- The answer to this question depends on the definition of an STD. For instance, Shigella was once though to be a Gastrointestinal disease, but with modern sexual practices and the increase of oral to anal intercourse it is now becoming an STD as well. Therefore, no precise number of STDs can be stated but there are now >30 infections classified as predominantly sexually transmitted (Harrisons, 2008, p. 822)
- The most common viral STD is HPV. It is said that nearly ½ of the population is infected with the virus at any given time. Both males and females can become infected with different sequelae of the disease. With the advent of the vaccine, Gardasil, hopefully the rates will decrease substantially (Harrisons, 2008, p.822)
- The most common bacterial STDs are: Neisseria gonorrhoeae, chlamyida trachomatis, treponema pallidum, haemophilus ducreyi, calymmatobacterium granulomatis, and ureaplasma urealyticum. (Harrisons, 2008, p.822). They can be rather dangerous and cause infertility. However, they are relatively easy to treat using antibiotics, and if caught early, will have few lasting effects except for the damaged ego and hopefully a lesson to have safe-sexual practice.
- Different STDs have different modes of transmission depending on the pathogen at play. Sexual intercourse, anal sex, oral sex, oral-anal sex (Robbins, p.341) have all been implicated in the spread of these diseases. Furthermore, the sexual practice may cause different outcomes of the same disease. HPV acquired through intercourse will lead to genital warts, whereas HPV from oral sex may lead to dysplasia of the esophagus.
- Approximately 80% of all STDs occur in the 15-29 age group (http://wonder.cdc.gov/controller/datarequest/D58). This is a logical number since the age group is less likely to be in a monogamous, married relationship. Furthermore, the youth is well known for its proclivity towards risk-taking behavior.
- Anywhere from 25-50% of men do not know how to use a condom properly (http://www.publish.csiro.au/view/journals/dsp_journal_fulltext.cfm?nid=164&f=SH11095). The number may be as high as 80% if you consider how few people inspect the condom before putting it on. Common mistakes include putting the condom on after starting intercourse, unrolling it before putting it on the penis, and not squeezing the air from the tip.
- About ½ of the population will get an STD by the age of 25.
(http://www.pimahealth.org/disease/documents/STDOverview_factsheet.pdf) The most commonly acquired STD will be an HPV infection. Furthermore, bacterial STD infections may be silent and go unnoticed for a very long time, potentially infecting many partners before it comes to the host’s attention.
- At any point in time 42.5% of people have an HPV infection (http://www.cancer.gov/cancertopics/factsheet/Risk/HPV) and 1/5 women and 1/9 men have a herpes infection. HPV and Herpes may lie dormant in the host and go undetected for a long time. HPV as noted is the most commonly STD acquired and is hard to detect in women. Therefore, it is imperative that women go to their gynecologists and do a yearly pap-smear. With the advent of Gardasil hopefully this number will be greatly reduced
- Most chlamydia and gonorrhea infections are asymptomatic in women (http://www.cdc.gov/std/infertility/). Recognition of the disease may only come about after it has progressed to pelvic inflammatory disease which is a major risk for infertility. The symptoms of the disease mimic many other conditions such as ovarian cysts and therefore it is necessary to go to a physician for regular testing and imaging if necessary.
- About 50% of chlamydia is asymptomatic in men and 10% of gonorrhea is asymptomatic in men (http://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm) (http://www.plannedparenthood.org/health-topics/stds-hiv-safer-sex/gonorrhea-4269.htm). Symptoms, when apparent, will include a urethral discharge and burning sensation upon urination or ejaculation. Testing for the diseases in men uses a swab that is pushed into the urethra.
- HPV -> Cervical cancer in women and penile cancer in men, HIV -> non-hodgkins lymphoma in men and women, trichomonas ->prostate cancer. The pathomechanism of HPV leading to dysplasia and cancer is very clear. HIV is believed to lead to lymphomas because of the defect in the immune system. Trichomonas may lead to prostate cancer by also causing dysplasia in the reproductive tract.
