Category Archives: Early Disease Detection

Early Disease Detection

August is National Immunization Awareness Month

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An annual observance held every August promotes the National Immunization Awareness Month (NIAM). The said program covers widespread information on the importance of vaccines for both the young and the old in order for them to be aware about how they can prevent deadly diseases.

The National Public Health Information Coalition (NPHIC) serves as the sponsor of NIAM.

The Center for Disease Control’s National Center for Immunization and Respiratory Diseases works hand in hand with NPHIC to come up with communication toolkits that will further discuss vaccines to the public.

Each week of #NIAM16 will focus on topics intended for specific age groups:

  • Adults (August 1-7)
  • Pregnant women (August 8-14)
  • Babies and young children (August 15-21)
  • Preteens and teens (August 22-28)

An abbreviated toolkit is available to help parents be reminded of the vaccines needed by their school-aged children. Please visit the NIAM website to download the toolkits.

CDC has also provided several online resources to raise awareness on the importance of immunization, some of which include the following:

  • Further information to parents on the importance of vaccine in protecting their children’s health.
  • Motivate college students to see a healthcare professional to know what vaccines they may need before the school starts.
  • Inform adults (elderly and those with chronic medical conditions) which vaccines are necessary that could help with their present state.
  • Provide enough information to expectant mothers about being vaccinated to protect their unborn children from diseases like pertussis (whooping cough).
  • Let everyone know that the flu season is just months away.
Early Disease Detection Health & Wellness

Important Things You Need To Know About HIV Testing and Treatment

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The HIV epidemic continues to be a major global health threat. A report by the World Health Organization (WHO) showed that by the end of 2014, a total of 36.9 million people around the world were living with the HIV infection. That same year, the organization recorded a total of 1.2 million deaths from the AIDS virus. Since the onset of the epidemic, almost 71 million people have been infected worldwide, accounting for about 34 million deaths, according to this article.

In the United States, the Centers for Disease Control and Prevention (CDC) reported that by the end of 2012, an estimated 1.2 million people of ages 13 and older were living with HIV. Of these, 12.8% were unaware of their condition. There are about 50,000 new HIV cases in the country per year, CDC said.

The world of medical science still has to find a cure for the disease that continues to affect and threaten the lives of a substantial number of people. Through the years, various health agencies and communities have exerted significant efforts to combat the epidemic. Emphasis is placed on prevention, early detection, and immediate treatment. Though the end of the search for the ultimate antidote is not yet in sight, advances in therapies including contemporary antiretroviral drugs have shown to be effective in increasing life expectancy among HIV patients. Next to prevention, the key is early detection.

HIV testing

Types of HIV Tests

HIV tests are used to determine whether a person is infected with the Human Immunodeficiency Virus (HIV) which triggers a more deadly disease called Acquired Immunodeficiency Syndrome (AIDS).  These tests detect the presence of certain antibodies, antigens, or RNA in a person’s blood, saliva, or urine which signifies that the individual has been infected by the virus.

The tests are available in physician’s offices, clinics, hospitals, health centers, and health departments. Standard tests are either inexpensive or completely free. Testing centers implement a strict confidentiality policy for the protection of the patients. Anonymous testing is also available in most states.

The available types of HIV tests include the following:

Antibody Tests

These are the most common forms of HIV testing. These tests are done to detect the presence of antibodies to the virus in the person’s blood. Some tests can also detect these biomolecules in the saliva. With a normal antibody test, a patient waits for a few days to a few weeks before he gets a result. A rapid antibody test, however, can give the patient the results between 20 to 30 minutes.

There are two general types of antibody tests that are commonly used:

Enzyme-Linked Immunosorbent Assay (ELISA)

This is usually the first test conducted to determine the presence of antibodies to HIV. If such antibodies are detected in the blood, the test returns an HIV Positive result. It is usually repeated for the confirmation of the diagnosis. When the initial ELISA test returns an HIV Negative result, no further tests need be conducted.

Western Blot

This is performed when two ELISA tests return a positive result.  This test is necessary to confirm the diagnosis. It is more difficult and takes longer to perform. Hence, it is also more expensive.

Both tests are highly accurate and when the combination shows positive results, a patient is clinically diagnosed to be HIV positive.

However, the antibody tests cannot successfully detect HIV immediately after exposure because it takes between 2 weeks and 6 months for antibodies to appear in the blood. This is called the “window period” within which a person may be infected and still may not test positive for the virus.

