Debunking Myths About HIV Vaccine

In honor of World AIDS Day tomorrow, SRxA’s Word on Health wants to share with our readers the top 10 myths about HIV vaccine research.

With the help of our friends at the HIV Vaccine Trials Network (HVTN), we’d like to set the record straight.

Myth # 1: HIV vaccines can give people HIV

HIV vaccines do not contain HIV and therefore a person cannot get HIV from the vaccine. Some vaccines, like those for typhoid or polio, may contain a weak form of the virus they are protecting against, but this is not the case for HIV vaccines. Think of it like a photocopy: It might look similar, but it isn’t the original. In the past 25 years more than 30,000 volunteers have taken part in HIV vaccine studies worldwide, and no one has been infected with HIV by any of the vaccines tested.

Myth #2: An HIV vaccine already exists

There is no licensed vaccine against HIV or AIDS, but scientists are getting closer than ever before.  In 2009, a large-scale vaccine study conducted in Thailand showed that a vaccine combination could prevent about 32% of new infections. Researchers around the world continue to search for an HIV vaccine that is even more effective. Leading this effort is the HVTN.

Myth #3: Joining an HIV-vaccine study is like being a guinea pig

Unlike guinea pigs, people can say yes or no to participating in research. All study volunteers undergo informed consent to ensure that they fully understand all of the risks and benefits of being in a study and those volunteers are reminded that they may leave a study at any time without losing rights or benefits.

Myth #4: A person must be HIV positive to be in an HIV vaccine study

Not so. While some research groups are conducting studies of vaccines that might be used in people who are already infected with HIV, the vaccines being tested by the HVTN are preventive vaccines which are tested on volunteers who are not infected with HIV.

Myth #5: Vaccine researchers want study participants to practice unsafe behaviors so they can see whether the vaccine really works

Not true. The safety of study participants is the No. 1 priority of HIV vaccine researchers and study site staff. Trained counselors work with study participants to help them develop an individual plan on how to keep from contracting HIV.

Myth #6: Now that there are pills that can prevent HIV infection, an HIV vaccine is no longer necessary

Although high risk, HIV-negative people can take antiretroviral medication to lower their chances of becoming infected if they are exposed to the virus, it has not yet been recommended for widespread use. This type of therapy known as  PreExposure Prophylaxis is unlikely to be an option for everyone because the pills are expensive, are not always covered by insurance, may cause side effects, and not everyone has access to them.

Myth #7: An HIV vaccine is unnecessary because AIDS is easily treated and controlled

While treatment for AIDS has dramatically improved over the last 30 years, it is no substitute for prevention.

Myth #8: The search for an HIV vaccine has been going on for a long time and it’s just not possible to find one that works

The science of HIV-vaccine development is challenging, but scientific understanding continues to improve all the time. Science has come a long way in the 30 years since AIDS was discovered. In comparing preventive HIV vaccine work to other vaccine development, the time it has taken is not so surprising; the polio vaccine took 47 years to develop.

Myth #9: Vaccines cause autism and just aren’t safe

This is not true. Numerous studies in the past decade have found this claim to be false. The British doctor who originally published the finding about vaccines and autism has since been found to have falsified his data.

Myth #10: People who aren’t at risk don’t need an HIV vaccine

Not true either. A person may not currently be at risk for HIV, but life situations can change along with disease risk.

So now you know!  By correcting these myths we hope in some small way to be able to help in the mission of this World AIDS campaign – bringing the number of AIDS deaths to zero.

When Doctors Don’t Listen

He was the third dentist I saw last week. After 7 days of unrelenting pain, no sleep, and a failed root canal, I was referred to an oral and maxillofacial surgeon. During the long drive to his prestigious offices, I imagined him to be my knight in shining gloves, mask and goggles, the hero who was going to extract the fractured, unsalvageable tooth. Although his introduction was a little brusque, I gave him the benefit of the doubt when he said he’d get me out of pain. Even after he’d roughly forced open my swollen, inflamed jaw I followed him like a lamb to slaughter into his O.R.

