while the survival rate is 66 percent for bone sarcomas.

Because sarcomas are difficult to distinguish from other cancers when they are found within organs, their incidence is probably underestimated, according to the National Cancer Institute.

 Fast facts on sarcoma

  • There are over 50 types of soft tissue sarcoma.
  • Symptoms may not be apparent; often, the only sign of sarcoma is a lump.
  • Pain may occur depending on where the tumor is located, or if it presses on nearby nerves.
  • Treatment, as for other forms of cancer, can include surgery, radiation therapy, and chemotherapy.

Symptoms of soft tissue sarcoma

People with soft tissue sarcomas often have no symptoms. There may be no signs until the lump grows to a large size and can be felt; however, even this may go unnoticed. The main symptoms are:

  • Pain – the most obvious symptom. Once the tumor affects local tissues, nerves, or muscles, it can be felt as pain in the general area.
  • Inflammation – the tumor grows and eventually affects the area with inflammation and swelling.
  • Location specific symptoms – inability to move limbs properly (if the sarcoma is on the arms or legs for example) and other impairments depending on the location.

Specific symptoms may reflect the particular type of sarcoma. For instance, tumors in the gastrointestinal system may bleed, so these sarcomas might produce symptoms like blood in the stool, or a stool that has a black, tarry appearance.

Types of sarcoma

Types of soft tissue sarcoma are defined by the specific tissue or location affected; they include:

  • Undifferentiated pleomorphic sarcoma – previously known as malignant fibrous histiocytoma – this tumor is most often found in the arms or legs but sometimes at the back of the abdomen.
  • Gastrointestinal stromal tumor (GIST) – this affects specialized neuromuscular cells of the gut.
  • Liposarcoma – sarcoma of fat tissue.
  • Leiomyosarcoma – affects smooth muscle in organ walls.
  • Synovial sarcomas – these are usually found around a joint in the arms or legs.
  • Malignant peripheral nerve sheath tumor – also known as neurofibrosarcoma, it affects the protective lining of the nerves.
  • Rhabdomyosarcoma – this forms in muscle and is a childhood cancer. While rare overall, it is a relatively common tumor in children.
  • Angiosarcomas – these develop in the cells of the blood or lymph vessels.
  • Fibrosarcomas – sarcomas that usually form in the limbs or on the trunk, forming from fibroblasts, the most common cell type in connective tissue.
  • Kaposi’s sarcoma – a sarcoma that affects the skin and is caused by a virus. The most common form of Kaposi’s sarcoma is related to AIDS.  Kaposi’s tumors often produce distinctive skin lesions but also affect other soft tissues.  Kaposi’s sarcoma is caused by the human herpesvirus 8.
  • Further examples – these include dermatofibrosarcoma protuberans, a skin lesion; epithelioid sarcoma, which often affects young adults’ hands or feet; myxoma, which affects older adults, usually in the arms and legs; mesenchymomas, which are rare and combine elements of other sarcomas and can be found in any part of the body; vascular sarcomas, containing many blood vessels; and malignant neurilemmoma (also known as schwannoma).  Sarcoma of the bone includes osteosarcoma, Ewing sarcoma, and chondrosarcoma.

Causes of sarcoma

The causes behind sarcoma are unknown, but there are some known risk factors. In adults, for instance, exposure to phenoxy acetic acid in herbicides or chlorophenols in wood preservatives may increase the risk. High doses of radiation are also known to cause sarcomas in some people, as are certain rare genetic alterations. The following inherited diseases are also associated with an increase sarcoma risk, according to SFA:

  • Li-Fraumeni syndrome, which is associated with alterations in the p53 gene
  • Von Recklinghausen’s disease (neurofibromatosis), which is associated with alterations in the NF1 gene

Having certain inherited disorders can increase the risk for other soft tissue sarcomas, including retinoblastoma, tuberous sclerosis, Werner syndrome, and nevoid basal cell carcinoma syndrome. Other risk factors for soft tissue sarcoma include past treatment with radiation therapy for certain cancers; exposure to certain chemicals, such as thorium dioxide, vinyl chloride, or arsenic; and long-term lymphedema in the arms or legs.

Past treatment with radiation can increase the risk of osteosarcoma and other types of bone cancers. Other risk factors for osteosarcoma include treatment with anticancer drugs called alkylating agents, having a certain change in the retinoblastoma gene, and having certain conditions including Paget disease, Diamond-Blackfan anemia, and Werner syndrome.

Tests and diagnosis of sarcoma

After understanding a patient’s medical history and completing a medical examination, medical imaging scans will help to inform a diagnosis, which will need to be confirmed through laboratory analysis of a tumor sample.

The following physical features should prompt a doctor to investigate:

  1. larger than 2 inches in diameter or growing in size
  2. fixed, immovable, or deep
  3. painful
  4. return of tumor previously removed

Medical imaging helps to locate, characterize, and give further information about a tumor to guide diagnosis. It may also be used to gauge the success of treatment or to look for spread of cancer.

Imaging techniques include X-rays, CT scan (computed tomography), MRI(magnetic resonance imaging), ultrasound, and PET (positron emission tomography).

Treatments for soft tissue sarcoma

The following treatment options can be used for sarcomas:

  • Surgery – the most common sarcoma treatment. It aims to remove the tumor and even some of the normal surrounding tissue. A biopsy sample is often taken at the same time to confirm the exact type of tumor.
  • Radiation therapy – this destroys cancer cells and may be done in addition to surgery, before or after the operation.
  • Chemotherapy – this could also be used in addition to surgery, though less often than radiation therapy.

Some soft tissue sarcomas have other available treatments, such as specific drug treatments, gene-targeted therapies, or biological therapies such as immunotherapy.

Treatment choice and intensity are also guided by the stage and grade of cancer, by the size of the tumor, and extent of any spread.

Prevention of sarcoma

Sarcoma is not typically preventable. Radiation therapy is a risk factor, so reducing exposure to it may be preventive, although a need for radiation therapy usually outweighs any subsequent sarcoma risk.

Observing Sarcoma Awareness Month

Sarcoma is still considered to be the “forgotten cancer.”  Efforts to encourage research and drug development are made more challenging due to a lack of awareness and understanding.  How as a community do we raise funds for vital research if people don’t know that this cancer exists?

Though the Sarcoma Foundation of America works tirelessly every day to raise awareness, during Sarcoma Awareness Month, they aim to further highlight the extraordinary challenges sarcoma patients face and the need for more sarcoma research and better sarcoma therapies.  Please join in efforts and pledge to bring awareness to your community.  Here are a few ways you can help highlight the need for ongoing research on sarcoma:

  • This July, take a moment to share a message via social media or speak with your friends and family about this relatively unknown condition.
  • Join sarcoma patients, survivors and their loved ones for the Steps to Cure Sarcoma.  Every dollar raised will be used to fund research, patient advocacy and education.
  • Take a moment to listen to a Sarcoma Awareness Month Public Service Announcement campaign. Share it online to raise awareness.
  • Get together with others in the sarcoma community and donate today!

