What’s the Deal with HPV?

genital wart caused by HPV infection

photo: timeinc.net

Use protection

HPV stands for Human Papillomavirus. There are over 100 strains of HPV, about 30 of which can be sexually transmitted. HPV can cause a number of different diseases including genital warts and cervical cancer, as well as other less common cancers of the anus, throat, penis, vulva and vagina. Different strains of HPV cause different diseases; the “low-risk” types are more likely to cause genital warts while the “high-risk” types are more likely to lead to cancer.

The CDC (Centers for Disease Control and Prevention) estimates that about 50% of sexually active men and women will get HPV at some time in their lives.  Some people who have HPV have no visible signs of infection, so they spread it to their partners without even knowing they have it.  HPV is spread by direct skin-to-skin contact so you can get it even if you are using a condom.  There is no medical treatment for HPV but fortunately, in about 90% of cases an individual’s immune system will get rid of the virus on its own within two years. 

It is very important that all sexually active women receive an annual exam.  Your health care provider will examine you for genital warts and/or signs of precancerous changes of the cervix called “cervical dysplasia.” Cervical cancer is most successfully treated when it is caught early.

A vaccine that protects against the four most common strains of HPV is now available for men and women ages 9-26. This vaccine will greatly decrease your chances of becoming infected with one of the viruses that can cause cervical cancer.  If you’ve already been infected with one of these four strains, the vaccine won’t cure you but it can prevent you from getting one of the other types.  Even if you do get the vaccine, it is very important that women still go for regular exams.

The staff at Student Health Services is happy to answer any of your questions, perform all recommended exams and tests, and provide the HPV vaccine.  In the meantime, here are some other good sources of reliable information:

http://www.cdc.gov/std/hpv/    http://www.ashastd.org/hpv/hpv_learn_myths.cfm 

http://www.itsyoursexlife.com/gyt/know/std-low-down/

Angie Walker (Ohio State College of Medicine)

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

New Influenza in United States

Bing Images

“Iowa reports three novel swine-origin H3N2 cases”

Another influenza strain has appeared in the United States.  Cases are limited, and most are associated with direct contact with pigs.  Cases spread from person to person remain limited. The virus is a swine-origin triple-recombinant H3N2 that includes the matrix gene from the 2009 H1N1 virus.

  • As of yesterday, 10 cases have been counted in Pennsylvania, Maine, Indiana, and Iowa. 
  • Symptoms are similar to seasonal flu and include fever, cough, tiredness, body aches, and loss of appetite. None of the patients were seriously ill, and all have recovered.
  • The current flu vaccine does not contain this particular strain, but may offer some protection against the novel strain.
  • Personal protective measures such as covering coughs and sneezes and staying home when sick are important.

Though rare, the swine-origin flu infections in humans can occur, especially after close contact with swine.

Swine-origin viruses have shown sensitivity to antiviral drugs oseltamivir (Tamiflu) and zanamivir (Relenza), it said.

From: CIDRAP News, Nov 22, 2011

Roger Miller, MD (OSU Student Health Services)

Get Smart About Antibiotics

photo: ehow.com

cardiophile.com

You wake up this morning with a stuffy nose, and your throat looks red and swollen.  You talk to your roommate, your mom, and your pillow pet, and all of them advise you to get in to see the doctor, and get some antibiotics.  Sounds good?  Well… perhaps not.

The CDC recormmends that you get smart about when antibiotics are appropriate – to fight bacterial infections. Taking them for viral infections, such as a cold, most sore throats, acute bronchitis and many sinus or ear infections:

  • Will not cure the infection;
  • Will not keep other people from getting sick;
  • Will not help you feel better;
  • Will not prevent a future bacterial infection; and
  • May cause unnecessary and harmful side effects.

What Not to Do

  • Do not demand antibiotics when a doctor says they are not needed.
  • Do not take an antibiotic for a viral infection like a cold or most sore throats.
  • Do not take antibiotics prescribed for someone else. The antibiotic may not be appropriate for your illness. Taking the wrong medicine may delay correct treatment and allow bacteria to multiply.

If your doctor prescribes an antibiotic for bacterial infection:

  • Do not skip doses.
  • Do not save any of the antibiotics for the next time you or your child gets sick.

What to Do

Just because your doctor doesn’t give you an antibiotic doesn’t mean you aren’t sick.

