STD tested – Heiki http://heiki.org/ Fri, 22 Oct 2021 03:58:32 +0000 en-US hourly 1 https://wordpress.org/?v=5.8 https://heiki.org/wp-content/uploads/2021/04/cropped-icon-32x32.png STD tested – Heiki http://heiki.org/ 32 32 Harrison County Board of Health Votes to Hire LPN; Approves Retention Incentive For Health Department Employees | New https://heiki.org/harrison-county-board-of-health-votes-to-hire-lpn-approves-retention-incentive-for-health-department-employees-new/ https://heiki.org/harrison-county-board-of-health-votes-to-hire-lpn-approves-retention-incentive-for-health-department-employees-new/#respond Thu, 21 Oct 2021 23:10:00 +0000 https://heiki.org/harrison-county-board-of-health-votes-to-hire-lpn-approves-retention-incentive-for-health-department-employees-new/

CLARKSBURG, Va. (WV News) – The Harrison County Board of Health has approved the hiring of a full-time licensed practical nurse and a one-time retention incentive for employees.

The board of directors voted 3 to 1 to hire the IAA, with member Annetta Payne voting against.

The decision to provide a one-time retention incentive of $ 1,300 for each classified and exempt classified part-time and full-time employee, pending approval from the Division of State Personnel, was unanimous.

The incentive, if approved by the state, will be funded by a public health crisis grant, according to board member Patsy Trecost.

– Executive Director Chad Bundy said the latest increase in COVID-19 cases was the worst in the pandemic, but cases have started to decline in the county. Yet more than 50 cases a day continue to flow.

– Nurse Director Donna Riffle reported that public health nursing programs are operating at full capacity, including family planning, elimination of tuberculosis, HIV and STDs, immunizations and surveillance programs and disease investigation.

Blood lead tests initiated as part of the response to lead found in tap water at some homes in the Clarksburg water system are also underway, Riffle said.

Bundy said individuals can call the health department to schedule a blood lead test. Although there was an initial response at the start of the program, the number of people requesting this test has since declined. Among those tested, none have had elevated blood lead levels to date, he said.

– Riffle said there was an RSV outbreak and a small outbreak of foot-and-mouth disease in the county.

– Threat Preparedness Coordinator Cindy Murphy reported that the Harrison County Emergency Management Department and Office had received “two semi-trailers loaded with personal protective equipment from the National Guard.”

It is now in storage. An inventory system has been developed to track the “very large amount” of personal protective equipment available, she said.

Senior Editor JoAnn Snoderly can be reached at 304-626-1445, by email at jsnoderly@theet.com or on Twitter at @JoAnnSnoderly.


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Asus Chromebook CX9 review | PCMag https://heiki.org/asus-chromebook-cx9-review-pcmag/ https://heiki.org/asus-chromebook-cx9-review-pcmag/#respond Wed, 20 Oct 2021 18:47:16 +0000 https://heiki.org/asus-chromebook-cx9-review-pcmag/

Whether it’s the HP EliteBook 840 Aero G8, the Lenovo ThinkPad X1 Carbon Gen 9, or one of the many, 14-inch lightweight business laptops are the backbone of executives on the go. According to Asus, the same goes for “cloud-based business” too: the Chromebook CX9 (starting at $ 749.99; $ 999.99 according to testing) can use it with any Windows slimline, but it is based on Chrome OS and Google Workspace. Impressively light but packed with features ranging from a fingerprint reader to Thunderbolt 4 ports, the CX9 is an expensive yet capable device that will appeal to any business that has chosen to embrace Chromebooks.


Core i7 is probably overkill

The base $ 749.99 model of the Asus CX9 Chromebook combines an 11th generation Intel Core i3 processor, 8 GB of memory, a 128 GB SSD and a Full HD (1920 x 1080 pixel) touchscreen. Upgrading to our $ 999.99 test unit, you get a 2.4GHz Core i5-1135G7 quad-core processor with integrated Intel Iris Xe graphics, 16GB of RAM, and a 256GB SSD (with PCI Express Gen 3 instead of the slightly faster Gen 4 interface, but that’s still much faster than the eMMC flash storage on cheaper Chromebooks).

(Photo: Molly Flores)

As you’ll see in the performance section below, our Core i5 CX9 turned out to be one of the fastest Chromebooks we’ve ever tested, but if you’re looking for even more speed you can spend 1,149, $ 99 for a Core i7-1165G7 model with 512 GB SSD. Another $ 100 on top gives you a 4K (3840 x 2160) resolution screen.

Like elite Windows business laptops, the Asus meets Intel Evo specifications for connectivity and responsiveness and has passed MIL-STD 810H torture tests for shock, vibration, and extreme environmental conditions. There’s virtually no flex if you grab the corners of the screen or crush the keyboard, which is tilted for comfortable typing by the ErgoLift hinge also seen in Asus’ luxury Windows laptops. (The bottom of the screen frame supports the base at a slight angle.)