Knowing I have a high pain threshold, I opted to have local, rather than general, anesthesia.   Smiling, I braced myself for the needle, almost looking forward to the numbness that would finally take away the discomfort.  One, two, three cartridges of local anesthetic later, I was still waiting.  “Numb?” he asked.  “No, nothing’s happened yet” I replied.   He looked at me with the kind of look normally only seen on the face of a driver who’s just been rear-ended.  “If we are going to do this,” he said, “you’re going to have to be straight with me.

Straight with you? Do you think I’m making this….Oh My God!  It suddenly hit me. This white-coated icon of the medical establishment had branded me a hysterical female. Everything I’d said, every symptom I’d described was being filtered through his base conclusion: This bi**h is crazy.

Whether to prove his point or the invincibility of his drugs he started to prod and poke at the problem tooth.  I almost hit the ceiling, and let out a high decibel scream. Not my finest moment, I admit, but it was to be followed by one that was even worse.

Naively, I guess I expected some sort of apology or maybe a placating hand on my shoulder. What I got was a stream of expletives, the dramatic gesture of him peeling off his surgical gloves and throwing them to  the floor and a parting image of his backside as he stormed out of the O.R.

I could not have known that my pain would call into question my right to treatment.  Was it my fault that he’d failed to provide adequate anesthesia?

His assistant looked acutely embarrassed, his receptionist told me I may want to find another doctor.

I slunk back to my car, in tears, in pain…and angry beyond belief.  If it wasn’t so painful to talk, I’d have called the American Dental Association and reported him.

Instead, I’ve let a week pass and tried to learn a lesson from this encounter. I’ve asked myself again and again: what did I do wrong? The answer is clear. I trusted a doctor who did not trust me.  It’s a common mistake. And it’s one I would urge patients everywhere not to repeat.

Nevertheless, I still believe in the medical profession and I know most clinicians put their patients above their egos.  But, I’m still hurting. Anyone know a good tooth-puller in the Washington DC area?

Top Ten Healthy Gifts for the Holidays

Happy Black Friday to all of our readers.  Before you head out to the stores this morning to buy the perfect presents for your loved ones, why not consider giving the greatest gift of all – health.

“Health truly is the gift that keeps on giving,” says James Rohack, past-president of the American Medical Association.

With disposable income more scarce than ever this year, giving practical gifts is in vogue. And what could be more useful than a well-woman exam, or a gym membership?

Here’s SRxA’s Word on Health’s 10 suggestions to help make 2011 gift-giving a little healthier:

1. Be a Tooth Fairy. We’re not suggesting you add free root canals to your Christmas stockings, but since dental coverage is either limited or non-existent for so many people, a tooth cleaning could make a great gift for anyone who’s been putting off getting dental care because of cost. Most dentists offer gift certificates. A  $50 certificate might get you a basic cleaning, and for a little more you could give a professional whitening treatment.

If you’re buying for kids, consider a cool toothbrush such as Tooth Tunes Musical Toothbrush or a fun Spinbrush. For grown-up gadget fans, a high-end electric toothbrush or flosser can be a great present.

2. Office Visits. With almost 50 million Americans lacking health insurance and skyrocketing co-pays and deductibles, a pre-paid visit to the doctor’s office or a drug-store gift card for someone who has high pharmaceutical bills makes a useful present.

These may be especially appropriate for young, single women. National Center for Health Statistics data show that unmarried women ages 25 to 64 were more likely to be uninsured than married with in the same age group.

3. Fancy Foods. Organic fruits and vegetables are often pricey and end up being one of the first things to be cut from the family budget when times are tight. Even non-organic fruit can seem expensive these days, so consider a monthly shipment of produce or other healthy treats. Visit on-line sites such ashttp://www.americasbestorganics.com/ or check with a local organic farm.

4. Fit Club.  Splurge for a friend or family member who enjoys working out. If they are already a member or if a full years gym membership is beyond your means, how about a gift certificate for a personal-training session?

5. Yoga Stuff. Is there a better gift than inner peace?  Yoga helps with stress, flexibility and blood flow. “It’s one of those forms of exercise that not only works your body but works your mind, works your soul, your spirit,” says yoga instructor Peter Sterios. Buy the yoga lover in your life some great gear, a fabulous mat or a gift certificate for classes at a local yoga studio.

