Monday, April 2, 2018

WELLNESS WEDNESDAY: CHILD ABUSE PREVENTION


Child abuse and neglect are significant public health problems in the United States.

Each day more than five children die as a result of abuse or neglect. On average, a child abuse report is made every 10 seconds for a total of approximately 3.3 million child abuse reports annually. 


Child abuse and neglect includes all types of abuse or neglect of a child under the age of 18 by a parent, caregiver, or another person in a custodial role that results in harm, potential for harm, or threat of harm to a child.

There are four common types of abuse and neglect.

Physical abuse is the use of physical force, such as hitting, kicking, shaking, burning, or other shows of force against a child.
Sexual abuse involves inducing or coercing a child to engage in sexual acts. It includes behaviors such as fondling, penetration, and exposing a child to other sexual activities.
Emotional abuse refers to behaviors that harm a child’s self-worth or emotional well-being. Examples include name calling, shaming, rejection, withholding love, and threatening.
Neglect is the failure to meet a child’s basic physical and emotional needs. These needs include housing, food, clothing, education, and access to medical care

Guide to preventing child abuse
  • ·         Never discipline your child when your anger is out of control.
  • ·         Participate in your child’s activities and get to know your child’s friends.
  • ·         Never leave your child unattended, especially in the car.
  • ·         Teach your child to use their voice to allow them to prevent abuse in their own life.
  • ·     Ask questions; for example, when your child tells you he or she doesn’t want to be with someone, this could be a red flag.
  • ·         Listen to them and believe what they say.
  • ·         Be aware of changes in your child’s behavior or attitude and inquire into it.
  • ·         Teach your child what to do if you and your child become separated while away from home.
  • ·         Teach your child the correct names of his/her private body parts.
  • ·         Be alert for any talk that reveals premature sexual understanding.
  • ·         Pay attention when someone shows greater than normal interest in your child.
  • ·    Make certain your child’s school or day care center will release him/her only to you or someone you officially designate.


Unexplained injuries aren't the only signs of abuse. Depression, fear of a certain adult, difficulty trusting others or making friends, sudden changes in eating or sleeping patterns, inappropriate sexual behavior, poor hygiene, secrecy, and hostility are often signs of family problems and may indicate a child is being neglected or physically, sexually, or emotionally abused.

If you witness a child being harmed or see evidence of abuse, make a report to your state's child protective services department (link below) or local police (link below). When a child talks about abuse, listen carefully, assure the child that he or she did the right thing by talking to you, and affirm that he or she is not responsible for what happened.

http://patientcareofwilmington.com/      Patient Centered Care, PLLC  910-799-6262

Sunday, March 25, 2018

WELLNESS WEDNESDAY: E-Cigarettes


Definition: Electronic cigarettes (e-cigarettes) are battery-operated devices that heat a liquid usually containing nicotine, producing a vapor that the user inhales. E-cigarettes entered the market as consumer products without government regulation.

Conventional cigarettes burn tobacco and generate smoke, e-cigarettes have a cartridge containing a liquid (sometimes referred to as "e-liquid"), which contains nicotine and other constituents. The main components of the liquid vaporized is nicotine, propylene glycol or glycerol, and flavorings. A variety of other compounds have also been identified, some with carcinogenic potential.

The long-term health consequences of e-cigarette use are largely unknown but are likely to be less than continuing to smoke conventional cigarettes because e-cigarettes do not expose the user to many of the toxins in tobacco smoke. E-cigarettes expose users to nicotine as well as heated and aerosolized propylene glycol and glycerol and other compounds. The toxicity of chronic exposure to these and the other components of e-cigarettes is uncertain. We do not have long term data examining the health effects of e-cigarettes.

Nicotine Exposure: From e-cigarette use, as with cigarette smoking, increases heart rate and introduces levels of blood cotinine, a nicotine metabolite. The consequences of chronic inhalation of e-cigarette vapor are largely unknown, and levels of toxic and carcinogenic compounds may vary by e-cigarette liquid components and device used. We do know the potential adverse effects are related to nicotine exposure as well as exposure to other components in the vapor produced by the devices. There have also been documented emergency department visits for burns from electronic nicotine delivery systems (ENDS) due to device malfunction either while stored (eg, in a pocket) or during use, resulting in burns to the thigh, groin, face, and/or hand.

Passive Exposure: There is limited evidence on the health effects of passive vapor exposure and no conclusions can be drawn. Passive exposure to e-cigarette vapor produces small increases in serum cotinine, comparable with that from passive exposure to cigarettes. However, passive exposure to e-cigarette vapor is expected to be less toxic to bystanders than combustible cigarette smoke.