Rear View of the Asus CX9 Chromebook

(Photo: Molly Flores)

Its aluminum alloy frame measures 0.71 x 12.7 x 8.1 inches and tips the scales at 2.31 pounds. The HP Elite c1030 Chromebook Enterprise has a 13.5-inch display with a 3: 2 aspect ratio instead of Asus’ usual 16: 9 aspect ratio, tilting its aspect ratio to 0.7 by 11.6 by 8.5 inches, and weighs 2.87 pounds. Lenovo’s ThinkPad C13 Yoga Chromebook, winner of our company’s Chromebook Editors’ Choice award, weighs a pound more than the CX9 despite its smaller 13.3-inch display, but that goes with its convertible hinge.

We’re giving major accessories to Chromebooks with HDMI ports rather than bothering external monitor users with DisplayPort dongles. The Asus has one on the left side, as well as two USB-C ports with Thunderbolt 4 capability, one of which accommodates the AC adapter. On the right, you’ll find a USB 3.2 Type-A port, a microSD card slot, an audio jack, and a security lock slot.

Asus Chromebook CX9 Left Ports

(Photo: Molly Flores)


A screen to see

The lower screen frame is not particularly thin but is hidden under the keyboard by the ErgoLift hinge; overall, Asus claims an almost borderless screen-to-body ratio of 92%. The 1080p screen offers sufficient brightness and contrast. The only things that spoil extreme viewing angles are the reflections on the touch screen glass.

Colors are rich and well-saturated, and white backgrounds are immaculate instead of dull. Fine details are crisp; as with most Chromebooks, you can choose from an array of bogus “look-alike” resolutions – the default is 1,536 by 864 – if the native 1080p makes screen elements too small for your liking.

Front view of the Asus Chromebook CX9

(Photo: Molly Flores)

The 720p webcam captures colorful and lightly speckled images with a little noise or static electricity. It has a sliding shutter in the upper bezel for more privacy. A fingerprint reader to the right of the keypad allows you to log in after locking the system or not entering passwords. Lower speakers produce loud, somewhat loud, or harsh sound at high volume; the bass is minimal, but you can distinguish the overlapping tracks.

The backlit keyboard offers a standard Chromebook layout (with a search / launch key instead of Caps Lock) and a fast typing feel. Generously sized buttonless touchpad glides and types smoothly; it has easy and quiet click action.

Asus Chromebook CX9 Keyboard

(Photo: Molly Flores)


Chromebook CX9 review: 11th gen processors lead the way

The only other company-specific Chromebook to complement our new benchmark plan is the HP Elite c1030 Enterprise Chromebook mentioned above. So I put together an assortment of other systems, including HP’s Chromebook x360 14c, a 14-inch Core i3 convertible. The 2021 version of Lenovo’s IdeaPad Flex 5 Chromebook is a 13.3-inch convertible currently under review that features an 11th-gen Core i3 chip, while the 15.6-inch Samsung Chromebook 4+ is an example of this. entry-level laptop with Intel Celeron. power, be sure to follow our test results. You can see their basic specs in the table below.

We test Chromebooks with three overall performance suites: a Chrome OS, an Android, and an Online. The first, Principled Technologies’ CrXPRT 2, measures how quickly a system performs daily tasks across six workloads such as applying photo effects, graphing a stock portfolio, analyzing DNA sequences and the generation of 3D shapes using WebGL. The second, UL’s PCMark for Android Work 3.0, performs various productivity operations in a smartphone-style window, while Basemark Web 3.0 runs in a browser tab to combine low-level JavaScript calculations with CSS content and WebGL. All three give numerical scores; higher numbers are better. (Learn more about how we test laptops.)

The Asus raced to victory in CrXPRT 2, with Lenovo’s 11th gen Core i3 edging out HP’s 10th gen Core i7 for the silver medal. The Elite c1030 got its revenge by posting the highest PCMark score for Android, but the CX9 was a good second, with the IdeaPad the surprise winner of Basemark Web 3.0. The Asus turned out to be the best performer overall, with the cheap Samsung being, as you might expect, the poorest.

Another Android benchmark focuses on the processor: Geekbench from Primate Labs uses all available cores and threads to simulate real-world applications ranging from PDF rendering and speech recognition to machine learning. Finally, to test the battery life of a Chromebook, we loop a 720p video file with screen brightness set to 50%, audio volume at 100%, and Wi-Fi and backlight. keypad disabled until the system is closed. If there is not enough internal storage to hold the video, we play it from an external SSD plugged into a USB port.

The CX9’s new Core i5 is powered by Geekbench’s processor drive, with HP Elite’s older Core i7 not far behind. Samsung’s Celeron did pitifully. The battery life of Chromebooks was less than that of current Windows subnotebooks, but was found to be more than enough to get you through a full day of work or school.