- Chlamydia and gonorrhea infections can cause scarring and lead to infertility in men and women. It is difficult to detect in women as they are usually asymptomatic and therefore serological testing is very important to conduct on a regular basis for all sexually active individuals. The mechanism of scarring involves the implantation of the bacterium in either the urethra or the fallopian tubes and over time they will eat away at the affected organ. From repeated healing, reinfection, and wounding, eventually scars which clog the entire tube may form and this leads to infertility. (http://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2009/May/Conditions-That-Affect-Fertility)
- Viral stds, including herpes, hepatitis B, HPV, and HIV are incurable. However, they are manageable and should not be ignored simply because no “cure” can be obtained. Herpes can be controlled nicely with acyclovir, HBV can be controlled with interferon, HPV lesions can be burned off, frozen off, or cut away, greatly reducing their virulence. HIV can be controlled by the HAART therapies to nearly undetectable levels and in modern practice HIV positive mothers do not necessarily give birth to HIV infection children. Bacterial stds, trichomoniasis, chlamydia, gonorrhea, syphilis, and cancroid are curable http://www2.hu-berlin.de/sexology/ECE4/html/curable_stds.html. Simple antibiotics are used to cure the bacterial STDs. Some, are even cured by only a one time high dose of antibiotics. However, it is important to note that with the overuse of antibiotics there is a growing resistance to the drugs which may turn some of these infections into the incurable type shortly.
- HIV used to be thought of as a death sentence. Today, with proper management, it is more of a chronic condition than a death sentence. (http://std.about.com/od/treatment/u/userpath3.htm). Frankly, calling any disease a death sentence ascribes to the disease some moral judiciary authority that is inappropriate; a disease is an illness and not some sort of arbitrator of justice. Someone infected with HIV should be careful and engage in appropriate safe sexual practices. With the use of HAART therapies, today, an HIV infected individual is able to live an almost normal life span, free of many of the devastating affects seen when the aids epidemic started in the 1980s.
- The most common protocol is two nucleoside reverse transcriptase inhibitors and 1 non-nucleoside reverse transcriptase inhibitor – leading to 3 pills, however there are more than 20 medications that can be taken in a variety of combinations. (http://www.avert.org/treatment.htm) Drugs can cost from 2000-5000 dollars a month depending on the regimen. The treatment protocols are called HAART, or Highly Active Anti-Retroviral Therapy. HAART is very effective at controlling the HIV virus to the point of non detection of viral load in the blood. Furthermore, there is a mutation of the CCR5 receptor which ascribes an immunity to HIV to the carriers of the mutation. Finally, there are several studies and case reports of patients that underwent complete immune system transplants who have been seemingly cured of their infections. (http://www.npr.org/blogs/health/2012/07/27/157499134/cost-of-treatment-still-a-challenge-for-hiv-patients-in-u-s)
- The HIV infection rates of college students are 1 in 500, so 2 in 1000. The free-spirit nature of the college campus makes it a particularly potent breeding ground for STDs of all varieties. Furthermore, there is a slightly higher prevalence in this age group for HIV due to the higher risk taking behaviors seen in youth and fact that they are less likely to be in monogamous safe relationships. Furthermore, sexual experimentation is higher and practices that are riskier may be attempted in the college setting. (http://www.stateuniversity.com/blog/permalink/College-Students-and-HIV-AIDS.html)
- In 2004, Aids was ranked the 9th leading cause of mortality in those aged 35-64 and was ranked the 3rd leading cause among African Americans of the same age range. (Harrisons, 2008, p. 1148). AIDS has a disproportionate impact on minorities as well as homosexual men. There are various theories as to why this occurs, but none are particularly convincing. Safe sexual practices must be encouraged at all times to all demographics.
- About 20% of new infections occurred in the <21 age group, including in the very young (http://www.cdc.gov/hiv/youth/). This is due to a host of reasons, including higher risk taking proclivity, and the higher incidence of drug use in this group. Furthermore, those teenagers always think they’re invincible and are less likely to get tested or talk about the potential for their infection with either parents or medical practitioners. - Sub-Saharan Africa has the most cases of HIV and AIDS with more than 66% of all worldwide cases (Harrisons, 2008, p. 1146). In Africa, the majority of cases occur among heterosexuals as opposed to north America or Europe where the majority of cases occur in homosexual communities. Some parts of Africa have AIDs infection rates approaching 50%. It is estimated that the toll that the virus is taking in Africa is such that within a few years, the average life expectancy will fall to below 40 years. - HIV tests are free at local, state, and federal health departments. Testing may be anonymous, but the rules depend on the state. It is very easy and it can be done through blood, salivary swab, or urine testing. Given the ease of testing, it is important to regularly get a test done for all sexually active individuals. (http://www.plannedparenthood.org/health-topics/stds-hiv-safer-sex/hiv-testing-19857.htm) - Education, counseling, and behavior modification are the basis of STD prevention strategies. The only absolute way to remain uninfected is abstinence (Harrisons, 2008, p. 1202). Given what we saw above with the low knowledge of proper condom usage, it is impossible to say that condom usage is an effective STD prevention strategy absent education.
