Twinkies Really Are Like Crack!

photo: ehow.com

Hitting the press this week, results of a peer-reviewed study from the Scripps Institute contending that Ho-Ho’s and junk food in general are food heroin.

The headline in Science News: “Junk Food Turns Rats into Addicts” made me want to pull up a Nutty Bar and read more. Investigators contend that if you give a rat bacon, a Ho-Ho or cheesecake, he’ll soon be knifing his fellow rats in the alley for more money for the vending machine.

To prove the addictive powers of junk food, researchers went to the grocery store and picked up a bunch of bad-for-you-but-oh-so-tasty foods like sausage, cake, bacon and Ho-Hos. They divided rats into two groups: unlimited junk food versus yummy “high nutrient, low calorie” chow.

What they found was the Ho-Ho rats started eating with abandon. They become compulsive about ingesting cheesecake, and they would even endure an electric foot shock to get their fix. Standard chow-fed rats who were allowed to have only the occasional nibble of something tasty and were not as willing to be shocked for the sake of a Frito.

As Ho-Ho rats continued eating, it took more and more junk to achieve a “high”. And once the junk food was removed and the rats were offered only the high nutrient, low calorie chow, they simply stopped eating; as I might if offered edible cardboard after cheesecake and Doritos.

Researchers suggested that this study was “the most complete evidence to date” suggesting that both obesity and drug addiction have similar neurologic causes.

Perhaps. These findings are certainly compelling, but it is important to remember that humans aren’t rats. Our brains are similar, not identical. Most humans won’t ever be addicted to anything. While rats are clever, humans are capable of informed, learned, nuanced behavior.

Are these studies a fair fight? There’s no question – at least in humans – that most would choose to eat something tasty versus something pasty, and that has nothing to do with addiction. Nevertheless, as I reach for another Tootsie Roll, I am unsettled. Am I an addict?  Are you?

Victoria Rentel, MD (Student Health Services)

H1N1line – trouble with Student ID number??

 We are getting a number of questions related to the H1N1 vaccine telephone system and the Student ID number.  This is an 8 or 9 digit number assigned to you as a student in the Student Information System.  Newer BuckID cards have it printed just above the BuckID number. 

Some older BuckID cards do not have the ID number listed. If this is the case for you, you will need to go to www.buckeyelink.osu.edu and scroll down to “Personal Information”. Click on “Lookup your OSU ID Number” and follow the prompts. 

Roger Miller, MD for BuckMD

 

How can women prevent urinary tract infections?

photo: wikimedia commons

Q: How can women prevent urinary tract infections?

A: Urinary tract infections (“bladder infections” or “UTI’s”) are much more common in women than men mostly due to anatomy: women’s urethras are much shorter.  Most women experience at least one UTI in their lifetime and many especially unlucky ladies experience multiple UTIs. In one study, 27% of college women with UTI had recurrence of their UTI within 6 months.

The most common cause of a UTI is bacteria that live in and around the anus.  These critters can travel to the urethra, especially during sex or when wiping from back to front after going to the bathroom.

So what can you do to prevent them?!

  • Avoid the use of spermicides, which can harm the normal “healthy” vaginal bacteria
  • Drink plenty of fluids and urinating after sex to “flush out” bad bacteria
  • Drink cranberry juice, which acidifies the urine and helps prevent bacteria from clinging to the wall of the bladder where they cause infection
  • Make sure to wipe front to back every time you go to the bathroom
  • Some women who have frequent UTI’s may need daily antibiotics to prevent them

If you have symptoms of a urinary tract infection – burning with urination, blood in your urine, urinary urgency (the need to go “all of a sudden”), urinary frequency or cloudy/foul smelling urine – be sure to see your health care provider for evaluation.  If left untreated, UTI’s can occasionally progress into more serious infections of the kidneys. 

Angela Walker, Med IV (Ohio State College of Medicine)

Sheila Westendorf, MD (Ohio State Student Health Services)

Intranasal steroids and the Flumist vaccine

photo: PRNewsFoto

Q: Can someone who is using an intranasal steroid such as fluticasone still receive the Flumist version of the flu vaccine?

A:  Great question!  Flumist does not list any specifics but I spoke with Glaxo-Smith-Kline, the manufacturer of the intranasal steroid Flonase (fluticasone) and they advised against using the nasal vaccine if you are currently using an intranasal steroid.  The drug information insert that comes with fluticasone also recommends against using intranasal steroids if you have a viral infection present.

Other common intranasal steroids include mometasone (Nasonex), triamcinolone (Nasocort), budesonide (Rhinocort) and beclamethasone (Vancenase, Beconase).  If you are using any of these medications, be sure to talk with your health care provider prior to receiving a nasal spray version of the flu vaccine.

