Well, That’s a Mouthful

Ah, the dentist. Just the sound of the word “dentist” is enough to make you cringe because you remember that time your gums were being pricked at with a pointy apparatus, and your lips were stretched by a twofold. Perhaps such an experience made you swear you would never return to that maleficent office; however, you visited the dentist many times after that experience anyways. Even though some visits to the dental clinic may be frustrating and painful, they are still helping you achieve a greater health status than before. Like machines, humans can have glitches and dentists could be considered potential engineers who could masterfully fix those maxillofacial “glitches” you may have. Dentists are huge contributors to ones physiological and aesthetic image. Likewise, maintaining the oral cavity is essential since its presentation mirrors that of the entire body; poor oral hygiene could place the body at a higher risk of obtaining serious infectious diseases.

Throughout the years, researchers in clinical dental studies have discovered how oral health and other physiological systems interconnect with one another. As children, we were constantly pushed to brush our teeth and floss daily. Such a routine should have been instilled in our daily routines throughout the years; however, some people may not take proper care of their teeth. Improper care for ones teeth could result in periodontitis, gingivitis, or lead to harmful internal infections. Recently, researchers have found that inadequate oral hygiene could be associated with risk of gastric cancer. Thus, regular checkups at the dentist allow one to keep their health in check.

As for aesthetics, dentists allow one’s self esteem to increase if the patient is uncomfortable with his or her hygiene. Likewise, dentists would provide proper alignment to individuals’ teeth as well as whiten them, or control and treat oral infections. Dental aesthetics play a huge role in developing individuals, especially in multifarious cities like New York. Individuals are constantly encountering one another, going to meetings or social events. In other words, that “dreadful” visit to the dental office may give you a healthier and brighter smile, one that would stand out from the crowd of people who were too afraid to step foot into that office.

In summation, dentists are glorified mechanics who mend ones teeth in order to provide both proper oral health and esthetic presentation. Any signs of oral health could be a result of improper care for the oral cavity; however, it could also mean one may be suffering from another internal disease. Maintaining orderly and efficient care for the mouth is one of the many keys to living a healthy lifestyle. Now floss away!

Written By: Danielle Golder

Advertisements

A Scope for a Life

People usually frown upon the idea of receiving a colonoscopy. They are only concerned about the unpleasant preparation that needs to be consumed in order to ensure maximum accuracy during the procedure. What they are unaware of are the inconceivable health benefits that come by undergoing just one colonoscopy procedure. The masses are not aware that roughly 140,000 Americans will be diagnosed with colon cancer and about 50,000 of those diagnosed will die because they did not receive prior screening. Colon cancer is the second leading cause of cancer death in men and woman combined in the United States. Colon cancer begins with a small colonic polyp, which is a type of abnormal growth that is found on the inner walls of the colon. Polyps are harmless at first but eventually turn into carcinomas, cancers of epithelial tissue, if not removed.

Colon cancer is a very slow growing cancer, which is the reason why it can be easily prevented. The guidelines set by the “U.S. Preventive Services Task Force”(USPSTF) state that a person, with no family history of colon cancer, personal history of cancer of the colon, rectum, ovary, endometrium, or breast, or history of ulcerative colitis or Crohn’s disease, should be screened at the age of 50; however, there is a strong possibility that the age minimum will be dropped to 45 or even 40 because of a recent increase in cases of colon cancer found in people between the ages of 40 and 50. People tend to only visit a doctor after they have experienced certain symptoms for “x” amount of time. Unfortunately, early stages of colon cancer do not exhibit any symptoms, so it is important to get checked if any of the following symptoms persist: Blood in the stool, unexplained weight loss, abdominal pain, or unexplained fatigue.

It is unfortunate that so many people have to suffer and die as a result of this condition because a simple colonoscopy procedure can prevent one from developing this aggressive illness! The procedure alone takes approximately 10 minutes and is normally done under a carefully administered dosage of propofol, which is significantly safer than using general anesthesia. Typically performed by a gastroenterologist, a scope with a camera at the end is inserted through the rectum and into the colon. The gastroenterologist searches for polyps so that he may remove them using an instrument built into the scope that is operated by his assistant. Depending on how many polyps are found, the doctor would recommend the patient to return for a repeat colonoscopy anywhere between 1-5 years. If only people focused more on the pros as opposed to the cons that come with getting a colonoscopy, we could eventually bring down the colon cancer death rate… to zero.

