Wanna keep your heart healthy? Brush your teeth!

Dentistry

We have learned over the years that inflammation is the ultimate culprit in many types of disease.  A recent article in the British Medical Journal has looked at a link between inflamed gums and the likelihood of developing fatty deposits in blood vessels (called atherosclerosis), which leads to lots of bad things down the road like heart attacks and strokes.  These researchers looked to see if there was a relationship between the frequency with which someone brushed their teeth and the likelihood of them developing heart disease.  Turns out that brushing twice a day was associated with less heart disease than brushing less frequently. 

Now, I am sure there are scientists out there saying, “Well, people who don’t brush their teeth probably don’t take care of themselves in other ways, too so how do you know it was the tooth brushing that helped them.”  If you thought the same thing, good logical thinking!!  The researchers took a lot of other variables – age, gender, wealth, smoking, physical activity, weight, family history of heart problems, high blood pressure, and diabetes – into account when they designed the study to help them decide if there really was a significant association between what they are studying and what they found.  And they decided that toothbrushing really did have an impact on developing heart disease.  You can read the details yourself to see if you think they really proved it – I’m sure they’d love to hear from you.

Bottom line – keep brushing those pearly whites, and you may just be around longer to use them! 

Roger Miller, MD (OSU SHS Preventive Medicine)

Too much of a good thing . . .

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I’ve heard I’m supposed to wear sun block all the time, so I’ve been using an SPF 15 that’s included in a moisturizer.  If I use a higher SPF on a daily basis, is there anything nasty in it that wouldn’t be good to have on my skin 24/7/365?

A great question for the first day of summer!

There are quite a few rumors out there about sunscreens. Let’s shed some light on the subject:

  • A high SPF guarantees protection: There are two kinds of risky rays: UVA and UVB. Believe it or not, the present rating system is only for UVB. An SPF of 8 billion may tell you that you could walk on the surface of the sun without a single UVB ray getting to you, but it says nothing about how many UVA rays will microwave your skin when you’re walking around the Oval. The FDA is working on this, but for now, it’s all we’ve got.
  • The higher the SPF the better: There’s actually not a lot of incremental benefit as SPF increases. Going from SPF 15 to SPF 30 only blocks about 3% more UVB, and going from 30 to 40 only improves things by about 1%. Higher SPF products can cause more allergic reactions to product ingredients so if you want to go higher than 15, going over 30 probably won’t provide much extra benefit. Regardless of SPF, you should always apply sunscreen generously and reapply often.
  • Sunscreens cause cancer: There is a mountain of evidence that sunscreen prevents skin cancers, particularly squamous cell carcinomas. There was some speculation that if newer ingredients like oxybenzone, avobenzone, titanium and zinc oxide (for UVA protection) were absorbed through the skin they might mess with estrogen and testosterone levels and put people at an increased risk of cancer but there’s no evidence that this actually occurs in humans.
  • Never, ever go out in the sun without protection: You will never be sorry you used sunscreen on your face. Leaving the issue of cancer aside, sun supercharges wrinkles and other signs of age (sagging, discoloration). For the rest of your body, though, it’s not as clear. The problem is partly with our climate. We need sun to convert precursors in our skin to Vitamin D. Given that we spend several months of the year practically sun-free, many Buckeyes have Vitamin D deficiency. While there is some evidence that low levels increase our risk for certain cancers, there are real risks of Vitamin D deficiency, for example, osteoporosis and an oldie but a goodie, rickets. It doesn’t take a lot of sun exposure to generate Vitamin D production in the skin, only 10-15 minutes a few days a week.

In general you’re okay if you:

  • Apply sunscreen generously and reapply every couple hours if you must remain outside.
  • Stick with a sunscreen with an SPF of 15-30.
  • Look for a sunscreen that offers UVA and UVB protection. Look for the American Academy of Dermatology seal of approval.
  • Here in Central Ohio, it’s probably okay to skip the sunscreen for brief exposures of 10-15 minutes two-three times a week during non-peak hours. (Peak hours are 10am-4pm). Cover up that face, though.
  • If you’re worried about your Vitamin D supply, schedule an appointment to discuss a diagnostic blood test and/or dietary replacement with your healthcare provider.

For more than you ever wanted to know about UVA, UVB, and the evidence about sunscreen, cancer, and toxicity, click here.

Victoria Rentel, MD (OSU SHS)

Is HPV vaccine available for men?

Get your vaccination

A BuckMD reader asks:  If so many forms of HPV do not show symptoms, why isn’t the vaccine approved and recommended for men as well?”

A: The HPV vaccine has finally been approved for men between 9-26 years of age, and is given in a three-shot series over six months.  It protects against four types of HPV virus that cause warts, and two of those types can also cause cancer of the cervix in women.  It is a fairly expensive vaccine, so check with your health insurance plan to see if they provide vaccine benefits for this vaccine.

HPV is a skin-surface viral infection that can be spread sexually by direct skin-to-skin contact.  Condoms can help, but if you have infection in places that the condom doesn’t cover, then you can still spread it.  Most HPV warts resolve and go away over time, but they can recur and spread. There are a number of treatments available through your clinician to treat the warts and get rid of them faster.

Since there is a link between cervical cancer and HPV in women, we are often asked about other cancers in either gender.  There are links between HPV and penile cancer, anal cancer, and some throat cancers.  It will take time to determine if the HPV vaccine protects against these cancers, since most of them are rare.  For more information about HPV and cancer, the American Cancer Society has a detailed review available at this link

Photo credit: Public Health Image Library, CDC

Roger Miller, MD (SHS Preventive Medicine) for BuckMD

Still Open for Business!

Wilce Student Health Center

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Surfer on the Beach

Q: Does the Student Health Center stay open over the summer?

A: Absolutely!   We are here all summer to take care of your health care needs.  In fact, we’re not so jam-packed over the summer since many students do leave campus, so it is a great time to take care of those routine visits you didn’t have time to get to during the school year: eye exams, dental cleanings, women’s annual exams (pap smears) or STI screenings.  To schedule an appointment, just call our appointment desk at (614) 292-4321.

If you have Student Health Insurance, be sure to schedule your appointment before June 20, 2010 – that’s when your spring quarter coverage ends.  If you want to keep your insurance coverage over the summer, be sure to purchase off-term summer coverage no later than June 20, 2010 at the Student Health Insurance website.  Summer quarter coverage is in effect from 6/21/10 – 9/14/10.

If you get your health insurance through another company, be sure to contact them directly to confirm what type of coverage you have at the Student Health Center.  We are happy to bill outside insurance companies, but for us to do that effectively you need to register your insurance with us.  You can call (614-292-0113) or visit our Patient Relations Department on the 3rd floor of the Wilce Student Health Centerfor help with that. 

Enjoy your summer!

Susan Henn

Manager, Patient Relations (OSU SHS)

What do I do for health insurance now that I’ve graduated!?

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Don't get lost in the crowd!

womenshealthmag.com

Q: I’m graduating but don’t have a job yet.  What do I do for health insurance?

A: Graduating from THE Ohio State University is a major accomplishment.  It’s a time for excitement and celebration – you earned it. 

But once the speeches end and you turn the cap and gown back in to the bookstore, you’ve got to face the “real world” and that can be kind of a scary place.  Especially if you don’t have a job.  Or the job you do have doesn’t provide you with health insurance.

So as a graduation present to all of our newly minted Buckeye alums, we’ve compiled a list of resources that can help you find affordable (relatively speaking) health coverage.  We know it ain’t a new car or a Rolex (talk to your parents about that),  but it may be even more valuable to you – one illness or accident without insurance can cost you big bucks in a hurry. 

Congratulations on everything you’ve accomplished.   Now go out there, work hard, stay healthy and take the world by storm!

Go Bucks!

COBRA insurance They have an alternative plan that can provide temporary health insurance for 30 days, 6 months and 12 months. The length of coverage might be able to be adjusted to meet the consumer’s needs. Visit http://cobrainsurance.com/ for details.

Compare 6 plans and receive a free prescription plan http://www.consumerbenefits.net/cobra-insurance.htm. This is an alternative to COBRA insurance. You can compare all 6 plans on their website and receive a free prescription plan when applying through this site.

GradMed http://www.gradmed.com. This is an official program of the Ohio State University Alumni Association. It is recognized by almost 200 colleges/alumni associations. Comprehensive coverage for alumni and family members under age 65 is available. Great for new grads and other alumni between jobs. The graduate would have a deductible between $500 and $2500. After deductible is met, GradMed will pay 100% of the usual and customary medical expenses up to $1 million. 

The best perk with this option is that there is no co-pay for office visits and no list or network of health care providers to select from. You can go to any licensed doctor or hospital of your choice.  Policy can go into effect the very next day.  Coverage period can range from 30 to 180 days, but you can request an extension of coverage.

Temporary Insurance Quotes http://www.temporaryinsurancequotes.com/ This website is similar to shopping for car insurance. You plug in the required information and health insurance companies will respond with quotes for temporary health insurance coverage.

Free Health Clinic There might be a free health clinic where you are move. Some places do charge a very little fee ($20) while some will ask for a small donation. Some are for low income people. Some only serve the local community residents, etc. You can visit http://www.freemedicalcamps.com to access the listing of free health clinics. If this does not work; consider contacting the local county Health Department.

Can you really break your penis!?

abc.go.com

Q: I saw a guy on Grey’s Anatomy who supposedly fractured his penis.  Is that really possible!?

A: Yes, my friend, unfortunately that was not pure Hollywood make-believe.  While it’s pretty rare, you can actually “break” your best friend. 

Now, despite the ever-popular slang term for an erect penis, there is no actual bone involved.  Penises become erect when blood flows into two side-by-side spongy, cylindrical tubes called the corpus cavernosa.  These tubes are surrounded by a layer of connective tissue called the tunica albuginea.  If an erect penis is forcefully or suddenly bent, the tunica albuginea can rupture – this is a penile fracture. 