Getting Help

Since sarcoma is a rare cancer, many people are unfamiliar with the disease and have not been affected personally. However, many children’s lives have been altered because of this disease, and advances in early detection and treatment could help save lives.

A number of clinical trails are underway for people with sarcoma. If you’ve been recently diagnosed, ask your doctor if a clinical trial, which could give you access to novel treatment options, is right for you.

Trying to find the right doctor to determine if that lump or new pain is something more than just a little annoying is made easy at HealthLynked.  We are the first ever social ecosystem designed to connect physicians and patients in a truly collaborative platform to Improve HealthCare.

Ready to get Lynked?  Sign up for free today and take control of your wellness!

Sources:

Han, MD, Seunggu.  “Sarcoma: Symptoms, types, treatments, and causes.” Medical News Today.  23 May 2017.

Sarcoma Awareness Month

https://www.aacrfoundation.org/Pages/sarcoma_awareness_month.aspx

https://www.gatewaycr.org/gateway-blog/posts/2017/july/july-is-sarcoma-awareness-month-what-is-sarcoma/

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

The Often Misunderstood Diagnosis of Post-Traumatic Stress Disorder

PTSD stands for Post-Traumatic Stress Disorder and is a condition that many veterans and non-veterans alike suffer; PTSD can occur when someone experiences or witnesses a traumatic event. This condition wasn’t always understood properly by the medical or military community, and Department of Defense press releases often point to earlier attempts to identify PTSD symptoms in the wake of service in World War 2, Vietnam, and other conflicts.

PTSD Awareness Day is observed today, Wednesday, June 27, 2018.

The History of PTSD Awareness Day

In 2010, Senator Kent Conrad pushed to get official recognition of PTSD via a “day of awareness” in tribute to a North Dakota National Guard member who took his life following two tours in Iraq.

Staff Sergeant Joe Biel died in 2007 after suffering from PTSD; Biel committed suicide after his return from duty to his home state. SSgt. Biel’s birthday, June 27, was selected as the official PTSD Awareness Day, now observed every year.

How Do People Observe Post-Traumatic Stress Disorder Awareness Day?

Much of what is done to observe PTSD Awareness Day involves encouraging open talk about PTSD, its’ causes, symptoms, and most important of all, getting help for the condition. When today, PTSD is often misunderstood by those lacking firsthand experience with the condition or those who suffer from it. PTSD Awareness Day is designed to help change that.

The Department of Defense publishes circulars, articles, and other materials to help educate and inform military members and their families about the condition. The Department of Veterans Affairs official site has several pages dedicated to PTSD, and when military members retiring or separating from the service fill out VA claim forms for service-connected injuries, illnesses, or disabilities, there is an option to be evaluated for PTSD as a part of the VA claims process.

What Is Post-Traumatic Stress Disorder?

The current American Psychiatric Association’s Diagnostic and Statistical Manual, DSM-IV, says PTSD can develop through a range of exposures to death or injury: direct personal involvement, witnessing it or, if it concerns someone close, just learning about it.  Post-traumatic stress disorder is a form of anxiety that can happen after experiencing or witnessing actual or near death, serious injury, war-related violence, terrorism or sexual violence.  While most people typically connect this disorder to military veterans or refugees, it can happen to anyone.

Almost no other psychiatric diagnosis has generated as much controversy.  The diagnosis is almost four decades old.  PTSD is not a sign of weakness, and people can be affected by PTSD even when they were not directly part of the traumatic event.

The specific nature of the trauma can and does vary greatly. Experts are quick to point out, while combat and combat-related military service can be incredibly challenging, and while witnessing or being a victim of an event that rips the fabric of daily life can be traumatic, not everyone responds the same way. Some may develop symptoms of PTSD, while others may be unaffected.

Post-Traumatic Stress Disorder: How Widespread Is It?

Some sources estimate that as many as 70% of all Americans have experienced a traumatic event sufficient to cause PTSD or PTSD-like symptoms. That does not mean that all 70% of Americans WILL suffer from PTSD. Using these statistics, some 224 million Americans have experienced a traumatic event. Of that number, some 20% will develop PTSD symptoms, roughly 44 million people.

Of that 44 million, an estimated eight percent experience active PTSD symptoms at any one time. An estimated 50% of all mental health patients are also diagnosed with Post-Traumatic Stress Disorder.

PTSD: Often Misunderstood and Misidentified

“Shell shock” and “combat shock” were earlier attempts to define and understand the symptoms of PTSD. Post-traumatic stress disorder was often stigmatized in popular culture after the Vietnam conflict, and many films and television shows featured antagonists or unsympathetic characters suffering from “Vietnam flashbacks” or other issues.

The misunderstanding of PTSD slowly began to change in 1980 when it was recognized as a specific condition with identifiable symptoms. It was then the disorder was listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

This manual is a diagnostic tool for mental health professionals and paraprofessional workers in the healthcare field and is considered a definitive reference. The addition of PTSD to the DSM was a highly significant development.

Today, the symptoms of Post Traumatic Stress Disorder are better understood, treatable, and recognized by the Department of Veterans Affairs as a service-connected condition. PTSD is not exclusive to veterans or currently serving members of the United States military, but a portion of those who serve are definitely at risk for PTSD.

What Are the Symptoms of Post-Traumatic Stress Syndrome?

Some PTSD symptoms may seem vague and non-specific, others are more readily identified specifically as evidence of PTSD. In this context “non-specific” means that the symptoms may be related to other mental health issues and not specifically limited to Post-Traumatic Stress Disorder.

In the same way, more “specific” symptoms may be manifest outside PTSD, but when looking for specific signifiers, these issues are common “red flags” that indicate PTSD may be the cause of the suffering rather than a different condition. This is often circumstantial, and there is no one-size-fits-all diagnosis for the condition.

Suicidal thoughts or self-destructive acts are often a result of PTSD or related symptoms. Anyone experiencing thoughts or urges to self-harm should seek immediate care to prevent the condition from getting worse in the short-term. (See below)

That said, more non-specific symptoms include varying degrees of irritability, depression, and suicidal feelings. More specific problems-especially where veterans and currently serving military members are concerned-include something known as “hypervigilance” or “hyperarousal”.

Other symptoms include repeatedly experiencing the traumatic event(s) in the form of flashbacks, nightmares, persistent memories of the event(s), and intrusive thoughts about the traumatic event(s).

These symptoms vary in intensity depending on the individual and are not ‘standardized”. They may come and go, or they may be persistent over a span of time. Sometimes PTSD sufferers can be high-functioning, other times they may be more debilitated by the condition.