Set to work

We’ve been impressed with the 11th Gen Intel mobile chips in Windows laptops, and we’re also impressed with them in Chrome OS laptops. Asus’ Chromebook CX9 costs $ 999.99 for our well-equipped Core i5 unit or $ 1,249.99 for a Core i7 model with a 4K display, but your money gets you a near-flawless enterprise Chromebook, with nothing major missing except maybe mobile broadband for remote use from Wi-Fi hotspots.

Asus Chromebook CX9 Straight Ports

(Photo: Molly Flores)

It’s lightweight yet rugged, with great performance, plenty of ports, and a first-class display and keyboard. A price drop of $ 100 or $ 200 would have earned him an Editors’ Choice award.

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The Maltese government doesn’t care about sexual health, here’s why https://heiki.org/the-maltese-government-doesnt-care-about-sexual-health-heres-why/ https://heiki.org/the-maltese-government-doesnt-care-about-sexual-health-heres-why/#respond Sun, 17 Oct 2021 06:46:55 +0000 https://heiki.org/the-maltese-government-doesnt-care-about-sexual-health-heres-why/

Ignorant budgets, stale data and priority pigeons: it’s recent government developments (or lack thereof) that quickly prove it doesn’t care about sexual health.

And as a country that proudly maintains a total ban on abortion, you would assume that national leaders would at least invest time and money to improve the sexual health system which in no way reflects modern society.

But the government seems indifferent to the astronomical rates of teenage pregnancies, unintended pregnancies and STDs that Malta harbors.

You see, in addition to the questionable international titles our country holds, Malta is among the top ten developed countries with the highest rates of STDs. It is also the country with the highest teenage pregnancy rates in southern Europe.

But what else would you expect from a country with a sexual health education system that still promotes abstinence as one of its guiding principles?

Or a country that favors the use of free contraception to fight against the annoying stools of pigeons when this is not yet the case for women and men in Malta?

The government has always put sexual health issues on the back burner, and here’s how:

1. Sexual health policy

The sexual health policy that was due to be announced in March of this year is once again overhauled as the research it was based on is about 12 years old, Health Minister Chris Fearne said.

Therefore, researchers must start over with a new study to understand the sexual practices of people today.

The fact that this was not done when the new policy was announced implies that they haven’t actually reviewed it until now – seven months past the supposed due date.

This is not the first time that this sexual health policy date has been pushed back.

The policy was originally due to be announced in 2020, but once again, sexual health has been taken to the bottom of the list – this time, due to the COVID-19 pandemic.

As it stands, Malta follows the 2010 Sexual Health Policy and nothing has been updated to reflect the significant legal and social changes that have taken place since that time.

A recently updated sexual health policy is integral to the well-being of the vast majority of people living in Malta and Gożo.

Such a policy would include improvements in education, accessibility of contraception and widespread promotion of sexual health, which the country sorely lacks.

The consequences of our current situation can be seen in national statistics which show that only 2% of the population visited Mater Dei Genitourinary Clinic (GU) in 2019 to get tested for STDs.

Since then, infection rates have steadily increased.

In fact, earlier this year the GU Clinic warned that there was a worrying increase in STIs in Malta among men who reported attending group sex parties.

Meanwhile, preventable STDs are also on the rise, with five people contracting HIV each month and nearly 800 people infected with HPV in 2019.

A sexual health policy will also tackle drug shortages like HIV in 2020. There has been a major stockout that has left people with the virus untreated.

2. The 2022 budget

Budget 2022 was recently released with several initiatives and programs aimed at improving the quality of life for Maltese and Gożitan citizens, and many of them are doing just that.

However, one crucial aspect has once again been overlooked and that is, you guessed it – sexual health.

Free drugs were in fact included in the government budget, but contraceptive drugs were not withheld.

Besides the obvious uses of contraception, hormonal methods are often treated as medicine to relieve the symptoms of a large number of medical conditions that afflict women and mothers.

Four main examples are PCOS – experienced by one in 10 women, endometriosis – experienced by 10% of women, PMS – experienced by three in four women and PMS – experienced by one in 20 women.

Bonus: Hormonal contraceptives are also used to treat menstrual irregularities that affect 9-25% of people with a uterus.

3. Contraceptives for pigeons

This movement to administer free contraceptives to pigeons – a notoriously hated bird – on real people is arguably the development that best illustrates the government’s lack of sex for sexual health.

I fully understand the nuisance this bird can be, but if you had to choose between getting pissed off by a pigeon or getting pregnant in a country that totally bans abortion, I think we would all collectively choose the former.

Unaffordable and inaccessible contraceptives that are touted as luxuries rather than medical necessities are one of the main contributors to unintended pregnancies.