Roger Miller, MD (Ohio State University Student Health Services)

Does Size Matter?

photo: buffetoblog.wordpress.com

Q: Does size matter?

A:  It kills me to even type those words – I feel like some cheese ball writer for Glamour or Maxim or something.  However, as a male physician in college health, I have a front row view of the health concerns (and to be quite frank, packages) of literally thousands of men, which makes me a somewhat reluctant expert on what is unfortunately a serious concern for a lot of men.  So guys, I hope to put your mind at ease once and for all.    

First, the facts:

  • The average adult penis ranges from 4 to 6 inches when erect.  
  • A penis smaller than 3 inches while erect can be an indication of a rare medical condition called ‘microphallus’ and should be evaluated by a health care provider.
  • The most sensitive areas of a woman’s anatomy are in the outer third of the vagina, so any normal sized penis is sufficient for physical stimulation.
  • Penis size has no relationship to fertility

But here’s the most important thing to remember – the size of a flaccid penis really has nothing to do with the size of an erect penis.  Some remain at or near full length when flaccid while others expand a lot during erection – some guys are “showers” and some guys are “growers” – and most major differences usually disappear when it really counts.  So don’t get freaked out if you happen to steal a glance at the guy next to you in the RPAC locker room; unless he’s really excited about his work out, you’re comparing apples and oranges (or maybe apples and bananas).   

Besides, worrying about the size of Big Jim and the Twins is as futile as being a Browns fan because the fact is, there’s nothing you can do about it.  All the penile calisthenics in the world – stretching, pulling, hanging weights on it (yes, I’m serious) – do nothing except expose your body to harm.  All those pills, creams and lotions you see on late night infomercials?  Garbage.  Penile enhancement surgery?  You do not want to go anywhere near that horror show. 

If you’re overweight, shedding a few pounds wouldn’t hurt; there’s a fat pad overlying the pubic bone that may reveal an extra inch or so if you can lose it.  And I suppose some creative manscaping might enhance your silhouette.  But please take it easy – there are guys walking around campus with more meticulous pruning in their pants than the average topiary garden and that kind of self attention is a little frightening. 

What you should really worry about is why you’re worried about this in the first place.  Some of it is cultural; unrealistic body image ideals promulgated by pornography and erotic images in the media, the aforementioned glossy rag magazines that rehash the topic over and over (after all, if people keep asking the question, there must be something to it, right?).  But it may be more serious and personal, such as a traumatic experience with a previous sexual partner.  Whatever it is, it’s usually more about anxiety than anatomy and if these concerns are having an adverse effect on your life, you should talk to someone at Student Health or CCS about it.

But don’t take it from me.  Take it from my high school Health Ed teacher, Coach “Crotch”:

Remember boys, your most important sexual organ is the one between your ears!

John Vaughn, MD (Ohio State Student Health Services) 

           

Is the H1N1 vaccine safe??

fluvaccine.com

Q: How can they make the H1N1 vaccine so fast and still know if it is safe?

A: The flu virus constantly changes, so a new seasonal flu vaccine is made every year.  Flu strains for the next season are selected during the winter and the vaccine is ready by September; this includes performing clinical trials and FDA approval.  Since H1N1 is really just a new influenza virus, the technology to make it is already in place so its production isn’t as rushed as it may seem. 

The H1N1 vaccine has been extensively tested and approved by the FDA.  As of October 23, 2009, there have been 1198 scholarly articles published about the vaccine, 218 of which are specifically about the clinical trials used to test it.  SO…this vaccine is considered to be just as safe and effective as the regular vaccine, which has a track record of safety dating back to the 1940’s.

Let me put it another way.  I am going to be vaccinated and I’m recommending it to all the members of my family according to their health status.

Roger Miller, MD (Ohio State Student Health Services) 

Where’s My Shot?

fluvaccine.com

Q: Where can I find a regular flu shot?

A: Student Health is continuing our fall outreach with the seasonal (regular) flu vaccine until we use up our supply or you stop asking for it, whichever comes first.  A lot of places are short on the regular flu vaccine right now because several of the vaccine companies had to stop making it in order to make H1N1 vaccine.  Our regular flu season starts right around January, and we hope the vaccine supply will improve before then.

Q: When is Student Health going to give H1N1 shots?

A: Everything is in place for us to start giving these shots – all we need is the vaccine!  We’ll let you know as soon as it arrives.  Registering on the H1N1line (614-514-4161 or 4-4161 from a campus phone) will help us immensely in getting the vaccine to everyone who needs it.  If you are interested in getting the shot, please call to register.

Stay tuned on the SHS web page and flu.osu.edu for more updates.

Roger Miller, MD (Ohio State Student Health Services)

Are you hot or not?