Get Treatment For PTSD

Those who experience symptoms of PTSD or PTSD-like issues should seek help immediately. Department of Veterans Affairs medical facilities, private care providers, counselors, and therapists can all be helpful in establishing an initial care regimen or refer those suffering from PTSD to a qualified care provider.

The Department of Veterans Affairs has more information on help for PTSD on its’ official site including help finding a therapist.

Those experiencing suicidal feelings or self-destructive urges should get help immediately. The Suicide Crisis Hotline (1-800-273-8255) has a specific resource for veterans and the Department of Veterans Affairs offers a Veterans’ Crisis Hotline confidential chat resource.

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Adapted from https://militarybenefits.info/ptsd-awareness-day/

“Doing It My Way, Testing for HIV” | HIV Testing Day 2018

National HIV Testing Day (NHTD) is an annual observance encouraging people of all ages to get tested for HIV and to know their status.  Too many people are unaware they have HIV. At the end of 2014, an estimated 1.1 million persons aged 13 and older were living with HIV infection in the United States, including an estimated 166,000 (15%, or 1 in 7) persons whose infections had not been diagnosed.

Getting tested is the first step to finding out if you have HIV. If you have HIV, getting medical care, taking medicines regularly and changes in behavior help you live a longer, healthier life and will lower the chances of passing HIV on to others.

Testing is the only way for the Americans living with undiagnosed HIV to know their HIV status and get into care. CDC estimates that more than 90% of all new infections could be prevented by proper testing and linking HIV positive persons to care. HIV testing saves lives! It is one of the most powerful tools in the fight against HIV

How do I know if I am at risk to get HIV? 

Knowing your risk can help you make important decisions to prevent exposure to HIV.  Overall, an American has a 1 in 99 chance of being diagnosed with HIV at some point in his or her lifetime. However, the lifetime risk is much greater among some populations. If current diagnosis rates continue the lifetime risk of getting HIV is:

  • 1 in 6 for gay and bisexual men overall
  • 1 in 2 for African American gay and bisexual men
  • 1 in 4 for Hispanic gay and bisexual men
  • 1 in 11 for white gay and bisexual men
  • 1 in 20 for African American men overall
  • 1 in 48 for African American women overall
  • 1 in 23 for women who inject drugs
  • 1 in 36 for men who inject drugs

Your health behaviors also affect your risk. You can get or transmit HIV only through specific activities. HIV is commonly transmitted through anal or vaginal sex without a condom or sharing injection and other drug injection equipment with a person infected with HIV. Substance use can increase the risk of exposure to HIV because alcohol and other drugs can affect your decision to use condoms during sex. To learn more about your HIV risk and ways to reduce these risks, visit: https://wwwn.cdc.gov/hivrisk/

How do HIV, Viral Hepatitis, and STDs relate to each other? 

Persons who have an STD are at least two to five times more likely than uninfected persons to acquire HIV infection if they are exposed to the virus through sexual contact. In addition, if a person who is HIV positive also has an STD, that person is more likely to transmit HIV through sexual contact than other HIV-infected persons.

Hepatitis B virus (HBV) and HIV are bloodborne viruses transmitted primarily through sexual contact and injection drug use. Because of these shared modes of transmission, a high proportion of adults at risk for HIV infection are also at risk for HBV infection. HIV-positive persons who become infected with HBV are at increased risk for developing chronic HBV infection and should be tested. In addition, persons who are co-infected with HIV and HBV can have serious medical complications, including an increased risk for liver-related morbidity and mortality.

Hepatitis C Virus (HCV) is one of the most common causes of chronic liver disease in the United States. For persons who are HIV infected, co-infection with HCV can result in a more rapid occurrence of liver damage and may also impact the course and management of HIV infection.

How do I protect myself and others from HIV, Viral Hepatitis, and STDs? 

HIV Prevention

Your life matters and staying healthy is important. It’s important for you, the people who care about you, and your community that you know your HIV status.  Knowing give you powerful information to help take steps to keep you and others healthy. You should get tested for HIV, and encourage others to get tested too.

For people who are sexually active, there are more tools available today to prevent HIV than ever before. The list below provides a number of ways you can lower your chances of getting HIV. The more of these actions you take, the safer you can be.

  • Get tested and treated for other STDs and encourage your partners to do the same.All adults and adolescents from ages 13-64 should be tested at least once for HIV, and high-risk groups get tested more often.  STDs can have long-term health consequences.  They can also increase your chance of getting HIV or transmitting it to others. It is important to have an honest and open talk with your healthcare provider and ask whether you should be tested for STDs.  Your healthcare provider can offer you the best care if you discuss your sexual history openly.
  • Choose less risky sexual behaviors. Oral sex is much less risky than anal or vaginal sex for HIV transmission. Anal sex is the highest-risk sexual activity for HIV transmission. Sexual activities that do not involve the potential exchange of bodily fluids carry no risk for getting HIV (e.g., touching).
  • Use condoms consistently and correctly.
  • Reduce the number of people you have sex with.  The number of sex partners you have affects your HIV risk. The more partners you have, the more likely you are to have a partner with HIV whose viral load is not suppressed or to have a sex partner with a sexually transmitted disease. Both of these factors can increase the risk of HIV transmission.
  • Talk to your doctor about pre-exposure prophylaxis (PrEP). CDC recommends that PrEP be considered for people who are HIIV-negative and at substantial risk for being exposed to HIV.For sexual transmission, this includes HIIV-negative persons who are in an ongoing relationship with an HIV-positive partner. It also includes anyone who 1) is not in a mutually monogamous relationship with a partner who recently tested HIV-negative, and 2) is a gay or bisexual man who has had sex without a condom or been diagnosed with an STD in the past 6 months; or heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners). For people who inject drugs, this includes those who have injected drugs in the past 6 months and who have shared injection equipment or been in drug treatment for injection drug use in the past 6 months.
  • Talk to your doctor right away (within 3 days) about post-exposure prophylaxis (PEP) if you have a possible exposure to HIV. An example of a possible exposure is if you have anal or vaginal sex without a condom with someone who is or may be HIV-positive, and you are HIV-negative and not taking PrEP. Your chance of exposure to HIV is lower if your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral load is undetectable. Starting medicine immediately (known as post-exposure prophylaxis, or PEP) and taking it daily for 4 weeks reduces your chance of getting HIV.
  • If your partner is HIV-positive, encourage your partner to get and stay on treatment.  ART reduces the amount of HIV virus (viral load) in blood and body fluids. ART can keep people with HIV healthy for many years, and greatly reduce the chance of transmitting HIV to sex partners if taken consistently and correctly.

Hepatitis Prevention

The best way to prevent both Hepatitis A and B is by getting vaccinated.   There is no vaccine available to prevent Hepatitis C.  The best way to prevent Hepatitis C is by avoiding behaviors that can spread the disease, such as sharing needles or other equipment to inject drugs.

STD Prevention

The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do several things to lower your chances of getting an STD, including:

  • Get tested for STDs and encourage your partner(s) to do the same. It is important to have an honest and open talk with your healthcare provider and ask whether you should be tested for STDs.  Your healthcare provider can offer you the best care if you discuss your sexual history openly.
  • Get vaccinated. Vaccines are safe, effective, and recommended ways to prevent hepatitis A, hepatitis B, and HPV.
  • Be in a sexually active relationship with only one person, who has agreed to be sexually active only with you.
  • Reduce your number of sex partners.  By doing so, you decrease your risk for STDs. It is still important that you and your partner get tested, and that you share your test results with one another.
  • Use a condom every time you have vaginal, anal, or oral sex. Correct and consistent use of the male latex condomis highly effective in reducing STD transmission.

What puts me at risk for HIV, Viral Hepatitis, and STDs? 

Risks for HIV

The most common ways HIV is transmitted in the United States is through anal or vaginal sex or sharing drug injection equipment with a person infected with HIV. Although the risk factors for HIV are the same for everyone, some racial/ethnic, gender, and age groups are far more affected than others.

What puts me at risk for Hepatitis A?

Hepatitis A is usually spread when a person ingests fecal matter — even in microscopic amounts — from contact with objects, food, or drinks contaminated by the feces or stool of an infected person. Due to routine vaccination of children, Hepatitis A has decreased dramatically in the United States. Although anyone can get Hepatitis A, certain groups of people are at higher risk, including men who have sex with men, people who use illegal drugs, people who travel to certain international countries, and people who have sexual contact with someone who has Hepatitis A.

What puts me at risk for Hepatitis B?

Hepatitis B is usually spread when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact with an infected person or sharing needles, syringes, or other drug-injection equipment. Hepatitis B can also be passed from an infected mother to her baby at birth.

Among adults in the United States, Hepatitis B is most commonly spread through sexual contact and accounts for nearly two-thirds of acute Hepatitis B cases. Hepatitis B is 50–100 times more infectious than HIV.

What puts me at risk for Hepatitis C?

Hepatitis C is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. Hepatitis C was also commonly spread through blood transfusions and organ transplants prior to the early 1990’s. At that time, widespread screening of the blood supply began in the United States, which has helped ensure a safe blood supply.

STDs

Risks for  Genital Herpes

Genital herpes is a common STD, and most people with genital herpes infection do not know they have it.   You can get genital herpes from an infected partner, even if your partner has no herpes symptoms.  There is no cure for herpes, but medication is available to reduce symptoms and make it less likely that you will spread herpes to a sex partner.

Risks for Genital Human Papillomavirus (HPV)

HPV is so common that most sexually active people get it at some point in their lives. Anyone who is sexually active can get HPV, even if you have had sex with only one person. In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer. HPV is passed on through genital contact (such as vaginal and anal sex). You can pass HPV to others without knowing it.

Risks for Chlamydia

Most people who have chlamydia don’t know it since the disease often has no symptoms.  Chlamydia is the most commonly reported STD in the United States.  Sexually active females 25 years old and younger need testing every year. Although it is easy to cure, chlamydia can make it difficult for a woman to get pregnant if left untreated.

Risks for Gonorrhea

Anyone who is sexually active can get gonorrhea, an STD that can cause infections in the genitals, rectum, and throat. It is a very common infection, especially among young people ages 15-24 years. But it can be easily cured.  You can get gonorrhea by having anal, vaginal, or oral sex with someone who has gonorrhea. A pregnant woman with gonorrhea can give the infection to her baby during childbirth.

Risks for Syphilis

Any sexually active person can get syphilis. It is more common among men who have sex with men. Syphilis is passed through direct contact with a syphilis sore. Sores occur mainly on the external genitals, anus, or in the rectum. Sores also can occur on the lips and in the mouth. A pregnant women with syphilis can give the infection to her unborn baby.

Risks for Bacterial Vaginosis

BV is common among women of childbearing age. Any woman can get BV, but women are at a higher risk for BV if they have a new sex partner, multiple sex partners, use an intrauterine device (IUD), and/or douche.

Managing Your Appointments

HIV is a treatable condition. If you are diagnosed early, get on antiretroviral therapy (ART), and adhere to your medication, you can stay healthy, live a normal life span, and reduce the chances of transmitting HIV to others. Part of staying healthy is seeing your HIV care provider regularly so that he or she can track your progress and make sure your HIV treatment is working for you.

Your HIV care provider might be a doctor, nurse practitioner, or physician assistant. Some people living with HIV go to an HIV clinic; others see an HIV specialist at a community health center, Veterans Affairs clinic, or other health clinic; and some people see their provider in a private practice. Current guidelines recommend that most people living with HIV see their provider for lab tests every 3 to 4 months. Some people may see their provider more frequently, especially during the first two years of treatment or if their HIV viral load is not suppressed (i.e. very low or undetectable). Current guidelines say that people who take their medication every day and have had a suppressed viral load at every test for more than 2 years only need to have their lab tests done two times a year.

In addition to seeing your HIV care provider, you may need to see other health care practitioners, including dentists, nurses, case managers, social workers, psychiatrists/psychologists, pharmacists and medical specialists. This may mean juggling multiple appointments, but it is all part of staying healthy. You can help make this easier by preparing a plan for yourself.

Before Your Visit

For many people living with HIV, appointments with their HIV care provider become a routine part of their life. These tips may help you better prepare for your visits to your HIV care provider and get more out of them:

  • Start with a list or a notebook. Write down any questions you have before you go. (The Department of Veterans Affairs offers a useful list of sample questions you can bring with you.)
  • Make a list of your health and life goals so that you can talk about them with your HIV provider and how she/he can help you reach them.
  • Make a list of any symptoms or problems you are experiencing that you want to talk to your provider about.
  • Bring a list of all the HIV and non-HIV medications that you are taking (or the medications themselves), including over-the-counter medications, vitamins, or supplements. Include a list of any HIV medications you may have taken in the past and any problems you had when taking them.
  • Bring along a copy of your medical records if you are seeing a new provider who does not already have them. You have the right to access your medical records and having copies of your records can help you keep track of your lab results, prescriptions, and other health information. It can also help your new provider have a better understanding of your health history. The best way to do this is by using a global, portable personal health record like the one you will maintain here at HealthLynked.
  • Be prepared to talk about any changes in your living situation, relationships, insurance, or employment that may affect your ability to keep up with your HIV appointments and treatment or to take care of yourself. Your provider may be able to connect you with resources or services that may assist you.
  • Be on time. Most healthcare providers have full appointment schedules—if you are late, you throw the schedule off for everyone who comes after you. If you are late, there is a chance your provider will not be able to see you the same day.

