Archive for the ‘Infections’ Category:
US doctors pushing to increase circumcisions
Once again, the US is pushing for circumcisions. There had been ongoing debate for years and even urologists had not reached a consensus regarding circumcisions in terms of reducing rates of urinary tract infections (UTIs). Circumcision rates were high at one point, but have recently dropped off. Now, the doctors in the US are urging people to consent to circumcisions for their sons in order to reduce infection rates of sexually transmitted diseases such as herpes, HPV and even HIV.
Reports state that circumcision rates are lowest amongst blacks and Hispanics – the groups with the highest rates of HIV, herpes and cervical cancer. Of course, since cervical cancer only occurs in women, this statement assumes that black women are either getting it or giving it to black men and Hispanics. Though no one understands why the extra flap at the end of the penis would make such a difference in terms of infection, the hypothesis is that the wet skin allows more viruses to stick or that the wetness can lead to ulcerations, which can then allow viruses to enter.
US scientists are pointing to a research done by their colleagues from Johns Hopkins, a well-renowned teaching and research institution. However, the research was carried out in Uganda and only investigated the role of circumcision in HPV and herpes transmission. Apparently, previous research had shown that circumcision led to a “sharp” risk reduction of HIV transmission – the “sharpness” was not revealed in terms of numbers. But, according to this latest research, HPV transmission was reduced by a third while herpes was reduced by 25%.
As with the argument in UTIs, would the reduced risk be nullified if proper hygiene was practiced by uncircumcised males? But, of course, one of the biggest arguments against this research is that a study amongst a group of African males in a country rampant with sexually transmitted diseases cannot be applied across all races in all countries.
‘New’ compound to prevent HIV transmission?
Scientists have recently rediscovered a compound that may block the transmission of HIV during sexual contact. The compound, glycerol monolaurate (GML), has been used in foods and cosmetics as an antimicrobial and anti-inflammatory agent. One of the mechanisms by which HIV causes infection is by using the body’s natural immune defenses against itself. Therefore, to counteract this mechanism, it is believed that an agent needs to prevent or alter the immune response to HIV. GML has already been used to block infections and affect certain molecules in the immune response. The agent has been tested on monkeys via a vaginal preparation and has been shown to be effective in preventing the transmission of SIV (the primate version of HIV). Scientists hope to do further research before developing a similar agent for human trials. GML is very cheap and common and easily prepared as a vaginal agent. Scientists are hailing this as a significant step for fighting HIV infection, but warn that other measures (such as condom use) will still need to be in force until GML is developed. They also believe that GML will help block transmission of other sexually-transmitted diseases. It would be prudent, in my opinion, to continue use of other protection as having more than one agent to prevent infection is better than one. If one fails, there is still back-up. I also wonder how they could possibly run a human trial for this agent. It is one thing to do a trial with HIV patients to test the effectiveness of a new drug. It is another to do a trial to test whether HIV can be transmitted. It would be unethical to potentially infect someone with HIV or any other sexually-transmitted disease. They may test GML in vitro, but they cannot conclude its effectiveness in vivo, unless they have human subjects. So, how will they design this test?
The threat of HIV and STDs is still very real
HIV and AIDS seem to have become backburner issues in recent years. Though there are continuing efforts in research to create new and better antiviral agents to replace those that are now ineffective due to resistance, much attention has been focused elsewhere. This is partly due to the fact that, for the most part, known HIV and AIDS cases are under good control. Because of this, the public has become rather complacent about the disease. There are fewer ads addressing the issue of unprotected sex, which can lead to various sexually transmitted diseases, HIV included. Sex education in schools is supposed to include material on contraception. Yet, the rate of teenage pregnancies has really not declined, so it’s easy to conclude that kids are not getting the message. What’s even clearer is that adults are not getting the message. These adults are supposed to understand the risks they take with unprotected sex – that is, unwanted pregnancies and sexually transmitted diseases. Over the last few years, STDs such as Chlamydia, gonorrhea and syphilis have been on the rise. Yet, little is said of HIV. In the US, STDs are reportable to the state and they keep a list of those who have been infected. But because HIV is such a highly sensitive topic, it is not reportable. However, those with HIV who knowingly infect others are liable for a criminal offense. I do not know the status of reporting for STDs in the UK, but I do know that HIV-infected persons can be charged as a criminal if they knowingly and deliberately attempt to infect others without that person’s knowledge. A recent police report in the Devon and Cornwall area highlights this ruling. Though I believe that the supposed HIV-infected person is criminally liable, if indeed he did such a thing, I think those women should have shown some sexual maturity. He did not prey on youngsters. These were young women. Why did they have unprotected sex? Why did they have sex with someone they did not know well? Though I would not put the onus on the women in a court of law, I still feel they should learn some responsibility. It’s too easy to blame someone else for your own mistake. Next time, don’t have sex with someone you can’t trust. And don’t have unprotected sex. HIV is not dead and gone. It is still out there and scientists are still working on it. Don’t be fooled into thinking that no one gets it anymore. And, even if you are not concerned about AIDS, think about the other STDs. These are just as harmful as they have always been.
Excessive use of antibiotics to treat ear infections
It seems that despite all the warnings about overuse of antibiotics, doctors are still prescribing them excessively. This is probably due to the determination by some patients and parents to acquire them. Or, it could be because they are at their wits’ end to figure out what to do for a condition.
Now, there is a new report on the overuse of antibiotics in treating chronic middle ear infections in children. Although antibiotics are appropriate in some cases, it is insufficient or unnecessary in others. This is especially the case with recurrent ear infections where fluid builds up in the middle ear, or when the membrane perforates and there is excessive drainage. Used incorrectly, it will not treat the problem, which can then lead to ear problems, especially deafness in children. In very young toddlers, recurrent infections will also affect their sense of balance, which will interfere with their walking, or learning to walk.
In some cases, the treatment could require the placement of ear tubes to drain fluid behind the ear drum. If this is deemed necessary, the child should be referred to an ear specialist, who is a surgeon qualified to perform the insertion of the tube. Seems like a simple thing, but for some reason, some doctors are reluctant to make referrals onward. Perhaps, instead of asking for antibiotics, parents should ask for a referral.