Penile fractures usually occur during aggressive sexual activity, but can happen during any activity in which an erect penis is subjected to blunt trauma.   There has actually been a case report of a running back suffering a penile fracture while getting tackled.  (It must’ve been a really exciting game… )

Penile fractures are extremely painful and are often accompanied by an audible “pop” or “snap” sound.  They cause immediate bruising and swelling of the penis, and blood will often leak out of the tip. 

Penile fractures are a surgical emergency – if they are left untreated, they can lead to penile deformities and erectile dysfunction.  If you experience any of the above symptoms, you need to get to your nearest emergency room ASAP.

Adam Brandeberry, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

A Medicine By Any Other Name

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Medicines are as confusing as they are expensive.  Your doctor prescribes you Prevacid for your heartburn, but you get a bottle of something called Lansoprazole.  You ask your pharmacist for some Advil for your headache, but he grabs a bottle of Ibuprofen off the shelf.  What’s going on? 

What’s going on is a name game, my friends, and if you learn the rules, you will save yourself some serious cash over the next few years.

Medicines can have two names: a generic name and a brand name.  The generic name is the actual scientific name of the drug and the brand name is a specific trade name used by a specific manufacturer.  So are brand and generic medications the same?

For all intents and purposes – yes.  In order for a generic medication to be allowed onto the market, it has to have the exact same active ingredient at the exact same strength as the brand name. Where they are allowed to differ is color, shape, size, etc.  So unless you have an allergy to certain dyes, you shouldn’t have any problem with the generic version.

So why are brand name medications so much more expensive if they are the exact same medicine as the generic?  Unfettered greed on the part of the Big Pharma evil empire?  Not exactly…

A drug company may spend millions of dollars to develop a new medicine and bring it to market.  After the patent runs out, the drug’s secret formula is no longer a secret and generic manufacturers can swoop in and sell it without having to invest any of that time and money so they can charge a lot less. That’s good for us, but the brand manufacturer needs to cover their development cost and turn a profit so they are given the patent window to do so. 

Where it gets a little shady is in the realm of what you could call “copy cat” medicines.  When a brand name drug is about to go off patent, drug companies will sometimes launch a “new” drug that is really just a slightly tweaked version of the old one.  They’re technically different medicines so the patent clock gets reset, but they essentially do the same thing.  When your health care provider gives you a prescription, it can never hurt to ask if there is a generic equivalent available.  It can save you big bucks.

In my next post, I’ll give you a quiz – match the generic medicine to its brand name.  Unlike most of the tests you take here at Ohio State, this one could actually save you money!

Jason Goodman, PharmD, RPh

Do I have a bug or not?

My belly hurts!

osumccooking.blogspot.com

Jogging with tunes

Q: I was wondering if there is a stomach bug going around in the Central Ohio area? I, along with several others, have been experiencing stomach pain and diarrhea on and off for about a week. 

A: As of this posting, there are no new bugs happening to our knowledge.  If you are having these symptoms for more than a few days, you should see a clinician for an evaluation.

Student Health watches for any information on illnesses in the community that could impact our students.  Our colleagues at the OSU Medical Center, Columbus Public Health, and Ohio Department of Health provide expert support.  Several weeks ago, when the E coli O145 appeared in Ohio, Michigan, and New York, we worked together looking for cases and performing surveys to help identify the cause.  This was the first suspected outbreak of this particular bacterium in the US.

Meanwhile, with the spring growing season underway, and warmer spring and summer temperatures, it is also the time of year for illnesses related to poor food handling.  I hope that was not the case for you, but here are a few tips from the Ohio Department of Health for all of us to keep in mind:

Start clean

  • Wash hands thoroughly before eating, preparing food, after using the bathroom, changing diapers or after contact with animals.
  • Thorough hand washing is defined as using warm water and washing with soap for at least 30 seconds. In public restrooms, use a paper towel to turn off the faucet and open the door.
  • Wash meat thermometers, counters and utensils with hot, soapy water after coming in contact with raw meat.
  • Wash all fruits and vegetables well, especially those that will be served raw.

Food and Grilling Safety

  • Keep meat and poultry refrigerated until ready to use, and keep raw meats and their juices away from other foods.
  • Meat and poultry cooked on a grill often browns very fast on the outside. Use a food thermometer to be sure the food has reached a safe internal temperature. Whole poultry, 180 °F; breasts, 170 °F; Ground beef hamburgers, 160 °F; ground poultry, 165 °F. Beef, veal and lamb steaks, roasts and chops, 145 °F. All cuts of pork, 160 °F.
  • After cooking meat and poultry on the grill, keep it hot until served – at 140 °F or warmer.
  • When taking food off the grill, use a clean platter. Don’t put cooked food on the same platter that held raw meat or poultry.
  • In hot weather (above 90 °F), food should never sit out for more than one hour.

Some other wise tips

  • Drink only pasteurized milk, juice or cider.
  • Keep your cooler out of the direct sun and place it in the shade or shelter. Avoid opening too often. Pack beverages in one cooler and perishables in a separate cooler.

Adapted from Summer Safety, an ODH Feature last updated 5/27/10

Have a healthy summer! 

Roger Miller, MD (SHS Preventive Medicine) for BuckMD