During Your Visit

  • If your provider wants to run some lab tests during your visit, make sure you understand what the lab tests are for and what your provider will do with the results. If you don’t understand, ask your provider to explain it in everyday terms. Typically, you will be asked to give a sample (blood, urine) during your visit and your provider’s office will call you with your results in a few days. Keep track of your results and call your provider back if you have any questions.
  • Be honest. Your provider isn’t there to judge you, but to make decisions with you based on your particular circumstances. Talk about any HIV medication doses you have missed. Tell your provider about your sexual or alcohol/drug use history. These behaviors can put you at risk of developing drug resistance and getting other sexually transmitted infections (STIs) as well as hepatitis. Your provider will work with you to develop strategies to keep you as healthy as possible.
  • Describe any side effects you may be having from your HIV medications. Your provider will want to know how the HIV medications are affecting your body in order to work with you to solve any problems and find the right combination of medications for you.
  • Ask your provider about your next visit and what you should bring to that appointment.
  • Ask for a list of your upcoming appointments when you check out. Work with your case manager, if you have one, to develop a system to help you remember your appointments, such as a calendar, app, or text/e-mail reminders.

Asking Questions and Solving Problems

It’s important for you to be an active participant in your own health care and it’s your right to ask questions. You may need to direct your questions to different people, depending on what you need/want to know:

HIV care providers (doctors, nurse practitioners, physician assistants) can answer specific questions about a wide range of issues that affect your health. They can also help you find resources and solutions to problems you may have that affect your health, including:

  • Your prognosis (how your HIV disease is affecting your body)
  • How to manage any symptoms you may be experiencing
  • Medication issues, including medication changes, new medications, and how the HIV medications may interact with other medications you take.
  • Sexual health issues, including questions about any sexual symptoms you may be having, and how you can prevent or treat STIs, and how you can prevent transmitting HIV to your partner(s).
  • Family planning considerations, including your goals; birth control options for you and/or your partner, if relevant; your options for having children should you wish to do so; and, if you are an HIV-positive woman who is pregnant or considering getting pregnant, how you can reduce the risk of transmitting HIV to your baby
  • Substance use issues, including how alcohol/drug use can affect your HIV treatment and overall health, and whether you should be referred for substance abuse treatment
  • Mental health issues, including questions about any mental health symptoms you may be having, and whether you should be referred for mental health treatment
  • Referrals for other medical issues you may be experiencing
  • The meaning of lab test results
  • The need for surgical procedures, if relevant
  • Medication adherence strategies (tips for keeping up with your medication and ensuring you take it as scheduled and exactly as prescribed)
  • Any clinical trials or research studies that may be relevant for you
  • Information about resources and services that can help you with issues or challenges you may be having that affect your health.

Nurses and case managers often have more time to answer questions about what you discuss with your provider and to help identify solutions to problems that are affecting your health, particularly around:

  • Understanding your HIV treatment plan, including how many pills of each medicine you should take; when to take each medicine; how to take each medicine (for example, with or without food); and how to store each medicine
  • Understanding possible side effects from your HIV medication and what you should do if you experience them
  • Challenges you may have in taking your medications and/or keeping your medical appointments, and strategies for overcoming these challenges
  • Resources to help you better understand lab reports, tests, and procedures
  • Mental health and/or substance abuse treatment, housing assistance, food assistance, and other resources that exist in your community
  • Insurance and pharmacy benefits, and other aspects of paying for care
  • Understanding other medical conditions you may have
  • How to quit smoking and resources that are available to assist you
  • Information about resources and services that can help you with issues or challenges you may be having that affect your health.

If you are HIV positive, attending your medical appointments is one of the most important things you can do to ensure your HIV is optimally managed. Make sure you are ready for your appointments with HealthLynked.  Using our novel healthcare ecosystem, you can collate your medical information in one place and Connect there with the physicians who care for you.

Ready to get Lynked?  Go to HealthLynked.com today to sign up for Free!

Adapted from:

HIV.org

CDC.foc

Aidsinfo.NIH.gov

Insight into Vitiligo: The Truth and Treatment of Leucoderma

Today, June 25th, marks World Vitiligo Day, aimed at raising awareness about the disease.  Vitiligo affects roughly 100 million people worldwide and almost 2 million in the US. It’s not contagious or fatal, but scientists are unsure of what causes it.

What is Vitiligo

Vitiligo is a patchy loss of skin coloring (pigmentation). The average age of onset of vitiligo is in the mid-twenties, but it can appear at any age.  95 percent of people with vitiligo have been diagnosed before reaching age forty. It tends to progress over time, with larger areas of the skin losing pigment. Some people with vitiligo also have patches of pigment loss affecting the hair on their scalp or body.

Myths VS Facts

Myth 1: Vitiligo is an outcome of the wrong combination of foods, for instance, milk consumption shortly after eating fish can bring on the disorder.

Fact: Vitiligo has no apparent link with the diet. It is irrational to deprive patients of healthy foods they enjoy in the hope of declining the possibility of the disease.

Myth 2: Vitiligo is a kind of leprosy and is communicable.

Fact: Though often referred to those who do not understand the disease as “white leprosy”, vitiligo is in no way linked to leprosy. It is not infectious or contagious and, hence, cannot pass on from one person to another.

Myth 3: Vitiligo is connected to serious skin diseases, such as skin cancer and albinism.

Fact: There are clear dissimilarities among each of these syndromes, and not of them are linked to Vitiligo.

Myth 4:  There are no effective treatments for vitiligo.

Fact: Medications like steroids, Ultraviolet A, immunomodulator drugs and the newer narrowband Ultraviolet B are accessible, along with several surgical options.

Types of Vitiligo

Generalized vitiligo, also called non-segmental vitiligo, is the most common form.  It involves loss of pigment (depigmentation) in patches of skin all over the body. Depigmentation typically occurs on the face, neck, and scalp, and around body openings such as the mouth and genitals. Sometimes pigment is lost in mucous membranes, such as the lips. Loss of pigmentation is also frequently seen in areas that tend to experience rubbing, impact, or other trauma, such as the hands, arms, and places where bones are close to the skin surface (bony prominences).

Segmental vitiligo is associated with smaller patches of depigmented skin that appear on one side of the body in a limited area; this occurs in about 10 percent of affected individuals.

What causes Vitiligo?

Vitiligo is generally considered to be an autoimmune disorder. Autoimmune disorders occur when the immune system attacks the body’s own tissues and organs. In people with vitiligo the immune system appears to attack the pigment cells (melanocytes) in the skin. About 15 to 25 percent of people with vitiligo are also affected by at least one other autoimmune disorder, particularly autoimmune thyroid disease, rheumatoid arthritis, type 1 diabetes, psoriasis, pernicious anemia, Addison disease, or systemic lupus erythematosus.

In the absence of other autoimmune conditions, vitiligo does not affect general health or physical functioning. However, concerns about appearance and ethnic identity are significant issues for many affected individuals.

Some researchers think that the melanocytes destroy themselves. Others think that a single event such as sunburn or emotional distress can trigger vitiligo. But these events have not been proven to cause vitiligo.