Written By: Daniel Shoykhet

Breast Cancer Diagnosis and Classification

Breast cancer is the second most occurring cancer for women in the United States. It is estimated that there are 230,000 new cases arising in American women annually. It also occurs in men, but at a much lower rate of 2,300 annually.

Breast cancer is a form of carcinoma, cancer that originates from epithelial cells. The type of breast cancer is determined through a series of tests on breast tissue by a pathologist, a physician specialized in examining tissues in order to diagnose disease and recommend treatment. The pathologist examines the tissue through a microscope and identifies if cancer is indeed present and whether it is “in situ”, meaning non-invasive, or if it is invasive. Non-invasive cancers stay within their origin tissue, and have not yet spread to other normal tissue but invasive cancers have spread out to once noncancerous cells. For invasive cancers, the cancer is graded 1 to 3, through a comparison of the patient’s breast tissue with normal healthy tissue. The lower the grade, the less likely the patient has a cancer that will spread further. The higher the grade, the faster growing the cancer is, and therefore the larger the probability of spreading.  

Additionally, breast cancer cells can have estrogen receptors (ER+), progesterone receptors (PR+), both receptors or neither receptors. Two-thirds of breast cancer types have at least one of these hormone receptor types. The receptors allow cancer cells to obtain and utilize their respective hormones to fuel their development. Furthermore, one in five of breast cancers have too much HER2/neu, a protein that fosters cell growth. HER2/neu positive cancers are more invasive than other types. The amount of HE2/neu is usually identified through immunohistochemistry, an antibody test that changes cell color in response to an overabundance of HE2/neu, or a fluorescent in situ hybridization test (FISH) that uses fluorescent pieces of DNA to bind to the HER2/neu gene in cancer cells.  A triple negative cancer doesn’t have estrogen or progesterone hormone receptors and doesn’t have too much HER2/neu. Conversely, a triple-positive cancer is ER+, PR+ and HER2+.

A PAM50 test, working through identification of patterns of molecular features, is another classification method and divides breast cancer into 4 types. These are Luminal A, Luminal B, HER2 type and basal type. Luminal A/B cancers are ER+ cancers, but A type cancers are low grade, slow growth. B type cancers are high grade, fast growth.  HER2 type cancers are high grade and result from excessive copies of the HER2 gene in cells. Basal type cancers are triple negative type cancers, high grade, and require different treatment than the other types.

The extent the cancer has spread through the body can further be identified through more tests such as a chest x-ray, CT scan, bone scan, MRI, ultrasound and or PET scan. These tests allow the determination of the “stage” of the cancer in the body and are not usually used for early stage cancers. The most common system for “staging” used is the American Joint Committee on Cancer (AJCC) TNM system. T stands for primary tumor and is ranked zero to four, indicating the tumor size and spread to chest or skin. N stands for nearby lymph nodes and is ranked zero to 3, indicating if nearby lymph nodes have cancer and how many are cancerous. M stands for metastasis and is ranked 0 or 1, with 1 indicating the cancer has reached distant organs from the source. Combinations of the TNM ratings determine the stage of the cancer, from Stage I to Stage IV, with non-invasive cancers at Stage 0. Larger numbers for the TNM system indicate greater size, spread and severity.

Continuing research into cancer will augment our understanding of the mechanics of breast cancer and how to treat it. The fast pace of advancement in the medical field means that some of the current methods for diagnosing breast cancer may even become obsolete or new technologies may be invented. As such, the way breast cancer is diagnosed and classified is “subject to change”.

Written By: Kevin Yiu

Sources:
  1. http://www.mayoclinic.org/diseases-conditions/breast-cancer/basics/definition/con-20029275
  2. http://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm

 

Step 1: Teach

I was swept away in the conversation about life choices, movies, and culture. As I walked out of the room, I was shocked to find out that almost an hour had passed by already. I was at New York Methodist Hospital volunteering as a part of the Congestive Heart Failure Volunteer Intervention Program (CHF-VIP).