Talk with your doctor about the best treatment for your illness. To feel better when you have an upper respiratory infection:

  • Ask your doctor or community pharmacist about over-the-counter treatment options that may help you feel better;
  • Increase fluid intake;
  • Get plenty of rest;
  • Use a cool-mist vaporizer or saline nasal spray to relieve congestion; and
  • Soothe a throat with ice chips, sore throat spray, or lozenges.

Finally, always follow your doctor’s advice about when to return to be rechecked.  Viral infections CAN open the door for secondary bacterial infections.  So, if the doctor says that you should be feeling better in a few days and to return if you are still sick in a week, take that seriously.

Roger Miller, MD (OSU Student Health Services)

Medical Mythbusters – broken bones

you need x-ray specs to see this!

Q: If I hurt my arm or leg but can still move everything, then it’s not broken, right?

A: Wrong!

Bones are long, hard, mineral-filled struts, if you will; kind of like the wood or metal framing inside a house. The connective tissue matrix, or “nails” holding the “struts” together is made up of ligaments, tendons, and strong sheets of fascia. As the framing of a house is attached to insulation and an exterior (a skin), your skeleton is anchored to the rest of your body via a delightfully complicated system of sturdy connective tissue.

As a result of all this connectedness you can breach the support (the bone) and not necessarily have a breakdown in function. Often only a part of the bone is broken (an avulsion or “chip” fracture) and the broken piece isn’t horribly out of place. If the connective tissue matrix isn’t badly damaged odds are you might be able to keep things moving, even if a joint is involved.  The bottom line: It is possible to move a fractured bone.

So how do you know when something is broken? Sometimes it’s obvious: the bone is sticking out of the skin staring back at you or there is a clear deformity of the affected limb.  If that’s the case, by the way, head directly to the emergency room: do not pass go, do not collect $200.

Often, though, the signs are more subtle and you need x-ray vision to evaluate the damage.  Come in to see us and we’ll help you figure it out. We’ll ask you a bunch of questions, poke around to see where it hurts and if we still aren’t sure, we’ll break out our high-tech digital x-ray machine and get a final answer. 

This baby is really cool.  We can look at the x-rays with you on the computer screen right in our office, and while we’re doing that the images are instantaneously zapped over to the radiologists at the medical center to make sure we don’t miss anything. Almost always, we have a definitive answer before you walk (or limp) out the front door so we can make sure you get the proper follow up care.

John A. Vaughn, MD
Student Health Services
The Ohio State University

What causes cold sores and how do you get rid of them?

photo: howtogetridofthis.com

Q: I get cold sores on my mouth a lot. What causes them and how can I get rid of them?

A: Cold sores are caused by the herpes simplex virus (HSV), a stinker of a bug that establishes permanent residence in your nervous system once it infects you.  Fortunately, most of the time the virus lies around doing nothing, but it can be “reactivated” by any number of things: stress, fever or sickness, menstrual cycle, burns and damage to the skin by sun or wind.

When the virus becomes active, there is usually some numbness or tingling in the area where a cold sore will form. About two days later, painful blisters called “vesicles” develop, which then pop and ooze. The sores usually take 7-10 days to completely heal, although in general the pain is the worst the first day or two. Cold sores usually develop on the lips, but can occur anywhere in the mouth.

Unfortunately, there is no cure for cold sores.  There are, however, some things you can do to make the virus less likely to re-activate and treat it if it does:

  • Avoid stress! (Isn’t that an obnoxious thing to say during fall quarter?) Get enough sleep; eat right and use sunscreen if you’re outside.
  • Antiviral medications can make the cold sores less severe and go away a little faster, but they have their limitations: they are expensive, must be started within a few hours of symptom onset to be effective, and don’t all work fabulously well.
  • There are a variety of medications that can minimize the symptoms.
  • Suppressive therapy (medicines taken daily even when there is no active cold sore) can be helpful for patients with frequent reactivation.

If you have a cold sore, wash your hands frequently to avoid spreading the virus to other people or other parts of your body.  It is especially important to wash your hands before touching your eyes or genitals, as these areas are particularly susceptible to the virus. Herpes simplex virus infections of the eye can lead to permanent visual impairment.

