The majority of Americans black or white under 67.5 have to work to have medical coverage (unless under disability), if not the majority of Americans would be rich.

Health care disparities heighten disease differences between African-Americans and white Americans.

• African-Americans are three times more likely to die of asthma than white Americans.
• Diabetes is 60% more common in black Americans than in white Americans. Blacks are up to 2.5 times more likely to suffer a limb amputation and up to 5.6 times more likely to suffer kidney disease than other people with diabetes.
• Deaths from lung scarring — sarcoidosis — are 16 times more common among blacks than among whites. The disease recently killed former NFL star Reggie White at age 43.
• Despite lower tobacco exposure, black men are 50% more likely than white men to get lung cancer.
• Strokes kill 4 times more 35- to 54-year-old black Americans than white Americans. Blacks have nearly twice the first-time stroke risk of whites.
• Blacks develop high blood pressure earlier in life — and with much higher blood pressure levels — than whites. Nearly 42% of black men and more than 45% of black women aged 20 and older have high blood pressure.
• Cancer treatment is equally successful for all races. Yet black men have a 40% higher cancer death rate than white men. African-American women have a 20% higher cancer death rate than white women.

Why?

Factor 1 – Genes definitely play a role. So does the environment in which people live, socioeconomic status,  says Clyde W. Yancy, MD, associate dean of clinical affairs and medical director for heart failure/transplantation at the University of Texas Southwestern Medical Center.

Living in a low socioeconomic environment puts you at risk to eating fast foods or deli food (especially in the cities) and increasing, over long term eating fast foods, causing disease (DM, Obesity, Heart Disease and could go on).

Factor 2 – Another reason is that a higher percentage of black Americans than white Americans live close to toxic waste dumps — and to the factories that produce this waste.

Addressing socioeconomic groups first, Dr. Yancy says that all humans have the same physiology, are vulnerable to the same illnesses, and respond to the same medicines. Naturally, diseases and responses to treatment do vary from person to person. But, he says, there are unique issues that affect black Americans.

Like Yancy, LeRoy M. Graham Jr., MD, says the time is ripe for Americans to come to grips with these issues. Graham, a pediatric lung expert, serves on the American Lung Association’s board of directors, is associate clinical professor of pediatrics at Morehouse School of Medicine in Atlanta, and serves as staff physician for Children’s Healthcare of Atlanta.

“I just think we as physicians need to get more impassioned,” Graham tells WebMD. “There are health disparities. There are things that may have more sinister origins in institutionalized racism. But we as doctors need to spend more time recognizing these disparities and addressing them — together with our patients — on a very individual level.”

A 2005 report from the American Lung Association shows that black Americans suffer far more lung disease than white Americans do.

Some of the findings:

• Black Americans have more asthma than any racial or ethnic group in America. And blacks are 3 times more likely to die of asthma than whites.
• Black Americans are 3 times more likely to suffer sarcoidosis than white Americans. The lung-scarring disease is 16 times more deadly for blacks than for whites.
• Black American children are 3 times as likely as white American children to have sleep apnea.
• Black American babies die of sudden infant death syndrome (SIDS) 2.5 times as often as white American babies.
• Black American men are 50% more likely to get lung cancer than white American men.  For starters this race is highier overall than caucasians in smoking in the U.S.A.
• Black Americans are half as likely to get flu and pneumonia vaccinations as white Americans.

“The environment is involved, and there is potential genetic susceptibility — but we also have to talk about the fact that African-Americans’ social and economic status lags behind that of Caucasians,” Graham says. “And low socioeconomic status is linked to more disease.”