So why are contraceptives still not subsidized?

4. Sexual health education

The Guidelines for Sexuality and Relationship Education in Maltese Schools include one of its core principles “Abstinence and Deferral of Sexual Activity and Sexual Intercourse for Young People”.

This is unrealistic, ineffective, and extremely damaging, as you can see from the aforementioned statistics.

Young people need proper education that will teach them adequate protection against STDs and pregnancy so as not to be afraid of pathetic and inaccurate videos preached by underqualified and biased teachers.

They also need to be taught more about consent, respect and communication, because sexual health is not just about preventing pregnancy and STDs.

It is about understanding your own body and your needs as well as those of your sexual partner (s).

Sexual health education also goes hand in hand with advocacy, students should be counseled on where to go when they encounter abnormalities, like this, more than 2% of the population will use the services they have access to.

However, this service is still not sufficient.

The GU clinic in Mater Dei is the only government funded way to test for sexual diseases.

And that’s why Deputy Premier Chris Fearne announced that very soon more sexual health services will be provided in clinics across the country.

A key phrase in this sentence is “soon”. No date was mentioned and no investment plan was mentioned.

Promises of reform without dates or concrete plans are totally meaningless. They are there to silence complaints but not to improve our disastrous health care system. This is how little the government cares about it.

If the government does not give us adequate sexual health policies that include free or subsidized contraception and real education, then they might as well legalize or at least decriminalize abortion because without the right policies, unintended pregnancies will continue to grow. crack down. Not to mention the devastating impact it can have on people’s sexual health.

And the only people who will be seriously affected by this will be those in vulnerable situations who cannot afford to travel for an abortion or get the drugs they desperately need, which often face shortages.

So please, instead of investing in a 20 million euro race track or other unnecessary property, invest in the future and protection of Malta’s sexual health.

What sexual health policies do you think should be implemented?

READ NEXT: Restaurant Association Backs Call to Remove Restrictions As Wage Supplement Ends

Ana is a university student who enjoys heated debates, she is very passionate about humanitarian issues and justice. In her free time, you will probably find her watching too many TV shows or thinking about her next meal.


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Dell Latitude 5430 Rugged and Latitude 7330 Rugged Extreme launched for people working in extreme environments https://heiki.org/dell-latitude-5430-rugged-and-latitude-7330-rugged-extreme-launched-for-people-working-in-extreme-environments/ https://heiki.org/dell-latitude-5430-rugged-and-latitude-7330-rugged-extreme-launched-for-people-working-in-extreme-environments/#respond Thu, 14 Oct 2021 13:51:03 +0000 https://heiki.org/dell-latitude-5430-rugged-and-latitude-7330-rugged-extreme-launched-for-people-working-in-extreme-environments/

Dell has announced two new laptops for its Latitude Rugged PC portfolio as the first laptops that come with Windows 11 preinstalled. Although the Latitude 5430 Rugged and Latitude 7330 Rugged Extreme were designed for specific use cases. Here’s how.

Dell Latitude 7330 Rugged Extreme

STRONG POINTS

  • The Dell Latitude 7330 Rugged Extreme is the industry’s smallest 13-inch fully rugged laptop.
  • The laptop has been drop tested up to 6 feet for optimum durability.
  • At the same time, Dell Latitude 5430 Rugged was launched with a total weight of 1.97 kg.

Dell Latitude 5430 Rugged and Dell Latitude 7330 Rugged Extreme were launched by the company as two new offerings in its Latitude Rugged line of laptops. While the former is the lightest 14-inch semi-rugged laptop, the Dell Latitude 7330 is considered the smallest 13-inch fully rugged laptop in the industry.

Dell explains what it means by these terms. Fully Rugged refers to a device tested to MIL-STD-810H specifications, which means it has been drop tested up to 6 feet and has an IP rating against water, dust and dirt (IP) -65.

As for the former, the Dell Latitude 5430 Rugged weighs only c and has an (IP) rating of -53 for protection against dust, dirt and water. The laptop has been tested for drops up to 3 feet, not as much as the other thrown alongside, but still impressive enough for a laptop.

Both Dell laptops come with 11th Generation Intel Core processors and optional professional discrete graphics cards. This productivity is further enhanced by software optimizations through the preinstalled Windows 11 software application and Dell Optimizer.

Dell Latitude 5430 rugged

Dell says the screens on both laptops have been upgraded for better daylight visibility and better responses to glove contact. The displays support up to 1400 nits of brightness for optimal use in the field.

Dell promises nearly 25 hours of battery life on both laptops. These also come with two hot-swappable batteries when the running battery is discharged. They support Express Charge Boost up to 35% charge in 20 minutes.

Connectivity is provided with Intel Wi-Fi 6E and optional 5G capability on both devices. For added security, the Dell Latitude 5430 Rugged and Latitude 7330 Rugged Extreme come with TPM 2.0 ControlVault authentication, a contactless smart card reader, fingerprint sensor, and embedded cryptographic keys contacted.

