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.

 

 

Eyes on the Road: The Dangers of Distracted Driving

Author: Bridget Gardner, Injury Prevention Coordinator

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Have you ever been on a cell phone and passed your exit? Have you reached for an item in your vehicle or taken your eyes of the road just for a second, only to find yourself swerving to avoid the car ahead?

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When you are in your car, a moment’s distraction can easily have more devastating consequences.

According to the National Highway Traffic Safety Administration (NHTSA), 9% of the fatal crashes in the U.S. were caused by distracted driving and 3,450 people were killed in motor vehicle crashes involving distracted drivers.

Distractions aren’t just cell phones. Distracted driving is any activity that diverts your attention away from the primary task of driving.

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Distractions include adjusting a radio, GPS or MP3 player, texting, talking on a cell phone, updating social media, selecting a song list, talking to passengers, eating, drinking, grooming, like shaving or applying makeup, reading, and diverting your attention to crashes and billboards.

If you remove your eyes off the road for 4.6 seconds, at 55 mph, you will drive the length of a football field.  So, you’re basically driving blindfolded for the length of the football field. This not only places you at risk, it places every driver on the road at risk.

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Cell phones are a primary distraction, because it involves three types of distraction simultaneously:

  • Visual (taking your eyes off the road)
  • Manual (taking your hands off the wheel), and
  • Cognitive (taking your mind off driving).

In the fractions of a second in which you need to identify a danger, process the decision, react and respond to the hazard, there isn’t enough time when you do not remain focused or your attention isn’t on driving.

Forty-four states, including Louisiana, ban text messaging for all drivers. Fourteen states prohibit hand-held cell phone use by drivers.

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Currently, Louisiana has a bill to propose the use of hands free devices only for drivers.

University Medical Center, which is home to the region’s only Level I Trauma Center, has a strong commitment to the prevention of injuries due to distracted driving. The Trauma Center’s Injury Prevention Team is committed to decreasing the risk of injury through programs such as Sudden Impact.

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Twice per week, high school sophomores attend the hospital-based program to understand the real consequences to such high-risk behavior. Helping them understand the risks of distracted driving is essential – after all, 76% of participants state that they have been in a crash or near crash because the driver of the vehicle was distracted.

Distracted driving is also written into the script for the Sudden Impact Mock Crash, “Consequences of Impact” and the Mock Trial, “Lifetime of Consequences.”

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We encourage you to not be the next victim.

Reduce cell phone distractions

If there is an option to turn your phone off or send automatic replies to texts while driving, this is highly recommended.

It can wait

Most conversations and texts can wait and if they cannot, pull to a safe, well-lit area to return the call or text.

Safety first

Be a role model to the passengers in your vehicle. If you have a call or text that needs to be returned, have a passenger return the call or text for you.

Eyes on the road

Keep your eyes on the road and always be aware of your surroundings.

Drive defensively

Be ready to avoid a crash by driving defensively.

Remember, crashes are PREVENTABLE.

The Benefits of Breakfast

Author: Rosetta Danigole, Lead Nutritionist at UMC

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Are You a Breakfast Eater?

Studies show that there are many benefits to choosing a healthy breakfast every morning.

First, there’s the energy factor. Your brain needs glucose from food – especially good carbohydrates such as whole grains, fresh fruits and low-fat dairy products – in order to work well.

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What Happens When You Skip Breakfast

When you skip breakfast you may end up with a brain-energy slump by mid-morning.

Skipping the benefits of breakfast can lead to an increase in LDL (“bad” cholesterol) levels, according to researchers.

Going without breakfast means you likely will eat more throughout the day. People who eat breakfast, on the other hand, get their metabolism humming and tend not to consume as many calories during the entire day, so they wind up weighing less than those who don’t get the benefits of eating breakfast.

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You may be jeopardizing your long-term health. One study found that those who skipped breakfast were more resistant to insulin. Insulin resistance increases the risk of developing diabetes.