- A lack of dietary fiber can cause constipation, weight gain, blood sugar fluctuations, diet-related nausea and tiredness, high cholesterol, diabetes, cancer, hemorrhoids, and irritable bowel syndrome (http://www.webmd.com/food-recipes/features/4-warning-signs-your-diet-may-lack-fiber).
- The following categories and items are high in fiber:
Fruits: apples (with skin), pears (with skin), rasberries, Banana
Vegetables: artichoke, broccoli, brussle sprouts
Grains/pasta/cereal: bran flakes, brown rice, whole-wheat pasta, rye bread
Legumes: Lentils, Lima beans, Black beans
Nuts/seeds: Sunflower seeds, Almonds, pistachio nuts
- Men require 38 grams of fiber and women require 25 grams of fiber. This is a relatively easy number to get to in individuals eating the proper amounts of fruit and vegetable every day.
For instance, all it takes is 1 cup of raspberies will give 8 grams, an outbran muffin will give 5 grams, split peas will give 16 grams, and an artichoke will give another 10 grams. Eat fruit and vegetables to eat enough fiber. (http://www.mayoclinic.com/health/high-fiber-foods/NU00582)
- The three main ways to prevent constipation are: eat a high fiber diet, limit low-fiber foods, and drink plenty of liquids. Constipation can be very dangerous, leading to bowel obstructions and perforations. Keeping ones bowel movements regular is important for good health. (http://www.mayoclinic.com/health/constipation/DS00063/DSECTION=prevention)
- Non-neoplastic polyps are benign and have no malignant potential, and therefore are usually just incidental findings. Adenomatous polyps are usually benign, but have a high malignant potential and are a precursor to adenocarcinoma. It is therefore important for men of a certain age to regularly get colonoscopies to screen for these diseases and to biopsy any suspicious lesion that is discovered so the pathologist can determine its cancerous potential (Step up to medicine, 2013, p. 116-17).
- For the average at risk patient, starting at the age of 50, once every 10 years. If a patient has a single or multiple polyps or a personal history of colo-rectal cancer: repeat every three years after initial colonoscopy. If everything appears healthy, repeat after 5 years. If there is a family history of colon cancer in first degree relatives, colonoscopy should be started at 40 years old, or 10 years younger then the initial patient was at the start of the cancer. Repeat colonoscopy every 3-5 years. High risk patients ie. Familial polyposis: genetic testing begins at age 10, and starting at puberty colonoscopies should occur every 1-2 years. (Step up to Medicine, 2013, p. 479-480)
Nutrition and exercise
- Heart disease is the leading cause of death in the U.S. Heart disease is responsible for nearly 600,000 deaths annually in the United States. The next leading cause of death is cancer. Both cancer and heart disease can be prevented through proper diet, exercise and abstaining from cigarettes. (http://www.cdc.gov/nchs/fastats/lcod.htm)
- Over 66% of the US adults are categorized as overweight or obese (Harrisons, 2008, p.468). However, different sources list different numbers. The CDC states that about 30% of adults are obese. Obesity means a BMI of >30. Overweight is a BMI between 25 and 30. Normal BMI is 18.5-24.9. BMI is calculated as mass (kg)/height (m)^2.
- 12.5 million children, or about 1/6 of american children are obese. This is a growing problem as we are going to begin to see the effects of a lifelong obesity. In prior generations, obesity was only a disease of the middle aged and aged and the youth were largely not obese. However, with the growing obesity in youth, we are seeing diseases such as type II diabetes occurring ever earlier and cardiomyopathies occurring too. It is effectively unchartered health territory. (http://www.cdc.gov/nchs/data/databriefs/db82.htm)
- Yes, I looked it up. BMI is calculated as mass (kg)/height (m)^2. I am in the normal range.