Dell will also provide its business services and support, including the option of next business day onsite support as well as laptops. The Dell Latitude Rugged 5430 and 7730 laptops will be available to order worldwide on December 9, 2021. Pricing for the laptops has yet to be announced.

Click here for IndiaToday.in’s full coverage of the coronavirus pandemic.


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With Alarming Spike In Congenital Syphilis In Humboldt, DHHS Urges Community To Get Tested | Lost Coast Outpost https://heiki.org/with-alarming-spike-in-congenital-syphilis-in-humboldt-dhhs-urges-community-to-get-tested-lost-coast-outpost/ https://heiki.org/with-alarming-spike-in-congenital-syphilis-in-humboldt-dhhs-urges-community-to-get-tested-lost-coast-outpost/#respond Wed, 13 Oct 2021 18:37:11 +0000 https://heiki.org/with-alarming-spike-in-congenital-syphilis-in-humboldt-dhhs-urges-community-to-get-tested-lost-coast-outpost/

As COVID continues to sweep through Humboldt County, the Department of Health and Human Services (DHHS) is concerned about another outbreak that could affect the community more than we think – an outbreak of syphilis, an infection sexually transmitted infection, which, if left untreated, can have devastating effects.

Hava Phillips, public health nurse for communicable disease prevention at DHHS, says that in 2021 Humboldt County recorded two cases of congenital syphilis – a rare and often extremely serious condition caused by a mother with syphilis transmitting the infection to the baby during pregnancy. And while two cases may not seem like a lot, Philips says the number is incredibly surprising. Humboldt recorded a case of congenital syphilis in 2020 and before that the county had not seen a single case in over a decade.

“Congenital syphilis is a really horrible outcome,” Phillips told the Outpost in a recent phone interview, adding that the disease can lead to serious conditions including low birth weight, birth defects, miscarriage and even stillbirth. “It is a disease that public health would like to ensure is prevented in our community. “

The increase in congenital syphilis is not unique to Humboldt. The United States has seen a dramatic increase in the number of cases in recent years. According to the CDC, 1,870 cases of congenital syphilis were reported in 2019 – including 94 stillbirths and 34 infant deaths – a 477% increase from 2012.

Aside from the horrific results, what’s troubling about the re-emergence of congenital syphilis, Phillips said, is that it indicates a serious epidemic of syphilis in general. Rates of syphilis are traditionally lower in women than in men, and even lower in pregnant women. The rate of babies born with syphilis is even lower because it can often be prevented with early detection and treatment. So, due to the very low chances of seeing these two cases, public health can assume that the infection is much more present in the community than the test numbers indicate.

This raises another worrying factor – the number of STD / STI tests administered in the county has dropped significantly during the pandemic, Phillips said. So while indicators such as congenital syphilis cases show the infection is spreading in Humboldt County, the numbers are not there to confirm it and many cases are clearly not being detected and treated. As people get vaccinated and things get slack, Phillips expects that to change.

“We expect an increase in the number,” Phillips said. “We would see that as a good thing at this point. We would rather see people come in for testing and treatment, rather than just having indicators of their presence in the community. ”

Overall rates of STDs and STIs have been on the rise in recent years, with the CDC reporting an all-time high of 2.5 million cases of chlamydia, gonorrhea and syphilis – the three most common STIs – in 2019. The The same was true in Humboldt, with the county reporting an unprecedented rise in HIV and syphilis in 2018.

At the time, public health said that although intravenous drug use was a risk factor for contracting HIV, none of the cases had been contracted this way and was largely linked to relationships. unprotected sex organized through hookup apps like Grindr.

Phillips said the increase in HIV cases has not been significant in Humboldt County since the 2018 epidemic and that the continued increase in syphilis cases is currently the main concern. She also said the recent cases were not necessarily related to the use of hook-up apps, but were certainly caused by unprotected sex, as syphilis is mainly spread through sex and not through intravenous drug use.

With this continuing spike in syphilis cases, Phillips stressed the importance of using condoms and getting tested regularly. Even during the pandemic, people still need to get tested for STDs and STIs. She also wanted to stress the importance for pregnant women to get tested and seek antenatal care as soon as possible. Severe symptoms of syphilis and congenital syphilis can be prevented with early detection and treatment.

“Everyone who is sexually active should be tested for STIs,” Phillips said. “And it’s important to let health care providers know what kind of sex you are having. If you have oral sex, you will need an oral swab. If you are having anal sex, you will need an anal swab. Whatever your risk factors, just get tested.

If you don’t have a primary care provider, the public health branch of DHHS offers free testing on Tuesdays and Thursdays from 8:30 a.m. to 3:30 p.m. (closed for lunch between noon and 1 p.m.) at 529 I Street, Eureka.


