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Gun Violence

Hello everyone! The past few weeks have been quite an adventure in my personal life due to family members moving, medical school interviews, and the unfortunate febrile illness going through the house. It was never my intent to leave readers hanging without a weekly post, but here we are, unfortunately.

Due to the recent mass shooting attack on the eve of October 1st at the Route 91 Harvest Festival in Las Vegas, Nevada, I would like to bring recognition to gun violence and its associated research, or lack thereof. I have already written a post regarding these issues when I was an author with UT Dallas’ Public Health Initiative. My post, with pertinent links and sources, can be found here. Although the article primarily focuses on the single victim incidents that were relevant at the time of my post (made almost a year ago in November 2016), the information is still pertinent to the mass shooting that occurred recently.

Unfortunately, mass shootings have occurred multiple times throughout the US and elsewhere across the globe in recent history. The Las Vegas shooting is the most deadly mass shooting attack in US history. In response to the recent mass shooting, there have been calls to continue to address the issues surrounding firearm safety. The NRA has even spoken out about the need for more regulation on some types of firearm equipment, most notably the bump stock, which can make guns perform more like automatic weapons. The gun control debate is still ongoing in light of recent events.

I would like to extend my thoughts and condolences to individuals, families, and friends affected by gun violence, as well as my support and recognition to all of the service men and women in out health care, public safety, and protection services that have lent their expertise and support to all who have been affected. Gun violence is not the solution to our country’s issues.

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Famous Names · Uncategorized

Dr.Luc Montagnier

This month’s notable figure in public health does not stand alone in his crowning achievement- the discovery of HIV as the cause of AIDS. As a result, the other members that contributed to the discovery of the link between HIV and AIDS will also be given a nod.

Luc Montagnier was born in France in 1932 where he grew up amidst World War II and the German occupation of the country of France. He was inspired to pursue virology after learning of the discovery of the Tobacco Mosaic Virus and the subsequent research conducted on the virus. His early research in virology involved hand foot and mouth disease, which proved that viral double-stranded RNA can replicate in a similar fashion to DNA. His research then turned to oncogenic viruses, or viruses that cause cancers. He discovered that the genetic material contained within the virus is enough to have a cancerous effect. His research specifically focused on oncogenic viruses that contained RNA instead of DNA. These viruses became known as retroviruses. Dr. Montagnier’s lab began searching for retroviruses in human cancer patients.

In 1982, Dr. Montagnier became involved in HIV research in France due to the growing suspicion that the disease may be caused by a virus. Multiple virologists around the world were working to determine the composition of the HIV infectious agent. In early 1983, his lab discovered Lymphadenopathy Associated Virus (LAV), named for the virus isolated from patients displaying swollen lymph nodes in early stages of AIDS. The growth of the lymph cells in cultures utilized the technique discovered and developed by Dr. Robert Gallo. His lab’s discovery allowed researchers to grow T-cells and study the viruses that affect them, thus making LAV research possible. Dr. Montagnier, aided by the assistance of Françoise Barré-Sinoussi and Jean-Claude Chermann who both had previous research and experience with retroviruses, grew and examined LAV cells in cultures. These gentlemen recorded the RT activity in the culture and conducted valuable research in the growth and development of the samples of the new virus. In September 1983, in the midst of the AIDS outbreak, Dr.Montagnier made a presentation of his team’s scientific findings and data that linked the newly determined LAV to the disease in a causal manner. LAV would later become known at HIV. At the time this announcement was controversial because the viral data collected by Dr.Montagnier classified the virus in a different family from HTLV, the only known retrovirus of the time. However, closely followed research performed by Dr. Gallo and Dr.Jay Levy confirmed and extended the findings that the HIV virus was not part of the HTLV family. The 2008 Nobel Prize in Physiology or Medicine was awarded to Dr. Montagnier and Dr.Barré-Sinoussi for the discovery of HIV and their pioneering work in the field of virology. (There has been a controversial debate surrounding the members of the award as Dr.Gallo was notably absent from the recognition despite the use of his techniques and previous research in the discovery and testing of HIV)

Today, thanks to the research of Dr. Montagnier and other scientists, we now know that HIV stands for human immunodeficiency virus. The virus’s transmission to humans is linked to a type of chimpanzee in Central Africa. This transmission from animals established a new disease among the human population and eventually began a worldwide outbreak of HIV. The HIV virus attacks a component of the immune system, called T cells. Since it affects the immune system’s function, people with HIV are more likely to get infections and as the disease progresses, uncommon opportunistic infections and cancers can result from the body’s inability to adequately protect itself. AIDS is the most severe stage of HIV. At this level, the number of T cells is below 200 cells per cubic millimeter of blood (normal is 500 to 1,600). Unfortunately, there is no cure for HIV or for AIDS, but there is treatment available to prolong life and slow the progression of HIV. Without treatment, people with AIDS typically survive about 3 years, but people who are treated with antiretroviral therapy (ART) while in the HIV stages of the disease can live almost as long as their healthy counterparts.

