Is HIV How you ID?

Author: Lauren Richey, MD, MPH, FIDSA, UMC Internal Medicine and Infectious Disease Specialist and LSU Health Sciences Center Associate Professor of Medicine

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Human Immunodeficiency Virus (HIV) is an infection that can cause serious damage to your body and immune system if not treated; however you can be without symptoms for many years. The lack of symptoms makes people think they are healthy, and, as a result, they often do not seek out or request testing.

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It is important to find out about the infection early because there are simple, effective treatments which can keep you healthy and prevent any damage to your immune system.

The only way to know if you have HIV is to get tested.

How Do I Get HIV?

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HIV can be transmitted through:

  • sexual fluids during sexual activity,
  • mother to child during birth,
  • breast feeding, and
  • blood.

Blood transmission can occur through blood transfusions and the use of intravenous (IV) drugs.

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How is HIV/AIDS Diagnosed?

As mentioned before, early HIV infection often causes no symptoms, and must be detected by testing a person’s blood for the presence of antibodies — disease-fighting proteins — against HIV. These HIV antibodies generally do not reach levels high enough to detect by standard blood tests until 1 to 3 months following infection, and may take as long as 6 months to do so.

People exposed to HIV should be tested for HIV infection as soon as they think they may have been exposed to HIV.

When a person is highly likely to be infected with HIV and, yet, antibody tests are negative, a test for the presence of HIV itself in the blood is used. Repeated antibody testing at a later date, when antibodies to HIV are more likely to have developed, is often recommended.

Who Should Get Tested?  Everyone! 

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There are a lot of misconceptions about HIV and how it is transmitted but anyone, regardless of race, sex, gender, sexual orientation, or educational level, who has had sex should be tested.

The Centers for Disease Control and Prevention (CDC) recommend that everyone between the ages of 13 and 64 gets tested for HIV at least once as part of routine health care. About 1 in 7 people in the United States who have HIV don’t know they have it.

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People at higher risk should get tested more often. Sexually active gay and bisexual men may benefit from more frequent testing (for example, every 3 to 6 months).

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If you’re pregnant, talk to your healthcare provider about getting tested for HIV and other ways to protect you and your child from getting HIV.

What are My Options for HIV/AIDS Treatment?

As with many other conditions, early detection offers more choices for treatment. Today, there are medical treatments that not only can slow down the rate at which HIV weakens the immune system, but  may keep HIV in check so that the individual has a chance to live a normal life span.

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Unfortunately, there is no cure for an HIV infection.

Talk with your healthcare provider for more information regarding various drug therapies for the treatment of HIV/AIDS.

Where Can I Get Tested?

We offer testing at University Medical Center New Orleans in the Infectious Disease Center (ACB building, Clinic 4C). There is also routine HIV testing in our Emergency Department. So if a medical condition or any risk of exposure to HIV brings you to the ED, you can get tested!

To find other testing centers near you, you can enter your zip code into: gettested.cdc.gov.  Other places include your primary medical doctor, OB/GYN doctor, or at a community testing event.

How Can I Protect Myself Against Acquiring HIV?

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  1. Use Condoms: Using condoms during sexual encounters is one of the simplest ways to prevent HIV transmission.
  2. Take PreP (pre-exposure prophylaxis): PreP involves taking a daily medicine to prevent HIV acquisition and is very effective.
  3. Use Clean Needles: If you inject drugs, using clean needles, and never sharing needles, is another way to prevent HIV transmission.
  4. Talk to Your Partner: Before having sex for the first time with a new partner, you and your partner should talk about your sexual and drug-use history, disclose your HIV status, and consider getting tested for HIV and learning the results.

Where Can I get PreP? Where Can I Receive Treatment for HIV?

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The HOP (HIV Outpatient Program) clinic nested in the Infectious Disease Center of the ACB building Clinic 4C provides both comprehensive HIV care and PreP.

Call (504) 702-4344 to make an appointment or to refer a patient. 

Click here for more HIV Resources.

About the Author

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Dr. Lauren Richey, MD,MPH, FIDSA is an Internal Medicine and Infectious Disease specialist in New Orleans, Louisiana. She has more than 11 years of diverse experience with HIV and other infectious diseases.

 

 

Open Up: The Truth About Oral Cancer

Author: Rohan Walvekar, MD, Co-Director of ENT Services at UMC

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Oral cancer will be responsible for over 10,000 deaths and will affect over 50,000 people in the United States in 2018.

These numbers may surprise you, because, in general, oral cancers are not thought of as commonly occurring; however, Louisiana is one of the states with highest incidence of oral and pharyngeal cancers in the United States.

What is the rate of these cancers in Louisiana?

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April honors Oral Cancer Awareness, and is a good time to learn about the signs, symptoms and treatment of oral cancer, as well as the importance of early detection.

What are oral cancers and why should we care about these cancers?

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Oral cancers are cancers that affect parts of our mouth such as the gums, tongue or palate. They are most commonly caused by tobacco use and alcohol consumption. There is a new threat called Human Papilloma Virus (HPV-16) that can also cause certain types of oral and oropharyngeal cancers.

