On Organ Donation

November 29, 2011

As of October 2011, a reported 112,178 patients in the U.S. were awaiting organ donations and every 11 minutes another individual is added to the waiting list. Though an average of 75 people per day receive organ transplants daily and more than 86 million people in the U.S. are registered as donors, a critical shortage of organs remains. Increasing information about the importance of donation could help to encourage new donors and save lives.

Organs and tissues including heart, kidneys, liver, lungs, skin, and corneas can all be donated and transplanted. According to experts, the organs and tissue from a single donor could help as many as 50 recipients. There are no age restrictions for donors, and depending on the type of donation, organs may come from a deceased or living donor. Current data indicates that as of October 7, 2011 there had been 113,693 living donors and 143,662 deceased donors since the tracking of organ donation was initiated.

Any individual is eligible to register as an organ donor, though the process for registering varies by state. If an individual who was not a registered donor dies due to massive trauma to the brain or is declared brain dead and cannot be revived, the individual’s family members must authorize the donation of the individual’s organs. Only organs with blood and oxygen flowing through them at the time of donation are viable for transplant, and each must be transplanted within hours to help prevent rejection by the recipient. When organs become available, they must tissue and blood typed to identify the appropriate individual on the transplant waiting list who is a match, as well as ensuring that they are the appropriate size for the recipient.

The recovery of organs for transplant is performed by a team of surgeons, nurses, and the transplant coordinator in the operating room where the donor received care. Just prior to removal, each organ is flushed free of blood and then placed in a sterile container for transportation to the recipient’s transplant center. Organs must be transplanted quickly – hearts and lungs within four hours, livers within 12-18, and kidneys within 24-48 hours of removal from the donor.

The risks associated with receiving an organ transplant are outweighed by the benefits as individuals receiving transplants are those who would not be able to survive without them. Though all organ recipients must take anti-rejection drugs following transplant, reports indicate that 15 percent still suffer some rejection in the first year. In addition, though the Centers for Disease Control and Prevention (CDC) reports that though the risk of disease transmission from donated organs is rather small, between 2007 and 2010 more than 200 cases of suspected transmission were investigated. To increase the safety of organ transplants, the CDC has drafted new guidelines for advanced organ testing which would screen for hepatitis B and C as well as HIV.

In 2010, 28,665 organ transplants were performed, but reports indicate that as many as 6,000 Americans die each year while waiting for a transplant. By encouraging individuals to consider registering as donors, it may be possible to save thousands of lives each year.

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On the Malaria Vaccine

November 7, 2011

A recent WHO report indicates that nearly a third of all countries affected by malaria are on course to eliminate the disease over the next 10 years. Though malaria can lead to complications or even death, it is a preventable and curable illness caused by a parasite that is passed from one human to another through the bite of infected Anopheles mosquitoes. Infected individuals frequently experience high fevers, flu-like symptoms, and anemia; and in 2008 malaria caused between 190 and 311 million clinical episodes and between 708,000 and 1,003,000 deaths. Anti-malarial medications, insecticidal nets, and other control and prevention measures have saved an estimated 1.1 million lives in Africa over the past 10 years, but the availability of an effective vaccine  is vital to halt its spread.

In the 109 countries and territories where the risk of malaria transmission is the greatest, newly developed malaria vaccines could save lives. Reports indicate that there were 225 million cases of malaria and an estimated 781,000 deaths in 2009, but these figures have steadily declined in recent years. Though preventative measures have helped to reduce infection rates, experts note that the development and use of a malaria vaccine could reduce them further. During a major clinical trial,  a recently produced experimental vaccine known as RTS,S halved the risk of children in Africa contracting malaria. Currently children under five years of age account for the majority of the 800,000 people who die each year as a result of malaria. According to the developers of the vaccine, the adverse effects observed during the vaccine trial are comparable to those seen in children receiving other vaccines.