Of course these 2 factors put you at risk for disease, but you want to live in a better environment do your research.   Some may say it due to blacks being treated poorly or the word “racism”.  Is this the case, No not at all.  You need the facts why you blacks are highier in living in a toxic or low socioeconomic group.  One, that is where they can afford and decide to live their. Two is because they feel they can not or they decide not to move due to personal reasons like lack to apply self to get in a better environment (whether it be due to fear, lack of knowing their success in the move/challenge so they don’t want to take the chance or not wanting change and decide to stay in that toxic or low socio-economic area.  No one puts a magnum 45 to anyone’s head telling them they have to stay in these areas.  In America you can live where you want.  So its up to the individual with the family having the will to make the move in their life to be less exposed to areas poor for you health.  Its up to them to research areas less expensive or better enviroment exposure areas in America; no one else is going to do that for them or any one else.  Than there are those that simply don’t mind living in areas like toxic or low socioeconomic exposed but many don’t understand that thinking.  The risk is that individual and their family put themselves at risk for a higher chance of getting these diseases like lung cancer, heart disease, etc…   Make the move and get out of those places and live a better quality of life for you and all in your family.  Its all up to you to make the move.  Keep in mind disease is not just environmental related.  You need to look at all factors like genetic, the diet you are on, how active you are; its not just one factor in most cases.  You have to take a holistic approach on seeing what diseases you could be exposed to and why.  Don’t wait till symptoms start finding out its possibly too late.  Think PREVENTION over treatment.  Its your life and up to you!

Part II tomorrow

“February is dedicated to the work of perianesthesia nurses. Perianesthesia nurses specialize in helping or caring for patients who are entering or recovering from anesthesia. These nurses help many patients and families all the time and deal with normal and adverse reactions to sedation multiple times a day. They are extremely passionate about the work they do, which is why, this week, the American Association of Perianesthesia Nurses, is stressing the importance of celebrating the exceptional work practiced by these nurses.”

Legacy Health Services (https://lhshealth.com/2019/02/perianesthesia-nurse-awareness-week/)

The nation’s 60,000 perianesthesia nurses will highlight and celebrate their work during PeriAnesthesia Nurse Awareness Week (PANAW), which is observed throughout the United States the first full week of February.

Perianesthesia Nurses care for patients before and after procedures requiring anesthesia, sedation, and analgesia. Approximately 40 million surgical procedures take place in the U.S. each year.

The work environments these nurses work in consists of  a few areas that are critical:

“Millions of people in the United States are living with a visual impairment. A visual impairment can make it hard to do everyday activities, like getting around, reading, or cooking. And it can’t be fixed with glasses, contacts, or other standard treatments, like medicine or surgery.

The good news is that vision rehabilitation services can help people with a visual impairment make the most of the vision they have — and keep doing the things they love. Take some time this Low Vision Awareness Month to learn about vision rehabilitation.”

NIH – National Eye Institute (https://www.nei.nih.gov/learn-about-eye-health/outreach-resources/vision-rehabilitation-resources/low-vision-awareness-month)

Prevent Blindness has declared February as Age-related Macular Degeneration (AMD) and Low Vision Awareness Month. According to the American Academy of Ophthalmology, AMD is a leading cause of vision loss in people 50 years or older, and more than 2.9 million Americans age 40 and older have low vision. Low vision is defined as a visual impairment that is not correctable through surgery, medicine, eye glasses or contact lenses.

According to the National Eye Institute, currently 4.2 million Americans ages 40 and older are visually impaired. Of these, 3 million have low vision. By 2030, when the last baby boomers turn 65, the number of Americans who have visual impairments is projected to reach 7.2 million, with 5 million having low vision.

Magnification devices, electronic devices, computer-access software, and other access and mainstream technologies are used to help people with low vision maximize their remaining vision or learn alternative ways to do things, such as using their sense of touch or their sense of hearing.

“Darier’s disease is a dominantly inherited condition affecting skin, nails and mucosae.   Prevalence is estimated at 1 in 36 000 (in North-East England). Skin signs generally develop between 6 and 20 years of age, although lesions may be overlooked until aggravated by heat, sweating or sunlight.

Clinically, the distinctive lesion is a warty plaque formed by coalescing firm, greasy, skin-coloured papules. The seborrhoeic areas of the trunk and face are predominantly affected. Pruritus is common, occurring in 80% of patients, and may be intractable; pain is unusual. When flexures are involved, the lesions may be hypertrophic, fissured and malodorous.”

National Library of Medicine (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC539598/)

Darier disease, previously known as keratosis follicularis, is a rare autosomal dominant genodermatosis characterized by keratotic papules and longitudinal eyrthronychia; it is caused by mutations in the ATP2A2 gene, encoding a calcium pump within the endoplasmic reticulum.