Ideally, antibody tests should be conducted beyond the window period. It is recommended that testing is done at 6 weeks, 3 months, and 6 months after exposure or contact with a person who is HIV infected, as reported in this article.

Other tests

Here are some other tests that may be used to check for HIV:

Antibody / Antigen Tests

These are tests that can detect the presence of both antibodies to the virus and antigens or particles of the virus itself. Antigens of HIV typically show up within 2 to 4 weeks after infection. Thus, antigen/antibody combination tests can detect HIV much earlier than the standard antibody tests. These screening methods are available only for blood testing. A rapid antibody/antigen test can deliver results within as quickly as 20 minutes.

Polymerase Chain Reaction

The PCR test can identify the presence of the virus itself in a person’s blood. It checks to find genetic material of the virus (RNA or DNA) in the person’s white blood cells. PCR testing requires highly technical skills and costly laboratory equipment. Thus, it is not as common as antibody testing.  Not all hospitals and clinics offer this service.

PCR can detect the virus within days or weeks after exposure. It is recommended to be performed when the results of antibody tests are uncertain such as when they were done within the window period. The test is also conducted for the screening of organs and blood intended for donation. In addition, it is done to determine if a baby born to an HIV-positive mother has likewise been infected.

In-Home Test Kits

Home test kits can screen either the blood or saliva for the presence of HIV antibodies. There are two tests currently approved by the US Food and Drug Administration.

Some home testing kits are conducted by pricking the finger, placing drops of blood on the given card, and mailing the card to a licensed laboratory. The sample will be tested using the ELISA and Western Blot methods. The screening is done anonymously and the patient is given an identification number to be used when he claims results by phone call within three business days.

Meanwhile, others can detect antibodies in the saliva. To perform the test, the user swabs his upper and lower gums and places the collected sample in the given vial. This is sent to a laboratory for screening. Results can be expected within 20 to 40 minutes, but a follow-up test should be done if the initial results are positive.

Benefits of Early Detection

CDC recommends that all persons of 13 years of age and older must be tested for HIV, regardless of risk factors, based on the agency’s report. It is also advised that routine screening for adults, adolescents, and pregnant women be conducted in healthcare settings in the United States, according to this informational article.

Persons exposed to risk factors such as those having multiple sex partners, engaging in unprotected sex with a possibly HIV infected person, engaging in risky sexual behavior such as men having sex with men (MSM), and sharing needles for intravenous drug use should get themselves tested right after the lapse of the window period.

It is important to confirm a possible diagnosis as soon as possible for several reasons:

  1. To avoid transmitting the virus to others, including to other sexual partners or to an unborn child;
  2. To reduce the viral load in the blood;
  3. To get immediate treatment.

The earlier the virus is detected, the sooner can treatment and monitoring can begin. Treating the condition in the early stages can significantly slow down the growth rate of the virus. This increases life expectancy and delays the onset of AIDS.

Over the years, newer HIV treatment options have developed including advanced anti-retroviral medication which has shown to greatly increase a patient’s life expectancy.

HIV signs symptoms

HIV Treatment

Untreated, the HIV virus will spread rapidly and the illness will progress to AIDS, the most advanced stage. When the immune system is considerably damaged, the body will be susceptible to a host of life-threatening opportunistic diseases and cancers until death occurs.

Early medical attention can effectively delay progression and when administered properly, patients can continue to live normal and productive lives although they must employ special precautions to avoid contaminating other people.

HIV patients are treated with a combination of several medications. This regimen is called the antiretroviral therapy (ART). While the medicines cannot cure the virus, they control the spread and reduce the viral load or the number of HIV copies multiplied in the body. With a lower viral load, the immune system is maintained strong enough to fight off and recover from a number of infections and cancers. Having lesser HIV copies in the body also reduces the risk of transmitting the disease.

For instance, a research published in 1994 showed that the use of the drug called zidovudine or AZT by HIV-infected women and by their newborns reduced the risk of HIV transmission from about 25% to 8%.  Another study showed that pregnant women who received at least two weeks of ART reduced the risk of perinatal transmission to less than 1 percent.

There are 6 major classes of drugs for HIV treatment, according to aids.gov. These are non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), protease inhibitors (PIs), fusion inhibitors, CCR5 antagonists (CCR5), and integrase strand transfer inhibitors (INSTIs).