6. A Rub Down.  After a workout, or a stressful day, a massage can go a long way to making you feel better. To find a massage therapist who meets all state or local licensing requirements, visit:  www.findamassagetherapist.org.

7. Exercise Gear. Good shoes are a runner’s best friend, but they’re expensive. And it’s not just about fashion. If you don’t have good foot support, then you wind up getting foot injuries, and then your motivation to get healthy is limited. So don’t let your favorite amateur athlete work out in worn-out gear. Buy them a gift certificate to a good sports supply store.

8. Health Monitoring Gadgets. While buying someone a bathroom scale might be a bit insulting, high-tech at-home self-test kits such as a blood-pressure monitor could be just the ticket. Eighty million Americans have high blood pressure, and only a third of them have it under control.

9. Pick Up the Check. Most restaurants now offer healthy options. One way to find good spots: the National Restaurant Association‘s (NRA) partner site,www.healthydiningfinder.com. According to the NRA, 77% percent of consumers say they would like to receive a restaurant gift card.

10. Good-For-You Reads. Skip the fads and invest in books like the American Medical Association’s “Complete Guide to Prevention and Wellness,” the American Pediatric Association’s “Caring for Your Baby and Young Child” ; “The Pill Book: An Illustrated Guide to the Most-Prescribed Drugs in the United States.or even the hard-core Merck Manual.

Happy Shopping!

A Healthy Holiday Dinner Table?

Before you click away, this is NOT one of those stories admonishing you to eat broccoli and brussel sprouts rather than turkey and all the trimmings.  This blog could improve your health without having to forego a single calorie!

Will Grandma be coming up from Florida during Thanksgiving or will Great Uncle Tony be joining you for Christmas?  Do you need something other than the Presidential candidates, Penn State sex scandal, or football scores to talk about over dinner?

Well, according to University of Alabama genetics experts you should use this opportunity to learn more about your family health history from the very people who know.

The holidays are a great time to collect your family history,” says Lynn Holt, M.S., Director of the School of Health Professions Genetic Counseling program. “Most people don’t know much about the family history beyond their first-degree relatives, their own parents and siblings.”

She advises people to talk to their grandparents or great-grandparents about any health problems that they may have had.  Also find out about their immediate family such as  parents, siblings and children. And don’t just talk, jot down names and their year of birth and death. Ask if any siblings died during childhood and if so, why? While many people don’t like to talk about a sibling who died young, knowing if it happened – and why, can produce very valuable information.

We sometimes hear people say they’ve been told their mother’s brother dropped dead at age 20, for example,” says Holt. “Was it because of a genetic heart condition that you might have inherited, or is it simply that brother was guilty of some accident that nobody wants to talk about?

Likewise, if there is cancer in the family, ask about the kind of cancer and at the age at which family members first were diagnosed. Age of diagnosis is more medically valuable than age of death in determining inheritable conditions. Ask similar questions about heart disease, diabetes, mental health conditions and other common conditions. And don’t forget to look into any environmental exposures that may explain family health problems such as occupational exposures, smoking or pollution.

Not only will you learn a great deal, the knowledge you gain can help you protect your own health.  As an added bonus, older family members may welcome the chance to share their story and memories of loved ones who have passed away…and it’s a chance to grow closer as a family.

So rather than bickering over the green beans or sulking into the sweet potatoes, how about serving up a dose of health history these holidays?

After you’ve collect all this information, share it with your physician to help determine if there are any health conditions, based on your family history, that need further evaluation or monitoring.

Happy Holidays!

Emergency Epinephrine Act

SRxA’s Word on Health is pleased to start the week with some good news.  Last Friday a new federal bill known as the School Access to Emergency Epinephrine Act was introduced in the Senate.  The Bill encourages schools to prevent allergy-related deaths by allowing trained, qualified staff to give an injection of epinephrine to a student suffering from a severe allergic reaction.

The tragic deaths of teenagers in Georgia and Illinois, who did not have immediate access to epinephrine, underscores the importance of immediate treatment and the passage of this legislation. One, a 13-year-old student from Albany Park, IL who had previously suffered from only minor allergies died at her school because of a severe allergic reaction.