If you experience cold sores with eye irritation, cold sores that recur frequently, or cold sores bigger than a toy poodle, be sure to schedule an appointment with your health care provider.

John A. Vaughn, MD
Student Health Services
The Ohio State University

Taking a Drive? Take a Nap!

Obey the sign

Did you know that being awake for more than 20 hours results in an impairment equal to a blood alcohol concentration of 0.08, the legal limit in all states? Not only does drowsiness impair reactions times just like alcohol and drugs, it also impairs judgment and performance.

It is a goal of the National Sleep Foundation to help promote awareness of “drowsy driving.” The National Traffic Safety Administration estimates that 100,000 police reported crashes each year are caused primarily by drowsy driving. With more than 1,550 deaths, 71,000 injuries and $12.5 billion in monetary losses, the consequences of drowsy driving can be life altering.

To help make the roads a safer place, here are some important driving dos and don’ts:

Don’t

  • Drive if you are tired or on medication that may cause drowsiness.
  • Rely on the radio, an open window or other tricks to keep you awake.
  • Drive at times when you would normally be sleeping.
  • Drink even a small amount of alcohol, especially if you are sleepy.

Do

  • Get a good night’s sleep before a long drive.
  • Get off the road if you notice any of the warning signs of fatigue.
  • Take a nap – find a safe place to take a 15 to 20-minute nap.
  • Consume caffeine – the equivalent of 2 cups of coffee can increase alertness for several hours, but DO NOT rely on it for long periods.
  • Try consuming caffeine before taking a short nap to get the benefits of both.
  • Drive with a friend. A passenger who remains awake can help watch for signs of fatigue in the driver and can take a turn driving, if necessary.
  • Always wear your seatbelt.

Check out these websites for more information about Drowsy Driving (www.DrowsyDriving.org) or to learn about the National Sleep Foundation (www.sleepfoundation.org).

HEY YOU!  WAKE UP AND STAY ON YOUR SIDE OF THE ROAD!!

Meredith Greene
Student Health Services
The Ohio State University

Roger Miller, MD
Student Health Services
The Ohio State University

Does listening to loud music hurt my hearing?

Jogging with tunes

Happy times

Q: Since coming to college, I have been going to concerts and listening to music more often. I am worried about hearing loss. Am I at risk?

A: You have good reason to worry about your hearing. Noise-Induced Hearing Loss (NIHL) is a condition that can cause permanent damage to the inner ear. It can occur after a very loud single event (like a bomb blast) or after repetitive exposure to moderately loud sounds. Going to loud concerts and listening to headphones too loud has been shown to lead to NIHL.

The intensity of sounds is measured in decibels. Whispering is in the neighborhood of 30 dB, while normal conversation is around 60-70 dB. A lawnmower puts out about 90 dB and an iPod at its highest setting cranks out 100 dB. The National Institute of Health has found that repetitive exposure to sounds greater than 85 dB can lead to NIHL. How loud is that? If you turn a stereo up to just loud enough so that you can have normal conversation over the music, it is roughly 85 dB.

There are two components involved with NIHL. The first is how loud the noise is, while the second is how long you’re exposed to it.  So what is a safe level of exposure?  It has been found to be safe to listen to iPods at 70 percent volume for 4 hours.

So what can you do to enjoy music and protect your hearing at the same time?

Most mp3 players now have options to lower the maximum volume, which is a good idea.  Purchasing noise-canceling headphones will reduce the need to turn up the volume because the ambient noise is too loud, but they’re pretty pricey.  A cheaper option would be larger ear-cup headphones that block out ambient noise better than ear buds.  If you frequent a lot of concerts, you should consider wearing earplugs – believe me, at 110-120dB (!!) you’ll still be able to enjoy the show.

Adam Brandeberry (Ohio State University College of Medicine)

Kathy Horava, MD (Ohio State University Student Health Services)

What can I do if I think I’ve been given a “date rape” drug?

www.silc.ku.edu

While thankfully rare, incapacitated sexual assault does occur on college campuses.  Womens Services at Student Health has put together some really useful information about what Ohio State students can do if they feel that they were the victim of a “date rape” drug. 

Please check it out.  And remember to be careful when going out to bars or parties or any other place where you might be given a drink from someone you don’t know.  Keep your friends close by to make sure you all get home safely.  

Beth Askue, MS, CNP
Student Health Services
The Ohio State University