The 6 classes include several medicines, depending on how each fights the virus.  There are 25 medicines that are currently approved for HIV treatment. A treatment regimen will usually combine at least three different medicines from at least two of the six categories, based on this article. A mixture of drugs is necessary to efficiently reduce the viral load and prevent resistance to medication.

In prescribing the medications, the doctor will consider several factors including the patient’s health history, results of other diagnostic tests performed after the diagnosis which measure the viral load in the patient’s body (e.g. CD4 Count), results of drug-resistance testing, possible side effects of the medicines, possible contraindications, convenience, and costs.

The drugs can cause several side effects. The most common reactions are nausea, vomiting, diarrhea, anemia, fatigue, dizziness, headaches, skin rashes, and insomnia. In considering an ART regimen, doctors will consider a combination of drugs that will efficiently control the disease with the least possible side effects.

ART is a lifetime treatment plan to which a patient must religiously adhere. His commitment to the regimen and to certain lifestyle changes will determine the effectiveness of the therapy and the quality of life he can expect while living with HIV.

Any concerns that arise while on certain medications should be discussed immediately with the health care provider or physician. Barriers to effective treatment should be reduced or eliminated as soon as possible.

While research continues to provide critical information for the development of advanced treatment plans and therapies, medications will not solve the global epidemic. The thrust of government and health agencies should focus more on education and prevention methods. Controlling and combatting the crisis requires a combination of measures including increasing access to screening methods and testing facilities, intensifying health campaigns, providing more HIV and AIDS support programs, and strengthening partnerships between government health agencies, communities, and the private sector to maintain effectual prevention programs.

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Early Disease Detection Health & Wellness

HPV Increases Risk of Head and Neck Cancer

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A new study from researchers at Albert Einstein College of Medicine has found that individuals with human papillomavirus, specifically HPV-16 in their mouths are 22% more likely to develop a type of head and neck cancer compared to people without it.

In their study, the researchers conducted two different nationwide studies consisting of almost 97,000 people. Patients who were considered cancer-free at the beginning of the study were asked to provide mouthwash samples for the study. Researchers identified 132 cases of head and neck cancer after an average of four years of follow-up. Also included was a comparison group of 396 healthy subjects.

Participants who displayed symptoms of HPV-16 were 22 times more likely to be diagnosed with oropharyngeal cancer compared to participants who showed no signs of HPV. The Einstein College team also discovered the presence of other types of oral HPV: Beta- and gamma-HPV, which are usually detected in the skin, but were associated with the development of head and neck cancers.

There was some good news from the study, as well. Easy-to-collect mouthwash samples could potentially help predict a person’s risk for head and neck cancer development, the team said.

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Early Disease Detection Health & Wellness

Breast Cancer Prevention: False-Positive Results on Mammography Screening Are Common

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In a surprising twist on breast cancer prevention, a new study from researchers in Portland discovered the existence of false-positive mammography results.

Mammography is a useful tool for women who want to verify their risk of breast cancer. The new discovery, which was revealed through a study by Heidi D. Nelson and colleagues from the Oregon Health & Science University and Providence Health & Services, might affect the reliability and reputation of this screening mechanism.

The revelation was based on data review from more than 405,000 women who underwent digital mammography from 2003 to 2011. The women, who were between 40 and 89 years old, were followed up after a year to assess for cancer or “ductal carcinoma in situ”, as reported in a news article.

Results showed that false-positive results occur in more than 120 per 1,000 women between 40 and 49 years of age. Meanwhile, females who were diagnosed with breast cancer risk factors were found with more false-positive results. “False-positive mammography results and additional imaging are common, particularly for younger women and those with risk factors, whereas biopsies occur less often,” the authors said.

The study and its details were published in the Annals of Internal Medicine.

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Early Disease Detection Health & Wellness

Cure For HIV May Be Found In Alcoholism Treatment Drug

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HIV treatments at present are confined to antiretroviral therapy, but is not considered a real cure because it merely renders the virus dormant in human cells. A breakthrough discovery is now looking at disulfiram, a drug known for treatment of alcoholism, as a potential cure for HIV.

This was revealed in a new research by scientists from the University of Melbourne in Australia as published in The Lancet HIV journal. The anti-alcoholism drug helps a person abstain from drinking. In a biological viewpoint, disulfiram blocks the dehydrogenase enzyme, which functions as an alcohol metabolism agent, as stated in a news article.