Following this, Illinois passed a law that allowed school nurses to administer epinephrine shots to any student suffering from a severe allergic reaction. The new legislation proposed by Illinois Senators Mark Kirk and Dick Durbin would expand the law by allowing all trained and authorized school personnel — not just school nurses — to administer the shot.

U.S. Senator Mark Kirk (R-IL) said, “For the millions of children suffering from serious, potentially fatal allergies, the safe and expedient administration of epinephrine can mean the difference between life and death. Something as seemingly harmless as a bee sting during recess or a peanut butter and jelly sandwich during lunch can quickly become a tragedy.”

For about 1 in every 13 children, school lunchtime or a classmate’s school birthday party can risk exposure to foods that can cause a severe and life-threatening reaction. For these children, the consequences of exposure to the wrong food can be fatal.  However, if epinephrine is available such consequences are preventable.

The legislation would reward states that require schools to maintain a supply of epinephrine auto-injectors, such as EpiPen, and train authorized school personnel to administer an epinephrine injection if a student experiences an anaphylactic reaction. The bill also contains a provision that requires those states to have Good Samaritan laws in place to protect school employees who administer an epinephrine injector to any student believed to be experiencing anaphylaxis.

Although students with severe allergies are allowed to self-administer epinephrine if they have a serious allergic reaction, a quarter of anaphylaxis cases at schools involve young people with no previous allergy who are unlikely to carry a personal epinephrine injector.

Attorney General Lisa Madigan applauded Durbin and Kirk on their push for federal legislation. “Growing numbers of children suffer from life-threatening food allergies,” Madigan said. “In Illinois, we were able to eliminate bureaucratic barriers that previously prevented schools from acting when a child could be suffering from a severe allergic reaction but whose medical records didn’t reflect an allergy diagnosis.”

Word on Health also applauds the introduction of a law that could save children’s lives and raise awareness that in anaphylaxis every second counts. We also hope it will stimulate a wider dialog that could eventually lead to epinephrine autoinjectors becoming available in airports and on airplanes, in restaurants, sports stadiums and other public places…much as automated external defibrillators (AED’s) are today.

Our Darwin Award Winner of the Week

SRxA’s Word on Health was so shocked to read the following news headline – “Washington man loses his arm from a homemade guillotine” that we would like to share the following cautionary tale with our readers.

According to the man in question, the guillotine unexpectedly dropped on his shoulder Thursday severing his arm. However it’s what happened next that shocked us even more.

According to news reports, following the accident, he left the arm behind and rushed to Bellingham Urology Specialists.  Doctors and nurses from the office rushed to help but it was10 minutes before an ambulance took him to the hospital two blocks away.

Police officers later discovered a camp in a wooded area near the clinic which was believed to be the temporary home of the victim. At the camp, officers located the severed arm and a homemade guillotine, which they said was at least 12-feet tall and had been constructed from timbers that the man found by scavenging the local area.

A lot of thought and a lot of work and lot of preparation went into making this device,” said Mark Young of the Bellingham Police.  Apparently guaze and tape were found near the scene, indicating that this might have been something other than an accident.

Although the condition of this man is not known at this time, and we wish him well, should he not recover he will be a worthy contender for a Darwin Award. As many of you know, the Darwin Awards commemorate individuals who protect the gene pool by making the ultimate sacrifice of their own lives. Darwin Award winners eliminate themselves in such an extraordinarily idiotic manner, they thereby improve the human race’s chances of long-term survival!

While we don’t normally judge others – “Guillotine Man” qualifies on so many levels. Not only did he build the contraption in the first place, it seems he decided to test it on himself.  Then having successfully demonstrated how well it works he failed to take the severed limb with him for potential reattachment and, in perhaps his most genius moment yet, decided to seek help at a urology clinic!

We’d like to leave you with one final message – please don’t try this at home!  Have a great weekend.

Scientists Step up to the Plate in the Fight Against ALS

Until this week, most medical text books and online publications agreed that in 90- 95% of  amyotrophic lateral sclerosis (ALS) cases, the disease occurs at random with no clearly associated risk factors.