E-cigarettes are not approved by the US Food and Drug Administration (FDA) for smoking cessation and the FDA has not endorsed their safety or efficacy for smoking cessation. Using e-cigarettes is probably less harmful than smoking conventional cigarettes, but we do not know how safe they are to users or those around them. They continue the user's exposure to nicotine. The health consequences of vapor exposure are unknown, and there may be risks from inhaling e-cigarette flavorings on respiratory function.

WARNING: The typical 5 mL vial of e-cigarette liquid refill may contain a nicotine concentration of 20 mg/mL (100 mg/vial). The known lethal dose of nicotine is about 10 mg in children.
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Wednesday, February 28, 2018

WELLNESS WEDNESDAY: COLON CANCER

Colorectal cancer (cancer of the colon or rectum) is the second leading cause of cancer deaths in the United States.  Greater than 50,000 people die from colorectal cancer every year.  This disease is highly preventable, by getting screened beginning at age 50.
Screening tests help prevent colorectal cancer by finding precancerous polyps (abnormal growths) so they can be removed. Screening also finds this cancer early, when treatment can be most effective.
·         Risk increases with age. More than 90% of colorectal cancers occur in people aged 50 and older.
·         Precancerous polyps and colorectal cancer don’t alwayscause symptoms, especially at first. You could have polyps or colorectal cancer and not know it. That is why having a screening test is so important. Symptoms may include—
o    Blood in or on the stool (bowel movement).
o    Stomach pain, aches, or cramps that do not go away.
o    Losing weight and you don’t know why.
·         Some people are at a higher risk than others for developing colorectal cancer. If you think you may be at increased risk, talk to your provider about when to begin screening, which test is right for you, and how often to get tested.
·         There are several screening test options. Talk with your provider about which is right for you.
o    Colonoscopy (every 10 years).
o    High-sensitivity guaiac fecal occult blood test (FOBT) or fecal immunochemical test (FIT) (every year).
o    Sigmoidoscopy (every 10 years, with FOBT or FIT every three years).
o    Sigmoidoscopy alone (every 5 years).
o    Stool DNA test (FIT-DNA) every one or three years.
o    CT colonography (or virtual colonoscopy) every five years.

Patient Centered Care, PLLC
910-799-6262

Tuesday, February 20, 2018

SHINGRIX, THE NEW SHINGLES VACCINE

Shingles is a painful rash that usually develops on one side of the body, often the face or torso. The rash consists of blisters that typically scab over in 7 to 10 days and clears up within 2 to 4 weeks. Some people describe the pain as an intense burning sensation. For some people, the pain can last for months or even years after the rash goes away. This long-lasting pain is called postherpetic neuralgia (PHN), and it is the most common complication of shingles. Your risk of getting shingles and PHN increases as you get older.  Many are wondering about the new Shingles Vaccine. 

Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia (PHN), the most common complication from shingles. CDC recommends that healthy adults 50 years and older get two doses of the shingles vaccine called Shingrix®, separated by 2 to 6 months, to prevent shingles and the complications from the disease.

Shingrix provides strong protection against shingles and PHN. Two doses of Shingrix is more than 90% effective at preventing shingles and PHN. Protection stays above 85% for at least the first four years after you get vaccinated. Shingrix is the preferred vaccine, over Zostavax®.

Healthy adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. You should get Shingrix even if in the past you:  had shingles, received Zostavax or if you are not sure if you had chickenpox.  There is no maximum age for getting Shingrix.

Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. About 1 out of 6 people who got Shingrix experienced side effects that prevented them from doing regular activities.  Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.

You might have a reaction to the first or second dose of Shingrix, or both doses.  If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.  Severe allergic reactions to any vaccine are very rare

There are several ways shingles vaccine may be paid for:
 Medicare
Medicare Part D plans cover the shingles vaccine, but there may be a cost to you depending on your plan. There may be a copay for the vaccine, or you may need to pay in full then get reimbursed for a certain amount.
Medicare Part B does not cover the shingles vaccine.
Medicaid
Medicaid may or may not cover the vaccine. Contact your insurer to find out.
Private health insurance
Many private health insurance plans will cover the vaccine. Contact your insurer to find out. 
Vaccine assistance programs
Some pharmaceutical companies provide vaccines to eligible adults who cannot afford them. You may want to check with the vaccine manufacturer, GlaxoSmithKline, about Shingrix.