- Hypertension, Type II Diabetes, and Depression are all diseases that come with obesity. Each of these three diseases may be alleviated with weight loss. In a substantial number of patients, diet and exercise will cure them completely of diabetes and hypertension to the point of obviating the need for any outside pharmacological control.(Harrisons, 2008, p. 470)
- There are 9 calories/gram of fat. Carbohydrataes and proteins each have 4 calories/gram, so yes, it’s more than double. (http://www.nutristrategy.com/nutrition/calories.htm)
- Fat should be between 20-35% of calories of a healthy adult diet (http://www.mayoclinic.com/health/fat-grams/HQ00671). A big mac has 29 grams of fat (http://www.mcdonalds.com/us/en/full_menu_explorer.html). A 2500 calorie a day diet should have about 80 grams of fat. Therefore a single burger at mcdonalds will represent more than 1/3 of the daily fat intake that a large male is supposed to have. Once French fries are included the number is more than 50% of the daily fat intake. If non-diet sodas are used. The calorie count alone will be approximately 2/3 of the daily intake. (http://www.health.gov/)
- Half of your plate should be fruits or vegetables. This has a very practical effect of controlling the calories consumed as well as providing the individual with the maximum amount of vitamins, nutrients, and fiber. Fruit and vegetables contain high levels of indigestible fibers that take space in the stomach making the eater feel more full. He is therefore able to eat less of calorie rich foods such as fats, and still feel satiated. (http://www.choosemyplate.gov/food-groups/fruits.html)
- No more than 10% of calories should be saturated fats. There are many risks with eating a diet high in saturated fats, including atherosclerosis, obesity, and heart disease. Furthermore, the knock-off diseases associated with obesity are too numerous to list here, but the risk increases for all of them with a diet high in saturated fats. (http://caloriecount.about.com/saturated-fat-facts-nf606)
- Cheese, milk, butter, ice cream are all foods that are high in saturated fats. Essentially, anything fatty that is animal based has saturated fat. Dairy products, fatty meats, and similar products should be eaten sparingly and judiciously. (http://caloriecount.about.com/saturated-fat-facts-nf606)
- Fats that come from animal products or oils that are hydrogenated may be trans fats. Hydrogenation is the process of making liquid fats solid at room temperature. This has many storage benefits and benefits with regards to the food preparation, however, health wise they are a disaster which lead Mayor Bloomberg of New York City to ban them from use in restaurants throughout the city of New York. (http://www.fda.gov/food/resourcesforyou/consumers/ucm079609.htm)
- The recommended daily serving of the food categories are: 2.5 cups of vegetables, 2 cups of fruits, 5.5 oz of protein, 6 oz of grains, and 3 cups of dairy. (https://www.supertracker.usda.gov/foodtracker.aspx)
- males require 13 cups of water, whereas females require 9 cups. This is important to replace the water lost to urination and perspiration as well as to prevent constipation and to dilute any toxins that may have been ingested with foods. (http://www.mayoclinic.com/health/water/NU00283http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/phytochemicals)
- 300 mg of cholesterol is the daily-recommended cholesterol intake. 2 eggs have about 360 mg of cholesterol. Any animal based food potentially is high in cholesterol. It is important to eat a diverse range of proteins and it should be balanced over time. Eating 2 eggs a day is bad for certain populations, eating 2 eggs; 2x a week is acceptable for most. It is important that a diet be balanced over time and one should not worry about the daily balance too much. (http://www.cdc.gov/nutrition/everyone/basics/fat/)
- Foods that are high in fats will contain cholesterol. Particularly high fat animal products will contain cholesterol, however, even a high fat vegetable like an avocado will have a fair amount of cholesterol. (http://www.cdc.gov/nutrition/everyone/basics/fat/)
- 2300 mg of sodium if healthy, and 1500 mg if at risk for health problems associated with sodium, such as kidney disease, of congestive heart failure. (http://www.hsph.harvard.edu/nutritionsource/salt/)
- table salt, soup broth cubes, leavening agents all contain very high levels of dietary sodium (http://nutritiondata.self.com/)
- Foods that are rich in omega 3 include fatty Fish such as: Mackerel, salmon, anchovies, sardines and also seeds and nuts such as, walnuts and flax seed.