The RTS,S vaccine triggers an immune response which targets the Plasmodium falciparum parasite that causes malaria. This immune response prevents the parasite from maturing and multiplying in the liver of the vaccinated individual. Unlike other previously developed malaria vaccines, this new vaccine has been created to target different forms of the disease and to trigger a range of antibody responses. Though researchers have been working for 40 years to develop an effective malaria vaccine, to date the outcomes have not been entirely successful. Additional research and testing of the RTS,S vaccine is needed, but according to Dr. Mary Hamel of the Centers for Disease Control and Prevention, “these findings show we are on track in the development of a vaccine.”

With further testing and refinement, this vaccine has the potential to save millions of lives each year and eradicate a disease that affects 3.3 million people – half the world’s population. An effective malaria vaccine could reduce malaria-related deaths, 89 percent of which occur in Africa, and could improve the lives of individuals in regions impacted by the diseases.


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On Arthritis Worldwide

October 24, 2011

Causing swelling and pain in the joints, arthritis leads to substantial activity limitation, work disability, reduced quality of life, and increased healthcare costs, arthritis is the most common cause of disability in the United States with nearly 19 million Americans reporting activity limitations. Experts indicate this figure will balloon to 67 million by 2030. An estimated half a billion people – 10 percent of the world population – experiences some form of impairment or disability, and as the population of the U.S. and other nations increases, it is expected that the incidence of age-related disabilities including arthritis will also increase. Careful monitoring of the condition can help to improve treatment outcomes, and gaining an understanding of the condition and taking precautions to care for one’s joints before arthritis develops may make it possible to mitigate its effects or delay its onset.

Image by Deborah Ervin

Arthritis is caused by the breakdown of the cartilage that normally protects the joints of the body, and is typically seen in individuals 65 and older. The inflammation of one or more joints most commonly associated with arthritis frequently worsens with age. There are over 100 types of arthritis, but osteoarthritis and rheumatoid arthritis are among the most common. Osteoarthritis is caused by wear and tear on the joints and is seen almost exclusively in older individuals, while rheumatoid arthritis is an autoimmune disorder and may be seen in younger individuals as well. Regardless of type, arthritis causes pain, inflammation, and swelling, and restricts movement. Standard treatments focus on relieving symptoms and improving joint function, and may include medications, physical therapy and exercise regimes, lifestyle changes, and surgery if the condition does not improve through the use of more conservative measures.

Steroidal and non-steroidal anti-inflammatory drugs (NSAIDs) can be used to relieve some of the pain and irritation associated with arthritis, and experts are working to identify new medications that may prove beneficial. While medications do provide relief for some individuals, moderate exercise has been found to be highly beneficial to individuals with arthritis. Certain exercises and stretching techniques have been observed to markedly improve the range of motion and strength of muscles surrounding joints in individuals with arthritis. Despite the benefits of moderate exercise to reduce pain and ease stiff joints, a recent study  found that many individuals with arthritis do not get the recommended 2.5 hours of moderate-intensity, low-impact activity per week which could improve their condition.

By ensuring that individuals with arthritis and pre-arthritic individuals understand the importance of stretching and exercise, it may be possible to lessen the severity of the condition. In addition to strengthening the joints, these activities can lead to weight loss and improve overall health.


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On Ovarian Cancer

October 10, 2011

Reports indicate that approximately two million women develop breast or cervical cancer each year, and these rates continue to increase. Though not as common, ovarian cancer – the fifth most common cancer in women – causes more deaths than any other type of female reproductive cancer. According to the National Cancer Institute, to date in 2011 there have been an estimated 21,990 new cases of ovarian cancer, and 15,460 deaths due to the disease. Making women aware of the possible symptoms of ovarian cancer and encouraging them to have routine gynecological appointments may help to improve rates of diagnosis of the condition.

While nearly one in three women will develop breast cancer in their lifetime, one in seven will develop ovarian cancer, but detection and diagnosis is significantly more difficult in ovarian cancer. The symptoms associated with ovarian cancer are often vague, and are commonly associated with other common conditions. According to experts, women should see their doctor if they experience bloating, difficulty eating or feeling full quickly, and pelvic or abdominal pain on a daily basis for more than a few weeks. Because of the difficulty detecting ovarian cancer, it is frequently not detected until it has spread within the pelvis and abdomen. In its late stages it is often fatal, but if diagnosis is made early and treatment is received before the cancer spreads outside of the ovary, the 5-year survival rate is very high. In order to combat difficulties diagnosing ovarian cancer, researchers are working to develop new flureoscence-guided techniques that may make it possible to identify very small tumors that may have been missed using traditional detection methods.

All women are at risk of developing ovarian cancer, but approximately 90 percent of women who get the disease are 40 years of age or older, with the greatest number of cases occurring in women aged 60 and older. Women who have children earlier in life have a decreased risk of developing ovarian cancer, while those who have a personal history of breast cancer or a family history of breast or ovarian cancer have an increased risk. Once ovarian cancer has been positively diagnosed, as with other cancers, it is most often treated surgically. This frequently involves the removal of the uterus, both ovaries and fallopian tubes, and/or removal of the lymph nodes. In addition to the surgical removal of tumors, individuals with ovarian cancer may undergo chemotherapy, however radiation therapy is seldom used in the United States to treat ovarian cancer.

Though difficult to diagnose, if treated quickly ovarian cancer can be beaten. By encouraging women to monitor their health and communicate any concerns to their physician, it may be possible to identify cases more quickly and improve treatment outcomes.


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Salmonella Infection

September 26, 2011

Bacteria of the Salmonella genus are a major cause of food-borne illness worldwide. Symptoms in most individuals infected with Salmonella are not life-threatening, however in young children, the elderly, and individuals with compromised immune systems, Salmonella infection can be significantly more harmful. By ensuring that food is prepared carefully and properly, it may be possible to reduce the infection rates of Salmonella.

Each year there are approximately 40,000 reported cases of Salmonella infection in the United States, and infection rates are higher in nations with poor sanitation. The majority of infected individuals experience diarrhea, fever, and abdominal cramps within 12 to 72 hours after infection. Though Salmonella infection usually resolves without medical intervention within 7 days, for some individuals dehydration related to diarrhea may become severe and require hospitalization. In addition, a small number of infected individuals develop pain in their joints, irritation of the eyes, and painful urination.

Two serotypes of the approximately 2,500 that have been identified, Salmonella Enteritidis and Salmonella Typhimurium are the most common in the United States and account for half of all human infections. In addition to these common strains, antibiotic strain of Salmonella has recently been identified in 26 states, and to date it has sickened 77 people and killed one. Salmonella infection occurs when the bacterium are ingested, and it is commonly accepted that between 1 million and 1 billion bacteria are needed to cause infection.

The majority of infections are due to the consumption of foods that have been contaminated with animal feces. In recent years, outbreaks have been associated with chicken, turkey, and other meats; as well as eggs, and spinach and a number of other vegetables. To help limit the possibility of infection, experts suggest that consumers follow food preparation guidelines aimed at ensuring that food is properly cleaned and cooked thoroughly. These include washing surfaces and hands frequently, keeping raw meat separate from other ingredients, and ensuring that foods are fully cooked and properly stored. By ensuring that food is handled appropriately, it may be possible to reduce rates of Salmonella infection.


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Ensuring Accessibility During Natural Disasters

September 12, 2011

Reports indicate that individuals with disabilities are disproportionately affected by natural disasters and emergency situations, due in large part to a lack of adequate planning. Available facilities are frequently inaccessible or are ill equipped to accommodate the needs associated with certain disabilities, therefore, by including individuals with disabilities in all stages of the disaster management process, particularly during the planning and preparation phases, the effectiveness of disaster responses can be greatly improved.

An estimated half a billion people – 10 percent of the world population – experiences some form of impairment or disability. Following recent natural disasters including Hurricane Katrina, studies have found that the regions affected by these disasters are frequently not prepared to evacuate, shelter, transport, or meet the medical needs of individuals with disabilities. In addition, the shelters, transportation services, and emergency communications and information broadcasts available in many regions are often not accessible.

