John T. Rowe, MD

HPV or Human Papillomavirus Infection

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           Several recent high profile cases of cancer resulting from infection with human papillomavirus or HPV have sparked an increased demand for information about this sexually transmitted disease.  In June 2009, actress Farrah Fawcett died of anal cancer and last month actor Michael Douglas announced that he has oral cancer.  Both of these tragic cases have been attributed to human papillomavirus. 

          There are some 100 types of HPVs that infect humans and more than 40 of these can infect the genital tract and anus of males and females.  A subgroup can cause uterine and cervical cancer and are linked with both anal cancer and penile cancer (more than 1,000 new cases in U.S. per year) as well as head and neck cancers.  HPV is spread by sexual contact and the risk increases with the number of sexual partners.  Changing sexual practices have led to a dramatic rise in throat cancer in the past two decades and experts predict an epidemic on the horizon.  Victims of throat cancer are no longer just older individuals as was the case in the past, but have been much younger in recent years. 

          The most common HPV types are HPV-6 and HPV-11 which are considered lower risk, but are responsible for very unpleasant venereal warts or condylomata acuminata and the more ominous HPV-16 and HPV-18 which cause the majority of cervical and anogenital cancers.  

          HPV is the most common sexually transmitted disease in the U.S.  More than 6 million Americans become infected each year and 50% of these are between ages 15 and 25.  More than 50% of all sexually active men and women in the U.S. will be infected with HPV at some time in their life.  HPV infection is mostly asymptomatic and most men and women are not even aware that they have it, partially accounting for its ease of spread.  Venereal warts can be diagnosed be visual inspection, but other types are more difficult to diagnose.  Regular PAP smear testing in women may identify abnormal cells indicating early cervical cancer.  

          There is no known cure for HPV, although many infected individuals with healthy immune systems will rid themselves of the infection within two years.  Condoms do not provide compete protection from HPV.  It is important for young people to understand that oral sex is not safe sex, as some mistakenly believe.  The most reliable method of prevention is abstinence or a traditional monogamous relationship.  For those who are unable to adhere to this recommendation, avoidance of unhealthy sexual practices would be prudent.  Finally, a vaccine has recently been approved by the FDA for ages 9 through 26 which confers immunity against the four most common types of HPV.  Your personal physician can provide information about the risks and benefits of this vaccine.

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Hip Fractures

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An article in the Annals of Internal Medicine on March 16, 2010 reported that ‘older adults have a 5 to 8 fold increased risk for all-cause mortality during the first three months after hip fracture.  Excess annual mortality persists over time for both men and women, but at any given age, excess annual mortality after hip fracture is greater in men than women’.

There are a number of things that elderly adults can do to help prevent hip fracture.  Staying active promotes good bone health.  A bone density test can determine if you have osteoporosis.  Discuss with your personal physician whether calcium or vitamin D might help you.  Have your vision checked once a year, as cataracts and other eye problems can increase your chance of falling.  Have your physician review your medications to see if anything you are taking can cause dizziness.  Don’t smoke or drink and, finally, do a safety check of your home.  Make sure there are no loose objects on the floor and that rugs are securely fastened to the floor.

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Arthritis Supplements

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Glucosamine and Chondroitin Don’t Work        

Glucosamine and chondroitin are no better than placebo for knee or hip osteoarthritis, according to a study reported this week in the British Medical Journal.  The two popular supplements are components of normal human connective tissues found in cartilage and bone.

A network meta-analysis by researchers at the University of Bern in Switzerland evaluated ten randomized controlled trials, which included a total of 3,803 patients with osteoarthritis (sometimes called degenerative joint disease) of the knee and hip.  They concluded that neither glucosamine nor chondroitin, whether taken separately or in combination, improved pain or had an impact on narrowing of the joint space.

The study’s authors went on to say that there was “no harm in having patients continue taking these supplements as long as they perceived a benefit and cover the cost of treatment themselves”.  Global sales of glucosamine approached $2 billion in 2008.

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Autism

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Autistic Children Not Susceptible to Contagious Yawning

          In a fascinating article in HealthDay, Jenifer Goodwin reports that autistic children do not seem to be susceptible to contagious yawning, a normal response to seeing others yawn, and suggests that this behavior may indicate a lack of recognition of others’ feelings.  Yawning is a type of “emotional contagion” or unconscious response that reflects how others are feeling.  Autistic children’s lack of imitation may account for their not being able to learn empathy and other social skills.  Follow the link below to read the entire article. 

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Smoking and Your Health

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           There is nothing good about smoking cigarettes.  It is important for everyone to know that more than 8 million people are sick or disabled simply because they use tobacco and 450,000 Americans die each year as a result of smoking.  Some of the chronic diseases associated with smoking include cardiovascular disease (heart attacks, strokes, claudication), emphysema (chronic obstructive pulmonary disease) and lung cancer.  Less serious side effects include gum disease, premature aging and wrinkling of the skin.  In short, cigarette smoking is the most common cause of preventable death and disability in the United States. 

          Eric Lindblom reports in his Fact Sheet, Campaign for Tobacco Free Kids in September 2010 that 6 million kids under 18 who are alive today will ultimately die from smoking unless the rates decline.  Smoking kills more people than alcohol, AIDS, car accidents, illegal drugs, murder and suicide combined.  Lindblom goes on to point out that of the kids who become new smokers each year, almost one third will ultimately die from it.  Smokers lose an average of 13 to 14 years of life because of their smoking. 

          The health problems related to smoking take a tremendous toll on the health care budget.  The total annual private and public health care expenditure caused by smoking is estimated to be $96 billion.  Productivity losses caused by smoking each year amount to $97 billion.  Taxpayer’s yearly federal and state tax burden from smoking-caused government spending comes to an average of $619 per household. 

          Indeed, there is nothing good about smoking cigarettes.  If you or someone you know is smoking and would like to learn more about quitting, the best place to start is with your personal physician.  There are many strategies available to assist you.  Make that call today.

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California Pertussis Epidemic

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          A Pertussis Epidemic was officially declared in California on June 18, 2010.  To date there have been over 3,000 cases reported and now eight infant deaths.  Pertussis or Whooping Cough is an infectious disease of the lungs caused by the bacterium Bordatella pertussis. 

          Pertussis vaccination begins at 2 months of age, but young infants are not adequately protected until the initial series of three shots is completed at 6 months of age.  Adults are the largest reservoir for spread of Pertussis to others.  If infected, adults may have mild cold symptoms and unknowingly infect infants and children who have not been vaccinated and can cause serious disease and even death. 

          In 2005 the FDA approved the Tdap (Tetanus, Diphtheria, acellular Pertussis) vaccine, which is a safe, effective vaccine designed to protect adolescents and adults against Pertussis.  Immunity from childhood vaccination wears off by late adolescence and having the disease does not provide life long protection.  If you have questions about whether you should have the Tdap vaccine, you should consult your personal physician.

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