These cancers are important because they have a devastating effect on a person’s ability to communicate with the world around them by affecting speech and swallowing, breathing and appearance; treatment, which is most commonly involves surgical removal, may also have an serious impact on these functions that are so vital to us.

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Surgical management is the ideal treatment for oral cancers but comes with the possibility of a disfiguring operation (e.g. removal of jaw bone or tongue affecting appearance or speech) and loss of function.

Early detection of oral cancer plays a vital role improving quality of life and function by limiting extent of surgery and consequently side effects of treatment.

In addition, it’s important to note that early-stage tumors (i.e. tumors detected at an earlier stage of the disease) have better chances of cure (5-year disease-free survival: 60-80 percent) as compared to cancers diagnosed when they are too large or advanced (5-year disease-free survival rates: 30-40 percent).

Unlike other types of cancers that may miss detection until they are too advanced; oral cancers can be diagnosed earlier with inspection and a biopsy – both of which can be easily done during an oral cavity examination by an expert in the clinic or at a cancer-screening event.

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Patients who notice a sore, ulcer or growth in the mouth that has not responded to treatment or a lump in the neck (oral cancers can spread to lymph nodes in the neck) that does not go away either after treatment or spontaneously in 2-3 weeks, should get check by an oral cavity expert such as an ENT surgeon or Head & Neck Cancer Surgeon.

The slogan that the Head Neck Cancer Alliance (OHANCAW) promotes –“All you have to do is open your mouth” is a testament to how a simple cancer screening can save lives and improve outcomes for oral cancer patients who are diagnosed early.

Get screened – promote screening – save lives!

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Click here to learn more about our Cancer Services and future screenings.

To make an appointment with an ENT, visit our website here. 

About Dr. Walvekar

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Rohan R. Walvekar, MD, earned his doctoral degree from the University of Mumbai. After graduating in 1998, he completed a residency in Otolaryngology and Head Neck Surgery at the TN Medical College & BYL Nair Charitable Hospital, Mumbai, India, with triple honors. Subsequently, he completed two head neck surgery fellowships, and trained at at the Tata Memorial Hospital, Mumbai, which is India’s most prestigious cancer institute, catering to over 5000 new head neck cancer registrations a year. After completing an Advanced Head Neck Oncologic Surgery fellowship at the University of Pittsburgh, he became an Assistant Professor in Head Neck Surgery within the Department of Otolaryngology Head Neck Surgery at the University of Pittsburgh/VA Medical Center, prior to joining the LSU Health Sciences Center in July 2008. His clinical interests are head neck surgery and salivary endoscopy. His research interests include evaluating prognostic markers and clinical outcomes of head and neck cancer therapy and treatment of salivary gland disorders.

Colon Cancer: When & Why You Should Start Screening

Author: Guy Orangio, MD,  FACS, FASCRS, UMC Colorectal Cancer Surgeon

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Colorectal cancer is the fourth most commonly occurring cancer and the second leading cause of cancer deaths in the United States, with over 56,000 people expected to die from this disease each year. However, this cancer is preventable and curable when detected and treated early.

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March is Colorectal Cancer Awareness Month, a perfect time to learn more about  this disease and when and why to get screened. Because there are often no symptoms when it is first developing, colorectal cancer can only be caught early through regular screening.

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Most colon cancers start as non-cancerous growths called polyps. If we are able to find these polyps while they are still non-cancerous, we remove them and the cancer may be prevented. Major surgery can usually be avoided.

STAGES

Screening programs begin by classification of risk based on personal, family and medical history. People who are at increased risk may need earlier and more frequent screening depending upon the recommendation of their healthcare provider.

The American Society of Colon and Rectal Surgeons (ASCRS), which is dedicated to advancing the treatment of patients with diseases affecting the colon, rectum and anus, supports the following colorectal cancer screening guidelines:

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Recommendations Screening People at Average Risk

  • Men and women at average risk should have screening for colorectal cancer and adenomatous polyps beginning at age 50 years.
  • A colonoscopy (a test that allows the physician to look directly at the lining of the entire colon and rectum) every 10 years or a barium enema (x-ray of the colon) every 5 to 10 years are acceptable alternatives. •

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Recommendations for Screening People at Increased Risk

  • People at increased risk of colorectal cancer or adenomatous polyps include those with first-degree relative (parent, sibling or child) with colon cancer or adenomatous polyps diagnosed before 60 years
  • People with two first-degree relatives who were diagnosed at any age, should have screening colonoscopy starting at age 40 years — or ten years younger than the earliest diagnosis in their family — and then repeat every five years.
  • People with a first-degree relative with colon cancer or adenomatous polyp diagnosed at age greater than 60 years or two second degree relatives with colorectal cancer should be advised to be screened as average risk persons beginning at age 40 years
  • People with one second-degree relative (grandparent, aunt or uncle) or a third-degree relative (great-grandparent or cousin) with colorectal cancer should be screened as average risk persons

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Prevention Tips

In addition to timely and regular screening for colorectal cancer, people may be able to lower their risk of getting the disease by:

  • Avoiding foods that are high in fat.
  • Eating plenty of vegetables, fruits and other high-fiber foods.
  • Exercising regularly and maintaining a normal body weight.
  • Not smoking and drinking alcohol only in moderation.

 

For information on the Comprehensive Colorectal Cancer Program at UMC, click here.

 

About Dr. Orangio

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Guy Orangio, MD, is a board-certified colorectal surgeon at UMC and an Association Professor of Clinical Surgery at LSU Health New Orleans.

 

What Do I Do? I Think I Have the Flu!

Author: Peter DeBlieux, MD, UMC Chief Medical Officer and Pulmonary Critical Care Physician

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This year’s flu season as been an active and aggressive one. According to the Centers for Disease Control and Prevention, the disease has reached its peak, but many more people are expected to be infected with the flu before all is said and done.

So, what do you do if you have the flu?

Prevention

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Get your vaccine – it’s the best defense against the flu.

It’s not too late to get the flu shot. The flu vaccine reduces your likelihood of getting the flu. However, if you do get the flu, the vaccine is still beneficial, as it reduces the likelihood of hospitalization and death as a result of the disease.

Flu virus are spread by contact with droplets that go airborne when an infected person sneezes or coughs. You can get the flu by inhaling the droplets or touching objects where the droplets have landed, which means…

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Handwashing – You should wash your hands often with soap and water.

Scrub for at least 20 seconds, then dry.  If soap and water are not available, use an alcohol-based hand sanitizer.

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Is it a cold or flu?

Early on, it is difficult to distinguish the difference between a cold and influenza. According to the CDC, colds are usually milder, and people with colds are more likely to have a runny or stuffy nose. The flu can result in a series of health problems, such as pneumonia, bacterial infections, hospitalizations and, in some cases, death.

Here’s how you can tell:

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Symptoms

These can vary from person to person. Although the flu is a respiratory disease, it can affect your entire body, including the gastrointestinal system.

Common symptoms include:

  • Cough, often severe
  • Extreme exhaustion
  • Fatigue for several weeks
  • Headache
  • High fever
  • Runny or stuffy nose
  • Severe aches and pains
  • Sneezing at times
  • Sometimes a sore throat
  • Vomiting and diarrhea

According to the CDC, you’re contagious a day before the symptoms start and 5 days after.

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Call your doctor to see if an antiviral medication is appropriate for you, but keep in mind that medication such as Tamiflu is not helpful after two days of symptoms.

If you have the flu, don’t interact with people who are sick. Especially if you have cold symptoms or have fever greater than 100.3. Stay away from others until you have not had symptoms for 24 hours.

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Avoid close contact with people who are sick, especially if you have cold symptoms or have fever greater than 100.3.

Stay away from others until you have not had symptoms for 24 hours.

If you’re sick:

  • Cover your cough and sneeze with a tissue – not your hands.
    • Try not to touch your eyes, nose, and mouth.
    • Wash your hands frequently.
    • Clean and disinfect surfaces and objects that may be contaminated with germs like the flu.

Get smart this flu season, not sick!

 

Have Your Cake…and Your Hair, Too!

UMC Offers FDA-Cleared DigniCap Scalp Cooling System to Minimize Hair Loss During Chemotherapy

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For patients recently diagnosed with cancer, it often feels like there is much to lose: time, energy, money, perhaps hope. Hair doesn’t have to be among the mix. Because of the DigniCap scalp cooling treatment, cancer patients across the United States are undergoing chemotherapy and seeing less hair loss. Now patients at University Medical Center New Orleans can do the same.

If you’re a patient looking to have your cake, and your hair, too, here’s what you need to know:

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How It Works

The DigniCap scalp cooling treatment is a proven approach to reduce chemotherapy-induced hair loss that has been used successfully by tens of thousands of patients worldwide. The reduced temperature results in a reduced blood flow to the scalp area so that less chemotherapy reaches the hair cells. Hair cells are therefore not exposed to the full dose of chemotherapy and may be able to survive the chemotherapy treatment. In addition, cellular metabolism within the hair cells is slowed down.

As a result, hair is less likely to fall out.

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How It Feels

We sat down with one of our patients, and the term she used was “pain-free.” The DigniCap is designed to comfortably fit patients’ heads and comes in varying sizes. Although it can get a little cold at times, most patients tolerate scalp cooling with DigniCap® scalp cooling system very well because the system cools the cap down gradually from room temperature. The cap temperature never drops below freezing to help make the treatment more comfortable for patients.

Common Side Effects

Side effects, as a result of the DigniCap, are minimal. They include feelings of coldness, headaches, scalp pain and/or light-headedness, which is rare. Your doctor can provide a pain reliever if you develop a headache.

What It Costs

Scalp cooling costs roughly $350-400 per treatment. The number of treatments required is determined by a patient’s physician.

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How You Can Receive Treatment

For more information, or to express your interest in being treated with the DigniCap scalp cooling system, contact the UMCNO Cancer Center at (504)702-3113 or visit www.umcno.org/dignicap.