There are several risk factors for heart disease and stroke. These include obesity, high blood pressure, diabetes, smoking history, high blood cholesterol levels, and family history of heart disease and stroke. High cholesterol can build up in your blood vessels causing narrowing and reduced blood flow. This can lead to heart disease and stroke.
The U.S. Preventive Task Force recommends that men get a blood cholesterol test at age 35 years and women at age 45 years. This should be done every five years. The cholesterol test may be performed at an earlier age or more frequently if you have any of the cardiovascular risk factors mentioned above. The accuracy of cholesterol tests done at public screenings such as health fairs varies. It is probably better to discuss this with your provider who can order more reliable testing.
Clinical Correlations is a blog managed by the NYU Department of Internal Medicine. I was perusing it this week and came across a great post about whether or not you can catch gonorrhea from sitting on a toilet seat. The blog is written by medical students and physicians for medical students and physicians, so it’s a little heavy on the scientific details, but it’s actually pretty readable and since this is a topic that is always of interest around campus, it’s definitely worth a read.
Check it out… and always remember to put the lid down when you’re done!
John A. Vaughn, MD Student Health Services The Ohio State University
Dr. Emily Gibson, Director of Student Health Services at Western Washington University, wrote a great story about the risks of frequent pubic hair removal in their student paper. I agree with my esteemed colleague that the obsession with pubic hair removal on campuses nationwide has gotten out of hand – I encourage you to check out the article, and put the razor/wax/light saber away for a while.
John A. Vaughn, MD Student Health Services The Ohio State University
Let’s say you are going to Student Health or your private caregiver. In most cases, they are going to ask you a few questions about your sexual health and sexual practices. These questions are very personal, but they are as important as the questions about other areas of physical and mental health. Your answers are kept in strict confidence.
So, are you ready to talk about your five P’s? The five “P”s stand for Partners, Practices, Protection from STDs, Past history of STDs, and Prevention of pregnancy.
Partners
Are you currently sexually active? (Are you having sex?)
In the past 12 months, how many sex partners have you had?
Are your sex partners men, women, or both?
Practices
What kind of sexual contact do you have or have you had?
Genital (penis in the vagina), Anal (penis in the anus), Oral (mouth on penis, vagina, or anus)?
Protection from STDs
Do you and your partner(s) use any protection against STDs? If not, why? If so, what kind”
How often do you use this protection? If “sometimes,” in what situations or with whom do you use protection?
Are there other forms of protection that you would like to discuss today?
Past history of STD’s
Have you ever been diagnosed with an STD?
Have you had any recurring symptoms or diagnoses?
Have you ever been tested for HIV, or other STDs? Would you like to be tested?
Has your current partner or any former partners ever been diagnosed or treated for an STD?
Prevention of pregnancy (Based on partners noted earlier, conception and contraception questions may be appropriate)
Are you currently trying to conceive or father a child?
Are you concerned about getting pregnant or getting your partner pregnant?
Are you using contraception or practicing any form of birth control?
Do you need any information on birth control?
Finally, before you move on to discuss other things with your caregiver, consider:
Are there other things about your sexual health and sexual practices that you should discuss to help ensure your good health?
Any other concerns or questions regarding sexual health in general?
Student Health Services can offer you expert advice, all the current diagnostic and treatment options, and vaccinations that can protect you long term. Come see us, and GET YOURSELF TESTED!
Q: Can a wart on my finger spread to my genital area?
A: All warts (or “verrucae”) are caused by Human Papilloma Virus (HPV). On the hands, they’re referred to as common warts; on the bottom of the feet they’re called plantar warts; around the fingernails they’re called periungual warts; on the genitals or around the anal area they’re called genital warts.
Take a deep breath… I know those 3 little letters strike fear in the hearts of all college and grad students, especially those who are sexually active, but there are over 150 distinct strains of HPV and they all prefer certain body parts and skin types. For instance, HPV-1 has a foot fetish and causes plantar warts while HPV 6 and 11 prefer to hang out in the “junk yard” and cause genital warts.
So while you technically have HPV on your finger – which I know is creepy to think about – it really likes the neighborhood and has no plans to move down to the “Short North” so to speak. I know the blogosphere and wiki-land is ripe with people who swear that they got genital warts from fingers (either their own or someone else’s) – and while the mysterious nature of life (and fear of lawyers) preclude me from “never saying never” – the odds of that really happening are extremely small.
On the surface (ha ha) warts seem like a silly thing to worry about, but they can become a serious emotional issue – the thought of being “infected” by anything can make you feel gross and the fact that they are visible and are spread by skin-to-skin contact can make them especially embarrassing and even affect relationships. But it’s very important to remember that besides the strains of HPV that cause cervical and some other extremely rare types of cancer, warts are only a cosmetic issue. They are not a threat to your health or the health of your partners, and they almost all clear on their own within a year or two.
And the good news is that if you don’t want to wait that long, there are pretty good treatment options available at the Student Health Center to get rid of them quicker. I’ll talk about them in my next post, but for now, rest assured that you don’t need to wear gloves every time you go to the bathroom!