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Chlamydia and Gonorrhea | Annals of Internal Medicine https://heiki.org/chlamydia-and-gonorrhea-annals-of-internal-medicine/ https://heiki.org/chlamydia-and-gonorrhea-annals-of-internal-medicine/#respond Mon, 11 Oct 2021 21:33:19 +0000 https://heiki.org/chlamydia-and-gonorrhea-annals-of-internal-medicine/

CMF objective: To review the current evidence for the screening, diagnosis, treatment, prevention, and practice improvement of chlamydia and gonorrhea.

Source of funding: American College of Physicians.

Acknowledgement: The author thanks Kimberly Workowski, MD, author of the previous version of this In the Clinic.

With the help of other medical editors, the editors of Annals of Internal Medicine develop At the clinic using MKSAP and other resources from the American College of Physicians. The Patient Information page was written by Monica Lizarraga of the Patient and Interprofessional Partnership Initiative at the American College of Physicians.

At the clinic does not necessarily represent official clinical policy of the CPA. For ACP clinical guidelines, please visit https://www.acponline.org/clinical_information/guidelines/.

Disclosures: ACP contributing author Dr Dombrowski reports a research grant from Hologic to the University of Washington, consulting fees from the National Alliance of State & Territorial AIDS Directors, and honoraria from the Planned Parenthood Federation of America and is a member the executive committee of the American Sexually Transmitted Diseases Association and the National Medical Committee of Planned Parenthood Federation of America. The disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-0907.

Publisher Disclosures: Editor-in-Chief Christine Laine, MD, MPH, reports that her spouse has stock / equity options in Targeted Diagnostics and Therapeutics. Stephanie Chang, MD, MPH, associate editor, reports employment with the Agency for Healthcare Research and Quality, Guidelines International Network travel allowance and committee membership Methodology of the Patient-Centered Outcomes Research Institute. Vineet Chopra, MD, MSc, associate editor, reports grants received from the Agency for Healthcare Research and Quality and royalties from UpToDate and Oxford University Press. Deborah Cotton, MD, MPH, associate editor, reports that she has no financial relationships or interests to disclose. Eliseo Guallar, MD, MPH, DrPH, Associate Editor, Statistics, says he has no financial relationships or interests to disclose. Christina C. Wee, MD, MPH, associate editor, reports a job at Beth Israel Deaconess Medical Center and a consultation with Boston Medical Center. Sankey V. Williams, MD, associate editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Associate Editor, Reports Employment at Perelman School of Medicine at University of Pennsylvania and Consultants to U.S. Food and Drug Administration and Colorado State .

This article was published on Annals.org on October 12, 2021.


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Molnupiravir Hype illustrates America’s failure to prioritize prevention https://heiki.org/molnupiravir-hype-illustrates-americas-failure-to-prioritize-prevention/ https://heiki.org/molnupiravir-hype-illustrates-americas-failure-to-prioritize-prevention/#respond Mon, 11 Oct 2021 18:30:14 +0000 https://heiki.org/molnupiravir-hype-illustrates-americas-failure-to-prioritize-prevention/

Merck recently announced promising trial results for molnupiravir, a new oral antiviral for the treatment of COVID-19. While it is encouraging to note that we may soon have a new weapon in our arsenal to fight the pandemic, the drug must not distract us from the essential role of prevention. Time and time again during the pandemic, we have seen a decrease in the focus on prevention and an inordinate focus on treatment.

The COVID-19 pandemic has shown the value of strong public health systems and public health policies. Limiting the spread of highly contagious infectious diseases requires detection (exploration and interpretation of data), surveillance (testing and contact tracing), mitigation (social distancing and quarantines), prevention (vaccination and masking), treatment ( therapy) and ramp-up planning (improvement of medical infrastructure, provision of PPE, workforce planning, etc.). A good public health plan minimizes the number of active cases, so people don’t get sick and pass pathogens to others.

Yet in several states, leaders have politicized and turned against proven public health measures while touting treatments as the holy grail. Take Florida for example. Gov. Ron DeSantis (R) opposed mask warrants and even threatened to reimburse school districts that implemented mask warrants. He appointed a general surgeon – Joseph Ladapo, MD, PhD – who teamed up with the “demon sperm” doctor and said, “The vaccines depend on the person; they are nothing special compared to any other preventive measure. Both continue to downplay the benefits of wearing a mask and getting vaccinated – two of the most effective ways to control this pandemic. At the same time, DeSantis promotes monoclonal antibody treatment centers while continuing to overlook discussion of the important role of vaccination. I wouldn’t be shocked if, as a next step, he banned hand washing or subsidized the purchase of tobacco for asthmatics.

We have to stop here. We must stress that this is not a public health plan. I don’t know what it is, but it’s not a plan to help people in Florida deal with a pandemic. These ideas and policies are counterproductive and deserve derision.

