Acupuncture, Will It Work For You

Acupuncture has been around for thousands of years. It has gained acceptance and popularity in the West over the last 10-20 years, but do we know if it works?

Several studies have been completed, and the bottomline, according to The Medical Letter, May 8 2006 issue, is that acupuncture may be effective when used as an adjunct but not alone in the treatment of the following:

• chemotherapy-induced nausea and vomiting
• cancer pain
• low back pain
• osteoarthritis of the knee
• headaches

Conditions which were studied but for which acupuncture did NOT show any benefit were:

• smoking /addiction
• weight loss
• depression
• neurologic disorders including stroke

For details of these studies or more general information on acupuncture see National Center for Complementary and Alternative Medicine.

Image: courtesy of LiewCf.com

PRODUCT RECALL ALERT

Dear Bloggers,

If you are using the following product, please be advised that
Bausch and Lomb's Renu with Moistureloc contact lens solution has been recalled by the FDA as of 5/11/06 . See FDA statement. The concern has been the relationship of this solution to a possible infection of the eye with with Fusariform fungus.

If you go to B&L's home page,http://www.bausch.com/, there's a
link to assisst you to get a refund.


Obligatory Disclaimer: The information provided on this Web site is not intended to be used as a substitute for medical advice. Any concerns or questions you have about your health or the health of your family should be discussed with your family physician. Please note that medical information is constantly changing. Therefore some information may be out of date.

What is the most prevalent sexually transmitted disease in the US?

A. HIV
B. Herpes
C. Human papilloma virus
D. Chlamydia







Answer is: B. For details please see previous blog on Herpes.

Photo: courtesy of Oaxaca Exhibitions

Herpes, To Test or Not To Test

Recently some new tests for herpes have become available which are both helpful and confusing. I would like to review the indications for testing after a brief review of herpes.

Type 1 Herpes Simples virus (HSV-1) is responsible for most oral herpes commonly known as cold sores, but it can also cause genital ulcers.
Type 2 Herpes (HSV-2) is responsible for 85% of genital herpes. HSV-2 is the most prevalent sexually transmitted disease (STD) in the United States. 45-60 million people, 1 out of 5 Americans, live with this infection. There are 1 million new cases each year. About 25% of the US population aged 25-45 years old has been exposed to HSV-2 compared to 90% of the population exposed to HSV-1.

Signs and symptoms vary. The classic finding is a cluster of tender blisters which turn into shallow ulcers. The first episode is usually the most severe and may be associated with symptoms such as fever. A culture of these lesions is the gold standard to establish the diagnosis.

A variety of triggers such as stress, fatigue, mechanical irritation, and menstruation can cause the symptoms to recur. Recurrent symptoms are usually milder than the first episode, but the psychological impact of the disease can be severe. Depression and anxiety from fear of recurrent attacks or transmission to current or potential partners are not uncommon. The infection may be transmitted even when there are no symptoms. This is called asymptomatic shedding which occurs in nearly all infected individuals. Condoms help protect against herpes but they are not 100% effective.

So what about testing ? HSV type specific serological (blood) tests are now available, however, the test is NOT recommended for routine screening in the general population. Who may be considered for the test? According to the 2003 California STD Controllers Guidelines, HSV-2 serology may be used in this group but mostly if it will impact behavior.

--Asymptomatic partners of HSV-2 positive patients.
--Diagnosis of atypical genital lesions.
--Screening of high risk behavior patients.
--Selected pregnant patients.
--Asymptomatic HIV positive patients.

As an aside for the docs, IgM testing is not recommended.

Treatment is available which can reduce the severity of the disease, the number of recurrences and the transmission risk to partners. However, there is no cure. Vaccine trials are underway. Herpevac is one of the many under investigation.

Resources for patients with HSV: National Herpes Hotline (916-361-8488), American Herpes Foundation (201-342-4441), American Social Health Association ( 919-361-8400), and social web sites .

References:2003 California STD Controllers Association Guidelines. Shedding in the absence of lesions. Wald A et al. N England Journal of Medicine. 2000;342:845-850. Managing patients with genital herpes and their sexual partners. Patel, Rompalo. Infect Dis Clin Norht Am 2005;19(2):427-38, x. Tracking the Hidden Epidemics, Herpes. Dr. Huyen Cao, Director of International Cellular Immunology, California Department of Health Services.
Photo courtesy of: Worried.

Buzzzzzzzzzzzz

Do you know: What percent DEET is needed in insect repellents to be effective?

A. 7%
B. 20%
C. 30%
D. 98%
E. All of the above





Answer is: E. All of the above

What is DEET? DEET is N,N-diethylmetatoluamide which was developed by the U.S. Army in 1946 for use by military personnel in insect-infested areas.

How does it work? It creates a vapor above the area of application as it evaporates which repels the insects.

Children should use the lowest dose effective which can be less than 10%, however, it may not stay on as long as the higher concentrations. See Bug Repellent Comparison.
DEET is not recommended for use in children less than 6 months old, and it should be considered for children up to 2 years old only if very high exposure to insects is expected. Avoid applying it to children's hands if they tend to put them in their mouths.

Adults may consider 30% concentration. Consumer Reports June 2006 concluded that 30% was needed for very good results.

Pregnant women should not use it.

Where is it applied? It should be applied to any exposed skin sparingly. Avoid using it around the eyes and mouth, and any open skin such as scratches and skins. Do not apply it under clothing. Wash your hands after applying it.

Alternative to DEET: Most experts agree that non-DEET containing repellents are not as effective. A panel in Consumer Reports June 2006 thought that Repel Plant Based Lemon Eucalyptus worked better than the other non-DEET products but they did not like its smell. This is also NOT recommended for use in children less than 3 years old.

For more information: see Insect Repellent Use and Safety.

References: Insect repellents: an overview, J Am Academy of Dermatology, 1997.
DEET-based insect repellents: safety implications, Canadian Medical Association Journal, 2003. Dr. J. D. MacLean, McGill University
Photo: courtesy of SoulTek.com/blog