April is National Sexually Transmitted Diseases Awareness Month, and the CDC and other organizations are teaming up with MTV to sponsor GYT(Get Yourself Tested).org. Click on this link to check out their web site, and once there, click on the Facebook Campus Challenge link too! Let’s spread the word that Buckeye Nation plays it smart when dealing with STD’s!
Roger Miller, MD for BuckMD
Patients have asked me for years to diagnose things over the phone (and now the internet). And okay, sometimes it works; once you’ve had a bladder infection, for example, it’s pretty hard to mix the symptoms up with anything else, and I can get a pretty clear picture of what is going on without actually seeing you.
But more often than not, I want to see you. Nailing down exactly what ails you is much easier in person, where the nuances of your posture, color, ability to carry on a conversation, and innumerable other visual clues are right there in front of me. Lots of things that I can diagnose with a quick glance – rashes, for example – are practically impossible for you to explain over the phone, unless you’re fluent in dermatology-speak and are comfortable with statements like, “I have fluctuant erythematous macules with scaly, raised satellite lesions and non-tender indurated papules.”
To prove my point, let’s steal a page out of Yale Medical School’s playbook and hone our observational skills on a famous work of art. Ladies and gentlemen… I give you the Mona Lisa!
Look at her picture for a few seconds. Now try and tell me exactly what is going on with her. Evoke an accurate picture in my mind. Is she happy? Sad? Tired? Anxious? Make it good enough that I can feel comfortable prescribing medication, ordering lab work or knowing exactly what kind of radiographic study to get. Give it a shot and post it as a comment. It’s not easy!
We’re visual, us humans.
Which reminds me. I was tickling my eyeballs with a stroll through the world wide web today and chanced upon a serious visual gem, something I will refer to myself – and refer patients to – over and over again. This particular image organizes the evidence for vitamins and other nutritional supplements in a unique and visual manner. It’s beautiful. It’s clean. It’s referenced (PubMed and Cochrane, for those of you keeping score). I love it. It’s the iPod of nutritional supplementation knowledge. Take a look for yourself. It’s from the always fascinating Information is Beautiful blog. Enjoy and share with your friends over a lovely cup of green tea, which, as you can see, might actually do you some good!
Thanks to Life in the Fast lane for the head’s up.
Victoria Rentel, MD (OSU SHS)
photo: wikimedia commons
Q: So how do I get rid of these warts?
A: In my post last week, I hopefully reassured you that you don’t have to worry about warts on your hands spreading to more sensitive areas. Now let’s talk about what you can do to get rid of those annoying little suckers!
Cryotherapy: This is the granddaddy of wart treatments. We soak a cotton swab in liquid nitrogen and apply it to the wart to freeze it and the surrounding skin. You can get an over-the-counter kit to do this yourself but they’re kind of expensive and we can usually do a better job for you. About 75% of warts clear with liquid nitrogen therapy, but it often takes at least a couple of treatments spaced a few weeks apart to get the job done. It stings a little but the freezing kind of numbs the area so it isn’t too bad; most people get some redness and irritation for a few days afterwards, but it’s pretty mild.
Salicylic acid: There are a lot of over-the-counter (OTC) salicylic acid preparations available out there – Compound W is probably the most recognizable brand name. The Student Health Pharmacy also has a plaster (MediPlast) that is a lot stronger and more effective for tougher warts and those in areas with thicker skin, like plantar warts. They are available without a prescription and cost less than 2 bucks each. They’re about the size of an index card – you cut off a piece big enough to cover the wart, peel the paper off the back, stick it onto the wart and leave it on for 24-48 hours. You can cover the plaster with a piece of tape to hold it in place if necessary. You peel it off and then scrub away the dead skin and repeat the process until you get to the bottom of the wart. It may take a few weeks, but is also about 70-80% effective at cure.
Squaric acid: The new kid on the block for wart treatment at SHS is squaric acid. It is a 0.2% liquid compound that you apply directly to the wart once a week for 6-8 weeks, leaving it on for 24 hours at a time. How it works isn’t exactly known, but it sensitizes the skin and stimulates the immune system to attack the wart. There isn’t a lot of research into how effective it is compared to other treatment options, but in my limited experience with it, it has been effective when other treatments failed. It requires a prescription and is also inexpensive.