Role of Genetic Changes

Variations in over 30 genes, occurring in different combinations, have been associated with an increased risk of developing vitiligo. Two of these genes are NLRP1 and PTPN22.

The NLRP1 gene provides instructions for making a protein that is involved in the immune system, helping to regulate the process of inflammation. Inflammation occurs when the immune system sends signaling molecules and white blood cells to a site of injury or disease to fight microbial invaders and facilitate tissue repair. The body then stops (inhibits) the inflammatory response to prevent damage to its own cells and tissues.

The PTPN22 gene provides instructions for making a protein involved in signaling that helps control the activity of immune system cells called T cells. T cells identify foreign substances and defend the body against infection.

The variations in the NLRP1 and PTPN22 genes that are associated with an increased risk of developing vitiligo likely affect the activity of the NLRP1 and PTPN22 proteins, making it more difficult for the body to control inflammation and prevent the immune system from attacking its own tissues.

Studies indicate that variations in a number of other genes also affect the risk of vitiligo. Many of these genes are also involved in immune system function or melanocyte biology, and variations in each likely make only a small contribution to vitiligo risk. Some of the gene changes associated with an increased risk of vitiligo have also been associated with an increased risk of other autoimmune conditions.

It is unclear what specific circumstances trigger the immune system to attack melanocytes in the skin. Research suggests that the immune system of affected individuals may react abnormally to melanocytes that are stressed by factors such as chemicals or ultraviolet radiation. In addition, the melanocytes of people with vitiligo may be more susceptible to stress than those of the general population and therefore may be more likely to be attacked by the immune system. The condition probably results from a combination of genetic and environmental factors, most of which have not been identified.

What are the symptoms of Vitiligo?

White patches on the skin are the main sign of vitiligo. These patches are more common in areas where the skin is exposed to the sun. The patches may be on the hands, feet, arms, face, and lips. Other common areas for white patches are:

  • The armpits and groin (where the leg meets the body)
  • Around the mouth
  • Eyes
  • Nostrils
  • Navel
  • Genitals
  • Rectal areas.

People with vitiligo often have hair that turns gray early. Those with dark skin may notice a loss of color inside their mouths.

Will the white patches spread?

There is no way to tell if vitiligo will spread. For some people, the white patches do not spread. But often the white patches will spread to other areas of the body. For some people, vitiligo spreads slowly, over many years. For other people, spreading occurs quickly. Some people have reported more white patches after physical or emotional stress.

How is vitiligo diagnosed?

A doctor will use family and medical history, physical exam, and tests to diagnose vitiligo. The doctor may ask questions such as:

  • Do you have family members with vitiligo?
  • Do you or family members have any autoimmune diseases?
  • Did you have a rash, sunburn, or other skin problem before the white patches appeared?
  • Did you have some type of stress or physical illness?
  • Did your hair turn gray before age 35?
  • Are you sensitive to the sun?

A physical exam will be completed to rule out other medical problems.

Tests might include:

  • Taking a small sample (biopsy) of the affected skin to be examined
  • Blood tests
  • An eye exam.

How is vitiligo treated?

Treatment may help make the skin look more even. The choice of treatment depends on:

  • The number of white patches
  • How widespread the patches are
  • The treatment the person prefers to use.

Some treatments are not right for everyone. Many treatments can have unwanted side effects. Treatments can take a long time, and sometimes they don’t work.

Current treatment options for vitiligo include medical, surgical, and other treatments. Most are aimed at restoring color to the white patches of skin.

Medical treatments include:
  • Medicines (such as creams) that you put on the skin
  • Medicines that you take by mouth
  • A treatment that uses medicine plus ultraviolet A (UVA) light (PUVA)
  • Removing the color from other areas so they match the white patches.
Surgical treatments include:
  • Skin grafts from a person’s own tissues. The doctor takes skin from one area of a patient’s body and attaches it to another area. This is sometimes used for people with small patches of vitiligo.
  • Tattooing small areas of skin.
Other treatments include:
  • Sunscreens
  • Cosmetics, such as makeup or dye, to cover the white patches
  • Counseling and support.

Complications

Vitiligo does not develop into other diseases, but people with the condition are more likely to experience:

  • painful sunburn
  • hearing loss
  • changes to vision and tear production

Overcoming social challenges

If the skin patches are visible, the social stigma of vitiligo can be difficult to cope with. Embarrassment can lead to problems with self-esteem, and in some cases, anxiety and depression can result.  75% of those with vitiligo report having social anxiety in some from as a result of the changes to their skin.

People with darker skin are more likely to experience difficulties, because the contrast is greater. In some countries, vitiligo is known as “white leprosy.”

Increasing awareness about vitiligo, for example, by talking to friends about it, can help people with the condition to overcome these difficulties. Connecting with others who have vitiligo may also help.

Anyone with this condition who experiences symptoms of anxiety and depression should ask their dermatologist to recommend someone who can help.

Use HealthLynked to build the right team of professionals who know what you are going through and will truly help you in every way possible. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Sources:

NIH.org

Medical News Today.com

Five [PLUS] Senses Working Overtime. Are You Tuned In…?

Today is Celebration of the Senses Day – a time to consider your amazing sensory abilities and how they interrelate. We all learn as children humans have five basic senses: touch, sight, hearing, smell and taste. Science has done a fantastic job describing the organs associated with each, how they send information to the brain to help us understand and perceive the world around us, and has gone even further to uncover how they uniquely cross-talk for heightened awareness.

Touch

Touch is thought to be the first sense humans develop, according to the Stanford Encyclopedia of Philosophy. Touch consists of several distinct sensations communicated to the brain through specialized neurons in the skin. Pressure, temperature, light touch, vibration, pain and other sensations are all part of the touch sense and are all attributed to different receptors in the skin.

Touch isn’t just a sense used to interact with the world; it also seems to be very important to a human’s well-being. For example, touch has been found to convey compassion from one human to another.

Touch can also influence how humans make decisions. Texture can be associated with abstract concepts, and touching something with a texture can influence the decisions a person makes, according to six studies by psychologists at Harvard University and Yale University, published in the June 24, 2010, issue of the journal Science.

“Those tactile sensations are not just changing general orientation or putting people in a good mood,” said Joshua Ackerman, an assistant professor at the Massachusetts Institute of Technology. “They have a specific tie to certain abstract meanings.”

Sight

Sight, or perceiving things through the eyes, is a complex process. First, light reflects off an object to the eye. The transparent outer layer of the eye – the cornea – bends the light that passes through the hole of the pupil. The iris (the colored part of the eye) works like the shutter of a camera, retracting to shut out light or opening wider to let in more light.

The cornea focuses most of the light. Then, it passes through the lens, which continues to focus the light.  The lens of the eye then bends the light and focuses it on the retina, which is full of nerve cells. These cells are shaped like rods and cones and are named for their shapes. Cones translate light into colors, central vision and details. The rods translate light into peripheral vision and motion. Rods also give humans vision when there is limited light available, like at night. The information translated from the light is sent as electrical impulses to the brain through the optic nerve.