Darier disease, also known as Darier-White disease, keratosis follicularis, or dyskeratosis follicularis (MIM #124200), again know it is a rare autosomal dominant genodermatosis characterized by a persistent eruption of red-brown, keratotic papules scattered to confluent in a seborrheic distribution, nail abnormalities, pitting of palms and soles, and mucosal changes [1]. The disease usually starts around puberty and runs a chronic course with exacerbations induced by sun exposure, heat, friction, or infections.

Darier disease is exacerbated by sunlight, heat, infections, and friction. This activity reviews the clinical presentation encompassing multiple red or brown papules with hyperkeratosis, nail anomalies including longitudinal erythronychia, and mucosal changes typically surfacing around puberty and persisting throughout life. By exploring evaluation techniques and treatment modalities, this session empowers healthcare professionals to adopt a holistic approach, focusing on interdisciplinary collaboration to manage this dermatological disorder effectively. The interprofessional team’s role in assessing, diagnosing, and coordinating care for Darier disease patients is underscored, recognizing the impact of external exposures and emphasizing tailored therapeutic strategies to improve patient outcomes and quality of life.  Avoid going to the dermatologist which is the worst move you could do since it will only get worse to the spread of the disease to completely over the body over  years due to what exacerbates it (take the sun just alone).

This disease can be characterized by multiple dark scaly patches of itchy skin most commonly affecting the chest, back, ears, forehead, scalp, neck, and groin areas. These wart-like lesions can be foul smelling and disfiguring and has been known to affect nails and mucous membranes of the individual.

The occurrence of Darier disease is rare with the age of onset usually in the first or second decade of life. It is frequently worse in the summer with heat and humidity as major precipitating factors and can be exacerbated by sun exposure, trauma, or bacterial infections.

Review of the cause of this disease is oftentimes due to a mutation in a specific gene known as ATP2A2 which can alter the function and development of the skin. The affected parent with this gene has at least a fifty percent chance of passing it down to their children. Patients with this disease may be associated with behavioral disorders and rarely with decreased intelligence. Most patients with Darier disease have a family history of either one or both parents being affected. However, it can also present itself without any family history as well. Even though the severity fluctuates over time, Remember, Darier disease is a chronic condition that persists throughout life and is not associated with any skin cancers.

Darier disease is a rare disorder that affects all ethnic groups. The estimated prevalence ranges from 1 to 4 per 100,000 people [2-5]. In a Singaporean study, the incidence was 0.3 per 1 million people per year.

What helps diagnosing this disease     :

1 A dermatology consult for the MD just to look at the skin as the first approach is the best MD to go to, the expert on skin disease diagnosing.

2. Depending on the area affected, patients with Darier disease often presents with multiple crusty and itchy patches of skin. When the scaly crusts are removed, a slit-like opening becomes visible. In areas such as nails, they are described as a sandwich of red and white bands running along the length of the nail that is thin with its characteristic V-shaped scalloping. Mucous membranes may present as white, cobblestone appearing lesions of the cheeks, palate, and gums. With the discovery of the ATP2A2 gene, skin biopsy is helpful in diagnosis through gene sequencing when suspected. SKIN BIOPSY is always helpful with diagnosing skin disease which includes tumors on the skin.

Treatments for Darier’s Disease:

This disease depends on the severity of the presented clinical symptoms.

1. For most minor cases , the disorder can be managed by using sunscreen, moisturizing lotions, avoidance of non-breathable clothing, and excessive perspiration.

2, For more severe cases of Darier’s disease, hospitalisation may be required to heal affected individuals who display frequent relapse and remit patterns. In less severe cases, signs and symptoms may clear up completely through hygienic interventions. Most patients with Darier’s disease live normal, healthy lives. Rapid resolution of rash symptoms can be complicated due to the increased vulnerability of affected skin surfaces by secondary bacterial or viral infections.

****In cases of Epidermal Staphylococcus aureus, human papillomavirus (HPV) and herpes simplex virus (HSV) infections have been reported. In these cases, topical and/or oral antibiotic/antiviral medications may need to be prescribed.****

Typical recommendations are the application of antiseptics, soaking in astringents, antibiotics, benzoyl peroxide, and topical diclofenac sodium.