Duct tape: People have been using good old fashioned duct tape to treat warts for a long time. Medical researchers have actually looked into this and some studies found it to be effective while others didn’t. The best I can tell you is if you’re going to try it, use the silver form of the tape since the rubber-based adhesive sticks to the skin better (unless, of course, you’re allergic to latex). The studies that showed benefit had people leaving the tape on for 6 straight days, then removing it, soaking the wart and scrubbing away the dead skin. The process was repeated until it was gone. You can apply a 17% OTC salicylic acid to the wart before covering it with the duct tape but if you do, remove the tape and check the wart every 24 hours since this increases the chance of having a more severe reaction.
There are a few other options out there which we can discuss with you, but those are the biggies. If you’re having trouble with warts, or any other skin problems, come in to see us at Student Health – we’re happy to check it out!
duct tape photo: daddytypes.com
mediplast photo: concentric.net
John A. Vaughn, MD
Student Health Services
The Ohio State University
Today is World TB Day, which recognizes the anniversary of Dr. Robert Koch’s discovery of the bacterium that causes tuberculosis on March 24, 1882. This may not seem like a big deal in 2010, but think about this:
The hardest thing about this disease is that a person can be exposed to infection, but not develop disease for decades. That’s like getting a cold virus when you are ten, and not starting blowing your nose until you are 50! Current estimates are that about 1/3 of the world’s population has been exposed to TB, and, according to the World Health Organization, a person dies of this disease somewhere in the world every 7 seconds.
Public Health agencies are working hard around the globe to develop new strategies to confront, and hopefully eliminate this threat to our health. Our Student Health Services providers have the expertise to answer any questions you may have about this disease, and our nurses and laboratory do the most up-to-date testing procedures when indicated. We also have our own x-ray department right here in our building.
Come see us for any questions or concerns you may have about this disease.
Roger Miller, MD for BuckMD
Photos: Public Health Image Library from CDC (http://phil.cdc.gov/phil/home.asp)
I know you’ve all heard the condom lecture a million times. “Blah blah blah contraception blah blah sexually transmitted infections.” And I know that when I whip out my patented “Herpes really IS a gift that keeps on giving” spiel most of you just hear a buzzing noise. Well, in science news you can use, a couple of observational studies recently suggest that a condom alone might not be enough for pregnancy and STI protection. You have to be a condom connoisseur, a fashionista if you will, choosing (and using) a condom that not only makes you look good, but feel good.
Like all good fashion, condoms have form and function. Ignore either at your own (and your partner’s) peril. Let’s start with function:
Once you put it on, keep it on! In a recent study, about 40% of male participants reported removing their condom because of fit, or in our analogy, poor form. Commonly cited reasons for removal included penile irritation, loss of erection from discomfort, and partner complaints. A few important fashion tips from the condom runway:
No need to search for a condom tailor. Your local grocery, drug, or big box store is stocked with condoms in all shapes, colors, and sizes. Experiment until you get the fit right. Do that penis proud! I know that in the heat of the moment it might seem like a buzz-kill to look for a condom. But just remember this; when it comes to killing the mood, a few minutes of scrambling through your pockets is nothing – and I mean nothing – compared to the crying of a baby, the flowing of pus from your favorite body part, or the weeping of a herpes vesicle.
‘Nuff said.
Victoria Rentel, MD (OSU SHS)
Reference: Poor Fit Undermines Condom Use, Medpage Today, February 16, 2010
photo: pimpmyrubbish.co.uk
Student Health Services is voluntarily accreditated by The Joint Commission, an independent organization that reviews the quality and safety of care in hospitals, ambulatory care facilities, nursing homes, and other sites across the country.
The Joint Commission is sponsoring Patient Safety Awareness Week, March 7-13, and is offering you a Patient Safety IQ Quiz. The quiz is a fun way that patients can test their knowledge about how to prevent infection, what they need to know about their medicines, how to talk to their doctor, and other important safety tips.
The direct link is http://www.surveymonkey.com/s/Patient_IQ_Quiz. Everyone who takes the quiz will be entered in a drawing to win one of 20 of The Joint Commission’s patient safety books, “You: The Smart Patient” or the new “The Smart Parent’s Guide.” The quiz contains 11 questions and will be available through March 13.
Have fun! BuckMD
The snow is melting, finals are approaching, and then: SPRING BREAK!!!
As you make your spring break plans, whether they involve a sunny beach or a ski slope, or perhaps just a restful time at home or with friends, BuckMD wants you to be safe and healthy. The American College Health Association and the US Centers for Disease Control and Prevention also want to remind you of the risk for H1N1 influenza. Even though the number of cases is much less than in the spring and fall of 2009, there can still be exposures with travel and large grouping of people. Please read this important joint statement for more information.
If you haven’t been vaccinated against H1N1 flu, it is not too late! Vaccine is still available at Student Health, at many doctors’ offices around the community, and at through Columbus Public Health. If you have questions, please call Student Health Services at 293-4321, or email us at: buckmd@studentlife.osu.edu.
Roger Miller, MD for BuckMD
Q: I turn really red after drinking alcohol. I’ve been told it’s because I’m Asian. Is that true and if so, is there anything I can do to prevent it?
A: Unfortunately, it is true and a fairly common problem – it’s estimated that 50% of people of Asian descent suffer from the “Asian flush” when drinking. Some have it worse than just turning red; more severe reactions can include swelling, nausea, vomiting, chest pain, vertigo, palpitations and low blood pressures.
The problem arises from an inactive enzyme called acetaldehyde dehydrogenase, which breaks down a toxic byproduct of alcohol metabolism called acetaldehyde. When acetaldehyde accumulates in the body it causes the symptoms mentioned above. While this can be annoying, there is no evidence to suggest any long-term side effects from the buildup. The amount of alcohol needed to produce the reaction varies from person to person.
An article that I recently read in Time Magazine suggested that the reaction is actually a trait that evolved in the ancient Asian population to protect against alcoholism. Recent studies do show that there is a much lower rate of alcoholism in individuals with the inactive enzyme, for obvious reasons. In fact, there is a medication used to treat recovering alcoholics called Disulfiram (“Antabuse”) that blocks the acetaldehyde dehydrogenase enzyme to cause an artificial “Asian flush” reaction and therefore make drinking alcohol less appealing.
Inheriting the inactive enzyme is genetic, so one or both of your parents also probably has the condition. Since there is no way (yet) to replace the inactive enzyme, the only way to avoid the flush is to avoid alcohol. That may make for a lame New Year’s Eve, but at least now you know what causes your redness and you have a good excuse to abstain the next time your friends want to go out drinking.
Adam Brandeberry, Med IV (OSU COM)
John A. Vaughn, MD (OSU SHS)
photo: sloonart2008.blogspot.com
We’ve been seeing a lot of students here recently who are preparing for travel abroad – see our last post. These visits are fun. They’re exciting! Pack your bags; brave new world; new foods; exotic locations….It takes me back to my own study abroad days. Thinking about flying across the ocean, though, makes me tired.
Jet lag occurs when you cross multiple time zones without giving your brain – which regulates your internal (cirdadian) clock – time to catch up. It’s a common phenomenon of air travel; if you’ve even flown across country you might have experienced it: irritability or moodiness, fatigue and daytime sleepiness, insomnia (ironic in that you are bone-tired but can’t fall asleep), upset stomach, and trouble concentrating. Jet lag may cause one, several, or all of these symptoms.
Some people can tolerate big changes in their sleep-wake cycle, but for most of us, the farther the travel the more severe the symptoms. In general, traveling east-to-west is more difficult that west-to-east. And those of us who fly in the cattle car, er, coach, find that we tend to be more tired than those who recline and sleep in business and first class.
There are some things you can do to minimize the pain:
Don’t forget to send us a postcard!
Victoria Rentel, MD (OSU SHS)
American Academy of Sleep Medicine’s Melatonin information page.
Jet Lag. Sack, RL. New England Journal of Medicine Volume 362:440-447. February 4, 2010.
Photo: forbestraveler.com
Take a trip with SHS!
Student Health Services sees a lot of students with plans to travel internationally, either as part of one of the many OSU Study Abroad opportunities, other travel associated with academic programs, or recreational travel. Before you grab that passport and head for the airport, here are some healthy pointers:
Keep in mind, disease exposures can occur on a 3 month excursion across a continent or during a 5 day trip to a beach resort. So, come see us before you order your Spring Break airline tickets. Reduce the risk of having your trip to Cabo result in spending the first weeks of Spring Quarter sick from a preventable illness.
Healthy Travels!
Roger Miller MD and Pat Balassone, CNP for BuckMD