People without sight may compensate with enhanced hearing, taste, touch and smell, according to numerous studies. Their memory and language skills may be better than those with sight, as well.

“Even in the case of being profoundly blind, the brain rewires itself in a manner to use the information at its disposal so that it can interact with the environment in a more effective manner.”  That’s according to Dr. Lotfi Merabet, senior author of a 2017 study and the director of the Laboratory for Visual Neuroplasticity at Schepens Eye Research Institute of Massachusetts Eye and Ear.

Hearing

This sense works via the complex labyrinth that is the human ear. Sound is funneled through the external ear and piped into the external auditory canal. Then, sound waves reach the tympanic membrane, or eardrum. This is a thin sheet of connective tissue that vibrates when sound waves strike it.

The vibrations travel to the middle ear. There, auditory ossicles — three tiny bones called the malleus (hammer), incus (anvil) and stapes (stirrup) — vibrate. The stapes bone, in turn, pushes a structure called the oval window in and out, sending vibrations to the organ of Corti.  This spiral organ is the receptor organ for hearing. Tiny hair cells in the organ of Corti translate the vibrations into electrical impulses. The impulses then travel to the brain via sensory nerves.

People retain their sense of balance because the Eustachian tube, or pharyngotympanic tube, in the middle ear equalizes the air pressure there with the air pressure in the atmosphere. The vestibular complex, in the inner ear, is also important for balance, because it contains receptors that regulate a sense of equilibrium. The inner ear is connected to the vestibulocochlear nerve, which carries sound and equilibrium information to the brain.

Smell

Humans may be able to smell over 1 trillion scents, according to researchers. They do this with the olfactory cleft, which is found on the roof of the nasal cavity, next to the “smelling” part of the brain – the olfactory bulb and fossa. Nerve endings in the olfactory cleft transmit scents to the brain, according to the American Rhinologic Society.

Dogs are known as great smellers, but research suggests humans are just as good as man’s best friend. Research published in the May 11, 2017, issue of the journal Science suggests humans can discriminate among 1 trillion different odors; it was once believed humans could discern only about 10,000 different smells.

“The fact is the sense of smell is just as good in humans as in other mammals, like rodents and dogs,” John McGann, a neuroscientist at Rutgers University-New Brunswick in New Jersey and the author of the new review, said in a statement. The Rutgers study backs up a previous study at the Rockefeller University in New York, whose findings were published in the March 2014 issue of the journal Science.

Humans have 400 smelling receptors. While this isn’t as many as animals that are super smellers have, the much more complicated human brain makes the difference.  In fact, poor smelling ability in people may be a symptom of a medical condition or aging. For example, the distorted or decreased ability to smell is a symptom of schizophrenia and depression. Old age can also lessen the ability to smell properly. More than 75 percent of people over the age of 80 years may have major olfactory impairment, according to a 2006 paper published by the National Institutes of Health (NIH).

Taste

The gustatory sense is usually broken down into the perception of four different tastes: salty, sweet, sour and bitter. There is also a fifth taste, defined as umami or savory. There may be many other flavors not yet discovered. Also, spicy is not a taste. It is actually a pain signal, according to the National Library of Medicine (NLM).

The sense of taste aided in human evolution, according to the NLM, because taste helped people test the food they ate. A bitter or sour taste indicated that a plant might be poisonous or rotten. Something salty or sweet, however, often meant the food was rich in nutrients.

Taste is sensed in the taste buds. Adults have 2,000 to 4,000 taste buds. Most of them are on the tongue, but they also line the back of the throat, the epiglottis, the nasal cavity and the esophagus. Sensory cells on the buds form capsules shaped like flower buds or oranges. The tips of these capsules have pores that work like funnels with tiny taste hairs. Proteins on the hairs bind chemicals to the cells for tasting.

It is a myth that the tongue has specific zones for each flavor. The five tastes can be sensed on all parts of the tongue, although the sides are more sensitive than the middle. About half of the sensory cells in taste buds react to several of the five basic tastes. The cells differ in their level of sensitivity. Each has a specific palette of tastes with a fixed ranking, so some cells may be more sensitive to sweet, followed by bitter, sour and salty, while others have their own rankings. The full experience of a flavor is produced only after all of the information from various parts of the tongue is combined.

The other half of the sensory cells are specialized to react to only one taste. It’s their job to transmit information about the intensity — how salty or sweet something tastes.

Other factors help build the perception of taste in the brain. For example, the smell of the food greatly affects how the brain perceives the taste. Smells are sent to the mouth in a process called olfactory referral. This is why someone with a stuffy nose may have trouble tasting food properly. Texture, translated by the sense of touch, also contributes to taste, and recent studies even show color and shape can affect the way we perceive a properly attribute taste to a food.

The sense of space

In addition to the traditional big five, other senses help us translate a myriad of inputs into how we perceive and relate to the physical world.  One deals with how your brain understands where your body is in space. This sense is called proprioception.

Proprioception includes the sense of movement and position of our limbs and muscles. For example, proprioception enables a person to touch their finger to the tip of their nose, even with their eyes closed. It enables a person to climb steps without looking at each one. People with poor proprioception may be clumsy and uncoordinated.

Researchers at the NIH found that people who have particularly poor proprioception through mechanosensation — the ability to sense force, such as feeling when someone presses down on your skin — may have a mutated gene that is passed down from generation to generation. That comes from a September 2016 study in the New England Journal of Medicine. “The patient’s version of [the gene] PIEZO2 may not work, so their neurons cannot detect touch or limb movements,” said Alexander Chesler, a principal investigator at the National Center for Complementary and Integrative Health and the lead author of the study.

Additional senses & variations

There are more-subtle senses that most people never really perceive. For example, there are neuron sensors that sense movement to control balance and the tilt of the head. Specific kinesthetic receptors exist for detecting stretching in muscles and tendons, helping people to keep track of their limbs. Other receptors detect levels of oxygen in certain arteries of the bloodstream.

While our five  basic sense seem to operate independently, as distinct modes of perceiving the world, in reality, they collaborate closely to enable the mind to better understand our surroundings. We can become keenly aware of this collaboration under special conditions.

In some cases, a sense may covertly influence another we think is dominant. When visual information clashes with that from sound, sensory crosstalk can cause what we see to alter what we hear. When one sense drops out, another can pick up the slack.  For instance, people who are blind can train their hearing to play double duty. Those who are both blind and deaf can train touch to step in—even to help them interpret speech.

Our senses must also regularly meet and greet in the brain to provide accurate impressions of the world. Our ability to perceive the emotions of others relies on combinations of cues from sounds, sights and even smells.  Perceptual systems, particularly smell, connect with memory and emotion centers to enable sensory cues to trigger feelings and recollections, and are incorporated within them.