All photos: UpToDate.com
John A. Vaughn, MD Student Health Services The Ohio State University
Q: Which Sexually Transmitted Infections (STIs) can you test for at Student Health and which ones are curable?
A: If you come to the Student Health Center to get screened for STIs (meaning you don’t have any symptoms or worrisome exposures), we check for the following infections: HIV, Syphilis, Chlamydia, and Gonorrhea.
How do we do it? We draw some blood and have you pee in a cup – it’s as simple as that. The blood test checks for HIV and syphilis, and the urine test checks for Gonorrhea and Chlamydia. If you have the Comprehensive Student Health Insurance Plan, STI screening is covered once a year. If you’re on another insurance plan, check with them about coverage.
There are other STIs out there that we can check for if you have specific symptoms or exposures.
Herpes: The only way to confirm that someone has genital herpes is by taking a swab of an active sore. We can do a blood test for antibodies to the Herpes virus, but they aren’t very helpful; they only tell whether or not someone has been exposed to the virus, which doesn’t necessarily mean that they have (or ever will have) active disease.
Hepatitis B&C: We can do a blood test for antibodies to these viral infections if someone is at high risk for acquiring them or if they have been exposed to it, but their incidence is so low in the general population that screening for them isn’t useful or cost effective.
HPV: There is currently no screening test for HPV. The annual Pap smear that women receive is kind of an indirect test for HPV exposure since it screens for cervical cancer, which is caused by HPV infection, but in terms of checking for exposure to strains of HPV that cause genital warts, there are no tests. The only way to confirm if someone has HPV is if they develop a visible genital wart.
Trichomoniasis: Trich (sounds like “trick”) is caused by a protozoan microorganism called Trichomonas Vaginalis. The infection may not cause any symptoms, but since it’s not as common in the U.S. as other parts of the world, and because it usually does cause symptoms like discharge and itching, we don’t routinely screen for it. We can test for that infection by doing a swab and looking at it under the microscope or taking a culture.
In terms of “curing” STIs:
Trichomoniasis and STIs caused by bacteria – Syphilis, Chlamydia and Gonorrhea – are eradicated with antibiotics. Once they are treated, they’re gone.
Those caused by viruses on the other hand – HIV, Herpes and Hepatitis – are a different story. There are no “cures” for any of these diseases; while antiviral medications can help manage flare-ups or delay the progression of the diseases they cause, once you’re infected with them they stay with you for life. As they say in med school: What’s the difference between love and herpes? Herpes is forever!
HPV is a special case. The infection is caused by a virus, and can cause serious long term complications such as cervical, anal and throat cancer, but the majority of people infected with HPV clear the virus on their own and don’t suffer any serious health consequences as a result of having it.
If you have any questions or concerns about STI testing, please make an appointment with Student Health Services – we’re here to help!
John A. Vaughn, MD Student Health Services The Ohio State University
To celebrate the last day of Movember, we’re re-running a two-part post about a men’s health issue that is especially important to male college and graduate/professional students.
In part 1 of this post, I introduced the L (lethal) A (all men) N (numbers) C (curable) E (early self-detection) of testicular cancer, inspired by the cancer survival story of cyclist Lance Armstrong. Now, I want to elaborate further on the topic of early detection.
All males between the ages of 15-35 years are encouraged to do testicular self-examination at least once a month, ideally while taking a warm shower so that the scrotal skin is relaxed. The exam is easy: feel around the testicles for a firm lump the size of a pea or marble that wasn’t there before. If you find one, you should visit your health care provider as soon as possible; a testicular tumor can double in size every 10-30 days and the longer it goes untreated, the greater the potential for metastasis.
Most testicular tumors are painless, at least initially, but sometimes there is tenderness or a sensation of heaviness in the testicle. Sometimes there is just some vague change in the texture or size of the testicle. Other benign conditions – such as varicocele, hydrocele, epididymal cyst, seminoma, or epididymitis – may also cause many of these findings, but diagnosing should be left to the healthcare provider. When the physical exam is concerning or unclear, the next step is usually ultrasound imaging of the scrotum, which is a fast and painless procedure.
Another benefit of periodic testicular self-examination is that the man is more likely to note other problems with his penis or scrotum, such as genital warts, which might then be treated prior to transmission to another person.
Millions of people are now wearing yellow bracelets from the Lance Armstrong Foundation to recognize those who have been affected by cancer. We encourage you to let L.A.N.C.E. remind you of the 5 key facts about testicular cancer, and let each sighting of a yellow bracelet remind you to take charge of your own health and routinely check your testicles (or those of the man you care for).
James R. Jacobs, M.D., Ph.D., FACEP
Director, The Ohio State University Student Health Services
To celebrate the last day of Movember, we’re re-running a two-part post about a men’s health issue that is especially important to male college and graduate/professional students.
The dramatic story of cyclist Lance Armstrong’s cancer survival has raised public awareness of testicular cancer and has made it easier to discuss. Seizing this opportunity, I want to highlight 5 facts about testicular cancer that everyone must know – the L.A.N.C.E. of testicular cancer.