- grapes, eggplants, red cabbage, cauliflower, licorice, soy products are all examples of foods that are rich in phytochemicals and will provide good anti-oxidant coverage to keep you healthy. (http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/phytochemicals)
- Vitamin A, Vitamin C, Vitamin E are considered the vitamin anti-oxidants. Essentially, they are capable of trapping free radicals, which are unmatched Oxygen molecules that can wreak havoc inside cellular structures in living organisms. (http://www.cancer.gov/cancertopics/factsheet/prevention/antioxidants)
- Iodine is the nutrient that humanity is general most deficient of. This is not true in western europe or North America where iodized table salt is cheap and accessible, however, in the developing world this is a major cause of thyroid disease and all its dependent diseases. (http://www.who.int/nutrition/publications/VMNIS_Iodine_deficiency_in_Europe.pdf)
- Vitamin A deficiency is the leading preventable cause of blindness in the world. Experiments are underway with genetically modified grains such as “golden rice” which have vitamin A implanted in them in order to alleviate this world wide blight of the developing world. (http://www.who.int/nutrition/topics/vad/en/)
- Men should limit their alcohol consumption to 2 units of alcohol daily. Women should limit themselves to 1 unit of alcohol per day. (http://www.cdc.gov/alcohol/faqs.htm)
- Breast milk is best for infants, unless there is a contraindication for it, infants should be exclusively fed breast milk for the first few months of life. (http://www.nlm.nih.gov/medlineplus/infantandnewbornnutrition.html)
- Each teaspoon is approximately 4g of sugar. Therefore 40g of sugar is equal to abiout10 teaspoons of sugar (http://www.webmd.com/food-recipes/features/sugar-shockers-foods-surprisingly-high-in-sugar)
- A can of coca-cola has 39 grams of sugar, which is about 10 teaspoons of sugar. I would not put that in my coffee. It is called an empty calorie because there is no other nutritional value aside from the calories.
- Salt, smoke, and nitrates have all been linked to cancer and are all found in smoked and processed meats. (http://www.npr.org/blogs/thesalt/2013/03/06/173637699/salami-suicide-processed-meats-linked-to-heart-disease-and-cancer)
- Pre-cooking food before grilling it, using aluminum foil to house the food, lowering the heat to prevent burning, marinating food, and cleaning your grill of burnt residues may all contribute to a lower carcinogenicity of grilling food. (http://www.rd.com/health/healthy-eating/10-guidelines-for-healthier-grilling/)
- Garlic, broccoli, tomatoes, strawberries, carrots, spinach, and whole grains have all been linked to cancer prevention. (http://www.webmd.com/cancer/features/seven-easy-to-find-foods-that-may-help-fight-cancer)
- Eating a few nuts will be calorie dense and make one less hungry the next day. Nuts contain fats and proteins as well as a very nice balance of minerals and vitamins.
- A big mac meal. The sandwich: 29 grams of fat, 970 mg of sodium, and the French fries contain 19 grams of fat and 270 mg of sodium. (mcdonalds.com)
- Aerobic exercise should be conducted for at least 2.5 hours a week, spread over 3x/week. Strength training should occur at least 2x/week, and stretches should also be about 2x/week (http://www.choosemyplate.gov/physical-activity/amount.html)
- It depends on the state, however in some states cigarettes are approaching $12 a pack. This translates into $4380/year or $21900 in five years
- A change in bowel habits, a sore that doesn't heal, unusual bleeding or discharge, thickening somewhere, indigestion, obvious changes in size, color, shape, or thickness of a wart or mouth sore, nagging cough or hoarseness are all symptoms of cancer. (http://www.webmd.com/cancer/understanding-cancer-symptoms)
- Asymmetry, irregular borders, color, depth, evolution of a mole. An easy way to remember that is ABCDE. Another method for screening melanoma is the “Ugly Duckling,” that is, if you have many moles, you should look for one that is substantially different from all your other moles. (http://www.skincancer.org/skin-cancer-information/melanoma/melanoma-warning-signs-and-images/do-you-know-your-abcdes)
- Eat healthy, be active, get screened, don’t smoke are all ways to prevent cancer. (http://preventcancer.org/)
- 1g = 9 calories, 28g = 1 oz = 252 calories, 1lb = 16oz = 4032 calories. In order to lose 1 pound a week, 4032 calories would need to be removed from the diet or excercised away.