The crosstalking of the senses provides some of the most magnificent material for interesting science, illusions, inventions and just plain art.  Here are a few of the best examples of the complex interactions – and extraordinary feats – of our cross-wired senses.

Calling to See

Bats and dolphins, among other animals, emit sounds into their surroundings —not to communicate with other bats and whales — but to “see” what is around them.  They read echoes of the sound waves, which bounce off objects, to identify and locate objects.

This sensory system is called echolocation. Although most of us can only imagine the pictures that form from sound, some sightless people have managed to master a form of echolocation. By uttering sounds and clicks, these individuals can use their ears to navigate. Some, such as Daniel Kish, have even taught others to use this form of human sonar. Kish once described human echolocation as “something like seeing the world in dim flashes of light.”

Fingers Do the Hearing 

People who are both deaf and blind are incredibly good at using other senses, such as touch, to navigate and understand the world. Some use the Tadoma Speechreading Method to perceive speech by touching the lips of another person as they talk. First taught in the 1920s, lip-reading by touch was a popular form of communication among the deafblind. Helen Keller was one of its early adopters.

If taught early in development, the Tadoma Method can help a deaf-blind child learn to speak as well as to understand others. Those who lose their sight and hearing later in life can use it to read lips.

But because the method is extremely difficult and time consuming to learn, by the 1950s it began to lose ground to American Sign Language as the dominant teaching method. Today, only about 50 people in the world still use of the Tadoma Method.

Still, In ASL, the deaf-blind place their hands over another signer’s hands and follow the motions with their fingers—which is easier because the movements are far less subtle.

Beep Baseball

Blind baseball seems almost impossible to even imagine, but since 1975, when a few blind Minnesotans invented “beep baseball”, those who lack sight have taken part in America’s favorite pastime. Thanks to a one-pound beeping oversized softball and some tweaks to the game, players can hit a home run without ever seeing the ball. They use the sound the ball emits to orient themselves, make contact using a bat and to field.  Special bases make it possible to round the diamond. They might be particularly well-suited to this form of the game, as previous research suggests that blind individuals can more easily localize sounds than sighted people can.

Then there is synesthesia

For a few individuals with a condition called synesthesia, the senses collide dramatically and uniquely to form a kaleidoscope world in which chicken tastes like stars, a symphony smells of fresh baked bread or words are bathed in red, green or purple.

People with synesthesia have a particularly curious cross wiring of the senses in which activating one sense spontaneously triggers another. They see colors when they hear noises, associate particular personalities with days of the week, or hear sounds when they see moving dots.

Synesthesia is thought to be genetic, and recent research even suggests it may confer an evolutionary advantage.  Most synesthetes don’t notice anything strange about the way they perceive their environments until it is brought to their attention.

Given that, at any moment in time, we are bombarded by such a diverse combination of sensory experiences, our appreciation of the individual senses can become somewhat muddled. Our taste experience is affected by the smell, texture and temperature of our food. Similarly, our hearing is said to decrease after overeating, and our sight is affected by noises around us. Sight can also be hampered after eating fatty foods.

Here’s another interesting snippet – if a sad, depressed person tells you their world is dull and grey, and flowers have lost their smell, they’re not just speaking metaphorically. Research shows sensory perception can actually be diminished in depressed individuals.  So focussing on a renewed appreciation of your senses can actually help one get out of an emotional rut.

Five senses? More than ten!

The categorization of our five primary senses (sight, smell, hearing, taste and touch) is attributed to Aristotle. While this basic list is still valid, humans have a number of additional ‘sensory abilities’ not covered above. These secondary senses include:

  • Sense of balance and acceleration– the ability to sense body movement, direction and acceleration, and to maintain balance and equilibrium.
  • Temperature sense– the ability to sense heat and the absence of heat (cold).
  • Sense of Pain– the sense of pain was previously believed to be an overloading of pressure receptors, but it has since been identified as a distinct phenomenon that intertwines with the other senses, including touch.
  • Sense of Time– the ability to perceive the passage of time, both short passages as well as longer time cycles.

We are gifted with a complex system of basic and intertwined senses designed to help us take it all in….If any of these seem a little “off” for you, consider seeing a physician who can help you with a tune up. To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Sources:

livescience.com

idahoptv.org

Can mangoes protect heart and gut health

Can mangoes protect heart and gut health?

Published

Mangoes have been cultivated in South Asia for thousands of years, and they now find homes across many of the warmer regions of Earth.

They are the national fruit of India, Pakistan, and the Philippines, and for good reason: they’re delicious.

As far as nutrition goes, the mango contains a range of vitamins and minerals, though not in particularly high concentrations.

That is, with the notable exceptions of vitamin C and folate.

Mangoes also contain a range of polyphenols such as flavonoids, a group of compounds that has gained popularity in health food circles over recent years.

Mangoes and polyphenols

The potential health impact of polyphenols has proven a controversial topic; they are considered to have an antioxidant effect, but studies have shown that our guts break the majority of them down before they get a chance to affect our body.

However, the breakdown products of these molecules could also have an impact on health. To date, though, evidence to support their health benefits is contradictory.

That said, sometimes, the whole is greater than the sum of its parts. With this in mind, a group of researchers from the University of California, Davis set out to see whether they could measure specific health benefits of consuming mango.

To this end, they recruited 24 healthy postmenopausal women and asked them to consume 330 grams of mango each day for two weeks. Specifically, they chose the honey mango because of its relatively high levels of polyphenols.

After the 2-week mango intervention, the participants returned to their standard diet for 13 days, avoiding mango.

The researchers’ findings were presented recently at the American Society for Nutrition’s annual meeting, Nutrition 2018, held in Boston, MA. They have been published in The FASEB Journal.

In order to assess the bioactivity of mango, the researchers took measurements at various points throughout the trial, including heart rate and blood pressure.

The team also sampled blood and breath. By analyzing breath samples, it becomes possible to gain an understanding of gut health. This is due to the fact that they provide a snapshot of the gases produced during fermentation in the intestine.

The scientists found that systolic blood pressure — that is, the pressure in the arteries as the heart contracts — was significantly lower than the baseline reading 2 hours after consuming mango.

Pulse pressure — which is a measure of the force that the heart generates every time it contracts — was also significantly lower 2 hours after eating mango.

The breath test measured hydrogen and methane levels. Some participants had methane, some had hydrogen, others had neither, and others still had both. In this type of test, methane is considered a sign of poor gut health.

Of the 24 participants, one quarter produced methane at the start of the trial. Of these six people, half showed reduced methane output after consuming mango.

So, a study that used a small group of a specific cross-section of society seemed to show some benefits of eating mangoes in a study partially funded by the National Mango Board.

More work is needed to back these findings up. Until these results are corroborated, mango can still be safely enjoyed, with or without specific gut and cardiovascular health benefits.

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.