Through the research, it was discovered that the anti-alcoholism drug can reactivate HIV cells that lay dormant, making the virus open to being destroyed. Although earlier studies have seen similar effects by using cancer treatment drugs, disulfiram did not exhibit any toxic side effects even in high doses of up to 2,000 mg.

Study lead author Sharon Lewin of The Peter Doherty Institute for Infection and Immunity said that the alcoholism treatment drug may be the answer that the world is looking for, in terms of an HIV cure. “This trial clearly demonstrates that disulfiram is not toxic and is safe to use, and could quite possibly be the game changer we need,” Lewin said.

Meanwhile, study co-author Julian Elliott said that the action of disulfiram on HIV cells is just the first step, although it’s a big one. “This is a very important step as we have demonstrated we can wake up the sleeping virus with a safe medicine that is easily taken orally once a day… Now we need to work out how to get rid of the infected cell. A kick-start to the immune system might help. We have an enormous amount still to learn about how to ultimately eradicate this very smart virus,” Elliot said.

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Early Disease Detection Health & Wellness

Breast Cancer Prevention: Single is Better Than Double Mastectomy

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In spite of the recent trend of undergoing double mastectomy to prevent breast cancer in women, a new study suggests that single mastectomy may already be enough for early-stage cancer.

This was confirmed by a team of researchers led by Dr. Nicolas Ajkay of the University of Louisville School of Medicine in Kentucky. In the study presented during the 2015 Clinical Congress of the American College of Surgeons, the research team looked into the benefits and disadvantages of single (or unilateral) mastectomy and double mastectomy for non-hereditary breast cancer in its early stage. The study focused on cases wherein the cancer cells were found on only one breast. Data from earlier studies on mastectomy were cross-referenced with the quality-adjusted life years (QALYs), a parameter that measures the quality of life of a person.

Results revealed that in a span of 20 years, patients who underwent single mastectomy were found to have 0.21 more QALYs than those who had both of their breasts removed. The QALY figure is equivalent to an additional 3 months of healthy life. Dr. Ajkay attributed the lower QALYs in double mastectomy patients to “struggling with surgical complications of reconstruction, lost work productivity and significant emotional hardship,” as reported in a news item.

In terms of costs (including regular screenings for 20 years), the average overall costs for single mastectomy was $13,525. In contrast, double mastectomy procedures cost $18,577 over a 20-year period. “Even under worst-case scenarios, we found that costs and quality of life were superior with unilateral mastectomy. With our study results, I can counsel patients that they may incur a higher cost over their lifetime with a lower quality of life for several months if they choose (double mastectomy),” Dr. Ajkay said.

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Early Disease Detection Health & Wellness

Angelina Jolie’s Preventive Mastectomy Increased Public Awareness, Says Study

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Breast cancer has been a well-documented and properly investigated disease, especially with millions of women around the world developing the disorder. Despite this, many women in past years were not able to receive sufficient advice about the issues surrounding breast cancer, including the idea of reconstructive surgery and preventive measures. It wasn’t until Angelina Jolie announced her preventive double mastectomy that the world took notice.

This was discovered by a recent study published in the journal Cancer. According to study lead author Dr. David B. Lumenta, “This is the first prospective report to prove the media’s effect on the health care-related issue of breast cancer among the general public,” said Lumenta in a news article.

The study conducted a survey on 1,000 women who were asked about reconstructive breast surgery. The first batch was asked one month before Jolie released her statement, and the other batch surveyed a month after the announcement. Results of the survey are as follows:

  • An increase by 4 percent was observed in women’s awareness on the possibility of reconstructive surgery.
  • Awareness on using a patient’s own tissue as the source of breast reconstructive surgery increased by 11 percent.
  • A 19-percent boost in awareness on breast reconstruction during double mastectomy was observed.

Jolie’s announcement in 2013 catapulted the term “BRCA1 gene mutation” into public awareness. The gene abnormality was discovered to be a potential risk factor for cancer development.

[ Image source: Gage Skidmore via Wikipedia Creative Commons ]

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Early Disease Detection

About Half of Asian and Latino Diabetes Sufferers Remain Undiagnosed

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More than half of Asian Americans and almost half of Hispanic Americans who have diabetes remain undiagnosed, according to the National Institutes of Health and the Centers for Disease Control and Prevention.

