Gynecology Exams: ACOG or the American College of Obstetricians and Gynecologists has made a recommendation on the annual pelvic exam and cervical cytology screening. The reason that ACOG chose to make a statement at this time regards the confusion that has been created by Merck’s advertising of Gardasil as a cervical cancer vaccine. The recommendations for the exam appear to be the same as pre gardasil. Once a woman becomes sexually active or when she turns 21 the general exam and cervical cytology should begin. The cervical cytology is the pap smear. Women who do not have risk factors only need exams every three years and women over age 65 can forgo the pap smear as long as they have no history of cancer and have had ten years of normal paps. The important message is that the vaccine for HPV does not take the place of gynecological care.
Disclosure: The concern that clinicians and researchers have been receiving incentives from drug and medical device makers has gained credence. The Institute of Medicine is calling for voluntary changes and policies regarding conflicts of interest. They urge that those practicing direct care do not accept any sample meds, free meals, stipends or gifts. All relationships should be identified and shared with employers and organizations. The IOM makes this recommendation on the heels of Senator Charles Grassley’s call for action and also encourages legislation. They assert that voluntary changes are encouraged and without them, strict regulation will be necessary.
OTC Label Changes: In 2006 it was proposed that some over the counter pain and or fever medications have their labels updated to include a health warning from overuse. I am not certain, but I believe that the concern was first raised by the Center for Science in the Public Interest. The label change is now mandated by the FDA and will include liver damage warnings for acetaminophen containing products and stomach bleeding warnings for ibuprofen products. Two less familiar drugs are noted as well so keep an eye on the labels. Note that acetaminophen concerns are aggravated by alcohol and that individuals on the blood thinner warfarin should not take acetaminophen without informing their doctor.
Behavior Economics: In reading an article about incentive programs that are being implemented by employers, I learned of this concept – behavior economics. Those in the field note that consumers do not always act in ways that would be in their best interest.(say like buying things that they cannot afford or will never use) Of course, those of us in the field of public health know better than anyone that people struggle mightily with doing the right thing. So employers are offering incentives to people who struggle with life changes when the only reward is well.. a changed life… you know, a healthier one! So to get people to quit smoking, start exercising and stay on their blood pressure meds, companies offer days off, money, lotteries and continuous incentives. The newest thing in employee wellness being the need to keep offering the incentive after the change has been completed, or else, people will revert to their old unhealthy ways. Hey, no one changes for free, not even for their own benefit it seems.
Prostate Cancer Treatment: We have recently been concerned with whether or not to test, but now I am asking whether or not to treat. At least, in regards to the latest story on a drug called Avodart. The drug in question is from GSK and is sold now for treating an enlarged prostrate. In one study, the drug was compared to placebo in men who had an increased risk of getting prostate cancer. Over 8000 men were involved and after four years, 22.5% of the men on the drug versus 29 % not on the drug, got the cancer. The report on the study does not tell us if the four percent is statistically significant or what the side effects of the drug are. The side effects may be worse than the effects of the cancer which is usually slow growing. So I am waiting to learn more about this. BTW, Fosomax, the drug many women take to prevent osteoporosis was once tried for prostate cancer prevention but caused more aggressive cancers instead.
FLU: Just a brief note on this very current issue. H1N1 is a combination virus of bird, pig and human making. We do not currently have a vaccine for this strain and that is why it can spread more rapidly and take more lives than the “regular” flu. There is no herd immunity. This was a concern a few years ago with Avian flu which had not mutated to human to human transmission as the current flu has. It is usually the case that healthy people may get ill, but not critically so, with a flu virus. For now, avoid sick people, eat right, exercise, drink water, wash your hands and if you become ill, isolate yourself, talk to your doc and perhaps treat your symptoms with an antiviral like tamiflu.
Today’s video is for pumpkin cream cheese. You will need fat free cream cheese, canned pumpkin, ground cloves and cinnamon, a sweetener and a mixer. There is about 10 cals per TBSP.
Get Moving!
Deirdre
pumpkin cream cheese video
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