Imagine a public health policy for polio that does not emphasize vaccines after one of the first effective polio vaccines – developed by Jonas Salk, MD – becomes available, but instead extols the virtues of iron lungs , crutches, wheelchairs and physiotherapy. If that had been the case, a polio public health meeting in the 1950s chaired by DeSantis and Ladapo might have looked like this:

Salk: This vaccine can prevent children from getting polio. We can administer the vaccine in schools and …

DeSantis: Slow down, Jonas, we’ve got iron lungs AND crutches. Maybe we could make a vending machine with crutches for everyone to have access to.

Ladapo: Yeah, great idea. The vaccines are nothing special.

Salk: Are you pro-virus?

Fortunately, such conversations weren’t a reality – people in the 1950s didn’t complain that public health messages emphasized the important role of the polio vaccine. My parents, who were young children at the time, complained about walking to school in heavy snow back and forth, but never once complained about the lack of crutches. When preventative measures like polio or COVID-19 vaccines are so effective on a large scale, political leaders and health providers need to encourage as many people as possible to get vaccinated.

Beyond protecting people from disease, public health policies that emphasize vaccinations even limit health care costs. Preventing people from needing a hospital or intensive care unit has obvious cost-saving benefits. The numbers tell the story:

  • About $ 30 to $ 40 for each dose of COVID-19 vaccine (with the benefit of limiting infection at the population level and being highly effective in preventing hospitalization or death in the event of infection)
  • $ 1,250 or more for each monoclonal antibody treatment (without benefit of long-lasting immunity or community protection, 70% effective in preventing hospitalization and death in people with mild COVID-19)
  • $ 700 for a full course of the new antiviral molnupiravir (no benefit of long-lasting immunity or community protection, 50% effective in preventing hospitalization or death)

Add the fact that overcrowded hospitals postpone surgeries for people with cancer and literally drain resources like clean water, and we can see that treatment-first policies are not only stupid, but dangerous.

Public health messages should focus on prevention rather than therapy, and most of the time our patients are not unhappy with this. Our patients want our advice on diet, exercise and smoking cessation – tools for staying healthy – more than our opinion of the most effective pacemakers and stents. Patients agree with our efforts to convince them to have colonoscopies and to avoid the need for chemotherapy and colostomy bags. No one wants to get to the point where these interventions are needed.

The available COVID-19 treatments are a miracle for infected patients and should be widely available to people at an affordable cost, but they are a second line of defense. Vaccines are a miracle for everyone, can help prevent people from getting infected, and are widely available at no cost to the public. Keeping communities healthy by preventing disease should be a primary goal for any public health worker. Let’s continue to encourage each other to help our communities by wearing masks, washing our hands, getting tested and getting vaccinated.

Kenneth J. Stanley, MD, MBA, is board certified in family medicine and works as an emergency physician in rural Texas. He is also a volunteer for the Houston Health Department and a member of the Advisory Board of the Energy Industries Council.



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Face masks can cause bacterial spread to the eyes during intravitreal injections https://heiki.org/face-masks-can-cause-bacterial-spread-to-the-eyes-during-intravitreal-injections/ https://heiki.org/face-masks-can-cause-bacterial-spread-to-the-eyes-during-intravitreal-injections/#respond Sun, 10 Oct 2021 22:01:14 +0000 https://heiki.org/face-masks-can-cause-bacterial-spread-to-the-eyes-during-intravitreal-injections/

SAN ANTONIO – The face masks were seeded “almost instantly” with oral and nasopharyngeal bacteria, posing a potential risk of spread to the eyes during intravitreal injections for macular degeneration, according to a study reported here.

The masks of the 73 patients involved in the study tested positive for a variety of common organisms, as well as some rare microbes. Bacteria grew on both sides of the masks, regardless of the age of the mask material.

Despite the proximity of infectious organisms, no patient developed endophthalmitis, Avinash V. Honasoge, MD, PhD, of the Retina Institute of St. Louis, reported at the meeting of the American Society of Retina Specialists ( ASRS).

“We did not find any correlation between mask age and indoor or outdoor growth, which suggests [other evidence] that even a few hours after wearing a mask, you can see bacteria on them, ”he said. “Men had greater growth inside the mask than women. This has already been assumed to be due to facial hair. “

“Everyone here does intravitreal injections, and you will have to make a choice,” Honasoge added. “How are you going to try to protect the periocular surface after sterilizing it with iodine?” Are you going to tape the mask, institute a no-talk policy? Maybe just remove the mask and dilute the particles and away from the periocular space? The other question is, as this pandemic continues, will we see a change in the flora present for our post-injection endophthalmitis?