Using newly available data from 2011-2012, the CDC’s National Health and Nutrition Examination Survey (NHANES), researchers were able to quantify diabetes prevalence for Asian Americans for the first time and found that they have the highest proportion of diabetes that was undiagnosed among all ethnic and racial subgroups studied, at 51%. Diabetes was also common in Asian Americans, at 21%. Hispanic Americans had the highest prevalence of diabetes at nearly 23%, with 49% of that undiagnosed.

The results were published Sept. 8 in JAMA, the Journal of the American Medical Association.

The data also found that Asian Americans often develop type 2 diabetes at a lower body mass index (BMI). The NHANES data showed the average BMI for all Asian Americans surveyed was under 25. For the U.S. population overall, the average BMI was just below 29. A BMI of 25 to under 30 is considered overweight, and a BMI of 30 or greater is considered obese. The American Diabetes Association recommends Asian Americans get tested for diabetes at a BMI of 23 or higher, a lower BMI threshold than the general population.

“The large proportion of people with undiagnosed diabetes points to both a greater need to test for type 2 diabetes and a need for more education on when to test for type 2 diabetes, especially since populations such as Asian Americans may develop type 2 at a lower body mass than other groups,” said the study’s senior author, Catherine Cowie, Ph.D., director of diabetes epidemiology programs at the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

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Early Disease Detection Health & Wellness

Most Americans’ Hearts are Older Than They Are

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Three out of every four Americans may have a heart that is older than their actual age, a new report from the Centers for Disease Control and Prevention says.

“Heart age” is a calculation of the age of a person’s cardiovascular system based on their risk factor profile. The risks include:

  • high blood pressure,
  • cigarette smoking,
  • diabetes status, and
  • body mass index as an indicator for obesity.

The report shows that heart age varies by race/ethnicity, gender, region, and other sociodemographic characteristics

CDC researchers used risk factor data collected from every U.S. state and information from the Framingham Heart Study to determine that nearly 69 million adults aged 30 – 74 have a heart age older than their actual age.

“Too many U.S. adults have a heart age years older than their real age, increasing their risk of heart disease and stroke,” said CDC Director Tom Frieden, M.D., M.P.H.  “Everybody deserves to be young – or at least not old – at heart.”

Key findings in the report include:

  • The average heart age for adult men is 8 years older than their chronological age.
  • The average heart age for adult women is 5 years older than their chronological age.
  • Heart age exceeds chronological age for all race/ethnic groups.
  • Heart age is highest among African-American men and women (average of 11 years older for both).
  • Among both U.S. men and women, excess heart age increases with age and decreases with greater education and household income.
  • There are geographic differences in average heart age across states.
  • Adults in the Southern U.S. typically have higher heart ages.
  • Mississippi, West Virginia, Kentucky, Louisiana, and Alabama have the highest percentage of adults with a heart age 5 years or more over their actual age.
  • Utah, Colorado, California, Hawaii, and Massachusetts have the lowest percentage of adults with a heart age above their actual age.

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Early Disease Detection Health & Wellness

Lack of Vitamin D May Cause Multiple Sclerosis

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Lack of vitamin D may be a direct cause of multiple sclerosis, a new study has found.

MS, a potentially disabling auto-immune disease that damages nerve fibres, tends to be more prevalent in places that get less sunshine and sunshine triggering a chemical reaction in the skin is the primary source of vitamin D.

While previous studies have suggested an association between lower vitamin D levels and a higher risk of MS, this latest study has demonstrated a genetic correlation that points strongly to a causal link.

Scientists checked the DNA of nearly 34,000 people and identified variants in the genetic code that were closely associated with a vitamin D blood marker.

A comparison between thousands of MS sufferers and healthy individuals found that people whose genetic makeup was associated with a lack of vitamin D  were at least twice as likely to have multiple sclerosis.

Writing in the online journal Public Library of Science Medicine, the authors, led by Dr Brent Richards from McGill University in Canada, wrote: “The identification of vitamin D as a causal susceptibility factor for MS may have important public health implications, since vitamin D insufficiency is common, and vitamin D supplementation is both relatively safe and cost-effective.

“The importance of these findings may be magnified in high-latitude countries, which have disproportionately higher rates of MS and also higher rates of vitamin D insufficiency.”

The finding provided “strong evidence in support of a causal role of vitamin D in MS susceptibility”, said the scientists.

They added: “Whether vitamin D sufficiency can delay or prevent multiple sclerosis onset merits further investigation in long-term randomized controlled trials.”

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