For any readers interested in the complex (and slightly messy) discovery of HIV, a great dramatization of the events is displayed in the movies “And the Band Played On.

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V-v-v-vaccines! Part 2

Hello everyone! I thought this week would be a good opportunity to expand upon the importance of vaccines as a follow up to V-v-v-vaccines! Part 1:Flu from last week, which discussed the seasonal flu vaccine. Today, we are going to take a look at the development of vaccines and why they are such an important component of public health.

Infectious diseases have always had an impact on human life, particularly since the development of cities and townships, which provided close quarters and more human to human (or human to animal) contact, allowing diseases to spread easily. In fact, it is believed that almost 30% of children died before reaching 15 years old in the 1500s. These deaths can largely be contributed to the effects of infectious disease. Additionally, if you can recall back to your highschool history class, you probably learned that European settlers brought new diseases to the Americas that devistated the native population. Things like smallpox, whooping cough, chicken pox and the bubonic plague ravaged native peoples who had never been exposed to these illnesses before. In fact, it is believed that a whopping 80-95% of the native population perished to disease.

Deaths due to infectious disease lessened after the discovery and use of vaccines. Dr.Edward Jenner developed the first vaccine in 1796. He used material from cowpox lesions to innoculate people. The cowpox virus was similar enough to smallpox to confir immunity to the smallpox virus. Thus, people who were vaccinated against smallpox using Dr.Jenner’s cowpox vaccine did not become infected with smallpox. This was a huge medical development since smallpox had appeared around 10,000 BC and had been causing devastating disease outbreaks since that time. The development of the smallpox vaccine changed the course of human development and ultimately the path of public health and medicine. The use of the smallpox vaccine quickly took hold by the 1800s and completely replaced variolation in England in the 1840s. Smallpox was declared as completely eradicated from the world in 1980.

The development and use of vaccines has grown over time, and today it is considered one of the top 10 accomplishments of global public health efforts, as well as a top 10 achievement for US public health. Although Dr.Jenner discovered and used the first effective vaccine in the 1700s, it wasn’t until the 1900s that vaccine development really exploded due to further scientific advancements and interest in vaccinations. Since the turn of the 20th century, there has been the development of 21 vaccines. Now, let’s return to the basics and discuss why vaccines are relevant now. Let’s start with the basics. A vaccine is and “product that produces immunity from a disease and can be administered through needle injections, by mouth, or by aerosol.” On the other hand, vaccination is defined as “the injection of a killed or weakened organism that produces immunity in the body against that organism.” Therefore, vaccination is treatment with a vaccine, which causes an immune response. In the United States, it is standard care for children to receive vaccines against 14 diseases by the age of 2. This plan arose after the development of national efforts and use of federal funds to promote the use of the polio vaccine in 1955. Since that time, all levels of the government have been involved in a partnership with healthcare providers to develop and maintain a certain level of vaccine use among the population as a means of disease control. The CDC even has a table outlining all recommended vaccines and the most appropriate ages to give each vaccine under normal and altered circumstances.

I recognize that this introduction to vaccinations may have created more questions than it has answered for many of my readers. However, it is important to understand the history and development of vaccines before continuing onto current information (and controversies) surrounding the subject. Next week, we will continue to unpack some of the facts and myths surrounding childhood vaccines. See you then!

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V-v-v-vaccines! Part 1: Flu

Every year at the start of flu season there seems to be this ongoing debate about what the flu vaccine is and why it is necessary. I’m here to shed a little light on the practice and share why vaccines are such an important component to public health.