Photo: Catherine Ledner/Getty Images

A question I ask patients oh, 10 or 15 times a day is, “Have you had a fever?” This question, seemingly so simple, is actually fairly complicated.

Normal body temperature, we’ve all been taught, is 98.6º. This is a bit of medical mythology. Nobody’s temperature is 98.6º all the time. Core body temperature is regulated by an area in the brain called the hypothalamus and it changes throughout the day. We generate heat through various metabolic processes in the liver and muscle (like shivering when we’re cold) and we lose heat through our skin and lungs. Our environment obviously plays a part as well.

“Normal temperature” can vary from 96.0º to 100.8º. Most of us are in the lower end of our range in the morning and reach our peak around 4 in the afternoon. The normal range for women also varies during the menstrual cycle. Temperature often rises after we eat. As we get older, our baseline temperature goes down a little and our ability to mount a fever in response to illness can become less predictable.  This is why your grandmother wears a sweater to the pool in August, and unfortunately, why she can sometimes be a lot sicker than she looks. 

When we get sick, the set-point of our thermostat (the hypothalamus) gets moved up, just like the thermostat in your home, and a message is dispatched to the blood vessel control center in the brain suggesting that you “clamp up”. This vasoactive center issues forth a plethora of chemical messages which cause the blood vessels in your hands and feet to constrict which shunts blood from the skin to the internal organs.  This causes your core body temperature to go up, while you simultaneously feel colder.

People often get hung up on the absolute numbers – I’ll often hear, “My temp is 99.6º but I usually run low, so that’s a real fever for me.”  I’m not so worried about that.  In general, a temperature of 100.4º or more is concerning but I’m more interested in trends. What about today, yesterday, last week, last month? Are you a lot higher in the morning or evening? Does your temp spike and trough during the day? Does this happen a few times a week? Has it been going on for months? What else is going on?

In other words, I want to know exactly when and how hot you really are.

Victoria Rentel MD

CDC says no to Gardasil for boys

Photo: ABC News

In a follow up to yesterday’s post, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control & Prevention (CDC) voted against the routine use of the Gardasil vaccine in boys and men.  The Gardasil vaccine offers protection against the most common strains of the Human Papilloma Virus (HPV) that cause cervical cancer and genital warts.

The ACIP actually gave Gardasil a “permissive recommendation.”  That means that physicians can offer the vaccine to boys/men if they feel it is indicated, but they are not required to.  

This issue will most likely continue to evolve over the next few years.  Student Health Services will monitor the situation and keep you posted on any important updates.

John A. Vaughn, MD (Ohio State Student Health Services)

Will Student Health offer the HPV vaccine to men?

Photo: ABC News

Q: Now that Gardasil has been approved for use in boys and men ages 9 to 26, will the Student Health Center start offering it to the male population of OSU?

A: On Friday, the FDA approved the use of the HPV vaccine Gardasil in boys and men ages 9 to 26 for protection against genital warts.  Gardasil has been approved for use in girls and women since 2006 to prevent two strains of HPV (Human Papilloma Virus) that cause about 70% of cervical cancer. It also protects against two other strains of HPV that cause 90% of genital warts.

The next step is to see if the CDC’s Advisory Committee on Immunization Practices will recommend routine vaccination of boys – they’re scheduled to vote next Wednesday.  The CDC currently recommends that girls receive Gardasil vaccinations at age 11 or 12.

This looks very promising, but it’s important to remember that there can be a significant time delay between the FDA approving a medical treatment and that treatment being readily available.  It could be months or even years before there is any possibility of insurance coverage for males receiving the HPV vaccine. 

While it’s too soon to know whether or not men at Ohio State will be able to get the HPV vaccine, this is a good opportunity to talk about whether or not they even should.  It’s not as clear cut as you might think.

While over 50% of sexually active people acquire HPV infection at some point in their lives, genital warts only affect 1% of the population and are not life threatening.  HPV has been associated with penile and anal cancers in men, but these too are extremely rare.  It has been suggested that vaccinating men against HPV would benefit women by reducing the spread of HPV to their sexual partners.  But women can get the vaccine themselves, not to mention routine Pap testing which has already greatly reduced the incidence of cervical cancer.

The vaccine costs about $400 and studies have shown that vaccinating men against HPV is not cost effective, even when considering its benefit to women.  Studies done by Merck, the company that makes Gardasil, have purportedly shown that it is cost-effective, but of course they have an enormous financial incentive in having the vaccine administered to as many people as possible. 

If and when Gardasil becomes available for men, rest assured that Student Health Services will work with the Student Health Insurance Office, the University and you to make sure you have the best options available for your health.

John A. Vaughn, MD (Ohio State Student Health Services)