The COVID-19 pandemic has led to widespread use of face masks, made of a variety of materials and of varying quality. Ill-fitting masks present a clear risk to patients during intravitreal injections. Changing masks is not a solution, he continued. A few hours after putting on a fresh mask, bacterial RNA can be isolated and bacteria can adhere to a mask for hours after wearing.

“While masks are very effective at blocking forward transmission, if you don’t stick a mask on or have an ill-fitting mask, you can get an upward flow of particles,” Honasoge said. “Not speaking seems to help. Recording seems to help, but the question we were asking ourselves is what type of bacteria are we dealing with.

To examine the problems of bacterial variety and quantity, the researchers prospectively evaluated 73 patients with appointments for intravitreal injections. Patients wearing N95 / KN95 masks were excluded, as were patients receiving intravitreal injections of endophthalmitis antibiotics.

Patient masks were swabbed internally and externally and evaluated for Gram stain, aerobic culture, and speciation. The main outcomes were bacterial composition and mask growth.

The study population had a median age of 76 to 77 years and the mask material was cloth in 31 cases; surgery in 42. The age of the mask ranged from less than a day to over a month. More than a third of the masks had been worn for a week or more. One patient had not washed his fabric mask for over a year.

Laboratory analysis showed bacterial growth inside 97.2% of the masks and 90.2% on the outside. Some masks had bacteria inside and out and some had more than one type of bacteria.

“The bacteria included the usual suspects, such as coagulase-negative staphylococcus and streptococcus viridans, but also certain types of bad players – enterobacter, E. coli, bacillus. Each mask had between one and two species on either side of the mask. “

Quantification studies have suggested strong growth both inside and outside the masks, he added.

A second study reported at the same ASRS “Symposium on Inflammatory and Infectious Diseases” provided further evidence of upward scattering of microbes by patients wearing masks during sham intravitreal injections. The study involved 15 healthy volunteers who wore different types of masks, with and without tape, and with and without a silent environment (the latter consisting of a standardized script).

In total, patients participated in the assessment of six mask scenarios, said Samir Patel, MD, of Mid-Atlantic Retina, Wills Eye Hospital and Thomas Jefferson University, both in Philadelphia. Culture plates were attached to the forehead of each participant, and the plates were grown for both aerobic and anaerobic species. A total of 90 cultures were obtained during each of the no-talk and talk settings.

The results showed that a properly fitted mask with tape on top and an N95 mask performed best, and both were associated with an average of 0.20 colony forming units (CFU) during adjustment let alone. The N95 performed better numerically in the talk simulation, but did not differ significantly from the mask fitted with tape (0.20 vs. 0.27 CFU). A well-fitting mask without tape gave significantly poorer results (1.13 CFU without speaking, 1.40 CFU with speaking, P<0.01) and was similar to no mask, loose mask, or cloth mask.

The organisms most often isolated in talking and silent simulations were Staphylococcal spp (51-64%).

“There was no difference in bacterial dispersion between tight-fitting surgical masks with duct tape and N95 face masks,” Patel said. “Gluing the top portion of the patient’s face mask may limit bacterial dispersion when performing intravitreal injections. However, the clinical implications of these findings are unknown, and it is not clear whether the alterations in the number. units forming colonies around the eye necessarily alter the clinical risk of endophthalmitis. “

  • Charles Bankhead is editor-in-chief for oncology and also covers urology, dermatology and ophthalmology. He joined MedPage Today in 2007. To follow

Disclosures

Honasoge has not disclosed any relationship with the industry. Some co-authors have revealed relationships with Allergan, Bausch and Lomb, Regeneron, Genentech, and Dutch Ophthalmics.

Patel did not disclose any relationship with the industry. Some co-authors have disclosed relationships with Aerpio, Apellis Pharmaceuticals, Bausch + Lomb, Deciphera, MDIntelleSys, Retina Implant / Wills Eye Hospital, Santen, Topivert, Genentech, Ophthotech, Alcon, Astellas, Iconic, Notal Vision, Novartis, AGTC, AsclepiX, Beaver Endo Optics, BioTime, Covalent Medical, Janssen, Kang Hong Chengdu, Notal, ONL, Optovue, Orbit Biomedical, PanOptica, ProQR, RegenxBio, Sanofi, Second Sight and Alimera Sciences.



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Delaware County officials sound the alarm after highest number of early syphilis cases reported in 20 years – CBS Philly https://heiki.org/delaware-county-officials-sound-the-alarm-after-highest-number-of-early-syphilis-cases-reported-in-20-years-cbs-philly/ https://heiki.org/delaware-county-officials-sound-the-alarm-after-highest-number-of-early-syphilis-cases-reported-in-20-years-cbs-philly/#respond Wed, 06 Oct 2021 22:23:00 +0000 https://heiki.org/delaware-county-officials-sound-the-alarm-after-highest-number-of-early-syphilis-cases-reported-in-20-years-cbs-philly/