Now, according to a study published in the Journal of Experimental Medicine, scientists have discovered two proteins that can conspire to promote the invariably fatal neurological disease.

ALS, or Lou Gehrig’s disease, is a rapidly progressive, devastating neurodegenerative disorder that results in progressive loss of motor function and ultimately death.

Jean-Pierre Julien and colleagues at Laval University in Quebec now find that a protein called TDP-43 binds to an inflammatory protein called NF-kB p65 in the spinal cords of ALS patients but not of healthy individuals.

TDP-43 and p65 were also more abundant in ALS than healthy spinal cords.  It appears that TDP-43 and p65 cooperate to ramp up production of factors capable of promoting inflammation and killing nearby neurons.

Treatment of TDP-43 mice with Withaferin A, an inhibitor of NF-κB activity, reduced neuron loss and denervation and ALS disease symptoms.

These findings highlight p65 as a potential therapeutic target for this debilitating disorder which currently affects as many as 20,000-30,000 people in the United States and the additional 5,000 people who will be diagnosed with the disease each year. ALS is one of the most common neuromuscular diseases affecting people of all races and ethnic backgrounds. ALS most commonly strikes between 40 and 60 years of age, and men are affected more often than women.

SRxA’s Word on Health will be following this story and bringing you news on further advances in the fight against ALS, as they break.

NP’s prevent patient readmissions

Researchers at Loyola University Health System  have shown that adding a nurse practitioner (NP) to an in-patient hospital surgical department can decrease post-operative emergency department (ED) visits. According to a study just published in Surgery, by improving the continuity in care and troubleshooting problems for patients, an NP can reduce ED visits. The addition of an NP also resulted in an improved use of resources and financial benefits for the health system.

NP’s are advanced practice registered nurses who have completed graduate-level education (either a Master’s or a Doctoral degree) and have a dramatically expanded scope of practice over the traditional RN role. Their core philosophy  is individualized care. Nurse practitioners focus on patients’ conditions as well as the effects of illness on the lives of  patients and their families and make prevention, wellness, and patient education their priorities.

The study analyzed 415 patient records one year before and one year after the NP joined the staff. The two groups were statistically similar in age, race, type of surgery, length of hospital stay and hospital readmissions. Patients were tracked after they were sent home from the hospital to determine how many unnecessarily returned to the ED (defined as an ED visit that did not result in an inpatient admission).

Mary Kay Larson, the nurse practitioner involved with this study, communicated with patients and coordinated their discharge plan. During this time, telephone conversations with patients increased by 64%; and visiting nurse, physical therapy or occupational therapy services increased from 25% before Larson joined the department to 39% after. Most importantly, these services resulted in 50% fewer unnecessary ED visits.

This study demonstrates the important role that nurse practitioners have in our increasingly complex health-care system,” said senior author Margo Shoup, MD, FACS, Division Director of Surgical Oncology, Loyola University Health System. “Hospitals must continue to adapt to the changing health-care environment. The addition of a nurse practitioner clearly represents a way that we can adjust to meet the increasing demands of patient care while we are being asked to do more with less.”

SRxA has long recognized the value of NP’s and physician assistants (PA’s) in both patient and peer-to-peer education. To help our clients gain access to this important and rapidly growing group of health professionals we have recently established an NP/PA group.   For more information, and to find out how you can leverage their expertise in your next project, contact us today.

Honoring Our Military

Today, Veterans Day, our nation honors the men and women who have served our country. Cities host parades, department stores have sales, schools and the Federal Government close. Most of us are thankful for a day off. But how many of us will stop and think about the tremendous sacrifices made by those in the military community – the risks they take and the burdens they carry? And how many of us will take the time to reflect on how families and lives are forever changed as a result of war?

Since September 11, 2001, over 2 million men and women have deployed to fight the wars in Iraq and Afghanistan – many of these have deployed multiple times.  During this time, countless family members have suffered through multiple separations. And let’s not forget the 5,798 American men and women who have died during these wars or the 40,000 who have come home with significant physical injuries. In addition, many of our troops come home with invisible injuries of war including post traumatic stress, traumatic brain injury, depression and anxiety.