If Darier’s is more localized, common treatments include:

• Topical retinoids: used to help in the reduction of hyperkeratosis, retinoids work by causing the skin cells in the top layers to die and be shed off. The common retinoids used for this disorder are:
  • Adapalene
  • Tazarotene gel
  • Tretinoin
• Dermal abrasion
  • Removal of the top layer of skin to help smooth and stimulate new growth of the skin.^[21]
• Electrosurgery
  • Used to help stop bleeding and remove abnormal skin growths.
• Topical corticosteroids

“Every year in the US, approximately 19 million people are infected with an STD (1), and 50,000 people are infected with HIV (2). The risk of STD and HIV infection can be greatly reduced with correct and consistent condom use (3), yet condom use remains low, even among individuals who are engaging in sexual behaviors that put them at risk for STDs and HIV (4, 5).”

NIH-National Library of Medicine (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108502/)

On Valentine’s day every year it started National Condom Week.

In the US, February National Condom Month originally started on the campus of the University of California – Berkeley, it has grown into a educational even for high schools, colleges, family planning organizations, AIDS groups, sexually transmitted disease awareness groups, pharmacies and condom manufacturers.  In hopes to help young ones and all in preventing STDs.  Using condoms helps prevent you getting sexual transmitted diseases through intercourse.  Also having one sex partner only with both checked for STDs first.  STDs you don’t want to get especially those that can shorten your life.

Sexually transmitted diseases (STDs) have been known to mankind for centuries. Before the advent of modern medicine, people’s lack of awareness and understanding of STDs contributed to the widespread transmission of the infections while few or no treatments were available to treat the conditions.

In medieval times, syphilis and gonorrhoea were two of the most prevalent STDs in Europe.

Some STDs can have severe, life-changing consequences; syphilis, for example, can eventually cause progressive destruction of the brain and spinal cord, leading to mental dysfunction and hallucinations, speech problems and general paresis.

It’s kind of puzzling that sexually transmitted diseases are so prevalent—particularly when you consider that you have to get pretty up close and personal to contract one. An STD is characterized by any disease that is spread by one partner to another via sexual contact, and that can be orally, vaginally, anally, or via hand to genital contact. Regardless, they are spread when one partner passes the disease-causing organism on to the other. Obviously, preventing STD transmission is first and foremost by practicing safe sex (PREVENTION) and not enough do it in America for some crazy reason hurting themselves and other people. However, if you think you might have contracted one of the most common STDs, recognizing the disease is imperative for swift treatment and preventing further spreading.

Top venereal diseases in the USA:

1-Gonorrhea

The Centers for Disease Control estimate that 700,000 new cases of Gonorrhea, or the “clap”, crop up every year. This long-term STD that is spread bacterially, affecting a female’s cervix, a male’s urethra, or the throat in both sexes, which means that it’s transmitted by vaginal, oral, and anal sex. The symptoms of gonorrhea are pretty subtle; the most noticeable being burning when urinating or a yellowish penile discharge in men.

2-Hepatitis

Sexually transmitted hepatitis is hepatitis B (or HBV), which afflicts more than 1.25 million individuals in the U.S. even though there is a vaccine. If left untreated, a Hep B infection will scar and damage the liver, causing cirrhosis and liver cancer. Unfortunately, over half of those affected show no symptoms, but those who do suffer muscle pain and fatigue, yellowing of the eyes (or jaundice), nausea, and a distended stomach.

3-Syphilis

Syphilis is a particularly sneaky STD that caused by a type bacterial infection of the genital tract, known as Treponema Pallidum. Syphilis is transmitted when direct contact is made between the small, painless sores on the mouth, rectum, vagina, or around the genitals in areas not protected by latex condoms. It can also be transmitted via infected mother to her baby during pregnancy. When there are no sores, the disease is still present. Syphilis symptoms are rare , however, the most telling are sores or lesions on and around the genitals, as well as hair loss, sore throat, fever; headache; and a white patchy skin rash.