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If you are not a breakfast eater and have a hard time eating in the morning you may just have a bad habit.  To start breaking that habit try a light breakfast such as a banana and a glass of milk or even a cup of low fat low-sugar yogurt and fruit.  You may just need to re-train your system to accepting food in the morning.

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Lastly, what are the good and bad breakfast choices?

  • Try not to load up on caffeine — one cup is a good limit, but if you need two cups maybe try a cup of hot tea as it is higher in antioxidants.
  • Avoid muffins, large bagels, sweet pastries, sweetened cereal, & high-fat meats such as bacon.
  • Eggs are good choices (high in protein and not the cholesterol offender as once thought). Studies say to it is good to include eggs 3 to 4 times per week; preferably organic and high in omega 3 fatty acids.
  • Try whole grains coupled with high quality protein such as eggs and oatmeal or yogurt and fruit.
  • Don’t forget the healthy fats such as almonds/walnuts/or flax seeds.

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…But What About Grits?

Here in New Orleans we love grits and a lot of folks ask dietitians about that. Grits are made from corn and is not that bad in and of itself but it is a refined food. Include it occasionally for breakfast but not daily as other options offer more nutrients.

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About the Author

Rosetta

As the lead dietitian at University Medical Center New Orleans, Rosetta Danigole manages clinical dietetic operations. She is a member of the Academy of Dietetics and Nutrition and belongs to the clinical dietitian practice group. She has been a dietitian for 35 years.

 

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

Guy Orangio

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

 

The ABC’s of Antibiotics

Author: Jennifer Lambert, PharmD, MPA, UMCNO Clinical Pharmacist

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What are Antibiotics?

Antibiotics are types of medicine that help stop infections caused by bacteria. How they do this is by (1) killing the bacteria or (2) keeping the bacteria from reproducing.

The word antibiotic, itself, means “against life.”

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Did You Know?

An estimated 2 million illnesses and 23,000 deaths occur each year in the US due to antibiotic resistant infections.1 Antibiotics are drugs used to treat bacterial infections, not viral infections. Using antibiotics the wrong way can lead to antibiotic-resistant infections that cause illness or death. This is why healthcare providers are being more careful when prescribing antibiotics.

  • When not used correctly, antibiotics can be harmful to your health.
  • Antibiotics can cure most bacterial infections. Antibiotics cannot cure viral illnesses.
  • Antibiotics cause one out of five Emergency Department visits for drug-related side effects.
  • It is estimated that more than half of antibiotics are unnecessarily prescribed.1
  • Antibiotics can lead to severe forms of diarrhea that can be life- threatening, especially in elderly patients.
  • When you are sick, antibiotics are not always the answer

Antibiotics: The Alphabet Letter by Letter

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A (Ask)

  • “Are these antibiotics necessary?” and “What can I do to feel better?”

B (Bacteria)

  • Antibiotics do not kill viruses. They only kill bacteria.

C (Complete the Course)

  • Take all of your antibiotics exactly as prescribed (even if you are feeling better).

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How Can You Help Prevent Antibiotic Resistance?

  • Take antibiotics exactly as your healthcare provider instructs.
  • Only take antibiotics prescribed for you.
  • Do not save antibiotics for the next illness or share them with others.
  • Do not pressure your healthcare provider for antibiotics.

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Do You Need an Antibiotic?

Illness Virus Bacteria
Colds NO
Flu NO
Whooping cough YES
Strep throat YES
Most ear aches NO
Bronchitis NO
Pneumonia YES

What Can You Do to Help Yourself Feel Better if You Have a Viral Illness?

Pain relievers, fever reducers, decongestants, saline nasal spray or drops, warm compresses, liquids, and rest may be the best things to help you feel better. Ask your healthcare provider or pharmacist what symptom relief is best for you.

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Prescriptions for antibiotics can be filled and picked up at the Walgreens Pharmacy at UMC.

 

If you are in need of a healthcare provider, click here.

 

Citations:

1 CDC. Antibiotic Resistance Threats in the United States, 2013. 16 September 2013. 32.