Lethal. Most testicular tumors are malignant, meaning that they have a tendency to metastasize (spread) to other parts of the body, like the lymph nodes, lung, and brain. It is invasion of these other organs, rather than damage to the testicle itself, that leads to serious illness or death.
All men. Testicular cancer occurs most commonly in Caucasians, but all men are at risk. The cause of testicular cancer is not known, but there are well-established risk factors:
History of an undescended testicle. Even with corrective surgery, an undescended testicle is 3-5 times more likely to become cancerous than a properly descended testicle.
A testicle that has not developed properly because of previous trauma, torsion, or mumps infection
Family history of a brother who has had testicular cancer.
Numbers. Testicular cancer is the single most common type of malignant tumor occurring in men ages 15-35. The incidence of testicular cancer has been increasing in many countries, including the United States. The American Cancer Society estimates that approximately 8,400 new cases of testicular cancer are diagnosed in the United States each year.
Curable. Among all forms of malignancy, testicular cancer is one of the most curable. If it is diagnosed in an early stage (e.g., while the tumor is still localized to the testicle) the cure rate is nearly 100%. Even when it is widely metastatic prior to detection, the cure rate with aggressive treatment is greater than 80%. At a minimum, treatment of testicular cancer requires surgical removal of the cancerous testicle. Abhorrent as this might seem, it does not typically have any long-term effect on fertility or sexual function, as long as the remaining testicle is normal. When metastases are present, treatment requires chemotherapy and sometimes radiation therapy or additional surgery.
Early self-detection is critical. Most testicular tumors are discovered by the man himself, through intentional or inadvertent testicular self-exam, and sometimes even by an intimate partner. The reality is that testicular cancer discovered during a routine medical examination, or after symptoms have developed, is likely to be much further advanced than one discovered by the man himself.
If you are worried that you may have an undescended testicle, of if you notice any change in the size or shape of your testicle, be sure to seek medical consultation as soon as possible. Next week, we will discuss testicular self-examination.
James R. Jacobs, M.D., Ph.D., FACEP
Director, The Ohio State University Student Health Services
Ohio State has a new student organization known as Buckeyes for Public Health as of October, and they are kicking off their second month with a men’s health awareness activity known as Movember, as part of the international men’s health charity of the same name.
The kicker is that they are encouraging men to join a one month campaign of mustache growing.
For real.
They are shaving guys at the RPAC this evening, then asking them to post pictures every day as they grow a mustache. As they chronicle their facial hair progress, viewers are asked to make donations in support. Funds collected are passed on to the Prostate Cancer Foundation and Livestrong.
If you are interested in more information, visit the Buckeyes4PH and Movember sites. The kickoff “Shave Down” event is scheduled for Nov. 1, 2012, 5:30-9:00 p.m., at the Ohio State Recreational and Physical Activity Center (RPAC) Amphitheater.
As if you needed another reason to practice safe sex, the Centers for Disease Control and Prevention (CDC) just updated their guidelines for the treatment of gonorrhea, an sexually transmitted infection (STI) caused by a bacterium called Neisseria gonorrhoeae. Gonorrhea is one of the most common STIs in the United States and we see it fairly regularly here at the Student Health Center.
Gonorrhea is a really smart bug – it has become resistant to every medication we’ve ever used to treat it so we’ve had to keep coming up with new options. Until now, we’ve been able to use oral antibiotic (one you take by mouth) to treat it, but sure enough, recent trends have shown that our latest option, Cefixime (Suprax), is starting to become less effective.
So now we’re literally down to our last shot – an injectable antibiotic called Ceftriaxone (Rocephin). According to the new guidelines, if you get gonorrhea you need to get a single shot of Ceftriaxone PLUS an oral antibiotic, either azithromycin (Zithromax) or doxycycline.
We can test and treat you for gonorrhea (along with other STI’s) at the Student Health Center, so if you are having any symptoms like burning when you pee, lower abdominal or pelvic pain, or a discharge from your penis or vagina, come in and see us ASAP.
If gonorrhea goes untreated, it can cause serious health problems. In women, it can lead to chronic pelvic pain, life-threatening ectopic pregnancy, and even infertility. In men, it can cause epididymitis, a painful condition that may lead to infertility. Infection also increases the risk of contracting and transmitting HIV.
Although some people have symptoms, most people do not so it is absolutely critical for you to protect yourself from gonorrhea. If you’ve never had sex, then you’re in good shape. If you are sexually active, there are some important things you should do to lower your risk of infection.
· limit the number of people you have sex
· always and correctly use a condom
· get screening lab tests to check for STIs once a year (remember, they often don’t have symptoms)
But this (really very serious) public and potentially personal health issue isn’t just about sexual behavior, it’s about medication behavior. The more we use antibiotics for any reason, the more opportunities bacteria have to adapt and become resistant to them. So then we have to switch to another antibiotic, then another, then another, until – like we’re facing now with gonorrhea – we run out of options.
So believe your health care provider when she tells you that you really don’t need an antibiotic for your cold or sore throat – she really does have your best interests at heart. And if she does prescribe you an antibiotic, make sure you take it as prescribed and until it’s gone. Leftover pizza can be a great thing; leftover antibiotics never are.