Influenza, commonly known as the flu, is a seasonal virus that can cause serious symptoms, leading to hospitalization or even death. The typical symptoms include fever, chills, upper respiratory symptoms (cough, congestion, runny nose, sore throat), body aches and headaches.However, if the flu is not treated appropriately, in some people, it can lead to pneumonia, ear/sinus infections, dehydration, or complications involving chronic health problems. The flu is very contagious and can spread easily from person to person through respiratory droplets. These droplets form during talking, coughing, sneezing, or kissing and can be further spread through physical contact or touching persons/objects with the virus. This virus infects millions of people each year, particularly during the months from October to May. Many cases can be avoided or have lesser severity, thanks to the flu vaccine, which targets specific types or strains of the virus.

The New York State Department of Health explains that the vaccine changes every year to account for forecasted dominant strains of the virus, so as to protect people from the most likely culprits. The typical vaccine is a trivalent variety and consists of protestion for 3 flu virus types from the influenza A and influenza B families. There is also a quadrivalent vaccine which protects against an additional virus type. There are many types of each of these vaccines that vary in their concentration or administration method. This is so that there are enough methods of protection to benefit the highest number of people. For example, a fit, young adult may have different needs than an elderly person with chronic medical problems. Their immune systems are different, so it makes sense that their vaccines may need to be different too.

So who should be vaccinated? That is a great question! The CDC recommends that anyone over 6 months of age receive an annual flu shot, including pregnant women. There is a small subset of people who are either advised not to recieve the shot or to talk to their doctor before being vaccinated, but most healthy people do not fall into this categoy. If you think you may have an egg allergy or a chronic health problem that puts your health at risk when receiving a vaccine, please refer to the CDC’s recommendations here. If you are concerned about what happens when you receive a flu shot or what the possible side effects may be, the Mecklenburg County website offers great, easy to read information.

We are coming up to the start of this year’s flu season, so now is an optimal time to get the shot and be protected. It takes 2 weeks for our immune systems to exert their fullest effects in response to the vaccine, so getting a shot before the season is in full swing is in your best interest. If you are unable to make an appointment at your PCP or regularly attended clinic, there are other options available. For my readers in my home state of Texas, the Texas Department of State Health Services allows you to search for locations near you based on your zip code, here. For readers outside of Texas, the CDC also has a great “vaccine finder” website. Another simple option is to frequent your local drugstore, such as CVS or Walgreens.

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“I like to move it, move it”

Continuing with the lifestyle posts over the past 3 weeks, excluding the Hurricane Harvey intermission post, this week we will discuss exercise and physical fitness! Along with diet, physical exercise is one of the largest components of health. There is often information about exercise on television, social media, and even in the news, because, like dieting, fitness is not immune to fads or phases. Information about leg day in the weight room, yoga on the beach, or even about whether to exercise in the morning or night is available everywhere. Rather than tell you what the latest fads are in fitness today, I am going to outline the basics that you can use to direct your workout decisions. It is impossible to build a great routine if you don’t have a sturdy foundation.

The American Heart Association defines physical activity as “anything that makes you move your body and burn calories.” This includes walking, daily activities, and deliberate exercise such as scheduled trips to the gym, work out classes, or team sports. The rule of thumb is to achieve at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week. Often times, the advice to have 30 minutes of physical activity 5 days a week is used, because it is easier to remember. Specific details of the types and combinations of exercise that are recommended for adults can be viewed on the CDC’s website, including examples of types of work outs appropriate for your age group.

The NFL Play 60 campaign pushes this goal even farther and encourages youth to have 60 minutes of physical activity to combat the obesity epidemic. In fact, while adults are encouraged to obtain at least 30 minutes a day, the US Department of Health and Human Services actually recommends 60 minutes of moderate to vigorously intense exercise every day.

So, what are the types of exercise that we can become involved in? Well, I am glad you asked! The NIH has a great outline of four major exercise categories with detailed descriptions on each. I will go over each one here.

Aerobic activity- This first category of exercise is what most children and many adults associate with exercise. Aerobic activity uses large muscle groups and is implicated in endurance training. This type of activity increases your heart rate, causes you to breath harder and faster, and helps build strong hearts and lungs. This is often referred to as “cardio” work outs. It includes walking, running, biking, swimming, many team sports such as basketball, tennis, and soccer. It can also include mowing the lawn, or vacuuming the floor if you work hard enough to elevate your heart rate.