Sadly, a large number of those who suffer these invisible injuries fail to seek the care that they so need and deserve. The stigma associated with seeking mental health care and our cultural reluctance to admit mental health concerns prevents many of the brave men and women in our armed forces from obtaining proper treatment.

Families are suffering. A recent study in the journal, Pediatrics, found that young children in military families are about 10% more likely to see a doctor for a mental health difficulty when a parent is deployed than when the parent is home. Social scientists have long known that the cycle of deployment and reintegration puts a significant strain on the families of those who serve, particularly spouses. Given that the conflict in Iraq has been underway for over seven long years, tens of thousands of military children have only known the experience of war.

While most civilians are familiar with the terms “post traumatic stress” and “traumatic brain injury” it is striking how little the average person knows about these very understandable, yet potentially devastating, consequences of war.  Movies and television programs often portray veterans suffering with post traumatic stress as out-of-control and hyper-aggressive. While difficulties with impulse control and rage are indeed possible manifestations there is a range of other symptoms and reactions that are less well known. Some withdraw and become disengaged from those around.  Others have difficulty finding meaning in life, while others may experience anxiety, flashbacks and severe sleep disturbance. Sometimes the painful mental health symptoms that result from the experience of war lead to self-medication and substance abuse and suicide. Then there is the dramatic increase in the number of suicides reported by active duty personnel as well as those who have separated from the military.

Some members of our military community come home to families that cannot possibly understand what they have seen or done. Unable to bridge the gap between who they were when they deployed and who they are upon return, our service members find themselves in relationships that falter and marriages that fail.

But there is reason to hope. Many within government and Veterans Affairs, the academic community, the nonprofit sector, the entertainment industry, and caring individuals in communities across the country are stepping up to assist those who serve our country and their families.

The rest of us can help by recognizing and accepting psychological injuries of war and encouraging our veterans to receive proper care and treatment in a timely manner.  Together, we can stem the tide of suicides and save hundreds of thousands of service members who have come home from war with injuries that they alone cannot heal. In order to be successful in this mission, however, we must harness the goodwill, the knowledge, the resources and the commitment of a thankful nation that recognizes the sacrifices made by so few for so many.

SRxA’s Word on Health would like to honor and thank all of our Veterans.

The Business of Fatherhood

Here’s a question for all you working moms and dads out there.  When your child becomes an adult, will they thank you for how you raised them?

Those of you tussling with the Terrible Two’s or being tormented by teenagers, may be rolling your eyes at this point.  Before you utter “no way” we’re pleased to let you know that it’s not too late.  Help is now at hand…or at least a quick click to Amazon.com away!

SRxA’s founder, President and CEO, Christos Efessiou PhD, has just published his first book: CDO – Chief Daddy Officer.

Throughout the book, Dr. Efessiou shares with readers the lessons he himself learned after his first marriage dissolved and he was left to raise his seven year old daughter Persephone on his own.  Already a successful entrepreneur, he applied his business knowledge to the business of parenting.

Clearly it worked.  Those of us who know Persephone recognize that she has turned into a wonderful and unique young lady. Smart, intelligent, savvy, confident and driven, we marvel at her relationship with her father and we  know that she thanks her dad every day for the way in which she was raised.

In CDO-Chief Daddy Officer, Chris shows how principals such as communication, respect, team-building, and mentoring, so essential to a successful business are also the pillars of creating a loving family.  Using textbook business strategies he shows how to achieve success in the business of parenthood.

Matthew Cronin PhD, Associate Professor of Management at George Mason University says “CDO is a highly thoughtful application of foundational business wisdom to the practice of parenting”  It is eminently sensible in both HOW business fundamentals could be applied to parenting, but also WHICH business fundamentals should be applied.”

Those of us lucky enough to work for Chris have already read a copy of the book. For anyone else whether you’re a parent, CEO, employee, employer or student we highly recommend it.  Take a read and let us know what you think.

Learn more about Chris and the book by visiting his Facebook Page or www.ChrisEfessiou.com