This program trains volunteers to teach heart failure (CHF) patients about healthier life choices and prevent re-hospitalization. We visited the patients in the hospital to give them “teachbacks.” During the teachbacks, we covered diet changes, reminders to take prescribed medicine, and ways to survey if symptoms were worsening. Then, if given permission, we gave callbacks every two weeks for six weeks after the patient’s discharge. In the callbacks, we answered patient’s questions, and reminded them about what we talked about in the teachback. We also encouraged them to make an appointment with a cardiologist within two weeks after discharge.

Often times, I would finish these teachbacks in 10 to 15 minutes. I would go in and follow the lesson I had practiced many times teaching, wait for any questions and then leave the room. However, during one of my shifts I ended up speaking to the patient for almost an hour regarding his past failures to change his lifestyle for his health. As I continued talking to him, he seemed encouraged, even motivated to learn more and change. He even quoted from a movie, “We all die, but it’s about how we die.” I was inspired by his response to take these teachbacks as opportunities to look into the window of the patient’s life. I took more time to ask the patient questions and empathize his or her situation. I found the time spent much more rewarding, and experiences confirmed my hopes of becoming a doctor someday.

During a lecture I attended as a part of NYM’s Summer College Intensive Program, an E.D. doctor wisely told us, “All doctors are teachers. In order to be a good doctor, you must be able to teach your patients about the disease, symptoms, and possible solutions.” I did not really see the truth behind her words until I saw how my teachbacks and callbacks affected patients. NYM’s CHF-VIP has taught me and helped me develop one of the most important steps in becoming a good physician: to teach.animated-light-bulb-gif-30

 

Written By: Sharon Pang

A Refresher on Healthcare in the 2016 Presidential Election

Amidst the ubiquitous poll numbers and televised debates that draw widespread attention to the 2016 presidential candidates, lies the issue of healthcare. With a variety of stances present in the field, it’s important to consider the potential plans that will shape the healthcare system in the years to come. Whether attune to or averse to the political landscape of the country, the policies shaped by the next commander-in-chief will impact us all. Here is a summary of the vision current front-runner candidates have for healthcare in America.

Within the Democratic party, Hillary Clinton and Bernie Sanders have quite the difference in their philosophy on the fate of the current Affordable Care Act. Secretary Clinton believes in keeping the majority of the Act [1]. Among her proposed policies include initiatives to put a limit to out-of-pocket drug costs [ibid]. Senator Sanders, on the other hand, has proposed a single-payer healthcare system that would essentially be a Medicaid-for-all system [2], though he too is seeking to address high prescription drug costs. The Republican group of candidates, on the other hand, has expressed a pronounced desire to get rid of the Affordable Care Act. Donald Trump believes in open competition and letting individuals shop for insurance, though in 2000 he supported universal healthcare [3]. Senator Cruz in 2013 led a government shutdown in an effort to defund the Affordable Care [ibid], and seeks to repeal the entire Act. Senator Rubio has opposed the Act, saying it stifles entrepreneurship [ibid].

On the subject of vaccines, there is more concurrence. Secretary Clinton and Senator Sanders favor vaccinations [3], saying they are supported by science and electing not to vaccinate is dangerous, respectively [3]. Donald Trump says he’s for vaccines, but believes in “smaller quantities to avoid autism” [ibid]. Senators Cruz and Rubio believe in vaccinations [ibid].

In light of global health issues, the candidates have differing levels of commitment. In 2014, to combat Ebola Secretary Clinton proposed putting resources into Africa, and in 2007 pledged to support $50 billion towards AIDs relief in the US and around the world [3]. Senator Rubio said that only the US could combat Ebola, and that the World Health Organization could not [ibid].

In deciding which candidate is most fit to be the next leader of our country, we must ask what we believe to be the ideal and pragmatic health system ourselves. Do you believe in a centralized or decentralized system? A president that will place global health issues high on the priority list? These are all questions to consider the next time you hear from the 2017 presidential hopefuls.

American Election
American election campaign fight as Republican Versus Democrat represented by two boxing gloves with the elephant and donkey symbol stitched fighting for the vote of the United states citizens for an election win.

Written By: Prima Manandhar-Sasaki

Sources:
  1. “Presidential candidates on healthcare.” New York Times. n.d. Web. 16 Feb. 2016
  2. “2016 presidential candidates on healthcare.” Ballotpedia. n.d. Web. 16 Feb. 2016.
  3. “Health Care.” On the Issues. n.d. Web 16 Feb. 2016