By learning from problems identified following natural disasters, regarding the needs of individuals with disabilities, emergency response initiatives can be modified to ensure that the needs of people with and without disabilities are met. According to experts, all individuals, regardless of their disability status, should prepare for potential disaster situations by having a store of food and water on hand to last a minimum of three days. In addition, it is recommended that individuals with disabilities have a supply of items related to their specific needs – which may include eyeglasses, hearing aides, a laminated communication board, or medications – for at least seven days. FEMA, which recently launched a disaster preparedness app, notes that individuals with certain types of disabilities may need to take additional steps to prepare for and receive assistance following natural disasters. It is suggested that individuals with disabilities establish a network of friends, family, and neighbors who may be able to assist them in the event of an emergency.

While natural disasters affect everyone within a given region, individuals with disabilities may face barriers that can cause additional issues. A number of government agencies, including the Department of Health and Human Services (HHS) have put measures in place to help mitigate the barriers faced by individuals with disabilities in emergency situations. Ensuring the inclusion of individuals with disabilities and their representatives in strategic planning efforts and the provision of information in accessible formats before, during, and following natural disasters are among HHS’s chief concerns. In addition, the UN Convention on the Rights of Persons with Disabilities and other international policy initiatives aim to ensure that humanitarian responses to natural disasters are inclusive of the needs of individuals with disabilities.

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Click here to read the International Disability Rights Monitor (IDRM) report on Disability and Early Tsunami Relief Efforts in India, Indonesia and Thailand

On Chickenpox Worldwide

August 29, 2011

Chickenpox was once considered a rite of passage for most children, but since the establishment of routine vaccination programs, complications from the virus have seriously decreased. While the condition very seldom leads to secondary infections or other issues, it is highly contagious and can be problematic in some individuals. It is important that parents ensure their children receive vaccinations for chickenpox and other common childhood illnesses, and remain mindful when interacting with infected individuals.

In the 16th century, the varicella zoster virus (VZV), the virus that causes chickenpox was identified, but it was not until the end of the 19th century that physicians were able to reliably distinguish chickenpox from smallpox. VZV is a member of the herpes virus group, and like other herpes viruses, it has the capacity to persist in the body after the first infection as a latent infection and can reappear as shingles. Shingles, which manifests as a painful rash on one side of the body, occurs in approximately one in 10 adults. It is the result of re-activation of the VZV virus which persists as a latent infection in sensory nerve ganglia and can occur in any individual who has recovered from chickenpox, but it is most common in individuals over 60.

Spread through direct contact with the rash or droplets dispersed into the air by coughing or sneezing, chickenpox manifests as a red, itchy rash which first appears on the face, trunk, or scalp. The rash usually appears 10 to 21 days after infection, and may be accompanied by a fever, abdominal pain, headache, and a general feeling of unease and discomfort. If scratching the rash is not discouraged through the use of oatmeal or baking soda baths, the application of calamine lotion, or antihistamines, individuals may contract a bacterial infection of the skin. Other complications that can result from chickenpox include viral pneumonia, bleeding problems, and infection of the brain (encephalitis).

Before the introduction of a vaccine, approximately 10,600 people were hospitalized and 100 to 150 died as a result of chickenpox in the U.S. every year. Vaccination became routine practice in the U.S. in 1995, and there are now two live, attenuated VZV-containing vaccines available for use. Recent studies have shown that in children, two doses of the chickenpox vaccine is 98 percent effective in preventing infection, compared with 86 percent effectiveness for a single dose. Recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics indicate that children should receive their first shot at 12 to 15 months, and the second at four to six years to ensure the maximum benefit. While a reported 15 to 20 percent of vaccinated individuals do still become infected with chickenpox if they are exposed to it, their condition is significantly milder and lasts for a shorter period of time.

By increasing awareness about the importance of vaccination, it may be possible to further decrease rates of infection and complications associated with chickenpox. Vaccination against chickenpox and other childhood illnesses can not only protect the individual receiving the vaccination, but can help to protect individuals who may not be able to receive vaccinations due to health conditions by contributing to the herd immunity of their community


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