Anaerobic activity- The other 3 categories of exercise are all encompassed under this umbrella. Anaerobic activity is anything that does not depend heavily on oxygen supplies, and often does not elevate heart rate or respiratory rate. Instead, the benefits of these movements are accumulated through repetitive actions. The first of this sub-group is muscle strengthening activities. These actions increase the strength, power, and endurance of your muscles. This includes things like lifting weights, push ups, sit ups, and using resistance bands. Around the house, gardening, moving heavy furniture, or climbing stairs can contribute to this. Bone strengthening exercises are the second sub-group. In this category, activities strengthen the integrity of your bones to prevent breakage or damage. The exercises that improve bone strength are encompassed in other activities, such as running, walking, and lifting weights. The last category is flexibility and includes stretching and balance. This type of exercise works on your body’s joints and can improve your muscles by reducing risk for injury. Warm up stretches such as touching your toes or the “sit and reach” exercise increase flexibility. Yoga and Pilates also have a large flexibility component to their routines.

What are the benefits of physical activity? Well, the CDC lists many positive benefits of becoming active and fit on it’s website.In addition to strengthening bones and muscles as we described above, there are many other health benefits of physical activity, including improved mental health, reduced stress, higher sleep quality, and a better overall mood. Many adults are motivated to exercise as a form of weight management, because regular exercise, when paired with a healthy lifestyle, can help prevent obesity or be a contributing factor to weight loss. Exercise can also reduce your risk for disease development, including hypertension, type 2 diabetes, obesity, heart disease, and even some forms of cancer!

These guidelines are not solely specific to America. In fact, the World Health Organization also promotes physical activity. In fact, the WHO specifically denotes on their website that exercise recommendations ” are applicable for all adults irrespective of gender, race, ethnicity or income level. They also apply to individuals in this age range with chronic noncommunicable conditions not related to mobility.” The WHO has established a “Global Strategy on Diet, Physical Activity, and Health” because it understands that by improving diet and exercise, they can significantly reduce deaths and the burden of disease.

Famous Names · Uncategorized

Dr.Virginia Apgar

This month’s “Notable Figure in Public Health” is Dr.Virginia Apgar. She played an important role in the development of a medical evaluation for newborns, called the “Apgar Score,” and she contributed to the development of an NGO organization that promotes awareness and funding for research.

The life and career of Dr.Apgar includes momentous accomplishments that have contributed to the direction of the medical field more than 50 years later. Her career began as a medical student at College of Physicians and Surgeons at Columbia University during the onset of the Great Depression. Despite the economic and social challenges of the time, she continued to thrive in her education and even graduated 4th in her class in medical school in 1933. She wanted to pursue surgery, a field completely dominated by men at the time. At the encouragement of Dr.Whipple, upon seeing her drive and skill, she was encouraged to pursue anesthesiology after the completion of her surgical residency. At that time, anesthesiology was not a recognized specialty and the field was still under continuous growth and development. She eventually trained with the first anesthesiology department in the country, located at the University of Wisconsin-Madison. She returned to Columbia University College of Physicians and Surgeons as an anesthesiologist in 1938, and when the field became a recognized specialty, she was appointed as the first full time female professor at the school.

During her time as a professor, her main focus was on obstetrical anesthesia. This is the study of the affects that anesthesia given to mothers during labor has on the newborn baby. During her study in this field, Dr.Apgar developed the Apgar Score. Changing the Face of Medicine states that the Apgar Score was “the first standardized method for evaluating a newborn’s transition to life outside the womb.” The Apgar Score scoring system evaluates newborns on their heart rate, respiration, movement, irritability, and color one minute after birth and again at five minutes after birth. The Apgar scor is represented by the APGAR acronym that represents Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration. This scoring method is now an established standard of evaluation for newborns around the world. The scoring method reduced infant mortality and laid the foundations of neonatology. Furthermore, Dr.Apgar and her partners were able to establish a correlation between a newborn’s Apgar Score and the mother’s delivery conditions.

In 1958, obtained her Master of Public Health degree from Johns Hopkins. Following this, she became involved in the March of Dimes organization for 15 years. In fact, the website states, “she became a pivotal figure in redirecting the March of Dimes mission in the 1960s from polio to birth defects and other infant health problems such as premature birth.” She acted as the head of the Division of Congenital Malformations. During her time with the organization, she promoted rubella immunization through the organization after a German Measles outbreak in the mid 1960s. She also worked tirelessly to reduce the stigma surrounding birth defects. She even co-authored a book with Joan Beck titled Is My Baby All Right? addressing birth defects.