4- Chlamydia

Like Gonorrhea, Chlamydia affects a man’s penile urethra and a woman’s cervix. However, oftentimes those who’ve contracted Chlamydia don’t show symptoms for months or even years, which explains why it’s the most common and rampant STD. If you do show symptoms, you’ll feel pain during intercourse and have a discolored, thick discharge from the vagina or penis. Transmitted via sexual penetration with an affected partner, using latex condoms can prevent transmission of this curable STD.

 5. Crabs

If you feel a creepy-crawly, itchy sensation in your genitals, you may have crabs (or public lice). They show themselves as visible eggs or lice in the coarse hair of the genital region (even if you shave it off), and they can spread to the armpits and eyebrows if left untreated. Typically transmitted via sexual contact, crabs can also be passed via contact with infested linens or clothing .

6. Human Papilloma Virus

Human Papilloma Virus (or HPV) is currently the most wide spread STD. It affects roughly three-quarters of the sexually active population and a staggering one-quarter of sexually active women, which is why there is a North American vaccine to protect young women from certain types of HPV that are linked to genital warts and cervical cancer. HPV is transmitted through genital contact—via vaginal and anal sex, and also oral sex and genital-to-genital contact. Most times HPV doesn’t show any symptoms until it’s far advanced, but genital warts as well as RRP, a condition where warts grow in the throat and eventually cause breathing difficulties are common.

7. Bacterial Vaginosis

Bacterial Vaginosis, or BV, is not always considered an STD even though it typically afflicts those of child-bearing age with multiple or new sex partners. BV occurs when healthy bacteria in the vagina overgrow and become imbalanced, causing burning and itching around the vagina and a thick, grey discharge with a strong fishy odor. Antibiotics will quickly clear up bouts of BV, but it can reoccur, leaving the victim prone to pelvic inflammatory disease, other STDs, and premature births (if pregnant).

 8. Herpes

Painful sores or lesions on your mouth or genitals may indicate herpes, a viral STD that comes in two forms HSV1 (herpes of the mouth) and HSV2 (herpes of the genitals). Herpes is transmitted skin-to-skin—for instance, from genital to genital, mouth to genital, or mouth to mouth contact with an infected individual, even when they don’t have visible sores. Even though herpes symptoms be treated with antibiotics, the virus never goes away and reoccurs typically 2 to 4 times per year.

9. Trichomoniasis

Trichomoniasis, or “trich”, often masks itself as a yeast infection or bacterial vaginosis (BV) in women with similar symptoms—including a thick, grey discharge, offensive vaginal odor, pain or burning intercourse, and itchiness. A parasitic trichomonas vaginalis infection affects the urethra and the vagina in women. It can be transmitted back and forth between sex partners (man to woman and woman to woman) via vaginal intercourse and contact. However, most men typically don’t have any symptoms.

10. HIV

HIV is transmitted via the exchange of body fluids—such as semen, vaginal secretions, blood, or breast milk. Within a month or 2 of contracting HIV, about 40 to 90-percent of those afflicted suffer from flu-like symptoms including fever, fatigue, achy muscles, swollen lymph glands, sore throat, headache, skin rash, dry cough, nausea, rapid weight loss, night sweats, frequent yeast infections (for women), cold sores, and eventually, pneumonia. Luckily, many individuals who are diagnosed early can live a long, productive life with HIV thanks to a combination of highly active anti-retroviral drug therapy, which prevents to progression to AIDS causing death.

Vaccination is another way that you can prevent yourself from becoming infected. So far the only effective vaccines we have available are for hepatitis B and HPV. We’re recommending that teenage girls be vaccinated against HPV, because certain strains are associated with cervical cancer.

So Don’t be silly, protect your willy
When in doubt, shroud your spout
It will be sweeter if you wrap your peter
No glove, no love!

Don’t lac but get your vac to prevent a poor sex act!

Remember PREVENTION!

While humor is used to help provide education, National Condom Week has become a tool to help educate young adults about serious risks involved with unprotected sex. This includes the risk of catching and spreading sexually transmitted diseases including AIDS as well as helping to prevent unwanted pregnancies.

“Heart and blood vessel disease, also called heart disease, includes numerous problems, many of which are related to atherosclerosis.

Atherosclerosis is a condition that develops when a substance called plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can block the blood flow. This can cause a heart attack or stroke.”

American Heart Association AHA (https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease)